Transformative Innovations in Reproductive, Maternal, Newborn, and Child Health over the Next 20 Years

As part of the "Grand Convergence:
Aligning Technologies and Realities in Global Health" Collection, Cyril Engmann and colleagues discuss promising innovations that have the potential to move the RMNCH agenda forward.

Vyšlo v časopise: Transformative Innovations in Reproductive, Maternal, Newborn, and Child Health over the Next 20 Years. PLoS Med 13(3): e32767. doi:10.1371/journal.pmed.1001969
Kategorie: Collection Review
prolekare.web.journal.doi_sk: 10.1371/journal.pmed.1001969


As part of the "Grand Convergence:
Aligning Technologies and Realities in Global Health" Collection, Cyril Engmann and colleagues discuss promising innovations that have the potential to move the RMNCH agenda forward.


1. Verguet S, Norheim O, Olson Z, Yamey G, Jamison D. Annual rates of decline in child, maternal, HIV, and tuberculosis mortality across 109 countries of low and middle income from 1990 to 2013: an assessment of the feasibility of post-2015 goals. Lancet Glob Health. 2014;2(12): e698–e709. doi: 10.1016/S2214-109X(14)70316-X 25433625

2. Kassebaum N, Bertozzi-Villa A, Coggeshall M, Shackelford K, Steiner C, Heuton K, et al. Global, Regional, and National Levels and Causes of Maternal Mortality During 1990–2013: A Systematic Analysis for the Global Burden of Disease Study 2013. The Lancet. 2014;384(9947): 980–1004.

3. Wang H, Liddell C, Coates M, Mooney M, Levitz C, Schumacher A et al. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet. 2014;384(9947): 957–979.

4. Lozano R, Wang H, Foreman K, Rajaratnam J, Naghavi M, Marcus J et al. Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. The Lancet. 2011;378(9797): 1139–1165.

5. Viner R, Coffey C, Mathers C, Bloem P, Costello A, Santelli J et al. 50-year mortality trends in children and young people: a study of 50 low-income, middle-income, and high-income countries. The Lancet. 2011;377(9772): 1139–1165.

6. Naghavi M, Wang H, Lozano R, Davis A, Liang X, Zhou M, et al. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet. 2015;385(9963): 117–71.

7. Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn J et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. The Lancet. 2015;385(9966): 430–440.

8. Lawn J, Blencowe H, Oza S, You D, Lee A, Waiswa P et al. Every Newborn: progress, priorities, and potential beyond survival. The Lancet. 2014;384(9938): 189–205.

9. Official Development Assistance 2014 (by OECD) [Internet]. 2015 [cited 22 December 2015].

10. Hsu J, Pitt C, Greco G, Berman P, Mills A. Countdown to 2015: changes in official development assistance to maternal, newborn, and child health in 2009–10, and assessment of progress since 2003. The Lancet. 2012;380(9848): 1157–1168.

11. WHO Global Health Expenditure Database. Rwanda 2013 [Internet]. 2015 [cited 16 November 2015].

12. World Bank | World Development Indicators. Data [Internet]. 2015 [cited 16 November 2015].

13. OECD. Development Co-operation Report 2014: Mobilising Resources for Sustainable Development. Paris: OECD Publishing; 2014.

14. Singh S, Darroch J, Ashford L. Adding It Up: The Costs and Benefits of Investing in Sexual and Reproductive Health 2014. New York: Guttmacher Institute; 2014.

