This is after holding a successful field research in Malindi where they got to interview health officers, traditional birth attendants, government officials and mothers to get information that will help them in prototyping an improved fetoscope.
Part of the invites present were midwives, biomedical engineers, MSc Physics students, and startup founders.
Rapid prototyping was one of the exercises of the day where the ‘Fetoscope Team’ got to hear the views of the stakeholders on the pinard fetoscope. The expertise views are set to help the team in its prototyping of the fetoscope.
The top highlight of the day was that, the views were used to create a Computer Aided Design (CAD) prototype design that will be used to create an actual prototype.
Up next is an Innovation Research symposium at the University of Nairobi. The ‘Fetoscope Team’ will be making their presentation. Watch out for the next article.
Lets connect from where we left from the first article of the Malindi Lessons. We’re in day 2 of the Fetoscope Team’s field study and we got new experiences and lessons for you. Enjoy the ride!
Interview with traditional birth attendants
The team starts the day by interviewing the traditional birth attendants. All they want to know is the experience of the birth attendants in helping mothers deliver children the traditional way.
Most traditional birth attendants recognize fetoscopes since they have encountered them during their quarterly training at their regional mission hospitals. They however can’t afford the fetoscope so they mostly rely on palpation using their hands on the pregnant women to determine fetal health status. They use massage to realign the fetus in case of complications. They were willing and desire to use fetoscopes if provided.
Most Traditional Birth Attendants (TBAs) cannot afford the fetoscope because they are extremely poor.
Occasionally, the working conditions by the TBAs can be unsanitary since they offer their services at homes.
Their quarterly meetings involve sensitization on referring pregnant women to hospital for antennal care and dangers of home deliveries.
The attendants are integrated into the health system, after training, to improve maternal health services.
The Story of a Local Chief.
The local chief has only seen the fetoscope when bringing in his wife to the clinic when her pregnancy was due to delivery. Otherwise, he only sees the equipment being used for training on traditional birth attendants. He holds a negative view of traditional birth attendants because he considers them unsanitary and unsafe. He is of the view that equipment and training should be availed to traditional birth attendants (since they can’t be ridden off) to make safe antenatal care and home deliveries. Ironically, despite his views, he only recounts one death in the hands of TBAs in the local region throughout his entire term. He acknowledges campaigns to phase out TBAs in the community through drives to sensitize mothers to prefer hospitals.
Boom! The team is done with the field study and objectives met. It’s now time to go home, brief the client, and work on the prototype of the enhanced fetoscope.
The University of Nairobi Innovation Fellows together with students from Aalto University ,Finland today made their first visit to stakeholders in the health sector in Malindi. We got the entire experience and lessons for you.
Visit to Venoma Private Clinic
The team interviewed a clinician at Venoma Private Clinic. The setting was a small clinic with several staff and few patients. The temperatures are high, humid and the environment is quiet. The clinician starts by giving details as regards to the management of the facility and its role in the healthcare system in Kilifi – including referral system. She then gives information about her duties at the facility in context to maternal health.
Constant check up should be done during pregnancy to help detect complications at early stages to avoid dangers and to help in timely treatment.
It is only possible to monitor fetal heart rate using a fetoscope from six months after conception.
Maternal heart rate is subject to variation depending with physiology and state of the mother and can be confused with that of the fetal heart rate.
A pinard horn fetoscope is the most efficient, easy to use, cheap, portable and easily available tool to use.
Fetoscope accuracy depends on the experience of the midwives.
Accuracy is achieved by comparing results with another midwife’s readings.
The fetoscope sound is low and one has to be really keen or strain to listen to fetal heart rate in a noisy environment.
The level of accuracy can reduce as the age of midwives increases due to hearing problems.
The story of a recent mother.
The team interviewed a young mother who delivered her first child, a son, at the facility. Her son is aged 2.8 yrs and plays around happily during the interview. The mother said that a fetoscope was used to monitor her pregnancy every time she visited the facility. It took the midwives about 3 minutes to effectively auscultate her fetus’ FHR each time during the monitoring. Sometimes the fetoscope hurts when being used on her (pressed) especially during the latter stages close to delivery. They prefer hospital services to Traditional Birth Attendants because hospitals are better equipped to handle complications.
Visit to Imani Private Clinic
The team interviewed a clinical officer at Imani Private Clinic in the afternoon. The setting of the interview is the consultation room of the clinical officer. The temperature out is very hot in contrast to the cool temperature in the room.
