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Issue Community Health Workers (CHWs) are vital to maternal and child health in developing countries but lack appropriate tools to enhance their ability to make health decisions, and to link women and infants to appropriate care. Solution The mHealth for Maternal and Newborn Health project was a randomized controlled trial to test the hypothesis that community health worker (CHW) services improve with access to mobile phone software.…Results of the project have helped foster a primary healthcare program that puts Maternal, Newborn and Child Health (MNCH) at the forefront of its activities. Through USAID support and additional funding, the team from AMPATH (the Academic Model Providing Access to Healthcare) has implemented novel approaches in MNCH in seven innovative sites covering a population of 750,000 since 2010. This program has produced significant gains and was renewed to cover a population of 3.5 million people. The study team has been invited by government and USAID leadership to lead discussions and showcase the clinical decision support platform, both in Kenya as well as in other parts of East Africa.…

…not know which women in the community are pregnant and may lack basic demographic information, such as where the pregnant women live and when they are due to deliver. This hampers planning and delivery of preventive and curative care for mothers and babies, and can result in maternal and newborn mortality. Solution An experimental trial was undertaken in Uganda to test the efficacy of using the village…of the study have been disseminated through conference presentations. The project teams plan to continue expanding the intervention beyond the current geographic scope and hope to scale up to target a population of from 2,000 to 11,500 pregnant women and, later, into the entire region. The Ministry of Health and other organizations carrying health interventions…

…is challenging. Natural human neutralizing antibodies block HIV entry into T cells, but such antibody production is very rare in patients, while making conventional antibodies in bulk for treatment is difficult, expensive and inefficient. There is a need for rapidly and inexpensively producing neutralizing antibodies that recognizes newly identified regions of HIV proteins and can…(llamas, camels and alpacas) are very stable and would be very useful if they could be isolated and produced. Solution The major objective of the project was to produce a short peptide corresponding to the membrane proximal external region (MPER) of GP41, to use as an immunizing agent to develop a unique form of antibody made in the camelid family. Previous studies from other groups identified the MPER region of the HIV glycoprotein as the target of very rare human neutralizing antibodies produced by individuals who show natural immunity to HIV infection.…

Issue Birth asphyxia, defined as the failure to establish breathing at birth, accounts for an estimated 900,000 deaths each year and is one of the primary causes of early neonatal mortality. Research has proved that effective resuscitation with proper ventilation can save 192,000 lives every year. Often, a single person is required to perform multiple …provide proper ventilation. Solution This project aimed to develop a novel, integrated, easy-to-use newborn resuscitation solution, to empower front-line health workers to resuscitate newborns effectively. The team designed, developed, engineered and conducted bench validation of the prototype, and have initiated a limited market release. A foot-operated resuscitation system that frees one hand of the operator…to achieve pressure safety comparable to bag-mask through the use of the novel technical innovation (patent applied), the project team have been able to achieve pressure safety superior to bag-mask. A total of 20 human-ready pilot units were fabricated and rigorously tested, according to developed testing criteria that included those prescribed by 13 relevant EN:ISO…

Issue Unsafe water supplies represent one of the leading causes of death in developing countries. Approximately 1.8 million deaths worldwide are a result of exposure to waterborne bacterial pathogens. In developing countries, waterborne pathogen detection requires outsourcing samples to labs with expensive equipment, taking 2–6 weeks to obtain results. Solution The project sought to develop …nanoparticles. In the device, the detector region would change colour from blue to red if bacteria were present, providing an easy visual output indicating water quality. Microspheres also allow for easy scale-up during the manufacturing and the system eliminates the need for an expensive detection system. Outcome The successful development of a working prototype for affordable and…