15. Ahman E, Shah I. New estimates and trends regarding unsafe abortion mortality. Int J Gynaecol Obstet. 2011;115(2): 121–126. doi: 10.1016/j.ijgo.2011.05.027 21885049

16. Nara P, Nara D, Chaudhuri R, Lin G, Tobin G. Perspectives on advancing preventative medicine through vaccinology at the comparative veterinary, human and conservation medicine interface: Not missing the opportunities. Vaccine. 2008;26(49): 6200–6211. doi: 10.1016/j.vaccine.2008.07.094 18708109

17. Pilishvili T, Lexau C, Farley M, Hadler J, Harrison L, Bennett N et al. Sustained Reductions in Invasive Pneumococcal Disease in the Era of Conjugate Vaccine. J Infect Dis. 2010;201(1): 32–41. doi: 10.1086/648593 19947881

18. Bustreo F, Okwo-Bele J, Kamara L. World Health Organization perspectives on the contribution of the Global Alliance for Vaccines and Immunization on reducing child mortality. Arch Dis Child. 2015;100(Suppl 1): S34–S37. doi: 10.1136/archdischild-2013-305693 25613965

19. Omer S, Goodman D, Steinhoff M, Rochat R, Klugman K, Stoll B et al. Maternal Influenza Immunization and Reduced Likelihood of Prematurity and Small for Gestational Age Births: A Retrospective Cohort Study. PLoS Med. 2011;8(5): e1000441. doi: 10.1371/journal.pmed.1000441 21655318

20. Carlo W, Goudar S, Jehan I, Chomba E, Tshefu A, Garces A et al. Newborn-Care Training and Perinatal Mortality in Developing Countries. N Engl J Med. 2010;362(7): 614–623. doi: 10.1056/NEJMsa0806033 20164485

21. Goudar S, Somannavar M, Clark R, Lockyer J, Revankar A, Fidler H et al. Stillbirth and Newborn Mortality in India After Helping Babies Breathe Training. Pediatrics. 2013;131(2): e344–e352. doi: 10.1542/peds.2012-2112 23339215

22. Pai NP, Dhurat R, Potter M, Behlim T, Landry G, Vadnais C, et al. Will a quadruple multiplexed point-of-care screening strategy for HIV-related co-infections be feasible and impact detection of new co-infections in at-risk populations? Results from cross-sectional studies. BMJ Open. 2014;4(12): e005040. doi: 10.1136/bmjopen-2014-005040 25510882

23. Lucignano B, Ranno S, Liesenfeld O, Pizzorno B, Putignani L, Bernaschi P et al. Multiplex PCR Allows Rapid and Accurate Diagnosis of Bloodstream Infections in Newborns and Children with Suspected Sepsis. J Clin Microbiol. 2011;49(6): 2252–2258. doi: 10.1128/JCM.02460-10 21471340

24. Zumla A, Al-Tawfiq J, Enne V, Kidd M, Drosten C, Breuer J et al. Rapid point of care diagnostic tests for viral and bacterial respiratory tract infections—needs, advances, and future prospects. Lancet Infect Dis. 2014;14(11): 1123–1135. doi: 10.1016/S1473-3099(14)70827-8 25189349

25. Rasanen J, Quinn M, Laurie A, Bean E, Roberts C, Nagalla S et al. Maternal serum glycosylated fibronectin as a point-of-care biomarker for assessment of preeclampsia. Am J Obstet Gynecol. 2015;212(1): 82.e1–82.e9.

26. Chan R. Biochemical Markers of Spontaneous Preterm Birth in Asymptomatic Women. BioMed Res Int. 2014;2014: 1–8.

27. Polsani S, Phipps E, Jim B. Emerging New Biomarkers of Preeclampsia. Adv Chronic Kidney Dis. 2013;20(3): 271–279. doi: 10.1053/j.ackd.2013.01.001 23928393

28. Acestor N, Goett J, Lee A, Herrick T, Engelbrecht S, Harner-Jay C et al. Towards biomarker-based tests that can facilitate decisions about prevention and management of preeclampsia in low-resource settings. Clin Chem Lab Med. 2015.

