The atrium of the Washington, D.C. government building looks like a particularly high-class science fair. The people manning poster-board stations, however, are all adults — and rather than rather than baking-soda volcanoes, their displays are nearly all adorned with pictures of mothers and children.
The presentations are part of the sixth year of “Saving Lives At Birth,” a development challenge spearheaded by a variety of partners, including USAID, the Bill and Melinda Gates Foundation, to come up with audacious solutions to one of the oldest problems in the book: the high rate of death of women and babies in childbirth.
For many people around the world, the time between labor and 48 hours after delivery is one of the statistically riskiest times of their life. Globally, 2.7 million babies die shortly after birth every year, in addition to 2.6 million stillbirths. Neonatal deaths make up nearly half of the world’s child deaths, according to numbers from UNICEF. For mothers, the data is also stark: 303,000 women die every year in childbirth — about two every minute. 99 percent of these deaths occur in the developing world.
“Maternal and neonatal health is really not an area that had been getting as much attention.”
While child deaths have declined by half in the past 25 years, neonatal mortality has remained a persistent problem — even here in the United States, which has one of the worst records on infant mortality in the developed world. Many of these deaths are entirely preventable. But despite how often politicians talk about the need to protect babies when they’re in the womb, comparable attention hasn’t been given to how to protect babies when they’ve entered the world.
“It’s an area where we’ve really had a lack of innovation and a lack of new ideas on how we can do a much better job at saving lives in some of these most vulnerable populations,” Wendy Taylor, the director of USAID’s Center for Accelerating Innovation and Impact, told ThinkProgress at the presentation.
That’s where Saving Lives at Birth comes in. Supported by a directive by the Obama administration, which Taylor says has “put a huge emphasis on maternal health,” it’s one venture that aims to change the global picture by supporting science and innovation targeted at saving mothers and babies.
Since the program launched in 2011, inventors from over 100 countries have submitted 3,500 ideas to help address the problem. Successful inventors are given support, mentorship, and money by the program as they try to enter their products in markets all around the world; to date, the program estimates that the inventions have helped 1.5 million women and newborns and saved about 10,000 lives.
“It’s this grand challenge to identify groundbreaking innovations to save the lives of mothers and newborns,” said Taylor. “We’re really interested in the gamechangers, these big ideas that lead to serious improvements in maternal and neonatal health.”
Here are a few of the highlights from the initiative:
The Argentine Car Mechanic Who Dreamed How To Save Babies
Innovations can come from anywhere — college students, entrepreneurs, NGOs, corporations. In fact, one of Saving Lives at Birth’s most interesting and widely-covered ideas came from an Argentine car mechanic.
Jorge Odon says that the idea for the Odon Device — which helps women give birth when the baby is trapped in the birth canal by using suction from a plastic bag — came to him in his sleep after he watched a YouTube video about how to take a cork out of a wine bottle. He built his first prototype in his kitchen using a doll, a glass bottle and a fabric bag.
Now, the device has been developed into a viable birthing tool: when a doctor uses the Odon device, they slip a plastic bag inside a lubricated sleeve and inflate it to grip the head and pull on it — pulling out the baby with less risk of infection and less cost than cesarean sections or other ways of pulling the baby out.
“The Odon Device is a great story about how great innovations can come from anywhere,” said Taylor.
It’s still being tested for safety before going to market, but it’s the first innovation in obstructive labor since doctors started using vacuum extractors decades ago, and since the forceps came around in the 1700’s.
An Umbilical Cord Antiseptic That Costs Pennies
In Nepal, nearly half of births occur at home and the umbilical cord is treated with the likes of tumeric powder, mustard oil, or cow dung — which can lead to dangerous infections. That’s partly why two in 100 Nepalese children die before they reach one month old.
But one idea that came out the Saving Lives at Birth initiative is already being put to widespread use in Nepal to address this.
Chlorhexidine is essentially a low-cost antiseptic for umbilical cords. It’s a relatively simple solution — a small tube that “costs pennies per dose” and has been shown in studies to reduce overall neonatal mortality by 24 percent when it replaces the traditional, infection-inducing standards of cord care.
“Even in Nepal alone [it has] already saved 9,000 lives,” said Taylor. “It’s a really exciting innovation.”
A Pump That Recycles Patients’ Blood
Many of the innovative ideas that come out of the challenge are, like Odon, seemingly out of left field — but incredibly simple once described.
One of them, developed by a female-led Global Health company named Sisu, aims to disrupt the blood donation market in Africa, where a severe shortage of blood donations and the subsequent high cost of blood — up to $250 per unit — leaves many doctors high and dry in the case of an emergency, like a childbirth during which a woman is losing a lot of blood.
