Improving Care for Babies in Low-Resource Settings Through Essential Newborn Health Technologies

Rice University’s BreathAlert device at the Saving Lives at Birth Developmentxchange in Washington, DC. Photo: Ian Hurley/Save the Children

The Saving Lives at Birth Grand Challenge calls on the brightest minds across the globe to identify and scale up transformative prevention and treatment approaches for pregnant women and newborns around the time of birth. This is the second installment of the Healthy Newborn Network’s series profiling several innovations from this year’s DevelopmentXchange. 

At the Saving Lives at Birth Development Exchange in July, we saw many cutting-edge technologies designed to improve neonatal care in the developing world and prevent the nearly three million newborn deaths annually.

Many newborns will be saved by these technologies. However, too often new health tools such as these focus on improving only one aspect of care, when what is needed to promote and sustain better health outcomes for newborns in the developing world is an integrated set of essential newborn health technologies that supports clinicians delivering essential newborn care.

More than half of all newborn deaths annually are caused by complications from prematurity and infection. The Saving Lives at Birth nominees and other organizations are innovating new tools to address these major causes of neonatal mortality in low-resource settings. Diagnostics For All, for example, is developing a rapid, disposable, point-of-care nucleic acid amplification test for early diagnosis of HIV in infants, enabling ART to be started immediately. The Brilliance phototherapy light designed by D-Rev performs as well as traditional phototherapy devices but operates for longer using less energy at a fraction of the cost. 

With the support of a Saving Lives at Birth grant, Rice University, in partnership with the University of Malawi, is developing BreathAlert, a $25 battery-powered monitor that detects and corrects apnea in premature infants, using a small vibrating motor.  BreathAlert will be evaluated and optimized for use in low-resource settings. The team will also determine the product requirements and specifications to prepare BreathAlert for commercial manufacturing.

The challenge before the appropriate health technology community now is to incorporate the life-saving tools it is developing into affordable technology packages for central and district hospitals in developing countries. An essential newborn health technology package would include technologies that provide adequate hydration and nutrition, offer breathing support, stabilize temperature, prevent and treat infection, and monitor for and treat jaundice. Designed for impact in the developing world, these technologies must be safe, effective, affordable, robust, easy to operate, functional using a range of power sources, and compliant with international regulatory standards. 

The technologies cannot require numerous consumables or batteries, or regular maintenance. For maximum impact, essential newborn health technology packages should be accompanied by appropriate training and mentorship programs for nurses, including a certification program for nurses who specialize in neonatal care and commit to remaining in the neonatal ward.

Recently, we visited the neonatal ward at Queen Elizabeth Central Hospital in Blantyre, Malawi, where we saw a newborn baby boy being treated simultaneously for hypothermia, jaundice, and respiratory distress syndrome (RDS). The baby was sleeping in a wooden incubator heated with incandescent light bulbs that was constructed by the hospital. He was being treated with a phototherapy light designed by Malawi Polytechnic, and a CPAP device designed by Rice University and Queen Elizabeth Central Hospital. Any one of these technologies alone would not have been enough to guarantee the survival of this tiny patient, but together, they made his outlook much brighter. 

Photo: Rice University

Working together, the appropriate health technology community can make effective, affordable, essential newborn health technology packages available to hospitals throughout the developing world. When all babies have access to a comprehensive set of essential newborn health technologies, we can turn the tide on newborn mortality. 

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