A mobile ear for pregnancy problems

In much of Africa, only the very richest have access to quality healthcare. Nowhere is this more apparent than in family medicine. According to the UN, a woman dies from complications in childbirth every minute and eight million babies die each year before or during delivery or in the first week of life. The maternal mortality ratio in Africa is the highest in the world and has actually increased over the last 20 years. In 2007, experts warned that if nothing was done to arrest this trend there would be 2.5 million maternal deaths, 2.5 million child deaths and 49 million maternal disabilities in the region over the next 10 years. Now, thanks to the ingenuity of a group of computer science students, a primitive 19th century device and some 21st century technology, something is being done. The Pinard Horn, named after the French doctor who invented it back in the 19th Century, is a medical device used to monitor the heart rate of a fetus during pregnancy. It functions similarly to an ear trumpet by amplifying sound. The wide end of the horn is held against the pregnant woman’s belly, while the doctor, nurse, or midwife listens through the other end. Despite its antiquity, the Pinard Horn is still used in many parts of the world and can be very effective in the right hands. It can determine the age, position and heart rate of the fetus, along with an indication of its overall health. But to do this consistently, can take many years of practice. This led the three Ugandan computer science students to think about improving the design. “We saw the technology gap and started thinking about how we might bridge it.” In developed countries, ultrasound is the answer, but these machines are expensive. Even if a hospital could afford one, few expectant mothers could. And so, a new project, known as WinSenga was born.  The new device still consists of a plastic trumpet, but with a highly sensitive microphone inside. It is placed on a women’s abdomen just like the original horn, but now it connects to a Windows-based phone running an app that plays the part of the midwife’s ear. The system picks up the fetal heart rate, transmits it to the phone, and then the phone runs an analysis. The app, developed in conjunction with Unicef medics then recommends a course of action, if necessary, for the mother and her unborn child. “When I first heard the idea, I thought it was brilliant,” says Davis Musinguzi, a medic and Unicef advisor. “But being software developers, they needed guidance on the medical component of the application.” The doctor advised on the medical parameters, procedures and standards that needed to be part of the software. The value of going mobile is pretty clear, allowing carers to visit mothers wherever they are. The students, Joshua Okello, Aaron Tushabe and Josiah Kuvuma won the 2012 Microsoft East and Southern Africa Imagine Cup competition before losing out in the finals held at Sydney. Still, the event partly inspired the name of the new device. The “Win” part comes from the software giant’s own products, while “Senga” refers to the local Ugandan name for the traditional “birth attendants” who used to help village mothers-to-be with their antenatal care and their births. Their loss at the world finals has not held them back. The students have since been approached for potential partnerships and are currently looking for funding to launch a six-month field trial of their system. If that’s successful, then WinSenga could launch as a product. While the team says it’s too early to talk about pricing, they are heartened that the cost of smartphones is rapidly dropping across Africa, making their system much more attractive to potential clients. While they wait for funding, the WinSenga team is far from idle. Despite the fact that all three team members still have busy university schedules, they have already launched an expanded version of the software designed to assist healthcare workers and mothers during labor. The group’s website also promises a version called WinSenga Plus, which would assist with postnatal care as well. And as if that isn’t enough, WinSenga say they are almost ready to launch an Android version of their application, and will then start work on a version for iOS. The use of mobile technology is a relatively new intervention to improving health services,” says Dr. Musinguzi.  “WinSenga and other devices and apps that are coming on to the market, will have to prove themselves to healthcare professionals by reducing the burden of doing what they have always done.” It will take training and investment, he says, but it “will pay off in the long run”. Kudos to you gentlemen. You’re winners in our book!