Improving Maternal Health and Continuing Medical Education Using Solar and Low-Power Computer Technologies

Improving Maternal Health and Continuing Medical Education Using Solar and Low-Power Computer Technologies

IgangaProvo
Year Founded:
2009
Organization type: 
nonprofit/ngo/citizen sector
Project Stage:
Scaling
Budget: 
$50,000 - $100,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Safe Mothers, Safe Babies seeks to reduce maternal and neonatal mortality and morbidity through demand-driven, collaborative, sustainable, and scalable means.

WHAT IF - Inspiration: Write one sentence that describes a way that your project dares to ask, "WHAT IF?"

What if every birth was a safe and happy experience, regardless of where one was born or the circumstances in which he or she lived?
About Project

Problem: What problem is this project trying to address?

Each year, more than 350,000 women and millions of babies die from complications of pregnancy and childbirth while millions more are injured. Many interventions have sought to improve these conditions by increasing access to health centers and life-saving medications. Yet these interventions often assume an absolutely vital support structure: the existence of trained health care providers, which frequently do not exist. This is not always because there aren’t enough providers, but because a breakdown in continuing medical education means that those providers that do exist don’t have the training they need to keep their skills up to par. What is needed is a concerted effort to strengthen the continuing medical education aspect of rural obstetric health care.

Solution: What is the proposed solution? Please be specific!

Continuing medical education (CME) occurs in the form of hands-on training and the distribution of handouts. In Uganda, this training is conducted at district health offices (DHO) and hospitals. The primary obstacle is that many rural health center staff can't participate, as they are located so far from the training location that travel cost and lack of communication regarding when trainings will occur are prohibitive. Our solution builds on our successful installation of “Solar Suitcases” (innovative solar technology) in rural health centers by adding low-power computers. Solar Suitcases currently light deliveries, but in our solution will also power the computers that will house databases of CMEs conducted at the district level, including digitized versions of written materials along with video of any trainings provided by the DHO, filmed via a low-power flip video camera. These materials will then be available for any health provider at any clinic where the technology is installed.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

In order to use the technology most efficiently, our model includes: 1) Strengthening the demand for rural obstetric care by working with local change agents to improve maternal behavior in culturally sensitive ways, 2) Teaching the health center staff to use the technology in participatory trainings, and 3) Promoting health center and community ownership of the project. First, Safe Mothers, Safe Babies (SAFE) looks for change agents who are already impacting local health. These individuals help SAFE engage communities in defining, prioritizing, and improving maternal and child health in locally sustainable ways, for example, working with civil society to write dramatizations and songs about reproductive health that they perform in their villages; each solution is designed and implemented by the community, with cursory support from SAFE. A solar unit is simultaneously installed in the local health center, accompanied by training regarding optimal usage, care, and repair, and awareness campaigns using identified change agents. The solar unit lights deliveries, charges phones, and powers medical equipment, improving the quality of care. Our 2010 and 2011 pilot projects revealed over 100% increases in the number of health center deliveries, STD testing, and prenatal care attendance. The final step is building a database of local, DHO-provided obstetric CME materials provided. This ensures adherence to local protocols and provides training in whatever the local language is. A low-power computer is then installed in the health center and linked to the central database.

Impact: What is the impact of the work to date? Also describe the projected future impact for the coming years.

The project is lighting 22 maternal health facilities, including delivery rooms, post-partum wards, and operating theaters; and is concentrated in one region to strengthen its whole health care system. Collectively, these solar systems are lighting around 2,000 births/year. In our 4 primary facilities, there has been a 35% increase in the number of deliveries, and our district hospital has experienced a 65% decrease in maternal mortality. By adding in the low-power computers to facilitate high-quality, easily-accessible medical education, we feel that we could improve the number of health center deliveries by an additional 20% and decrease mortality by an additional 10%. We also anticipate building electronic data collection into the system, which would allow us to track maternal and child health indicators in real-time, and would facilitate monitoring, evaluation, and scale-up.
Sustainability

Financial Sustainability Plan: What is this solution’s plan to ensure financial sustainability?

