KINDO

Two and a half million children died in the first month of life in 2018 worldwide, in which 75% occurs in the first week of life. In Indonesia, a newborn dies every 6 minutes. Each of these deaths is a calamity because the majority are preventable. Too many newborns die at home because of several factors, and one of the factors is the delay in recognizing red flags or seeking care. Lack of health knowledge regarding newborns is very common, especially in remote areas where language often becomes the biggest cultural barrier to obtaining knowledge.

Capella Project Foundation came to establish KINDO, a radio (in form of wireless speaker) embedded program which provides expectant parents with comprehensive newborn health information in more than five hundred local language throughout Indonesia. We want to remove the knowledge barrier for caregivers about newborn health so that every child has equal opportunities to live.

As the largest archipelago country in the world with more than 600 local languages, having a good and essential knowledge regarding newborn health in Indonesia is like gold: rare and expensive. Almost 5 million births and more than 100,000 of them died every year. Language, as a part of cultural problems, plays a big role in knowledge gap. Our survey showed that many parents are unfamiliar with important red flags and did not know how to take care of newborns. There are also false beliefs that are often dangerous. According to the latest Indonesian data, more than half (59%) rural population and one third (33%) of urban population had low social economic status. Around 11% of Indonesian people never attend school, and less than half population continued to higher education, with median length of school was only 6 years. These most disadvantaged population—those who have lower income and education—are the group of people who were affected most with the highest mortality rate: 85 vs 24 per 1,000 live births in lowest vs highest socioeconomic status; and 116 vs 19 perinatal deaths per 1,000 live births on those who obtained less than 6 years of education vs higher education.

KINDO is a radio-like technology (wireless speaker with built-in memory card) that provides expectant parents with newborn health information, such as dangerous signs of a sick newborn--how to recognize and when to seek healthcare--breastfeeding and adequate nutrition, growth, development, and immunization. Radio speakers are a common device used in Indonesia.

KINDO’s technology is very simple with expectations that everyone, especially those who have low education or live in a remote area, will be able to operate without any trouble. KINDO will use a wireless speaker as the main device embedded with a memory card, which is filled by a local health provider’s voice. Therefore, there is no language barrier for people who live in different areas with different languages.

Doing the right thing the right way is very important to keep the babies alive. Good knowledge is the basic and foremost thing to have for expectant parents and caregivers in reaching health equity. Through KINDO, knowledge would be accessible across regions and socioeconomic status. Parents and caregivers will be more prepared and confident in taking care of newborns. We aim to reach all underserved people, but we would like to prioritize people who live in remote areas, unable to access technology and information, and places where the infant mortality rate is high, such as Papua, West Papua, and Maluku. As we saw from the demographic data mentioned earlier, there are too many people from the disadvantaged group (low socioeconomic status, low education, lack of information access). Therefore, we are confident that by providing access to knowledge, people from different backgrounds could have chances to learn and apply what they have learned, so that more babies could live, and even have a better life.

Reaching health equity is our most important goal. Kindo is one of our proposed projects that address this issue by adding another goal: to reduce infant mortality rate. By giving a high-quality and free access to knowledge of newborn health, we reduce health literacy gap in Indonesia. Parents and caregivers--especially those who live in remote areas, lack access to technology and information, and have language barrier--now can be more aware and have good attitude and high-quality practice in caring for their babies. We expect to see mortality rate reduction (parallel to Solve's challenge goal) and increase in parents' knowledge.

The uniqueness of KINDO is the simplicity of the technology, which can be used by everyone and everywhere. Nowadays there are many sophisticated technologies which are very good; However, not everyone can access and use technology, for example, areas that lack an internet connection. Furthermore, we found no prior project related to the use of this simple technology with specific educational content to address urgent issues, such as infant mortality rate and newborn health.

The core technology we use is the combination of existing technologies, which are a wireless speaker and a memory card. Both hardware devices that we use are cheap, easy to get, and broadly available nowadays.  As mentioned before, we are going to input the health-care provider’s recording. We will give health information about newborns into the memory card. Moreover, the memory card will be put inside the wireless speaker; thus, the expectant parents and caregiver can directly listen to the information without any trouble regarding internet connection or other technical limitations.

1. Built-in memory card speaker (radio) is cheap
2. Built-in memory card speaker (radio) is easy to use and widely used, even for people who are lack of technology literacy
3. Previous studies have shown that education plays an important role in reducing mortality rate.
4. Previous studies found that radio-education intervention could increase knowledge.

Sources:

• Evaluation of a Health Education Intervention to Improve Knowledge, Skills, Behavioral Intentions and Resources Associated with Preventable Determinants of Infant Mortality
• The effect of maternal education on infant mortality in Ethiopia: A systematic review and meta-analysis
• Education Is Key to Reducing Child Mortality: The Link Between Maternal Health and Education
• The Impact of Radio on Nutrition-Related Knowledge Behaviors in Senegal
• A Radio-Education Intervention to Improve Maternal Knowledge of Obstetric Danger Signs

Our simple technology solution is certainly available in remote and non-remote areas. In other words, there will not be any boundaries that can hinder this implementation and distribution. As we target the remote areas with low-middle income classes, which are not equipped by any great or extensive technology facilities or broad social-networking, it would be hard to use advanced technology because of limited resources and technology literacy. Therefore, we firmly believe by offering simple technology such as KINDO will be effective and easy to implement in our target population. Since it is easy to implement, the output of our solution will be immediately seen: Increased parents' knowledge. We believe in order to have a good attitude and practice, having a good knowledge is the most basic thing for every parent and caregiver to have. As expectant parents have enough knowledge and information about how to take care of their newborn well, we expect they will apply the knowledge immediately to ensure that their newborn would have good health and higher life expectancy/survival. Moreover, for the long-term outcomes, we can look at the comparison of the mortality rate of the newborn in every remote area that we have targeted.

