The Bill & Melinda Gates Foundation is currently accepting proposals for the Grand Challenge on “Improving Access to and Use of Safe and Appropriate Cesarean Section”.

The Gates Foundation invites proposals for interventions to address the following challenges related to the cesarean section:

  • Increasing access to cesarean section where it is currently inadequate.
  • Increasing quality and safety of cesarean section to reduce iatrogenic harm to both mothers and newborns.
  • Reducing rates of non-medically indicated cesarean section.

Interventions addressing more than one challenge (e.g. quality and access) are encouraged. In some geographies all three of these challenges exist simultaneously, at different times for different populations; in other geographies only one or two of these challenges predominate. Applications should clearly state which of these three challenges is being targeted and provide clear rationale for why the intervention is likely to address the challenge. The Challenge is particularly interested in geographies with high fertility and weak health systems that will face challenges to ensure the provision of safe c-sections can keep pace with medical need, and they will thus consider applications proposing activities to be implemented in Sub-Saharan Africa or South Asia (India, Pakistan, Bangladesh)

Cesarean section (CS) is a life-saving procedure for mother and newborn. However, too often c-section is not available, is provided without adequate quality, or is provided when not medically indicated – all dimensions that lead to maternal and newborn mortality and morbidity. They see an opportunity to nurture the field to identify and demonstrate feasibility of interventions to address challenges related to safe, timely, and appropriate cesarean section in low and middle income countries.

Grant Funding Levels

The Foundation seeks to make Seed Grants to generate proof of concept of novel interventions together with Validation Grants to generate further evidence of feasibility at a larger scale for existing interventions.

  • Seed Grants of $100K for up to 24 months: These grants are intended to provide proof of concept of an intervention that is entirely novel at small scale (e.g., single facility or district). Applicants should conduct a literature review to verify that the proposed intervention has no documented evidence; documentation of the methods and outcomes of this review must be provided in the application. These grants should demonstrate the feasibility of a novel intervention and its impact on one or more of the c-section challenges identified in this call for applications.
  • Validation Grants of $300K for up to 24 months: These grants are intended to demonstrate the feasibility of a single intervention or a combination of interventions at the scalable unit of a health system. Validation grants must replicate, confirm or more rigorously test one intervention – or multiple interventions – that have previously demonstrated proof of concept at a smaller scale. Given the complexity of the problem, they acknowledge that multi-component interventions are required, and they encourage applications exploring these.

All applications should:

  • Focus on health service or delivery innovation. This call for applications excludes development of new medical devices and non-interventional analysis of data.
  • Describe how the intervention will be tailored to the epidemiology and health system where it will be implemented.
  • Ensure that women and newborns receive care that respects and preserves their dignity, including informed consent.
  • Include participation from institutions based in South Asia and sub-Saharan Africa; applications led by institutions from these geographies are encouraged.
  • Propose interventions that align with the attributes of scalable health innovations.
  • Report impact on c-section rates disaggregated by Robson classification , and safety with indicators such as case fatality rates and rates of post-operative complication.
  • Propose activities to be implemented in a country in Sub-Saharan Africa or South Asia (India, Pakistan, Bangladesh).

A few of the many options will consider include (but are not limited to): clinical team huddles for improving quality of CS; interventions to improve immediate breastfeeding and bonding among mother-infant pairs after CS; interventions to improve communication between patient and care team; restructuring labor wards to facilitate latent phase labor management; adjustments to financial incentives related to CS; policy and liability reform.

Eligibility Criteria

  • Grand Challenges is open to both foreign and domestic organizations, including non-profit organizations, for-profit companies, international organizations, government agencies and academic institutions. Individuals and organizations classified as individuals for U.S. tax purposes are not eligible to receive an award from the foundation as part of the Grand Challenges initiative.
  • Upon registration, applicants must provide information about the tax status of their organization as different terms and conditions may apply. You should confirm your organization’s tax status with the appropriate advisor or entity within your organization such as your grants or contracts department, finance, or office of sponsored research. The foundation may request additional information regarding your tax status.

How to Apply

Interested applicants can apply via given website.

For more information, visit Bill & Melinda Gates Foundation.

Name of the Organisation
The Bill & Melinda Gates Foundation
Grant Amount
USD 1,00,000
Closing date of Proposal
Wednesday, 22 April, 2020
RFP Email
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