Connecting the Community for Maternal Health 2.0

Connecting the Community for Maternal Health Challenge: Research Capacity Building in Maternity Care Deserts (CCMH 2.0)

Maternal mortality remains a serious public health challenge in the United States, with rural and under-resourced communities facing disproportionately high rates. Many of these communities are located in "maternity care deserts," areas lacking hospitals, birth centers, or obstetric providers, and community-based organizations working in these areas often lack the research infrastructure needed to fully participate in and lead maternal health research.

Building on the success of the original 2022 Connecting the Community for Maternal Health Challenge, CCMH 2.0 is a National Institutes of Health (NIH) prize competition under the IMPROVE initiative that rewards non-academic 501(c)(3) organizations, advocacy groups, and state or federally recognized Tribes for building the research capacity and infrastructure needed to lead or partner in maternal health research, with special emphasis on maternity care deserts and, newly, research into fathers' role in maternal health outcomes.

Through this multi-phase competition, participating organizations will strengthen their ability to lead or partner in future NIH- and HHS-funded maternal health research, ensuring the communities most affected by poor maternal health outcomes have a central role in shaping the research that serves them. The Challenge is open to U.S.-based non-academic 501(c)(3) organizations and state or federally recognized Tribes; academic partnerships are welcomed but not required.

Maternal mortality in the U.S. remains high relative to peer nations, with 649 women dying of maternal causes in 2024 (a rate of 17.9 deaths per 100,000 live births). Over 5.5 million U.S. women live in areas with no or limited access to obstetric care, and more than 35% of U.S. counties are considered maternity care deserts, meaning they have no hospitals, birth centers, or obstetric providers. Rural maternal mortality rates run as much as 65% higher than urban rates, and closures of rural obstetric units are likely to widen this gap further.

Addressing these disparities requires advances in prevention, diagnosis, and treatment, along with meaningful inclusion of the communities most affected, including mothers, fathers, and extended family, in shaping the research itself. Community-based organizations face real barriers to participating in the biomedical research enterprise. Funding opportunities are often written for university settings, and many organizations lack the research infrastructure, staff, or administrative capacity to compete for and sustain research programs. This gap leaves them dependent on academic partners, often at the cost of their own voice in setting the research agenda, even though these organizations have a unique understanding of the communities they serve.

In 2019, NIH launched the IMPROVE initiative to reduce preventable maternal deaths and improve outcomes before, during, and after delivery, with community engagement as a core priority.

Recruitment Phase

The Recruitment Phase is 6 weeks long and is open to all community-based or advocacy organizations and Tribes that meet the eligibility criteria stated below in the Rules section of this announcement. Informational webinars during this period will introduce the challenge sponsors at NICHD, provide general guidance on proposal submission, and share the opportunities that participation in this challenge will provide. There will be question and answer sessions at the end of every webinar. We recognize that many organizations may be unfamiliar with the process of working with the NIH and with developing and articulating their research ideas. Introductory materials will be provided during the Recruitment Phase to orient them to the research process and to the Challenge process.  

At the end of the Recruitment Phase, organizations that are interested in continuing in this Challenge will be asked to complete a very short Training Phase Entry Application to participate in the Training Phase. Organizations do not need to participate in the Recruitment Phase to submit a Training Phase Entry Application. Training Phase Entry Applications will be evaluated based on the Training Phase Entry Application Evaluation Criteria stated below. Up to 50 organizations will be accepted to participate in the Training Phase.

Training Phase

Up to 50 Training Phase participants will receive deeper and more customized training for six weeks. Training services will include online training and other forms of educational guidance to help organizations create a complete and competitive Training Phase Final Submission that organizations must complete to be considered for participation in the Proposal Phase of the competition. The Training Phase participants will have access to training webinars, join weekly workshops, and receive feedback on one draft of their Training Phase Final Submission. 

The Training Phase Final Submission will consist of a brief, one-page proposal describing their organization and the research idea they wish to implement if selected to participate in the later phases of the challenge. Research ideas must be relevant to maternal health, address community-identified needs, and specifically align with the objectives of the IMPROVE initiative (see specific requirements in evaluation/judging criteria below). Only organizations that participated in the Training Phase can submit a proposal to advance to the next phase of the Challenge, the Proposal Phase. Up to 20 organizations will be selected to advance to the Proposal Phase of the challenge based upon the Training Phase Final Submission Judging Criteria described below. Each of the 20 advancing organizations will receive a $10,000 award. 

