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Compendium of innovative health technologies for low

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1. Product specifications Dimensions mm 300 x 250 x 70 Retail Price USD 2400 Weight kg 2 2 includes notebook probe speakers List price USD 1100 charger and thermal printer Other features Software use telemedicine capability Consumables Transmission gel thermal printer paper mobile capital equipment Life time 10 years Year of commercialization Anticipated 2014 Shelf life 1 year Contact details Rita van Rooyen Email rhoescheler hotmail com Telephone 27 12 841 3512 Web http bit ly byc92Z http www who int medical_devices Other technologies 7018 Other technologies Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Postpartum uterus trainer Country of origin Norway Health problem addressed 77 gt There is a large unmet need for family planning and postpartum uterus care 95 000 maternal deaths can be prevented annually if women who desired to postpone or avoid childbearing had used effective family planning The intrauterine device IUD is an effective safe and reversible long acting family planning method and can be safely inserted immediately after delivery of the placenta
2. Product description The product is a mattress with an opening to accommodate the pressure relief seat cushion of the patient s wheelchair Product functionality By having the space to accommodate the pressure relief seat cushion in the mattress the pressure is relieved at the usual pressure points such as in the tailbone and hip bones while in the supine position The wheelchair seat cushion is placed in the hole of the mattress to make a full mattress The whole matress is covered with water resistant fabrics Developer s claims of products benefits This modified pressure relieving mattress prevents development of pressure sores in the supine position It saves on unnecessary health care expenditures to heal manage the pressure sores It also helps to reduce the time needed for full rehabilitation It can be made locally with easily available and accessible resources such as an ordinary foam mattress It is affordable and water resistant Development stage The product has been used in a rehabilitation centre for people with spinal cord injuries This product has been approved by the multidisciplinary team of the specialized Spinal Cord Injury Unit of the largest paraplegic centre of Bangladesh Use and maintenance User Self use family member care giver Training Not required Maintenance Not required Environment of use Settings Rural urban ambulatory at home primary health post health center s
3. gt 15 Maternal health Tanzania F i z Si mHealth platform for community health workers 53 Newborn simulator for resuscitation training 103 Non invasive hypothermia indicator for newborns 3 7O Non pneumatic anti shock garment 91 Oral syringe dosing clip P i P a 73 Oxygen concentrator driven bubble CPAP 36 Oxytocin in prefilled auto disable injection system 92 Phototherapy for neonatal jaundice treatment P 94 Postpartum uterus trainer 40 Registre electronique de consultation REC 58 Reusable neonatal suction device 98 Transcutaneous bilirubin measurement system for infants 100 Umbilical artery doppler analyser i i 4 38 Surgery Intramedullary nail and interlocking screw system 67 Low pressure anaesthesia machine 182 Portable anaesthesia machine gt 75 m oOo Si N n o0 p oO n S ps fe n oO T z n Q o0 Ke e LE U g Je Q oO Je v gt D a gt e Ee 0 z TD f Q GL ie Introduction One of the cornerstones of the Universal Health Coverage UHC initiative is access to essential medicines and health technologies Medical devices assistive devices and eHealth solutions ar
4. Requirements Clean though nonsterile setting trained healthcare provider bed biologics disposal box Product specifications Dimensions mm 22 x 60 x 60 Life time 5 years Weight kg 0 011 Shelf life 2 years Consumables Gauze pads scissors spatula forceps List price USD 15 20 dressing betadine anesthetic cream Other features Portable Contact details Tzameret Fuerst Email non surgicalmc gmail com Telephone 972 77 693 5607 Fax 972 37 621 196 http wwwwho int medical_ devices 72 Medical devices Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Oral syringe dosing clip Country of origin United States of America Health problem addressed 3 Studies show that 40 60 of parents make errors when giving children liquid medication Misdosing medication can have serious consequences For example with liquid Anti Retroviral Medications ARVs for HIV positive infants and children inaccurate doses can lead to drug resistance which can be fatal Tong des Product description The oral syringe dosing clip is a small plastic clip that fits into the barrel of an oral syringe and acts as a stopping me
5. Solution description Web platform open source iPath secure server Server allows to upload and download clinical data and images perform discussions upload additional information as evidence base for recommendations send receive e mail alerts Scheme E mail SMS referral doctor prepares anonymous clinical data sends it via e mail to the expert hospital and sends SMS as alert about urgent request Doctor on duty after receiving SMS opens e mail and reads the case sends answer immediately via e mail Perform discussion upload additional information as evidence base for recommendations send receive e mail alerts Functionality Telemedicine service is provided by both synchronous and asynchronous telemedicine methods Patient confidentiality and security achieved by patient s consent secure server VPN lines anonymity sending data in DICOM or SCP ECG Developer s claims of solution benefits Cost effective and available based on existing IT infrastructure easy to introduce and use clinically effective do not need technicians or long preparation Future work and challenges Integration of digital signature tools Development of tele assistance based on low cost devices for transmission of video from arthroscopy and ultrasound devices Randomised trials for evaluation User and environment User physician nurse Training training is required on basic computer skills medical data preparation skills
