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Two Michigan Medicine Efforts Named Among Top 100 Proposals for MacArthur $100M Grant

Proposals would improve emergency care delivery and maternal mortality rates in Africa

Press release authored by Katie Vloet.

Two Michigan Medicine-led programs have been named among the 100 highest-scoring proposals in the John D. and Catherine T. MacArthur Foundation’s 100&Change competition. One of the 100 proposals will win a $100 million grant to help solve one of the world’s most critical social challenges.

One proposal is led by the Michigan Medicine Department of Emergency Medicine: “Reducing Mortality and Improving Health in Africa Through Emergency Care.” This proposal aims to improve access to emergency care in Africa through sustainable, effective, financially inclusive systems that deliver low-cost, quality care by a specialty-trained health care workforce.

One proposal is led by the Michigan Medicine Department of Obstetrics and Gynecology: “Eliminating Preventable Maternal Mortality in sub-Saharan Africa.” The intent of this proposal is to measurably eliminate preventable maternal mortality in Africa by building professional capacity through U.S./African OB-GYN/midwife partnerships with access to information, networking, and rural reach.

Reducing Mortality and Improving Health in Africa Through Emergency Care

“We are thrilled that the MacArthur Foundation has recognized the importance of the work we have been doing,” says Rockefeller Oteng, M.D., assistant professor of emergency medicine at Michigan Medicine and the leader of the effort. “If we were to win the competition, we could further assist our international colleagues in creating emergency care systems for their populations. We could enhance and in some cases create a safety net of emergency health care provision.

“We could take steps to ensure that a person’s outcome following an acute illness or injury isn’t dictated by their GPS location,” Oteng adds.

The Michigan Medicine Department of Emergency Medicine’s proposal addresses the fact that 28 million people die annually from medical emergencies, representing half of the world’s mortality. In Africa, emergencies lead to double the global average for lost years of life. Few patients have access to the life-saving treatments for time-sensitive medical conditions that emergency departments and emergency medical systems effectively provide in developed countries.

Using existing infrastructure, the project initially builds sustainable emergency care systems across three countries in sub-Saharan Africa, then scales to other countries. An appropriately trained and staffed emergency medical system can reduce death and disability across Africa, connecting the sick and injured to the care they need without delay, Oteng notes. These systems also enhance preparedness for large scale emergencies. “Our team would partner with hospital and governmental leaders to replicate proven capacity building training programs that have been in operation in Ghana for more than a decade,” Oteng says.

The Ghana Emergency Medical Collaborative (GEMC), established in 2008, brings together the Ghanaian Ministry of Health, the National Ambulance Service, the graduate medical education body, and Komfo Anokye Teaching Hospital in Kumasi, Ghana, with U-M’s Department of Emergency Medicine. Together the group has established a first-of-its-kind model of professional training and emergency medical capacity building. The GEMC launched its emergency physician residency program in 2009 and soon added emergency nurse training. Emergency medicine is now an established Ghanaian medical specialty and training is government-funded.

“We have demonstrably improved patient care and outcomes throughout Ghana,” Oteng says. The GEMC has burgeoning collaborations in Ethiopia and Tanzania, respectively, with Addis Ababa Burn Emergency and Trauma Hospital and Muhimbili University of Health and Allied Sciences. The African Forum for Research and Education in Health (AFREhealth) will be invaluable for recruiting additional hospitals and disseminating knowledge, the proposal says.

The Department of Emergency Medicine also collaborates with the William Davidson Institute, located within U-M’s Stephen M. Ross School of Business. The institute has undertaken hundreds of health care projects in Africa over 25 years.

