routine ultrasound; avoid preterm birth

Because of the recall bias associated with date of last period and proven efficiency of ultrasound scanning in estimation of length of pregnancy,many mothers in rural communities do not access ultrasound scanning soon in pregnancy and in uganda high risk preterm birth screening is not done as a routine. 

with this utilization , many mothers at high risk of preterm birth will be given prophylactic treatment and immediate referral in case of need to deliver.with immediate identification and intervention to these patients, outcomes of neonates will be improved and risks to mothers minimized.

Such a project can be run on minimal resources by empowering midwives and other front care providers who may be more available and can  also be scaled up to involve public health facilities. A franchise of equipped clinics will be set up to ensure growth of the enterprise, and this will be run along with outreach programs. 

preterm birth is delivery of a baby prior to 37 weeks of gestation. According to World health organisation,  preterm birth is 10.6% of all live births while 81.1% of these occur in Asian and sub Saharan Africa.

Preterm birth is globally the leading cause of neonatal mortality. poverty, poor access to antenatal care and quality of antenatal care increase the risk of preterm birth.

uganda is the 28th country world wide with highest preterm birth rates at 13.6 per 1000 live births with Busoga region being among the top 5 regions with poor perinatal outcomes. 

world heath organisation standard High risk preterm birth assessment tools  are not routinely done during antenatal care in uganda and the access to ultrasound scanning during antenatal is as low as 10%. this creates a lot of missed opportunities which this project wishes to address  due to timely interventions including referrals to tertiary facilities. 

we shall set a franchise of clinics to better access to quality antenatal care, routine ultrasound for gestational age and high risk  to preterm birth assessment tools will be used. mothers will be treated  with corticosteroids and tocolysis if needed and then referral to tertiary institutions will also be done.  

Accurate gestational age estimation will be done  with routine antenatal ultra sound scan and High risk preterm Birth assessment will be incorporated into the antenatal care to allow for closer monitoring of the pregnancy and hence more timely interventions in case preterm labor was detected.

we also consider partnering with and scaling this up to the public facilities for sustainability and for and increasing numbers. midwives and other front care providers will be empowered to perform these services and portable rechargeable ultrasound machines will be used to factor in the power constraints.

outreaches of these services will also be performed to increase impact of this solution to the population.

online images that can not be evaluated by front care providers will be forwarded to radiologists and imaging technologists.  

people in rural uganda and especially eastern uganda region whose health indicators  have remained at the bottom of the league table countrywide. this will greatly improve quality of antenatal care and through timely intervention reduce neonatal mortality and maternal morbidity due to premature delivery.

this will reduce on the economic burden associated with this nightmare while also improving psycho social state of the family and community at large. once this project is scaled up to cover the whole country then these effects can be replicated while changing policies at a national level  

this project is simply going to utilize already documented interventions and extend them to the less privileged population in the rural areas whose maternal child health indicators need great improvement. we shall use front care providers who are more available in the rural region and of course routine support from the more specialized team  in the urban areas will be a great advantage and support for this community. outcomes of this project will go a long way to better economic situation in the beneficiary communities. scalability of such a project can impact national policies within the country,

ultrasound scanning has been available but not accessible to the rural communities. we shall empower midwives to conduct obstetric scanning in these communities which is much cheaper, avail the ultra sound scans  and demisify their use. the world health organisation high risk assessment tool for preterm labor will then be utilized and those at high risk will receive prophylactic corticosteroids between 24 and 34 weeks of gestation to better lung maturity,health education about danger signs and referral for safer delivery with our standby ambulances and ambulance network around the region to a facility in position to take care of the preterm. This will require us setting up a franchise of outlet clinics and also partner with the public facilities within the region whose midwives will also be empowered to use the technology. This will greatly lower neonatal mortality due to prematurity since better screening and gestational age determination will be done.

ultra sound scanning is a  technique that has been here for years and strongly recommended during pregnancy because of its safety and efficacy as there is no emission of harmful rays when it is done.

it has revolutionized from desktop scans to portable rechargeable scans that can be used in rural settings with power problems.

the machine transmits high frequency sound pulses through a probe, these waves travel through the body hitting boundary between tissues.some of the waves continue further while others are reflected to the probe and relayed to the machine.

the machine calculates the distance between probe and boundaries using speed of sound and the time of each echo's return. The machine displays the distances and intensities of echoes on the screen forming images on the screen.  

this technology has been proved to work even in pregnancy as the world health organisation recommends at least one ultrasound scan before 24 weeks of gestation for dating and another in the second trimester for anatomy of the fetus. unfortunately in the rural setting this privilege can not be obtained by many mothers during antenatal care.

currently 1200 people per year who walk into our clinic get these services and better the outcomes of their neonates.

in the next year we expect these numbers to multiply about 50 times to 60,000 if we opened up 10 franchise clinics in other regions that are less accessible to our current location and closer to the population.

by using a multiplier effect of 10 franchise clinics for different rural regions and ensuring ready transportation to facillities that can attend to their needs, we visualise 600,000 people accessing this service in 5 years through our franchise. after partnering with the public facillities  these numbers can grow to over 2,000,000 by end of 5 years.  

