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Grand Challenges is a family of initiatives fostering innovation to solve key global health and development problems. Each initiative is an experiment in the use of challenges to focus innovation on making an impact. Individual challenges address some of the same problems, but from differing perspectives.

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Addressing the Fourth Delay: Improving Community-Based Accountability for Maternal and Neonatal Health

Julia SongokMoi University School of MedicineEldoret, Kenya
Grand Challenges for Development
Saving Lives at Birth
14 Dec 2011

We seek to address a critical fourth delay that sustains high rates of maternal and neonatal mortality in western Kenya: the delay in a community's accountability to its mothers and infants. We will develop an innovative information technology that fosters rapid communication and feedback between mothers, their communities, and their healthcare providers: The Mother-Baby Health Network. This information platform will accomplish three primary objectives: (1) Facilitate home and group-based care through Community Health Workers (CHWs) to improve collective advocacy; (2) Provide communities with the capabilities to activate an emergency alert system; and (3) Foster transparency in community and health system responsiveness to maternal and newborn health. CHWs will be equipped to use clinical decision-support on Android phones to correctly triage women and newborns for care. Integrated with SMS messaging, they will be capable of notifying healthcare providers, alerting nearby GPS-tracked Mother-Baby Taxis in an emergency transport system, and activating a personalized community of Mother-Baby Advocates to mobilize local resources.

Pay it Forward Maternal Health Model

Ken MwendaZoe Alexander LtdNairobi, Kenya
Grand Challenges for Development
Saving Lives at Birth
9 Dec 2011

Malezi-Bora is a mobile application, availed in local languages, with audio content regarding maternal and newborn health. It works on ultra-low-cost handsets and leverages village social networks. It utilizes a pay-it-forward business model, designed to incentivize mothers to virally share its content, and mapping technology to identify mothers in distress. The application focuses on addressing the inability of current health information-sharing systems gaining critical-mass usage and the inability of community health workers to reach every mother. It creates scenarios that ensure that mothers in dispersed villages have access to life-saving information regarding maternal and newborn health. The application leverages village social networks, and provides clear incentives to mothers-to-be, to not only use the content, but also re-distribute it continuously to other mothers-to-be. Its location-mapping technology enables nurses to quickly reach mothers in distress.

Micro Health Franchise System

Shahid YusafFINCONIslamabad, Pakistan
Grand Challenges for Development
Saving Lives at Birth
18 Nov 2011

Micro Health Franchise System empowers community midwife worker in providing high quality and cost-effective healthcare services to mother and child in poor communities; at their door steps. Micro Health Franchise system also provides entrepreneurial support to the community midwife workers that lead to the standardization of services, access to financial services and having support by an efficient referral network that can respond to emergencies in a proactive manner. At the core of this solution lies the Telehealth module. It is designed keeping in view the advantages of service oriented architecture and provides the Web (Electronic Medical Record), SMS (Short Text Messaging System) and data services (MMS, GPRS) to share and communicate through HL7 standards between community midwife workers and medical specialists at referral center.

Prenatal Calcium to Prevent Preeclampsia and Preterm Birth in Resource-Poor Rural Settings: Can a Novel Differential Time-Release Microencapsulated Powder Overcome Barriers to Adherence and Scale-up?

Daniel RothThe Hospital for Sick ChildrenToronto, Ontario, Canada
Grand Challenges for Development
Saving Lives at Birth
15 Nov 2011

We propose to develop a novel once-daily microencapsulated micronutrient powder containing iron, folic acid, and calcium (Prenatal Sprinkles) to overcome barriers to the integration of calcium into prenatal care in developing countries. If successful, our innovation - "differential time-release microencapsulation" - will mask the taste of iron and the gritty tongue-feel of calcium, and facilitate differential iron and calcium absorption.

Islamic Opinion Leaders: Building Capacity for Maternal, Neonatal and Child Health in Northern Nigeria

Yahaya HashimDevelopment Research and Projects Center (dRPC)Kano, Nigeria
Grand Challenges for Development
Saving Lives at Birth
15 Nov 2011

We propose to further empower Islamic scholars to enlighten health providers at service delivery points in 5 resistant communities with low uptake on the correct Islamic precepts on MNCH. This project will contribute to improved health seeking behaviors of men and women of reproductive age; increased uptake of services in primary health facilities; improved capacity of health providers to counter negative perceptions of modern MNCH services; improved immunization coverage; improved uptake of modern family planning methods of the 5 communities. The standard practice amongst development partners in Nigeria is that Islamic Opinion Leaders are engaged in MNCH projects in demand creation role narrowly restricted to changing the opinion, behavior and practices of community members in the Ummah.

