Altarum Institute

MICHIGAN CENTER FOR EFFECTIVE IT ADOPTION, MI'S REGIONAL EXTENSION CENTER

REDUCING THE BURDEN OF CHILDHOOD DENTAL DISEASE

HEALTH CARE INNOVATION CHALLENGE

ENHANCING NATIONAL STD/HIV PREVENTION EFFORTS BY PROMOTING HOLISTIC, COMPREHENSIVE AND EVIDENCE-INFORMED, HEALTH AND WELLNESS APPROACHES THROUGH STRATEGIC PARTNERSHIPS - IN SUMMER 2022, THE U.S. EXPERIENCED A RAPID AND UNEXPECTED OUTBREAK OF MPOX. THE PUBLIC HEALTH COMMUNITY QUICKLY MOBILIZED TO HELP PREVENT THE SPREAD OF MPOX BY ENCOURAGING THOSE MOST AT RISK OR EXPERIENCING SYMPTOMS TO GET TESTED, VACCINATED, AND/OR TREATED, AS NEEDED. HARM REDUCTION BEHAVIORS WERE ALSO PROMOTED TO REDUCE EXPOSURE TO MPOX THROUGH CLOSE CONTACT, SEXUAL ACTIVITIES, OR CONTACT WITH CONTAMINATED SURFACES AND MATERIALS. WITH THIS SUPPLEMENTAL FUNDING, ALTARUM INSTITUTES OVERALL AIM IS TO LEAD MESSAGE TESTING, RESEARCH, AND MATERIALS DEVELOPMENT THAT WILL REDUCE THE BURDEN OF MPOX ESPECIALLY ON DISPROPORTIONATELY AFFECTED COMMUNITIES, AND HELP ENSURE WE ARE PREPARED FOR THE POTENTIAL EXPANSION OF MPOX OUTBREAKS INTO ADDITIONAL POPULATIONS. TO DO SO, WE WILL CONDUCT TWO OVERARCHING ACTIVITIES.

