Innovations & Impact
Shivgarh Community Health Intelligence Platform (CHIP)
The Shivgarh CHIP has been set up as a community-embedded innovation ecosystem in rural Uttar Pradesh. Originally set up to power the Shivgarh newborn survival trial in 2003 with a community of 100,000 people, it has now expanded to include a community of 1 million across an area of 2,000 sq. km. Each rural household in this area is uniquely identifiable, and each village is mapped onto a geographical information system. About 250 young women from the community serve as community research investigators and acquire data, ensuring that each household is visited every 2 months. The Shivgarh CHIP is powering several studies on improving maternal and newborn health and child development.
The CEL team is known globally for its expertise on newborn survival in community settings. Its landmark study on newborn survival in 2004-5, which tested an essential newborn care intervention co-developed with the community leading to a 54% reduction in newborn deaths (read the article here), has informed national and global programs and policies including WHO recommendations on home visitations by community health workers (read the article here).
An important innovation from CEL has been community-based skin-to-skin contact for all newborns in community settings as a strategic point of convergence for interventions related to breastfeeding, hypothermia prevention, preterm management and neurodevelopment (read the articles here 1, 2, 3, 4, 5).
Most recently, the CEL team with sponsorship from WHO, has embarked upon a trial to understand if massage with cold-pressed sunflower seed oil, which has been found to reduce newborn infections and deaths in clinical settings, can also lead to improved newborn survival in community settings (read about the trial here).
A key finding of the Shivgarh study on newborn survival was that maternal health outcomes are inextricably linked to newborn health, and therefore the two of them should be programmatically approached as a continuum (read the article here). Shivgarh is also part of the Alliance for Maternal and Newborn Health Improvement (AMANHI), a WHO-led global consortium on understanding the burden and risk factors of maternal illnesses, deaths and stillbirths.
In partnership with Johns Hopkins University and King George's Medical University, CEL has set up a hospital-based sentinel surveillance system to track incidence of childhood meningitis caused by Hemophilus influenzae and Streptococcus pneumoniae.
Behavior Change Management
The term ‘Behavior Change Management’ (BCM) was coined by CEL scientists to emphasize that adoption of new practices within communities requires a change management approach, that involves addressing gaps in knowledge, motivation, skills and establishing an enabling environment and support systems. CEL scientists have an expertise in co-developing and localising innovations with communities, and using the BCM approach to increase their adoption at scale (read our article here).
At CEL, we firmly believe that ultimately our shared future depends on our ability to ensure that every child is poised to live up to their fullest potential. We have a strategic thrust in two key areas: developing community-centric early child development innovations and developing improved methods for community-based assessment of children at scale.
We have recently completed a follow-up study, supported by Grand Challenges Canada’s Saving Brains platform, for assessing the neurodevelopment status of children who were part of the original Shivgarh trial, through use of in-house developed ipad based assessment tools. Based on this experience, we are developing a technology platform to enable trained community-based workers to conduct assessments and follow-up children. This work has been partly supported by Grand Challenges Canada’s Stars in Global Health program.
Technology for Impact
At CEL, we believe smart use of technology can be a game changer for disadvantaged communities, radically reducing barriers to knowledge and services. While we use technology extensively to facilitate our work, from workflow management to data collection, we also develop our own technology products.
We are currently developing a technology platform for end-to-end management of community-based research, and another as part of our thrust on child development, to enable community-based workers to conduct neurodevelopmental assessments and follow-up children for intervention.