Programmatically Feasible Gestational Age Assessment of Newborns in Low- and Middle-Income Countries (LMICs)

Approximately 36% of neonatal deaths are due to preterm birth complications. An accurate assessment of gestational age (GA) is critical to identify preterm birth and provide adequate care. However, in many low- and middle-income countries (LMICs), gestational age dating is often inaccurate or unknown, leaving the estimation of the GA to after the baby is born. In this study, we developed programmatically feasible approaches to estimate newborn gestational age (GA) in low-resource settings.

Technology for Retinopathy of Prematurity (ROP) Screening in Resource-Limited Settings: Development of a Target Product Profile (TPP) 

The number of preterm infants who survive is increasing, as are the complications of preterm birth, including retinopathy of prematurity (ROP), a potentially blinding condition. Rates of ROP and blindness from ROP are disproportionately higher in low- and middle-income countries (LMICs), where exposure to modifiable risk factors can be higher and where services for ROP screening and treatment are under-resourced or nonexistent.

Validity of Using a Low-Tech, Handheld Icterometer to Screen for Potential Neonatal Jaundice 

Neonatal jaundice (NNJ) remains a leading cause of newborn mortality in much of sub-Saharan Africa. NNJ is difficult to recognize without special, hospital-based equipment, particularly in dark-skinned infants. Previous work in developing handheld, low-tech icterometers to assess jaundice has focused mostly on light-skinned infants or the tool's diagnostic capability - whether it assesses the exact level of hyperbilirubinemia. We sought to examine the validity of using a handheld icterometer in dark-skinned infants as a screening tool, that is, whether it is accurate in determining which children need further assessment.

Clinical Evaluation of a Novel, Low-Cost Continuous Respiratory Rate and Apnea Monitor for Newborns 

Preterm birth interrupts physiological development, leaving newborns vulnerable to complications that require respiratory rate (RR) monitoring. Complications include respiratory distress syndrome (RDS), a leading cause of death in preterm newborns, and apnea of prematurity, which affects 50% of preterm newborns and can indicate conditions such as sepsis, hypoglycemia, or anemia. When patient monitors (PMs) are unavailable, the World Health Organization (WHO) recommends counting breaths for 60 seconds to measure neonatal RR. In low-resource settings, patient monitors are often prohibitively expensive, and counting can be impractical due to high nurse-to-patient ratios. Rice360 developed a low-cost, continuous RR/apnea sensor to accurately monitor RR in low-resource settings. The device detects breathing motion through two inertial measurement unit (IMU) sensors attached opposite the centerline of an abdominal belt. This study clinically evaluates the device against reference visual counting and compares performance to existing PM technology.