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Kenya's Breast Milk BankIn April 2019, Kenya’s Ministry of Health launched Kenya’s first breast milk bank at the Pumwani Maternity Hospital in Nairobi. Given Nairobi’s high neonatal death rate of 38 deaths per every 1,000 live-births, the Ministry launched the bank as a pilot to test if it could reduce the neonatal mortality rate. 

Background

Kenya’s breast milk bank serves infants who are premature, malnourished, underweight or orphans that do not have access to their mother’s breast milk. PATH, like several other global health organizations, cites human milk as the greatest tool for child survival. Breast milk contains a dense number of nutrients and antibodies critical to human development. Therefore, PATH estimates that if children had access to universal breast milk, breast milk could save about 823,000 children’s lives under the age of 5.

Human milk banks are an alternative to ensuring that infants have consistent access to breast milk. At the time of the bank launch, Kenya’s Ministry of Health stated that if the bank was successful, the Ministry would open several more banks in the country. Here are 5 facts about Kenya’s breast milk bank.

5 Facts About Kenya’s Breast Milk Bank

  1. The Pumwani Maternity Hospital: The Technical Working Group selected Pumwani Maternity Hospital to host Kenya’s first breast milk bank because the hospital promotes kangaroo mother care– skin-to-skin contact and breastfeeding–as part of its neonatal program. The hospital’s neonatal program caters specifically to preterm, underweight and malnourished infants.
  2. Mothers as Primary Milk Donors: Lactating managers from the Pumwani Maternity Hospital select mothers with more milk than their infant requires to donate it to the milk bank. The managers require mothers who agree to donate to undergo health and lifestyle screenings in order to ensure that they are viable candidates. The screenings include health and lifestyle questionnaires and laboratory blood tests. If lab workers identify alcohol, tobacco and drugs, HIV, Hepatitis B or C or Syphilis in a mother’s blood test, they will disqualify her from donating milk.
  3. Storing and Pasteurizing Donor Mother’s Milk: Mothers at the Pumwani Maternity Hospital donate their milk both naturally and with an electric pump. The hospital stores every mother’s milk separately in batches that contain codes for every mother. Once every batch volume reaches capacity, the hospital pasteurizes the batches to kill any bacteria or viruses in the milk.
  4. The Ministry of Health and Kenya’s Newborn Care Guidelines: Given that Kenyan infants now have access to breast milk due to Pumwani Maternity Hospital’s milk bank, the Ministry of Health (MOH) has added donated human milk to Kenya’s newborn care guidelines. These guidelines help to ensure that Kenyan infants receive the growth-development benefits from breast milk in order to increase their chances of survival.
  5. The Milk Bank’s Impact: As of October 2019, after six months since the MOH launched the bank, the Pumwani Maternity Hospital has delivered nutrient-rich breast milk from over 400 donors to 75 infants.

As stated in these 5 facts about Kenya’s breast milk bank, Kenya’s Pumwani Maternity Hospital is impacting the lives of numerous vulnerable infants. The Ministry of Health looks toward the hospital impacting an increasing number of infants and significantly reducing Kenya’s neonatal mortality rate.

– Niyat Ogbazghi
Photo: Flickr

Epsom salt
In order to bring attention to the life-threatening pregnancy condition Pre-eclampsia, many health organizations observed World Pre-eclampsia Day on May 22, which allowed PATH the perfect opportunity to share its progress with an innovation that uses Epsom salt to save lives.

The nonprofit global health organization’s new innovation aims to make preventive solutions for pre-eclampsia and eclampsia more accessible in lower-income countries.

Every day about 800 women dies from preventable pregnancy-related causes, like pre-eclampsia and eclampsia, according to the World Health Organization (WHO). The WHO also reported that 99 percent of these maternal deaths take place in low-income countries.

How Is Epsom Salt Used to Save Lives?

Beginning in the 20th century, doctors discovered that Epsom salt worked as a method of treating pre-eclampsia, a condition that results in high-blood pressure and damage to the liver and kidneys, among other symptoms.

