Monday, November 28, 2011

Improving Maternal & Neonatal Health

More than 98 percent of maternal and neonatal deaths occur in low-resource settings. Strategies to reduce maternal and neonatal deaths are needed to improve access and care especially in home and community settings where over half of the more than 60 million births occur each year.

Delivering innovative technologies across the continuum of care including technologies for frontline workers to use not only in homes and communities but also in first level clinics may significantly improve pregnancy outcomes. However, no quantitative process currently exists to evaluate and prioritize technology development options based on the potential to save lives in low resource settings.

To address the problem, the Bill and Melinda Gates Foundation issued a new grant program to address “Grand Challenges in Global Health”. The grant program in partnership with the “Global Alliance to Prevent Prematurity and Stillbirth” (GAPPS) is seeking letters of inquiry starting in November with final letters of inquiry due January 31, 2012. For more information on this new grant program, go to

This initiative is hoping that the scientific knowledge on the causes and mechanisms important to preterm birth in developing countries would lead to low-cost novel technologies to address the problem

In another grant project to improve maternal and neonatal healthcare in low-resource countries, RTI International developed a web-based tool to objectively assess the impact of new medical technologies on maternal, fetal, and neonatal mortality. The assessment tool “Maternal and Neonatal Directed Assessment of Technology” or referred to as MANDATE is also being developed with funding from the Bill & Melinda Gates Foundation.

By calculating the potential number of maternal and neonatal lives saved, the tool allows users to identify and compare the potential impact of a technology. Users may adjust variables related to a technology’s availability, appropriate use, and efficacy to determine how a technology might be improved to have the greatest impact.

Once the variables are set by the user, MANDATE can determine the technology’s potential impact by patient category, medical condition and healthcare settings in sub-Saharan Africa and South Asia, the regions with the highest burden of mortality. The tool will soon be available to the public on the MANDATE website at free of charge.

“Some very good technologies are simply not practical for use in low-resource settings,” said Doris Rouse, PhD, Project Director and Vice President of Global Health Technologies at RTI. “In some cases, innovative, low-tech solutions are more appropriate in these settings. MANDATE enables the user to assess the reduction in maternal and neonatal mortality that might results from a new or improved technology that is more appropriate or effective in specific settings.”

With other grant funding, researchers at Ecole de Technologie Superieure in Canada with funding from the Gates Foundation Grand Challenges Exploration Grants are designing and testing a diagnostic tool using computer acoustical analysis of newborn cries to better detect medical conditions such as asphyxia, hypoglycemia, and infections.

With funding from another Gates Foundation Grand Challenges Exploration grant, researchers of Global Health Partnerships and the University of New Mexico are going to work with care providers in Nepal to evaluate the use and acceptance of inexpensive devices constructed from local materials that works to decrease blood flow to the pelvic organs for treating post-partum hemorrhage, a major cause of maternal morbidity and mortality in the developing world.