CPAP-Machine-for-Newborns

The neonatal continuous positive airway pressure machine, or CPAP, can be used to save the lives of newborns in developing countries who struggle to breathe after birth. PATH named the neonatal bubble CPAP machine a top breakthrough innovation of 2015 that can help save women and children.

The CPAP machine is used for newborns with breathing difficulties, a leading cause of death in premature babies. The machine contains three main parts: the mask that fits over the nose (or nose and mouth) with straps to keep it in place, the tube that connects to the machine’s motor and the motor that blows air into the tube.

It works using a positive pressure system to help a newborn experiencing respiratory distress syndrome (RDS). RDS is more common in newborns because they have not yet produced enough surfactant, a liquid that coats the lungs to help the baby breathe in air. Without enough surfactant, the infant’s lungs collapse.

The problem is that the neonatal CPAP machine costs up to $6,000, a price tag far too high for most developing countries. Because of this, a group of Rice University faculty, students, clinicians and public and private sector partners dedicated to health technology initiatives sprung into action.

Partnering with Queen Elizabeth Central Hospital, Baylor College of Medicine and 3rd Stone Design, this group, called Rice 360°, created the bubble CPAP to treat infants with RDS in the developing world. Using an aquarium pump to deliver air and a water bottle to relieve pressure, the machine costs as low as $800 instead of $6,000.

With this more reasonable price range and help from the Saving Lives at Birth grant, Rice 360° and its partners are looking to implement the device where it is needed, starting in Malawi, Zambia, Tanzania and South Africa. In areas where premature babies have a low chance of survival, the bubble CPAP machine will change the odds and decrease infant mortality.

Hannah Resnick

Sources: NIH 1, NIH 2, PATH, Rice 360°
Photo: Tracheostomy

fish_tank_pumpThe birth of a child is supposed to be the happiest moment in a parent’s life, but this moment can soon turn into tragedy if a child dies due to lack of necessary equipment. For several parents in certain regions of Africa, this is a reality.

Babies born prematurely struggle for every breath because their lungs are so undeveloped. In developed countries such as the United States, there is technology that can help newborns survive, but in developing countries such as Africa, these luxuries do not exist. This is why students at Rice University set to work to solve this real world problem using nothing but a box and a fish tank pump.

This combination is made to model a CPAP, or Continuous Positive Airway Pressure machine, which is utilized in developed countries. The difference between a CPAP machine and a simple oxygen breathing tube is that the CPAP provides both oxygen and a small amount of pressure to inflate the baby’s lungs and allow them to begin to function on their own, rather than merely providing them with air. A typical CPAP costs around $3,000 but the students’ version is only $350, which provides massive savings to hospitals in need.

The invention is all part of a program through the university that encourages students to create inventions and test them in the real world. In this case, the students tested their invention in Malawi, a country with one of the highest preterm birthrates, around 18 for every 100 live births, and they saw real progress. The survival rate of premature babies increased from 43 percent to 71 percent.

The CPAP was initially designed in a simple box from Target but after performing these field tests, it is now housed in a metal compartment. This increases the durability and longevity of the product, especially in the harsh African climate.

Several neonatal specialists have reviewed and utilized this new invention and are pleased to report that it is just as good as the actual machine. A CPAP machine provides enough air to inflate the baby’s lungs and circulate the air through. The fish pump in the students’ invention acts in the same way, and it has the perfect amount of air flow so it is able to remain at exactly the right level.

So far the fish pump breathing aid has been utilized in nine hospitals, mainly in Malawi. Most of these hospitals have very outdated equipment and limited staffing – one nurse may be tending to over 40 patients – so this new, cheap invention has given them the technology and extra funds they need to save as many lives as possible.

Although this pump is very well equipped to save lives, it is facing some push-back from the communities since many locals associate breathing tubes with death. Hopefully, over time, families will come to the realization that this is an invention that can save children’s lives and pump life back into their beloved communities.

– Sumita Tellakat

Sources: CNN, NPR
Photo: NPR

maternal_mortality_nigeria
Nigeria is second only to India in terms of the number of maternal deaths it experiences, and along with five other countries—India, Pakistan, The Democratic Republic of the Congo, China and Ethiopia—Nigeria is part of a group which makes up more than 50 percent of the maternal mortalities that occur in the world.

