Richards-Kortum, Oden, Palamountain: All Babies Deserve a Chance to Survive
By Rebecca Richards-Kortum, Maria Oden and Kara Palamountain
November 18, 2016
History shows that saving newborns is perhaps the most powerful key to initiating economic development in poor nations.
This year, more than 1 million babies will die simply because they were born too soon. Premature birth is now the world's leading cause of death for children, and progress to improve newborn survival is frustratingly slow. A recent study predicted that at current rates of progress, it will be 150 years before a baby born in Africa has the same chance of survival as one born in the United States and other high-income countries.
World Prematurity Day, which was commemorated last week, focused attention on this tragedy and reminded us that it can be ended. A growing community of frugal innovators is leading the fight with new technologies and sustainable business models that are already reducing preterm deaths in sub-Saharan Africa. If we are to capitalize on this success and give all the world's babies a better chance of surviving, we must expand support
for the coalitions of inventors, health care providers, nonprofits and medical technology companies that are turning the tide.
History shows that saving newborns is perhaps the most powerful key to initiating economic development in poor nations. When families have confidence their babies will live, they choose to have fewer children.
Families with fewer children have more resources to invest in each child, and they are more likely to keep their daughters in school. As fertility rates fall, each working adult has fewer dependents to support, and the economy is allowed to expand.
In the U.S., newborn survival did not improve until we implemented a regionalized system of neonatal intensive care units (NICUs) in the 1960s. Today, most African hospitals lack even simple tools to monitor vital signs, keep babies warm, help them breathe, and diagnose and manage infections. Efforts to donate equipment designed for high-income countries, such as incubators and oxygen concentrators, cannot solve the problem because these technologies often fail in the hot, dusty and humid environments of African hospitals. Clinicians working in low-income countries must have access to medical technologies that are explicitly designed to work in cost-conscious, understaffed, environmentally harsh conditions.
But frugal innovators are showing it is possible to improve care at low-resource hospitals for a fraction of the cost of existing technologies used in high-income countries. Entrepreneurs already have created phototherapy devices, breathing machines and other technologies that are boosting newborn survival in more than 20 nations. These innovations are making a difference, but they don't yet add up to a NICU for African hospitals.
Applying the principles of frugal design more broadly to meet the comprehensive needs of African newborns could also improve newborn outcomes at home. The average cost for delivery and care of a premature baby born in the U.S. is $54,194, as compared with a healthy baby at $4,389. There is a significant economic incentive for more affordable technologies, and the process of reverse innovation - where products created for developing economies are adapted for use in developed economies - could produce more affordable options.
For example, the United States Agency for International Development's Saving Lives at Birth program is supporting the development of a new class of diagnostic tools that can be used at home or at a doctor's office to better identify women who are at risk of giving birth prematurely. These tools can lower premature birthrates in low- and high-income countries alike. This is especially important in the U.S., which received a "C" grade on the 2016 March of Dimes Premature Birth Report Card because of slow progress toward reaching its own goal of reducing prematurity below 8.1 percent of all births by 2020.
We can do better, and have the global resources to do so. Preterm births need not be a destiny.
Richards-Kortum and Oden are professors in Rice University's Department of Bioengineering and co-directors of the Rice 360 Institute for Global Health. Palamountain is a research associate professor at Northwestern University's Kellogg School of Management and executive director of the school's Global Health Initiative.