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Making the most of scarce resources through “frugal innovations”: Training community health workers to treat anxiety and depression and providing telephone-based coaching and support to families of children with behavioral difficultiesMental health disorders, of which alcohol abuse, depression and anxiety are the most prevalent, constitute one-sixth (16%) of the disease burden in Vietnam, exceeding the…and middle-income countries on the availability of mental health care, with 1.7 psychiatrists and 11.5 psychosocial care providers per 100,000 population. A project led by the Centre for Applied Research in Mental Health and Addictions (CARMHA) at Simon Fraser University’s Faculty of Health Sciences project helps to fill this service gap in two low-cost ways:…approach, screening almost 1,300 people, of which 127 now receive treatment for depression — more than three times the number anticipated — and pre/post treatment evaluations show statistically-significant decreases in symptoms. Building on that success, the adult depression program will be scaled up and rolled out in 32 communities across nine provinces in Vietnam.  It is expected that roughly 4,250 people with depression will access services, of which 1,280 will…

In Cambodia, six in 10 women are anemic due to iron deficiency in their diets, causing premature labour, hemorrhaging during childbirth and the impaired brain development of their babies. Usually obtained through red meat or other iron-rich foods, a small chunk of iron added to water in the cooking pot can release a life-saving iron supplement. But attempts to persuade mothers to do so were unsuccessful. On a 2008 study mission in Cambodia, University of Guelph researcher Chris Charles thought of creating a…measures in place. About 7.5 cm (3 inches) long, and made from recycled material at a cost of about $5 each, the iron fish provides health benefits for roughly three years. “Our goal is to produce 10,000 Lucky Iron Fish this year and another 50,000 next year,” says Gavin Armstrong, President and CEO of Lucky…

…culture is the gold standard in tuberculosis (TB) diagnosis, but takes 4–6 weeks. This delay in diagnosis may result in further progression of the disease, may lead to infected individuals continuing to spread the disease to others or may result in patient loss to follow-up. Solution The idea behind the project was to make diagnosis of TB by culture method faster and more automated, enabling quicker diagnosis. Work was undertaken to develop…that compartmentalizes a sample into millions of micro volumes and analyzes them in parallel, reducing the assay time to a few hours. Using E.coli as a proxy for TB (because M. Tuberculosis requires BSL-3 safety equipment, which the lab did not have), the team focused on design development, fabrication of arrays of nanoliter wells, distribution of mL volume into million nL volumes and characterization of the existing fluorescence technology for oxygen detection in the…

…fuel. Smoke from inefficient fires in poorly ventilated homes also makes indoor air pollution (IAP) the fourth biggest killer in the developing world. Solution The project team designed and fabricated a unique cook stove (the ECOS stove) with a dual purpose:  providing boiling water while, at the same time, cooking food. The stove contains two chambers, a cooking pot and an inner boiling pot. High temperatures emanating while cooking food also heat up the water in the boiling chamber, thus killing pathogens contained in water. The water can then be used for domestic purposes, including drinking and hand washing. This approach also saves on energy costs, as the cooking of food and boiling of water are done simultaneously. A feasibility study was conducted to test the stove and quantify the environmental impact of the stove. A market survey was also conducted and a distribution model developed that enabled a better environment…

Issue Complete and timely health information is essential to inform public health decision-making, but is often lacking in resource-constrained settings. Electronic medical record (EMR) systems are particularly amenable to maternal and child health services and HIV disease management. An EMR system could enable the mother and child, or HIV-positive patients, to be tracked and monitored…two-sample test of proportions, pre- and post-implementation, of EMR-based data verification. A total of 946 pregnant women and 17,145 HIV patients were registered in the EMR system for antenatal care and HIV care respectively. Outcome The study showed that EMR-based data verification can improve the completeness of data collected in the patient record for maternal and child health and for HIV. Findings showed significant improvements in completeness of the antenatal record through implementation of EMR-based data verification. With use of the EMR, there was a 42.9% reduction in data missing from…was recorded post-implementation, along with a 79.7% reduction in those eligible but not on ART (880).  An additional 1,312 people living with HIV and previously lost to follow-up were identified and have been returned to care. The Ministry of Health in Kenya – which now has ownership of the data – has scaled the project…