The Maternal Mortality Rate (MMR) in Nigeria was 560 per 100,000 live births in 2013. As UNICEF states, Nigeria loses 145 women to maternal mortality each day. This high level of maternal mortality is also linked to Nigeria’s high rate of deaths for children under 5—newborns account for a quarter of the under-five deaths which occur in the country.

There are many reasons why maternal mortality in Nigeria is so high, including a lack of access to healthcare, rampant poverty, substandard health care and the prevalence of child marriage.

Urban women have more of an opportunity to receive healthcare than rural women do. As stated in a Global One report about Nigeria, women in urban areas have over twice as many deliveries taking place in public and private health facilitates than women in rural areas. This is because women in rural areas are normally not able to afford the transport to the hospitals in urban areas, and have to settle for midwives or traditional birth attendants—or no help at all—when giving birth. Many of these traditional birth attendants do not have the skills and training necessary for delivering a baby—for example, many are not able to perform C-sections—and for treating complications that can occur during birth.

Rural women do not have the money to travel to hospitals to receive better care. Nigeria has a high poverty rate, with a 2010 report stating that 64.4 percent of the population lived in extreme poverty and 83.9 percent of the population lived in moderate to extreme poverty. The fact that many people cannot afford the healthcare that they need contributes to Nigeria’s high MMR.

Even if women in Nigeria are able to have access to a hospital, they sometimes still end up suffering. This is because some hospitals in Nigeria have substandard care. For example, Global One’s report states that substandard birth techniques in government hospitals in North-Central Nigeria, including poor C-section procedures, accounted for 40 percent of all fistula injuries suffered by women in Nigeria.

A fistula, according to the World Health Organization, is a hole in the birth canal. Fistulas are directly connected to obstructed labor, a problem that contributes to high levels of maternal mortality. Even if women survive labor, many of them still have to live with the fistula. Approximately two million women live with an untreated obstetric fistula in Sub-Saharan Africa and in Asia, and women with fistulas suffer incontinence, social segregation and health issues.

Fistulas are more common in women who give birth at a young age. These women’s bodies are not ready for childbirth, leading to many health problems, including obstetric fistulas. Nigeria has an extremely high rate of child marriage—43 percent of girls get married before the age of eighteen—and many of those girls are not given the option of whether or not they want to get pregnant. Contraceptive use is slowly becoming more widespread and acceptable, but in 2008, only 10 percent of women used contraceptives.

Since contraceptive use is still stigmatized, many brides under the age of 18 are forced to give birth, and their bodies are very vulnerable to complications, therefore contributing to a high maternal mortality rate. Nigeria also has a high fertility rate—five children per woman in 2014—which also impacts the MMR.

If Nigeria wants to reduce its high levels of maternal mortality, it has to make sure that access to healthcare is more widespread. It also needs to improve the quality of healthcare available, reduce the number of child marriages and de-stigmatize contraceptive use.

– Ashrita Rau

Sources: UNICEF, WHO 1 WHO 2, WHO 3WHO 3, Global One Girls not Brides, IRIN News CIA World Factbook
Photo: Healthy Newborn Network

Improving-Infant-Mortality-Rate
Each year, the Save the Children Fund releases the “State of the World’s Mothers Report,” detailing the worst and best places to raise children.

India has the highest newborn mortality rate in the world with 300,000 babies dying the same day they are born. This constitutes about a third of total newborn deaths around the world.

Globally, 40 million women give birth without professional help. In many cases, maternal care is far too expensive, sometimes amounting to the cost of a family’s food bill for an entire month.

Moreover, 50,000 Indian women die yearly from complications during childbirth. Most of the time, women give birth at home. Those who receive care in a public hospital rarely have better conditions, or even more favorable outcomes.

The report also revealed that the greatest gap between the rich and the poor exists in India. Children living in extreme poverty are three times more likely to die before the age of five in comparison with more economically advantaged families.

Save the Children’s Saving Newborn Lives program is supported by the Bill and Melina Gates Foundation. Started in 2000, Saving Newborn Lives is globally distinguished as the leading program advocating for newborn health.

