Scaling Essential Newborn Technologies

Globally, an estimated four million infants die within 28 days and one million newborn die in their first week of life. While most women deliver their babies in the health facilities, there has been widespread gaps that impede early adoption of simple   comprehensive care for newborn.This has been attributed to lack of access to right technology, shortage of trained health workers and lack of finances to introduce, scale quality programs. Poor vulnerable women in rural areas have the least access to skilled attendance. Newborns do not have access to basic care thereby increasing risk for preventable but life-threatening infections and mortality. Our solutions address neonatal mortality using simple lifesaving technologies. We will educate healthcare providers and the mothers to demonstrate efficacy and cost-effectiveness while  building sustainable distribution network critical for the newborn survival.

In Uganda, nearly 45,000 newborn die every year. In Uganda,the Neonatal Mortality Rate is 27 per 1,000 births mostly due to preventable causes. The common causes of neonatal deaths are birth infections, birth asphyxia and complications of preterm birth. Neonatal deaths are inextricably linked to conditions of delivery and newborn care. Majority of the deaths are due to poor access and utilization of health services during pregnancy childbirth and postpartum period. Most of the rural health facilities have insufficient trained skilled health workers, lack access to right technology, lack finances to introduce and expand quality programs, lack of basic equipment coupled with the long distances from home to health care facilities. All these are major deterrents to skilled facility delivery causing increased newborn mortality. Providing quality comprehensive care during labor, delivery and the first week of life can reduce newborn deaths by 75 percent. In rural setting of Uganda, health facilities lack simple low cost, affordable life-saving technologies that could prevent 75% causes of neonatal deaths within the first week of life, reducing the chances of neonatal survival. Currently there is high demand for low cost technology for newborn survival fueled by rapid increase need to prevent neonatal mortality.

We are introducing   Essential Newborn Technologies (ENBT) solution that addresses the neonatal health care gap using innovation to optimize a package of rugged, affordable technologies for quality care. Our solution increases access to newborn care using evidence to generate large-scale demand. We will  build and expand the low cost rugged ENBT, educate health providers and mothers demonstrating efficacy and cost effectiveness, while building a sustainable distribution network for reducing neonatal deaths. Our Solution include bundles of technologies that address the leading causes of newborn infections, hypothermia and birth asphyxia. The packages include the most effective, affordable and sustainable options. The Solution support the mothers and health workers to unleash the ENBT preventive effect on neonatal infections, hypothermia, and asphyxia. The ENBT contains simple tools that prevents hypothermia, infection, asphyxia and training tools that gives healthcare workers the ability to adhere to best practices and deliver cutting-edge services to the newborn. To achieve this, we will build the capacity of the health providers to provide foundation for the use of the solution for the needed long term health system change for newborn care. In addition, we will develop optimal distribution system while integrating the solution to the existing health care services.

The Essential Newborn Technologies (ENBT) solution targets newborn including their mothers living in the rural setting of Uganda. An estimated 35% of 42 million Ugandan lives in rural setting.23% of this are women of childbearing Age and 17% are pregnant women and 4% are newborns. These group of beneficiaries are marginalized (pregnant women and newborn) and the newborn bear the brunt of morbidity and mortality during birthing period and first week of life due to preventable causes. The newborns are vulnerable to infections, hypothermia, births asphyxia and other birth complications leading to loss of their lives, morbidity, absenteeism from work for their caretakers, loss of income, out of pocket expenditure for the treatment cost and this in long run causes poverty. Therefore, a robust and affordable newborn technologies that is good for promoting healthier newborn and productive communities is required. The Essential Newborn Technologies is helping to address the most preventable causes of neonatal mortality. Over the past one year, we have been working continuously with the stakeholders, mothers and the District Health Directorate to build the best solution that is affordable and cost effectiveness for the population that can prevent the major cause of neonatal mortality in rural setting.

Our solutions address the highest causes of neonatal mortality in Uganda which is aligned with the MIT Solve Maternal and Newborn challenge. In Uganda, 27% of the newborn die due to preventable cause and it is no surprise that people continue to believe that newborn in rural setting  are bound to die mainly due to infections,birth asphyxia hypothermia and birth complications. Interestingly, our newborn solution(ENBT) can prevent this happening and put it at minimal rate. Our solution will catalyze the change in newborn health care system, saving 30% of the neonatal lives every year in rural Uganda with minimal cost.

