Maternal, Newborn, and Adolescent Health

Viviana Gradinaru of the California Institute of Technology in the U.S. will perform imaging-based, high-throughput screens using adeno-associated virus (AAV) delivery vectors to rapidly identify ovary-specific macromolecules that are essential for fertility and could be used to develop non-hormonal contraceptives.

Stephanie Seminara of Massachusetts General Hospital in the U.S. will perform large-scale, human genetic studies to identify gene variants that influence fertility for developing novel non-hormonal contraceptives. Globally, many women do not use contraceptives for reasons including negative side effects of hormonal methods, leading to poor method acceptability. This leads to 88 million unintended pregnancies per year globally.

Jeffrey Lee of the University of Toronto in Canada will engineer single-domain camelid antibodies (nanobodies) to block the interaction between two proteins exclusive to the sperm and egg that mediate their fusion and thereby fertilization, as affordable, non-hormonal contraceptives with fewer side effects. Nanobodies are exquisitely specific binding proteins that make attractive therapeutics because of their additional simplicity, stability, and smaller size compared to antibodies, also lowering the cost of their production.

Darryl Russell of the University of Adelaide in Australia will use genomics approaches to identify the molecular pathways that control ovulation for developing more non-hormonal contraceptives with fewer side effects. The classical progestin-based contraceptive pill disrupts natural hormone cycles; requires long-term, regular use; and causes a range of harmful side-effects. An alternative approach is an acute treatment that directly blocks ovulation – the release of the oocyte from the ovary.

Leo Han of Oregon Health and Science University in the U.S. and colleagues at the University of North Carolina and the Marsico Lung Institute will build a hydration-based drug discovery platform for the cervix to screen drug libraries for long-lasting non-hormonal contraceptives that alter mucus hydration. Contraceptives that thicken cervical mucus to block the movement of sperm and thereby inhibit fertility would be well tolerated and may also protect against pathogens.

Joshua Vogel of the Burnet Institute in Australia will generate evidence to support adoption of the new WHO Labor Care Guide to reduce the rate of cesarean sections and enhance the quality of care during childbirth by developing an implementation strategy for hospitals in India. In many low-middle income settings, women giving birth in busy hospitals are often alone, undermedicated, and inappropriately monitored, which increases the rates of cesarean sections.

Soo Downe of the University of Central Lancashire in the United Kingdom will develop a multi-media program for lawyers and judges who work on medical litigation related to childbirth to help ensure that they understand the evidence on risks and benefits of the procedure as well as legal rights of patients. There has been a large increase in the numbers of cesarean sections across all sectors of society, which is party caused by a fear of litigation.

Jody Lori of the University of Michigan in the U.S. will implement a WhatsApp platform for medical staff and community health workers in rural areas in Liberia to communicate with staff at larger hospitals to accelerate the referral and treatment of obstetric emergencies. Liberia has one of the highest maternal mortality rates in the world. Many of the leading medical causes of death, including obstructed labor, are preventable if the women were more quickly referred to higher level care centers where life-saving procedures like cesarean sections can be safely performed.

Seth Cochran of Operation Fistula in the U.S. and Nick Bennett of Simprints in the United Kingdom will incorporate facial recognition technology from Simprints into their existing automated patient registry to better track and support women with obstetric fistula in low-resource settings. Obstetric fistula is caused during childbirth and leads to the uncontrolled release of bodily wastes. It is estimated that more than 2 million young women live with untreated obstetric fistula in Asia and sub-Saharan Africa.

Yasmin Chandani of inSupply Health Limited and Pratap Kumar of Health-E-net Limited both in Kenya will develop a simple digital health tool to support the maternal and child health supply chains for low-literate, nomadic communities spread sparsely across Kenya. Counties in semi-arid lands have poor maternal and child health indicators caused by vast distances, low literacy rates, no fixed health facilities, and no data on supply chains.