Instead of relying on expensive or unavailable donor blood, doctors can recycle blood from internal bleeding and redirect it, a process called auto-transfusion. But many health centers in the developing world can’t afford the expensive machines used in Western hospitals to filter blood. Instead, in operating rooms in African countries, attendants may use a bucket, a soup ladle, and gauze to scoop out and filter blood before using it.
The Hemafuse, invented by Sisu, is an cost-effective, hygienic alternative to the soup ladle — it resembles a giant pump that cleanly and effectively pulls out the blood, filters it, and transfers it to a blood bag where it can be used for surgery, including surgery from childbirth complications and ruptured ectopic pregnancies. It’s still being developed, but its advocates estimate it could save nearly 300,000 lives per year in Ghana, where Sisu aims to introduce it first.
A Bracelet To Monitor Newborns’ Body Temperature
Some innovations — like the Hemafuse — are developed because of the cost barriers the developing world faces to high standards of care. Others come out of specific market needs.
Ratul Narain, founder of the company Bempu, developed his device after extensive observation and consultation with pediatricians in India, which has the highest rate of death due to preterm babies in the world. One of the main reasons for the high death rate is low birth weight, and a corresponding high risk of hypothermia — if a baby’s temperature drops even a bit, they will start burning necessary body fat, putting them at severe risk of brain damage or death.
In the United States, for example, such children are kept in the hospital until they’ve gained enough weight to leave without constant risk. But in India, many families don’t have that luxury, and the only hope is constant vigilance 24 hours a day — a tough ask for an exhausted new mother, particularly one with a job, a household, or other children to care for.
“Practically, that has limited accuracy, and the mother has to be trained on it, and she has to do it, and she also has to sleep,” said Narain. The problem is deceptively simple: the babies need to be watched constantly to ensure that they’re warm enough. However, in practical terms, constant, accurate attention is a difficult ask.
In response, Bempu developed a simple bracelet that accurately monitors the baby’s temperature full-time and acts as a warning system. Retailing for about $27 dollars, it provides round-the-clock protection for two months — the time when the baby is at the highest risk.
“The bracelet sits on the wrist of the baby and monitors it, and it blinks a soft blue light if the temperature is okay,” Narain told ThinkProgress. “If the baby is hypothermic at any time, it sounds an alarm and blinks a bright red light to wakes up the mother so she can warm the baby through kangaroo care [which is where she holds the baby next to her chest].”
Bempu is also working on developing a bootie that will help babies with apneas by ‘flicking’ their feet to remind them to keep breathing — currently, in India, the standard is crowded neonatal wards and harried nurses.
Affordable Screening Tests For Expectant Mothers
Preeclampsia — which first came to many people’s awareness when was featured in an episode of Downton Abbey — is a potentially deadly condition that effects expectant mothers. Marked by the swelling of the hands and feet, abnormally high protein content in the urine, and high blood pressure, it’s a leading cause of maternal mortality in developing countries, and complicates 2- 8 percent of all pregnancies.
In the Western world, frequent trips to the doctor or expensive automated diagnostic systems can identify preeclampsia so they can get the care they need before the condition turns deadly for the mother and the baby. However, those screening tests aren’t available to most women around the world, and especially not to those most at risk.
Multiple teams are working on finding accessible, low-cost ways to detect preeclampsia in mothers early. One of these, the Urine Congo Red Dot test, is a simple test for mother’s urine that detects one of the markers — a high rate of misfolded proteins.
It uses only a specially developed red dye and simple, cheap paper — the type used to make mailing labels. Overall, the cost to make the kit is less than 4 cents, and it uses widely-available products.
In the case of preeclampsia, as in the case of many diseases, the early screening can make the difference between life and death. Other teams are also working on diagnostic tests for HIV, syphilis, and other diseases — all focused on making accurate screening more accessible to more women.
Many of the devices that have come out of the “grand challenge” have, above all, emphasized ease and cost-effectiveness — everything from a fish-shaped block of iron that women can cook with to reduce anemia, to a simple measuring stick that mothers can hold up to their child’s skin to see if they are developing jaundice. In the developing world especially, cost and lack of access to high-level care are the culprits behind many deaths, and by coming up with innovating solutions that work for more of the world, scientists and entrepreneurs can help save thousands of lives.
In other areas, though, the inventions address a need that people didn’t seem to realize was there — or a need that hasn’t been prioritized. Taylor blames the lack of innovation, at least partially, on a lack of funding.
“We’ve put a lot of money into innovations around the big attention-getters, into HIV, malaria, TB, and maternal and neonatal health is really not an area that had been getting as much attention,” she said.
But childbirth has always been dangerous for women and children. In many areas of modern life, smart innovations have made huge differences — and mothers and babies are one area that desperately need that attention.