Mkanda Salama

Despite existing innovative interventions, the world is still burdened with high rates of maternal morbidity and mortality. Every day, approximately 800 women die worldwide from preventable causes related to pregnancy and childbirth. Over 95% of these deaths are in low and middle-income countries, 62% from sub-Saharan Africa. As other LMIC countries, Tanzania has one of highest MMR at 579 per 100,000 livebirths with 29% of these deaths being due to postpartum hemorrhage [PPH].

Due to the fact, more women delivering in health facilities, most of the facilities lack adequate numbers of skilled providers and/or lack the skills or essential resources to provide timely and adequate care to women with PPH. Interventions that make use of compression such as balloon tamponade, aortic compression and anti-shock compression garment is costly, require some training, are labor intense and usually are unavailable. Consequently, these measures that can reduce bleeding and prevent deterioration until a woman reaches next level of care are not fully utilized.  There is no cost effective clinical practical approach that make use of low and scarcely placed skilled personnel in PPH management in low level facilities.

Mkanda Salama, translated as ‘’Safe Wrap’’, is designed to control PPH until necessary interventions are carried out. It is strapped around a woman with PPH while they are transferred to hospitals. Mkanda Salama massages the uterus and compresses abdominal aorta thus reduce blood loss and buy time for appropriate interventions, especially in situations where a woman requires advanced interventions that are not immediately available such as needing to be transferred to higher level or the theatre.

 Mkanda Salama is a user friendly, non-invasive, easy to use and affordable medical device. It is reusable and its human centered design ensures that its effectiveness is not affected by either user’s ignorance or physical strength. It can also be used by low skilled birth attendants. This means that Mkanda Salama can be owned by any pregnant mother as a precautionary device, by traditional birth attendants, ambulance services, makeshift health camps and nearby health facilities that might need to refer a hemorrhaging mother.

Our Target Clients are 7,912 Health care facilities which include dispensaries, health centers and hospitals in Tanzania. We shall adopt current Medical Store Department supply channel which is being used by Government in supplying medical supplies in Health care facilities of Tanzania. Mkanda Salama kits will be supplied directly to the healthcare facilities and will be used by healthcare providers when they are managing cases of postpartum hemorrhage and referring the patients from low level healthcare facilities to higher level health care facilities.

Dr. Fadhlun Al-beity is a PhD holder in Safe Motherhood, a senior lecturer at Muhimbili University of Health and Allied Sciences and Public Health Specialist. She has vast experience in clinical practice, teaching and research in maternal health in low income countries and Public health interventions and their evaluations.

Mr. Franc Musa is the Innovator and Researcher at Afya intelligence and Afya Lead. He is driven on innovations in healthcare and emerging technology that have a positive impact on Tanzanian community and all around the world. In order to improve the perception of healthcare in Tanzania and throughout Africa, Franc has a unique talent for integrating various healthcare innovation, including social innovation and artificial intelligence.

He was nominated as the best innovator in healthcare 2022 by NIMR-TANZANIA representing Afya Intelligence team, His team of Mkanda Salama also emerged as first winner during MAKISATU 2022. Franc also won in 15th Win and learn Academic event in health influential facts category 2021.

Dr. Elias Kweyamba is an Obstetrician and Gynaecologist and a TTCIH tutor. He is one of the founding Tutors of the CEMOC programme in Tanzania; he participated also in CEMOC curriculum development. He has Masters of Science in Obstetrics and Gynaecology from Muhimbili University. At TTCIH he has been coordinating CEMOC training and Community Health Workers Programmes. Currently he teaches in the Assistant Medical Officers School and the Medical School at St. Francis University College and works at the St. Francis Hospital as an Obstetrician and Gynaecologist. Elias has diverse experience in Health projects coordination and maternal intervention projects.

Mr. Paschal Kija is the innovator working with Afyalead Company. He has vast of experience in implementing various innovation with focus on Pharmaceutical Supply Chain and Well being of Women. He emerged as the first Winner during Makisatu Competition in University Category with the innovation of Mkanda Salama. He is also working with Afya Intelligence who emerged as the best innovator in healthcare system of Tanzania during NIMR Scientific Conference On May 2022.

Mr. James Kalema is the Innovator and Research scientist at Afya Lead Company and Muhimbili University of Health and Allied Science. His research areas are mainly focusing on Maternal health and Child health. He is the Project Leader of Mama Check Project that is the innovative project that aims at developing strips that help in detecting inflammation molecules among mothers with Preeclampsia, the project is being implemented by Ifakara Health Institute with Support from Foundation Botnar and Essential Med Foundation.

We are applying for this challenge so as to gain more partnership with international agencies, mentorship support, technical support and financial support for Production costs, Physical space and Scaling the product in Tanzania and other Sub Saharan Countries.

Despite the existing interventions in management of PPH like uterine balloon tamponade and aortic compression, these interventions requires high skilled personnel and cannot arrest bleeding from all types of PPH. Uterine balloon tamponade can only stop bleeding due to uterine atony and requires high skilled personnel to practice It. Aortic compression is labor intense and cannot be applied to a patient who is transferred from one health facility to another.

An innovative method was used to design a belt like-garment, that can be wrapped around the abdomen below the umbilicus, specifically designed to compress the uterus and arrest bleeding. The garment, called   ‘Mkanda Salama ’ requires less skilled personnel, stops bleeding from all the causes of PPH [Uterine atony, tissue, trauma and thrombi] and allow the client to be transferred from one health facility to the other. Mkanda Salama has proven usage where It was tested at St. Francis referral hospital Ifakara where out of ten mothers who had PPH and used Mkanda Salama, 8 mothers stopped bleeding and had good prognosis. 

