innovation and integration dr eric silfen

Dr Eric SilfenChief Medical Officer, Philips Healthcare

Innovation and Integration:

How mHealth can strengthen the work of community healthworkers through public/private partnerships

Fabric of Africa

Maternal and child health• Complications of pregnancy and childbirth contribute to 358,000

maternal deaths annually of which 99% occur in resource-poor countries; mostly in Sub-Saharan Africa

• Two million cases of obstetrical fistula occur worldwide with 50,000 – 100,000 new cases each year; mostly in Sub-Saharan Africa and Southeast Asia

• In Africa, newborn mortality is high accounting for 29% of neonatal deaths globally

• In developing countries, approximately 30 million newborns per year are affected with intrauterine growth restriction; mostly in Sub-Saharan Africa and Southeast Asia

Addressing clinical challenges

• Education and training of community health workers• Education of women and their husbands• Availability of suitable equipment and technologies along with

supporting healthcare infrastructure• Improve transportation to appropriate healthcare facilities• Improve nutritional status and environmental conditions for

newborn babies• Enable rural community outreach and partnerships

Our goal

To strengthen, in a sustainable manner, maternal and child care, regardless of geographic boundaries, in the communities of Africa

Our programs

Implementing sustainable health systems at the community level

Imaging the World

OneByOne (Fightfistula)

InterGrowth 21st

The mHealth value propositionEasy to use, low cost ultrasound integrated with telecommunications allows community health workers to improve health outcomes

Changing the social dynamics of communities

The mHealth value propositionUltrasound technology can identify women at high risk of experiencing obstructed labor and developing fistula, thus creating a powerful prevention opportunity

A low cost, high-quality, obstetrical ultrasound device accurately measures the obstetrical conjugate determining if a woman is at high risk for developing birth trauma

Clinical studies• A strong association between

obstetric fistula and the size of the obstetric conjugate as measured by ultrasound

• Women with obstetric fistula are significantly more likely to have a small obstetric conjugate when compared with women who had normal deliveries

Demographic studies

• 1,480 rural educational activities• Over 120,000 people reached in

17 counties• 450 fistula patients found and

counting• 350 fistula patients repaired and

counting• 160 women in 5 support groups

• Develop new "prescriptive" standards describing normal fetal growth, preterm growth and newborn nutritional status in eight geographically diverse populations and relate these standards to neonatal health risk

• Develop scientifically robust clinical tools to assess fetal growth and the nutritional status of newborn infants, as adjuncts to the WHO growth charts for children ages 0 to 5

• Incorporate these tools into national and international maternal and neonatal programs to monitor infant health and nutrition at a population level

The mHealth value propositionThe accurate use of anthropomorphic and ultrasound measurements can accurately evaluate fetal growth to ensure optimal nutritional status and overall health

Ongoing development

Building community health worker capacity via • mHealth• Telemedicine• Changes in social dynamics

Contact details

Dr Eric SilfenPhilips Healthcarewww.philips.com/healthcareChief Medical OfficerEric.Silfen@philips.com

Imaging The Worldhttp://imagingtheworld.org/Kristen K DeStigter, MDCo-founderKristen.DeStigter@vtmednet.org

OneByOne (Fightfistula)http://www.fightfistula.org/Heidi Breeze-HarrisCo-Founder & Executive Directorheidi@fightfistula.org

InterGrowth 21sthttp://www.intergrowth21.org.uk/Prof Stephen KennedyProject Directorstephen.kennedy@obs-gyn.ox.ac