Maternal, Newborn, and Adolescent Health

To increase demand for and access to quality maternal and neonatal services for women living in hard to reach areas of Senegal, Africare is proposing to develop an innovative model that integrates community based support services (Maternal Care Support Groups/MCSG) with mobile and telemedicine platforms. This innovative technology platform, combined with community services, will bring prenatal care services closer to 303,920 women in rural Senegal, allowing for early detection of potential problems and their quick referral to centers equipped to manage emergency obstetric care.

Our proposal will provide this life-saving treatment to isolated, extremely resource poor people by obviating the need for electricity. This will be achieved by applying recently developed hydrological engineering approaches to extract the pressure differential required for the adsorption process exploited by Oxygen concentrators. This project aims to develop and test an electricity free Oxygen concentrator suitable for a developing world health facility.

We propose to develop a low-cost Nipple Shield Delivery System (NSDS) to administer drugs or nutrients to breastfeeding infants via easily disintegrating tablets within a modified nipple shield. A wide-range of active pharmaceutical ingredients (APIs) could be delivered to infants using the NSDS such as antibiotics, antimalarials, antiretrovirals, vitamins, nutrients, and probiotics. Use of the NSDS would empower a breastfeeding mother during the early postnatal period by allowing her to personally administer medicines in a natural setting.

We propose to develop a rapid, low-cost and effective method for detecting sepsis in early stages. We will take advantage of the potential of histones to be sensitive and effective biomarkers for sepsis, and of the versatility, simplicity and low-cost of test strips. The diagnostic test will be simple, comfortable, easy to interpret and low-cost for prognosis/early diagnosis of sepsis based on histone expression. The test can be used by non-technical experts in any hospital or health center worldwide, though it has been designed intentionally for low-resource countries.

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.

Vitamin A deficiency (VAD) is a major problem in the developing world that disproportionately affects pregnant women, children, and infants. Vitamin A's role in development and immunity make it critically important to natal/neonatal health. Fermented dairy products, particularly yogurt, are traditionally made by women using small-scale fermentations, often on a per-household basis. In all fermentations, local strains of lactic acid bacteria (LAB) have been utilized for generations as yogurt starter cultures, continuously cultured by a process called back-slopping.

We provided novel evidence that the urine of preeclamptic women is highly enriched in misfolded proteins. Based on this, we developed the Congo Red Dot (CRD) as a diagnostic and clinical prognostic tool for preeclampsia. This project takes advantage of our basic science finding (congophilia of preeclamptic urine), translating it in innovative manner toward development of low-cost paper-based diagnostics with potential to decrease maternal and fetal mortality worldwide.

Injectable oxytocin has been recommended by the World Health Organization for routine use in prevention and treatment of Postpartum hemorrhage (PPH). However, safely delivering an injection requires a trained provider and sterile equipment, ideally in a health facility setting. Additionally, delivering a lifesaving dose of oxytocin is further complicated by the poor stability of oxytocin - it is inactivated if exposed to high ambient temperatures.

We propose to design a gel formulation for sustained release of sulfate (MgSO4) via the rectal route of administration. We will carry out preclinical studies to determine the pharmacokinetics and efficacy of rectal administration of the novel MgSO4 formulation. We will also conduct a user assessment study in Western Kenya among health providers to evaluate the acceptability and feasibility of introducing a rectal delivery method for Preeclampsia and eclampsia.

We have designed a low-cost, hand-held, non-contact, point-and-click vital sign monitor (VSM) for neonates that assesses heart and respiratory function, PO2 saturation, thermal regulation and blood vessel branching to improve detection and referral of frail newborns. The VSM can be used by community health workers (CHW) and clinic-based personnel. We propose to assess the potential of the VSM as a tool to save newborn lives.