Accuracy of the fetoscope depends on the experience of the user.
Monitoring using fetoscope is dependent on time of pregnancy, only measurable after six months from conception.
It is not possible to determine fetal heart rates for twins in some occasions.
Maternal heart rate is subject to fluctuations especially during complications.
The fetoscope is effective, durable and easily available.
A display screen that shows the heart rate would make the nurses’ experience exciting.
We believe you have learned something from this article. Watch out for the next one, THE ‘MALINDI LESSONS’ – DAY 2 as we tell you the team’s experience on the second day of the field study. Cheers!
The University of Nairobi Innovation Fellowship team working on improving the Fetoscope makes a visit to Malindi to pursue on ground information that will help them in improving the Fetoscope.
The fellows in collaboration with students from Aalto University, in Finland are seeking to get first hand information from stakeholders such as the traditional midwives and nurses on the functionality of the current Fetoscope and develop a base for improving it.
The Aalto students are also looking to understand the health system in Kenya so that they are able to define their innovation problem. The field research exercise is set to take two days.
We will be taking you through the journey in our subsequent articles. Stay tuned.
Well well well! The University of Nairobi Innovation Fellowship is on the move and we already have teams formed. One of the teams will be handling a Universal Healthcare issue, one of Kenya’s BIG 4 AGENDA and they will be developing a pinard Fetoscope which would help in their prototyping of an enhanced Fetoscope.
Here are the brains behind the Innovative Fetoscope.
David is a Biologist by profession with a BSc in Biological Sciences from the University of Nairobi. He is experienced in laboratory techniques, bioinformatics methods, and program management having previously worked at Kenya Institute of Bioinformatics, Council of Governors and World Youth Alliance Africa. He is a self-taught web designer, PHP, and Python programmer.
His inspiration for joining the University of Nairobi Innovation Fellowship is the desire to acquire skills that will enable him to convert his ideas to practical applications that will make an impact in the country. His focus is, especially, within the health realm and wishes to contribute towards the attainment of Universal health coverage in the country.
He is strong on the values of modesty and loyalty. David is very passionate about science and loves to read, travel, watching movies/sports, and playing football.
Edwin is a Computer Scientist with three year’s experience in web development. He graduated from the University of Nairobi with a Degree in Computer Science in 2018. He has worked closely with government agencies, development partners and urban sector experts in ecosystem development projects such as Nairobi Innovation Week and Transformative Urban Mobility Initiative.
He is currently a programmer at C4DLab where he is part of a team that develops software/websites for projects such as NIW.Startups , TUMI Accelerator and other related domains. He has deep interest in technology and design and their potential to offer equitable and sustainable living for the youth.
Jephter is a graduate in remote sensing and GIS from the University of Nairobi with second class honors (upper division) and currently finished his master’s in the same field. Jephter has strong technical experience and education in Big data and space science. He possesses strong skills in GIS programming, big data mining, data analysis and strong customer service to his clients. He has a full understanding of the full life cycle of remote sensing. He also has experience in learning and excelling at new technologies as needed. He is a resourceful investigator, a creative problem solver and a strong motivator. He likes to research new trends, analyzing information, and discovering new inspirations.
Kevin Gat has a Bachelor’s degree of Science Biology from the University of Nairobi with a passion for research and development (R&D).Gat has worked as a librarian at the UON Chiromo library. He is also passionate about matters affecting communities hence his participation in the anti-lead poisoning campaign held at the University of Nairobi in December 2018.
Kevin is an all-rounded individual with equal passion for extra-curricular activities. He has a brown belt in martial arts from Kenya Federation of Karate.
Phelister is a fifth year student at the University of Nairobi undertaking a degree in Electrical and Electronic Engineering. She always purposes to achieve her full potential and perform with honesty and integrity in all her endeavors. She has previously served as the Academic Secretary Engineering Students Association in University of Nairobi 2017/2018. She was the chairperson during the first Engineering Students conference held in Kenya. She currently serves as a mentorship team member in Womeng Kenya. She has previously won awards such as the first prize student energy challenge, 2018. She was the team leader of a team that represented University of Nairobi in Unilever Idea Trophy Kenya 2016 finals. She is a competitive person who believes in working as a team for the best results and she is always at the fore front trying to push many boundaries so as to learn more, meet new people and try out new experiences.