KANGAROO MOTHER CARE SOLUTIONS TO SAVE NEONATAL LIVES

We are trying to address reduction in neonatal deaths, which in 2015 were 0.7 Mn in India alone, representing 25% of global, through timely and effective Kangaroo Mother Care (KMC) solutions, for preborn neonates, in resource constrained geographies lacking adequate healthcare facilities.

Timely care administered to neonates at the onset of drop in body temperature, by the healthcare provider through effective skin to skin contact could save lives. 

Challenges to overcome include round the clock monitoring for a timely alerts, effective administering of KMC and access to healthcare professional or facility. 

Leveraging technology and Internet of Things could offer a frugal solution that is affordable and scalable to reach out to the masses, given the proliferation of digital connectivity. 

Following is a paper detailing the problem, and on the pilot undertaken to address it by teams from St. Johns Hospital, Bangalore and the Indian Institute of Science, Bangalore, for your kind reference. 

It discusses the problem faced and challenges addressed for product development, a 24x7 monitoring mechanism with defined actions and the societal issues resolved in the process. 

The study was funded by the Bill and Melinda Gates Foundation and the Robert Bosch Centre for Cyber Physical Systems at the Indian Institute of Science, Bangalore.  

Recent studies by the WHO too endorse the potential of Kangaroo Mother Care technique to save lives. One such report of study conducted in Tanzania, Nigeria, Ghana, Malawi and India is attached below for reference:

 https://www.who.int/news/item/26-05-2021-kangaroo-mother-care-started-immediately-after-birth-critical-for-saving-lives-new-research-shows

Our solution: in simple terms is to scale up, the successful pilot, already demonstrated at St. Johns Hospital Bangalore, by building a healthcare platform with supporting infrastructure, which will reach out to a larger population leveraging Internet of Things and mobile technologies, saving lives and extending healthcare support to millions of babies with a self sustaining financial business model. 

It will offer Kangaroo Mother Care monitoring and actioning support and then other value added services such as sleep apnea and health related diagnostics with the IoT infrastructure built. 

Technology: the device designed and developed for KMC based on which we propose to develop the commercial model is explained in the write up below:

The effectiveness and success of the device developed for IoT application is further detailed in the following paper, for reference:

https://innovations.bmj.com/content/4/2/60

The solution is innovative and differentiated since no other technological solution exists today, has the potential to reach out to a huge population through digital connectivity and is affordable. With increasing internet penetration in India, more so given the recent 5G spectrum auction, this is a game changing opportunity of tapped into with the right resources, management and skill.  

Based on the data from the results of the pilot we conclude that this a superior solution to existing methods adopted today for the following:

1. the alerts are timely and 24x7

2. the device accurately measures the temperate both for the baby as well as the care provider while also measuring the angle at which the baby is held thereby alerting on the effectiveness of care provided too

3. it can enable empaneled healthcare professionals and facilities into prompt action thus making a huge impact societally 

4. the technology is simple to operate at the same time frugal and robust 

5. other ailments such as sleep apnea, etc. could be diagnosed and treated too with added functionality in the device and the underlying algorithm.

An Ecosystem exists, this could be the missing link: Corporates with social responsibility intent and budget, NGOs, healthcare institutions and facilities, governmental institutions to support healthcare, etc. all exist today. A technology enabled, digital platform could provide an overarching framework for all of these to operate and reach out to those needing with a viable financial model. We seem to have the necessary product and technology available, hence we seek to undertake this scale up initiate and make it happen.

Target population - are the 0.7 Mn families in India currently, and 2.5 Mn globally who are impacted from lesser access to or cannot afford primary healthcare and need to be reached out to for support.  

The physical access to healthcare is limited in rural areas and not affordable as many cannot undertake frequent travel and stay to the nearest centers, often in urban areas. This solution will make it possible to reach out to this population and to monitor the progress hence greatly enhancing the chances of success. 

Access to all will be through current internet and digital tech proliferation which will be further enhanced with impending 5G rollout, which saw spectrum bids for over USD 20 Bn, and frugal monitoring products / systems that make administering affordable healthcare possible. 

Our proposed solution reaching out to them, through internet connectivity and with an affordable device, will be targeted to be administered in partnership with and through the government, private healthcare centers and NGOs in semi urban, rural India. 

Corporates with sites in remote locations, keen to offer community help and support there would be interested to partner in such an initiative and lead the efforts to enroll the needy to such an initiative, with committed budgets for corporate social responsibility. 

Healthcare institutions and bodies seeking to expand their reach geographically too are the targeted partners, including financial institutions offering insurance and coverage for health. 

Our team composition is mentioned below. It consists of founder members from St. Johns Hospital and Robert Bosch Centre who conceptualized and executed the entire pilot based on their interactions with the communities and patients from social strata who visited the health care center but did not have full time access or resources for healthcare. They continue their reach out to the semi urban and rural locations and are currently constrained to the extent it is possible physically. A digital option could expand the reach significantly. 

The team wanted to scale this up to reach out to the masses but were constrained on time and a regular job until I chose to start my firm SSASM Consulting and jump on the entrepreneurship bug. 

I am now given to understand that both of the above esteemed institutions too encourage entrepreneurship and could consider supporting an entrepreneurial venture if it can be suitably defined and implemented. 