29. Ma Y, Vilanova D, Atalar K, Delfour O, Edgeworth J, Ostermann M et al. Genome-Wide Sequencing of Cellular microRNAs Identifies a Combinatorial Expression Signature Diagnostic of Sepsis. PLoS ONE. 2013;8(10): e75918. doi: 10.1371/journal.pone.0075918 24146790

30. Berg J, Khoury M, Evans J. Deploying whole genome sequencing in clinical practice and public health: Meeting the challenge one bin at a time. Genet Med. 2011;13(6): 499–504. doi: 10.1097/GIM.0b013e318220aaba 21558861

31. Bhattacharjee A, Sokolsky T, Wyman S, Reese M, Puffenberger E, Strauss K et al. Development of DNA Confirmatory and High-Risk Diagnostic Testing for Newborns Using Targeted Next-Generation DNA Sequencing. Genet Med. 2014;17(5): 337–347. doi: 10.1038/gim.2014.117 25255367

32. Wlodarska M, Johnston J, Gardy J, Tang P. A Microbiological Revolution Meets an Ancient Disease: Improving the Management of Tuberculosis with Genomics. Clin Microbiol Rev. 2015;28(2): 523–539. doi: 10.1128/CMR.00124-14 25810419

33. Piumelli R, Nassi N, Liccioli G, Ernst C, Donzelli G. Telemonitoring for infants at risk of apnoea, bradycardia and hypoxaemia: transmission of data improves the family compliance during home monitoring. J Telemed Telecare. 2012;18(6): 344–347. doi: 10.1258/jtt.2012.120405 22933479

34. Liu H, Wang Y, Wang L. A review of non-contact, low-cost physiological information measurement based on photoplethysmographic imaging. Conf Proc IEEE Eng Med Biol Soc. 2012;2012: 2088–91. doi: 10.1109/EMBC.2012.6346371 23366332

35. Petersen CL, Chen TP, Ansermino JM, Dumont GA. Design and evaluation of a low-cost smartphone pulse oximeter. Sensors (Basel). 2013;13(12): 16882–93.

36. Abo-Zahhad M, Ahmed SM, Elnahas O. A wireless emergency telemedicine system for patients monitoring and diagnosis. Int J Telemedicine Appl. 2014;2014:1–11.

37. Kim HW, Greenburg AG: Toward 21st century blood component replacement therapeutics: artificial oxygen carriers, platelet substitutes, recombinant clotting factors, and others. Artif Cells Blood Subsit Immobil Biotechnol. 2006; 34(6): 537–550.

38. Grethlein S, Rajan A. Blood Substitutes [Internet]. 2015 [cited 3 February 2015].

39. PATH. Blood Substitutes: Technology Opportunities Assessment [Internet]. Seattle: PATH; 2012 p. 1–5.

40. Jahr JS, Akha AS, Holtby RJ. Crosslinked, polymerized, and PEG-conjugated hemoglobin-based oxygen carriers: clinical safety and efficacy of recent and current products. Curr Drug Discov Technol. 2012;9(3): 158–165. 21745179

41. Varnado CL, Mollan TL, Birukou I, Smith BJ, Henderson DP, Olson JS. Development of recombinant hemoglobin-based oxygen carriers. Antioxid Redox Signal. 2013;18(17):2314–2328. doi: 10.1089/ars.2012.4917 23025383

42. HaemO2—Creating a safe blood substitute for the 21st century [Internet]. 2015 [cited 22 March 2015].

43. Reeder BJ, Grey M, Silaghi-Dumitrescu RL, Svistunenko DA, Bulow L, Cooper CE, et al. Tyrosine residues as redox cofactors in human hemoglobin: implications for engineering nontoxic blood substitutes. J Biol Chem. 2008;283(45): 30780–30787. doi: 10.1074/jbc.M804709200 18728007

44. Say L, Chou D, Gemmill A, Tunçalp Ö, Moller A, Daniels J et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6): e323–e333. doi: 10.1016/S2214-109X(14)70227-X 25103301

45. World Health Organization (WHO). WHO Recommendations for the Prevention and Treatment of Postpartum Haemorrhage [Internet]. Geneva: World Health Organization (WHO); 2012.