6. Product description The product represents an anatomically correct postpartum uterus from 10 minutes up to 48 hours after the delivery of the placenta enabling the teaching and practice of the insertion of the postpartum IUD and balloon condom tamponade among other practices such as cervical and vaginal inspection _ gauze packing bimanual compression and removal of placental parts Due to its size and simplicity the instructor can actively interact with the learners and observers during hands on practices obtaining instant feedback from the uterine cavity and the vagino uterine angle It works as a stand alone product and also in combination with a birthing simulator d Developer s claims of products benefits Current models of IUD placement trainers are expensive heavy require additional accessories and are not durable enough Their vague anatomical features causes misinterpretations and malpractice such as too low IUD placements resulting in increased expulsion rates Their high cost prevents large scale implementation as well as high frequency low dosage training There are no other solutions in the market that can provide high fidelity training in various postpartum uterine interventions Suitability for low resource settings The product was developed to facilitate efficient training in low resource settings for important lifesaving postpartum interventions The simplicity and durability al
7. Deployment on a large scale would be greatly facilitated by partnership with mobile operators e g corporate social responsibility initiative or volume based pricing Emphasis on the importance of record keeping and the power of data will help highlight the advantages of the platform s various modules working together and motivate adoption e g targeted SMS follow up based on early identification of high risk mothers accreditation of health workers through online training to assess quality of human resources detailed reports to assist management in budget allocation User and environment User physician nurse midwife technician facility or health system administrator Training one week hands on training Settings rural urban ambulatory primary secondary and tertiary Solution specifications Solution is used to support Telemedicine Electronic Standards Format of structured data adheres to the Health Record Electronic Medical Record eLearning Tanzania Ministry of Health maternal health card mLearning mHealth Reporting portable diagnostics D Currently used in Tanzania facility management Software Hardware requirements The server side component of the platform requires specific software running on a secure Internet connected data centre The software is being made available on an international free for use license Customization of data forms for use outside Tanzania may require modest technical deve
8. In sub Saharan Africa its underdiagnosed poorly managed and lacks community wide preventive strategies AJH Solution description The self measured blood pressure SMBP e reader positioned in social points e g posho mills bars will be accessed by community members who want to check their blood pressure The digital SMBP machine will capture one s blood pressure interpret the reading and transmit the reading to Wes J health centers through cloud information services Community members will anonymously take readings however they will provide a phone number which will only be used to follow up readings deemed at risk Community members can check their readings as many times as they wish within the period of the project This is an opportunity for those unaware they have high blood pressure to know and seek treatment Functionality Using a provided step by step guide the user will measure blood pressure the machine will automatically interpret the results digitally and verbally to the user in the local language and automatically wirelessly transmit the blood pressure reading with the phone number as the only identifying information Developer s claims of solution benefits Self administered ease of use a step by step guide and use of the local language reduces training requirements It is cost effective in high blood pressure management by capturing asymptomatic and pre event at risk users It is population
9. Life time 3 5 years Currently sold in Mexico but projects can be established Retail Price USD 45 in new countries Contact details Fermin Reygadas Kara Nelson Email reygadas gmail com Telephone 1 510 898 8306 1 510 643 5023 Fax 1 510 642 7483 http wwwwhe int medical_devices 104 Other technologies Compendium of innovative health technologies for low resource settings 2011 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Water filter Country of origin United States of America Health problem addressed Infectious diseases caused by pathogenic bacteria viruses protozoa and helminthes are the most common and widespread health risk associated with drinking water WHO 2004 In Ghana where the ceramic pot filter is made 50 of people lack access to improved water supply Ghana has the 4th lowest worldwide rate of sanitation coverage Product description The filter unit consists of a fired clay pot filter element a plastic bucket storage unit a ring lid to support the ceramic pot a tap and a cover lid These filters are made from red clay and wood saw dust or rice husk which gets mixed pressed in mold and fired in a kiln Product functionality Particles