A NATIONAL COALITION TO ENHANCE STD/HIV PREVENTION THROUGH PROMOTION OF A HOLISTI

HEALTHY HEARTS FOR MICHIGAN (HH4M): PROVIDING SUPPORT TO IMPROVE THE HEART HEALTH AND HELP REDUCE CVD DISPARITIES BY ENGAGEMENT WITH PRIMARY CARE PRACTICES. - PROJECT ABSTRACT. HEART ATTACK AND STROKE ARE TWO OF THE LEADING CAUSES OF DEATH IN THE UNITED STATES, ACCOUNTING FOR APPROXIMATELY 800,000 DEATHS, AND OVER $300 BILLION IN HEALTHCARE AND DISABILITY COSTS EACH YEAR. TO REDUCE THIS BURDEN, IN 2011, THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES LAUNCHED THE MILLION HEARTS CAMPAIGN TO PREVENT ONE MILLION HEART ATTACKS AND STROKES BY PROMOTING THE "ABCS" OF CLINICAL PREVENTION (ASPIRIN THERAPY, BLOOD PRESSURE CONTROL, CHOLESTEROL MANAGEMENT, AND SMOKING CESSATION). MICHIGAN IS AMONG THE TOP 10 STATES WITH THE HIGHEST CARDIOVASCULAR DISEASE (CVD) BURDEN IN THE US. THE CDC ESTIMATES A CVD RATE OF 1,379 PER 100K PEOPLE IN MICHIGAN (MI). APPROXIMATELY 35% OF MI ADULTS HAVE HYPERTENSION (HTN), WITH 77% TAKING HIGH BLOOD PRESSURE MEDICATION, AND 20% REPORTING THEY WERE SMOKING. RURAL POPULATIONS EXPERIENCE A HIGHER THAN AVERAGE PREVALENCE OF HTN AND ARE MORE LIKELY TO BE PHYSICALLY INACTIVE, USE TOBACCO, AND HAVE DIABETES, WHEN COMPARED WITH URBAN COUNTIES. ALMOST 25% OF MI'S POPULATION LIVE IN RURAL COMMUNITIES WHERE INDIVIDUALS OFTEN FACE EXTENDED DRIVE TIMES TO THEIR PRIMARY CARE PROVIDER AND PROVIDER SHORTAGES. EACH OF MICHIGAN'S 57 NONMETROPOLITAN COUNTIES HAVE A SHORTAGE OF PC PRACTICES. WORK WITHIN THE AHRQ-FUNDED EVIDENCENOW PROGRAM SUGGESTS THAT SOME EVIDENCE-BASED QI STRATEGIES TO IMPROVE CVD CARE CAN BE ADAPTED AND IMPLEMENTED IN SMALL PC PRACTICES WITH LIMITED RESOURCES. THE HEALTHY HEARTS FOR MICHIGAN (HH4M) PROJECT WILL BUILD ON EVIDENCENOW BY ESTABLISHING A STATEWIDE COOPERATIVE AND NETWORK OF PRACTICE FACILITATORS IN MI WHO WILL SUPPORT SMALL RURAL PRACTICES TO IMPLEMENT CLINICAL INTERVENTIONS TO IMPROVE HTN AND TOBACCO CESSATION AND PROVIDE EDUCATION ON ABCS EVIDENCE. THESE EFFORTS WILL BE COUPLED WITH OPTIMIZATION OF HEALTH IT AND REMOTE MONITORING AND MANAGEMENT THROUGH TELEHEALTH TO ADDRESS BARRIERS TO ACCESS AND HEALTHCARE SHORTAGES IN RURAL MI. WE HAVE CONVENED A MULTI-DISCIPLINARY COLLABORATIVE THAT INCLUDES ALTARUM INSTITUTE, MICHIGAN CENTER FOR RURAL HEALTH, UPPER PENINSULA HEALTHCARE SOLUTIONS, THE AMERICAN MEDICAL ASSOCIATION, MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES, NORTHWESTERN UNIVERSITY AND PHYSICIAN ADVISORS. OUR COLLABORATIVE BUILDS ON THE PRIOR WORK OF ALTARUM AND OUR MI-BASED PARTNERS, DELIVERING QUALITY IMPROVEMENT SUPPORT TO SMALL PRIMARY PRACTICES, WITH THE LEARNINGS FROM A SUCCESSFUL EVIDENCENOW PROGRAM TO SPREAD EVIDENCED-BASED BEST PRACTICES AND BUILD A SUSTAINABLE PRIMARY CARE EXTENSION SERVICE IN MICHIGAN. SPECIFIC AIMS OF HH4M ARE TO: (1) CONVENE AND EVALUATE THE DEVELOPMENT OF A STATEWIDE COOPERATIVE TO SUPPORT THE IN-CLINIC IMPLEMENTATION OF THE HH4M MODEL FOR PATIENTS WITH HTN AND PATIENTS WHO USE TOBACCO; AND (2) EVALUATE THE ABILITY OF RURAL PRACTICES TO IMPLEMENT THE ELEMENTS OF THE HH4M MODEL BY IDENTIFYING FACILITATORS AND BARRIERS TO SUSTAINABLE IMPLEMENTATION, AND TEST WHETHER THE MODEL IMPROVES (A) BLOOD PRESSURE CONTROL AND (B) TOBACCO USE SCREENING AND CESSATION IN A STEPPED-WEDGE TRIAL WITH A PILOT AND THREE WAVES.

