MANDATE: Mobilizing innovations for maternal and neonatal health

The following post is part of our series, Technology and Innovation for Maternal and Newborn Health. Join the global conversation as we explore the potential for delivering innovative technologies to save the lives of newborns around the world.  Written by the MANDATE Team: Doris Rouse, Beth McClure, Robert Goldenberg, Alan Jobe, Beena Kamath-Rayne, Craig Shaffer, Delwin Coufal, Richard Satcher, and Emily MacGuire.

Global maternal and neonatal mortality rates are unacceptably high. More than 98% of these deaths occur in low-resource settings. Strategies to reduce maternal and neonatal deaths need to incorporate improving access to appropriate curative and preventive interventions, especially in home and community settings, where over half of the more than 60 million births per year occur.

Delivering innovative technologies across the continuum of care—including technologies for frontline workers to use in homes, communities, and first-level clinics—may significantly improve pregnancy and childbirth outcomes. However, no quantitative process currently exists to evaluate and prioritize technology development options based on the potential to save lives in low-resource settings.

RTI International, with support from The Bill & Melinda Gates Foundation, has developed a web-based tool to objectively assess the impact of new medical technologies on maternal, fetal and neonatal mortality.   This initiative, called the Maternal and Neonatal Directed Assessment of Technology, or MANDATE, provides a comprehensive technology assessment and analytical tools that help prioritize efforts to reduce maternal and neonatal mortality in low-resource settings.

The initial scope covers the major maternal and neonatal clinical conditions: hemorrhage, hypertensive diseases of pregnancy, maternal infection, complications from abortion, preterm respiratory distress, birth asphyxia, and neonatal infection - at home, clinic, and hospital settings in India and Sub-Saharan Africa.

By calculating the potential number of maternal and newborn lives saved, the MANDATE tool allows users to identify and compare the potential impact of a technology. Users may adjust variables related to a technology’s availability, appropriate use and efficacy, to determine how a technology might be improved to have the greatest impact.

The MANDATE tool can also be used to define the characteristics that a new technology would need to achieve the highest efficacy and coverage in various areas, and to estimate the potential benefit in lives saved of any new device under development.

The tool is available for public use on the MANDATE Web site (http://mnhtech.org) free of charge. The first condition, neonatal respiratory distress, is currently available, and additional conditions will be made available over the next nine months.

RTI plans to further evolve MANDATE to provide an enhanced user interface, expanded conditions and additional insights as to the key factors for optimizing technologies in different health care settings.

Why use the MANDATE tool?

•  Informs resource allocation decisions, maximizing potential for saving lives
•  Provides a quantitative and comprehensive view of how technologies can reduce mortality
•  Provides a foundation for cross-disciplinary discussion
•  Provides a Decision Support methodology with potential for broad application in global health

Photo: Andy Hall / Save the Children