Maternal, Newborn, and Adolescent Health

Our idea is to develop BiliSpec, a bilirubin monitoring device with a per-test cost of less than $0.10. BiliSpec includes: (1) a lateral-flow device to separate serum from whole blood in under 30 seconds and (2) a battery powered reader to measure light transmission through the separated serum on the strip and display the bilirubin concentration. We estimate our device could prevent the deaths of approximately ninety-thousand neonates who die every year due to lack of access to effective treatment and monitoring for neonatal jaundice in low-resource settings.

Lack of fast, affordable delivery of blood profoundly restricts the number of lifesaving transfusions performed in the Dodoma region. We will use an autonomous Unmanned Aerial System (UAS) called Stork to transport screened and typed blood from a blood bank in Dodoma to peripheral health facilities, on-demand. In many cases, ground transport of blood would either be impossible or too costly using traditional means. Stork can already deliver over 1kg over 75km in less than 45 minutes at a cost of $10, outperforming all known alternatives.

Regular temperature monitoring is an effective means of detection and prevention of hypothermia but in our extensive field research, we observed that newborn temperature monitoring is rarely practiced in under-resourced clinics and uneducated homes. After vetting the need with over 75 pediatricians and filtering through several proposed solutions, we are developing Bempu, a novel, simple low-cost newborn temperature monitoring wristband. The band intuitively alerts a mother in case of hypothermia, enabling her to take early action.

Effective resuscitation could reduce intrapartum related neonatal deaths by 30%, and deaths from prematurity by 10%, creating the potential to save 347,200 babies annually. However, one in five trained healthcare professionals (HCPs) fail to perform the resuscitation technique correctly, and those that do, often experience a rapid decline in proficiency. Our Augmented Infant Resuscitator's advanced training capabilities, instant feedback mechanism, and objective self-audit and retraining abilities will maximize and sustain gains from effective resuscitation.

Our plan is to scale up a proven e-voucher program covering the costs of maternity care and SMS reminders in order to reduce financial and informational barriers to care and to dramatically increase skilled facility-based deliveries. Specifically, we plan to (1) double the rates of institutional and skilled deliveries; (2) increase the rates of antenatal and postnatal care, particularly the number of women who receive four or more antenatal visits; (3) improve the quality of care delivered by incentivizing CHWs; and integrate our vouchers with a Government health financing plan.

Preeclampsia (PE) is a disease without targeted treatments. We propose a simple strategy to solve this problem: we will establish a cell-based assay to screen clinically-available, mostly generic and inexpensive, drugs that may have a therapeutic effect on PE. To do this, we will utilize new scientific knowledge, showing that anti-angiogenic factors released from the placenta trigger maternal vascular injury essential for the development of PE.

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.

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.

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.

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.