CENTER FOR MATERNAL AND CHILD HEALTH MEDICAID PARTNERSHIPS - THE CENTER FOR MATERNAL AND CHILD HEALTH MEDICAID PARTNERSHIPS (CMMP) WILL HELP STATE MEDICAID, CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP), AND TITLE V MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT (TITLE V) PROGRAMS IDENTIFY SHARED PRIORITIES AND PROVIDE MEANINGFUL, TAILORED ASSISTANCE TO ACHIEVE THEIR GOALS FOR MEDICAID AND CHIP-ELIGIBLE MATERNAL AND CHILD HEALTH (MCH) POPULATIONS. BY PROVIDING TOOLS, STRATEGIES, AND TECHNICAL ASSISTANCE (TA) TO ALIGN INTERAGENCY AGREEMENTS AND FINANCING AND FUNDING MODELS, THE CMMP WILL BUILD ON, SOLIDIFY EXISTING, AND ADVANCE NEW EFFORTS TO OVERCOME THE CHALLENGES INHERENT IN BUILDING A COMPREHENSIVE SYSTEM THAT IMPROVES ELIGIBILITY, COVERAGE, AND ACCESS; FORMALIZES POLICIES AND ACCOUNTABILITY MECHANISMS; CREATES INNOVATIVE PAYMENT MODELS; AND MAXIMIZES RESOURCES TO SCALE AND SUSTAIN IMPROVEMENTS. THIS CENTER PRESENTS AN OPPORTUNITY TO CREATE INNOVATION AND BREAK DOWN THE SILOS OF THESE STATE AGENCIES. IN PARTICULAR, THE FOCUS ON UNIQUE PAYMENT AND FINANCING STRATEGIES WITHIN AGENCIES TO SUPPORT AND BRAID FUNDING STREAMS WILL REDUCE GAPS IN ACCESS AND COVERAGE FOR MCH POPULATIONS WHILE FACILITATING THE SCALE AND SPREAD OF INNOVATIONS IN MCH CARE WITHIN AND ACROSS STATES. THE CMMP WILL NOT ONLY MOVE ACROSS AGENCIES, BUT ALSO UP AND DOWN THE CONTINUUM OF CARE BY INCLUDING MANAGED CARE ORGANIZATIONS (MCOS), SERVICE PROVIDERS, AND FAMILIES/PATIENTS AFFECTED BY THE DELIVERY OF CARE; THIS WILL ALLOW THE CMMP TO INCORPORATE VOICES NOT TYPICALLY INCLUDED IN STATE-LEVEL SYSTEMS CHANGE EFFORTS, BUT WHO ARE NEVERTHELESS KEY TO IMPLEMENTATION AND GREATLY IMPACTED BY STATE MCH EFFORTS. ALTARUM HAS UNITED HIGHLY QUALIFIED, LONG-STANDING PARTNERS, THE CENTER FOR HEALTHCARE STRATEGIES (CHCS), FAMILY VOICES, AND THE ASSOCIATION FOR MATERNAL AND CHILD HEALTH PROGRAMS (AMCHP) ALONG WITH A NEWLY DEVELOPED NATIONAL TECHNICAL EXPERT PANEL THAT INCLUDES PIVOTAL COMMUNITY-ENGAGED ORGANIZATIONS AND INDIVIDUALS WITH LIVED EXPERIEN CE, MCOS, CURRENT AND FORMER TITLE V AND MEDICAID DIRECTORS, AND KEY MCH-FOCUSED ASSOCIATIONS AND ORGANIZATIONS. OUR COLLECTIVE EXPERIENCE ALLOWS US TO SERVE AS A “UNIVERSAL TRANSLATOR” ACROSS MEDICAID, CHIP, AND TITLE V. OUR APPROACH INCLUDES ANNUAL VIRTUAL CONVENINGS TO ELEVATE STATE MODELS OF COLLABORATION THROUGH CASE STUDIES AND STATE LEADER PRESENTATIONS, A CMMP WEB BASED PORTAL HOUSING A PEER SHARING DISCUSSION PLATFORM WHERE STATES CAN DISCUSS ISSUES AND QUESTIONS, AND A TA MATERIALS AND RESOURCE REPOSITORY OF RESOURCES, SUCH AS A TERMINOLOGY PRIMER, A REPOSITORY OF MEDICAID STATE PLANS AND WAIVER LANGUAGE, AND OF MCO CONTRACT LANGUAGE. WE WILL ALSO SELECT AT LEAST 35 STATES (7 PER YEARLY COHORT) TO PARTICIPATE IN 1:1 TA FOCUSED ON COLLABORATION AND INTERAGENCY AGREEMENTS (IAAS) AND INNOVATIVE FINANCING STRATEGIES. WITHIN EACH OF THESE STATES WE WILL CREATE A STATE CMMP WORKGROUP THAT INCLUDES LEADERS/STAFF FROM MEDICAID, CHIP, AND TITLE V; HOLD KICKOFF CALLS WITH EACH STATE TO DISCUSS SHARED PRIORITIES AND CREATE STATE ACTION PLANS; PROVIDE DIRECT, TAILORED 1:1 TA TO SUPPORT ACTION PLAN IMPLEMENTATION; HOST LEARNING COMMUNITIES (2 VIRTUAL, 1 IN-PERSON PER YEAR) PER STATE IN EACH COHORT; AND PEER-TO-PEER MENTORSHIP VIRTUAL SESSIONS BETWEEN STATE COHORTS STARTING IN YEAR 2. BY CREATING A MORE COMPREHENSIVE NETWORK, WE WILL BUILD GREATER UNDERSTANDING AND STRENGTHEN RELATIONSHIPS TO ADDRESS BARRIERS TO COLLABORATION AND CREATE SUSTAINABLE SOLUTIONS TO IMPROVE CARE AND OUTCOMES AND REDUCE DISPARITIES FOR MCH POPULATIONS.

