Each year, 10.7 million children under the age of five years die, 4 million during the first four weeks of life. Another 3.3 million are stillborn and these are only the official reports. In the less developed countries, which account for 98 percent of reported neonatal deaths and 97 percent of reported stillbirths, these births and deaths are not always registered.
This is a complex problem which requires a multidimensional analysis. Neonatal deaths generally result from complications of preterm birth, asphyxia or trauma during birth, infections, severe malformations, or other specifically perinatal causes. The proportion attributable to each cause varies: for example, in areas where neonatal mortality is lower, preterm birth and malformations play a larger role; where mortality is higher, the contributions of asphyxia, tetanus, and infections are greater. Maternal health and nutrition are important for neonatal health and maternal infections contribute to adverse outcomes.
In Peru, mostly in rural areas, not all institutions that offer maternity services meet the minimal standards for safe childbirth and newborn care. Such facilities are often hampered by a scarcity of health care providers, outdated knowledge and inadequate skills, overcrowding, inadequate hygiene, and a lack of essential medicines, supplies, and equipment. Countries face the challenge of building health care systems that can meet the needs of an increasing number of women and infants.
Targeting new interventions for neonatal survival should be easy in one sense: we know when pregnant women and newborns will need care, since we estimate in advance the date of birth and most complications arise during late pregnancy and childbirth. There is no substitute for professional care during the critical 24 hours after birth. A skilled provider can support a woman during childbirth in a manner that is in keeping with her culture and beliefs and can promote breast-feeding, detect complications, and organize care by obstetricians or pediatricians as needed.
In this context, our proposal is to design a safe incubator that will be used in local health centers in order to allow low-weight births to receive medical care. Our protoype developed at IDDS 2008 at MIT is easily assembled and portable. It needs minimal operating capabilities and will keep the infant warm and hydrated.
This prototype meets the following design specifications:
a) Easy assembly: each part is designed to fit into one and only one location so that it is intuitive for any health worker to assemble.
b) Easy maintenance by an unskilled technician: in the event of a part malfunction, it will be clear which part needs to be replaced and it will be easy to remove only that part.
c) Scalability of features: this will allow target health centers to scale up in incubator features without having to buy a new model.
d) Easy replacement of parts: the incubator is designed with locally available materials that have parts that are easily replaceable.
e) Transportable bed: the bed is able to be moved from a primary or intermediate health center to a larger scale hospital with non-electric heat maintenance during transport.
The goal of the project is to improve the first prototype developed in the IDDS 2008 at MIT. The purpose is to develop a set of low-cost modules for the infant incubator. For this reason, our first proposal for this grant is to engineer a monitoring system which will record, graph and adjust the main parameters as temperature and humidity.
Our next steps are to develop the modular design of the infant incubator including alternative sources of power, heating/humidifier option, filtering system, pulse oxymeter, storage drawers and so on. When we build our ultimate prototype, we will be ready for field trials in Peru and other potential locations in Latin America. To define our business strategy, we will make market feasibility studies.
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