10. Training remote training is provided The service team is accessible online through a live chat feature Settings rural urban home ambulatory primary secondary tertiary Reviewers comments This proposed iCloud Web PACS having been tried by several countries can conceivably be built up over time to facilitate more exchanges The affordability of this technology in underserved communities depends largely on the company s case use fees This is an important consideration for prospective countries when considering this system Crossing jurisdictional governance between countries could hamper some privacy and confidentiality issues Solution specifications Solution is used to support Telemedicine Electronic Currently used in Technology is used globally The Health Record Electronic Medical Record RIS Radiology service has been originated in the USA The current Information Systems focus is throughout the Caribbean and Central South Software Hardware requirements Access to the Internet American markets is required with a recommended minimum bandwidth of 512K Medical images are uploaded and viewed over personal PC or PDA s Medical images need to be in the DICOM format Standards HL7 DICOM HIPAA The Health Insurance Portability and Accountability Act Contact details Mel Ferguson Email medical cloud yahoo com Telephone 1 817 400 6403 Fax 1 866 891 2953 http www who int ehealth 52 Compendium o
11. fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Pen mounted CCTV camera Country of origin India Health problem addressed Persons with very low vision due to age related macular degeneracy or advanced glaucoma have difficulty in reading their own writing due to the small size of the written font Product description The closed circuit television CCTV camera is mounted on a pen and connected to a computer monitor which shows the camera picture written font magnified to the extent necessary on the screen Product functionality A person can see on the screen what he or she writes on paper with the camera equipped pen The magnification of the font size is adjustable using a switch on the system Developer s claims of products benefits This camera enables persons with very low vision to see what they write Local production is possible with easily available accessible low cost CCTV cameras Development stage The product has been tested by patients at one of the largest eye hospitals in India Future work and challenges The idea is simple and made freely available at low cost to anyone who wishes to use it Drawings and production details may be requested from the contact person Use and
12. receiving SMS to patients and clinicians portable ultrasound integration dynamic filter based patient cohorts for targeted follow up scheduling of return visits or patient referrals in a central calendar and recording of orders and payments made during a clinic visit An additional continuing medical education module allows online creation and publication of multimedia courses and informal clinician accreditation Functionality 1 User registers mother at clinic 2 User submits outcome of clinical examination and schedules follow up visit 3 Specialist conducts portable ultrasound examination and saves image to the mother s record 4 Upon referral user at another facility accesses mother s full record 5 Mother receives targeted educational and reminder SMS Developer s claims of solution benefits Validate data instantly and track user performance to identify areas of weakness for retraining Enable community based care outside of clinic setting using networked computers Retain a full record of mother s information in health system Generate system wide clinical and operational reports without tedious data collection aggregation Enable portable obstetric ultrasound screenings better diagnosis early intervention Browser based platform overcomes limitations of phone based platforms Future work and challenges A large portion of active deployment costs come from the Internet usage and SMS costs for follow up with patients
13. Assistive devices 2012 Assistive devices Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Solar charger for hearing aid Country of origin Botswana amp Brazil Health problem addressed a 7 of the world s population is hearing impaired That is a total of 312 million people of whom two thirds are living in developing countries The extent of hearing loss leads to unnecessary poverty and hardship in the families and communities affected and by extension to the larger society It also costs governments up to 3 of their GNP Product description Rechargeable hearing aid solar charger and rechargeable hearing aid battery Product functionality This device has a rechargeable hearing aid battery which costs 1 and lasts h 2 3 years To charge the battery a novel but not patented solar powered battery recharger was developed which can be recharged via the sun household light or plug in using a Nokia cell phone electrical recharger 4 Developer s claims of product benefits This device is the only low cost rechargeable analogue and digital hearing aid on the market Operating steps During the
14. Concept emerged in 1993 Consumables Polypropylene sheets assembly items developed further since then and the development work Life time years 3 on prosthetic foot knee and hip is still ongoing Shelf life years Feet 18 months Remaining components Currently sold in 72 low middle and high income between 3 5 years depending on storage quality countries Retail price USD Trans tibial 150 trans femoral 275 List price USD Trans tibial 150 trans femoral 275 Contact details Olivier Chappuis Email ochappuis gmail com Telephone 41 22 354 8181 Web http bitly abyLnm http wwwwho int disabilities technology 8 Assistive devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Prefabricated components for lower limb orthoses Country of origin India Health problem addressed Despite polio eradication drives 0 5 of the those affected by polio or other neuromuscular conditions in India and low income countries require some kind of orthoses Among this population 75 live in rural areas with the majority unable to access an orthoses due to its cost and inappropriateness for the rural environment and lifestyle Product
