Maternal, Newborn, and Adolescent Health

In this proposal we focus on the postpartum period, and compare several low-cost and easily scalable approaches to improve the uptake and quality of postnatal care - approaches that take advantage of our strengths in technology, task shifting, clinical checklists, and community sales networks. In Kenya fewer than 20% of women receive postnatal care in the six-week postpartum period. Our objective is to find a cost-effective way to increase coverage of postnatal care and postnatal family planning within our patient population.

The new and innovative WE CARE Solar Suitcase is a simple, user-friendly technology that provides a sustainable source of power, allowing health workers to provide life-saving interventions 24 hours a day. The Solar Suitcase makes solar-power accessible, affordable, and useful in developing rural communities.

Jhpiego proposes a capacity building and sustaining "Day of Birth" approach to bring lifesaving services to remote health facilities where complications must be prevented and managed simultaneously and swiftly, often by a single provider. This approach uses evidence-based practices in prevention and treatment of the two biggest killers of women and newborns in the hours after birth -PPH and neonatal asphyxia.

In a rigorous cluster randomized controlled trial, we propose to evaluate the impact of promoting waterless hand cleansing with chlorhexidine on hand cleansing behavior of mothers, birth attendants, and others during the peripartum and neonatal periods. To inform future scaling up, we will assess the acceptability, barriers and motivators to chlorhexidine for hand cleansing. An evidence-based chlorhexidine hand cleansing intervention represents a robust low-technology solution to address the unconscionably high rates of preventable neonatal mortality worldwide.

The proposed Rapid Strip Assay (RDT) for Glycated Albumin (GA) will allow us to determine with good sensitivity and moderate specificity if a pregnant woman is likely to develop diabetes. Combining biometric information and health history with the RDT result will improve specificity. The screening result can be used to counsel high-risk women on diet and exercise and additional care during delivery, or to provide them a follow-up OGCT and insulin.

NOvate's first product offering, SafeSnip, is a patent-pending disposable and degradable plastic obstetric device that simultaneously cuts, clamps, and shields the umbilical cord from infection. SafeSnip's symmetric design and multiple safety features prevent misuse and shorten the delivery process by transforming umbilical cord severance into an intuitive one step procedure. SafeSnip will decrease healthcare costs and increase the standard of care for newborns by addressing infection-related mortality in developing countries while maintaining technologic relevance in developed nations.

The proposed tool, HemoGlobe, is a small, very low-cost device that transforms rural health workers' cellphones into noninvasive, prick-free hemoglobinometers. Hemoglobin levels are pictorially displayed on the cellphone screen for easy, actionable interpretation. Concurrently, the information is transmitted to a central server via automatic SMS, which contributes data to a real-time geographical map of anemia prevalence and severity that can be used for higher-level public health policy decisions.

Training approaches relying on conventional models are limited to large, group-based training requiring health workers to leave their sites for long periods. Jhpiego and Laerdal Global Health will address these challenges by demonstrating the efficacy and potential of a new PPIUD simulation model and a self-paced, blended learning approach through field-testing among trainers, providers and clients at facilities in Pakistan in collaboration with key stakeholders.

HealthPartners community-owned, sustainable health coop model empowers local stakeholders to partner for increased access to care and improved health outcomes. This is critical for reducing barriers for pregnant women to seek antenatal care, delivery with a skilled health professional and to receive critical follow up care immediately after birth. Addressing the problem of demand, HealthPartners Cooperative model reduces out of pocket, health-related expenditures for pregnant women through risk pooling. Healthy individuals offset expenses incurred by those who fall sick.

As part of a suite of jaundice diagnostic and treatment technologies aimed at ending kernicterus, we have developed Comet, an extremely low-cost, high-performance, and compact jaundice treatment device targeted at rural and limited-infrastructure clinics and hospitals in developing countries. Comet integrates low power consumption and high intensity LEDs with a lifespan of 3-5 years to provide phototherapy on par with state-of-the-art devices. However, Comet requires minimal maintenance and is designed to retail at less than $150.