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      "title_narrative":["ROAD2H: Resource Optimisation, Argumentation, Decision Support and Knowledge Transfer to Create Value via Learning Health Systems"],
      "description_narrative":["ROAD2H will develop novel Learning Health System (LHS) techniques to facilitate uptake of health interventions to achieve Universal Health Coverage (UHC) in Low- and Middle-Income Countries (LMICs). UHC is a specific target in the UN Sustainable Development Goals (SDG 3.8), with many LMICs attempting to extend population coverage of quality healthcare via public-subsidised health insurance schemes (HISs).  Two issues are key to achieving UHC via these schemes: i) how budgets should be best allocated among competing clinical interventions (allocative efficiency) ii) under what timing and circumstances particular interventions should be offered for what kinds of patients in which settings and to what standard of care (quality).Current attempts in LMICs to address efficiency and quality issues include Health Technology Assessment (HTA) based on cost-effectiveness analysis of individual healthcare interventions, and evidence-based guidelines/pathways recommending best practice within whole disease areas. However there have been limited uptake of system-wide mathematical optimisation techniques (in part due to significant data requirements); no efforts to using data routinely collected by HISs for billing and claims purposes, as well as Electronic Health Records (EHRs), for improving efficiency and quality, even though existing attempts among LMICs to use such data retrospectively as inputs into HTA and guidelines show promise.   We hypothesise that a LHS framework for national HISs, combining resource optimization, argumentation (as understood in AI), clinical decision support and clinical and policy analytics, will facilitate the uptake of evidence-based, cost-effective and data-driven healthcare interventions, and improve the overall efficiency and quality of integrated care systems in LMICs transitioning to UHC.   ROAD2H will deliver DSS tools that integrate individual patient data (drawn from EHRs) with localized clinical guidelines (including HTA, clinical pathways) obtained via policy and clinical analytics from best available clinical and cost-effectiveness evidence as well as HIS billing/claim data. We will use argumentation to parameterize optimisation problems drawn from cost-effectiveness and resource optimization considerations, and then use standard methods in mathematical optimisation to maximize efficiency of clinical interventions. We will use argumentation also to integrate optimization for maximal efficiency and reasoning with localized guidelines, and resolve conflicts as well as transparently explain recommendations for clinical interventions. The DSS will make use of these explained recommendations as well as data provenance techniques to generate and transparently collect patient-tailored recommendations to enable further learning, in line with the LHS methodology. The DSS tools will operate at the EHR/clinician/patient interaction and integrate data from multiple sources as well as have localised interfaces (by country and possibly hospital/clinician).  The project will be carried out in three phases: - Phase 1: To review existing HISs and infrastructures in three exemplar countries (China, Serbia, Myanmar), against the requirements for LHSs - Phase 2: Iterative development of a prototype digital methodology (encompassing policy, data, cost-effectiveness analytics, optimization, argumentation, DSS and provenance) to be embedded into existing HISs  - Phase 3: To evaluate, by means of proof-of-concept prototype DSS tools in Serbia and China and by scoping in Myanmar,  the technical and clinical feasibility of the ROAD2H methodology, its acceptability among end users, and its potential and preconditions for generalization across disease areas and health systems settings in order to support UHC.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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      "title_narrative":["Detecting and Monitoring Stroke in China Using a Low-Cost, Portable Microwave Scanner (DeMoStroke)"],
      "description_narrative":["The impact of stroke incidents is immense: five million people die and another five million are permanently disabled every year due to stroke incidents, and stroke is placed third among reasons for acute death and first among reasons for neurological dysfunction in the western world. Its impact and consequences, however, are even more devastating in developing countries, where according to WHO estimates, death from stroke accounted for 85.5% of stroke deaths worldwide in 2001, and the number of disability-adjusted life years (DALYs), i.e. years of life lost and years lived with disability, was almost seven times higher than in high-income countries.  In China, in particular, stroke is the leading cause of death, and it strikes earlier in life than it does in the western world. Its treatment relies to a great extent on the information provided by diagnostic methodologies, which are necessary to guide medical experts in choosing a treatment strategy and to assess its efficiency.  