Our team strongly believe in reducing neonatal mortality for communities living in the rural setting in Uganda. The Essential Newborn Technologies (ENBT) solution address the leading causes of newborn death in Uganda mainly by infections, asphyxia, hypothermia and birth complications within the first 24 hours and one week of life. Our solution uses local tools that prevents newborn infections and mortality that keeps community struggling for sophisticated solution. Our low cost, simple and affordable technologies bundled tool prevents infections, asphyxia and hypothermia. Our simple technology is highly versatile, adaptive and withstanding to the local environment. The innovation tool is the most effective, affordable and sustainable options that will be available for the communities in the rural settings to promote comprehensive newborn care. Our solution has been limited in health facilities for the rural area in Uganda grappling with weak and poor neonatal health care systems. We are building and expanding the Essential Newborn Technologies Solution for the first time in the rural setting. We believed that our solution will reduce the high cost of treatment of the newborn arising from infection, asphyxia and hypothermia. Our pilot interventions have showed that the solution contributed to preventing 75% of the morbidity caused by infections, asphyxia and hypothermia and reduces mortality by 30%. 

Our technology contains some essential tools that ensure infection reduction (e.g. Bath soap, mucous extractor, chlorhexidine gel for cord care) and thermal care using thermometer, receiving blanket and hat. The Essential Newborn Technologies also includes educational tools for both the mother and health worker inform of pictorial guide, tips on kangaroo care and breastfeeding that guides the health workers and mothers on its applications. The core technologies are:

1) Chlorhexidine component: completely eliminates the pathogens at the cord thus mitigating and preventing cord sepsis.

2) Temperature component containing thermometer, blankets and hat significantly keep warmth for the newborn babies preventing mortality from hypothermia

 3) Asphyxia component: Contains soap, and mucus extractor system provide emergency clearance of the newborn from mucus or and fluid preventing early initiation of breathing

4) Educational training materials containing pictorial newborn care guide, tips on kangaroo care and breastfeeding will focus on capacity building for health workers, mothers and the communities on the use of the technologies.

 5)  Care services to the communities. Most of the basic equipment and essential drugs for newborn care are lacking in many hospitals; nearly all higher grade health centers and many maternity units lack resuscitation kits. Services for managing sick newborns and low birth weight babies were inadequate in the majority of the facilities that were closest to the communities, and within the communities themselves.

Reducing neonatal mortality requires both the intervention of the health workers and the community. ENBT delivers cost effective impact to the newborn within their first 7 days of life. ENBT contain components that delivers the quantifiable and qualitative impact in reducing neonatal mortality. The principles that drive change with a proven model is its being sustainable, responsive, evidence informed, human centered, partnership driven, and aligned with advancing the Sustainable Development Goals and with the goal of MIT Solve Challenges of reducing newborn death. The simple technology helps the newborn survive (end preventable mortality) and thrive (improve health and wellbeing). Newborn health, survival and wellbeing is an urgent, recognized need around the targeted vulnerable communities. Infection is a leading cause of death for newborns in a resource constrained health facilities struggling to maintain a sterile birthing environment, provide warmth for the newborn to prevent heat loss, and stimulates and sustained breathing for the newborn within the first minute and that is where our technologies comes into prevent the major causes or neonatal morbidity and mortality in rural Uganda. This investment in education training for health workers provides the foundation for an innovation ecosystem and for future inventions needed for long-term health systems change. For the past one year of our ENBT pilot, we prevented over 75% of newborn morbidity and save 30% of newborn lives from infections, asphyxia and hypothermia.

We will build capacity and deploy it where morbidity and mortality rate for newborn is high in Uganda, launch the Solution production, build local capacity for implementing the newborn health services strengthen medical device and this is expected to prevent most newborn deaths. During the innovation, the team will carry out the following activities using the content of the innovation 1) Producing the product 2) Deploying the low technologies to the rural health facilities and communities 3) Training of the health workers. Our TOC will follow the needs, outcome and impact

Need 1: cleaning airway and stimulating crying

Need2: drying the baby with a clean, dry cloth, covering the head, without wiping the vernix caseosa, and refraining from bathing the baby for 24 hours

Need 3: immediate warming by placing baby in skin-to-skin contact with mother

Need 4: cleaning umbilical cord, applying chlorhexidine gel and wiping eyes with a clean cloth

Need 5: immediate and exclusive breastfeeding.

