NeoLinkID

Mobile, blockchain-based birth registration and mother/baby linkage for secure, verifiable, identity and health care tracking to improve newborn survival  

Preventable newborn death is our target. Globally, 2.5 million babies die during their first month of life (or neonatal period) and 2.6 million are stillborn (Healthy Newborn Network). Low/middle income countries bear a disproportionate burden, and it is estimated that 46% of all under 5-years child deaths occur during the first month of life (WHO). Low rates of birth registration and lack of a reliable system for tracking mother-baby pairs contribute to this problem by preventing health care systems from delivering and tracking crucial evidence-based interventions (AAP). Subsequently, parents can’t access services, ranging from nutrition programs to education, which would ensure a thriving childhood. Lacking legal identity is a profound threat during periods of conflict or forced migration, and a life-long barrier to accessing essential services such as voting, obtaining a passport or bank account, or mobile phone ownership. Africa has the largest number of people who lack any form of legal identification. (Principles on ID for Sustainable Development)

Our solution will use a mobile phone system linked to maternal/paternal SIM cards to create a verifiable credential of birth registration on the Sovrin blockchain linking mother/baby pairs. Similar phone-based systems have been deployed across Africa (see case study), without use of blockchain or linkage of mothers/baby pairs. The innovation of our system is the specific components of Sovrin that provide a higher level of privacy, security, and scalability including use of open standards, open source license, decentralized governance, and technology such as “zero-knowledge proofs” allowing for granular data sharing by identity owners (or guardians). This system can serve as the basis of a self-sovereign identity at the national level in Kenya, where the ICT Ministry has recently undertaken analysis of blockchain for implementation in finance and other sectors (CCN article). Design will focus first on use by healthcare workers and village elders/chiefs with the goal of transitioning to a system that mothers can use to register births with verification of health workers or village chiefs and/or elders. Our team has specific expertise in working with village elders in Kenya using a mobile phone systems to report newborn data (Gisore, P. 2012) and with health workers to evaluate the feasibility/acceptability of a data collection mobile application (Bucher, S, 2015). Integration of birth registration and mother/baby linkage with mHBS/DHIS2 will allow for tracking of mother/baby pairs to provide invaluable data on essential newborn care delivered and newborn health outcomes.

Kenya, our target country, has been the focus of a large birth registration advocacy effort over the last 10+ years (Plan International). Recently, our team presented our vision for the blockchain-based, mobile phone birth registration to the Ministry of ICT of Kenya – Task Force on Distributed Ledgers and Artificial Intelligence. Creating a seamless, private, secure, and scalable technology for birth registration, linkage of mother baby pairs, and acquisition of birth certificates will require collaboration of many stakeholders. Our team is well positioned to facilitate this process.      

NeoLinkID innovation includes using a public, permissioned, distributed ledger, the Sovrin Network, developed specifically for providing self-sovereign identity. We will create a system that allows mobile birth registration through interactive SMS/USSD using parents’ SIM cards. Machine learning will be used to identify potential inconsistencies in the registration process. NeoLinkID will be part of the larger technology suite, developed by Dr Sherri Bucher, which includes the mHBS/DHIS (mobile Helping Babies Survive) prototype for health worker education. Linkage of mother/baby pairs and integration with mHBS/DHIS will allow for robust interventions and data collection systems for for newborn survival.

The Sovrin Network has been designed as a global public utility for digital identity, including governance (the Sovrin Foundation and the Sovrin Trust Framework), scalability (validator and observer nodes and state proofs), and accessibility (minimal cost and maximum availability). Sovrin implements Privacy by Design on a global scale, through pairwise pseudonymous identifiers, peer-to-peer private agents, and selective disclosure of personal data using zero-knowledge proof cryptography. NeoLinkID embeds privacy by design principles by decentralizing the initial stages of birth registration to the mother using her cell phone with a unique SIM ID. Since SIM IDs are linked to the owners legally recognized national ID in Kenya, it is hard for a third party to impersonate the mother even if they had access to the mother’s phone as they would need to know also her ID number. Furthermore, NeoLinkID will maintain, via Sovrin, an immutable chain of credentials of the mother and birth verifier (health worker or village chief) and contextual information such as location where the birth was registered, that makes it exponentially harder for a nefarious actor to fake the credentials. NeoLinkID will also use machine learning to perform anomaly detection on the credentials and contextual information.

The eCitizen portal of Kenya is currently providing a digital application system for birth certificates. Our goal is to evolve our technology (and digital identity advocacy at the policy and community level through broad partnership with key stakeholders) to the point of being able to create and implement a seamless system of digital birth registration and birth certificate acquisition. 

We envision a solution which ultimately puts mothers at the center of birth registration with support and birth verification from key stakeholders such as village chiefs and elders and/or health care providers. Despite the gender gap in phone ownership and literacy, a growing number of women are able to use basic mobile phone functions. Our system will provide a mobile birth registration alternative while preserving the current paper-based “birth notification” system. In this way the evolution of the digital system can take place at the pace of the stakeholders involved.