Issue Breast cancer kills approximately 500,000 women every year, with almost 58% of deaths in developing countries. Limited capacity for early detection of serious breast problems by frontline healthcare workers in developing countries is one of the main barriers to better outcomes and most women do not seek timely care for breast cancer. As a result, mortality rates from breast cancer in countries like Bangladesh are as high as 80%. Solution The project sought to demonstrate the value of a 'smart' phone-empowered community health worker (CHW) model of care for breast health promotion, clinical breast examination (CBE) and patient navigation in rural Bangladesh. The study was a randomized controlled trial conducted in the Khulna Division of Bangladesh. Women in the…applications to guide the interview, report data, show a motivational video, and offer appointments for women with an abnormal CBE.Use of smart phone/apps identical to the first group by a CHW who also received training in ‘patient navigation’ to address potential barriers to seeking care.A control group where CHWs did not have smart phones and…

Issue Tuberculosis (TB) causes millions of deaths annually worldwide. Cell culturing, the current gold standard for diagnosis, is slow (4–6 weeks) and may result in further progression of the disease, or further spread. Molecular techniques offer a suitable promise but they are not widely used. The sputum liquid culture, “MODS” (microscopic-observation drug-susceptibility) assay, is a faster, cheaper and more sensitive test than other culture-based tests. It is a convenient test to diagnose TB, as well as to determine multidrug-resistance (MDR) in approximately seven days. While developed in Peru in 2000 and now used in several countries, use of MODS…for pattern recognition, to automatically classify and interpret digital microscopic images from MODS cultures. An ad-hoc, web-based system was also developed to allow the remote laboratories to upload the microscopic digital images, which are processed in real time by the mathematical algorithm in less than one minute. The project also involved nine experts in interpreting…

Training community health workers engaged in HIV/AIDS care to reach and assist the highest number of mental health patientsIn Sub-Saharan Africa, one in three HIV patients experience significant depression symptoms, known to interfere with motivation to take anti-retroviral medications. In Uganda, important gains in improving access to HIV/AIDS care but little has been done to …health workers and 180 lay health workers engaged in HIV/AIDS care in rural areas of three northern Uganda districts to also recognize and deliver Group Support Psychotherapy for depression. This will improve access to a first line treatment for depression and make its delivery more sustainable. The following outcomes are expected over the year ahead:…self-esteem, social support and function levels; 50% will be economically productive with increased livelihood assets and fewer disability days; and 20% will experience measurably less poverty. Scaled up throughout the north and other areas of Uganda with high HIV prevalence, up to 325,000 people could experience Group Support Psychotherapy care and over 65,000 could experience…key mental health policy maker at the Ministry of Health in Uganda. Partner funding of $450,000 will be provided by UK-based charity MQ: Transforming Mental Health, which promotes research to improve the impact of mental health treatment, illuminate causes of mental illnesses, and support the best and most innovative researchers and thought leaders of the…

…single risk or developmental stress causes most harm; the main problem is the accumulated impacts of multiple early childhood adversities. Single risk factor interventions are, therefore, unlikely to achieve the highest possible impact on child development.This project of the Zambia Centre for Applied Health and Development is designed as a comprehensive, integrated, community-based child development program, rolled out in Zambia’s Choma District.The key innovation, and a critical improvement over previous efforts: establishment of a new…their communities. CDAs will enroll eligible mothers and their child in the study, and then will be responsible for the health and development of the respective child up to 24 months of age. Each week, the CDA will be sent a list mothers and children who missed a scheduled services or appointments through an automated…

…the highest tuberculosis (TB) burden in the world, with 2.2 million of the 8.6 million new cases estimated worldwide. In limited-resource settings, where there is poor access to quality healthcare, TB patients are often not adequately monitored, leading to complications, such as the development of multidrug-resistance (MDR-TB). Solution OpASHA has developed and deployed eCompliance – a biometric terminal composed of an Android tablet and fingerprint reader that tracks patient adherence to scheduled treatment, under the supervision of a community health worker (CHW). The software has been updated to a text-free, image-based version for illiterate users. OpASHA uses a web-based business intelligence and reporting tool to collect and collate data from the eCompliance tablets, and to generate reports. Five hundred and…