Outcome 1 Keeping newborn warm: Caregivers and mothers make sure the newborn baby is immediately dried after birth, placed on the abdomen (skin to skin), covered with a clean towel/cloth and a hat on the head. They make sure the baby is NOT bathed for the first 24 hours.

Outcome 2 Help baby breathe: Caregivers and mothers assist the newborn baby to take its first breath by immediately rubbing its back and feet to stimulate it to cry and by clearing the mouth if it having any difficulty in breathing

Outcome 3 Keep baby clean: Caregivers and mothers wash their hands before touching the newborn baby, they cut the umbilical cord with a clean blade, they keep the cord area clean and dry, they apply chlorhexidine gel and not put anything on the cord after cutting the cord and then daily for 7 days)

Outcome 4 Help baby feed: Caregivers and mothers assist the newborn baby to breastfeed within 1 hour after birth and make sure the baby receives the first milk(colostrum) and only breast milk and no other fluids for the first 6 months.

 Impact: Reduced newborn mortality and  increased provider’s capacity.

By the end of 2019, we served 1,000 newborns with our pilot interventions in one District of West Nile region. By the end of 2020, we expect to serve about 2,000 newborns. In two- five years, we will be in a position to serve nearly 100,000 newborns each year. The target population, our solution directly impacts includes newborn within their first 24 hours and 7 days of lives. Beyond the newborns, it also serves the mothers and the individual health workers who are benefiting from the educational components of the essential solutions. We will work with the health workers to optimize the newborn care system. This will result in more growth for the use of the new Technologies. The health workers and mothers will be an important part of the Essential Newborn Technologies value chain system. Our model of delivery of the Newborn Technologies is by working with Village Health Team(VHT) and Community Health Extension Workers (CHEW) at the lower socio- background who are working in improving the health system. Our model will train VHT and CHEW who will support in distributing the simple technologies while creating incentive system for them. Moving forward, we anticipate training more VHT and CHEW to support the newborn health care system at the community and health facilities level. 

Uganda Ministry of Health (MOH) and the District Health Services (DHS) is building system at community level for preventing the common causes of newborn mortality. By providing nearly 80% of newborn with access to our solution, the country is likely to achieve healthy nation and reducing neonatal mortality.

 Currently, in Uganda, the national and local government is focusing on the use of simple, low cost and affordable technology to achieve no newborn deaths from preventable causes. 

This is where we are stepping in with the solution in our local communities. We are planning to expand and build wide base of our technologies based on our one-year impact. We plan to reach 1,000,000 in the next 5 years of our operations. 

To scale the solution, we are focused on executing a sustainable solution and expanding our capabilities in a holistic manner to achieve our goals. To accelerate the reach of the technologies to rural communities in Uganda, Democratic Republic of Congo (DR. Congo) and South Sudan based on our expansion model, our key role will be building partnership and network with the donors and the manufacturers. We will improve our working relationship with the government to increase the coverage in our area of operation.

The Essential Newborn Technologies solution is non-governmental start up project driven by mission and objectives of supporting the Ministry of Health to improve the quality of care for newborn and reduce high preventable   neonatal mortality in rural setting of Uganda. We also aim at building and expanding sustainable optimal distribution systems integrated into the existing government health system of improving health services for the under-fives. We can achieve this by having long term plan, objectives and goals. building and expanding the Essential Newborn technologies will be met with the following challenges and barriers: 

1) Funding: As the technology requires bundling and producing the tools together, the initial funding requirements will be a challenge and once this has come into play, will affect the planned scale up process.

 2)Delayed in scale up: As we plan to rapidly build and expand the Essential Newborn Technologies to other rural setting, we are required to build and form partnership with government at all levels which is crucial for smooth scale. However, this will somehow hinder the expansion and deployment process and slow the rapid scale up. 

3) COVID-19 Pandemic: The COVID-19 outbreak lock down is affecting our access to the mothers and the newborn. However, this seems to be temporary.