46. PATH. Technical Reference Team Recommendation 10: Product Innovation [Internet]. Seattle: PATH; 2012.

47. Hodgins S. Oxytocin: taking the heat. Glob Health Sci Pract. 2014;2(3):259–260. doi: 10.9745/GHSP-D-14-00102 25276584

48. Duley L, Gülmezoglu A, Henderson-Smart D, Chou D. Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev. 2010.

49. Lumbiganon P, Metin Gulmezoglu A, Piaggio G, Langer A, Grimshaw J. Magnesium sulfate is not used for pre-eclampsia and eclampsia in Mexico and Thailand as much as it should be. Bull World Health Organ. 2007;85(10): 763–767. 18038057

50. Bigdeli M, Zafar S, Assad H, Ghaffar A. Health System Barriers to Access and Use of Magnesium Sulfate for Women with Severe Pre-Eclampsia and Eclampsia in Pakistan: Evidence for Policy and Practice. PLoS ONE. 2013;8(3): e59158. doi: 10.1371/journal.pone.0059158 23555626

51. RMNCH Strategy & Coordination team. UN Commission on Life Saving Commodities: 2014 Progress Report [Internet]. independent Expert Review Group (iERG), World Health Organization; 2015.

52. PATH. Saving Women's Lives by Simplifying the Treatment for Preeclampsia/Eclampsia with Rectally Delivered Magnesium Sulfate [Internet]. Saving Lives at Birth: A Grand Challenge for Development. 2013 [cited 7 December 2015].

53. Ensor T, Cooper S. Overcoming barriers to health service access: influencing the demand side. Health Policy Plan. 2004;19(2): 69–79. 14982885

54. Tamrat T, Kachnowski S. Special Delivery: An Analysis of mHealth in Maternal and Newborn Health Programs and Their Outcomes Around the World. Matern Child Health J. 2011;16(5):1092–1101.

55. Kallander K, Tibenderana JK, Akpogheneta OJ, Strachan DL, Hill Z, ten Asbroek AH, et al. Mobile health (mHealth) approaches and lessons for increased performance and retention of community health workers in low- and middle-income countries: a review. J Med Internet Res. 2013;15(1): e17. doi: 10.2196/jmir.2130 23353680

56. Agarwal S, Labrique A. Newborn health on the line: the potential mHealth applications. JAMA. 2014;312(3): 229–230. doi: 10.1001/jama.2014.6371 24953141

57. Ngabo F, Nguimfack J, Nwaigwe F, Mugeni C, Muhoza D, Wilson DR, et al. Designing and Implementing an Innovative SMS-based alert system (RapidSMS-MCH) to monitor pregnancy and reduce maternal and child deaths in Rwanda. Pan Afr Med J. 2012;13:31. 23330022

58. Gisore P, Shipala E, Otieno K, Rono B, Marete I, Tenge C, et al. Community based weighing of newborns and use of mobile phones by village elders in rural settings in Kenya: a decentralised approach to health care provision. BMC Pregnancy Childbirth. 2012;12:15. doi: 10.1186/1471-2393-12-15 22429731

59. McNabb M, Chukwu E, Ojo O, Shekhar N, Gill CJ, Salami H, et al. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study. PLoS ONE. 2015;10(5): e0123940. doi: 10.1371/journal.pone.0123940 25942018

60. Piette JD, Marinec N, Gallegos-Cabriales EC, Gutierrez-Valverde JM, Rodriguez-Saldana J, Mendoz-Alevares M, et al. Spanish-speaking patients' engagement in interactive voice response (IVR) support calls for chronic disease self-management: data from three countries. J Telemed Telecare. 2013;19(2): 89–94. doi: 10.1177/1357633X13476234 23532005

