Maternal, Newborn, and Adolescent Health

Lactoferrin, a safe, naturally occurring iron-binding protein found in high concentration in breast milk, offers an exciting new approach to correct iron deficiency early in pregnancy, prevent low birth weight, preterm delivery and reduce neonatal deaths. It has few side effects, facilitates absorption of iron, and reduces maternal inflammation to enhance the utilization of iron giving it the potential to rapidly restore iron status in pregnant women, even in populations with high burdens of infectious diseases.

The overarching focus of PharmAccess is on improving access to affordable and quality maternal and child health care for low-income families in Nigeria. The essence of PharmAccess comprises an integrated approach of complementary initiatives that increase resources, efficiency and effectiveness within the healthcare system. Through quality improvement, loans for healthcare providers, and health insurance, the demand for and supply of care is stimulated.

D-tree International has developed and field-tested an integrated phone-based tool that supports screening and counseling of pregnant women using clinical algorithms, facilitates transportation to a health facility during labor using mobile banking and data storage, and supports the CHW to provide follow-up care to mothers and their infants using clinical algorithms.

Our objective is to develop a low-cost Smartphone attachment and application to diagnose and treat bacterial neonatal pneumonia in Pakistan. Currently, serious bacterial infection - pneumonia, sepsis and meningitis - results in preventable deaths of 700,000 neonates every year, 99% dying in resource limited settings such as Pakistan. Signs of serious infection in young babies are difficult to recognize. Diagnostic tests and chest X-rays are rarely available outside tertiary care hospitals.

In this project, we will develop a mobile phone oximeter attachment that can measure tissue oxygenation without touching the body. This makes it a valuable add on to the pocket of a community healthcare worker in a resource-poor country, helping him/her quickly identify sick children and allocate extremely limited resources to save their lives.

Laerdal Global Health's low-cost Fetal Heart Rate (FHR) monitor; MOYO and its training program will help providers measure FHR faster, automatically and more accurate to make timely obstetric responses when detecting fetuses at risk. This will reduce the burden of stillbirths and births asphyxia, estimated to account for 2million perinatal deaths annually. 98-99% of these deaths occur in low and middle-income countries. Expanding the use of MOYO to referring hospitals and dispensaries will help detecting fetuses at risk earlier and improve referrals.

we have developed a heat-stable oxytocin fast-dissolving tablet (FDT) for sublingual administration. Under this project, we propose to test the effectiveness of this simple, needle-free approach to prevention of PPH by conducting a human pharmacokinetic study in South Africa.

We have identified three promising urine-based biomarkers from published proteomic studies; our first project activity will be to develop these three urine-based biomarkers into three respective ELISA for proof-of-concept validation and technology transfer to lateral-flow assays.

Our Transition to Scale proposal will provide the ESM-Ketamine package to 34 health facilities (covering a catchment area of nearly 6 million people). The package includes: an ESM-Ketamine kit, and a one-week training program for providers that covers basic pharmacology, appropriate monitoring, Helping Babies Breathe, wall charts and checklists, and case-based learning. The adoption of ESM-Ketamine in Kenya will avert many maternal and neonatal deaths.

Using existing information, and gathering vital new information when necessary, we will develop and validate an integrated panel of maternal, fetal and newborn risk stratification tools that incorporate pulse oximetry to supplement the PIERS on the Move (POM) platform, converting the P of PIERS from pre-eclampsia to pregnancy and pediatric. Integrating these models within the PIERS on the Move (POM) app will prepare the way to implement an integrated platform to guide care in women and newborn homes.