Proposal Phase

In this third phase, each of the 20 participating organizations selected to advance from the Training Phase will develop a comprehensive research proposal over the course of 10 weeks. Each organization will be custom matched with a mentor and will be invited to participate in regular workshops and webinars on relevant topics. Interactions with mentor(s) and one another will help each organization develop a fully realized research proposal that is well-aligned with the objectives of the IMPROVE initiative. For many non-profit organizations with limited resources, this kind of sustained effort is extremely difficult to undertake. The $10,000 prizes awarded in the Training Phase could be used to help support their continued participation in this phase. Up to 10 organizations will be selected to advance to the Research Phase based on the Proposal Phase Judging Criteria and will receive a $150,000 award that could be used to stand up their research infrastructures and pursue their proposed research activities. 

Research Phase

In this fourth and final phase, the 10 organizations selected to advance from the Proposal Phase will have approximately 18 months to implement their project plans, conduct the proposed research, and report results. During this phase, each organization will continue to meet regularly with their respective mentors for specific advice and guidance, and all finalists will also be invited to participate in workshops and webinars to hear from different subject matter experts on topics related to maternal health and more broadly towards sustaining their research activities. For the Research Phase, services of an Institutional Review Board will be provided if needed. At the end of this phase, each organization will present in a research showcase and later submit a report that summarizes their activities, research findings, and conclusions. This report will also include a project plan outlining the next steps resulting from the initial findings and a proposed supporting budget. Organizations that are judged to have met the minimum criteria and satisfactorily provided the required information in their final research report will be eligible to receive one of up to eight 3^rd Place prizes of $100,000 each. Those organizations who are judged to have exceeded the minimum criteria and demonstrated successful completion of their proposed research projects will be considered for the 1^st Place prize of $350,000 and the 2^nd Place prize of $250,000. Any prize purse funds that remain un-awarded following the completion of the Research Phase may be added to each of the prize amounts awarded to the winners of the Research Phase. The 1^st Place, 2^nd Place, and up to eight 3^rd Place prizes will be awarded based on several factors, including reported outcomes from this phase and performance during the Research Phase. Those specific factors will be announced at the conclusion of the Proposal Phase and prior to the start of the Research Phase.  

The total prize purse for the Connecting Community for Maternal Health Challenge is $3,100,000. Prizes will be awarded across the multiple phases of this challenge as described in the table below. In addition to cash prizes, participating organizations in this challenge will be provided with substantial education, training, and mentoring opportunities. 

*Amounts will be awarded based on several factors, including reported outcomes from this phase and performance during the Research Phase. Amounts will range between a 1^st Place prize of $350,000, a 2^nd Place prize of $250,000, and up to eight 3^rd Place prizes of $100,000. Prize amounts may increase if there are prize purse dollars that were not awarded during previous phases of this Challenge.

Participation in the CCMH 2.0 is open to organizations that qualify for tax-exempt status under Section 501(c)(3) of the Internal Revenue Code or are state or federally recognized Tribes, have a primary place of business in the United States, are not institutions of higher learning, and (at the time of submission) are not listed as the primary awardee on a NIH grant, cooperative agreement, or contract award.  Examples of eligible organizations include but are not limited to federal or state recognized Tribes, advocacy, local community, faith-based, and other similar groups with a demonstrated interest in conducting maternal health research.  Eligible organizations may choose to partner with other groups, but the lead organization submitting to this challenge must meet the criteria stated below.  Organizations listed as the secondary or sub-awardee on a NIH grant, cooperative agreement, or contract are eligible to compete.  Participating organizations may add or change partners as they successfully advance through the different phases of the challenge, so long all eligibility criteria and participation rules continue to be met.

Eligibility Rules: 

(1) To be eligible to win a prize under this Challenge, a Participant Organization— 

1. Shall have registered to participate in the Challenge under the rules promulgated by the National Institutes of Health (NIH) as published in this announcement. 
2. Shall have complied with all the requirements set forth in this announcement; 
3. Shall be incorporated in and maintain a primary place of business in the United States; 
4. Shall be a registered tax-exempt organization and meet the criteria as defined under Section 501(c)(3) of the U.S. Internal Revenue Code and/or a state or federally recognized Tribe;
5. Shall not be an institution of higher learning as defined at 38 USC § 3452(f); 
6. Shall not, at the time of submission, be listed as the primary awardee on an active grant, cooperative agreement, or contract award issued by the National Institutes of Health; 
7. Shall not be a federal entity or federal employee acting within the scope of their employment; 
8. Shall not be an employee of the Department of Health and Human Services (HHS, or any other component of HHS) acting in their personal capacity; 
9. Who is employed by a federal agency or entity other than HHS (or any component of HHS), should consult with an agency ethics official to determine whether the federal ethics rules will limit or prohibit the acceptance of a prize under this Challenge;
10. Shall not be a judge of the Challenge, or any other party involved with the design, production, execution, or distribution of the Challenge or the immediate family of such a party (i.e., spouse, parent, step-parent, child, or step-child). 
11. In the case of any individuals participating on behalf of a Participant Organization, they shall be 18 years of age or older at the time of submission. 

