Imaging EmpowerHER

We aim to address the limited access to medical ultrasound technology in low-resource settings, particularly in Sub-Saharan Africa. This lack of access significantly impacts the lives of people living in poverty, especially pregnant women and children, by contributing to high maternal and perinatal mortality rates. Without access to timely and quality ultrasound screenings, high-risk pregnancies and life-threatening complications often go undetected, leading to adverse health outcomes and increased mortality rates. This issue has a substantial impact globally, with an estimated 4.7 billion patients lacking access to medical ultrasound.

The global Maternal Mortality Ratio (MMR) is estimated to be less than 70 maternal deaths per 100,000 live births by 2030. The global MMR in 2020 was estimated at 223 maternal deaths per 100,000 live births, down from 227 in 2015 and 339 in 2000.

In 2020, almost 95% of all maternal deaths occurred in low and lower-middle-income countries. In sub-Saharan Africa, as many as 200,000 mothers and 28 of every 1000 infants die in childbirth every year. Globally, many critical efforts are underway to improve the quality of antenatal care through investments in clinical training, healthcare infrastructure, and the supply chain. One element of the quality antenatal care puzzle is ultrasound during pregnancy and delivery is a critical tool for early detection of life-threatening complications. However, to date, access to affordable ultrasound technology has been extremely limited, especially in settings like sub-Saharan Africa.

In Kenya, MMR has remained stubbornly high, with 530 maternal deaths for every 100,000 live births in the country. These rates become even more acute in rural and peri-urban areas where the antenatal care (ANC) attendance index is relatively low, and perinatal ultrasounds become inaccessible.

Sierra Leone is a country with one of the highest maternal and child mortality rates in the world. The high MMR of 1,165 per 100,000 live births, and the neonatal and under-five mortality rates are 39 and 156 per 1000 live births respectively. The maternal mortality ratio, the number of women dying of pregnancy-related causes, stands at 355 deaths per 100,000 live births. Given the current annual births, this means that there are nearly 5,000 women and girls dying annually due to pregnancy and childbirth complications. Analysis indicates that the key factors affecting maternal health and increasing the number of maternal deaths include self-diagnosis and home deliveries, poverty, limited access to affordable health interventions, a limited number of specialists for care delivery, and a slow decision-making process by healthcare institutions at critical points.

By improving access to ultrasound technology, we aim to positively impact the lives of millions of individuals in these regions, ultimately contributing to improved maternal and child health outcomes and reducing preventable mortality.

1. Heather Harmon Donahoe. Transforming Maternal and Neonatal Health through Deployment of Portable Ultrasound at Scale.

2. Kenya Maternal Mortality Rate 2000-2024.

3. WHO Publication: Sierra Leone National Reproductive, Maternal, Newborn, Child and Adolescent Health Policy.

4. Achieving universal access to obstetric ultrasound in resource-constrained settings

Cedars Diagnostics' ’Imaging EmpowerHER’’ is a healthcare initiative focused on using ultrasound technology to empower and improve healthcare outcomes for women in resource-limited settings. The project aims to provide accessible and affordable ultrasound screening tailored to women's health needs by enhancing early detection, diagnosis, and monitoring of ailments such as breast cancer, reproductive conditions, and perinatal-related ailments.

The solution involves two key components:

1.    Providing access to modern ultrasound technology and screening

This involves partnering with leading equipment manufacturers/ equipment resellers/ financing partners to acquire modern ultrasound equipment. We deploy this acquired ultrasound equipment to primary healthcare facilities in underserved settings through; a. ‘’plug-and-play’’ model (it includes commissioning & installation of equipment, plus providing skilled personnel to operate the equipment on a revenue share model) and/or b. ‘’lease-to-own’’ model-Minimal Viable Product (improving asset affordability for healthcare providers by offering flexible asset financing packages so that low-resource primary healthcare facilities can access modern technological advancements at low up-front cost).

•  Integration of Teleradiology technology;

We utilize advanced proprietary teleradiology systems, such as Reacts (Remote Education, Augmented Communication, Training, and Supervision), to connect healthcare facilities with a remote team of radiologists and sonographers. This enables real-time collaboration, consultation, and interpretation of ultrasound scans, even in areas where on-site expertise is limited. Additionally, we are working on developing a streamlined teleradiology system coupled with a patient management platform to further enhance coordination and patient care across partner healthcare facilities.

