INFORM

Over 66% of newborn deaths happen during the first week of life due to the fragile immune system of the neonates that results in the rapid development of fatal conditions. In lower income countries, the majority of the population receives their primary health care by trained community health care workers (CHWs). The majority of births in the developing world occur at home, so the CHWs are critical to providing clinical assessments and referrals to healthcare facilities. Despite proven success of this intervention, the limited number of trained CHWs and frequency of visits creates a bottleneck for care. Because of this, the timing of proper assessment aligning with the onset of symptoms is happenstance. One caregiver that is not limited in their ability to monitor the neonate is the mother. We identified theunmet need to design interventions to improve maternal recognition of neonatal illness at home and prompt care seeking behavior.

A task shifting of neonatal assessment and recognition of danger signs to mothers is a promising strategy to improve early identification of neonatal illness. To accomplish this our team has developed INFORM (INfant monitoring FOR Mothers), a system that provides reliable and consistent monitoring of infants for identification of danger signs of severe illness during the critical first week of life to facilitate early referral of sick neonates. INFORM consists of two parts – an Interactive Voice Response (IVR) based mHealth platform and a low cost reusable wearable device. CHWs can enroll mothers into this system and provide them with the wearable device close. Once the mother or a family member notifies the system that she has given birth through a simple SMS or call, INFORM’s mHealth platform places a voice call to the mother or family of a newborn infant every day during the critical first seven days of life, starting a “virtual CHW visit”. The system will walk a mother through a clinical assessment of her baby and the wearable device will provide accurate measurements of the critical vital signs, temperature and breathing rate. Using this system, mothers will finally be empowered to identify severe neonatal illness effectively and in a timely manner.