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Intravenous (IV) administration is crucial in modern medical practice for delivering medications, fluids, and nutrients with precision, particularly in life-threatening emergencies. The gold standard for safe IV delivery is rate-controlled infusion devices, which prevent over- and under-dosing that can lead to medication toxicity, subtherapeutic concentrations, and potentially fatal adverse reactions, including heart rate abnormalities, unstable blood pressure, and respiratory distress. While these devices are readily available in high-income countries, low- and middle-income countries (LMICs) face critical access gaps. At Korle Bu Teaching Hospital (KBTH)—Ghana's largest tertiary care facility—only one infusion device is available for a 275-bed maternity ward, while Komfo Anokye Teaching Hospital (KATH) has just one device per 15 beds in its Accident and Emergency unit. Commercially available infusion devices cost between $700-$2,500 and require electricity, making them unsuitable for resource-constrained settings. Alternative methods like gravity drip IV or manual bolus injections require increased nursing attention, suffer from poor accuracy and reliability, and lead to inconsistent dosing that risks patient lives, yet nursing availability is already severely limited in LMICs.

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This project aims to evaluate and refine a novel, fully mechanical, low-cost ($150, 79% less costly than current market options) rate-controlled infusion device specifically designed for LMIC contexts through a collaborative partnership with colleagues in Ghana. The device operates without electricity, using a user-wound power spring, adjustable pendulum, and variable gear system to control infusion rate and duration for approximately two hours per windup. Through a mixed-methods study with healthcare professionals in the OBGYN unit at KBTH, the project will evaluate the device's usability, feasibility, and acceptability among physicians, midwives, and nurses; assess its adaptability within clinical workflows; and iteratively refine the prototype based on user feedback. Using validated usability scales, timed simulated trials, semi-structured interviews grounded in acceptability frameworks, structured observations, and focus group discussions, the study will engage approximately 80 healthcare professionals to understand device strengths, limitations, and integration opportunities.

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Expected outcomes include a holistic understanding of how OBGYN healthcare professionals perceive the device's usability, feasibility, and acceptability; a comprehensive assessment of workflow integration possibilities; identification of key design refinement opportunities informed by frontline user experiences; and a redesigned prototype with enhanced implementation potential validated for usefulness in the OBGYN unit at KBTH. The project seeks to contribute to health equity by developing a sustainable, contextually-appropriate medical device that breaks the cycle of donation dependence and inadequate fit, empowers nurses and midwives—often women—to deliver accurate medication infusion, improves access to life-saving treatment for conditions like preeclampsia (a top cause of maternal mortality globally), and provides strong evidence to proceed through clinical testing, local manufacturing in Ghana, and pilot implementation that could transform IV medication delivery across resource-constrained healthcare settings.

Intentional injury mortality, including suicide and homicide/femicide, is an increasingly serious yet understudied public health problem in lower-middle-income countries (LMICs). In Botswana, preliminary data reveal alarming rates of 7.46 suicides and 14.79 homicides per 100,000 people annually—comparable to the global suicide rate of 9 per 100,000 but significantly higher than the global homicide rate of 6.2 per 100,000. Between 2018 and 2022, men accounted for 88.2% of 746 suicides, with deaths disproportionately concentrated in the 18-45 age group (79.6%), while women represented 37.3% of 1,479 homicides spanning all age groups. Evidence suggests both suicide and femicide are worsening problems in Botswana, with significant COVID-19 pandemic impacts on mortality trajectories. These deaths are suspected to have strong urban-rural and socioeconomic status (SES) inequities, as urbanization and economic development introduce new social challenges while raising household affluence. However, a critical obstacle to identifying and addressing these inequities is the lack of digital tools to support retrospective data analysis and prospective surveillance for areas requiring urgent attention, as well as systems to bring attention to populations at highest risk, including the extremely poor and women.

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This project aims to quantify the nature and magnitude of intentional injury mortality in Botswana and engage diverse stakeholders—including policy makers in the Botswana National Government and Botswana Police Service (BPS)—to adapt and implement evidence-based prevention strategies. By creating a REDCap-based data entry system to digitize existing paper records from BPS investigations and enable ongoing data capture, the project will establish a comprehensive database of intentional injury-related deaths. Locally hired staff will manually enter current records, maintain the system for future entries, and ensure data quality for use by government public health groups and Botswana-based researchers. Through spatial/temporal and hierarchical clustering analyses merged with census, survey, and geographic datasets, the project will determine epidemiology and typologies of suicide and femicide, identify social, environmental, household, and individual risk factors, and reveal the most common decedent profiles to which evidence-based interventions can be tailored based on demographics, methods, timing, and location variations across the country. Expected outcomes include a pilot-tested surveillance system with demonstrated feasibility for maintaining ongoing BPS information access, data entry, and annual reporting; spatial/temporal analyses identifying intentional mortality patterns and health inequities between gender and socioeconomic groups disseminated through peer-reviewed manuscripts; an Evidence and Gap Map displaying available interventions for preventing suicide in LMICs and high-income countries; and dashboard-based reporting tools that alert municipal bodies such as BPS and the Ministry of Health to geographic "hot spots" and at-risk populations. The project seeks to contribute to health equity by empowering women in a patriarchal society where domestic abuse often goes unaddressed, creating cross-communication systems between government bodies including police, public health, and university researchers, and informing new laws, programs, and strategies that provide resources to local bodies for identifying and supporting those at risk for intentional mortality, ultimately helping prevent deaths and reduce gender-based and socioeconomic health inequities in Botswana.

