Prenatal calcium to prevent preeclampsia and preterm birth in resource-poor rural settings

The Hospital for Sick Children
Organization Location: 
Toronto, Canada

Problem: Hypertensive diseases of pregnancy (HDP) and preterm birth (PB) are major causes of maternal and newborn death, particularly in rural settings where access to emergency obstetric and neonatal care is limited.

Challenge: Prenatal calcium supplementation is a simple, low-cost intervention that could reduce maternal HDP-related mortality by 20% and PB by 24%. Yet, this seemingly simple intervention, prenatal calcium supplementation, has not been transitioned to scale because of unresolved technical challenges, including calcium-iron interactions, bulk and absorbability of supplemental calcium, and low adherence to prenatal tablet-based supplement regimens.

Innovation: We propose to develop a novel once-daily microencapsulated micronutrient powder containing iron, folic acid, and calcium (Prenatal Sprinkles) to overcome barriers to the integration of calcium into prenatal care in developing countries. If successful, our innovation – “differential time-release microencapsulation” – will mask the taste of iron and the gritty tongue-feel of calcium, and facilitate differential iron and calcium absorption.

Amenability to ‘integrated innovation’: We anticipate that novel once-daily Prenatal Sprinkles will be an effective means to supply supplemental calcium (and iron-folic acid) to pregnant women in rural settings, without causing adverse effects on iron absorption, thereby setting the stage for transition-to-scale efforts addressing community effectiveness, supply chain logistics, and demand creation. We have existing partnerships with the private sector in North America and internationally that will eventually enable the manufacturing of our new product in a timely fashion at the right price. As importantly, continuing collaborations with private and NGO sectors will facilitate market expansion, demand generation and international scale-up.

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