Safe Mothers, Safe Babies has been working in these communities for 7 years, and has no intention of leaving. Our operating methodology relies on community-based partnership--we work WITH, not for, those we serve. Additionally, we have built strong partnerships with all the key maternal and child health players, in both the governmental and non-governmental sectors. We will fund the project upkeep, and will grow the project through our partners.

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

There are many organizations focused on improving the demand for, or quality of, health care services; there are also many for-profit and non-profit organizations working with solar, information and communication technologies. We sometimes compete with these players for funding. That being said, no other projects that we know of are pairing solar technology, low-power computers, and participatory, demand-generating outreaches to strengthen continuing medical education and the quality of rural obstetric care services. By working with diverse partners, SAFE is developing an innovative model to sustainably improve maternal and child health outcomes, which—given the model’s reliance on local change agents and materials—will be easily expandable throughout the entirety of the developing world.
Team

Founding Story

During a 4-month stay in Uganda, I installed a very small solar unit on top of my house in a rural village. After I returned to the US, a Ugandan women’s group asked SAFE’s Program Manager if we would consider moving the solar unit to their local health center. "We are scared to deliver there at night. The nurses cannot see to help us, so we don't want to go there." It cost $30 to move the unit, but the effect it had on the utilization of services was staggering—in the 6 months following the installation, the health center saw more than 100% increases in the number of deliveries, prenatal care attendance, and HIV/STD testing! While evaluating that project, however, health care providers discussed their inability to get continuing medical education—essential to appropriately handling obstetric emergencies—because the health center was too far from the hospital where it was conducted. Using computers to share district training was the suggested solution.
About You
Organization:
Safe Mothers, Safe Babies
About You
First Name

Jacqueline

Last Name

Cutts

About Your Organization
Organization Name

Safe Mothers, Safe Babies

Organization Country

United States, UT, Provo, Utah County

Country where this project is creating social impact

Uganda, IGA, Iganga

How long has your organization been operating?

1‐5 years

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Innovation
How long have you been in operation?

Operating for 1‐5 years

Which of the following best describes the barrier(s) your innovation addresses? Choose up to two

Quality.

Social Impact
Please describe the goal of your initiative; outline what you are trying to achieve

Will improving the number of skilled care providers matter if there isn’t enough electricity to conduct life-saving procedures? Can a health care provider render high-quality care if he or she only receives limited training once in his/her lifetime? If you had to deliver your baby in the dark with a less-than-competent care provider, would you? The goal of Light the Night is to reduce the number of mothers and newborns dying from preventable conditions by improving health-seeking behavior, health center infrastructure, and health care provider education. We seek to accomplish this by bridging a gap that has long-existed in other programs with similar objectives, by pairing the installation of innovative technology with change-making public outreach and engagement.

What has been the impact of your solution to date?

To evaluate our 2010 pilot, we compared pre and post intervention health center data, which revealed more than 100% increases in monthly clinic births, prenatal care attendance, and STD testing.

Afterwards, we were co-awarded a $50,000 grant with our partner, WE CARE Solar, to scale up with 20 Solar Suitcases in rural Ugandan health facilities in December 2011. Since then, we have received reports of 100-200% increases in the number of health center deliveries along with stories of lives saved as a direct result of the lights provided. For example, after resuscitating a premature newborn, midwife Esther Madudu reported: “Without the lights, we wouldn’t be seeing the AMBU bag to resuscitate correctly… or the name of the drug to be sure it was right… now there will be a lot of mothers saved, a lot of babies saved.”

The installation of low-power computers is a new addition to this successful model, but given its basis on direct requests, it is expected to be equally impactful.

What is your projected impact over the next five years?

While in Uganda in December, 2011, SAFE Founder and President, Jacqueline Cutts, was able to forge national partnerships with the Ugandan chapters of the African Medical and Research Foundation (AMREF) and the White Ribbon Alliance, along with the Permanent Secretary for the Ugandan Ministry of Health, Dr. Asuman Lukwago. With these diverse partners, we are aiming to install Solar Suitcases and low-power computers in at least 100 health centers and hospitals all over Uganda over the next 2 years, through which we anticipate lighting over 65,000 births annually and providing continuing medical education services to at least 500 health care professionals every year.