15. Dimensions mm 2045 x 50 23 x 59 4 Weight kg 0 346 50 Other features Portable and reusable Runs on batteries and uses software List price of consumables USD approx 360 bag of Consumables Disposable calibration tip per test Life time 5 years Shelf life 20 months Retail Price USD 3500 List price USD 4295 Year of commercialization 2009 first version in 1996 Currently sold in Most of Europe as well as in Australia and several African Asian North and South American countries 65 countries Contact details Jim McKenzie Email susanjones 5 virginmedia com Telephone 1 412 380 8882 Fax 1 412 380 8850 http wwwwho int medical_ devices 100 Medical devices Compendium of innovative health technologies for low resource settings 2011 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Ventilator using continuous positive airway pressure Country of origin Vietnam Health problem addressed 3 Every year hundreds of thousands babies die because of respiratory failure Infant mortality could be reduced by application of CPAP relatively simple therapy addressing 90 of cases Diseases treated pneumonia apnea j hypoxia and respiratory failure main cause of infant
16. Rev Esp Cardiol 57 6 487 94 Yusuf S Hawken S Ounpuu S et al 2004 Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries the INTERHEART Study Case control study Lancet 364 9438 937 52 Allen J amp Murray A 2000a Similarity in bilateral photoplethysmographic peripheral pulse wave characteristics at the ears thumbs and toes Physiological Measurement 21 369 377 Bots ML Carotid intima media thickness as a surrogate marker for cardiovascular disease in intervention studies Curr Med Res Opin 2006 Nov 22 11 2181 90 Bots ML Dijk JM Oren A Grobbee DE Carotid intima media thickness arterial stiffness and risk of cardiovascular disease current evidence J Hypertens 2002 Dec 20 12 2317 25 Allen J Photoplethysmography and its application in clinical physiological measurement Physiol Meas 2007 28 R1 Zahedi E Chellappan K Mohd Ali M A amp Singh H Analysis of the Effect of Ageing on Rising Edge Characteristics of the Photoplethysmogram using a Modified Windkessel Model Cardiovascular Engineering 2007 7 4 172 181 Auvert B Taljaard D Lagarde E Sobngwi Tambekou J Sitta R Puren A Randomized controlled intervention trial of male circumcision for reduction of HIV infection risk the ANRS 1265 Trial PLoS Med 2005 Nov 2 11 e298 Erratum in PLoS Med 2006 May 3 5 e298 Bailey RC Moses S Parker CB et al Male circumcision for HIV prevention in
17. Settings Rural urban settings primary health post health center secondary general hospital tertiary specialized hospital Requirements Continuous power supply 100 240V Can withstand some fluctuations in voltage and occassional spikes but stable power supply is strongly recommended General cleaning supplies to disinfect after every infant are needed Product specifications Dimensions mm 1120 x 655 x 1800 minimum height List price USD 3500 can be ordered at different settings from factory Other features Software use mobile capital equipment Weight kg 72 Year of commercialization 2009 Consumables Reflector patches to cover the sensor are Currently sold in 115 countries Emerging market countries recommended in order to provide an accurate reading include Albania Algeria Brazil Bulgaria Cambodia Chile Life time 7 years Domnican Republic Egypt Gabon India Indonesia Iraq Shelf life 2 years 6 months without any operation Jordan Kazakhstan Kenya Lebanon Macedonia Nigeria Retail Price USD 3000 with considerable variation Palestinian Territory Philippines Syria South Africa between countries Vietnam Contact details Ashish Gupta Email lowresourcesetting gmail com Telephone 91 80 408 85941 Web OISE http www who int medical_devices Medical devices Inclusion in the compendium does not constitute a warranty of the Compendium of innovative health technologies for low resou
18. Trained clinical technical personnel to assemble the wheelchair Product specifications Dimensions mm 800 x 400 x 740 List price USD 95 Weight kg 11 with tubeless wheels 9 5 with pneumatic Other features Continuous use mobile tube Year of commercialization Anticipated 2014 Consumables Cushion accessories Life time years 3 Retail price USD 95 Contact details Chava Rothstein Email chava rothstein gmail com Telephone 972 52 428 8437 Web http bit ly I 7Vo7RW http wwwwho int disabilities technology Assistive devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Hollow mattress Country of origin Bangladesh Health problem addressed People with spinal cord injuries often develop pressure sores due to prolonged sitting or lying without changing position Sitting or lying on hard surfaces makes the situation worse Many people while sitting in a wheelchair use a pressure relief cushion but do not have the capacity to afford a pressure relief mattress As a result they often develop pressure sores which are difficult to manage and expensive to treat especially in low and middle income countries
19. and orders This is analyzed to infer indicators e g monthly consumption lead times and order fill rates Appropriate actors are notified of impending stockouts reorder quantities deliveries etc Developer s claims of solution benefits The proposed system provides real time reliable and accurate information directly to those with decision making capabilities It streamlines logistics systems with targeted actionable information to supervisors and managers it improves quality of reliable real time stock information to decision makers at all levels it facilitates detection resolution and prevention of stock outs and it reduces lead times through improved supervision of requisition and delivery and identification of bottlenecks Future work and challenges In the future partnerships with local telecom companies will be sought in order to bring SMS costs down Improvements to the system will also be made with inclusion of advanced stock level forecasting and optimal reorder point calculation As more and more deployments launch the body of open source technology behind the system will continue to grow allowing each individual deployment to benefit User and environment User Nurse midwife technician pharmacy worker supply officer laboratory staff immunization teams Training Training sessions of 1 2 days are provided by implementers programs and the Ministry of Health Settings Rural urban ambulatory primary heal