Preventing Neural Tube Defects in Nicaragua Through Rice Fortification

Indiana González MoysInstituto de Nutrición de Centro América y Panamá (INCAP)Managua, Guatemala
Grand Challenges for Development
Saving Lives at Birth
15 Nov 2011

This project will prevent neural tube defects in Nicaragua through fortification of rice - a staple food - with folic acid. We will support twelve early adopter rice mills that collectively produce 60% of rice in Nicaragua with training and equipment to enable local production of fortified rice, as well as a comprehensive branding campaign to promote the purchase and consumption of fortified rice. By establishing high consumer demand, high acceptability, and relatively low costs, the program will harvest market forces to drive sustainable production and consumption of fortified rice.

Tampostat: A Low-Cost, Self-Regulating Tamponade for Management of Postpartum Hemorrhage in Low-Resource Settings

Aminur RahmanInternational Centre for Diarrhoeal Disease Research, BangladeshDhaka, Bangladesh
Grand Challenges for Development
Saving Lives at Birth
15 Nov 2011

Tampostat is a self-regulating, low cost, emergency obstetric device designed specifically for use in low-resource settings by greatly increasing safety, efficacy, and ease-of-use over existing condom tamponades. While other condom tamponades take a volume-based approach, which may not account for varying uterus sizes, Tampostat is pressure-based and uses air to eliminate the need for saline. It features a safety valve to prevent over-inflation through auditory feedback and allows for periodic uterine contractions by constantly regulating the pressure. A proprietary probe, which allows a condom to be attached with an airtight seal, aids in guiding the condom into the uterus through guidance. With minimal training, a birth attendant in the field will be able to successfully administer Tampostat for about $1.50 USD.

m-CTG: A Low-Cost Mobile-Phone Cardiotocograph Device for Antenatal and Intrapartum Monitoring to Prevent Perinatal Mortality in Low-Resource Settings

Manoja Kumar DasThe INCLEN Trust InternationalNew Delhi, Delhi, India
Grand Challenges for Development
Saving Lives at Birth
15 Nov 2011

We propose developing a mobile phone based Cardiotocography (CTG) (m-CTG) with inbuilt algorithm and alerts that can be used to identify the at-risk fetuses and monitor high-risk pregnant women for early referral and appropriate action. The proposed cheaper m-CTG device (cost ~$100-120) shall have the functions of standard CTG devices including FHR, fetal movements and uterine contraction. The in-built algorithm shall allow categorization to identify the abnormal ones. This device shall be mobile/ portable and easy to handle. Real-time data transmission by the mobile device shall allow referral and action for high risk cases. Other m-Health applications can be easily integrated for comprehensive and single window continuum service delivery. This shall enforce standardize case management and protocol adherence.

Applying Low-Cost Health and Information Technologies at the Community and Clinic Level for Integrated Maternal/Child Health Delivery in Rural India

Amit JainHealthpoint Services India Private LimitedSecunderabad, Telangana, India
Grand Challenges for Development
Saving Lives at Birth
9 Nov 2011

Healthpoint Services India Pvt. Ltd ("eHealthPoint") proposes to deploy maternal/child health services that leverage its existing innovative rural healthcare delivery model while adding cutting-edge mHealth tools to reach out to surrounding communities. The existing model now serves 120,000 people and includes 1) a rapidly-expanding rural clinic network providing both safe drinking water and walk-in primary care on a "for pay" basis that has already achieved operating profitability; 2) village health workers employed by eHealthPoint that have a demonstrated ability to generate demand (> 50% of village households are customers within 3 months); and 3) world class eHealth tools including electronic medical records that span the continuum of care. The project will integrate these existing capabilities with outreach into the surrounding communities, supported by cutting-edge mHealth solutions including smart-phone tools for a) information gathering; b) capturing data from mobile diagnostics that is automatically transmitted to electronic medical records; and c) assisting village health workers in patient education/demand creation.

PIERS on the Move: Pre-eclampsia Integrated Estimate of Risk Assessment on a Mobile Phone

Mark AnserminoUniversity of British ColumbiaVancouver, British Columbia, Canada
Grand Challenges for Development
Saving Lives at Birth
3 Nov 2011

We will develop a mobile phone application to be used by community health workers in rural, low-resource settings that a) provides local, rapid and accurate risk assessment, referral, and treatment advice for pre-eclampsia, and b) transmits information to referral centers for coordination of triage, transportation and treatment.

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