Despite its name, Epsom salt is not a salt at all, but rather it is magnesium sulfate and is known to prevent and deter convulsions that are common with pre-eclampsia and eclampsia, according to a historical report published by the National Center for Biotechnology Information (NCBI).

For women in countries with more resources, magnesium sulfate is administered to them through an intravenous (IV) infusion before, during and after childbirth. Women in countries without access to reliable electricity cannot use IVs and must obtain the magnesium sulfate treatment via intramuscular injections which can be more painful, according to PATH.

While nearly 90 percent of the world’s population has access to electricity, stated by the World Bank data, 59 percent of healthcare facilities in low and middle-income countries lack access to reliable electricity, according to a report published on Science Direct. 

What Is PATH Doing About It?

Besides access to electricity, IV infusions can be difficult for low-income countries to access, taking into account the cost of purchasing, training and replacing parts. Knowing this, PATH began to develop a technology that would allow for a more reliable method of injecting medicine without the need for extensive training or electricity.

It took PATH innovators a few years to find the perfect technology that was simultaneously affordable, easy to use and did not need batteries or electricity. Ultimately, the group decided on using a bicycle pump, according to an article written by one of the developers, resulting in RELI Delivery System, or reusable, electricity-free, low-cost infusion delivery system.

The bicycle pump was able to have consistent delivery rates into the patient with just a few manual hand pumps. In 2016, PATH was able to produce a prototype and received two awards: the Saving Lives at Birth seed award and an honorary Peer Choice award.

The next step for the RELI Delivery System is to use the money from the awards and donations to PATH and follow the system in Rwanda and Uganda to see it work in action and gain feedback.

How Effective Is This Treatment?

A 2002 study conducted by The Magpie Trial Collaboration Group found that the use of magnesium sulfate halves the risk of eclampsia in pregnant women with pre-eclampsia. The same results were supported by a 2010 study conducted by several groups including the Centre for Epidemiology and Biostatistics, University of Leeds and Bradford Institute for Health Research.

In 2011, WHO recognized magnesium sulfate as a priority medicine for mothers for major causes of reproductive and sexual health mortality and morbidity.

Although the use of magnesium sulfate can ultimately save women’s lives, there are some side effects that come along with the treatment, including skin flushing (more common with intramuscular injections), nausea and vomiting, drowsiness, confusion, muscle weakness and abscesses.

While something as simple as Epsom salt being used to save lives is innovative in itself, developers, like those at PATH, are continuously working to ensure that everyone has equal access to these health benefits.

Makenna Hall
Photo: Pixabay

What Is PATH and How Have They Improved Global Health
The Program for Appropriate Technology in Health (PATH) is an international, nonprofit organization that is a leader in innovating global health solutions. The program’s aim is to bring about effective and cutting edge technologies and products to underserved areas of the world and to work toward providing major healthcare needs. PATH works closely with partners around the world to bring passion and innovation to solving these problems and to scale them on a global level.

PATH has five primary vehicles of innovation, being:

  1. Vaccines, which are developed to be quickly deployed to where they are needed most. Using its own Center for Vaccine Innovation and Access, PATH brings in top innovators from around the world to work on vaccines at every stage – from testing and producing to deployment technologies that promote safe usage.
  2. Drugs, where PATH works closely with partners to provide affordable medicines targeting low income countries. This allows life-saving medicines to be accessible by more people and more quickly where they are needed most.
  3. Diagnostics, which are an integral part of managing people’s health, is hugely developed by PATH. It is creating and implementing fast-acting, single use “point‑of‑care” diagnostic exams in order to get fast results when time matters and to ensure sterility.
  4. Devices, which PATH helps accelerate, are primarily focused on sterilization. Water, air, food and medical supplies all need to be clean in order to be effective and safe. This is where PATH steps in, reinforcing markets for water sanitation products, developing sterilization devices and making all of these available to areas without access.
  5. System and service innovations, which involves working with the current infrastructure, or, as in many cases, strengthening the currently standing one to allow the flow of medical innovations from suppliers to the local communities in need. Included in this is the training of local personnel where there are shortages and providing them access to digital aid to help local medical systems.