Our goal is to build and expand the Essential Newborn Technologies to the end user in the rural setting where it is required most. We are optimistic that MIT SOLVE Maternal and Newborn Challenge will help us to mitigate the barriers by providing valuable support in linking   the solution with donors and angel investors. 

We will address the barriers and challenges that could possibly affect building and expanding the newborn technologies in rural setting of Uganda. Our solution is receiving support from the District Health Services, international NGOs and few foundations.

 To move forward we are mobilizing resources from Foundations inform of grants and other private companies including participating in competitions. We have started to engage with various stakeholder, NGOs, Government and UN agencies particularly UNICEF and UNFPA who are directly dealing with Mothers and newborn. We are also creating network of companies innovating newborn technologies and seeking partnership.

The impact of our solution for the past one year on reducing neonatal mortality has motivated us to apply for the MIT Solve. Winning the MIT Solve prize money and other competitions will contribute to removing the critical barrier and challenges of funding. 

Additionally, working with government during our pilot phase provided us with motivation to continue working with them at all levels so as to support our system and have it integrated into the existing health system.We are again working closely with Government-Ministry of Health to ensure that the temporary inaccessibility of the mothers and newborn caused by COVID19 is addressed. 

N/A

Our current team composition is 5

Co-Founders - 2

Other full-time - 2

Volunteer - 1

The Essential Newborn Technologies team encompasses a diversity of backgrounds. The teams are experienced in the fields of Maternal and Newborn health, Public Health, Management, and Public relations and marketing. Team members collaborate and use their skills to better the world for children everywhere. The team are

1) Judith Draleru studied Midwifery and Public Health. She has 19+ years’ experience working in Reproductive, Maternal and Newborn and Public health. She is Midwife and Public Health Consultant with extensive experience in women empowerment and conflict resolution. She was speaker on TEDTEX on one baby at time. She has spoken extensively on reproductive health on media and newsletters in both South Sudan and Uganda. She is co-founder of the Essential Newborn Technologies and currently building the Reproductive Health and innovation portfolio

2) Primo Vunni MPH, Founder and Director, Partners in Community Social Action (PICSA) Uganda and

3) William Odhe: He is the Co-project lead with the required health, entrepreneurial, and management skills to support the project. William has 10+ years’ experience in health systems and Maternal and Newborn health projects. William is building a strong entrepreneurial, innovators and health team network for the project capable of working with private sector, researcher, government and local partners. Currently, William is coordinating with the District Health Services on the building and expanding the solution to the rural setting. 

 4) Mawadri Michael (MPH) 15+ years of experience, He is the research coordination for the innovation

We are partnering with the Ministry of Health particularly with Moyo District Directorate of Health Services during the pilots our Essential Newborn Technologies through end of 2019. 

We have also partnered National NGO working on Reproductive Health services, The NGO Alliance Forum for Development (AFOD) Uganda supported in training of health workers and mothers on the solution in their project area. 

We are still partnering with our existing partner Alliance Forum for Development and Ministry of Health in planning and expanding the solution.

Our innovation is designed on Nonprofit Organization model to ensure newborn in rural setting get the low cost and simple technologies for preventing the main cause of mortality among the newborns. Our main beneficiaries for the innovation are the newborn babies born to the mother with low education, poor access to health services and lack of mean to pay for the cost of health services for their newborn. However, as profitable innovation that envisioned delivering high impact value of care for the newborn, we will work with Ministry of Health to integrate the solution into the existing health services where minimal allocation can be made from the district and national budget. In the next 5 years, we shall also explore the avenues of creating public- private partnership to ensure that the innovation continue to serve the newborn.

With our solution being expanded to the communities, we are working to ensure the lifesaving solution has business delivery model in long run to solve one of the most challenging problem that affect millions life of newborn in rural Uganda. As we build, refine and expand the Essential Newborn Technologies to ensure newborn survival to make it acceptable and sustainable to deliver high impact solution for millions of the newborn with poor access to health services delivery. Becoming financial sustainable in the long-term is critical for us to continue to innovate our solution rigorously to achieve our vision. We will achieve financial sustainability with our team working on: 

1) Grant and donations: In 2019, we received small innovation Grant from Child Health Foundation to support our pilot phase. We are working on securing grant from governments, philanthropist, Foundations and Non-government organizations globally. We are planning to form partnership with USAID-DIV, DFID, and UNFPA for both financial technical support for Healthy Newborn. We will also participate in international and national competitions for innovation to raise more funds.