20. bacteria guinea worm cyclops and protozoa are removed by physical straining and also by the mechanisms of sedimentation adsorption diffusion inertia and turbulence The filter element is treated with colloidal silver which may act as a bactericide and viricide Developers claims of product benefits The ceramic pot filter made of terracotta clay can be produced in most countries around the world because of the simple component parts and the universality of clay and combustible material inputs Moreover there is the potential to create local self sustaining businesses from this endeavor Operating steps 1 Settle turbid water in a storage vessel before filling the ceramic pot 2 Keep the ceramic pot filled to the top This will improve filtration rate 3 Clean filter with brush provided when flow rate becomes too slow 4 Clean storage unit with soap and filtered water if necessary Disinfect with chlorine bleach iodine or boiling water Development stage The product is being manufactured in gt 20 countries In Ghana in 2007 it has been approved by UNICEF and the government for emergency distribution during a flood emergency In 2008 it was approved for emergency distribution during a guinea worm outbreak The product is being locally manufactured and sold in the region with the highest rates of diarrhea in Ghana The technology has become known through efforts of several international aid organizations and the work of several r
21. from the initial appointment uploading of data and fundus images to reading reporting follow up and automated recall scheduling Access to full history It further sets itself apart by the comprehensiveness of its flow management health result analysis and reading tools and its automated medical quality control It allows e consultation Can be used in situations with without immediate access to the Internet Future work and challenges Ways to promote global adoption and integration and to motivate people to increase the use of teleophthalmology for DR need to be found as it is a proven strategy to improve the quality of health care and collaboration among professionals worldwide The biggest obstacle is not that of attitude or that of access to the equipment but that of the will and of carrying out its organization to provide systematic screening for diabetic retinopathy to all diabetics User and environment User physician nurse technician Training intuitive solution with instructions for every step are provided no training needed Settings rural urban primary secondary and tertiary Reviewers comments Well organized integrated system for managing tele consultations for ophthalmology mostly for the screening of diabetic retinopathy which is also becoming a significant issue in developing countries The innovation lies mostly in the comprehensive integration of the whole process and includes quality control Th
22. in the program to ensure that infants receive the proper dose of liquid anti retroviral medication Future work and challenges The clip has been licensed and is available globally for purchase A preferred pricing structure for Global Alliance for Vaccines and Immunisation GAVI countries has been established Challenges ahead include identifying new non governmental governmental and corporate partners to scale up dissemination of the clip User and environment User Self use patient family member Training Healthcare provider can demonstrate clips and syringe to user in less than 2 minutes Maintenance None Environment of use Settings Rural urban ambulatory at home Requirements None Product specifications Dimensions mm 53 x 14 x 3 Retail Price USD 0 10 0 25 Weight kg 0 001 List price USD 0 10 0 25 Consumables None Other features Portable and reusable Life time 1 year Year of commercialization 2011 Shelf life 2 years Currently sold in Swaziland Contact details Robert Miros Email robertmiros gmail com Telephone 1 415 454 3005 Fax 1 415 329 1892 http wwwwho int medical_ devices Medical devices Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endors
23. nurse midwife technician community health worker Training optional training will be provided by qualified local distributors Settings rural urban ambulatory primary and secondary Reviewers comments The innovation of the project is mostly related to the hardware smart reader for rapid diagnostic tests However its information components are very well integrated into a coherent set of tools which represents the state of the art Solution specifications fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Solution is used to support Decision Support Systems mHealth Geographic Information System Health Research Software Hardware requirements Smartreader at POC minimally trained health worker Data transmission from POC to cloud any local cell network Cloud information services health program manager with standard web browser on any computer Smartreader functions for 4 days on internal battery rechargeable by electric outlet solar panel handcrank The software is proprietary and is charged on a pay per use basis The system hosts third party mHealth applications Standards Upcoming releases will support HL7 and HIPAA Currently used in Colombia Ecuador Kenya Tanzania Ghana Evalua