Close to two million babies all over the world do not survive past their first month. Of the 18,000 children who die before reaching age five, 44 percent are newborns.

Universally, four out of five infant deaths occur because of the following three causes: premature birth, development of infections or difficulties arising during birth. Each cause is preventable and treatable. Saving Newborn Lives believes that half of these deaths would not occur if expectant mothers had access to free healthcare.

Saving Newborn Lives extends aid to newborns in the most destitute circumstances in order to ensure survival past the one-month mark. They have specific programs based in seven different countries including Afghanistan, Bolivia, Ethiopia, Nepal and Vietnam.

In collaboration with regional, national and global networks, Saving Newborn Lives institutes solutions to successfully improve infant health. The program promotes the availability of more medical assistance through regular checkups as well as emergency treatment. This impacts the progression toward higher quality clinics, and more knowledgeable and skillful health practitioners.

Pediatricians working for Saving Newborn Lives inform mothers and clinicians about critical practices that could secure the health of their newborns, such as how to breast-feed, administer antibiotics or recognize the onset of infection.

The fourth Millennium Development Goal mandated by the United Nations aims to lessen the 1990 child mortality rate by two-thirds by 2015. In the past decade, child mortality has been diminished from 12 million by roughly one-half. Thanks to the work of organizations like Save the Children, countries plagued with poverty have seen improvements that allow for the attainment of this goal.

Along with its work overseas, Saving Newborn Lives now runs an information portal through the Healthy Newborn Network, an online source for information about newborn health.

– Lillian Sickler

Sources: NPR, Save the Children Healthy Newborn Network
Photo: World Health Organization

merck for mothers
Merck for Mothers is a 10-year, $500 million initiative that envisions, and works toward, a world where no woman dies giving life. Currently, an estimated 800 women die per day, primarily in developing nations. Merck’s global mission is to bring better healthcare and innovative health solutions to millions of people across the developing world; a commitment that has been in standing for more than 150 years. Working closely with its program leadership, advisory board, healthcare workers, maternal health experts and policy makers, the Merck for Mothers initiative has already served in more than 30 countries across the world.

As stated on its website, “Women are the cornerstone of a healthy and prosperous world. When a mother survives pregnancy and childbirth, her family, community, and nation thrive.”

Merck for Mothers aims to see nations thrive by saving as many lives as possible, and it does this by tackling the two leading causes of maternal mortality: excessive bleeding after labor and high blood pressure disorders during pregnancy and childbirth.

For example, in Uganda, where a woman faces a one in 49 chance of dying during pregnancy and childbirth, many of the private healthcare providers, such as independent midwives and local pharmacies, offer services that are not always regulated and can vary in quality. As a result, Merck for Mothers explores the ability of these local private providers and health businesses to deliver affordable and high-quality maternal healthcare. This is a program that has estimated to reach more than 150 thousand pregnant women over the span of three years.

Each of the 30 country programs is different and tailored to that country, yet they all strive for the same goal: giving mothers a better chance at surviving pregnancy and childbirth. In addition, Merck for Mothers focuses on family planning, which is known to play a key role in reducing maternal mortality. Merck for Mothers explains this through the Ripple Effect. When a mother dies, the ripple effect begins with her child who is more likely to die before the age of two. If she has other children, they are also up to 10 times more likely to leave school and suffer from poor health. But a mother’s death affects more than just her family.

Merck for Mothers believes that a woman’s death also impairs her community. Representing as much as one-third of the world’s gross national product, a woman’s unpaid work contributes to a community’s economic prosperity. In the end, this becomes a global economic issue. For these reasons, Merck for Mothers focuses on three key areas: innovation, access and advocacy.

At Merck, corporate responsibility is the cornerstone of its daily commitment to tackle global health challenges, such as river blindness, HIV/AIDS and cervical cancer. It has been a 150-year commitment, but that has not stopped Merck from making new additions.

With Merck for Mothers, it can now expand its scope and save the lives of millions of mothers across the globe, so that every day 800 more lives of women are spared.

