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NoviGuide Newborn Essentials: Clinical decision support tool to inform neonatal health care provider decision-making in Pakistan.

Award Number: R21TW012977
ORGANIZATION: FOGARTY INTERNATIONAL CENTER
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2026
PERIOD OF PERFORMANCE END DATE: 06/30/2028

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NoviGuide Newborn Essentials: Clinical decision support tool to inform neonatal health care provider decision-making in Pakistan. - Neonatal mortality remains a major global health challenge and reflects persistent gaps in the quality and reliability of newborn care. Scalable approaches to strengthen evidence-based neonatal care can improve outcomes and inform U.S. health systems. The U.S. records a preterm birth rate of 10.4% and neonatal mortality rate of about 3.7 deaths per 1,000 live births; these averages mask variations across demographic groups. A central challenge is enabling frontline providers to recognize and manage newborn complications at the point of care, since evidence often fails to reach practice. Pakistan offers a suitable research setting because of its large birth cohort, mixed public-private healthcare system, and substantial nursing and midwifery workforce. Its secondary and tertiary facilities encompass a range of settings, resources, workflows, and provider types, offering an opportunity to generate implementation evidence transferrable across health systems. NoviGuide Newborn Essential (NoviGuide) is a point-of-care clinical decision-support software designed to strengthen provider knowledge, confidence, and neonatal care decisions. Prior evaluations showed improved nurse knowledge and self-efficacy in African settings, but NoviGuide has not been evaluated in South Asia. We will be the first to assess nurse-sensitive indicators of quality neonatal care that serve as metrics related to neonatal mortality. The R21/R33 project aims to improve neonatal care and outcomes in secondary and tertiary healthcare settings in Pakistan. Over five years, we will adapt, implement, and evaluate NoviGuide in Pakistani secondary and tertiary facilities across two phases (R21 and R33). Phase 1 (R21, two years) will adapt NoviGuide via co-design and pilot feasibility and acceptability using an explanatory sequential mixed-methods approach guided by RE-AIM (Reach X Effectiveness, Adoption, Implementation, and Maintenance) evaluation framework. Phase 2 (R33, three years) will test the effectiveness of the NoviGuide in improving nurse-sensitive indicators of quality neonatal care with outcomes serving as metrics of neonatal mortality. We will use an effectiveness-implementation type 1 hybrid design with a mixed methods approach, guided by RE-AIM and Donabedian’s Structure-process-outcome theory. The project will build local research capacity and generate actional evidence on digital decision support for frontline neonatal care. It will also produce implementation evidence transferrable to U.S. settings to guide broader adoption of digital tools for high-quality neonatal care. Findings will provide actionable evidence on digital decision support for frontline neonatal care and inform implementation in U.S. settings addressing differences in neonatal outcomes. Overall, the project will produce transferable evidence to improve newborn outcomes and support scalable digital approaches to high-quality neonatal care.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $138,580 )
2026	2026	AGA KHAN UNIVERSITY	STADIUM ROAD	KARACHI				PAK	International Research and Research Training	000	1	9/8/2026	NEW	$109,725
2026	2026	AGA KHAN UNIVERSITY	STADIUM ROAD	KARACHI				PAK	International Research and Research Training	001	1	9/17/2026	SUPPLEMENT FOR EXPANSION	$28,855
														Subtotal = $138,580

Grand Total All Awards = $138,580

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NoviGuide Newborn Essentials: Clinical decision support tool to inform neonatal health care provider decision-making in Pakistan.

Award Number: R21TW012977

ORGANIZATION: FOGARTY INTERNATIONAL CENTER

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/01/2026

PERIOD OF PERFORMANCE END DATE: 06/30/2028

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