WiseMama Zambia and Babies Breathing Better-support IH faculty in the Saving Lives at Birth challenge!
Department of International Health faculty have been selected as finalists for the Gates Foundation-funded “Saving Lives at Birth” project. Their two proposals are described below. Unlike most of the peer-reviewed competitions we enter at DIH/CGHD, there is a “popular choice” option in this competition.
WiseMama Zambia: Feasibility, Acceptability and Preliminary Effect of Wireless Technology to Improve Adherence to Antiretroviral Therapy in Pregnant and Postpartum Women:
Antiretroviral therapy (ART) improves health and long-term survival of people living with HIV, but only if high adherence is maintained. Several studies have found perilously low ART adherence in pregnant and postpartum women (PPPW), the consequences which are dire: disease progression and death in women; HIV infection, death and orphanhood for babies; and a rise in drug resistant HIV. To improve ART adherence in PPPW, we will test the feasibility, acceptability, and preliminary effectiveness and cost-effectiveness of the use of wireless technology by PPPW and women’s support networks in Zambia. Our integrated approach taps the potential of wireless technology to monitor adherence in real time and engages PPPW and their support networks to use the data generated to improve adherence. Women will use a pill container that wirelessly monitors adherence and automatically sends a text message reminder to women who fail to take a dose on time. Women’s support groups will then use the monitoring data to provide follow up counseling and support. Demonstration of impact on adherence combined with cost data will enable us to evaluate the potential of this approach to help PPPW and all people living with HIV achieve the full life-saving benefits of ART. Our study will, for the first time, yield rigorous data on the effectiveness and cost-effectiveness of a novel ART adherence intervention that harnesses breakthrough wireless technology, women’s empowerment, and community-based service delivery to achieve healthy outcomes for mothers and babies.
Babies Breathing Better:
Indoor air pollution from burning biomass fuels increases the risk of low birth weight, prematurity, and pneumonia. With ≈1% of the Zambian population having access to improved stoves, most pregnant women and neonates are unprotected from indoor air pollutants. Little effort is invested in identifying interventions to reduce exposure of pregnant women and neonates to fine particles and carbon monoxide. Air quality interventions in homes of pregnant women and neonates have the potential to substantially reduce several causes of neonatal mortality (low birth weight, prematurity, and pneumonia). Among pregnant women, new mothers, and household decision-makers, we will evaluate acceptability and willingness to use/pay for structural interventions, such as improved stoves and solar fans, and behavioral interventions to reduce time spent near stoves. We will then evaluate the impact of an acceptable set of air quality interventions on maternal and neonatal exposure to air pollutants (PM2.5 and carbon monoxide). We will also assess feasibility of implementing recommended strategies, yielding information crucial to scale-up. This project is innovative in its goal to tackle the substantial risk posed to pregnant women and newborns by poor indoor air quality.
Link to proposals and voting: http://savinglivesatbirth.net/news/13/07/18/press-release-round-3-finalists-announced