We also engage in community outreach and educational campaigns to raise awareness about the importance of prenatal care and the benefits of ultrasound technology during antenatal care. This involves collaborating with local healthcare organizations, community leaders, and women's groups to ensure maximum impact.

We facilitate point-of-care in obstetrics ultrasound training (task-shifting) for community healthcare workers & develop standardized protocols to increase diagnostic accuracy while placing efficiency at the heart of operations. These efforts aim to enhance access to ultrasound technology, expand its utilization, & improve healthcare delivery for women in resource-limited settings. 

We increase diagnostic efficiency by digitizing diagnostic imaging processes by combining technology & skills from medical personnel, promoting timely diagnosis and intervention of ailments that can be averted if detected on time. Leveraging teleradiology technology has the potential to create an impact in immeasurable ways, it guarantees patients in resource-limited settings access to life-saving maternal screenings for instance, our teleradiology-enabled ultrasound equipment allows for community healthcare workers, i.e midwives, to pair with sonographers/radiologists to deliver quality and reliable imaging services. Moreover, this model allows for these services to exist locally, mitigating patients’ need to travel long distances. Our solution brings advanced ultrasonography to these patients’ communities so that pregnant mothers can enjoy improved maternal health outcomes within their communities.

Imaging EmpowerHER serves two primary beneficiary groups: peri-urban/rural primary healthcare providers across Sub-Saharan Africa and individuals living below the poverty line. These groups are often underserved in terms of healthcare access and quality due to a myriad of challenges such as limited resources, infrastructure, and skilled personnel.

Beneficiary 1- comprises peri-urban/rural primary healthcare providers who cater to over 70% of patients seeking care in resource-limited settings. These facilities operate in areas with weak access to urban centers and serve populations with monthly incomes ranging from $50 to $300. Despite being the primary point of care for millions, these facilities often lack adequate clinical and diagnostic support, resulting in suboptimal care quality. Limited access to medical equipment, including ultrasound technology, further exacerbates the challenges faced by these primary healthcare providers in delivering timely and accurate diagnoses.

Beneficiary 2- individuals living below the poverty line, including pregnant women, the urban poor, and rural communities who access our innovation through a panel of partnered healthcare facilities. These individuals typically have limited financial means, with daily incomes below $4. Due to financial constraints, they often struggle to access quality healthcare services, including diagnostic imaging, which plays a crucial role in the early detection and treatment of various health conditions, particularly those affecting women's health such as reproductive health ailments and pregnancy-related complications.

Imaging EmpowerHER aims to directly improve the lives of these underserved populations in several ways; 

a.  Access to Affordable Healthcare: By offering ultrasound technology through a 'plug-and-play' and/or ''lease-to-own'' model. Cedars Diagnostics makes advanced diagnostic imaging more accessible to peri-urban/rural healthcare providers and individuals living below the poverty line. This increased access to affordable imaging services enables early detection and diagnosis of health conditions, leading to timely interventions and improved health outcomes.

b.  Quality Healthcare Provision: Through partnerships with healthcare facilities, Cedars Diagnostics provides access to ultrasound technology and specialized personnel through teleradiology technology. We also train community healthcare workers on basic skills to operate the equipment. This ensures that healthcare providers in resource-limited settings can leverage the full potential of imaging technology to deliver accurate diagnoses and tailor treatment plans, thereby enhancing the quality of care provided to patients.

c.  Empowering Women's Health: Imaging EmpowerHER specifically focuses on addressing the healthcare needs of women by enhancing early detection, diagnosis, and monitoring of conditions such as reproductive health conditions and perinatal complications. By improving access to ultrasound screening and diagnostic services, the solution empowers women to take control of their health and well-being, ultimately reducing maternal mortality rates and improving overall health outcomes for women in Sub-Saharan Africa.

Our team comprises individuals with deep-rooted connections to the communities we serve, ensuring that our solution is not just designed for them but also for them.

Our team lead and members have extensive experience and understanding of the healthcare landscape in resource-limited settings, particularly in Kenya and Sierra Leone. Through our combined backgrounds in diagnostic healthcare service delivery, business development, sales, marketing, and clinical education, we comprehensively understand the challenges and opportunities within the healthcare industry.

