Global Health Challenge:


Acute respiratory infections are the leading cause of global child mortality and respiratory conditions associated with premature birth contribute to about 30% of neonatal death. In developed health systems, such conditions can be treated using bubble Continuous Positive Airway Pressure (bCPAP), a therapy that delivers pressurized flow to an infant to prevent air sac collapse and makes breathing easier. However, the typical bCPAP setup used in such settings costs anywhere from $6,000, making it inaccessible to most health facilities in developing countries. As such, the standard of care in resource-constrained settings for babies in respiratory distress is usually low-flow oxygen therapy, which on its own is inadequate.


Rice 360 Solution:


In partnership with Queen Elizabeth Central Hospital, Baylor College of Medicine, and 3rd Stone Design, Rice 360° has developed a low-cost, high-performance bubble CPAP system to treat infants with respiratory distress syndrome in the developing world. A clinical trial of the bCPAP device at the Queen Elizabeth Central Hospital in Blantyre, Malawi showed that the device significantly improved the survival of neonates in respiratory distress. At a significantly lower price point, the Pumani CPAP has also been proven to deliver therapeutic pressures and flows comparable to bubble CPAP systems used in the United States.


Current Status and Next Steps:


With support from a Saving Lives at Birth transition grant, Rice 360°, its partners, and the Malawi Ministry of Health have scaled up implementation of the device to all central and district hospitals in Malawi. Additionally, an award from GSK and Save the Children is funding the roll out of this life-saving technology in Zambia, Tanzania, and South Africa. Plans are also underway to further expand to Christian Health Association of Malawi (CHAM) facilities, which provide approximately 40% of the country’s primary health care services.


The rollout of Rice 360°’s bCPAP device includes rigorous training and continuous mentorship of health workers to ensure competency. In an effort to normalize use of bCPAP technology in Malawi, support is being provided to nursing and clinical officer training schools to integrate it into their curricula, and CPAP is being included in standard of care protocols.


A commercial version of the Pumani bCPAP device can now be purchased from 3rd Stone Design and comes with a teaching module, user manual, repair manual and a spare parts kit. Interested organizations/individuals can contact info@3rdstonedesign.com.   

A High-Value, Low-Cost Bubble Continuous Positive Airway Pressure System for Low-Resource Settings: Technical Assessments and Initial Case Reports. 

Brown J, Machen H, Kawaza K, Mwanza Z, Iniguez S, et al. (2013) PLoS ONE 8(1): e53622.doi:10.1371/journal.pone.0053622

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Rice 360˚ Institute for Global Health
6100 Main MS-636
Houston, Texas 77005-1827

Rice 360˚ Malawi

Queen Elizabeth Central Hospital

P.O. Box 95
Paediatric Department
Blantyre, Malawi