24. 100 health workers in four batches over six months The technical health messages in the content were approved by the Government of Bihar and developed with input from a range of medical experts and institutions in line with WHO guidelines Contact details Allen Aoife Email aoifeallen gmail com Telephone 44 78 277 86612 http www who int ehealth 15 Compendium of innovative health eHealth technologies for low resource settings 2013 Mobile supply chain management tool Country of origin United States of America Health problem addressed Stockouts and other supply chain disruptions pose real challenges in low resource communities According to a WHO report the problem is in getting staff medicines vaccines and information on time reliably and in sufficient sustained and affordable quantities to those who need them Solution description The solution is an open source turnkey product designed to strengthen logistics management through the use of mobile technology Its purpose is to support health workers and other mobile agents who manage commodities in low resource settings It has been proven at scale through real world deployments to provide reliable real time and actionable information to improve the performance of new and existing supply chains Functionality Users report stock through SMS an app running on Java Androids or tablets or the web They report data such as stock levels receipts
25. 76 of the medical facilities are concentrated in the urban areas and there is an overall shortage of medical personnel Product description The technology comprises of a USB powered multiparameter diagnostic device which captures ECG temperature heart amp lung sounds SPO2 and BP and communicates with the remote doctor through a low bandwidth audio video data conferencing Product functionality The technology enables rural patients to reach urban doctors through a telemedicine solution that integrates the whole healthcare delivery ecosystem to provide meaningful services The solution also captures the workflow of delivery processes and enables resource optimization by capturing and analysing operational data in service delivery Developers claims of product benefits Infrastructure bandwidth and skillset limits the reach of technological solutions This solution works at extremely low bandwidths 32 kilobits s onwards for real time audio video data tele consultation thereby reaching places where other existing solutions can t reach It is very easy to use by a village operator and is extremely power efficient works on USB power Further it is a comprehensive solution linking multiple providers doctors pharmacies labs hospitals and addresses 75 of healthcare needs at the point of care at sub USD 1 0 fees Operating steps A rural operator carries out remote consultation for the patient at the village with a doctor sit
26. Benin patient information Telemedicine in Jan 2010 In total 434 people had taken part in the project in the 3 test areas The tests took 2 weeks simultaneously in all areas More than 95 per cent were women The participants were satisfied with the experience The results also demonstrated that the system is easy to use by those with limited reading and writing skills Currently used in Benin Software Hardware requirements Internet access Mainly open source solutions will be implemented and no licence fees Mobile device uses USSD SMS or specific SIM menu to interact with the database Additional software to include localisation in the request will be used on smartphones tablets or equivalent The platform uses PostgreSQL MySQL database and Linux OS The system is not proprietary Contact details Thierry Edoh Email oscaredoh gmailcom Telephone 49 17 665 726 944 or 229 9771 9858 http www who int ehealth eHealth Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Health and hospital information system Country of origin Spain Health problem addressed Health centers in resource poor locations have deficiencies in the
27. Contact details Ingrid L rdal Email newbornsimulator gmail com Telephone 47 51 511 855 47 95 145 168 Fax 47 51 523557 http wwwwhe int medieal_eeviees 103 Other technologies Compendium of innovative health technologies for low resource settings 2011 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Point of use water disinfection system Country of origin United States of America Health problem addressed deaths annually In addition an estimated 4 billion cases every year make 7 GI the third highest cause of morbidity globally Unsafe drinking water is recognized as one of the major pathways responsible for the transmission of GI causing pathogens Product description The UV tube is easy to operate and maintain point of use water disinfection system that uses ultraviolet light to inactivate pathogens at a fast flow rate of 5 liters per minute without producing unpleasant or harmful disinfection by products The UV Tube is appropriate for households schools clinics and small communities Product functionality The UV tube uses a 15 watt germicidal lamp to deliver a UV C 254nm dose of 900 J m 2 to inactivate virus protozoa and bacteria suspended in water Developer s
28. Indonesia Tanzania Ghana and Bangladesh These users were competent performing limited obstetric ultrasound in rural and peri urban health centers Operating steps To start the device open the flap and the device will start automatically Select the OB preset and apply gel on the transducer to start scanning Increase or decrease depth with the up and down arrows and auto optimize by pressing and holding the central button Close the device after use and put on the docking station for recharging Regulatory status The device is both FDA approved and CE marked Use and maintenance User Physician technician nurse midwife Training Limited obstetric training is conducted by local trainers usually in the country s capital city Maintenance Limited routine maintenance that can be performed by a nurse physician technician or manufacturer Environment of use Settings Rural urban settings ambulatory at home primary health post health center secondary general hospital tertiary specialized hospital Requirements Some source of power even if intermittent for charging the device Product specifications Dimensions mm 135 x 73 x 28 Other features Software use portable capital equipment Weight kg 0 39 Year of commercialization 2010 Consumables Ultrasound gel cleaning supplies Currently sold in More than 40 countries Life time 7 years Retail Price USD 7900 USD with considerable variation