A NATIONAL COALITION: ADVANCING HEALTH AND WELLNESS TO PREVENT STDS AND HIV

ALTARUM INSTITUTE (ALTARUM), IN PARTNERSHIP WITH FACES & VOICES OF RECOVERY (F&V) AND CHANGE MATRIX (CM), IS PLEASED TO SUBMIT OUR APPLICATION TO THE BUREAU OF JUSTICE ASSISTANCE (BJA) IN RESPONSE TO THE BJA FY 2023 COMPREHENSIVE OPIOID, STIMULANT, AND SUBSTANCE USE PROGRAM (COSSUP) TRAINING AND TECHNICAL ASSISTANCE (TTA) SOLICITATION. THE ALTARUM TEAM IS WELL-POSITIONED TO PROVIDE SUPERIOR SERVICES AS THE CATEGORY 2A TTA CENTER FOR ACCESS TO TREATMENT, PEER RECOVERY, AND OTHER RECOVERY SUPPORT SERVICES (RSS). WE WILL ASSIST GRANTEES AND THE FIELD TO REDUCE THE IMPACT OF OPIOIDS, STIMULANTS, AND OTHER SUBSTANCES ON INDIVIDUALS AND THEIR COMMUNITIES, WHILE PRIORITIZING SUPPORT FOR COSSUP GRANTEES TO INCREASE ACCESS TO EVIDENCE-BASED TREATMENT, PEER RECOVERY SUPPORT SERVICES (PRSS), AND RSS, AS A COMPONENT OF SUCCESSFUL COMMUNITY REINTEGRATION. THE ALTARUM TEAM WILL WORK WITH BJA TO ASSIST GRANTEES IN SUCCESSFULLY ACCOMPLISHING THE OBJECTIVES OF THEIR SPECIFIC PROJECTS AND ENHANCE THE QUALITY OF AND REACH OF SERVICES THROUGHOUT THE FIELD. THE TTA CENTER ON ACCESS TO TREATMENT, PRSS AND OTHER RSS AT ALTARUM WILL PROVIDE A COMPREHENSIVE CONTINUUM OF TTA SERVICES. THIS SUITE OF SERVICES WILL INCLUDE ENHANCING AND EXPANDING OF THE ADVISORY BOARD, CONDUCTING CULTURALLY RESPONSIVE LISTENING SESSIONS TO ASSESS TRENDS AND NEEDS OF THE FIELD, AND PROVIDING SITE-SPECIFIC TTA. THESE LEARNINGS WILL INFORM OUR UNIVERSAL TTA PRODUCTS AND THE CREATION OR ENHANCEMENT/EXPANSION OF PERTINENT WEBINARS, PUBLICATIONS, TOOLKITS, PODCASTS, NEWSLETTERS, ONLINE LEARNING CURRICULUMS, COMMUNITIES OF PRACTICE, AND THE PRSS MENTORING INITIATIVE. ALTARUM IS COMMITTED TO CREATING INNOVATIVE WAYS TO DISSEMINATE AND ENCOURAGE THE ADVANCEMENT OF KNOWLEDGE. THE ALTARUM TEAM BRINGS TOGETHER TECHNICAL EXPERTISE AND LIVED EXPERIENCE TO OFFER A UNIQUE APPROACH TO SUPPORTING GRANTEES AND THE FIELD WITH PROJECT IMPLEMENTATION, ENHANCEMENT, PROMOTION, AND EVALUATION. WE HAVE OVER 25 YEARS OF EXPERIENCE PROVIDING NATIONAL LEVEL TTA UTILIZING MULTI-MODAL LEARNING THEORY TO TAILOR TTA SERVICES TO MEET THE NEEDS OF COSSUP GRANTEES AND THE FIELD. WITH A FOCUS ON CULTURAL RESPONSIVITY, THE ALTARUM TEAM UTILIZES AN EQUITABLE EVALUATION APPROACH TO ENSURE THAT ALL ACTIVITIES ARE PROVIDED THROUGH A LENS OF DIVERSITY, EQUITY, AND INCLUSION. KEY PROJECT STAFF FROM ALTARUM, F&V AND CM HAVE EXPERTISE IN THE DEVELOPMENT OF ONLINE AND DISTANCE LEARNING OPPORTUNITIES, THE DEVELOPMENT OF UNIFORM PROTOCOLS FOR EVALUATION AND REPORTING OF TRENDS, AND RESPONDING TO ADMINISTRATION/JUSTICE DEPARTMENT PRIORITIES. THE ALTARUM TEAM REQUESTS $2,500,000 FOR IMPLEMENTATION OF THE CATEGORY 2A TTA CENTER FOR BJA COSSUP.