We are currently serving more than 2,500 children and more than eight hundred healthcare workers from previous projects. In the next one year, we expect to serve 5,000 newborn and pregnant women; and in the next five years, we expect to serve at least 50,000 newborn and pregnant women.

Our goal within the next year:

• By implementing our solution, we aim to:
  • Increasing knowledge of expected parents and caregivers on newborn health
  • Good attitude and practices of expected parents and caregivers towards newborns
  • Build their confidence on taking care of newborns

Our goal within the next five years:

• By replicating solution to all remote areas in Indonesia and partnership with local health governments, we aim to: 
  • Reaching child health equity
  • Reducing infant and child mortality rate
  • Increasing Indonesia's human development index through higher survival rates of infants and children

Our biggest challenge to accomplishing goals is financial limitation. Though the basic equipment (wireless speaker and memory card) are cheap, we need at least one thousand sets of equipment to be distributed and translators fee. Furthermore, our organization needs sustainable operational fund.

We plan to overcome these barriers by proposing partnership with various organizations who have the same goals. One of them is by taking part in this SOLVE MIT Challenges.

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All our team are working voluntarily and most of us are full-time clinicians. We have 20 dedicated volunteers on our team who are passionate in solving maternal and child health problems in Indonesia.

Most of us are medical graduates and working with low-middle income population: We know the high burden and needs in the community. We also connect with pediatricians and obstetricians who are very supportive about our organization and solutions.

We are partnering with Indonesian Autism Foundation and Jakarta Indonesian Pediatric Society on community-based projects.

Our business model will be presented in The Business Model Canvas. Our core values of KINDO are free, simple, user friendly, and innovative. Our customer segments will be caregivers and expectant parents who live in remote areas with high infant mortality rates and lack access to information. We prioritize underserved parents--those with low-middle income and low education. We will provide them with KINDO through local primary health centers and private midwives while the expectant parents visit the healthcare facilities (face to face visitation, direct consultation, and routine follow-up). 

We hope KINDO will help them to learn more about newborn’s health and prepare for the newborn. Furthermore, mother will obtain knowledge and expected to give high quality newborn care, resulting reduction of infant mortality rate.

We aim to achieve our financial sustainability through:

• sustained donations and grants
• sponsorship from big organization
• partnership with organization through corporate social responsibility programs

Our most important motivation in joining this challenge is to express our passions in solving maternal and child health problem in Indonesia. Although our biggest concern is financial issue, we believe that networking is the most important rewards in this challenge. Getting to know other solver that we are not alone and seeing other passionate people/organizations showed their works, boost our spirit to never give up on our own community. 

We would be honored if our solution is considered to win the funding. It will make a significant impact for pregnant women in our country, especially in this uncertain time because of pandemic.

1. Funding and revenue model
   1. Our solution is greatly depending on available fund to buy sets of equipment, create the content, and distribute to underserved areas.
2. Monitoring and evaluation
   1. This step is very important for us if we have made significant changes, and what need to be fixed in order to become more impactful.
3. Marketing, media, and exposure
   1. The more people know about good solutions, the more support we expect to receive and the more likely to achieve and even exceed our established goals.

• Bill and Melinda Gates foundation
  • Funding, monitoring, and evaluation
• MIT faculty

  
  

  • Evaluation, marketing strategy, technology, and financial strategy
• Other Solve members
  • Comments and suggestions, funding, media, and exposures

Our most important motivation in joining this challenge is to express our passions in solving maternal and child health problem in Indonesia, a low-middle income country in Asia. We believe KINDO, a simple technology (memory card and wireless speaker) to provide expectant mother with comprehensive newborn health information in local language throughout Indonesia, will make a significant impact for pregnant women in our country, especially in this uncertain time because of pandemic. We believe by increasing parents and caregivers' knowledge, we could encourage good attitude and practice towards newborn care, leading to reducing infant mortality rate and reaching towards health equity.

Available funding will be used to buy sets of equipment, create the content, translator fees, promotion/marketing fees, and distribute to underserved areas.

Our most important motivation in joining this challenge is to express our passions in solving maternal and child health problem in Indonesia, a low-middle income country in Asia. We believe KINDO, a simple technology (memory card and wireless speaker) to provide expectant mother with comprehensive newborn health information in local language throughout Indonesia, will make a significant impact for pregnant women in our country, especially in this uncertain time because of pandemic. We believe by increasing parents and caregivers' knowledge, we could encourage good attitude and practice towards newborn care, leading to reducing infant mortality rate and reaching towards health equity.

Available funding will be used to buy sets of equipment, create the content, translator fees, promotion/marketing fees, and distribute to underserved areas.