PATH works hard to take the most innovative medical solutions available to countries that need it most, and in many cases, develops its own solutions to issues as well. By strengthening methods that give people access to important medical supplies, medicine, newer technologies and practices, PATH is an important ally in underserved areas.

Rebekah Covey

Photo: Flickr

PATH: A Global Health InnovatorFour of the U.N.‘s sustainable development goals in some way deal directly with health issues, whether they are concerned with decreasing world hunger or improving maternity health. Many of these goals have been addressed in a significant way, with improvements in health made across the board. However, there are still limitations on surveying health innovation effectiveness, as well as accessing and administering new technology.

Despite these issues, there are several nongovernmental organizations (NGOs) working toward bridging the gap between technology and innovation where these services are needed the most. PATH and its partner organization, Innovation Countdown, are doing just that.

Path is a global health innovator that has inspired and pioneered global health solutions. PATH has built its vision on accelerating technology availability by arming its team with entrepreneurial insight, scientific proficiency and public health knowledge, in order to produce measurable outcomes across many sectors in the healthcare industry. PATH was founded on the idea that healthcare should be available to everyone – especially women and children – and most importantly, where it is the least accessible. PATH believes that the antiquated notion of “population control” is not the solution to extreme poverty issues, but instead the solution lies in providing a more wholesome life that will in turn empower millions of people to take control of their lives and health conditions. The trickle-down, beginning with adequate health, has the potential to stabilize populations and churn out productive members of society.

Innovation Countdown, led by PATH, is a nonprofit dedicated to providing a platform for global health innovation, providing data resources and technology resource information. Supported by the Bill and Melinda Gate Foundation and the Norwegian Agency for Development Cooperation, Innovation Countdown brings together different donors and investors in order to raise awareness of technologies and make them more accessible to areas that are difficult to reach or have minimal resources.

The work of PATH, along with Innovation Countdown, brings hope for all people – no matter of their socioeconomic status – to be able to access and reap the benefits of necessary global healthcare innovations.

Casey Hess

Photo: Flickr

Improving Maternal and Child Health
The problem of poverty is not too big to tackle, but it is a huge issue. Chief Strategy Officer and Vice President of Strategy and Learning at PATH, Amie Batson, believes the answer is innovation, and she is especially optimistic about innovations geared toward improving maternal and child health. She worked with the United States Agency for International Development (USAID) on its Child Survival: Call to Action initiative that “challenges the world to reduce child mortality.”

This initiative united the governments of India, Ethiopia and the U.S. to work with UNICEF toward the goal of making sure every child reaches his or her fifth birthday. By 2035, Child Survival: Call to Action strives to reduce the number of deaths before age 5 to only 20 in every 1,000.

“We have the tools, the treatments and the technology to save millions of lives every year, and there is no excuse not to use them,” said UNICEF Executive Director Anthony Lake. He also stated that countries must focus on “scaling-up coverage of high-impact, low-cost treatments, sparking greater innovation and spurring greater political will to reach the hardest-to-reach children.”

One such low-cost practice proven to be effective in improving maternal and child health is “kangaroo mother care.” This practice involves immediate and prolonged skin-to-skin contact between mother and child after a child is born. Research shows that this contact results in exclusive breastfeeding, which is especially important for children in developing countries. It also helps with thermal regulation and creates a psychological connection between mother and child. It is a simple change with lasting impact.

Many other notable innovations involve giving women access to family planning. Sayan Press produces an injectable contraceptive available in small doses through an easy-to-use injection device. Its availability and ease of use allow community-level workers to hand it out, thus expanding its accessibility.

Batson encourages nonprofits and governments alike to continue the search for innovators as a way of reducing the number of preventable deaths among women and children.

“Local innovators have incredible ingenuity and capacity to drive ‘frugal’ innovations—low-cost, life-saving innovations tailored to local needs,” she said, encouraging countries to look within for their solutions.