INNOVATIONS IN NEWBORN SCREENING INTEROPERABILITY

ALTARUM NATIONAL TRAINING CENTER FOR COORDINATION AND STRATEGIC INITIATIVES

BJA COAP TRAINING AND TECHNICAL ASSISTANCE

MEETING THE FAMILY PLANNING NEEDS OF PEOPLE WITH SUBSTANCE USE DISORDERS: A CROSS-TRAINING INTERVENTION TO IMPROVE COLLABORATION, COORDINATION, AND CARE

RESPONSES OF THE PROGRAM OF ALL-INCLUSIVE CARE OF THE ELDERLY (PACE) ORGANIZATIONS TO COVID-19 CHALLENGES: EFFECTS AND LESSONS LEARNED - PROJECT SUMMARY/ABSTRACT. PACE (THE PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY) IS A WELL-KNOWN AND RESPECTED FINANCING AND CARE DELIVERY MODEL FOR A VERY CHALLENGING POPULATION: MEDICAID-COVERED ADULTS OVER AGE 55 NEEDING A NURSING HOME LEVEL OF CARE, 90% OF WHOM ARE ALSO COVERED BY MEDICARE. PACE PARTICIPANTS ARE GENERALLY DEPENDENT IN AT LEAST 2 ACTIVITIES OF DAILY LIVING (ADLS) OR NEED CONSTANT SUPERVISION DUE TO COGNITIVE DISABILITY. TO BE ELIGIBLE FOR PACE ENROLLMENT, PARTICIPANTS MUST BE ABLE TO LIVE SAFELY IN THE COMMUNITY WITH PACE SERVICES. THE HEART OF THE PACE MODEL LIES IN ITS COMPREHENSIVE SERVICE ARRAY, STARTING WITH A PARTICIPANT-CENTERED CARE PLAN CONSTRUCTED IN PARTNERSHIP WITH A MULTIDISCIPLINARY CARE TEAM AND ANCHORED IN A PACE DAY CENTER THAT REGULARLY OFFERS MEDICAL CARE, PERSONAL CARE, THERAPIES, MEALS, SOCIALIZATION, TRANSPORTATION, AND ACTIVITIES. DURING THE COVID-19 PANDEMIC, PACE PROGRAMS HAVE USED THEIR FLEXIBILITY AS A COMMUNITY-BASED PROVIDER OF MEDICAL AND LONG-TERM SERVICES AND SUPPORTS (LTSS) TO REDESIGN SERVICE DELIVERY AND KEEP FRAIL ELDERS AS SAFE AS POSSIBLE IN THE COMMUNITY. PRELIMINARY REPORTS TO THE NATIONAL PACE ASSOCIATION (NPA) INDICATE THAT MOST PROGRAMS QUICKLY EXPANDED TELEHEALTH AND MOVED MANY SERVICES TO THE HOME. ANECDOTAL ACCOUNTS INDICATE THAT SOME PROGRAMS HAVE IMPLEMENTED REMARKABLE ADAPTATIONS: E.G., PROVIDING OVERNIGHT CARE (NOT TYPICALLY ALLOWED IN PACE), RENTING HOTEL ROOMS FOR INFECTED PARTICIPANTS, MAKING PART OF THE PACE CENTER AN ISOLATION AREA, REDEFINING STAFF ROLES AND PROVIDING TRAINING IN THOSE NEW ROLES, AND PROVIDING POST-HOSPITAL THERAPIES IN THE PACE CENTER TO AVOID SENDING FRAIL ELDERS TO POST-ACUTE STAYS IN NURSING HOMES, WHICH HAVE HAD HIGH RATES OF COVID-19 INFECTION. HOWEVER, TO THIS POINT, RESEARCHERS HAVE NOT SYSTEMATICALLY INVESTIGATED, COMPILED, AND EVALUATED THE RESPONSES OF PACE PROGRAMS. OUR PROJECT WILL PROVIDE AUTHORITATIVE INFORMATION FOR EACH OF THREE SIX-MONTH PHASES OF THE COVID-19 EXPERIENCE, IDENTIFY EMERGING BEST PRACTICES, AND COMPARE PACE PERFORMANCE TO TRADITIONAL MEDICARE SERVICES, ADDING TO THE KNOWLEDGE BASE OF INNOVATIVE RESPONSES USED DURING THE COVID-19 PANDEMIC TO GUIDE ONGOING POLICY AND PRACTICE. WE WILL BUILD ON AN EXISTING NPA DATABASE, SUPPLEMENTING IT WITH AN ONLINE SURVEY OF PACE PROGRAMS. WE WILL IDENTIFY RESPONSES THAT PACE PROGRAMS REPORT AS BEING SUBSTANTIALLY BENEFICIAL, AND THOSE THAT HAVE NOT BEEN EFFECTIVE, FOR THE FOLLOWING: PACE PARTICIPANTS, THEIR FAMILIES, THE AVAILABILITY AND QUALITY OF ELDERCARE SERVICES IN THE GEOGRAPHIC COMMUNITY, THE HEALTHCARE WORKFORCE, AND PACE PROGRAM FINANCES. WE WILL COMPARE THE UTILIZATION AND QUALITY OUTCOMES OF PACE PARTICIPANTS AND COMPARABLE MEDICARE FEE-FOR-SERVICE BENEFICIARIES. WE WILL DIG DEEPER INTO PROMISING ADAPTATIONS THROUGH STRUCTURED INTERVIEWS. WE WILL ESTIMATE THE POTENTIAL EFFECTS OF BROAD SPREAD OF BETTER PRACTICES, AND WE WILL CONTINUOUSLY FEED OUR INSIGHTS INTO THE RESEARCH, CLINICAL PRACTICE, AND POLICY WORLDS TO ENGENDER IMPROVEMENTS IN ELDERCARE ARRANGEMENTS.