This project will build on existing expertise by the project partners in the UK and China towards the development of a portable and low-cost system which can detect the occurrence, and monitor the evolution of stroke and its treatment using microwave technology. The proposed system will use low-power, non-ionizing radio waves (microwaves) to image the occurrence and evolution of stroke in an accurate manner, thereby removing the need for expensive imaging systems (such as CT scans) which would result in significant delays in treatment decisions.  This approach can address several clinical needs. For example, the system can be used inside an ambulance to determine the type of stroke much earlier than CT scanners inside a hospital. This is particularly important for ischemic stroke patients (which account for over 80% of total cases), for which early detection is crucial for thrombolytic treatment (i.e. blood thinners that can dissolve clots in blood vessels due to ischemic stroke but would worsen the condition of a blood vessel rupture occurring in hemorrhagic stroke). Moreover, by serving as a point of care diagnostic tool for patients at their homes, the proposed approach can lead to more efficient management of stroke in the post-acute stage, which can improve the potential recovery of the patient. The scanner can therefore revolutionise stroke therapy and recovery in communities where CT or MRI equipment is scarce or not available, such as underdeveloped or rural areas in China and other ODA countries.  The project will develop the microwave device relying on academic and industrial UK expertise in microwave imaging algorithms and instrumentation. In addition to offering academic expertise in microwave medical imaging, the project's ODA partners will accelerate the proposed device's pathway to clinical use through a network of hospitals and medical centres and cooperation with over 35 hospitals across 30 cities in China in the planning of clinical trials. Although delivered in China, the project can make a difference in many developing countries where stroke is emerging as a health threat also for younger populations (e.g. South Asian countries), as the targeted device will be affordable and simple enough to use.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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      "title_narrative":["LoCoMoTE: Low Cost Morphable Teleoperated Endoscope for Gastric Intestinal Tract Screening"],
      "description_narrative":["Existing technologies are unable to meet China's endoscopic gastrointestinal (GI) screening needs, due to its large, aging population, insufficient infrastructure and high incidence of GI cancers. To address this challenge, we propose a novel and low cost soft endoscope, together with high-speed wireless communications to create a way to perform regular endoscopic screening programs in China.       The soft endoscope will be able propel itself inside torturous, compliant environments, such as the human gastrointestinal tract, and dramatically reduce the pain associated with conventional endoscopes. Because of the self-propelling feature and the inherent safety of using soft material, the new endoscope can be operated by non-specialist staff with minimal training and be supervised or even controlled remotely by specialist clinicians with wireless communication. The endoscope will be operated by clinicians via a custom made haptic interface. The endoscope itself will be made to be low cost and disposable. Therefore, this will enable rural medical clinics to run regular endoscopic screening programs with the system, as it will require no additional sterilisation facilities and will be easy to learn to use.       To facilitate adoption and to provide support for rural clinicians, the endoscope will be connected to a high-speed 5G wireless that will enable haptic tele-operation. Through this, expert clinicians in large hospitals all over the country will be able to monitor and directly control screening procedures from any location. Experts will therefore be able to train rural clinicians in techniques by physically demonstrating them, support rural clinics to ensure accurate diagnosis and allow experts to perform more complex procedures remotely. Aligning well with China's strategy of starting 5G commercial applications in 2020, this approach is timely and takes advantage of the wide-spread availability of wireless internet in China and deals directly with the challenges faced by efforts to create large-scale endoscopic screening programs in the country.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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      "title_narrative":["Development of New Low Cost Point of Care Diagnostic Technologies for Diabetic Retinopathy in China"],
      "description_narrative":["We will develop novel, low-cost, diagnostic technologies for the detection of a blinding condition called diabetic retinopathy (DR) in China. These technologies will enable cost-effective, large-scale detection of sight-threatening disease to be performed by non-expert health care workers at the time and place of patient care in China.  Over 110 million people in China live with diabetes and this number is expected to increase to 150m by 2040. Diabetes causes visual loss through damage to blood vessels of the retina at the back of the eye. Treatments are effective (and increasingly affordable in China) but only if the disease is detected early enough. Improving early diagnosis and treatment of DR is one of the principal objectives of the Chinese Government's 5-Year National Plan of Eye Health (2016-2020). Current methods of detecting DR rely on costly imaging equipment and many skilled personnel to take and interpret retinal images. China has very few health workers with these skills.  