Through the collaboration of organizations like USAID and PATH, it has been shown that even as few as 11 innovations can make a significant difference. There is much hope for the future of women and children’s health, and the best place to start is here.

Rebecca Causey

Photo: Flickr

DefeatDD fights children’s diseases
Forget the classic superheroes of the past, because WASH, Nutrition, Vaccines and ORS + Zinc have come to save the day and build a brighter future. PATH’S DefeatDD fights children’s diseases with its new video that brings awareness to major health issues — including chronic diarrhea and malnutrition — and helps the children, families and communities watching learn how to conquer them. These health superheroes fight off major illnesses like rotavirus, enterotoxigenic E. coli (ETEC), shigella and cryptosporidium.

Water, Sanitation and Hygiene (WASH) emphasizes the importance of efficient water and sanitation services and basic hygiene practices. Nutrition and Vaccines ensure a healthy lifestyle and keep conditions from worsening, and ORS + Zinc help to prevent diarrhea and pneumonia in children. Besides these characters, a handful of real-life superheroes are committed to saving more lives and helping children around the world to be healthy and strong.

Richard Walker of PATH and Lou Bourgeois of Johns Hopkins University are two skilled scientists working vigorously to advance vital new vaccines and add to the lineup of available resources to tackle the bacterial brutes.

Anita Zaidi and Duncan Steele lead the charitable charge at the Bill and Melinda Gates Foundation, dedicating their time to defeating diarrhea. Together, they bridge science and strategy to rally a revolution against common childhood threats, applying medical microbiology to pediatric perspectives.

In areas where children are exposed to unsanitary living conditions and prone to infection, understanding and being aware of the problem at hand is crucial step to finding a solution. Hope Randall, digital communications officer for PATH’s DefeatDD Initiative, expressed the connection between good nutrition and strong minds in regards to children.

Without the key nutrients of a nutritious diet, the continuous loop of malnutrition and diarrhea will keep children sick, and the effects don’t just wear off when the symptoms disappear, contrary to what many may think.

Chronic diarrhea and malnutrition can stunt physical growth and impact cognitive development, keeping children and their communities from reaching their fullest potential. This is why an integrated approach to prevent and treat such diseases is necessary and the only way to effectively address the long-term damage that the vicious cycle can cause.

In an article sponsored by PATH, A. P. Dubey, head of the Department of Pediatrics at Maulana Azad Medical College in New Delhi, wrote about the importance of vaccines in support of PATH’s DefeatDD Initiative: “I advocate for immunization to save children. It is important to have greater communication around this and it is critical for the media to address this issue. In India, public awareness about immunization is still lacking. Greater awareness will help increase immunization coverage. India can succeed in eliminating vaccine-preventable diseases.”

The same conscious and determined mind-set goes for other impoverished nations as well. PATH’S DefeatDD fights children’s diseases and is just one outlet actively educating individuals on how to treat and, more importantly, prevent major health issues.

Mikaela Frigillana

Photo: Flickr

Meningitis Vaccine
Meningitis is an infection, either viral or bacterial, that occurs around the brain and spinal cord. The bacterial form of this disease can have very severe consequences. According to PATH, 10 percent of victims die even with antibiotic treatment — 80 percent without any treatment — and survivors can still suffer from hearing loss or paralysis. Thankfully, a new meningitis vaccine offers hope despite these daunting statistics.

Sudan is one of 26 countries in Africa located in the “meningitis belt,” an area with a total population of about 450 million that has been deeply affected by meningitis over the past century. Epidemics arose about once every eight to 12 years according to PATH, and in 1996 twenty-five thousand people were killed in the largest meningitis epidemic.

Addressing meningitis in Africa is difficult because although meningitis A is one of the main causes of epidemics in Africa, most industrialized countries have meningitis C posing the largest problem. As a result, vaccine manufacturers focus on designing vaccines for industrialized countries to net more profit, and unfortunately, African countries then fail to receive the types of vaccines they need to combat meningitis A.