61. Tomlinson M, Rotheram-Borus M, Swartz L, Tsai A. Scaling Up mHealth: Where Is the Evidence?. PLoS Med. 2013;10(2): e1001382. doi: 10.1371/journal.pmed.1001382 23424286

62. Piette J, Lun K, Moura L, Fraser H, Mechael P, Powell J et al. Impacts of e-health on the outcomes of care in low- and middle-income countries: where do we go from here?. Bull World Health Organ. 2012;90(5): 365–372. doi: 10.2471/BLT.11.099069 22589570

63. Moyer CA, Adongo PB, Aborigo RA, Hodgson A, Engmann CM, Devries R. "It's up to the woman's people": how social factors influence facility-based delivery in Rural Northern Ghana. Matern Child Health J. 2014;18(1): 109–119. doi: 10.1007/s10995-013-1240-y 23423857

64. Pathmanathan I, Liljestrand J, Martins J, Rajapaksa L, Lissne C, de Silva A. Investing effectively in maternal health in Malaysia and Sri Lanka. Washington (DC): The World Bank. 2003.

65. Sakeah E, Doctor HV, McCloskey L, Bernstein J, Yeboah-Antwi K, Mills S. Using the community-based health planning and services program to promote skilled delivery in rural Ghana: socio-demographic factors that influence women utilization of skilled attendants at birth in northern Ghana. BMC Public Health. 2014;14: 344. doi: 10.1186/1471-2458-14-344 24721385

66. Ramundo K. The Female "Army" Leading Ethiopia's Health Revolution. Frontlines, USAID [Internet]. 2012 [cited 22 December 2015];(May/June 2012): 28–31.

67. Saprii L, Richards E, Kokho P, Theobald S. Community health workers in rural India: analysing the opportunities and challenges Accredited Social Health Activists (ASHAs) face in realising their multiple roles. Human Resources for Health. 2015;13(1).

68. Tshefu A, Lokangaka A, Ngaima S, Engmann C, Esamai F, Gisore P et al. Simplified antibiotic regimens compared with injectable procaine benzylpenicillin plus gentamicin for treatment of neonates and young infants with clinical signs of possible serious bacterial infection when referral is not possible: a randomised, open-label, equivalence trial. The Lancet. 2015;385(9979): 1767–1776.

69. Furtwangler T. Innovative health sector financing: the Vaccine Independence Initiative [Internet]. PATH blog. 2015 [cited 22 December 2015].

70. Fryatt R, Mills A, Nordstrom A. Financing of health systems to achieve the health Millennium Development Goals in low-income countries. The Lancet. 2010;375(9712): 419–426.

71. Vega J. Universal health coverage: the post-2015 development agenda. The Lancet. 2013;381(9862): 179–180.

72. Marten R, McIntyre D, Travassos C, Shishkin S, Longde W, Reddy S, et al. An assessment of progress towards universal health coverage in Brazil, Russia, India, China, and South Africa (BRICS). The Lancet. 2014;384(9960): 2164–2171.

73. McKinnon B, Harper S, Kaufman JS, Bergevin Y. Removing user fees for facility-based delivery services: a difference-in-differences evaluation from ten sub-Saharan African countries. Health Policy Plan. 2015;30(4): 432–441. doi: 10.1093/heapol/czu027 24816570

74. Amoako Johnson F, Frempong-Ainguah F, Padmadas S. Two decades of maternity care fee exemption policies in Ghana: have they benefited the poor?. Health Policy Plan. 2015;31(1):46–55. doi: 10.1093/heapol/czv017 25862731

75. Dzakpasu S, Powell-Jackson T, Campbell OM. Impact of user fees on maternal health service utilization and related health outcomes: a systematic review. Health Policy Plan. 2014;29(2): 137–150. doi: 10.1093/heapol/czs142 23372035

76. Glassman A, Duran D, Fleisher L, Singer D, Sturke R, Angeles G, et al. Impact of conditional cash transfers on maternal and newborn health. J Health Popul Nutr. 2013;31(4 Suppl 2): 48–66. 24992803

77. Oyebola BC, Muhammad F, Otunomeruke A, Galadima A. Effect of performance-based incentives for traditional birth attendants on access to maternal and newborn health-care facilities in Gombe State, Nigeria: a pilot study. The Lancet. 2014;384: S10.

