Every year, 2.8 million newborns die within the first 28 days of life. Complications during labour and delivery are responsible for approximately a quarter of these neonatal deaths worldwide1. In addition to this, there are 2.6 million stillbirths each year.
Continents such as Africa are carrying the main burden of this. For example2, in the UK the stillbirth rate is 1 in 250 births, but in Nigeria this is 1 in 24. And after a live birth, the number of infants that die in the first 28 days of life is 1 in 333 in the UK, but it is 1 in 26 in Nigeria. These stillbirth and neonatal death rates are more than 10 times as high as in the UK, and unfortunately the vast majority of these deaths are preventable.
Responding to this need, Philips has established a partnership with South Africa based not-for-profit organization, PET (PowerFree Education Technology)to develop, test and commercialize a Wind-up Doppler Ultrasound Fetal Heart Rate Monitor (in short: Wind-up Fetal Doppler). This device is a unique power-independent healthcare innovation aimed at addressing the high rates of preventable infant mortality across Africa.
As the Head of the Philips Africa Innovation Hub, I was in Nairobi to announce this collaboration and unveil the first Philips prototype of the device.
Signing of the MoU between Philips and PET. From left to right: JJ van Dongen – CEO Philips Africa, Dr. Maarten van Herpen – Head of Philips Africa Innovation Hub, Dr. Francois Bonnici – Director of PET and Director of the Bertha Centre for Social Innovation at the University of Cape Town Graduate School of Business.
Empowering health workers to give better care
For example, to catch up with OECD (Organisation for Economic Co-operation and Development) countries, Nigeria would need to train 12 times as many doctors by 2030, costing USD 51 billion (10 times the current annual Nigerian public health spend). In response to this huge shortage of doctors, the only option in Africa is to innovate and empower other health workers to become care givers, while at the same time lowering the cost of care. I believe that this challenge in Africa will enable creation of new healthcare innovations that will become the solutions for the future, also in the rest of the world.
In the Philips Africa Innovation Hub, which is the center for developing innovations “in Africa for Africa" we are working on many projects to improve access to quality health services in addition to creating innovations in lighting and healthy living.
What inspires me about the work we do in the Philips Africa Innovation Hub, is that there are many opportunities for social innovation; wherein companies like Philips can provide business solutions to address societal issues. This fits perfectly with the mission of Philips, to improve people’s lives through meaningful innovation. Business solutions have the potential to make a huge impact as they can be scaled to a large size.
For the case I am writing about now, we have been engaging with midwives and nurses to better understand the issues they face during deliveries. They told us that it is very important to keep a close watch on the heart rate of the baby during labour. If this heart rate goes down towards the end of a uterine contraction, that is an important indication that the fetus is not receiving enough oxygen and may die, or suffer brain damage. It is the role of the midwife to check on the fetal heart rate, so she can take necessary actions to save the child in case of an emergency.
Midwife using a Pinard-stethoscope (fetal scope) to count the heart rate of a fetus.
The nurse in the picture above (Image 2) is using a to listen to the heartbeat of an unborn child. She is holding a watch so she can count the number of heartbeats within one minute to find out the heart rate. Midwives and nurses constantly indicate that this is very difficult to do, because you need to be able to hear the fetal heart well and count the rate correctly. This is challenging; additionally, it is often also uncomfortable for the mother. They need a device that can measure the heart rate automatically, so they know how the baby is doing, and they know if they need to decide to intervene.
Some automatic devices exist, but these devices are not suited for the typical setting in which nurses and midwives do their work, especially in rural, off-grid environments. They are either too expensive, too inaccurate, too complex, rely on replaceable batteries or electricity to run.
PET has been working on the development of a hand-cranked, Wind-up Fetal Doppler for many years, and they verified the positive impact of the device in tests in Uganda, where 60% more cases of abnormal fetal heart rate were detected in labour, compared to the standard Pinard-stethoscope. The device is called the wind-up Doppler ultrasound fetal heart rate monitor. This device easily and accurately counts the fetal heart rate while the mother is in labour. What is special about the design by PET is that it has been designed especially for low resource settings in low-income areas of the world. For example, it is easy to use, it is extra strong, and it has a back-up wind-up power feature.
PET has tested the device in the field, and the response was very positive. Mothers also find it very encouraging to hear the heart rate of the baby. For example, a mother in Uganda said: “Every mother should have an opportunity to hear the heart of her baby. It makes you realize that it is real and it helps you to stay focused on why you are actually in labour. Hearing that little heart is very motivating."
A nurse using the wind-up fetal Doppler to check the heartrate of the unborn child. Photo credits: Photo: Chris Taylor/ Save the Children.
First pictures of the prototype of the Philips Wind-up Fetal Doppler.
At the signing of the MoU, we unveiled the first Philips prototype of the Wind-up Fetal Doppler. This prototype is subject to clinical testing and regulatory approval, before release for general usuage; however, it underpins Philips’ commitment to the partnership with PET.
Philips has consistently remained committed to reducing newborn and child mortality and improving maternal health, linked to the current UN Millennium Development Goals 4 and 5 (MDGs). The company has also made a pledge to UN Secretary-General Ban Ki-Moon’s initiative Every Woman Every Child and committed to improving the lives of 100 million women and children by 2025 targeting sub-Saharan Africa where high maternal and infant mortality can be addressed through early diagnosis and preventable care. Our collaboration with PET on the Wind-up Fetal Doppler is another example of our commitment to reducing infant mortality and improving maternal health in Africa.
1. Unicef, Committing to Child Survival: A Promise Renewed http://files.unicef.org/publications/files/APR_2014_web_15Sept14.pdf
2. WHO World Health Statistics 2013