Issue Obesity and being overweight pose major risks in developing countries for non-communicable diseases, such as Type 2 diabetes, certain cancers, cardiovascular disease, hypertension and stroke. Africans are increasingly adopting sedentary lifestyles and consuming high-calorie, low-fiber diets that are creating an upsurge in chronic diseases. Chronic diseases are largely preventable but many developing countries are not implementing strategies to combat them, as scarce health resources are focused on infectious diseases. Solution Implemented in Nigeria, the project team conducted an active pair study involving behavioural interventions in…

…can occur in young infants with severe acute illnesses or congenital cardiac anomalies, but is not reliably detected on physical exam. Pulse oximetry (PO) is widely used to detect hypoxemia but its application in low-income countries has been limited, and its feasibility in the routine assessment of young infants (aged newborn to 59 days) has not…Corporation)  according to a standardized protocol. Performance time (PT) was the time between sensor placement and attainment of an acceptable reading (i.e., stable SpO2 + 1 % for at least 10 s, heart rate displayed, and adequate signal indicators). PT included the time for one repeat attempt at a different anatomical site if the first attempt did not yield an acceptable reading within one minute. Parent/guardian…

Issue Adolescent girls in Zambia face social constraints that have psychological effects and make girls vulnerable to early pregnancy, HIV, domestic abuse and school dropout. Teenage girls drop out of school at a rate three times higher than boys; the rate of HIV in young women is double the rate in young men and early childbearing is one of the biggest risk factors for death during delivery. Solution A randomized controlled trial (RCT) was conducted in Zambia to assess whether teaching negotiation skills that empower girls – without severing social ties…result in more favourable allocations of resources to combat risky sex and HIV transmission. The intervention isolated the impact of the curriculum by employing an innovative, three-arm design:  a control group that met in a safe space, an Info-only group that received HIV/AIDS information, and an Info/negotiation group that was given both the HIV/AIDS information and a negotiation…

…nation.Currently, programming on pregnancy and female empowerment is targeted towards in-school youth. This is problematic, as half of girls across the country are not in school due to issues like pregnancy, early marriage, and financial instability.This leaves girls vulnerable because of their economic dependence and lack of empowerment to missing out on soft skills programming…Experience curriculum. Out-of-school girls aged 12-24 in Western Uganda were equipped with the knowledge and skills to begin their own passionfruit farms. KadAfrica facilitated access to land for agricultural training.KadAfrica recruited 9 new cooperatives and a total of 264 girls. Participants were recruited through: outreach events at religious institutions, community meetings, and other organizations through partnerships.Each cooperative was assigned a dedicated agricultural trainer and a Peer Facilitator who conducted class lessons and provided one-on-one support. Over an 8 month period girls received training on topics such as menstruation, hygiene, pregnancy, abortion, safe-sex, family planning, and nutrition.KadAfrica then facilitated girls taking a government…

Issue Globally, more than 1.3 billion people, with many of these living in Africa, lack basic electricity. Many rely on expensive, polluting and harmful kerosene to light their homes. Observational and other studies suggest a relationship between indoor air pollution (IAP) and the incidence of a number of serious health problems, such as cancer and…the LED lamps. The most robust finding was an 18% increase in the number of children who shifted from using dirty lighting sources to renewable clean lighting for the purpose of studying. The study team felt the study period was too short to demonstrate other predicted positive impacts from the approach. The team also demonstrated…School of Economics and Political Science (LSE). The team intends to apply for Transition To Scale (TTS) funding for additional funds, to conduct a large-scale RCT. The next phase of scale-up will see Nuru establish 2,000 village-level recharging stations in Rwanda over a two-year period (2017 and 2018), with the delivery of 200,000 Nuru lights.