Four initiatives from across Africa win share of global US$1 million Healthcare Innovation Award

Issued: London, UK

• Organisations from South Africa, Zambia, Kenya and Uganda recognised by GSK and Save the Children for innovations proven to help reduce deaths in under-fives

A simple mobile-phone app that helps staff at human milk banks (HMBs) with the pasteurisation of donor breast milk and a life-saving kit for the treatment of diarrhoea in under-fives have been awarded joint first prize in the annual GSK and Save the Children $1 million Healthcare Innovation Award. The University of Kwazulu-Natal (UKZN) and ColaLife Zambia were each awarded $370,000 for their innovative approaches to helping reduce deaths among newborns and infants.

The ‘FoneAstra’ human milk pasteurisation toolkit, originally developed by the University of KwaZulu-Natal in collaboration with health NGO PATH and the University of Washington, uses a mobile phone app to provide a step-by-step guide through the pasteurisation process. The app makes it easier to track and trace donor milk for increased quality control and assurance and can be adapted for use in settings with no electricity. Up to 25 per cent of premature or low birth-weight babies cannot get sufficient breast milk from their mothers, often for reasons of illness or low supply, which leaves them more vulnerable to life threatening conditions such as diarrhoea, pneumonia and neonatal sepsis.

Currently used in four milk banks at district-level hospitals in South Africa, the team from the Department of Paediatrics and Child Health at UKZN, is also, in collaboration with the Department of Health, rolling out the FoneAstra system to an additional five district hospitals across the KwaZulu-Natal Province. The team aims to set up a network of human milk banks across the country, which will act as local focal points for breast-feeding promotion and support beyond the district hospital level, reaching the needs of newborns and vulnerable infants in the community.

Professor Anna Coutsoudis, Department of Paediatrics and Child Health, UKZN, said: “Breastfeeding is one of the key strategies in South Africa for reducing infant mortality. Donated breast milk is a lifeline for premature babies whose mothers aren’t able to give them the nutrition they need. The FoneAstra system makes it much easier to provide safe donated milk and set up small-scale human milk banks in poorer settings as part of a comprehensive breast-feeding promotion campaign.” 

Joint first prize winner, ColaLife Zambia, won its award for its innovative ‘Kit Yamoyo’ (‘Kit of Life’), which brings affordable diarrhoea treatment to families in remote rural areas using the supply and distribution networks normally used to transport soft drinks. Diarrhoea is one of the world’s biggest killers of children under five. It can be simply treated using oral rehydration salts (ORS) and Zinc, yet less than one per cent of children in sub-Saharan Africa receive the treatment. In Zambia, ColaLife found that many parents were unaware of the correct treatment for diarrhoea and that suitable treatment options were not widely available.

ColaLife worked with mothers to design the specially tailored, low-cost treatment kit. Each kit contains 200ml sachets of ORS, 10 zinc tablets and soap, all packaged in a container that serves as a measure for the correct amount of water, a mixing and storage device, and cup for administering the ORS. It is promoted through rural health centres by community health workers and delivered by trained local village-based micro-retailers. Retailers travel to the nearest district town to buy the kits the same way they do for other fast moving consumer goods such as Coca-Cola, cooking oil, salt and sugar. At the end of a 12-month trial in Zambia, 45 per cent of children with diarrhoea received the correct treatment for diarrhoea. A Lives Saved Tool (LiST) estimate suggests that one life is saved for every 330 kits sold.  To date, 50,000 kits have been distributed.

Simon Berry, founder of ColaLife and project manager of the Kit Yamoyo trial, said: “We wanted our diarrhoea treatment kits to be as ubiquitous as Coca-Cola in remote village kiosks so we use existing private sector distribution networks to achieve this goal. The secret is that everyone in the value chain – manufacturer, distributor, wholesaler and retailer – makes a profit. That way, it’s a fully sustainable supply network and parents get the medicines they need for their children, closer to their home and at prices most can afford.” 

Ramil Burden, Vice President Africa and Developing Countries, GSK, said: “Innovation in healthcare is at the heart of GSK’s partnership with Save the Children.  We want to recognise excellent initiatives such as these, which are making a huge difference to the communities they operate in, often through simple changes and low-cost technologies. The Award will help them replicate and scale up their projects to ensure more young lives can be saved.”

Mavis Owusu-Gyamfi, Director of Programme, Policy and Quality, Save the Children, said: “The best solutions for complex problems are often created by people affected by or closest to the problem. Unfortunately many of these solutions very rarely get to scale.  So it is fantastic that the Healthcare Innovation Award has recognised pioneering healthcare solutions that have implemented to help save children’s lives. Through the recognition and funding from this Award these winning innovations can be replicated to help make a bigger impact for the world’s most vulnerable children.”

ColaLife Zambia and UKZN’s FoneAstra toolkit were two of four African initiatives, chosen from a list of over 100 applications from countries across the developing world, selected by a judging panel of experts from the fields of public health and development.

