NEW YORK — Two new, startup health care innovations could help cut neonatal deaths in remote areas with a key ingredient: tailored tech solutions for low-resource settings.
While the global number of neonatal deaths has halved since 1990, 2.5 million children still died in the first month of life in 2017, according to the World Health Organization. And the chance of dying before a child’s fifth birthday is 1.5 times higher in rural settings, according to UNICEF.
“We often find that medical equipment is not designed for 85% of the world's population.”— Sona Shah, CEO, Neopenda
The two organizations, Neopenda and E-Heza, presented different approaches to neonatal health care in Uganda and Rwanda respectively, last week at the annual MIT Solve forum in Cambridge, Massachusetts.
Solve, a 4-year-old Massachusetts Institute of Technology initiative, provides tech entrepreneurs with funding — a minimum of $10,000 each — plus access to experts and new networks. Its challenges for 2018 focused in part on solutions for frontlines of health. In September, a new group of entrepreneurs will present solutions in New York to address early childhood development, healthy cities, the circular economy, and community-driven innovation.
For both startups, which were selected as two of the 33 finalist Solve teams for 2018, quality data and equipment designed by and for health workers in low-resource settings is key.
“We often find that medical equipment is not designed for 85% of the world's population,” said Sona Shah, a biomedical engineer and CEO at Chicago-based startup Neopenda. “We realized if we really involve users in the design of the process, the devices won't fail and they won't end up in the graveyard.”
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The result is a rechargeable silicone band that wraps around a newborn’s head and continuously measures four vital signs: pulse rate, respiratory rate, blood oxygen saturation, and temperature. The blue band is designed to withstand extreme heat and exposure to dust and other elements.
The band collects data wirelessly, which then feeds into a dashboard on a tablet. This information would alert nurses if a newborn goes into distress, and also allows them to continuously monitor a baby’s vitals.
This could eliminate the problem of poorly functioning or absent medical equipment that rural health care workers and administrators describe. Shah and her co-founder have visited one-third of all hospitals in Uganda as they developed and revised the band’s design. Neopenda is now undergoing clinical evaluations for regulatory approval and could become a commercial product by the end of 2019. The cost for a package of 15 wearable bands and one tablet will likely be a fraction of the cost for a traditional monitor, according to Shah.
“There isn't really equipment that is designed for these settings. But when it is designed and functions as it is supposed to, it can be such an enabler for improvement,” Shah said.
Health care workers and mothers at nine rural Rwanda hospitals helped inform the design of E-Heza, which allows health care professionals to plug in health stats of children and pregnant mothers on a tablet in English or Kinyarwanda, charting a digital, real-time history of a patient’s health record. That data, which can be logged initially offline, feeds into the Rwandan government’s public health records, syncing the two separate systems.
About 5,000 children and mothers are presently in the E-Heza system and the Rwandan government — a partner with E-Heza — hopes to expand the program nationwide and to other countries.
“What we looked at is how do we solve the needs of the national government, because they really want that data, but also understand the needs and constraints at the frontline of health,” explained Wendy Leonard, CEO at the nonprofit The Ihangane Project, which created E-Heza. She also works as a primary care physician in California.
“What was happening was on the ground and at health centers, where 90% of health care is provided, they were not able to use the system in a way they could do it in front of the patients,” Leonard continued.
Logging health data on a paper-based system means that health workers might diagnose malnutrition, for example, days or weeks after an appointment. The app could lead to immediate diagnosis, and also help parents benefit from seeing a visualization of their baby’s growth.
“Rwanda has robust data management systems, but timely, reliable data at the community level is a big point in all health management information systems,” said Marijke Wijnroks, chief of staff at the Global Fund to Fight AIDS, Tuberculosis and Malaria.
“Because we support Rwanda’s national strategies, we rely on the national structures, and reporting systems and data for us is incredibly important,” Wijnroks continued.
Wijnroks connected with E-Heza last September at a Solve meeting and has been working to link them with partners in Rwanda and to provide technical support.
“The risk of developing such tools is you develop something in the capital, or wherever you are based, and then it does not really respond to what the community health workers need,” Wijnroks explained.
“The program is very easy and takes the health care worker through step by step, so it makes it very visible to the worker how the child is doing and is really developed with the end users in mind, which is really attractive,” she continued. “The real benefit also comes if you can link it into the national health care system.”