Since the Sovrin platform has been created with goal of establishing a global public utility for digital self-sovereign identity, it is an open source platform, and there has been heavy investment in establishing a developer community and a decentralized governance network supported by the Sovin Foundation. Sovrin is built on open standards and the Sovrin foundation is a leading player in standard setting bodies such as W3C. NeoLinkID will be developed with adherence to the Interoperability principle (part of Principles for Digital Development). The existing mHBS/DHIS2 app is an open-source digital health tool, with all code available on GitHub.

The prototype will be developed with offline use and asynchronous syncing capabilities for low connectivity environments. Initial users will be health workers and village chiefs and elders who have basic literacy and mobile technology use skills. The tool will then be adapted for lower literacy, possibly incorporating IVR technology. Since birth registration relies on verification of birth details, we will shift birth registration processes to mothers with the help of the birth verifiers (health workers and village elders/chiefs who will have already been trained in using the system).  

Year 1:

• ID for Good accelerator -  prototype development of Sovrin-based birth registration tool.

Year 2-3:

• Preliminary discussions with UNICEF Innovation indicate possibility for funding of a pilot once a prototype has been developed.

• Continue to solicit investment/funding and seek to partner with implementing organizations in order to pilot the tool across districts and adapt for use directly by mothers.

Beyond Year 3:

• Continue to seek funding and develop implementation partnerships

• Start generating revenue from implementations, and scale by offering a package of birth registration, tracking of mother baby pairs, and mHBS tools for health worker training across Kenya.

Evernym ID for Good accelerator 2019 - Invited to participate to develop a Sovrin-based newborn registration system.

Notre Dame University - accelerator conduit, academic home of Dr Geoffrey Siwo and collaborator Dr Adam Czajka (iris scanning/analysis technology expert).

Bill and Melinda Gates Foundation - funding mHBS/DHIS2 collaborative development of VR learning module with Washington University.

American Academy of Pediatrics (AAP) - Dr. Sherri Bucher is International Mentor for AAP  Helping Babies Survive and Country Mentor for Kenya

Moi University and Teaching Hospital with 23 health facilities - Dr Bucher has a long-standing research collaboration here including mHBS/DHIS2 prototype testing.

NeoInnovate four core members:

Dr Sherri Bucher, PhD, MA

Maria Freytsis, CNM, MPH

Dr Geoffrey Siwo

Dr Saptarshi Purkayastha

This team has expertise in the following areas:

1. Open technologies for health development (Open MRS, DHIS2, etc.) mobile phone-based applications (Purkayastha, Bucher, Freytsis)

2. Clinical MCH in high a low resource contexts and health worker education including mobile learning platforms  (Freytsis, Bucher)

3. Emerging technologies such as AI, Machine Learning, Blockchain, Biometrics) (Siwo, Purkayastha, Czajka)

4. Patents/licencing models, start-up/social enterprise business models (Siwo, Bucher, Purkayastha, Freytsis)

5. Extensive relationships with donors, researchers, MCH implementing and technology organizations in Kenya (Siwo, Bucher, Purkayastha, Freytsis)

NeoLinkID is part of a bigger social enterprise concept called NeoInnovate. NeoLinkID will have a transactional revenue model where we contract directly with district health ministries in Kenya as well as NGOs looking for scalable ID solutions for maternal/child health programs to provide localization/customization and implementation support services. We will explore feasibility of a subscription based model once the product is fully developed as well as other uses for the technology that allows linkage to Sovrin via SMS. We also envision having multiple revenue models over time based on the different innovations that are being developed under the NeoInnovate umbrella. This includes:

1. mHBS/DHIS implementation support as part of national Helping Babies Survive training programs  

2. NeoWarm - a biomedical device prototype for thermal care of small or preterm babies developed by Dr Bucher. Revenue will come from sales of the device at or above cost for high income market use cases and below cost in low resource settings

3. Licensing of biometric ID solutions developed under NeoLinkID such as newborn iris scanning technology which is currently in early research phase with collaborators at Notre Dame University

The Sovrin-based birth registration system will create a scalable identity solution that meets the privacy by design requirements of the Mission Billion Challenge. While mHBS/DHIS consists of a suite of digital tools that allow for tracking the newborn care skills of an individual health worker, the newborn ID system, NeoLinkID, will allow for linkage of mother baby pairs to also track delivery of essential components of newborn care and newborn health outcomes. Linkage of the NeoLinkID with DHIS2 will allow for reports and dashboards on newborn health and provide a unique combined solution to improve newborn survival in Kenya.

Funding is the biggest current need, and barrier to our progress.

Logistical barriers to acceptability of the NeoLinkID include reluctance by key stakeholders to accept digital systems. Another barrier is the the gender gap in phone ownership and general as well as technology literacy. Potential threats to the usability of an innovative and disruptive technology may also include resistance from governmental partners who might not accept digital IDs for key administrative processes such as census, school registration, or national ID cards . Will employ user-centered design approach and agile software development, and leverage our exceptionally strong stakeholder and community relationships.