Rose Weeks

Saving Lives at Birth: A Grand Challenge for Development

Last year, USAID, the Government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada, and The World Bank jointly launched Saving Lives at Birth: A Grand Challenge for Development to find tools and approaches for mothers and newborns in their most vulnerable hours. In the second round of the challenge, for which entries are due April 2, donor partners expect to award up to 30 grants.The challenge will award a total of $50 million over 5 years. This round, the partnership also welcomes a new partner, the United Kingdom’s Department for International Development (DFID).

The challenge responds to daunting health statistics:

The estimated 3.2 million stillbirths, 3.6 million neonatal deaths and 360,000 maternal deaths that occur globally each year signal a major gap for intervention specifically around childbirth and the early postnatal period – a time when mothers and babies are most vulnerable and global progress in reducing mortality has been particularly poor.

Accordingly, Saving Lives at Birth seeks out “radical” prevention or treatment interventions that can “leapfrog conventional approaches.” Submissions—whether they are at either seed stage or at “transition” stage with a proven concept ready to scale—should feature “breakthrough” technology, service delivery, and/or demand-generation activities.

I asked Wendy Taylor, director, Center for Accelerating Innovation and Impact within the Global Health Bureau at USAID, to explain what the partners are looking for and to discuss the first round winners.

RR: Are you looking to award both seed and transition grants this time?

WT: Much like our first round, applicants may apply for both seed and transition grants this round.

RR: Is there a requirement for the number of people a project must serve to be eligible for a transition grant?

WT: This program is not just about seeding new innovation but also investing in those most promising ideas that have the potential to scale up and sustain impact over time. Transition grants are intended to support an organization to develop, refine, and rigorously test the impact of an approach that has previously demonstrated proof-of-concept, which we define as having demonstrated beneficial health outcomes in controlled or limited settings and have the potential to credibly scale. There is no requirement for the number of people a scaled-up project must serve.

RR: There were three winners of transition grants in the last round. Can you describe what they will do?

WT: All three projects – Grameen Foundation USA (behind the MOTECH program), Columbia University, and JSI – were nominated for awards based on their promising and potentially groundbreaking innovation’s readiness to be tested on a much larger scale.

With the transition funds, Grameen will be able to scale up their mobile technology initiative, Mobile Technology for Community Health (MOTECH), to two new districts in Ghana to reach approximately 14,000 pregnant women and 46,000 children under five. Their integrated program – which enables midwives to communicate important information to patients via their mobile phones and allows community health workers to track and record important information on their patients – will increase access to accurate health information for pregnant women; generate increased demand for care before and after birth; and provide the Ghana Health Service with detailed information on health service delivery and outcomes.

Columbia University will further refine a novel, low-cost, and simple testing device for HIV and syphilis and begin deployment and planning for scale in Rwandan and other African community clinics. Early detection and treatment of sexually transmitted infections in pregnant mothers is an extremely cost-effective measure to avoid adverse health consequences to both mothers and their children, but these tests are often not available in rural and underserved areas. This potentially game-changing and unconventional approach to point of care diagnostics not only advances an important new front-line diagnostic, but it also transmits the results to a central health records database using mobile health technology. If successful, it will help ensure every mother is able to be tested and know her HIV and syphilis status; provide an easy-to-use and affordable device that links information to a central health records database; and help prevent thousands of stillbirths and reduce preventable health risks to mothers and children.

JSI will scale-up the use of the antiseptic chlorhexidine for newborn cord care in Nepal. In a pilot study, the promising impact of umbilical cord cleaning with chlorhexidine was proven to reduce the risk of death by 24 percent in Nepal. Using a highly integrated model that combines this promising innovation with a comprehensive approach to service delivery, community awareness and behavior change, and partnerships with the public and private sector, JSI will rapidly and sustainably increase demand, availability, and use of the product on a national scale. Few interventions have shown such promise for rapidly reducing newborn mortality in developing country settings.

RR: You are looking for innovations that can take root and scale in developing countries. Did you feel that the first round of funding focused sufficiently on organizations based in low- and middle-income countries?

WT: We established this program as a global call for the best ideas – regardless of where they come from. We also strongly believe that groundbreaking innovations can and will come from visionaries in low- and middle-income countries – where the problems are most acute. That is why we especially encourage applications from and partnerships with innovators in low- and middle-income countries (LMIC). In fact, in the first round, about a quarter of our applications were from these countries and that ratio held throughout our awards – a quarter our winners were from low- and middle-income countries. If you look at the partners for many of our awards, you’ll also see even broader participation from LMIC innovators and partners. We hope that in the second round we will continue to see strong participation from LMIC innovators.

RR: How new does a concept have to be to qualify?

WT: An innovation does not need to be new to qualify, but the idea shouldn’t be standard practice. In this round, we ask our applicants to specifically state why their concept is innovative and a significant improvement upon standard practice. For seed funds, innovative variations on existing approaches may be considered (e.g., a new means to deliver an existing service or a new way to make an old model demonstrably more effective or cost effective). Projects being considered for transition funds must have previously demonstrated beneficial health outcomes; the funding will support the development, refinement, and testing of the solution.

RR: Competitions have become a major feature in the development landscape. Do they have a unique ability to generate new solutions?

WT: The Grand Challenge model, pioneered by the Gates Foundation, is a great way of generating new solutions and reaching a diverse community of problem-solvers. Instead of saying we know the answer, we define the problem and crowd?source solutions – opening up the grand challenge to the world. This model, however, is new to USAID. We are thrilled to collaborate with the Government of Norway, the Gates Foundation, Grand Challenges Canada, DFID, and The World Bank in this endeavor. Through this model, we hope to yield tremendous gains in maternal and neonatal health.

RR: What’s happening at the Development Exchange July 2012 in Seattle? Will winners meet Bill Gates?!

WT: The DevelopmentXChange is a key feature of the Saving Lives at Birth program, and is designed to serve as the first step in building a community of innovators. Last year, we invited our 77 finalists to Washington, D.C. to participate in the XChange. They competed in the final stage of the review process; displayed their innovations in an open marketplace; participated in a series of workshops; and networked with other innovators, development experts, and each other. Though we’re still in the early planning stages, we envision this year’s DevelopmentXChange in Seattle to be equally exciting and rewarding for the participants. Finalists will benefit from new relationships, creative thinking and targeted training. In addition, by shining a spotlight on these innovators, we hope to inspire other innovators to take up the challenge and attract additional funding to this space – further leveraging our initial investment.

While we can’t yet guess who our finalists will meet this year, last year, the winners of both the People’s Choice and the Peer Choice Awards had the opportunity to meet Secretary Clinton!

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