Case detection strategies which are cost-effective in Western Europe cannot possibly be replicated at the scale necessary for China.  Building on an existing collaboration between the University of Liverpool, Peking University and the Chinese Medical Association (CMA), our joint research team from Liverpool and China of engineers, statisticians, education specialists, eye doctors and health economists are well placed to develop a new diagnostic imaging solution tailored to local needs.    Our objectives for this project are:  1. To develop a novel, low-cost, robust imaging device for detection of DR 2. To develop new automated computer algorithms to rate images of the retina for sight-threatening disease 3. To develop a novel comparative judgement method to refine the DR severity grading from automated computer algorithms 4. To validate the new technologies in the UK and test them in China to ensure maximum cost-effectiveness  We will develop a new low-cost, camera designed specifically for the needs of China. This device will produce both high-quality colour images and optical coherence tomography (OCT) images of the retina. OCT is widely available but current commercial systems are very expensive.  Our new device will be based on our novel patent-pending technology and will be first tested on human donor tissue.   We will develop and evaluate new, automated image analysis techniques allowing computers to learn to analyse both colour and OCT images of the retina. We aim to produce systems capable of differentiating between patients with and without DR and between those with mild/moderate and severe disease at the time and place of patient care.  In order to achieve a high level of diagnostic accuracy (over and above automated image analysis), we will develop and evaluate a new human learning system. This system will harness the collective judgements of Chinese health workers to rank images in terms of DR severity. We will create a self-sustaining network of activity where novices and experts support each other in making effective clinical judgements. We will develop new statistical methods to underpin the system and to evaluate both diagnostic accuracy and performance of the health workers. Our imaging and diagnostic system will be validated in 241 patients with diabetes in the UK. Our project team in China will then undertake a pilot study of 461 patients and a costing exercise. The diagnostic accuracy of the system and its cost-effectiveness will be investigated.  We will engage policy makers through our Chinese team who occupy leading roles in the CMA. Detection and treatment of sight threatening DR will prevent disability with benefit to Chinese society and China's economy. Our systems will upskill health care workers, strengthen existing health systems and build research capacity in China. Dissemination of our techniques through open-source software will maximise benefits for other low and middle-income countries.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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      "title_narrative":["TERSE: Techno-Economic framework for Resilient and Sustainable Electrification"],
      "description_narrative":["Rural electrification is fundamental for the social and economic development and well-being of developing countries, as it supports the development of vital critical infrastructures (e.g. communication and transportation) and it provides energy to critical services to peoples' quality of everyday life, such as home appliances, health and water supply. The lack or limited and highly unreliable access to electricity still remains one of the key challenges that rural and remote communities face in these countries. In order though for the electrification to go beyond lightning, it is critical to develop energy networks that are sustainable, cost-effective, and scalable, as well as resilient, particularly in areas that are frequently exposed to natural hazards, such as floods, monsoons, etc.       In this context, the ambition of this project is to develop a novel holistic techno-economic framework for supporting and enabling the decision, policy and regulatory making towards the design of transformative energy networks in developing countries. This holistic framework will be supported by the development of an options portfolio for sustainable electrification, including a mixture of infrastructure solutions (e.g. building new or upgrading existing infrastructure) and emerging low-carbon distributed energy resources that will focus on the development of sustainable microgrids (both grid-connected and off-grid). Further, integrated system simulation models will be developed to analyse the vulnerability and quantify the risk and resilience profile of these energy solutions to natural hazards and extreme weather. This is is highly timely given the latest evidence of the impact of such events worldwide and also highly critical if the rural communities are to withstand and quickly recover from such catastrophic events. Following these analyses, stochastic optimization planning techniques will be developed to support the optimal design of these energy networks, considering transformative energy technologies, to maximize the impact on the well-being of local communities.  