MVP to the Rescue

The creation of the Meningitis Vaccine Project (MVP) via a collaboration between the WHO and PATH in 2001 did much to help the situation. MVP was able to create a meningitis A vaccine, trademarked as MenAfriVac, that could also be cheaply administered for less than 50 cents for one dose.

MVP then introduced the vaccine in mass vaccination campaigns, and as a result 235 million people gained immunity. Amazingly, only 80 cases of meningitis A were recorded in 2015 — a huge improvement compared to the 250,000 reported cases from the 1996 epidemic.

Continuing the Success

So why then is Sudan incorporating the vaccine into its routine immunization program important if so much progress has been made in reducing meningitis outbreaks? Despite the success of the current round of immunizations, if the vaccines are not continually administered in the future, epidemics could begin again in as early as fifteen years.

The fact that the meningitis A vaccine is now part of Sudan’s routine immunization program means that at birth children will automatically receive the vaccine. As long as this program remains in effect, Sudan will likely not have to worry about meningitis. This year, 720,000 Sudanese children less than one year of age are expected to receive the vaccine.

Additionally, another vaccination campaign targeting children between one and five years old will go into effect this September. These children might have missed out on the Sudanese vaccination campaign that took place in 2012 and 2013, so the additional vaccinations provide another precaution against an outbreak.

Other countries should follow Sudan in adopting the meningitis vaccine into routine immunization programs. That way, these countries will be able to suppress meningitis on their own even without vaccination campaigns, and help hundreds to combat the deadly infection.

Edmond Kim

Photo: Flickr

World Hunger_Edible Insects Ghanian entrepreneur, Sofia, does not keep cows or pigs on her farm, nor does she grow edible plants. Instead, her farm is contained to three buckets held in a covered shed. Her livestock is “akokono” otherwise known as Palm Weevil Larvae, and farming these edible insects could be a necessary step to fight world hunger.

The adoption of new, efficient and sustainable nutritional practices grows ever more crucial as we struggle to end malnutrition in impoverished communities. According to UNICEF, malnutrition leads to the death of about 3 million children under five every year. Bodies that lack nutrients are unable to properly fend off infection, and often, going hungry can make common infections fatal. Additionally, in Ghana 76 percent of children under the age of two are anemic and 20 percent of maternal deaths are caused by anemia.

Organizations like PATH and Aspire are making strides in reducing malnutrition and iron deficiency rates by taking Sofia’s example and helping women establish home-based akokono farms. The large, cream-colored grubs have been a staple in Ghana for many years and are chock full of protein, iron and fat. In the past, workers harvested these edible insects while collecting sap to make palm wine. But as the use of pesticides rose, the populations of akokono fell, making them a less frequent meal in current day Ghana. However, insects are being put back on the table with the help of starter kits delivered by Aspire. The starter kits include a few larvae, a bucket, a screened lid and feed.

Not only do these micro farms provide food for a family, but they can also provide a means of income if the grubs are taken and sold at local markets. While there are many who turn up their noses at the idea of eating insects, the co-founder of Aspire, Shobhita Soor, believes that the cultural norm will change,“We definitely think it is the food of the future. I think the economics of food and the global constraints on the environment speak to that.”

Jordan Little

Photo: Flickr

The 30 Innovations PATH Chose to Save Lives
PATH, the Program for Appropriate Technology in Health, headquartered in Seattle, WA, is an international nonprofit organization and leader of global health innovation. For 40 years, PATH has improved health and saved lives.

PATH recently released the Innovation Count Down 2030 report, which identifies 30 key global health innovations. With support from the Norwegian Agency for Development Cooperation, the Bill & Melinda Gates Foundation, and the U.S. Agency for International Development, PATH assembled a group of experts and innovators from around the world “to identify, evaluate, and showcase health technologies and interventions with great promise to accelerate progress toward solving the world’s most urgent health issues,” according to the report.

The report features innovations that could hasten the pace of progress towards the health targets in the proposed United Nations Sustainable Development Goals (SDGs).