Moreover, our team members come from diverse backgrounds, mirroring the diversity of the communities we serve. This diversity allows us to approach problem-solving with a range of perspectives, ensuring that our solution is inclusive and responsive to the needs of all stakeholders.

Importantly, we prioritize community engagement throughout the design and implementation process. We actively seek input from healthcare providers, women's groups, community leaders, and other stakeholders to ensure that our solution aligns with their priorities and addresses their specific needs. This collaborative approach enhances our solution's effectiveness and fosters trust and ownership within the communities we serve.

We are not just delivering a solution but partnering with communities to co-create sustainable, community-driven healthcare solutions that empower women and improve health outcomes in Sub-Saharan Africa.

So far, we have built and tested the following;

1. Implementation in Kenya and Sierra Leone: We have successfully implemented our flagship model in Kenya and Sierra Leone. This demonstrates that we have navigated the complexities of establishing partnerships and deploying our innovation to resource-limited settings, indicating progress beyond mere conceptualization.

2.  Partnerships with primary Healthcare Providers in low-resource regions: We currently partner with 4 healthcare providers in Kenya and Sierra Leone. These partnerships are crucial as they signify the real-world implementation of the 'plug-and-play', lease-to-own models, and teleradiology integration within healthcare facilities. These engagements with care providers present a valuable opportunity to better understand the feasibility, effectiveness, and challenges of implementing our models to mitigate maternal mortality and morbidity through ultrasound technology, i.e. these engagements help us better understand how our model can be adapted to different healthcare settings and resource levels.

3. Impact: Through our partnerships with primary healthcare providers, we have tested/screened a total of 27,000 individuals, have conducted perinatal screening to over 19,500 women, saved approximately 850 pregnancies, have averted 350 maternal deaths, and impacted approximately 110 children as a result of early diagnosis of illness within Kenya and Sierra Leone.

4. Focus on Women's Health: We have tailored our solution, "Imaging EmpowerHER", to address women's health needs in resource-limited settings. This demonstrates a clear understanding of the target population's specific healthcare challenges and the customization of the solution to address those needs effectively.

5. Efforts towards achieving Health Equity: We believe that our solution aligns well with the goals of the MIT Solve program, particularly in leveraging technology to increase access to quality care and good health. Our solution's focus is on providing accessible and affordable ultrasound screening for women in underserved communities which resonates with MIT Solve's emphasis on innovation for health equity.

In this stage, we are focused on refining our innovation based on real-world feedback and scaling up our impact.

We are applying to MIT Solve because we believe in the transformative power of technology to improve healthcare access and outcomes, particularly for underserved communities.

While we have made strides in developing our solution and establishing pilot partnerships in Kenya and Sierra Leone, we recognize that there are still barriers that impede our ability to scale and maximize impact. These barriers include financial constraints, technical challenges in implementing and integrating our technology, and regulatory hurdles, as well as cultural factors that may influence the adoption and acceptance of innovative healthcare solutions.

Through the MIT Solve program, we hope to overcome these barriers by accessing a range of support mechanisms tailored to our needs. Specifically, we seek:

1. Potential Funding Opportunities: We aim to tap into funding opportunities including grants and impact investments from private investors to allow us to subsidize technology access to low-resource primary healthcare & subsidize service provision to end users. With the potential funding, we also look to expand our operations, reach more healthcare facilities, further validate our models, and develop our closed-loop patient management and engagement system and teleradiology system.

2.    Developing and implementing robust monitoring and evaluation systems is crucial for ensuring the effectiveness and impact of our solutions. Solve's tailored capacity workshops and monitoring and evaluation support can provide us with the necessary tools and guidance to build a robust impact measurement practice, enabling us to track our progress and make data-driven decisions for continuous improvement.

3.    We recognize the importance of refining our business strategy to ensure scalability, sustainability, and community focus. Solve's leadership coaching and access to a network of impact-minded leaders across industries can offer invaluable insights and guidance as we navigate the complexities of scaling our operations and maximizing our social impact.

4.    Software development is integral to the success of our teleradiology systems and patient management and engagement platforms. By connecting us with partners who can provide in-kind and pro bono resources such as software licenses and technical expertise, Solve can help accelerate the development and implementation of our telehealth solutions, making them more accessible and user-friendly for healthcare providers and patients in our target communities.

