Round 1 Innovators

This project confronts the barriers to maternal and neo-natal health constructed and maintained by some community and religious leaders (CRLs) in six states of Nigeria. CRLs provide the ideology, messages and personal life examples which counter the myriad maternal and neonatal health interventions in this region. Previous interventions avoided resistant CRLs, engaging only liberal scholars in one-off events such as workshops. This has failed to bring down the barriers and the death rates persist.

The transmission of HIV from mother to child during the birthing process can be largely prevented by the administration of anti­retroviral drugs. But, the child must receive the medication within 24 hours after birth to be effective. In Sub-Saharan Africa many clinics have the drug but most mothers deliver at home without it. Conventional containers, such as syringes, cups and pill bottles destroy the active ingredient in the medication. This means that the only way for most African children to receive medication is for the mother to travel to a clinic immediately after birth.

Grameen Foundation, in partnership with Ghana Health Service, is requesting support to expand the successfully piloted MOTECH (Mobile Technology for Community Health) initiative to two new districts in a transition plan towards national scale-up. The program will reach approximately 14,000 pregnant women and 46,000 children under five over the two-year implementation, increasing access to accurate health information, generating increased demand for antenatal, postnatal and neonatal care, and providing detailed data on health service delivery and outcomes to Ghana Health Service.

Jhpiego and its partners (Johns Hopkins University Center for Bioengineering Innovation and Design and Laerdal Global Health) propose to rapidly develop and conduct initial field-testing for an “E-Partogram,” an affordable, easy-to-use, handheld electronic decision-making tool for preventing or managing complications during labor. The E-partogram could positively transform safe childbirth by enabling front-line providers to more rapidly assess and respond to labor complications and receive crucial guidance to save the lives of women and newborns.

We seek to address a critical fourth delay that sustains high rates of maternal and neonatal mortality in western Kenya: the delay in a community’s accountability to its mothers and infants. We will develop an innovative information technology that fosters rapid communication and feedback between mothers, their communities, and their healthcare providers: the Mother-Baby Health Network.

A major cause of maternal and neonatal death and severe disability in developing countries is the lack of trained medical providers to perform emergency cesarean sections in cases of obstructed labor. Due to the shortage of doctors, many underserved countries rely on midwives and clinical officers to provide obstetrical care. These providers are not trained to perform cesarian section. A low cost method for training them to safely do this operation could reduce maternal/fetal mortality and devastating, non-lethal obstetrical complications such as recto-vaginal fistulas.

Baby Monitor, a mobile interactive voice response system, will bring clinical assessment and referrals directly to mothers and their infants in resource-poor settings who are unlikely to access routine care. To date, mobile applications largely have been used to send patient reminders and health information or to collect patient information through intermediaries such as community health workers. Patients in developing countries have not been end-users of mobile diagnostic tools and medical record systems.

Each year millions of births, including those in facilities, occur without effective monitoring or appropriate response. The baby’s heart rate is the most important signal of distress in labor. Inadequate heart rate monitoring and failure to respond to distress is an important determinant of almost 1 million newborn deaths and 1.2 million stillbirths each year globally. Effective monitoring during labor in challenging settings depends on rugged, reliable, simple devices able to be used without electricity or batteries.

Preterm birth leads to more annual neonatal deaths (1 million) than any other single cause; these deaths primarily occur in low income settings where many infants are born at home and gestational age is rarely assessed. Innovative ways to identify preterm infants in the community are needed to facilitate rapid and appropriate targeting of interventions and referral.

There is an urgent need for low-cost, easy-to-use tools that can accurately predict adverse outcomes associated with pre-eclampsia (a major cause of maternal and perinatal mortality). We will develop a mobile phone application to be used by community health workers in rural, low-resource settings that a) provides local, rapid and accurate risk assessment, referral, and treatment advice for pre-eclampsia, and b) transmits information to referral centers for coordination of triage, transportation and treatment.

Complications due to prolonged second stage of labor include potentially fatal maternal (hemorrhage, infection) and newborn complications (birth asphyxia and trauma).