Participation Rules:

(1) A Participant Organization may not use federal funds from a grant award or cooperative agreement to develop their Challenge submissions or to fund efforts in support of their Challenge submissions. 

2) Federal contractors may not use federal funds from a contract to develop their Challenge submissions or to fund efforts in support of their Challenge submissions. 

(3)  By participating in this Challenge, each Participant Organization agrees to assume any and all risks and waive claims against the federal government and its related entities, except in the case of willful misconduct, for any injury, death, damage, or loss of property, revenue, or profits, whether direct, indirect, or consequential, arising from participation in this Challenge, whether the injury, death, damage, or loss arises through negligence or otherwise. 

(4)  Based on the subject matter of the Challenge, the type of work that it will possibly require, as well as an analysis of the likelihood of any claims for death, bodily injury, property damage, or loss potentially resulting from Challenge participation, no Participant Organization participating in the Challenge is required to obtain liability insurance, or demonstrate financial responsibility in order to participate in this Challenge, or agree to indemnify the federal government against third party claims for damages arising from or related to Challenge activities in order to participate in this Challenge. 

(5) A Participant Organization shall not be deemed ineligible because the Participant Organization used federal facilities or consulted with federal employees during the Challenge if the facilities and employees are made available to all Participant Organizations participating in the Challenge on an equitable basis.

(6)  By participating in this Challenge, each Participant Organization warrants that they are sole author or owner of, or has the right to use, any copyrightable works that the submission comprises, that the works are wholly original with the Participant Organization (or is an improved version of an existing work that the Participant Organization has sufficient rights to use and improve), and that the submission does not infringe any copyright or any other rights of any third party of which the Participant Organization is aware. 

(7)  By participating in this Challenge, each Participant Organization grants to the NIH an irrevocable, paid-up, royalty-free nonexclusive worldwide license to reproduce, publish, post, link to, share, and display publicly the submission on the web or elsewhere, and a nonexclusive, nontransferable, irrevocable, paid-up license to practice, or have practiced for or on its behalf, the solution throughout the world. Each Participant Organization will retain all other intellectual property rights in their submissions, as applicable. To participate in the Challenge, each Participant Organization must warrant that there are no legal obstacles to providing the above-referenced nonexclusive licenses of the Participant Organization’s rights to the federal government. To receive an award, Participant Organizations will not be required to transfer their intellectual property rights to NIH, but Participant Organizations must grant to the federal government the nonexclusive licenses recited herein. 

(8)  Each Participant Organization agrees to follow all applicable federal, state, and local laws, regulations, and policies.

(9) Each Participant Organization participating in this Challenge must comply with all terms and conditions of these rules, and participation in this Challenge constitutes each such Participant Organization’s full and unconditional agreement to abide by these rules. Winning is contingent upon fulfilling all requirements herein.

(10) As a condition for winning a cash prize in this Challenge, each Participant Organization that has been selected as a winner must complete and submit all requested winner verification and payment documents to NIH within 10 business days of formal notification. Failure to return all required verification documents by the date specified in the notification may be a basis for disqualification of a cash prize winning submission.

Basis Upon Which a Winner Will be Selected. 

Submissions will be evaluated based upon the following Judging Criteria across each phase of the challenge:

Training Phase Entry Application Evaluation Criteria 

Training Phase Final Submission Judging Criteria 

Proposal Phase Judging Criteria

Research Phase Judging Criteria

At the end of the Research Phase each organization will submit a report that summarizes their activities, research findings, conclusions, and developments in their research capacity. This report will also include a project plan outlining next steps resulting from the initial findings and a supporting budget. Specific evaluation criteria for the research report submission will be announced at the conclusion of the Proposal Phase and prior to the start of the Research Phase. In general, these reports are anticipated to be evaluated based on the following categories of criteria: 

• Activities performed
• Results reported
• Analysis of results and conclusions drawn from analysis
• Lessons learned
• Proposed next steps
• Project plan and budget to support proposed next steps