Our main goal is to reduce maternal mortality and morbidity in Tanzania. Postpartum hemorrhage is the leading cause of maternal deaths in Tanzania for subsequent years, by reducing maternal deaths contributed by postpartum hemorrhage. we shall generally reduce maternal deaths in Tanzania.

For the next year, we plan to scale our product in all  healthcare facilities of Tanzania and in the next five years, we plan to extend our market in the nearby countries of Sub Saharan African which have high rate of Maternal deaths due to postpartum hemorrhage.

We shall achieve this by partnering with both public and private medical companies which will assist us in production and supplying of Mkanda Salama kits in Tanzania and other Sub Saharan African countries.

1. Reduced Number of maternal deaths due to postpartum hemorrhage. 
2. Reduced number of maternal morbidity due to postpartum hemorrhage
3. Reduced number of orphans in the community
4. Improved socioeconomic status among women in the community of Tanzania.
5. Reduction of maternal and newborn mortality and morbidity in Tanzania and other Sub Saharan Countries in Africa.
6. Increased number of healthcare providers trained on the use of Mkanda Salama kits.
7. Increased Level of awareness among healthcare providers on management of postpartum hemorrhage by using Mkanda Salama kit.

Tanzania has one of highest Maternal Mortality Ratio at 579 per 100,000 livebirths with 29% of these deaths being due to postpartum hemorrhage [PPH].Successful management of PPH depend on availability of skilled personnel, good quality medication and supplies and may rapidly escalate to require additional resources such as blood and can even require well equipped Intensive Care Unit. Hence rapid management and escalation of care is required to prevent further complications and death. Mkanda Salama, translated as ‘’Safe Wrap’’, is designed to control PPH until necessary interventions are carried out. It is strapped around a woman with PPH while they are transferred to hospitals.

The primary outcomes include reduced number of maternal deaths due to postpartum hemorrhage, reduced number of maternal morbidity due to postpartum hemorrhage and improved referral management of women with postpartum from low-level facility to higher level facility.

After successful implementation of Mkanda Salama project in few regions of Tanzania, we shall call investors and other stakeholders to invest in Mkanda Salama project so as to reduce maternal deaths contributed by postpartum hemorrhage in Tanzania and other Sub Saharan African countries.

Mkanda Salama massages the uterus and compresses abdominal aorta thus reduce blood loss and buy time for appropriate interventions, especially in situations where a woman requires advanced interventions that are not immediately available such as needing to be transferred to higher level or the theatre.

 Mkanda Salama is a user friendly, non-invasive, easy to use and affordable medical device. It is reusable and its human centered design ensures that its effectiveness is not affected by either user’s ignorance or physical strength. It can also be used by low skilled birth attendants. This means that Mkanda Salama can be owned by any pregnant mother as a precautionary device, by traditional birth attendants, ambulance services, makeshift health camps and nearby health facilities that might need to refer a hemorrhaging mother.                                                       

Currently there are 10 maternity care providers who collect data on the effectiveness of using Mkanda Salama kits in controlling postpartum hemorrhage and they receive incentives by getting  monthly allowances from the government councils  in the pilot districts.

Mkanda Salama Project team members consist of people from various academic backgrounds which include business personnel, medical personnel,public health personnel, ICT personnel and legal personnel. At the managerial level there are medical personnel, legal personnel, district health managers and policy makers from the ministry of health.

At the implementation level, we have biomedical engineers, maternity care providers, community health workers and health facility incharges. At the evaluation level, we have consultants who are highly experienced in the area of Maternal and child health who are not part of the team that help us in assessing the progress of the project and providing advice in regard to implementation of the project.

Key Partners

PATHFINDER

AMREF

MOH (maternal and child health)

Key suppliers;

MSD

Health facilities

PMO-RALG

MNH (Department of obstetrics and Gynaecology)

MUHAS (Department of obstetrics and Gynaecology)

Key Activities

Development of Mkanda Salama kits

Training of health care providers

Support supervision Data collection and analysis

Value Proposition

 Does not require high skilled personnel

It’s human centered design

Non-invasive

Affordable Re-usable

Customer Relationships

Regular meetings with the suppliers

Feedback from health care providers on the applicability of Mkanda salama

Perception from mother with PPH on the use of the kits Having a forum where various stakeholders can meet and discuss about Mkanda salama kit.

Key Resources

Raw materials

Human resources e.g. biomedical engineers

Transport

Infrastructure

Channels 

Adoption of Normal MSD supply channel

Cost Structure

 Production cost.

Training cost

Transport cost

Management and operation cost

Advertisement cost

Stationaries

Venues

Revenue Streams

Sales 

Partnership

There are mainly two ways which we plan to make our business sustainable;

1- Sales; This will involve direct sales of Mkanda Salama kits to the health care facilities, where each Kit will be sold at the price of Tshs 130,000.

2- Partnership; This will involve the partnership which will be created between Our Company and other development partners such as UNFPA who are being involved in various maternal health projects in Tanzania so as to increase the delivery of Mkanda Salama kits in healthcare facilities of Tanzania.

We have already partnered with UNFPA Tanzania who have agreed to purchase Mkanda Salama kits and supply them in the healthcare facilities  found in their supported regions. We continue call and welcome other potential stakeholders and investors  who can invest in Mkanda Salama  Project.