What barriers might hinder the success of your project? How do you plan to overcome them?

The greatest barrier we will face will be ensuring enough organizational capacity to handle our planned expansion. SAFE currently has one full-time Program Manager, 10 per-diem Ugandan employees, and 238 Ugandan volunteers. To successfully implement a project of this magnitude and ensure quality evaluation, we need to hire one Project Director whose focus will entirely be managing Light the Night, in addition to one Regional Director in each of the 5 areas in which we are expanding in the immediate timeframe. This translates to about $10,000 per year. To handle these expenses, we are growing our U.S. internship program from 12 volunteers per year to 40. Each intern pays a $1,000 program fee, including $500 that is given to projects, thus giving us $20,000/year for costs such as these.

Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact

Conduct extensive pre- and post- intervention evaluation of all intervention and control health centers.

Identify three major tasks you will have to complete to reach your six-month milestone
Task 1

Solidify quantitative and qualitative evaluation indicators with sociologist student interns and sociologist adviser.

Task 2

Seek IRB approval for study.

Task 3

Work with PEAT interns and sociologists to conduct assessments at 9 control and 9 intervention health facilities.

Now think bigger! Identify your 12-month impact milestone

Disseminate results of study to the public, and seek scale-up funding.

Identify three major tasks you will have to complete to reach your 12-month milestone
Task 1

Communicate results to all project partners.

Task 2

Write articles for publishing in peer-reviewed journals.

Task 3

Use results and work with project partners to pursue large grants for scaling up project.

Sustainability
Tell us about your partnerships

Our primary partner is WE CARE Solar, manufacturer of the highly efficient, stand-alone “Solar Suitcase” that has been deployed in 17 countries, with larger initiatives in Nigeria, Liberia, and Haiti. By adding WE CARE Solar's solar expertise with SAFE's model of participatory engagement, we are maximizing the projects' overall effectiveness.
Additionally, we have recently formed partnerships with the head executives of the African Medical and Research Foundation, White Ribbon Alliance, and the Permanent Secretary for the Uganda Ministry of Health.

Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?

We currently have Solar Suitcases all over Uganda, although the bulk of the units are currently concentrates in the East. After we have demonstrated the impact of the low-power computers, we will be scaling up into additional locations, per the request of our partners. In particular, AMREF's "Stand Up for African Mothers" campaign is seeking to train midwifes all over Uganda (and eventually in other countries) via online e-curriculum. Once we demonstrate the impact of our low-power computer addition on medical education, we plan to use the model to start working on this e-training.

What type of operating environment and internal organizational factors make your innovation successful?

I work with 14 of the most passionate, dedicated women I know, each of whom has a different role within SAFE. In addition, my husband is our Technical Director and several advanced professionals advise our work (and the project specifically), including medical advisors and sociologists. Our in-country staff are local Ugandans who speak the language and understand local culture, and we are all dedicated to operating on a methodology of participatory development, in which we work with local change agents to ensure that all of our projects are wanted and adopted in management and funding by the communities in which they operate. Collectively, our team and approach ensure that all of our innovations are utilized to their fullest extent and managed as effectively as possible.

Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list

I am happy to act as a pro-bono mentor to any individuals or organizations that need it. I am also happy to create diverse and dynamic partnerships, which I have already done for the project covered in this application using the associated Changeshop, "Light the Night," (partnership with Katherine Lucey of Solar Sister, which is covered in one of my impact reports).

Comments

Jacqueline Cutts's picture

How can community-based methods become an integral part of information and communication technology projects, particularly those that target maternal and child health?

The use of technology in health care field might be beneficial for people as it brings several health care changes in the medical system and serves a quality health care system. Technology and medical devices are providing better care opportunities to medical expert to deal with different types of medical programs. Here also we have found that how maternal health care system develops through the use of technology.
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