Imagine a product that only costs a dollar for one use, and is relatively easy to use with the proper training. Imagine that this product, and providing training on how to use it, also means the difference between life and death for women in lesser developed regions of the world. This product is the non-pneumatic anti-shock garment, or NASG. The NASG is a neoprene suit that easily wraps up in itself, making storage simple. When taken apart, the suit can be wrapped around a woman’s lower abdomen and legs quickly. Each section is clearly labeled with numbers to distinguish where the velcro straps are meant to go. When the NASG is implemented correctly, excessive bleeding slows down and shock can be prevented. For women living in rural, difficult to reach areas, this device has the ability to keep women alive while they are being transported to the hospital for a blood transfusion.
As the team describes it, “The AIM Malawi Program (Advancement in Innovation for Maternity Care) is a collaboration by the American College of Obstetricians, Baylor College of Medicine and the Ministry of Health to reduce maternal mortality in Malawi.” The goal of the AIM Skills Lab and NASG training in Malawi is to reduce the maternal mortality ratio from postpartum hemorrhage. From May 2016 to December 2017, 391 participants were trained. “A ‘train the trainer’ program provided comprehensive education to select staff on the indications for NASG use, proper application technique and removal, and method of cleaning and storage.” Once the training is complete, the participants can become what the AIM team calls “field experts,” transferring the knowledge they have gained to other staff members. In the self assessment survey implemented as part of the Skills Lab, participants indicated they felt greater confidence and a better grasp on how to use the NASG following their training experience.
On August 2, 2017, there was a training on how to use the NASG at the Bwaila maternity hospital in Lilongwe. One NASG was used for the training, and the other two given to the hospital for future use. While the AIM program is not currently taking place in any other countries, the goal is to expand the training from the three hospitals in Lilongwe to the entire country of Malawi.
Now as a next step, we ask what could be done to lower the costs of the implementation of the E-MOTIVE bundle? The most obvious answer is to consider displacing the tens of thousands of disposable plastic drapes with a purpose-built reusable device.
Fortunately one of the obstetricians involved in the E-MOTIVE study, Dr. Justus Hofmeyr, had been innovating around this very issue, designing a tray with wells that could fit under a woman’s buttocks, collect and accurately measure the. blood. This tray, theMaternaWellTraywas conceived as a device that could be sterilized and reused, and is manufactured in South Africa by Umoya.
The Pumani bubbleCPAP was designed to meet this need for Malawi and is now widely available through Maternova. We had a few questions about post-research phases of the Pumani bubbleCPAP which we posed to Jocelyn Brown, inventor of the Pumani bubbleCPAP, and Molly McCabe, Director of Product Management.