1. Kenya Plans

2. 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

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

4. 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

5. 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

6. 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

7. EFFECTIVE
AFFORDABLE
SUSTAINABLE

8. 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

9. 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

10. 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

11. Sample NICU Layout

12. 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

13. 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

14. Thank you