Sarah Murray and colleagues of Johns Hopkins Bloomberg School of Public Health and School of Nursing in the U.S. along with colleagues at the University of Bamako in Mali will develop a group approach to provide better antenatal care to pregnant adolescents in Mali and protect them from common mental disorders such as depression. Over half of adolescent girls in Mali have a child before their 18th birthday, and as a consequence are more likely to live in poverty, be uneducated, and experience violence. Although antenatal health services and support are available, they are limited. To address this, they will develop a group format for more efficient delivery of antenatal mental health care that encourages open discussions and provides social networks and support. This will be done in collaboration with adolescent mothers, their husbands, and health care providers. They will train health care workers to teach relevant coping strategies in a group format using cognitive behavioral therapy techniques, and pilot test their approach on small groups of pregnant adolescents with partners in Bamako, Mali.

Guitele Rahill and Manisha Joshi of the University of South Florida in the U.S. will harness the Haitian tradition of storytelling to produce online videos, brochures, and posters that support pregnant teenagers in Haiti who are at high risk of depression. There has been an increase in unplanned teenage pregnancies since the 2010 earthquake, due in part to the loss of parents, and a rise in transactional sex and sexual assaults facilitated by very limited resources. Pregnancy places a substantial additional stress on these children, which in turn causes long-term difficulties for their children. In Haiti, to tell a story you announce "Krik?", and to hear it you respond "Krak!" They will use this familiar story-telling framework and actors who resemble the target group to teach pregnant teenagers about childbirth, motherhood, and how to cope with depression. They will conduct two focus groups of six pregnant teens to identify the specific challenges they face, and use their feedback to help ensure the approach will work.

Tatiana Salisbury of King's College London in the United Kingdom along with colleagues at the Royal College of Art in the United Kingdom and the Manhiça Health Research Centre in Mozambique will develop a strategy to improve the mental health of young mothers in Mozambique by adapting existing technology-based and group-based methods to teach them life skills such as parenting and social skills. Almost half of Mozambican girls have had a baby by the time they are 18 years old. Together with associated events including being excluded from school and family conflicts, this can damage their mental health and lead to suicide. They will recruit experts in mental and maternal health and implementation science, analyze resources and local infrastructure, and, together with young mothers, their families, and other stakeholders, co-develop the skill-strengthening and delivery methods. Delivery methods to be analyzed include text messaging, mobile phone applications, and group meetings. They will then pilot test their strategy with three different delivery methods using up to 60 pregnant and young mothers (aged 15-24 years) over four months, and evaluate their effect on mental health.

Arun Shanbhag of Manipal University in India will use near field communication (NFC) tags to transform traditional bracelets worn by infants in India into portable vaccination records that better track particularly migrant communities to promote full childhood vaccination coverage. Vaccinations are recorded on paper, which are easy to lose and make it difficult for health workers to monitor children in migrant communities. They created beaded bracelets that can store vaccine records on a digital tag, and have developed a mobile application that can read the tag using an Android smartphone. In consultation with local communities, they have also developed a universal color code for the beads to represent the required individual vaccines so that they can be easily monitored by health workers. They will now evaluate their approach in a larger study across five villages to assess its overall performance including the stability of the records over time, data storage capacity, the effect on vaccination coverage, and ease of use.