5.    Mentorship, advisory, and leadership training are invaluable for guiding our team and enhancing our capabilities as social entrepreneurs. Solve's curated opportunities to connect and network with impressive peers, as well as leadership coaching, can provide us with the mentorship and support needed to navigate the challenges of running an organization and drive sustainable change in healthcare delivery.

6.    Cultural Sensitivity and Market Understanding: Cultural factors play a significant role in healthcare delivery and acceptance of new technologies. Through Solve's network and curated opportunities to connect with peers, we aim to gain insights into local contexts and tailor our approach to better meet the needs and preferences of the communities in which we operate. 

The "Imaging EmpowerHER" initiative represents a transformative approach to addressing maternal mortality and women's health disparities in Sub-Saharan Africa through innovative technology and sustainable business models. The initiative tackles the significant barriers hindering the uptake of ultrasound technology in Sub-Saharan Africa in a novel and comprehensive manner.

Addressing infrastructure and equipment shortages, we employ a "plug-and-play" model and a "lease-to-own" model. This approach ensures that healthcare facilities, even in resource-scarce settings, can access ultrasound equipment without the burden of high upfront costs. By providing installation, maintenance, and skilled personnel, we mitigate the challenge of equipment shortages and ensure sustainable operation.

Regarding cost and affordability, Cedars Diagnostics innovates by offering flexible asset financing packages. This approach makes ultrasound procedures more financially feasible for healthcare providers and patients alike, thereby increasing access to essential imaging services, particularly for maternal health.

To overcome geographical accessibility barriers, Cedars Diagnostics leverages telehealth solutions such as teleradiology systems. Through this telehealth system, healthcare facilities in remote or rural areas can connect remotely with a team of radiologists and sonographers. This expands access to expert interpretation of imaging results and reduces the need for patients to travel long distances for imaging services, overcoming transportation challenges.

Addressing the shortage of skilled personnel, Cedars Diagnostics ensures that its "plug-and-play" model includes skilled operators who can efficiently operate the ultrasound equipment. Moreover, through the teleradiology platform, remote supervision and training can be provided to local healthcare professionals, thereby improving the quality of ultrasound services and interpretation in underserved regions.

Instead of concentrating on putting up costly facilities on a ‘’brick and motor’’ model or centralized hubs, we prioritize empowering existing healthcare facilities, especially in rural/remote and periurban regions. Our emphasis is on delivering new technologies to those who require them most, distinguishing us from our competitors.

Cedars Diagnostics' solution has the potential to transform the market landscape by demonstrating a scalable and sustainable approach to leveraging technology for maternal healthcare in Sub-Saharan Africa. Cedars Diagnostics paves the way for improved health outcomes for women in underserved communities by empowering healthcare providers with the tools and support they need.

According to the World Health Organization (WHO), at least one ultrasound before 24 weeks gestational age is recommended to ensure a positive pregnancy experience. Previous studies prove that ultrasound technology availability during ante-natal clinic (ANC) can boost attendance and ANC compliance by offering higher-quality care and greater confidence in fetal health. Ultrasound can also promote facility-based deliveries by providing timely pregnancy information, leading to more effective complication management by skilled attendants. Additionally, early detection of high-risk pregnancies and birth defects through ultrasound contributes to lowering maternal and child mortality. However, accessing ultrasound technology in low-resource settings, especially in Sub-Saharan Africa, presents significant challenges. Through interactions with pilot partner healthcare facilities and other healthcare providers in similar settings, Cedars Diagnostics has identified several key challenges:

A.   Limited Access to Technology: Many healthcare facilities in low-resource settings lack access to diagnostic imaging technology such as ultrasound machines due to high upfront costs and limited infrastructure.

B.   Shortage of Skilled Personnel: Even when facilities have access to ultrasound machines, there is often a shortage of skilled personnel such as radiologists and sonographers to operate the equipment effectively.

C.   Geographical Barriers: In remote areas, geographical barriers make it difficult for women to access healthcare facilities equipped with diagnostic imaging technology, leading to delays in diagnosis and treatment.

D.   Cost Constraints: Affordability remains a significant barrier for both healthcare facilities and patients, with the cost of equipment, maintenance, and training being prohibitive.