 2) Private Sector: We are designing a business model to build a sustained revenue flows that grow over time. We will innovate private sector distribution sale points to generate revenue for our solution using the private pharmacies.       

Our solution of Essential Newborn Technologies Solution is aligned with the Solve Maternal and newborn Challenge. Essential Newborn technologies team is working to innovate the business delivery models to solve one of the most challenging problems that affect the lives of more than half of humanity on the earth. 

As we are building, piloting and scaling the solution into sustainable and profitable business model to deliver high impact solution for newborn in Uganda, we are working with stakeholders, government and supporters at all levels to build a strong support system.

 Being borne out of small innovative funding from CHF, has provided us with a solid start. We want to broaden our support base and strongly believe MIT Solve is a vital catalyst to enable us to move forward. We believe that Solve will help us engage with a wider global community and make the vision of healthier newborn and the population in Uganda as sure reality. 

Solve will provide us access to extensive network of organizations, advisors, mentors, experts who are as driven as we are to solving Maternal and Newborn challenge and reducing high newborn mortality. That is the most valuable resource we will gain at Solve. 

This is even more important for us as we attack the hard problem of newborn health infrastructure in Uganda not just only from technology but also from delivery model, financing and impact aspects. Additionally, the prize money that accompanies will help us in the initial phase of building and expanding the solution. 

Our Innovation require good business model so as to raise enough funds for building and expanding to prevent morbidity and mortality arising from infection, asphyxia and hypothermia for over 2 million newborns in Uganda and other countries. 

Our team capacity to raise adequate fund and develop sustainable business model for the Essential Newborn Technologies solution is still inadequate. Therefore, we would benefit from the MIT-Solve team, mentors, entrepreneurs and philanthropist in this aspect. 

We are willing to build partnership with organizations that we believe are critical for us to successfully deliver impact for the newborn on the ground.

 Firstly, the government at different levels including District Health Directorate and Health Sub District (County Health services). Furthermore, we also want to build partnership so that we can achieve our desired goal.

Secondly, financing and Grant organizations such as the Grand Challenges Canada, USAID-DIV, Global Affair Canada, World Bank, African development Bank and Gates Foundation will be crucial to build and expand our solution to vulnerable and marginalized communities. This groups of multilateral donors are working with the governments of developing economies to provide monetary support to scale up promising solutions.

Thirdly, experts and consultants in the Maternal and newborn Health such as UNFPA and UNICEF who will help us with developing policy and delivery model with the national and local health services. The UN agencies can help in mobilizing resources that supports us to builds and expand the solution.

When our team started to  work on the Essential Newborn Technologies solution plan to reduce newborn mortality caused by infection, asphyxia and hypothermia for the rural setting in Uganda for host women and their newborns, we also considered women who are in various refugee camps in Uganda particularly in West Nile hosting about 600,000 refugees.

Our innovative solution has been designed for the use of women and their newborn lead by women. It is innovative, engaging and scalable. We will use the award by Women Prize for: refining and building our solution to incorporate phone and SMS mentoring for the health workers and the mothers.

This will literally reduce the cost of in person mentoring and travels. In addition, the prize will support 20% of the incentive system for the health workers.

We believed that our solution of Essential Newborn Technologies is working to reduce newborn morbidity and mortality through the use of the Technologies bundles and education training of health workers and Community Health Extension Workers. 

We will use the prize to train 100 health workers at the health facilities supporting the communities who will in turn help to mentor the mothers in the use of the technologies. In addition, we will use the prize of the Health Workforce for mentoring the health workers using mobile phone. This will help in reducing the cost incurred on supervision and on site mentoring. 

To achieve this, we will develop training module tailored into the innovation solution that will later be integrated into refresher training curriculum for the health workers in Uganda for newborn care. 

The prize from the Health Workforce will also support in the cost of travels for the project team, incentives, per diems and producing more of the innovation products for the newborn.