Kenya Plans

2. 6 million newborn deaths worldwide 1 2.6 million newborn deaths worldwide 1.1 million newborn deaths in Africa 3 MAIN CAUSES Prematurity 35% Respiratory Distress Thermal Instability Feeding Challenges Infection Jaundice Hypoglycemia Infection 23% Sepsis Pneumonia Diarrhea Tetanus Injured in Delivery 24% Hypoxic Brain Injury

She also took me to the equipment graveyard and explained why the breathing machines used in America do not work at her hospital.

Power of Partnerships: NEST Team RICE University; Institute of Global Health Northwestern University; Kellogg School of Management 3rd Stone Design London School of Hygiene and Tropical Medicine (LSHTM) Center for Public Health and Development (CPHD) Kenya Paediatric Association; KEPRECON Oxford University; KEMRI-Wellcome Trust

Newborn Essential Solutions & Technologies (NEST) Prevent & Treat Infections Hydration & Nutrition Breathing Support Monitor & Treat Jaundice Yet all these causes of death can be addressed with a package of technologies that keep babies warm, hydrated and nourished, help breathing problems and then detect and treat complications early.   Imagine if we had a set of technologies that allowed us to do all these things. And what if those technologies were effective, affordable, and sustainable? Point-of-care Diagnostics Separate Neonatal Ward Temperature Stability

NEST 360 Product Categories Separate Neonatal Ward NEST Maintenance Tools Back Up Power Future technology Prevent & Treat Infections Syringe Pump Sepsis Diagnostic Temperature Stability Radiant Warmer Continuous Temp Monitor Warming Crib Hydration & Nutrition Future Technology Manage Jaundice Photo-therapy Lights Bilirubin Monitor Point of Care Diagnostics Glucose Monitor Hemoglobin Monitor pH Monitor Breathing Support Oxygen Source CPAP Suction Machine Pulse Oximeter O2 Concentrator Protector Apnea Monitor Commercially available 8 NEST facilities already equipped for Essential Newborn Care including resuscitation To be available (12-24 mo) 4 To be available (24-48 mo) 5

EFFECTIVE AFFORDABLE SUSTAINABLE

Health System Approach Newborn TWG integration Focus Newborn mortality burden counties UHC Counties Facility tech and clinical assessment Hub and Spoke model Learning sites Implementing sites In-service and Pre-service training Inter Country Learnings and Best Practice Sharing

Kenya Implementation Plan Goal Build NEST network and develop model distribution system Learning questions Refine district implementation; core neonatal records/data Outputs Neonatal Record Set Refined NEST Implementation & Planning Guide Refined NEST Financing Metrics Toolkit Model Distribution Network # project NESTs clinical teaching 15 12 65 # NESTs sold

What does it take? Infrastructure Equipment Staffing Space ~ at least 5m by 5m Power – clean and stable Equipment Respiratory – CPAP, Oxygen, Pulse Ox Temp – Warmer, Thermometer Support – Suction, Glucometer, Phototherapy Staffing 1 nurse to 3 babies; 1 MO or Paediatrician/Neonatologist Training – Biomed and Clinicians Maintenance schedule All these would cost ~ KES 3M

Sample NICU Layout

Our Plan Do baseline survey for Pumwani, Mama Lucy and Nyeri County Referral Hospital Give survey feedback to ICC and stakeholders in newborn health for Pumwani, Mama Lucy and Nyeri with action plan and involve interested partners to support in areas of their interest Do baseline survey for 2 learning sites (Machakos & Nakuru), 2 learning hubs (MTRH, JOTRH) and one Medical Engineering training institution KMTC (Nairobi) Roll out to other facilities as guided by TWG

Goal We cannot reach the SDG for newborn survival without scaling comprehensive, quality newborn care (12 yrs to get to 12) NEST integrates product introduction, facility distribution, service & maintenance, training & mentorship to ensure sustained, effective use of life-saving technologies

Thank you