– Chelsee Yee

Sources: Merck for Mothers, Poughkeepsie Journal, Mobi Health News
Photo: Modern Mom

james_dyson_award
The main focus of the James Dyson Award is on design and engineering, but there is also encouragement and support given to medical and scientific research to bring great change. The organization itself has donated over $14 million to these causes through grants, machine donations and fundraising endeavors led by the people at Dyson.

The James Dyson Award is aimed towards young people from 18 countries who think differently than others and come up with ideas to change the future. “Whatever the design, as long as it solves a problem, it’s got a chance of winning the James Dyson Award,” its website reads.

Along with the recognition, a $45,000 prize is given to the international winner to help take the idea from a prototype and launch it into a commercial product. The winner for this year’s award goes to a product called the inflatable baby incubator. The inventor is a Loughborough University graduate by the name of James Roberts. The project overall is called and referred to as “MOM” and is said to cost a fraction of the price of other alternatives currently in the market.

With the award money, Roberts is planning on continuing the project and perfecting it to bring to the market in 2017. The remarkable thing about this project is that it is delivered as a flat package to wherever its destination may be. The product is meant to be assembled at the site where it will be used. The inflatable incubator is a sheet of plastic that contains inflatable panels that can be blown up manually and heated by a ceramic element, which then keeps the newborn baby warm. When opened, it will stay open and not collapse on the baby. An Arduino computer keeps the temperature at a stable heat and also controls the humidification, a lamp and an alarm.

This product is huge step in taking care of infants, because it is safe for the baby and costs a lot less. Other incubators cost more because shipping the incubator requires large boxes. This incubator as mentioned above, ships flat and is easy to assemble once it is received.

The main purpose of this incubator is to decrease the number of premature child deaths within refugee camps. According to the MOM Incubator website, “Every year, an estimated 150,000 child births occur within refugee camps. Of these child births, 27,500 will die due to lack of sufficient incubation.”

Moving forward, the plans for MOM include using the money to perfect the prototypes and, if needed, doing a possible redesign to gain the best possible outcome for an inflatable incubator system.

– Brooke Smith

Sources: MOM Incubators, BBC, James Dyson Foundation
Photo: Flickr

education_lena_child_development
Nearly a quarter of American children are living in poverty, says the National Center for Children in Poverty, totaling about 14 million. This is 2.5 million greater than in 2000, with the number of children living in poverty increasing 21% between 2000 and 2008.

Thus, 14 million children are at an academic disadvantage from day one: they are on the losing side of an education achievement gap compared to children of more well-off parents.

Recent research reported in the New York Times suggests that “brain development is buoyed by continuous interaction with parents and caregivers from birth, and that even before age 2, the children of the wealthy know more words than do those of the poor.”

While there are several wide-reaching programs in place – subsidies for child-care, targeted education programs for toddlers – advocates for the poor argue that closing this gap begins in the home.

According to the McCormick Foundation, more than half of all children under 2 are cared for at home by a parent or relative on a daily basis. Thus, there has been a nationwide push to target in-home language acquisition and vocabulary expansion.

Several organizations employ a home visitation technique, with development experts training parents on how to stimulate conversation with their infants and toddlers. “We don’t want parents talking at babies,” Claire Lerner of the nonprofit development group Zero to Three said. “We want parents talking with babies.”

Linguistic development is just one of four aspects of critical early childhood development, says the World Bank, the others being physical, cognitive and socioemotional development.

While poverty places children at a developmental disadvantage, failing to enhance a child’s education and growth in the early years tightens the grip of poverty and perpetuates a cycle of impoverished existence.

To make tracking early childhood and linguistic development more accessible, philanthropists and researchers have developed LENA – the Language Environment Analysis System.

LENA is a small audio recorder that conveniently attaches to children’s clothing or slips in a small vest pocket.

The recorders “distinguish between words overheard from television or other electronics and live human conversations,” reports the New York Times. The audio recording is then analyzed by computer software and progress methodically tracked.

The LENA Research Foundation boasts the success of the “world’s first automatic language collection and analysis tool” and believes LENA can help both experts and parents improve language acquisition and development.

LENA provides an unprecedented level of dynamic analysis that more accurately accounts for the complications involved in closing the education gap.
“…It’s like fine, vocabulary is good,” said Bruce Fuller, a professor of education and public policy at the University of California, Berkeley to the New York Times. “But there is a deeper commitment to literacy and conversation around the dinner table and talking to kids about ideas and political controversies that is the more colorful fabric of literacy and conversation.”

