The Pratt Pouch is at an exciting point right now, on the verge of being introduced or expanded in a number of countries including Ecuador, Uganda, and Nigeria as the most prevalent contenders. With all the progress being made, we wanted to gather information of how the pouch is paired with the recommended ARV regimens, so we did some research on what drugs are recommended for babies born to HIV-positive mothers. Not only was this information usually buried in pages and pages of files, but it also varied widely across different sources. Some organizations provided regimens with specific measurements and timetables that depended on the regimen and serostatus of the mother, whereas other sources only had information as broad as “Nevirapine should be given to babies born to HIV-positive mothers.” With all the challenges we faced in comparing findings and determining reliable sources, we could not help but think what this means for a health clinic worker in Uganda or Ecuador. We are working with the marvels of modern technology, without language barriers, and with background understandings of reliable institutions. This just goes to show that access to the technologies for health are useless without access to information as well.
Nevertheless, the most reoccurring and reliable information confirmed that babies born to HIV- positive mothers should be given Nevirapine (NVP) daily, either for 6 weeks or until one week after the end of breastfeeding. The essential aspect of this is that NVP treatment is started as soon as possible after birth. For mothers who give birth at home or away from a health clinic, the pouch makes this a realistic possibility. The Pratt Pouch simplifies the process of providing ARV medicine to babies. More than this, however, through this process we are consolidating the information needed not only to deliver medicine but to ensure that it is delivered effectively. This way, mothers do not have to worry about making frequent return trips to a health clinic, and health workers do not have to sort through hundreds of sources for ARV regimens while trying to get medicine delivered to a community.
The pouch has gained global recognition from a number of sources, including WHO and USAID. Most recently, it won the Healthcare Innovation Award from the GlaxoSmithKline - Save the Children partnership. While awards and titles are encouraging, we really hope to use this momentum to implement the pouch in as many health care systems as possible. According to an estimate from USAID, Pratt Pouch could save 400,000 babies a year from HIV transmission. Regardless, every day 600 children are infected with HIV. We have the tools and technology to bring this number to zero. It is quite clear that this is not something that will happen overnight, but ensuring that the pouch is accessible for as many people as possible will make a huge impact in the future of prevention of mother-to-child transmission of HIV.
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.