Cedars Diagnostics aims to address these challenges through its solution, "Imaging EmpowerHER," which leverages ultrasound technology and teleradiology systems. The theory of change for Cedars Diagnostics' solution is as follows:

a.    Activities:

These activities include identifying & partnering with primary healthcare facilities on a ‘plug-and-play’ or ‘lease-to-own’ agreement. We then facilitate the commissioning & installation of equipment while integrating the Teleradiology technology system. We then facilitate training for healthcare workers on the fundamentals of maternal ultrasound screening. We also conduct outreach & sensitization programs to healthcare workers & to the community to create awareness of the importance of ultrasound & perinatal care.

b.   Outputs:

Outputs include Increased access to prenatal care services for pregnant women in underserved communities, improved quality of prenatal care through the use of ultrasound technology for early detection of complications, enhanced capacity of healthcare providers to diagnose & manage preventable maternal-related ailments, strengthened healthcare infrastructure of partnered healthcare facilities through augmentation of referral systems & job creation of job opportunities for healthcare professionals, particularly women

c. Outcomes:

Improved maternal health outcomes, including reduced maternal mortality rates and complications during pregnancy and childbirth. Higher survival rates and better health outcomes for women.

1. WHO antenatal care recommendations for a positive pregnancy experience. Maternal and fetal assessment update: imaging ultrasound before 24 weeks of pregnancy. Geneva: World Health Organization; 2022.

2. Impact of ultrasound scanning on pregnant Women's compliance with attendance at antenatal care visits and supervised delivery at primary healthcare centers in northern Nigeria: Initial experiences.

Impact Goals for Cedars Diagnostics' "Imaging EmpowerHER" Solution:

1. Reduce Maternal Mortality Rates: Cedars Diagnostics aims to significantly reduce maternal mortality rates in Sub-Saharan Africa by improving access to early detection and monitoring of pregnancy-related complications through ultrasound technology. Our goal is to decrease maternal mortality rates by at least 20% in the regions where we operate within five years.

2. Increase Access to Prenatal Care: We seek to increase the percentage of pregnant women receiving adequate prenatal care by providing accessible and affordable ultrasound screening services. Our goal is to ensure that at least 80% of pregnant women in the communities we serve receive at least one ultrasound screening during their pregnancy within the next three years.

3. Improve Reproductive Health Outcomes: Cedars Diagnostics aims to improve reproductive health outcomes by facilitating early detection and diagnosis of reproductive ailments such as ovarian cysts, fibroids, and cervical cancer through ultrasound screenings. Our goal is to increase the early detection rate of reproductive ailments by 50% within the next five years.

4. Empower Healthcare Providers: We aim to empower healthcare providers within resource-limited settings by equipping them with the necessary tools and training to operate ultrasound equipment effectively. Our goal is to train and certify at least 50 healthcare professionals in ultrasound imaging techniques annually.

5. Enhance Women's Health Awareness: Cedars Diagnostics seeks to enhance awareness among women in resource-limited settings about the importance of regular health screenings and prenatal care. Our goal is to conduct educational outreach programs reaching at least 10,000 women annually, focusing on the benefits of ultrasound screenings for early detection and monitoring of health conditions.

Measuring Progress:

1. Maternal Mortality Rates: We track and analyze maternal mortality data in the regions where we operate, comparing rates before and after the implementation of our ultrasound screening programs.

2. Prenatal Care Coverage: We collect data on the number of pregnant women accessing ultrasound screenings during their prenatal care visits, monitoring trends over time to assess the impact of our services on prenatal care coverage.

3. Early Detection Rates: We measure the percentage of reproductive ailments detected at an early stage through our ultrasound screenings, comparing pre-intervention and post-intervention data to evaluate the effectiveness of our programs.

4. Healthcare Provider Training: We track the number of healthcare professionals trained and certified in ultrasound imaging techniques, assessing their proficiency and confidence in operating ultrasound equipment.

5. Women's Health Awareness: We conduct surveys and interviews to gauge women's awareness and knowledge about the benefits of ultrasound screenings, monitoring changes in attitudes and behaviors over time.

The core technology powering "Imaging EmpowerHER," revolves around 3 key components:

1. Ultrasound Imaging Technology: Ultrasound technology forms the backbone of Cedars Diagnostics' approach to improving healthcare outcomes for women in resource-limited settings. Ultrasound imaging allows for non-invasive and real-time visualization of internal organs and tissues, making it invaluable for early detection, diagnosis, and monitoring of various health conditions. In the context of Cedars Diagnostics, ultrasound technology is utilized for screening and diagnosing ailments such as pregnancy-related complications, and reproductive health issues. By providing accessible and affordable ultrasound screening services tailored to women's health needs, Cedars Diagnostics aims to enhance early detection and improve overall healthcare outcomes.