LENA can help determine the effectiveness of home visits and audio recording in the short run in improving parent-infant communication.

In the long run, researchers will be looking for advancements in “future academic performance,” reports the New York Times. “Children who receive assistance in their early years achieve more success at school,” says child rights group UNICEF. “As adults they have higher employment and earnings, better health and lower levels of welfare dependence and crime rates than those who don’t have these early opportunities.”

Thus, LENA and early childhood education is not only an investment in children, but in our global health and economy.

– Mallory Thayer

Sources: New York Times, NCCPThe World Bank, UNICEF
Photo: 

Malnutrition_Cambodia
So far in 2014, three cases of Avian Influenza H5N1 have been confirmed in Cambodia; it appears malnutrition can play a key role in children’s contracting it.

Malnutrition severely impacts a child’s immune system–the healthier a baby is, the healthier they will continue to be their entire lives. Without certain vitamins, children are prone to develop iron deficiencies (from a lack of Vitamin A,) stunted growth, learning disabilities, anemia and an increased probability of getting sick.

Approximately 40 % of children are malnourished in Cambodia. The risk of malnutrition in Cambodia is particularly high in children under the age of five and in pregnant women.

In Cambodia, young children are contracting the Avian Influenza partially because of their exposure to domestic poultry. Children are commonly responsible for caring for, feeding, retrieving eggs, and cleaning the pens of domestic chickens and ducks. A weak immune system is an immune system with a higher risk of infection.

Since 18% of the population lives under the poverty line, raising livestock and domestic animals is necessary as a source of income.

For children who may come in contact with sick or dead poultry, having a weak immune system poses a severe threat. Although H5N1 does not commonly infect humans, when it does infect, it has a 60% likelihood of death. The disease can cause respiratory failure, seizures, diarrhea and high fever.

Malnutrition in Cambodia has created a desperate scramble for food. In some cases, people are eating dead birds that they know may be potentially hazardous to their health. This was the case for Leng Lal, whose 10 chickens died suddenly in January. After the chickens died, Lal cooked them because he believed throwing them away would be a waste.

“We needed to eat,” Lal stated, “…so when they died I decided to cook them for food.”

Deputy governor of the Snoul district Men Venna explained that impoverished families tend to eat poultry that have died because they have invested a lot of money and time in raising their livestock. Often finding meals take priority over health risks, and that is just what happened for Lal, who had been aware of the H5N1 warnings.

Lal’s son and daughter began showing symptoms of H5N1 a week after eating the dead poultry and died shortly after being hospitalized at Kompong Cham Provincial Referral hospital.

Venna stated that public health campaigns extend only so far when malnutrition in Cambodia is so prominent.

Becka Felcon

Sources: World Food Programme, UN Cambodia, Cambodia Daily, Results.org, Flu.gov
Photo: Global Giving

China_One_Child_Policy_Baby
In late December 2013, China’s Standing Committee of the National People’s Congress formally introduced measures to ease its notorious one-child policy.

The major tweak of the one-child policy now allows parents to conceive a second child if just one of the parents is an only child.

Previously, parents were allowed a second child only if each parent was an only child. Rural couples on the other hand, were allowed a second child only if the first born was female.

The new measures will be implemented in a phased process at the local level. Furthermore, provincial leaders now have the authority to introduce the changes in accordance with local demographic needs.

While modest, the change will hopefully reduce the number of human rights abuses perpetrated against Chinese women since the policy’s inception in 1979. In the New York Times, OP-ED contributor Ma Jian details some of the horrific experiences Chinese women endure when authorities become aware of a second conception.

She describes the staggering amount of personal invasion local officials engage in to enforce the one-child policy. Family planning officers vigorously chart data regarding menstrual cycles and pelvic exams of every female of child bearing age within every village.

Many of these women are subjected to forced abortions and sterilizations if they are found within violation of the policy.

Probably one of the most egregious injustices of the policy is its disproportionate enforcement. The policy frequently targets poor citizens while bypassing wealthy individuals.