Following are the members who would be keen to participate in a capacity, which is to be determined, if seed capital is available:

Pratik Kadakia - CEO, SSASM Consulting, based in Mumbai

Dr. Amrutur Bharadwaj - IISc, Bangalore  

Dr. Prem Mony & Dr. Prashanth Thankachan - St Johns Hospital, Bangalore

Mr. Vinay Shah - Investment Banker in Mumbai, exposure to Healthcare

Dr. (Mrs.) Neha Shah - ENT Surgeon, expertise in sleep apnea, Mumbai based

Dr. Sudhama Gopalan - Healthcare industry expert, USA

Essentially, as explained above, it is for financial seed capital to formalize a team and then develop, execute a successful business model.

We need venture capital funding for a start-up to deliver the solution, undertaking the following, based on the learning from the successful pilot:

1. develop commercial, frugal monitoring device for KMC, updating from the successful prototype used in the pilot study

2. set up a technological platform for IoT based 24x7 monitoring of neo nates and actioning healthcare support, as appropriate, from data collected  

3. initial business development for connecting to hospitals, healthcare institutions and government bodies 

4. tie-ups with corporate bodies for partnerships and reach to access remote locations and sites, on mutually beneficial terms and

5. meet day to day expenses and compensation to deploy resources. 

Two grants, for development, were received from Bill & Melinda Gates Foundation

Grant 1 -- Development of KMC Sensor for position and temperature [ID OPP1135359]. 2015-2016

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5961490/

Grant 2 -- Grand Challenges Explorations: Evaluation of a mHealth System for Tracking KMC [ID OPP1182699]. 2017-2019

https://gcgh.grandchallenges.org/grant/evaluation-mhealth-system-tracking-kangaroo-mother-care-and-temperature-southern-india

The solution is innovative for the following reasons:  

1. product development, for KMC device and monitoring mechanism underwent extensive development and was successfully tested, which is first such instance and

2.  its application, which along with a frugal commercial product is proposed as our solution, is a first instance too that is addressing a need that proliferation of digital and internet technologies now makes it feasible. 

There is a void in the industry today, as this is not perceived as a business where investment would pour in, for targeted returns. 

However, we believe that once a healthcare platform is set up successfully and adopted by the masses, leveraging existing infrastructure in the industry through internet technologies and mobile telephony, several other value added services including sleep apnea, etc. can be offered making it an economically viable.

We expect that once the concept is proven in the market, it will be path breaking and a host of related industry organizations will be drawn to become a part of it. 

Once we get the funding, over the next 12 months, we would have the technology platform, commercial production of the device and other aspects in place to launch the services across two states of Maharashtra and Karnataka initially to impact over 1000 lives. 

Over the 5 year period, we envisage having covered the geography of India and with identified partners covered critical countries in Africa including Ghana, Tanzania, Ethiopia, Malawi and in South America including Columbia where such solutions are most needed. 

All the members of our team have full time day jobs at organizations they founded or are working for. 

When we get the seed funding to undertake this initiative, we will define the appropriate capacity to drive this towards our stated objective which is to realize an opportunity to reduce neonatal deaths globally through a financially self sustaining healthcare platform. 

Our solution's success is based on the belief that technology can change lives for the better, if made available to the masses. 

Several instances from other industries are available to draw a parallel. To name a few, advent of internet telephony brought even the remote villages in India to connect with their families working in cities through apps such as WhatsApp, etc. This was unheard of a decade ago and two decades ago one had to book and wait for long distance calls. 

Now, when we add intelligent and smart devices which will connect to the mobile phones to provide better healthcare services and chances of survival for neonates, it will be adopted wholeheartedly and change the game. 

What was missing was a proper device to track and monitor and proof of concept. Development of such a device by the teams at Robert Bosch Center at Indian Institute of Science, Bangalore and establishing the proof of concept by the team at St Johns Hospital, Bangalore has filled in the gap. 

The next step now is for a financial institution to come forward and fund a project to implement this on a commercial scale. We are keen to undertake the execution and validate the social impact along with its associated business potential as well as feasibility, given an opportunity and confidence from a financing organization. 

The low power, remote neonatal temperate monitoring device developed monitors the temperate of the newborn as well as the care giver along with the angle of the KMC. The device was designed keeping in perspective the need for compatibility with human skin, low weight, radiations within safe limits, robust performance in all environments including wet and low power consumption while transmitting through mobile telephone device over a public telecom network. More details are included in the papers listed below:

https://pubmed.ncbi.nlm.nih.gov/29670758/

Trails were conducted to establish the feasibility of the technology to accurately monitor and action the data from the device to validate the concept. The results are detailed in the following 2 papers for reference:

https://pubmed.ncbi.nlm.nih.gov/29670758/

and 

https://pubmed.ncbi.nlm.nih.gov/29796294/

Based on the above, we propose to develop the commercial scale device along with a technology stack to set up a server, monitoring and alarming services to the various enlisted bodies to action healthcare support. This will leverage IoT and digital technologies.  

The health care data will be collected together with the institutions we will enlist on our platform so these institutions can arrange to render services, support to the patient when triggered for action. 

We are committed to diversity, equity and inclusion and will continue to incorporate these as we gain momentum in our project going forward. 

There will be a mix of revenue streams that will contribute to the financial self sufficiency. 

Once there are adequate number of cases that have been onboarded on to the platform, other value added offerings such sleep apnea, lifestyle improving support, etc. can be added to generate a steady income of pay per use and this would be financially viable given the large number of participants. 

The service is a life saving, societally beneficial offering. Initially, it will  sustain itself from revenues generated from the corporates with social responsibility budgets as well as from healthcare institutions offering a share of the business equity and debt along co-branding options on the platform. 

Another option to raise funds will be from healthcare service providers and other partners to whom referrals will be forwarded. 

We are seeking capital to get started so there are no cases so far for us.

However, we do understand that globally, there have been several successes for similar digitally enabled business models such as Livongo for diabetes care for instance.