October 22, 2012
GBCHealth, in partnership with Massachusetts General Hospital’s Center for Global Health, hosted a half-day symposium on technological innovations in support of maternal and child health on October 22, in New York City. The event explored how technological innovations, especially those delivered within existing health systems, have the potential to reduce death rates and improve health outcomes for women, newborns and children. The meeting brought together key stakeholders with bold ideas—engineers, clinicians, public health policy makers, entrepreneurs and private sector leaders—to discuss how we can accelerate the development of great technological innovations.
Dr. Kristian D. Olson of Massachusetts General Hospital’s Center for Global Health provided opening remarks and said that technological innovation is essential to progress in global health, specifically, maternal and child health. Olson, who is also the Medical Director of the Consortium for Affordable Medical Technology (CAMTech), highlighted its mission of testing and deploying innovative, high-quality and affordable health technologies to improve maternal and child health outcomes in the poorest regions of the world. He stressed the need to develop sustainable models for developing, commercializing and delivering innovative health technologies. He stated, “[we] need to not only look at public health expertise and clinical expertise, but also technical expertise and commercial viability.”
Dr. Doris Rouse of RTI International provided a global perspective on the current state of delivering innovative technologies to improve pregnancy outcomes. RTI received a grant from the Bill & Melinda Gates Foundation to create a framework, entitled Maternal and Neonatal Directed Assessment of Technology (MANDATE), to produce an interactive, computer-based quantitative model that compares the potential number of lives saved across maternal and neonatal technologies. Rouse, who serves as the Co-Principal Investigator for the project, highlighted how MANDATE will allow users to identify and isolate the potential impact of a technology by patient category, region and setting. She then noted the objectives of the symposium as:
Lois Quam of the Global Health Initiative at the U.S. Department of State provided compelling remarks on the role that disruptive innovation and technology can play in eliminating preventable maternal and child mortality. She began by stating that right now, women still die giving birth for the most basic reasons and “we are united to change this. We see this as a great frontier…where we can make a difference.” She called for the realization that while the development and implementation of technology are necessary tools, major work also needs to be done to change environmental and social norms that prevent mothers from getting care before, during and after the birthing process. “The opportunity we have in Maternal and Child Health is to really do things differently,” Quam said. “The resources are going to come from countries themselves in a much more significant way. They have to.”
Dr. Scott C. Ratzan of Johnson & Johnson underscored the importance of metrics in maternal health initiatives. He noted that innovations in maternal and child health need to be simple and scalable, such as the World Health Organization’s (WHO) checklist implementations. The checklists identify different phases and steps for a procedure, each corresponding to a specific period in the normal flow of work. In each phase, a coordinator must confirm that the healthcare provider has completed the listed tasks. Ratzan denotes the importance of simplicity in new tools with the example of two mHealth initiatives, Text4Baby and MAMA (Mobile Alliance for Maternal Action). Both initiatives provide simple instructional text messages pre- and post-pregnancy regarding pertinent vaccination and education notes to improve maternal and newborn health. These initiatives are simple and effective mechanisms of educating and empowering women to have control over their health.
Gary M. Cohen described BD’s strategic approach to global health issues by presenting three case studies in which BD helped tackle a global health issue. The first case study, disposable syringes, was in response to HIV/AIDS epidemic which led to collaboration with the World Health Organization (WHO), which wanted to develop a new type of syringe that was not reusable. The second case study, HIV Immune System Testing, also served as a great example of a simple technology that has been effectively implemented and has led to tangible outcomes. The third case study focused on the Odon device, a simple tool for assisted birth deliveries (not yet released). Cohen also spoke of the internal and external challenges of advancing an innovative idea within a company, and developing the product, noting that there are numerous barriers and challenges. To summarize, Cohen emphasized that BD’s approach to global health involves seven key elements: advocacy, policy, training, collaboration, technology, funding and clinical data.
Tore Laerdal of Laerdal Medical, Laerdal Foundation for Acute Medicines and Laerdal Global Health, began by reflecting on how his father used core competencies of his doll company to develop the first ever CPR doll. Today, the company has shifted from resuscitation of adults in pre-cardiac arrest to working newborns, because it’s estimated that efficient newborn resuscitation could reduce birth asphyxia by 50% and “fresh stillborn” by 25%, thereby saving 600,000 more lives a year. In this process, Laerdal has placed an emphasis on public-private partnerships, using its “Helping Babies Breathe” global implementation alliance to shift its emphasis from innovation to following through with implementation. Laerdal is also working on devices to educate and prepare frontline health workers to manage postpartum hemorrhaging.
Dr. Data Santorino of Mbarara University of Science & Technology (MUST) focused on healthcare solutions that are adaptable and resilient to the varied technological barriers and bottlenecks of developing nations. Santorino began by discussing the importance of integrating epidemiological technology and current on-the-ground research. At MUST, maternal and child mortality was addressed by focusing on developing strong community engagements with health and by conducting research that is sensitive to low-resource settings. He used his own research in specific communities in Uganda as an example of the importance of helping communities identify solutions to their maternal and child health problems.
Thomas L. Harrison of Omnicom Group Inc. served as the moderator for the discussion on the importance of improving technologies for infant and maternal health. His remarks, followed by audience questions, honed in on the importance of producing technologies that have long-term value, of advocating for increased funding to develop tools for global health and of developing strong public-private partnerships.
Timothy Prestero of Design that Matters (DtM) presented insights into what process essentials are required to design an effective, user-friendly and affordable health tool. His presentation focused on the development of Firefly, a phototherapy tool used to treat jaundice, a disease caused by excess of bilirubin in the liver. Each year, 5.7 million infants in South Asia and Africa do not receive necessary phototherapy treatment. At DtM, the design of Firefly took several years and went through numerous attempts at redesigning the tool. The process, Prestero said, “is not about complexity, but all about simplicity.” He indicated that the process involves designing for inspiration, as well as outcomes, specifically focusing on human centered designs. He also noted that appearances, context and cost are key factors of the design process.
Dr. Naveen A. Rao of Merck for Mothers and the MDG Health Alliance provided compelling closing remarks. He discussed the role that Merck, through its Merck for Mothers, program has played in this global health battle, stating, “[Merck for Mothers] is a global commitment to create a world where no woman has to die while giving birth,” he said. Rao wrapped up the day by summarizing three key questions about maternal, newborn and child health technologies that the symposium has tried to answer:
Participants then attended a “Show & Tech” exhibit for newborn and maternal health technologies.