2. Teleradiology Systems: We utilize teleradiology systems to connect underserved healthcare facilities with a network of remote radiologists and sonographers. This system enables remote transmission and interpretation of medical images such as ultrasounds, X-rays, and MRIs. The core features of the teleradiology system include:

• Secure Communication: Utilizing encrypted channels, medical images, and patient data are securely transmitted between healthcare facilities and remote radiologists and sonographers. This ensures patient privacy and confidentiality.

• Real-Time Collaboration: The teleradiology platform facilitates real-time collaboration between healthcare providers and specialists, allowing for immediate consultations and interpretation of imaging studies.

• Augmented Reality Integration: Incorporating augmented reality (AR) technology enhances the remote guidance and training capabilities of the system. This feature enables remote experts to provide virtual guidance and supervision to on-site healthcare professionals during imaging procedures, ensuring accuracy and quality.

• Scalability and Accessibility: The teleradiology system is designed to be scalable and accessible, enabling healthcare facilities in remote or resource-limited areas to access specialist expertise without the need for expensive infrastructure investments.

3. Patient Management System: In collaboration with healthcare tech companies, we seek to develop and integrate a closed-loop patient management system to streamline patient care and improve health outcomes. Key features of this system include:

• Electronic Health Records (EHR): The patient management system incorporates EHR functionality, allowing healthcare providers to maintain comprehensive and up-to-date medical records for each patient. This includes imaging reports, diagnostic results, treatment plans, and follow-up appointments.

• Patient Engagement Tools: Includes tools for patient engagement, education, and awareness. This includes SMS reminders for appointments, educational resources on women's health topics, and interactive features to encourage proactive healthcare-seeking behaviors.

• Integration with Partnered Healthcare Facilities: The patient management system seamlessly integrates with the existing workflows of partnered healthcare facilities. This ensures smooth communication and coordination between primary care providers, specialists, and support staff, facilitating holistic and patient-centered care.

• Data Analytics and Insights: By collecting and analyzing patient data, we can generate valuable insights into healthcare trends, disease prevalence, and treatment outcomes. This information can inform evidence-based decision-making and support ongoing quality improvement efforts.

Cedars Diagnostics solution team comprises 4 full-time staff members, 2 part-time staff members, 1 volunteer, and a network of 6 contracted sonographers who work as moonlighters.

We have been working on solution, "Imaging EmpowerHER," since 2018, striving to empower women in resource-limited settings through accessible and affordable ultrasound screening. Despite facing operational challenges and setbacks, including temporary closures in Kenya in 2020 and 2021, the team has persevered to enhance healthcare outcomes for underserved populations.

By prioritizing diversity, equity, and inclusion, we not only strengthen our team and organization but also enhance our ability to effectively serve the diverse communities we aim to impact through our healthcare solutions. We believe that by embracing diversity and fostering inclusion, we can drive meaningful change and improve health outcomes for all.

Here's how we approach it:

1. Diverse Leadership Team: Our leadership team reflects diversity in various aspects including gender, ethnicity, and professional backgrounds. We recognize that diverse perspectives drive innovation and problem-solving. Our team members come from different cultural backgrounds and possess unique skills and experiences that enrich our decision-making processes.

2. Commitment to Equity: We are committed to providing equal opportunities for all team members to grow and thrive within our organization. Our hiring and promotion processes prioritize merit and potential, ensuring fairness and equity.

3. Inclusive Environment: We foster a welcoming and inclusive environment where all team members feel valued, respected, and supported. We encourage open communication, collaboration, and feedback. We celebrate diversity and actively promote an atmosphere of belonging where everyone's voice is heard and valued.

4. Diversity Goals and Actions: We have set clear goals for enhancing diversity, equity, and inclusion within our organization. These goals include increasing the representation of underrepresented groups in our workforce and fostering a culture of inclusivity.

5. Continuous Improvement: We recognize that creating a diverse, equitable, and inclusive workplace is an ongoing journey. We regularly solicit feedback from our team members to identify areas for improvement and implement effective strategies for creating a more inclusive environment. We are committed to learning, growing, and evolving as an organization.