Building on this last point, the research team has developed a well-structured user-engagement strategy, bridging to wider socio-economic aspects of communities facing electrification challenges. The aims of this strategy are to get an in-depth understanding of the electricity needs of rural communities in the partner countries (China and Malaysia), enable their active role in the project and provide briefing and training sessions on the use of the new energy technologies to be applied in these communities. The UK and overseas research teams will jointly work with the local industrial partners to facilitate this active involvement of remote villages, communities and their local authorities.   This project will aim to complement and further strengthen the current electrification plans of the partner countries, i.e. Malaysia and China. The research team will work closely with Sarawak Energy and other authorities in Malaysia to review and improve its Rural Power Supply Scheme that was formulated in 2015, as well as evaluate and improve the design, operability and maintenance planning of existing microgrids in Zhoushan islands, China, which also serve as excellent testbeds for validating the simulation models developed by the project. Within this context, this project will also aim to develop recommendations for changes and improvements in standards, regulatory and policy-making frameworks. We will aim to make the key findings and recommendations of this work of generic applicability and validity to accommodate its international development importance. This would also be of UK national importance, where building sustainable energy networks for reducing its carbon footprint, while being resilient to extreme weather (e.g., the storms of 1987, 2007 and 2015 which resulted in major power outages) is key for safeguarding the social and economic well-being of the country.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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      "title_narrative":["Self-recovery housing for development: scaling up crisis preparedness and humanitarian shelter response"],
      "description_narrative":["Earthquakes, storms, floods, and conflict cause untold damage to infrastructure, services, agriculture and livelihoods. The destruction of housing is often most visible, and the most devastating to the families, with often hundreds of thousands of homes destroyed. Householders themselves are invariably the first to respond; they are never passive, and signs of shelter recovery are very apparent from the first days after a disaster. The majority - as many as 80 or 90% - receive little or no assistance from the international community and are the main drivers of their own recovery process. This process has been termed 'self-recovery'. Previous GCRF awards supported interdisciplinary teams led by ODI in collaboration with CARE International UK, BGS, UCL and Loughborough University. They developed the understanding of the self-recovery process and advanced the theoretical basis for humanitarian assistance to the process of supporting self-recovery in practice. In large part as a result of this work, self-recovery is now a strategic element of the humanitarian shelter sector discourse with many disaster responses purporting to support this inevitable process. In recognition of the value of a people-centred approach that moves away from the convention product-based modalities, the CARE Philippines post-cyclone self-recovery project won the 2018 World Habitat Award in acknowledgment of its self-recovery focus. Sixteen thousand houses were built, each one unique and reflecting the priorities and means of each family. https://www.world-habitat.org/world-habitat-awards/winners-and-finalists/post-haiyan-self-recovery-housing-programme/ The self-recovery approach that respects the primacy of agency and choice aligns well with current humanitarian and development concerns such as the 'humanitarian development nexus', the Grand Bargain's emphasis on localisation, participation and cash-based responses, the Sendai Framework on Disaster Risk Reduction, the Sustainable Development Goals and the Global Shelter Cluster strategy. This is further explained in the Business Case. However, very little has been done to develop guidance for practice. With the exception of the protocol 'Informing Choice for Better Shelter' that delivers a guide for the development of technical educational material, there are no published tools nor guidelines that provide an implementation framework for self-recovery in shelter projects. This project addresses this gap. CARE International has over 70 country offices across the world, all of them in ODA eligible  countries. All of the proposed activities will take place two hazard prone countries where there is a CARE presence and/or an activated coordination system in the form of a country level shelter cluster. The potential regions to be selected include South Pacific islands, East Africa, Central America, Philippines and SE Asia the precise locations to be dependent on ongoing and new disaster responses. In all instances the research team will be working with the Global Shelter Cluster, country level clusters and/or CARE International country teams. These will all be ODA eligible countries. The protocol developed will be adapted to become a preparedness tool for the specific ODA eligible country context. All outputs will be thoroughly scrutinised by the humanitarian sector and incorporated directly into practice.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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