Two other organisations awarded grants from the $1 million fund were:

• University of Nairobi, Kenya – awarded $120,000 for an innovation designed to tackle child deaths using a bar-coded Vaccination/Mother-Child Wellness Card that tracks vaccinations and rewards mothers with discounts on farm products. Child immunisation is seen as a critical measure to reduce death rates in children under five which currently stand at 71 per 1,000 live births in Kenya^[1].The vaccination card automatically updates when a newborn is registered and each time the child and/or mother receives a vaccine.  It then allows the mother discounts on farm products, such as seeds and fertilizer, from Agrovets shops run by the University’s partner agency.
• Living Goods, Uganda – awarded $120,000 to support the expansion of its innovative approach to tackling child deaths in remote areas by bringing life-saving health services directly to people’s doorsteps. Skilled micro-entrepreneurs known as Community Health Promoters, who work closely with local health authorities, operate as franchisees. The health promoters travel door-to-door teaching families how to improve their health, and diagnosing and treating patients. They also sell health products such as bed nets, de-worming pills, anti-malaria and diarrhoea treatments, fortified foods, and water filters.

The Healthcare Innovation Award is a key initiative delivered as part of an ambitious partnership between GSK and Save the Children, which aims to deliver a new model for corporate-charity working to help save the lives of one million of the world’s most vulnerable children.

Notes to editors

About the Healthcare Innovation Award

In 2013, GSK and Save the Children launched the first US$1 million Healthcare Innovation Award to identify and reward innovations that have proven successful in reducing child deaths in developing countries. As the best solutions to a particular challenge often come from those living and working closest to it, organisations from across the developing world were invited to nominate examples of innovative healthcare approaches they have discovered or implemented. Entrants to the Award had to ensure their approaches had resulted in tangible improvements to under-five child survival rates, were sustainable and have the potential to be replicated. The Award will continue annually until at least 2017.

About the GSK and Save the Children partnership

GSK and Save the Children have formed a long-term strategic global partnership combining their expertise, resources and influence to help save the lives of one million children. The new partnership is ambitious and innovative, and goes well beyond the traditional charity-corporate fundraising model. The partnership will touch many areas of GSK’s business, in particular using its R&D potential to save children’s lives. Through this partnership GSK and Save the Children will focus on:

• Developing child-friendly medicines to reduce child mortality and newborn deaths
• Widening vaccination coverage to reduce the number of child deaths in the hardest to reach communities
• Researching new affordable nutritional products to address the needs of children to help alleviate malnutrition
• Increasing investment in the training, reach and scope of health workers in the poorest communities to help reduce child mortality.

The GSK and Save the Children Healthcare Innovation Award judging panel (In alphabetical order) 

• Dr Mushtaque Chowdhury – Vice-Chairperson and Interim Executive Director of BRAC, Dr Chowdhury was a co-ordinator of the UN Millennium Task Force on Child and Maternal Health.
• Pamela Hartigan – Director of the Skoll Centre at The University of Oxford’s Saïd Business School, Adjunct Professor at Columbia Business School and co-founder of London-based Volans Ventures.
• Parveen June Kumar CBE – Former President of the British Medical Association, and President of the Royal Society of Medicine from 2010-2012, Professor Kumar (Barts and the London School of Medicine and Dentistry) became the first recipient of the Asian Woman of the Year (Professional) award in 1999, has held roles in the Medicines Commission UK, and is author of Clinical Medicine.
• Professor Joy Lawn - Professor of Maternal, Reproductive and Child Health and Director of the MARCH Centre at the London School of Hygiene and Tropical Medicine.
• Professor Alejandro Madrigal - Originally from Mexico, Professor Madrigal is Scientific Director of Anthony Nolan and President of the European Group for Blood and Marrow Transplantation (EBMT).
• Professor Angela A Okolo, FRCPCH, FWACP, FMCPed- Fellow of the Royal College of Paediatrics and Child health in the UK, and the American Academy of Paediatrics.
• Sir Michael Rawlins – Chairman of the National Institute for Health and Clinical Excellence (NICE) from its inception in 1999 until 2012, Sir Michael was then President of the Royal Society of Medicine until May 2014.

The judging panel was co-chaired by Sir Andrew Witty, CEO of GSK and Justin Forsyth, CEO of Save the Children. Andrew and Justin were represented at the judging panel meeting in person by:

• Ramil Burden (GSK) – Vice President, Africa and  Developing Countries
• Mavis Owusu-Gyamfi (Save the Children) - Director of International Programme Policy and Quality

Winners of the 2014 GSK and Save the Children Healthcare Innovation Award:

University of KwaZulu-Natal, South Africa – $370,000

• The University of KwaZulu-Natal (UKZN)’s winning innovation is designed to help premature or low birth-weight babies whose mothers cannot give them the breast milk they need. This leaves these infants more vulnerable to life threatening conditions such as diarrhoea, pneumonia and neonatal sepsis as human milk is much healthier for them than formula.
• The University’s Department of Paediatrics and Child Health worked with global NGO PATH and the University of Washington to develop a ground-breaking low-cost system that allows for the safe pasteurisation and storage of donated human breast milk. The ‘FoneAstra’ system uses a mobile phone app to guide milk bank staff through the process.
• Over the past two years, four small milk banks have been set up using the FoneAstra system. Most of the banks have successfully recruited an average of 5-10 donors per month - on average one donor will provide enough milk to support two pre-term babies for a few weeks, impacting 10-12 babies per month.
• The University team plans to use the award money, in collaboration with the Department of Health, to set up 5-6 model community-based human milk banks and breastfeeding support centres in the KwaZulu-Natal province.  The University will conduct an evaluation of the intervention to inform any plans for scale-up of these systems in other parts of South Africa, Africa and India.
• UKZN’s innovation was selected as an award winner due its proven viability and impact, and its potential to improve newborn health across the developing world if replicated further. The judging panel commended its simplicity, low cost, and intuitive nature that makes it ideal for use in poorer settings.

ColaLife, Zambia - $370,000

• ColaLife Zambia, initiated by UK-based charity ColaLife but run by Zambian NGOs, applies for-profit style supply-chain techniques to make health products available in even the most remote villages. 
• Its ‘Kit Yamoyo’ (‘kit of life’) is an affordable kit for the treatment of diarrhoea – one of the biggest killers of children under five – containing 200ml sachets of oral rehydration salt (ORS), 10 zinc tablets and soap all packaged in a container that is a measure for the correct amount of water, a mixing and storage device and cup for administering the ORS.
• The kit is promoted through rural health centres by community health workers and delivered by trained local village-based micro-retailers.
• Retailers travel to the nearest district town to buy the kits the same way they do for other fast moving consumer goods such as Coca-Cola, cooking oil, salt and sugar.
• At the end of a 12-month trial in Zambia, 45 per cent of children with diarrhoea received the correct treatment. A Lives Saved Tool (LiST) estimate suggests that one life is saved for every 330 kits sold.  To date, 50,000 kits have been distributed.
• The judging panel commended the proven intervention, designed with the end user in mind to increase uptake and help address the issue of access to healthcare.

 University of Nairobi - $120,000

• The University of Nairobi was awarded a share of the award money for an innovation designed to tackle child deaths using a bar-coded card that tracks vaccinations and rewards mothers for having their children immunised with discounts on farm products. The card sets out to tackle the related challenges of low immunisation rates and food insecurity in rural areas of Kenya where parents are often prevented from vaccinating children by the cost and difficulty of accessing health facilities. Under the new scheme, each time a mother has her child vaccinated, it is registered on the card and she can access discounts on things like seeds and fertilizer with the initiative’s partner organisation Agrovets.
• In the targeted villages in rural Kenya, the bar-coded card has enjoyed much greater success than previous vaccination campaigns, raising vaccination rates from 55 to 95 per cent. So far, the innovation has improved the lives of more than 2,000 rural families and touched more than 9,500 in North Western Kenya.
• The card has had multiple health impacts. The proportion of newborns delivered at home by traditional birth attendants who were brought to a health facility for their first immunisation rose from 20 per cent pre-pilot to 89 per cent in April 2014. Women’s attendance at ante-natal clinics also rose from 25 per cent to 90 per cent.
• Over the next two years, the University of Nairobi will expand the piloted bar-coded child vaccination card to reach approximately 50,000 children under five and 14,000 pregnant women, increasing access to immunisation and safe motherhood services, generating increased demand for antenatal, postnatal, and neonatal care, and improving family nutrition for approximately 20,000 rural households in North Western Kenya. The University will also set up four GrainBank centres with a full range of activities in two neighbouring districts in a transition plan towards national scale-up.

Living Goods, Uganda - $120,000

• Living Goods Uganda is tackling under-five mortality through a cost-effective, entrepreneurial community health promoter programme.  Living Goods recruits, trains, and supports networks of micro-entrepreneurs who travel door-to-door teaching families how to improve their health and selling life-changing products such as simple treatments for malaria and diarrhoea, safe delivery kits, fortified foods and water filters.The agents make a profit on both their sales and through other incentives, providing a motivating income.
• The community health promoters have a particular focus on serving expectant mothers and babies. They support women through pregnancy and make three visits to newborns in the crucial first week after birth to promote correct baby care, infection detection and recognition of danger signs needing referral to a health facility.
• An independent evaluation by Children’s Investment Fund Foundation and MIT’s Abdul Latif Jameel Poverty Action Lab (J-PAL) found the health promoters have helped reduced deaths among under-fives by 25 per cent. In making the award, the judges singled out Living Goods’ highly cost effective and sustainable model of increasing access to affordable health care.
• Over the next four years, Living Goods aims to use the award money to help recruit, train, equip and deploy more than 2,000 community health promoters in Uganda, directly serving more than a million people.   
• Living Goods launched as a partnership with the NGO BRAC Uganda in 2008.

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References

1. World Bank -  http://data.worldbank.org/indicator/SH.DYN.MORT