Reducing Newborn Deaths in Uganda and Beyond Through Real-Time Temperature Monitoring
Registered nurses look after newborns at the Princess Christian Maternity Hospital, in Freetown Sierra Leone

Geneva Health Forum’s Global Health Lab 3-5 May will showcase over 100 new diagnostics and treatment tools designed for resource-constrained settings. The Autothermo device for continuous, real-time temperature monitoring is one of the innovations being featured there. 

Early detection of patients’ temperature changes, especially in the case of newborns who lack adequate temperature control, can be lifesaving in almost any setting. 

This is especially the case for infants and newborns in hot climates, where conditions like hyperthermia, informally known as “evening fever syndrome” EFS can be life-threatening, particularly for premature babies in hospital and health clinic nurseries where cooling systems are inadequate  and air conditioning frequently fails. 

In addition, being able to leverage technology to monitor a child’s temperature in real time can also be important in many other contexts of childhood illness. 

And this is what the new device Autothermo aims to achieve. Autothermo is a wearable continuous temperature measuring bracelet with a remote display. It includes an alarm system and SMS capability for remote caretaker notification. It  is among more than 100 innovations on display at the Global Health Lab innovation exhibit next week. 

The exhibition is part of the Geneva Health Forum 3-5 May, which brings hundreds of global health policymakers and practitioners together from around the world. 

The Global Health Lab will be showcasing dozens of low-cost, digital, and hand-held tools that aim to make common diagnostic procedures and treatments more accessible, especially for resource-constrained countries.

Simple needs often overlooked in access to healthcare debates   

Autothermo team leader Nura Izath

When the poor state of healthcare in some African regions is discussed, it is often in the context of the lack of easy access to advanced automations and complex lifesaving procedures. 

While these concerns are valid, they often occlude, or minimize, the importance of certain basic-yet-essential indices such as body temperature. 

In human physiology, temperature is regarded as an index of illness because every metabolic reaction in the human body occurs at a certain temperature level. This makes it an age-old, but oft-forgotten index of disease and body states. 

However, a wide range of factors make adequate monitoring of this simple and basic metric challenging resource-constrained settings – including newborn nurseries. And this is what Autothermo is trying to address, the project’s team leader, Nura Izath, told Health Policy Watch.

“First of all, we have very few health workers, including pediatricians, versus the large number of newborns they have to manage at a time. It becomes hard for them to identify which newborns are in urgent need of thermocare interventions,” said Izath, a science and tech developer based in Mbarara, a city in south-central Uganda, who is the front-end developer and co-founder of the Autothermo innovation.

Managing 40 newborns at a time 

Autothermo’s innovation can be used to manage babies at risk.

At the Mbarara Regional Referral Hospital, for instance, there is only one nurse per shift, managing over 40 newborns in the hospital nursery at a time, notes Izath, who holds a degree from the Mbarara University of Science and Technology

Many of the newborns are premature or have other sensitive conditions, in which slight and subtle changes in temperature could signal the difference between life or death.  

“It’s so hard that by the time this nurse knows there is a baby in need of thermocare, it’s very late. In such scenarios we have lost lives. These are things that can be prevented by using interventions such as Autothermo.”

She says that the innovation should change the narrative regarding temperature management for newborns – insofar as health workers can remotely monitor babies at risk, and will also be able to prioritize thermocare interventions through the alerts they receive about newborns in need of the intervention.

“It will help them to manage the daily routines and will also save many lives,” she added.

Innovation emerged out of personal experience watching a young infant 

Izath’s innovation emerged out of a personal experience minding  newborn at home. 

“In 2014, I was tasked to babysit my one-day old nephew as his mother had to go for an exam,” she relates. “I was excited and at the same time understood the importance of this task. At the beginning, I held the baby until he slept, then kept checking on an almost 10 minute interval while I was doing other house chores. 

“To be honest, the back and forth was a bit tiresome. That’s when I thought of innovating something that could monitor and inform the parent or caregiver the status of their newborns in case of emergency and also support health workers in hospitals during admissions.” 

She shared the idea with a local clinician and pediatrician, Dr. Gloria Karirirwe – who quickly recognized the need such a device could fill in light of the challenges she had faced in her own practice, managing newborns with temperature-related challenges. 

They shared the idea further. Together with a group of six other professionals, they took the concept to Dr. Data Santorino, director of the Consortium for Affordable Medical Technologies, an innovation hub based at Mbarara University of Science and Technology, where Izath earned her degree.

“Dr. Data, together with his team, took us through concept development, proposal writing and the initial prototype development. Both the proposal and the initial prototype were helpful in aiding Autothermo to acquire its seed grant from the Ugandan Ministry of ICT and National Guidance. This fund was used to develop the minimum viable product that we currently have for studies.”

Also practical for outpatient clinics – where fever is one of main motives for seeking healthcare 

Other diagnostics and treatment tools, including Autothermo for newborns, will be found at Geneva Health Forum’s Global Health Lab 3-5 May

A fever also is one of the most common reasons for which parents will bring their toddlers and young children to a local health clinic or hospital, Izath adds. In fact, some 60% of children presenting to most medical emergency departments in Uganda have a raised temperature, she notes.

Unfortunately, many arrive too late — after complications have already set in — leading to febrile seizures and worsening of the underlying illnesses. High fever among under-fives can also result in heat stroke, often leaving affected children paralyzed and, sometimes, death.

Another selling point for Autothermo is that caregivers can easily interpret the temperature fluctuation situations and respond accordingly – based on the color-coded bars that it reports. And at a production cost of just $18 – it is a device that could be made widely available at simple health posts as well as hospitals. 

However, the Uganda-designed prototype still faces a long road ahead to obtain regulatory approval from the Ugandan National Council for Science and Technology.

“The health workers want to start using it but they cannot use it yet because we need  approval,” Izath said. “We are now seeking approval from the Mbarara University Of Science and Technology Ethics committee. After that, we will be moving to the Council. All these are the bodies that need to authorize the use of the Autothermo.” 

Izath will be attending the Geneva Health Forum, which will give her an opportunity to learn from other innovators in attendance, as well as seek out partnership and fund-raising opportunities.  

“We hope to see partnerships that can help us pilot studies in different facility settings. We also believe that the problem we are trying to solve is not only in Uganda, it’s a global challenge. We are not doing a solution only for Uganda. We would like to reach out to many stakeholders and see how we can make this come to light,” she concluded.

See the complete GHF 2022 programme. Register here: Until 2 May fees are CHF 400 for the entire event and CHF 150 for participants from low- and middle-income countries (OECD classification).  Daily rates are also available. 

Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite

Image Credits: World Bank/Flickr, Unicef, Geneva Health Forum .

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