29. Kearney and Linda Mundy from the Health Policy Advisory Committee on Technology HPACT Queensland Australia e Setefilla Luengo Matos from the Agencia de Evaluacion de Tecnologias Sanitarias AETS Institute of Health Carlos III Madrid Spain e Orna Tal from the Israeli Center for Emerging Technologies ICET Israel e Roberta Joppi and Chiara Poggiani from the Italian Horizon Scanning Project IHSP e Kristina Routh Biruntha Senthinathan and Sue Simpson from the National Institute for Health Research Horizon Scanning Centre NIHR HSC University of Birmingham United Kingdom e Marianne Klemp and Inger Natvig Norderhaug from the Norwegian Knowledge Centre for the Health Services NOKC Oslo Norway e Dr Johan Borg from Lund University Sweden e Kevin Clausen from the Nova Southeastern University USA e Antoine Geissbuhler from the University Hospital Geneva Switzerland e Kendall Ho from the University of British Columbia Canada e Tove Sorensen from the Norwegian Centre for Telemedicine Norway Special thanks to Heike Hufnagel and Amir Sabet Sarvestani who managed the call for innovative health technologies and the submissions We are additionally grateful to Keiko Fukuta for her support in producing the Compendium and Bel n Valladares Vaquero for her support throughout the project For their financial support of the 2013 edition we thank the Japan Ministry of Health Labour and Welfare the Netherlands Ministry of
30. Requirements USB 1 0 connection to a desktop or laptop computer Windows XP Vista operating system on the desktop or laptop Minimum 32 kilobits s internet speed for real time audio video data tele consultation Fixed static IPs at both ends for professional edition and at server for enterprise edition Product specifications Dimensions mm 225 x 165 x 40 List price USD 1800 Weight kg 0 61 Other features Software use installed stationary reusable Consumables ECG Gel Life time 5 years Year of commercialization 2008 Currently sold in Primarily in India some countries in SHER MSHS years Africa and South East Asia Retail Price USD 1800 Contact details Sameer Subhash Sawarkar Email sameersawarkar gmail com Telephone 91 804 111 0450 Fax N A http wwwwho int medical_ devices Non invasive hypothermia indicator for newborns Country of origin United Kingdom United States of America Health problem addressed The problem of detecting hypothermia exists throughout the disadvantaged world where up to 4 million newborns die within their first 28 days of life from either disease malnutrition or a combination of both Preterm sick a AL BLA 1 and below 320 RED START 6s Medical devices Compendium of innovative health technologies for low resource settings 2012 Inclusion in the compendium does not constitute a warranty of the fitness of any technology for a
31. The principal benefits of the pressure cooker autoclave are convenience and efficacy Pressure cookers can completely sterilize medical instruments whereas boilers cannot Spoken instructions in the local language facilitate use for health post employees enhance staff efficiency reduce training costs and ensure that the sterilization protocol is followed correctly Remote monitoring helps health administrators to measure the impact of the devices and know they are used regularly Suitability for low resource settings The pressure cooker autoclave is intended for use in remote and resource constrained clinics in lower and middle income countries By removing the dependency on electricity and featuring a built in instructor it is suitable for areas without regular electricity and addresses education and training challenges faced by normal autoclaves Operating steps Users select how the medical instruments are packaged wrapped in linen or not on the cycle monitor Verbal instructions then help users complete a successful sterilization cycle At the end of the cycle the monitor notifies users whether sterilization was successful and how to maintain the instruments clean until use Regulatory status Meets CDC standards for sterilization by exposure to high temperature and pressure The manufacturers hold ISO 9001 2008 ISO 13485 2003 QMS certifications and UL certifications CE mark certification is in progress Future work and cha
32. Uploaded to centralized web database Built and deployed database that Provides online data aggregation for analysing and disseminating data in real time Provided quality control system for data including online government approvals of data Enabled access to the data along with operational and quality of care indicators Developer s claims of solution benefits Supervisors have indicated that the system is enabling them to monitor and assess performance of the TB health delivery system identify problems and opportunities and in many cases take immediate action for improvements For example the rate of drug stock outs has significantly decreased and external quality control is easily obtained for quality service with far less delay Future work and challenges Scale up of initial training to Lagos and Abia States to nationwide implementation requires careful needs analysis and planning User and environment User technician clinic supervisor Training some level of training is required and will be provided by Ministry of Health officials Settings rural urban primary Solution specifications Solution is used to support Decision Support Systems mHealth Software Hardware requirements Access to a cellular network access to the Internet to link to the online database Android OS coded with Pendragon proprietary 1 license with open source EpiSurveyor software Currently used in Ethiopia Nigeria Co