“The opportunity to blend decades of WDI’s experience working with health care businesses in emerging markets with the expertise at the U-M’s Medical School illustrates the power an institution like the University of Michigan can bring to some of the largest global challenges,” says WDI President Paul Clyde

Read more:

https://solutions.leverforchange.org/100-change-2020/reducing-mortality-and-improving-health-in-africa-through-emergency-care/

https://globalreach.med.umich.edu/articles/game-changer-new-fellowship-expanding-emergency-care-ghana

https://medicine.umich.edu/dept/emergency-medicine/global/ghana-emergency-medicinecollaborative

Eliminating Preventable Maternal Mortality in sub-Saharan Africa

“Our unique approach to the elimination maternal mortality would make the world so much safer for mothers and babies, and I am very hopeful that our team can ramp up our work through this recognition,” says Frank Anderson, M.D., M.P.H., professor of obstetrics and gynecology at the U-M Medical School and clinical professor of health behavior and health education at the U-M School of Public Health. He also is director of the Global Initiatives program in the Department of Obstetrics and Gynecology. “We want to apply a new way to approach this problem that can create the ability on the ground to grow the midwives and doctors who can take care of pregnant women for the long term.”

Maternal mortality is an unresolved global crisis, Anderson says. Most deaths occur in sub-Saharan Africa, where human and technical capacity with deep involvement with communities have yet to integrate to create a total solution.

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The University of Michigan would be the organizing and data hub that pairs major U.S. universities with 10 African universities and hospitals to build permanent post-graduate OB-GYN/midwifery training programs, creating a permanent solution for the women of Africa. Obstetrics and midwifery care would be integrated with a core curriculum of open source teaching materials available free access through the Global Library of Women’s Medicine.

Interdisciplinary training programs would integrate evidence-based clinical and surgical care, team training, communication, certification, quality improvement, and policy work. World Vision, a leader in global health, “would link our expertise to under-served rural communities so that all women have access to modern and comprehensive obstetric care,” Anderson says. Civana, an organization whose mission is “to build and give to the world a digital community and collaboration platform that pushes our technology to its furthest extent, for good,” would create an innovative networking and management platform for our partners, and make it available to other partnerships anywhere in the world.

“Our unique international team has expertise and breadth to do what has never been done: create a comprehensive solution to preventable maternal mortality in eight African nations,” Anderson says. Those countries are: Ghana, Cameroon, Sierra Leone, Uganda, Mozambique, Botswana, The Gambia, and one to be determined. Leveraging existing colleges, medical schools, and ministries of health, the partnership also draws on multiple nongovernmental organizations and professional organizations to deliver and share information and knowledge with doctors and midwives, to build capacities in clinical care and community outreach, educational resources, real-time metrics and evaluation, and an innovative collaboration platform.

Michigan Medicine has decades of high-impact, self-sustaining partnerships in Ghana and Ethiopia. The experience in Ghana started in 1989, and over 250 OB-GYNs have been trained and now work in Ghana. “What we have learned will be applied throughout Africa to provide programmatic support, data collection, metrics, and analysis,” Anderson says. This proposal builds on the 1000+ OBGYN global training project, which began at U-M in 2014. Read more:

https://solutions.leverforchange.org/100-change-2020/eliminating-preventable-maternal-mortality-in-sub-saharan-africa/

https://labblog.uofmhealth.org/industry-dx/partnerships-key-to-reducing-deaths-of-moms-babies-abroad

https://globalreach.med.umich.edu/articles/u-m-obgyn-training-programs-continue-take-hold-africa

https://medicine.umich.edu/dept/obgyn/global-initiatives

100&Change

The top 100 proposals represent the top 21% of competition submissions. The proposals were rigorously vetted, undergoing MacArthur’s initial administrative review, a Peer-to-Peer review, an evaluation by an external panel of judges, and a technical review by specialists whose expertise was matched to the project.

Each proposal was evaluated using four criteria: impactful, evidence-based, feasible, and durable. MacArthur’s Board of Directors will select up to 10 finalists from these high-scoring proposalsthis spring.

In the inaugural round of 100&Change in 2017, Sesame Workshop and International Rescue Committee were awarded $100 million to educate young children displaced by conflict and persecution in the Syrian response region and to challenge the global system of humanitarian aid to focus more on building a foundation for future success for millions of young children. 

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