ADDRESSING THE IMPACT OF CONFIDENTIALLY PROVIDING TITLE X FAMILY PLANNING SERVICES: QUALITATIVE DATA ANALYSIS AND DISSEMINATION

CPD

ALLIANCE FOR INNOVATION ON MATERNAL AND CHILD HEALTH

PROMOTING PEER RECOVERY SUPPORT SERVICES IN CRIMINAL JUSTICE AND CHILD WELFARE

STIGMERGIC TRACKING OF IED FACTORIES, LOCATIONS AND EVENTS

A NATIONAL COALITION TO ENHANCE STD/HIV PREVENTION THROUGH PROMOTION OF A HOLISTI

SYSTEMS SCIENCE METHODS FOR ADDRESSING THE CARDIOVASCULAR DISEASE PREVENTION ???

DESIGNING AND TESTING A REPORT CARD ON HOSPICE PERFORMANCE: INCORPORATING CONSUME

EFFECTS OF CHANGES IN WIC FOOD PACKAGES ON REDEMPTIONS

CPD

AN EXAMINATION OF WIC PARTICIPANT REDEMPTION PATTERNS IN KENTUCKY PRIOR TO AND AFTER IMPLEMENTATION OF ELECTRONIC BENEFITS TRANSFER

CPD

PRICE VARIABILITY ACROSS WIC FOOD

SCIENTIFIC ADVANCES IN ADAPTIVE CLINICAL TRIAL DESIGN

CPD

REALIGNMENT OF HEALTH SYSTEM INCENTIVES

ALLIANCE FOR INNOVATION ON MATERNAL AND CHILD HEALTH