Application for Transition Grant
The persistence of mortality and severe morbidity from pre-eclampsia and eclampsia (PE/E) demands a new approach. Jhpiego—in a growing collaboration with Johns Hopkins University Center for Biomedical Innovation and Design (JHU-CBID), Laerdal Global Health, and other manufacturers—is making available new technologies and offering selected interventions through a new community-centered platform to reduce PE/E, the second leading cause of maternal mortality (after hemorrhage) worldwide. Jhpiego proposes to demonstrate the potential impact and scalability of a Universal Coverage Platform comprising community- centered prevention, detection and management of PE/E, and extending the continuum of knowledge regarding skills for, awareness of, life-saving solutions to PE/E—which are capable of reaching millions of underserved or unreached pregnant women. This approach blends evidence-based interventions with low-cost, appropriate technologies to facilitate greater access and uptake for pregnant women, including: Calcium “Sprinkles” (calcium supplementation) for primary prevention; a highly-affordable device to screen for elevated blood pressure at the community level; and a revised protocol for provision of a loading dose of magnesium sulfate for treatment of eclampsia convulsions and referral to a facility for emergency obstetric care. This platform package is designed for earlier detection of PE/E, and earlier initiation of treatment, and earlier referral to emergency obstetric care—key to reducing mortality and morbidity. The main change agents for this platform are community health workers (CHWs) and formal health system workers in remote areas closest to many women who have not been trained in nor empowered to provide critical PE/E services (peripheral health care workers PHCWs).