The goal is to ope up as many franchise clinics as we can with a target of eastern Uganda whose health demographics seem to be at the bottom of the curve. we shall open 10 franchise clinics in Busoga region next year but are also open to partnering with the public facilities as soon as next year to be our projected numbers sooner and make the impact bigger.

one year we can hit 150,000

five years we can hit 3,000,000

finances is our biggest barrier at the moment because ultra sound scans are expensive equipment and running it privately, affordability of its cost for the population in which we operate is a problem. we also privately can not afford training the midwives to our desired scale despite offering machines to our public partners. 

trying to access a rural population, marketing strategies are limited and are more expensive since we would require physical movement as internet is not readily available,   

Through lobbying and presenting our ideas at international fora, we hope to attract more attention and hence funding to ensure our dream becomes a reality.

not applicable

full time; 8 members comprising of a lab technician, medical imaging technologist, 2 clinicians, an administrator, and 3 midwives

part time, 5 members comprising of a gynecologist, anesthetic officer, radiologist, senior midwife, business experts

contractor; 10 members comprising of 2 medical officers, legal advisor, auditor, monitoring and evaluation, IT expert, 3 radiographers and anesthesiologist

my team composes of specialists in obstetrics, radiology and midwifery who will play agreat supervisory and supportive role during this implementation. these specialists also have very commendable reputations within the region.

we have worked with citi foundation and balon ventures who have gone a long way in helping us streamline our financials and supported our financial management as a team. 

we are reputable organisation who the local community would be willing to associate with since we have done a variety of corporate social responsibility activities.

our work with rotary club gives as a competing edge as a corporate organisation which considers the needs of the community 

1. PSI uganda supports our post abortal care services

2. citi foundation; supports our financial management and business growth

3. balloon ventures; financial support with funding and business growth strategies.

4. Jinja district local government;  supports our immunization services with a vaccines fridge and supply of vaccines

5.Aids information center; supplies us with anti retro viral therapy drugs and care of HIV clients

6.rotary club of Njeru; we do community service with rotary club and we offer free health care during their outreach programs

we have so far used our personal saved funds and have grown our business through debt acquisition via loans and re investment with marketing strategies to grow our revenue and turnover.

we have also solicited for partners who enable us offer services at a more subsidized price and hence attract more revenue. through partnerships with specialists who come in and offer services to clientele we have also widened our service range as this betters our revenue 

we are attempting to open our income sources by soliciting for grants  as this will help us subsidize the cost of our services and better marketing and social responsibility. 

sustained donations will be used to mantain our social responsibility and relevance by applying for global grants. we plan to raise investment capital as we have always done through re investing and debts through loans.

for a number of  other services without partnerships or grants we shall also utilise specialised doctors who will sell services and we work on growing our number of specialists to grow our diversity. 

Different communities might also have a number of other needed products which we could also invest in and consider selling to these communities to maintain our long term revenue.

we shall also keep soliciting for partnerships from organisations and business partners for sustainability and community service.

even though world health organisation recommends routine use of ultrasound scan during pregnancy and the importance of high risk assessment of preterm labor, many of the communities in rural settings are not that privileged and hence more at risk of poor maternal and perinatal outcomes.my solution lacks funding at the moment but looks forward to extending these opportunities to the rural population through expansion of the franchise and outreach opportunities to these communities. this is believed and has been proved to go a long way in improving maternal and new born outcomes and significantly lower mortality and morbidity due to preterm delivery due to timely intervention

we have an already tested and proven product which we would like to extend to the less privileged communities but are hindered by financial support which we greatly hope this pitch will be able to solve. we considering solve as a network opportunity which ill be able to attract to us more talent of which we are very open to work with and through this network we hope to meet more experienced people with whose advisory role will come in handy. solve is also a good marketing opportunity for our organisation, work and vision which we are ready to share with the rest of the world .

am open to all forms of support and partnership

our solution is directed toward women and will go a long way in preserving their health and dignity which will equate to empowerment through this technology which is also going to be popularized among their communities and hence knowledge of it will be able to reach the younger girls who seem to be the main escorts of their mothers to these clinics since male partner involvement is still very low.   through our partnerships with the public facilities this information can then reach the already established adolescent friendly services. our vision right now is entirely about women and we are utilizing technology hence  this falls in line with the women innovative prize

our team is going to spread a technology and train the front care health work face to embrace and utilize it with a vision of improving maternal and newborn health in the rural communities. we hope to expand use of this technology  and empower referral after assessment. we are also setting aside a team of specialized  health work force to support and supervise the front care providers. technology will also be used during the support supervision where unclear images can be forwarded bot routine visits will also be done. we believe our solution  will expand and support the health workforce for newborns, pregnant women, and new mothers in a low-income country like Uganda

looking at the current gap between the busy specialists and the front care health providers, the option of this stranded front care provider doing an ultrasound scan or assessing a mother being able to remotely reach the specialist through the set up on line platform goes a long way in impacting humanity and amplifying the future as this gap will not be closed soon but technology can be able to help. therefore this solution goes a long way in using these technologies to amplify our impact in the future. 

our solution considers extending this technology to as far as the public sector which has the bulk of the the patients as stipulated in our sustainability plan. the franchise clinics will also be making referrals to the public sectors that are equipped to handle the babies who are born too soon. most of our team of specialists which is going to support this implementation remotely is drawn from the public sector as it has the bulk of the expertise. not forgetting that at the end of it all this solution will improve the lives of the mothers and new born in the rural setting of the under privileged communities of a middle income country like Uganda