Newborn health in rural Nepal benefits from portable ultrasound donation

Sonosite’s portable ultrasound donation is providing life-saving health care to pregnant women and newborns in rural Nepal. Leading this project is Dr. Joanne Katz, Professor and Associate Chair of the Department of International Health at the Johns Hopkins Bloomberg School of Public Health. From over 200 project proposals received, Dr. Katz was selected as one of two prize recipients for the 2014 Data for Life initiative which focused on funding interventions aimed at reducing child mortality and scientifically evaluating the impact of their work in saving lives. During a project status call with Dr. Joanne Katz, she enthusiastically shared the story of a Sonosite portable ultrasound donation for her current work in Nepal. Along with Dr. Katz, we at the CappSci Children’s Prize would like to show our gratitude for your generous donation, it supports the advancement of scientific research and maternal and child health. Thank you, Sonosite!

Auxiliary Nurse Midwife conducting an ultrasound exam during a home visit. Sarlahi, Nepal.

 

Dr. Katz and her team are looking at the use of portable ultrasound for expecting mothers in rural Nepal where home births are very common. There are a number of risk factors that appear during the third trimester which can be detected with the help of portable ultrasound machines, allowing women to seek appropriate care and prepare for medical facility-based deliveries. Risk factors such as non-cephalic presentation (e.g. breech births) or multiple births (e.g. twins) require very skilled health workers and also the option of a cesarean section if labor does not progress properly. Trained entry-level auxiliary nurse midwives will use portable ultrasounds to uncover common risk factors during home visits. The goal of the project is to examine the sensitivity and specificity with which the auxiliary nurse midwives are able to detect conditions that may lead to delivery complications as well as compare the early neonatal mortality and stillbirth rates between those who received an ultrasound exam through the study and a separate comparable group.

Auxiliary Nurse Midwives (ANMs) conduct exam and make home visits in pairs. Sarlahi, Nepal.

 

In her own words, Dr. Katz shared the following account on the Sonosite portable ultrasound donation:

Sonosite SoundCaring and Global Health Humanitarian Programs allowed the Nepal Nutrition Intervention Project Sarlahi (NNIPS) in collaboration with Tribhuvan University Institute of Medicine and Johns Hopkins Bloomberg School of Public Health and School of Medicine, to apply for a refurbished portable ultrasound system. This equipment has allowed us to bring ultrasound examinations to rural women in their third trimester of pregnancy to screen for non-cephalic presentation, multiple gestation and placenta previa. Many women in this area of Nepal deliver at home, but even for those who do go to a facility, such facilities may not be able to provide the necessary care for safe delivery for women with these conditions. With support from the CappSci Children’s Prize and a donation of a portable ultrasound system from Sonosite’s SoundCaring program, home ultrasound examinations are being provided to rural women in Sarlahi from Auxiliary Nurse Midwives trained to identify these conditions using the Nanomaxx product from Sonosite. Women with non-cephalic presentation, multiple gestation and placenta previa are told about these conditions and encouraged to seek antenatal care and to present for delivery to a special Emergency Obstetric Care Facility where the providers are best equipped to manage these more complex deliveries.

Sonosite Nanomaxx product in its carrying case.

 

Given the difficult environment in which we operate (extreme heat, dust, humidity, variable electricity and transport of equipment on the back of a motorcycle over rough roads), the equipment has failed us on several occasions. With only one system, home visits have ground to a halt while we hand carry the equipment back to the US for repair or replacement. Sonosite has been incredibly generous in repairing or replacing the equipment each time, but the need for a second piece of equipment became apparent if we wanted to continuously provide service while non-functioning equipment is being repaired. We at Johns Hopkins Schools of Public Health and Medicine wrote to Sonosite to request a donation of a second machine. They have most generously agreed to provide us a second ultrasound system, also the Nanomaxx, to allow us to provide uninterrupted home examinations. The program continues and has examined 480 women through June 24, 2015.