78. Setel PW, Macfarlane SB, Szreter S, Mikkelsen L, Jha P, Stout S, et al. A scandal of invisibility: making everyone count by counting everyone. The Lancet. 2007;370(9598): 1569–1577.

79. Engmann C, Garces A, Jehan I, Ditekemena J, Phiri M, Thorsten V, et al. Birth attendants as perinatal verbal autopsy respondents in low- and middle-income countries: a viable alternative?. Bull World Health Organ. 2012;90(3): 200–208. doi: 10.2471/BLT.11.092452 22461715

80. Mahapatra P, Shibuya K, Lopez AD, Coullare F, Notzon FC, Rao C, et al. Civil registration systems and vital statistics: successes and missed opportunities. The Lancet. 2007;370(9599):1653–1663.

81. UNICEF, UNICEF. Every Child’s Birth Right: Inequities and trends in birth registration. New York: UNICEF. 2013.

82. Aborigo RA, Moyer CA, Gupta M, Adongo PB, Williams J, Hodgson A, Allote P, Engmann CM. Obstetric danger signs and factors affecting health seeking behaviour among the Kassena-Nankani of northern Ghana: a qualitative study: original research article. Afr J Reprod Health. 2014;18(3): 78–86. 25438512

83. Hill E, Hess R, Aborigo R, Adongo P, Hodgson A, Engmann C, et al. "I don't know anything about their culture": the disconnect between allopathic and traditional maternity care providers in rural northern Ghana. Afr J Reprod Health. 2014;18(2): 36–45. 25022140

84. Engmann C. Improving neonatal mortality in sub-Saharan Africa: any cause for optimism?. J Perinatol. 2011;31(12):745–748. doi: 10.1038/jp.2011.53 22124515

85. Owais A, Sultana S, Stein AD, Bashir NH, Awaldad R, Zaidi AK. Why do families of sick newborns accept hospital care? A community-based cohort study in Karachi, Pakistan. J Perinatol. 2011;31(9): 586–592. doi: 10.1038/jp.2010.191 21273989

86. Mangham LJ, Hanson K. Scaling up in international health: what are the key issues?. Health Policy Plan. 2010;25(2): 85–96. doi: 10.1093/heapol/czp066 20071454

87. Engmann C, Garces A, Jehan I, Ditekemena J, Phiri M, Mazariegos M, et al. Causes of community stillbirths and early neonatal deaths in low-income countries using verbal autopsy: an International, Multicenter Study. J Perinatol. 2012;32(8): 585–592. doi: 10.1038/jp.2011.154 22076413

88. Engmann C, Wall S, Darmstadt G, Valsangkar B, Claeson M. Consensus on kangaroo mother care acceleration. The Lancet. 382(9907):e26–e27.

89. Hayden EC. Maternal health: Ebola's lasting legacy. Nature. 2015;519(7541): 24–26. doi: 10.1038/519024a 25739614

90. World Health Organization (WHO). Strategic plan for polio outbreak response in the Middle East November, 2013. The Syrian Arab Republic, Iraq, Jordan, Lebanon, Turkey, West Bank and Gaza Strip. [Internet]. Geneva: World Health Organization (WHO); 2013.

91. Emerging economies drive frugal innovation. Bull World Health Organ. 2013;91(1): 6–7. doi: 10.2471/BLT.13.020113 23397344

92. Requejo J, Bhutta Z. The post-2015 agenda: staying the course in maternal and child survival. Arch Dis Child. 2015;100(Suppl 1): S76–S81. doi: 10.1136/archdischild-2013-305737 25613979

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