Residents of informal settlements in Latin America face compounding climate-related health threats that are intensifying as temperatures rise globally. These communities—structurally marginalized and often excluded from formal infrastructure, healthcare access, and municipal services—bear disproportionate exposure to extreme heat, flooding, and storms while possessing the fewest resources to adapt. Extreme heat poses particularly severe risks, linked to cardiovascular stress, pregnancy complications, cognitive impairment, and excess mortality. In self-built housing common to informal settlements, indoor temperatures frequently exceed outdoor levels, creating dangerous conditions especially for vulnerable groups including children, elderly residents, and those with chronic illnesses. Yet most heat-health research focuses on high-income countries or isolated heatwave events, leaving critical knowledge gaps about sustained heat exposure in tropical climates where residents endure elevated temperatures for months at a time. In Colombia, approximately 23% of urban residents live in informal or inadequate housing, routinely falling outside public health surveillance systems and climate adaptation programs. These communities face not only chronic heat exposure but also intersecting vulnerabilities—unstable terrain, water scarcity, infrastructure failures, and flood risks—that compound health impacts in ways that remain poorly understood. Urban heat island effects can raise nighttime temperatures by 4-5°C in areas like São Paulo's favelas, while in Colombian cities spanning distinct climate zones, residents experience vastly different exposure patterns and adaptive pressures.

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This project will explore how residents of informal settlements in three climatically diverse Colombian cities—Bucaramanga, Barranquilla, and Bogotá—experience, perceive, and respond to climate-related health risks, with particular emphasis on extreme heat while also examining flooding, storms, housing vulnerability, and infrastructure challenges. By leveraging climatic and social variation across sites, the research will characterize climate-related exposures in each location; compare health perceptions, symptoms, and adaptive behaviors to assess whether communities facing chronic heat exposure versus more seasonal patterns report distinct impacts or coping strategies; pilot feasible, low-cost, community-informed mixed-methods data collection approaches including structured surveys, symptom assessments, qualitative interviews, and potential indoor temperature monitoring; and co-create locally tailored dissemination products—such as heat-health toolkits or risk awareness materials—to strengthen adaptive capacity and inform neighborhood-level planning.

Expected outcomes include a successfully piloted methodology tested across both sites, yielding robust household-level data on climate exposure experiences, self-reported health symptoms, and community-grounded adaptation strategies; feasibility assessment for integrating low-cost environmental monitoring with identification of ethical, logistical, and practical considerations for future expansion; refined data collection instruments and preliminary analysis reports; co-created community dissemination materials in accessible, actionable formats; at least one peer-reviewed manuscript advancing climate-health equity scholarship; and strengthened collaborative infrastructure between academic and community partners positioned to pursue multi-country research initiatives. By centering local knowledge and developing participatory tools, the project aims to inform more equitable public health interventions and climate adaptation strategies while establishing foundations for larger-scale studies across climate-vulnerable regions of Latin America and the Caribbean.

Young people in East Africa face a critical and often overlooked health burden shaped by the intersection of rapid demographic growth, limited health infrastructure, and insufficient data systems to guide timely intervention. Africa is the youngest continent in the world, with 60% of its population under the age of 25—yet health research and early warning systems designed specifically for this population remain underdeveloped. The window spanning early life through young adulthood is biologically and socially consequential: environmental exposures, psychosocial stressors, and gaps in maternal, newborn, and child health care during these years can produce cascading effects on long-term well-being. Mental health represents an additional and frequently neglected dimension of this challenge. Despite the enormous volumes of health data now being collected across East Africa and rapid advances in artificial intelligence and data science, these tools have not been systematically applied to improve health trajectories for young Africans at scale.

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The Utilizing Health Information for Meaningful Impact in East Africa through Data Science (UZIMA-DS) Research Hub addresses this gap by building a state-of-the-art, scalable, and sustainable platform for advanced data science in health research. Hosted at Aga Khan University's Institute for Human Development, the hub applies cutting-edge data assimilation techniques alongside novel artificial intelligence and machine learning methodologies to develop early warning systems capable of significantly improving health outcomes. The name draws on the Swahili word uzima—meaning health or well-being—reflecting the hub's commitment to locally grounded, community-relevant science.

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The hub fosters synergistic collaboration among statisticians, computer scientists, and informatics specialists; healthcare clinicians and practitioners; and community stakeholders across Kenya and Tanzania. This interdisciplinary structure is designed to enhance the quality, efficiency, and relevance of health data science research, ensuring that analytical methods are matched by deep contextual knowledge and community trust. Expected outcomes include operational early warning systems for maternal, newborn, child, and mental health conditions; validated AI and machine learning models trained on East African health data; strengthened regional capacity in data science and health research; and peer-reviewed scholarship advancing the field of data-driven global health equity. By centering African data, African institutions, and African communities, UZIMA-DS positions East Africa not as a subject of research but as a leader in generating the evidence needed to protect and improve the health of the continent's young people.