In fact, all violators can avoid the consequences of having a second child if they pay a fine that falls within the range of three times to 10 times the annual household income. It goes without saying that poor citizens, unable to pay the steep fine, either flee their home to avoid the authorities or become victims of forced abortions.

Many see the easing of the policy as a response to the looming demographic crisis that China now faces after 30 years of steadily implementing the one-child policy.  Some say the change is too little, too late.

Nicholas Eberstadt reports in the Wall Street Journal, that even with the policy change, the Chinese government only expects one million extra births per year, resulting in only a six percent increase in the fertility rate.

He also discusses the lasting effect the one-child policy will have long after its easing. For instance, individuals born under the previous policy will be entering the workforce in 2030 and deciding to get married in 2035.

Demographers predict that at the end of the decade there will be over 24 million men incapable of finding a woman to marry. One can expect this number to increase by 2035.

The inability for many to reproduce will leave China with an aging population that will increasingly reduce the number of individuals who are able to work as well as government resources. By 2050, over one quarter of the Chinese population will be over the age of 65.

– Zachary Lindberg

Sources: BBC, The Wall Street Journal, The New Yorker
Photo:  Dailystormers

 

baby elephant
In one of the largest countries in Africa, a new program is working to change the outcome of premature births with a simple footprint.  Tanzania is home to an estimated 46,218,000 people who earn an average of $570 per year.  With about one third of its people living below the national poverty line, Tanzania is regarded as a ‘developing country.’  The term ‘developing country’ is described by Princeton as “a nation with a low level of material well-being.”  A common reality in developing countries is the limited or complete lack of access to medical assistance, whether a hospital, pharmaceuticals or a birth attendant.

The latter is an issue that can have devastating consequences.  In low-income countries, about 40% of births are unattended by a trained, medical professional.  Whether or not they are equipped with modern tools and resources, a trained professional is better able to determine the dangers and necessary steps to take before, during, and after birth, especially regarding premature babies.  Of the approximately 10% of infants worldwide born prematurely each year, about one million die, with over 80% of those deaths occurring in South Asia and Sub-Saharan Africa.

At present, Dr. Joanna Schellenberg and a team at Ifakara Health Institute (IHI) in Tanzania are researching a strategy with the potential to have a global impact.  The research began by attempting to solve how to reduce premature infant deaths without requiring entire health systems to be constructed (and funded) first. This is especially important since one of the greatest obstacles facing health care in rural areas is the absence of equipment.  However, the World Health Organization (WHO) estimates that 75% of preterm infant deaths could be prevented without the use of intensive care and modern resources.  Premature infant weights are under 5lb 5oz, yet since scales cannot be assumed to be available, the IHI team came up with another measurement: the size of a baby’s footprint.

Volunteer health workers visit villages with a laminated card picturing two footprints.  The health workers measure infants’ feet against the pictures and determine how to proceed based on their size.  If the infant’s footprint is the same size or larger than the bigger footprint, then the child is not premature.  If the footprint is between the two sizes, it may be premature but not necessarily in danger.

Health workers then proceed with suggestions on how to promote infant health such as holding the child skin-to-skin for warmth, or how to breastfeed effectively.  Finally, if the footprint is smaller than both samples, about 67mm or less, the mother is directed to the nearest health center where the infant can receive potentially life-saving care.

The strategy just described is called “Mtunze Mtoto Mchanga” which translates to “Protect the newborn baby,” a concept that local women have been quick to support.  With the persistent visits and encouragement by the project’s health workers, support has grown into a greater compliance by the public. Though the project will continue for another six months before clear results are available, the team is already poised to implement it throughout Tanzania.

The laminated-card system is not only relatively simple to duplicate, it also demonstrates potential self-sufficiency amongst rural women.  Moreover, once the procedure and subsequent actions are ingrained, the individuals could monitor their babies themselves without the need for health workers help with premature birth testing.

The versatility of the project only heightens anticipation for the results of the study.  If successful, the IHI project could mean saving up to three-quarters of a million infants each year with just a footprint.

Katey Baker-Smith

Sources: World Health Organization, Princeton University, United Nations Data, The World Bank, BBC
Photo: Giphy.com