The PAPAGAIO Initiative

From Simple Ideas to Life-Saving Impact

PAPAGAIO is part of the NIHR Global Health Research Group, which funds partnerships tackling urgent health challenges in low- and middle-income countries. PAPAGAIO focuses on reducing maternal and newborn deaths and complications caused by pre-eclampsia.

We are studying how placental growth factor (PlGF) testing can help doctors diagnose pre-eclampsia earlier and determine the safest time for delivery. This work is taking place in Sierra Leone, Zambia, India, Brazil, and South Africa.

PAPAGAIO is a global partnership between King’s College London, Welbodi Partnership (Sierra Leone), University of Zambia, State University of São Paulo (Brazil), University of Cape Town (South Africa), and the University of India.

The Phoenix and PAPAGAIO Studies: Scaling Success

Following the success of the Phoenix Trial — where not a single baby was lost — similar results were replicated in Zambia through the CRADLE 4 Trial, which prevented up to 75% of neonatal deaths. Building on these insights, the Papagaio Study aims to refine diagnosis and management of pre-eclampsia using affordable, accessible point-of-care (POC) testing for angiogenic biomarkers such as PlGF (placental growth factor).

The PAPAGAIO Diagnosis Trial is being implemented across four continents — with sites in Brazil, Zambia, India, and Sierra Leone — involving over 1,300 women to determine whether PlGF testing can reduce adverse maternal and neonatal outcomes for women with suspected preterm pre-eclampsia. The trial has already trained 70 research staff and more than 700 clinicians in testing and interpreting PlGF results. Despite challenges such as logistics, customs delays, and equipment failures, the teams have shown remarkable resilience and creativity in finding local solutions.

Community Engagement and Capacity Building

In Zambia, World Preeclampsia Day campaigns have helped raise awareness through community talks, drama skits, and survivor stories. Across all countries, capacity building has been central — with new PhD students emerging, local leadership strengthened, and strong links formed between research, policy, and practice. “It’s about doing the right research in the right way, with the right people,” Dr Alex Ridout reflected. “Sierra Leone dropped their maternal mortality rate because of this approach and if it can be done in the worst of places, it can be done anywhere. This work is about building the leaders of the future” she said.

Building the Future of Maternal Health Research

The workshop also explored the PAPAGAIO Biobank initiative — a groundbreaking effort to collect and store blood, serum, and urine samples from 1,500 women across three continents. These biobanks will support future biomarker validation and innovation, ensuring that discoveries made in high-resource settings can be adapted and scaled globally.

Another key focus was community participation. As Dr Louisa Samuels, one of the lead researchers and presenters commented: “No research about us, without us.” By engaging women and communities in defining research priorities, the Papagaio team ensures that science remains grounded in the realities of those it seeks to serve. She commented how the successes are due to the collaborative process which are iterative; utilising feedback from all partner countries on outcome selection and pilot database, drawing on obstetricians, midwives, neonatologists and statisticians.

From Bench to Bedside: Turning Research into Action

The workshop closed with a shared commitment: to translate research into real-world impact. “Preeclamptic deaths are largely avoidable,” said one clinician. “It’s not just about developing a test — it’s about what we do with it.” Participants emphasized the need to embed research into care, inspire health workers, engage policymakers early, and communicate results clearly and visually so they reach those who can make change happen.

As Professor Lucy Chappell, professor of obstetrics at King’s College London and the Chief Scientific Adviser for the UK Department of Health and Social Care, concluded:

“We are the vanguard of innovation. By empowering patients, inspiring the workforce, and fixing systems that no longer serve, we can make the shovel — the hard work of change — more appealing than the status quo.”

The PAPAGAIO project stands as a powerful example of what’s possible when science, compassion, and collaboration cross borders. Together, these global teams are not only advancing research but also building the future of maternal health — one life, one innovation, and one partnership at a time.