Part 2: Addressing Neonatal Deaths in Bangladesh

The GEMS Bangladesh Team conducted a landscape analysis of neonatal deaths to discern the gaps a monitoring device could address.

The first step for the four biomedical engineers on the team was to survey the Bangladeshi health system. The team interviewed Bangladeshi health workers and visited the field in the rural areas of Mymensingh and the packed urban communities and slums of Dhaka. Prior to arrival, the team identified the need for a neonatal monitoring device that would enable overburdened community health workers to monitor a variety of vital signs more efficiently and accurately in home-visits and hospital contexts.

Their primary object during this trip was to gather as much information from stakeholders in order to validate the team’s ideas. Over the coming months, the team will consider the multiple perspectives raised by various stakeholders. Looking forward, the team will design multiple devices. As one team member, Chanya Elakkad, articulated,

before we were thinking we really need a prototype. And I think more and more we’re starting to realize we need prototypes.

Consulting many different collaborators proved crucial as they brought light to systemic nuances, cultural factors and perspectives that even the multidisciplinary team may not have caught. The team gained insight into the culture and applied those observations to the health care context. One GEMS student, Joseph Pia explained how the biggest insight for him was

seeing the power of the community in this health care domain and realizing if you’re in tertiary care center or out in the rural settings, having that family and community supporting these advances in medicine is very vital to the success of new projects and new devices, and just change.

Many nuances and details arose as the team asked questions to discern what would be the best incarnation of a device for these settings, populations, and stakeholders. At times the team stepped outside of their multidisciplinary skills in engineering, informatics and data analysis. For example, the team delved into the business and financial aspects in order to consider the sustainability of the project and device. Ms. Elakkad explained, in Bangladesh

NGOs primarily offer free services and beneficiaries are used to that relationship and so that if you’re going to create a device there’s a sustainability issue that comes with the device because it costs money, it costs a lot more than the systems that are currently in place.

The team recognizes this as a challenge moving forward with their designs.

With the ultimate goal of prototyping multiple devices during a return visit, the team expressed a collective need to “digest” the mass of information and feedback collected. One team member, Victor San Hou Yu described where they are in the project and the road ahead,

we get to do a lot of solution landscaping and find out what solutions we can possibly implement and use to make the device itself and create a prototype that we can potentially do iterative usability testing and when we come back to the field, and that itself is really exciting.

- Emily Combs

People

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program

Robert Bollinger Jr., MD MPH

Director, Johns Hopkins Center for Clinical Global Health Education (CCGHE); Associate Director, Johns Hopkins Center for Global...

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases

Caitlin Kennedy, PhD MPH,BA

Co-Director, MPH concentration in Social and Behavioral Sciences in Public Health; Associate Director, Center for Qualitative...

Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation
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November 2019

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