Those targets include reducing the global maternal mortality ratio to less than 70 per 100,000 live births and ending preventable deaths of newborns and children under five years old; ending the epidemics of AIDS, tuberculosis, malaria, and other diseases; reducing by one-third premature mortality from noncommunicable diseases; and ensuring universal access to sexual and reproductive health care services.

The global health innovations listed below, are presented in four categories that align with the SDGs proposed health targets. To read the summary of each goal, visit path.org and click the IC2030 report.

Innovations for maternal, newborn and child health:

  1. New formulations of oxytocin
  2. Uterine balloon tamponade
  3. Handheld device to measure blood pressure
  4. Simple, safe device for assisted delivery
  5. Chlorhexidine for umbilical cord care
  6. Kangaroo mother care
  7. New neonatal resuscitators
  8. New treatment for severe diarrhea
  9. Rice fortification
  10. New tools for small scale water treatment
  11. Portable pulse oximeters to measure oxygen
  12. Better respiratory rate monitors

Innovations for combating infectious diseases:

  1. Protective malaria vaccine candidates
  2. Malaria transmission-blocking vaccine
  3. Potent, single-dose antimalarial drug
  4. Expanded use of rapid malaria tests
  5. Broadly neutralizing antibodies in HIV vaccines
  6. Long-acting injectable antiretrovirals
  7. Oral pre-exposure prophylaxis
  8. Novel multidrug treatment regimen for TB
  9. New vaccines to prevent TB
  10. Nucleic acid amplification tests

Innovations for reproductive health:

  1. Expanded access to implants and intrauterine devices
  2. Injectable contraceptives

Innovations addressing non-communicable diseases:

  1. One-year contraceptive vaginal ring
  2. Polypill
  3. Broader use of HPV vaccine
  4. Task-shifting for diabetes care
  5. mHealth innovations
  6. Portable, affordable screening for eye problems

“On the eve of launching the SDGs, the global community now knows what we can accomplish by coming together around a common set of goals and throwing our collective weight behind health solutions with the most potential for impact,” the report states. “As world leaders consider how to finance and scale up those solutions, we know that coordinated investment and financing will be essential in our efforts to reach the 2030 health targets—and to ensure we can financially sustain those gains into the future.”

Kelsey Parrotte

Sources: IC2030 Report, PATH
Photo: Flickr

medical_devices
Many developing countries do not have the same health resources available to them as developed nations. Healthcare workers must come up with creative solutions to problems. PATH is a nonprofit organization that works to solve world health issue with innovative and creative solutions.

This year, PATH–with support of Norad, Bill and Melinda Gates Foundation and USAID–published a list of 30 creative solutions to different healthcare challenges in areas such as maternal, newborn and child health; infectious and noncommunicable diseases; and reproductive health. The inventions were submitted by entrepreneurs, investors, innovators and health experts from around the world. Those selected demonstrated sustainability, success in field testing, high numbers of saved lives, and low cost.

There are new forms of oxytocin, used to stop bleeding after childbirth, that are in powder and tablet form. Both the new forms are easier to transport and are safe for lower-level health workers to use than the typical injection. There are also new ways to create typical medical devices used during delivery, for example, the uterine balloon tamponade. It is typically used in wealthy countries to control bleeding, but developing nations often don’t have access to it. The solution was to tie a condom to a catheter which is then inflated with clean water through a syringe.

For combating diseases, there are Malaria vaccines, BPaZ to treat multi-drug resistant TB in three months, and new nucleic acid amplification test for TB. The Polypill is a low-cost pill for the prevention of cardiovascular diseases. To treat visions issues which affects 300 million people worldwide, there are new portable devices that low-level health officials can use to diagnose eye issues.

In reproductive rights, innovators created a one-year contraceptive vaginal ring so that women have more control for pregnancy prevention

PATH sees this list of 30 innovations as game changers in addressing global health issues. They are low cost and easily portable and administered by lower level health care officials. The hope is that these drugs and devices will help the world reach the 2030 health targets set out by the UN. To read the full list of innovations, visit PATH’s website.

Katherine Hewitt

Sources: IC 2030, NPR
Photo: IC 2030