Maternal, Newborn, and Adolescent Health

With this proposal, we aim to evaluate the feasibility and acceptability of distribution of chewing gums and/or gummy bear snacks containing at least one polyol on the primary prevention of periodontal disease in association with PTB and SGA births through the rural expansion of our current established community-based health care efforts in Lilongwe, Malawi.

Iron deficiency is a major contributor to maternal death. Improving the health of women through iron fortification of a universally consumed food vehicle will result in significant saving of lives at birth. Tea is universally consumed in South Asia; however, iron forms complexes in tea, reducing bioavailability, and thus thwarting earlier fortification attempts. Our approach will make tea viable as an iron fortification vehicle.

Margaret McConnell and Jessica Cohen of Harvard School of Public Health in the U.S. will evaluate whether motivating pregnant women to choose a health care facility for delivering their baby prior to the onset of labor, along with offering free transportation to that facility, increases the safety of childbirth in Kenya. Currently, maternal and neonatal deaths in developing countries remain high despite the availability of high quality facilities for child delivery.

Günther Fink of Harvard School of Public Health in the U.S. will help parents to assess their child's development, thereby making them more likely to seek necessary treatment. They will test two strategies in a randomized controlled trial involving 600 children from Eastern Zambia. For one group, they will install life-size growth chart posters in selected households along with instructions for use and where to seek help if the child's height is below a critical level. For the other, they will arrange regular community meetings to measure children's heights and offer further advice.

Tanvir Huda of ICDDRB in Bangladesh will improve care and nutrition for pregnant women and young children by setting up a system whereby mobile phones are used to receive nutritional information and financial incentives for positive health-related behavior, such as attending clinics. They will perform a pilot study in Bangladesh by recruiting 350 pregnant women, providing them with mobile handsets, and establishing trained health workers who will send weekly nutritional advice and supply nutritional supplements.

Prakarsh Singh of Amherst College in the U.S. will test different financial incentives to motivate staff at day care centers in India to improve their performance. These day care centers provide meals for preschoolers and nutritional education to their mothers, however the service is often below optimal. They will perform a randomized trial in slum areas of Chandigarh to evaluate three different methods to financially reward caregivers for improving the weight-for-height of malnourished children visiting their day care centers.

Abdur Razzaque Sarker from the International Centre for Diarrhoeal Disease in Bangladesh will test whether group prenatal care for women has a positive effect on maternal and child health when compared with traditional one-on-one prenatal care. They hypothesize that prenatal classes with groups of 8-10 women will promote support networks and social interactions, and facilitate learning, thereby improving health outcomes. This will be tested using a prospective study in selected health centers in Bangladesh.

Ratul Narain of BEMPU Technologies Private Ltd. in India will develop and test a temperature monitoring baby bracelet to reduce the incidence of hypothermia in newborns. Newborns are unable to regulate their body temperature, and low temperatures can lead to life-debilitating illnesses. Skin-to-skin warming (kangaroo care) can maintain a healthy body temperature, but is not commonly practiced in resource-poor regions in India, where newborn hypothermia rates are high.

Niaina Rakotosamimanana of the Pasteur Institute of Madagascar in Madagascar will develop a low-cost tuberculosis diagnostic and molecular test for pregnant women using dried blood samples drawn from finger pricks. This dried-blood spot based test is minimally invasive, can be used in remote areas where people lack access to all-weather roads and lack of infrastructure that has direct impact on health outcomes.

Angela Koech Etyang of Aga Khan University in Kenya will make basic screening tests available to pregnant women at dispensaries and health centers that do not have laboratory facilities. These tests screen for conditions such as HIV, syphilis and anemia. They will employ simple existing technologies that enable these tests to be carried out during the clinic visit quickly, easily and by the nurse who is providing the care in pregnancy.