We operate on a multifaceted business model designed to address critical healthcare needs in resource-limited settings, particularly focusing on maternal health in Sub-Saharan Africa. Our primary goal is to empower and improve healthcare outcomes for women through accessible and affordable ultrasound screening services, tailored to their specific health needs.

We offer two primary services to our key customers, namely healthcare facilities and the women they serve:

a.    Ultrasound Screening Services: Through our "plug-and-play" model, we provide healthcare facilities with state-of-the-art ultrasound equipment and skilled personnel on a revenue-sharing basis. This model ensures that even small facilities can access cutting-edge technology without bearing the high upfront costs. By offering ultrasound scanning services, we enable early detection, diagnosis, and monitoring of conditions such as breast cancer, pregnancy-related complications, and other reproductive health ailments. Our services directly address the pressing healthcare needs of women in these communities, saving lives and improving health outcomes.

b.   Teleradiology Solutions: We leverage proprietary teleradiology systems to connect underserved healthcare facilities with remote teams of radiologists and sonographers. This enables real-time consultation, diagnosis, and guidance, bridging the gap in expertise and resources between remote areas and specialized medical centers. Our teleradiology services, exemplified by platforms like Reacts, ensure that women in even the most remote regions have access to expert medical advice and diagnosis, leading to timely interventions and improved healthcare outcomes.

In addition to our core services, we offer portable hand-held ultrasound devices through a "lease-to-own" model (MVP), further expanding access to ultrasound technology in resource-limited settings. This long-term revenue stream not only benefits healthcare facilities but also enhances the reach and impact of our services.

Our revenue streams are diversified, including:

• Revenue sharing from ultrasound scanning services is provided through the "plug-and-play" model.

• Sales revenue from lease-to-own portable ultrasound devices.

• Subscription fees from our teleradiology services.

• Additional revenue from portfolio products such as x-ray services.

Our business model is centered on providing innovative healthcare solutions that address the specific needs of women in resource-limited settings. By combining advanced technology, flexible financing options, and remote medical expertise, we strive to make a meaningful impact on maternal health outcomes while ensuring sustainable revenue generation for our organization.

We are developing a multifaceted approach to achieving financial sustainability while fulfilling the mission of improving healthcare outcomes for women in resource-limited settings.

Revenue Streams:

-Plug-and-Play Model: Cedars Diagnostics earns a percentage of the revenue generated from offering ultrasound scanning services to patients at partner healthcare facilities (typically a 70%:30% revenue share model). This model ensures a steady stream of income based on the utilization of Cedars' technology.

-Lease-to-Own Model: Long-term revenue is generated from the sale of portable handheld ultrasound devices through flexible asset financing packages. This model enhances asset affordability for healthcare providers and ensures recurring revenue for Cedars.

-Teleradiology Subscriptions: We generate revenue from subscriptions to its proprietary teleradiology systems, which connect underserved healthcare facilities to remote radiologists and sonographers. This subscription-based model ensures ongoing revenue from service provision.

-Additional Portfolio Products: Revenue is generated from providing additional services such as x-ray services, and expanding Cedars' revenue streams beyond ultrasound technology.

Partnerships and Agreements:

We have established partnerships and agreements with equipment resellers, ensuring a stable supply chain for necessary equipment on favorable terms such as long-term sale agreements. These partnerships contribute to Cedars' operational efficiency and financial sustainability.

Seed Funding and Investment:

We have successfully raised startup seed funds from equity stakeholders and startup bank loans in both Kenya and Sierra Leone, totaling $65,500. This initial funding has been utilized to establish operations and generate revenue.

We are actively seeking additional funding through grants and investment capital from philanthropic organizations, grantmakers, and private investors to support its expansion and sustainability efforts.

Evidence of Success:

We have demonstrated traction and revenue generation through its partnerships with four primary healthcare facilities in Kenya and Sierra Leone, resulting in a total revenue of approximately $315,600 across both countries.

We have successfully generated revenue from teleradiology subscriptions, amounting to $965, indicating the viability of this revenue stream.

The utilization of plug-and-play and lease-to-own models has enabled us to generate revenue from ultrasound scanning services and the sale of portable ultrasound devices, respectively, contributing to financial sustainability.