FUNDING ORGANIZATION	RESEARCH ORGANIZATION	PROGRAM	DIRECTOR	CITY	COUNTRY	ABSTRACT
	EC	CENTRE NATIONAL DE RECHERCHE SCIENTIFIQUE ET TECHNOLOGIQUE*INSTITUT DE RECHERCHE EN SCIENCES DE LA SANTE	ASSESSING THE IMPACT OF FEE EXEMPTION ON MATERNAL HEALTH IN WEST AFRICA AND MOROCCO: NEW TOOLS, NEW KNOWLEDGE	KOUANDA, SENI	OUAGADOUGOU	BURKINA FASO	View
There is a growing consensus that maternal health outcomes can only be improved through policies and programmes that combine interventions to address the different causes of ill health and target multiple groups. Such policies and programmes are complex in nature as they involve coordination between different tiers in the health system and multiple actors including communities, health workers and managers. User fee exemption for delivery and emergency obstetric care (EmOC) is one such policy that has been introduced by several African countries with the aim of improving access to care and thus improving maternal and neonatal outcomes. However, the current evidence base regarding the impact of this policy is not well developed, in part because of evaluation designs that are not able to capture all the necessary information for policy-makers to make informed decisions. This proposal aims to reduce this gap by developing research methodologies and tools that will lead to enhanced research on policy implementation, stronger evidence and improved dissemination.
	EC	CENTRE NATIONAL DE RECHERCHE SCIENTIFIQUE ET TECHNOLOGIQUE*INSTITUT DE RECHERCHE EN SCIENCES DE LA SANTE	MALARIA TRANSMISSION BLOCKING BY VACCINES, DRUGS AND IMMUNE MOSQUITOES: EFFICACY ASSESSMENT AND TARGETS	OUEDRAOGO, JEAN-BOSCO	OUAGADOUGOU	BURKINA FASO	View
Malaria is a complex disease, dependent on multiple host/parasite/vector interactions. This tripartite system offers numerous opportunities for disease-preventing interventions, but also creates robustness that undercuts ‘magic bullet’ expectations. Our interdisciplinary TransMalariaBloc will approach the challenge of malaria control in the field from this perspective. It utilizes the enormous recent advances in our molecular understanding of the three implicated organisms without prejudicing which targets or process will prove most suitable to transmission blocking (TB). In a feedback loop of experimentation and modeling, we will address the potential and actual impact of TB drugs and remedies which supplied to human hosts, can block transmission from an infected bloodmeal; TB vaccines which elicit human antibodies to antigens essential for transmission; and immune mosquitoes, genetically modified (GM) to achieve natural or synthetic refractoriness. Recent studies suggest that vector/parasite genotypic interactions determine the success or failure of Plasmodium falciparum to infect mosquitoes. In this perspective, we will assay genome-wide polymorphisms in both parasites and vectors to dissect important genotype*genotype interactions, thus guiding the development of effective TB vaccines, drugs and remedies, and GM mosquitoes. Effectiveness of TB interventions, especially via use of GM mosquitoes, depends on the balance of infection and resistance costs. Components of this balance will be explored, to foresee the dynamics of vectorial competence in mosquito populations and assess the efficacy of TB strategies, as well as guide the development of new targets. Again, interaction between modeling and experimentation will be a powerful combination. This proposal represents an ambitious, but feasible approach, spanning from molecular to population and environmental levels, to optimizing TB interventions for malaria control in endemic areas.
	EC	CENTRE NATIONAL DE RECHERCHE SCIENTIFIQUE ET TECHNOLOGIQUE*INSTITUT DE RECHERCHE EN SCIENCES DE LA SANTE	MISSED OPPORTUNITIES IN MATERNAL AND INFANT HEALTH: REDUCING MATERNAL AND NEWBORN MORTALITY AND MORBIDITY IN THE YEAR AFTER CHILDBIRTH THROUGH COMBINED FACILITY- AND COMMUNITY-BASED INTERVENTIONS	KOUANDA, SENI	OUAGADOUGOU	BURKINA FASO	View
Improving maternal and newborn health requires innovative approaches that maximise opportunities for impact throughout the continuum of care. In the past decade, maternal health services have largely focused on the management of intrapartum complications and on rationalising the package of antenatal services to include emergency obstetric care provided by skilled birth attendants. These interventions have sought to target what are widely considered to be the most common and immediate causes of maternal death. Yet this approach fails to address many underlying morbidities that are instrumental in generating high rates of maternal mortality, such as anaemia and inadequate birth spacing. Also missing is a direct focus on the substantial proportion of maternal deaths in the postpartum. Indeed, as a component of maternal health, postpartum care has been neglected, along with the field of newborn health in Africa. The essential package and optimum structure of postpartum services for women and newborns in Africa remains poorly defined, with missed opportunities for improved care. We thus propose developing a package of interventions targeting newborn health and women in the early postpartum period and throughout the first year after childbirth. This package will be delivered through a combined facility- and community-based approach designed to integrate services and strengthen health systems. It will be implemented in four African countries (Burkina Faso, Kenya, Malawi and Mozambique) by a consortium of five African and three European partners. Intervention design will be preceded and informed by a situational analysis of postpartum policies and practices in the four countries and a feasibility assessment. This will ensure that interventions are amenable to scaling up and appropriately tailored to local contexts. Implementation will be followed by health systems research to evaluate effectiveness and impact, and to identify determinants of healthcare improvements.
	EC	CENTRE NATIONAL DE RECHERCHE SCIENTIFIQUE ET TECHNOLOGIQUE*INSTITUT DE RECHERCHE EN SCIENCES DE LA SANTE	POPULATION AGE STRUCTURE AND AGE STRUCTURE MODIFICATION VIA WOLBACHIA IN ANOPHELES GAMBIAE	SIMARD, FRED	OUAGADOUGOU	BURKINA FASO	View
One of the most critical factors contributing to the vectorial capacity of malaria vector mosquitoes is the mean age attained by adult females, because after picking up the Plasmodium parasite there is a lengthy incubation period before transmission can occur. A virulent strain of the endosymbiotic bacterium Wolbachia called wMelPop reduces adult lifespan in its native Drosophila host, and has recently been shown to do the same following transfer into Aedes mosquitoes. We will examine its potential as a novel malaria control tool by creating and characterizing Anopheles cell lines containing wMelPop, and purifying and transferring it into An. gambiae by microinjection. We will then characterize the cytoplasmic incompatibility phenotype by which Wolbachia spreads itself, virulence (lifespan shortening effects), maternal transmission rates, and tissue distribution of introduced Wolbachia, together with analyses of mosquito gene expression using microarrays. Development of a molecular age estimation assay for the An. gambiae complex will be undertaken by adapting a new quantitative RT-PCR method for use in An. gambiae. We will then set up a greenhouse population of a member of the An. gambiae complex in Kenya that is viable over multiple generations, release marked mosquitoes to calibrate the molecular age estimation assays under semi-field conditions, and compare age structure between greenhouse and wild populations. In Burkina Faso we will estimate population age structure in the An. gambiae complex at 3 field sites, in different seasons and with / without insecticide treated net use. Liaison will take place with government institutions and local communities on regulatory issues and desirability of future Wolbachia-based trials in both countries. We will also build a suite of mathematical models to allow the analysis of different interventions that affect adult mosquito longevity, and incorporate the dynamics of Wolbachia spread in an age-structured population.