child mortality

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How a passing comment on an old medical test won a $100K Gates grant | 

Tom Paulson

Gates Grand Challenges award winner Kathleen Bongiovanni demonstrates how a simple idea may save the lives of millions of premature babies

Earlier this week, the Bill & Melinda Gates Foundation announced the latest 100 winners of $100,000 grants from its Grand Challenges Exploration program aimed at supporting high-risk, creative approaches to improving health and fighting poverty in poor countries.

Celebrated for funding “wild” and “wacky” ideas, this year’s batch of Gates Grand Challenge winners included proposals to develop, as the AP reported, unmanned drones to deliver vaccines, tattoos for monitoring pregnancy and a “tuberculosis breathalyzer.”

The Seattle Times followed up with an overview of the three local winners:

  • Kathleen Bongiovanni, a program manager at Seattle Children’s Research Institute, won for proposing a simple test to identify premature babies.
  • Two immunization technology improvement teams at PATH also each won a $100,000 Gates grant. Lauren Franzel of PATH won to do research using bar codes to improve vaccine delivery logistics. PATH’s Shawn McGuire and Nancy Muller got support for work aimed finding better refrigeration techniques during vaccine transport in poor countries.

None of these three local winners’ projects sounded too wacky to me.

PATH has long been a leader in creating new vaccine technologies so not much surprise or wackiness or wildness there.

Bubble check diagnostics

No, the wildest story here is about how Bongiovanni got the idea for her project and applied for the Gates grant despite a bit of skepticism about her chances from more experienced colleagues.

“It was just a passing comment,” she explained. Bongiovanni works in program administration for a project focused on respiratory diseases caused by premature birth at Seattle Children’s Research Institute. She is, in fact, pretty low on the totem pole. Her mentor there, Dr. Tom Hansen, is an expert neonatalogist and, well, an old guy.

During a routine meeting, Bongiovanni overheard Hansen talking about the ‘old days’ and this abandoned method of testing babies for respiratory distress by combining routine amniocentesis fluid with alcohol.

Hansen mentioned it in passing, she said, as he went on to discuss more sophisticated, modern analytical means for diagnosing respiratory distress in newborns.

“Basically, you’re just looking for foam,” Bongiovanni said. “It’s a beautifully simple and cheap test.”

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Will new, positive findings allow Jeffrey Sachs to stop shouting back at the critics? | 

Columbia University

Jeff Sachs

The renowned economist Jeffrey Sachs, now director of Columbia University’s Earth Institute, seems to irritate people — which also seems to prompt his critics to engage in vitriolic attacks of his efforts to combat global poverty and inequity.

The debates centered around Sachs remind me of some of the people I’d meet as a boy attending church, those folks who would argue angrily, endlessly and insultingly over fundamental disagreements about how best to love thy neighbor.

Whatever one may think about Sachs’ methodology or personality, can’t we all at least agree he has done a lot to promote the causes of global health, social justice and equity? For one, Sachs helped craft the Millennium Development Goals — which, if imperfect, gave the world a strategy for improving global health, reducing poverty and improving the lives of the poor worldwide.

One of Sachs’ biggest projects today is known as the Millennium Villages Project. Not surprisingly, it has been pilloried by many aid experts who say there is no evidence the project does any good.

Well, according to The Guardian, there is now evidence of good from Sachs’ Millennium Villages Project:

Death rates among children under five at the Millennium Villages – set up in Africa to demonstrate what is possible if health, education, agriculture and other development needs are tackled simultaneously – have fallen by a third in three years compared with similar communities, according to the project’s first results.

Sachs, in characteristic form, explodes all over the media with these positive findings to announce a breakthrough in the Huffington Post and to suggest, for CNN, that these results show that we can finally achieve “the dream of health for all, even the poorest of the poor… (This) can become a reality because of recent breakthroughs in technology and health systems.”

A bit over the top, yes, but that’s just the way Jeff likes to talk. You need to keep in mind he started on his campaign against poverty and the diseases of poverty back in the days when, well, hardly anybody gave a damn. He had to shout. And he’s still shouting.

So now, finally, he has some data to back his claims up and can maybe stop shouting.

Or maybe not. As Nature News notes, the findings aren’t likely to stop the critics:

“The core of the problem is lack of transparency and careful, independent analysis,” says Michael Clemens, a migration and development researcher at the Center for Global Development, an independent research institution in Washington DC.

The aid blogger Roving Bandit notes that even if child mortality declined in the Millennium Villages, the project itself found no statistical impr0vements in poverty, nutrition, education or other child health indices.

So I guess, no, the answer appears to be the shouting is likely to continue.

Premature births on rise globally (US ranks with Indonesia & Bangladesh) | 

Flickr, limaoscarjuliet

A new report by the World Health Organization has determined that one of every ten babies, 15 million worldwide, is born premature and the numbers are rising.

Disturbingly, if not surprisingly anymore when it comes to health indicators, the United States ranks between Indonesia and Bangladesh on premies.

As the Guardian noted, most of these premature births around the world are preventable if simple, inexpensive treatments were available to all. The rise in premie babies in the rich world was attributed to older mothers, an increased rate of C-section deliveries as well as the use of fertility drugs. In the developing world, comparatively:

In poor countries, where most of the deaths occur, the main causes of premature delivery are infections, malaria, HIV and the high number of adolescent girls getting pregnant. There is a huge difference in survival among the most premature. In rich countries, 90% of babies born before 28 weeks live. In poor countries, only 10% will do so.

Flickr, Mike Blyth

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Educating Mothers Saves Children’s Lives | 

It’s perhaps no surprise to find that better-educated mothers do better at improving the health of their children, but it may surprise some to see how much of a difference this can make — and that it matters much more than economic gain.

IHME

Child Mortality vs Maternal Education, Nicaragua

Between 1970 and 2009, mortality in children under age 5 dropped from 16 million to 7.8 million annually worldwide. Seattle researchers who studied this phenomenon in 175 countries report today in the Lancet that more than half of this reduction in child mortality (51 percent) can be attributed to improvements in education among women of reproductive age.

To the right is just one of their “scatterplots” for Nicaragua (go to their paper to get more info re the details) showing quite dramatically how child mortality plummets as maternal education rises — even if GDP per capita declines. Continue reading