33. and filter paper at the local laboratory an ELISA reader Product specifications Dimensions mm Not provided Retail Price USD 5 Weight kg Not provided List price USD 5 Consumables Specific reagents Other features Mobile single use Life time Not provided Year of commercialization 2008 Shelf life Not provided Currently sold in Brazil Guatemala India Spain Contact details Jordi Marti Gasc n Email jmarti dbs screening org Telephone 34 61 831 0633 Web a aa http www who int medical_devices Medical devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Electro hyperthermia Country of origin Germany Health problem addresed 7 In 2008 there were 715 000 new cases 95 in advanced stages and 542 000 deaths from cancer in Africa The available treatments are limited and the increasing incidence of cancer is a huge burden on the struggling economies in Sub Saharan Africa Heating tumours increases chemo radiotherapy efficacy improves survival and lowers healthcare costs Product description A 13 56 MHz low radiofrequency electric field is applied using capacitive coupling between tw
34. and move it across the abdomen to detect umbilical blood flow with good audible signal Record measurement review waveform diagram and plotted indices follow clinical management suggestions Save patient file print result and staple into the maternity case record Regulatory status Two external audits for ISO 13485 are scheduled for November and December 2013 The audit for CE marking is scheduled for February 2014 Future work and challenges Future work and challenges include training device operators in conducting waveform Doppler measurement establishing a medical device management system to support devices in the field developing a reliable remote expert support telemedicine feature for quality assurance and assistance of clinical personnel in the field and pursuing liability insurance system accreditation and tender based procurement by Departments of Health Use and maintenance User Nurse midwife Training Yes Maintenance Daily cleaning removal of any gel from keypad and probe by the nurse Environment of use Settings Rural urban settings primary health post health center secondary general hospital Requirements Access to electricity to charge the battery of the notebook because the probe is powered directly from the computing device via USB connection A lockable treatment or storage room against theft protection during hours when the clinic is closed 3G connection if remote expert support is desired
35. based thus labor saving for health providers by screening only those at risk and provides public health epidemiological surveillance of patterns in populations Future work and challenges Technology will be available in public areas distributed through local entrepreneurs who can use the screen platform to advertise their products thus contributing to local economies and leading to sustainability User and environment User Self use patient Training A point of contact community based worker for a 30 minute training Settings Rural social settings Reviewer s comments Blood pressure self monitoring is a good way for biosensors to help patients in optimal self management Several studies have demonstrated that this approach improves blood pressure simply through self monitoring even without medications This intervention at rural and underserved areas of the countries having the device solar powered and sending the signals to the cloud to monitor is a good approach to capture data Having patients being able to access the results by phone is reasonable although being able to access results through the same computer may be more useful especially in understanding the longitudinal changes Therefore even though this approach is not novel its practical applicability in low resource settings is an advantage Another additional benefit would be using this to track population level data to understand the prevalence and incidence of hype
36. between countries List price USD 12 000 Contact details Gisela Abbam Email lowresourcesetting gmail com Telephone 44 79 208 21780 Web http bitly HnwD5P http www who int medical_devices Medical devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Dry blood spot screening Country of origin Spain and Brazil Health problem addressed Early diagnosis and prevention are widely promoted by national health systems international organizations and NGOs because they have been shown to represent significant savings for health systems and the patients themselves Despite this access to these benefits by the poor is limited due to challenges in getting blood to labs for analysis Product description The test analyzes specific biochemistry parameters uric acid cholesterol triglycerides glucose creatinine in dried blood samples using standard laboratory equipment Blood samples are obtained by a single use lancet or pin prick The system does not require special conditions for storage or transportation and it requires only minimal investment in training the personnel that handle the samples Using the device only re
37. both in Malaysia PI2012700220 and the US 13 865 677 The technical aspects have been approved by the University of Malaya Medical Ethics Committee and the product has been clinically tested by lower limb amputees The findings of a technical evaluation have been published in the Institute for Scientific Information ISI journals A paper on the biomechanical evaluation of the system was awarded with the best research in the field of Advancing technologies in the 14th International Society for Prosthetics and Orthotics ISPO world congress Future work and challenges Future work includes implementation of large scale manufacturing and worldwide distribution Use and maintenance User Self use Training Not required Maintenance On site once a year Environment of use Settings Rural urban ambulatory at home Requirements A trained prosthetist to fit the product into a prosthesis Product specifications Dimensions mm 30 x 30 x 30 Other features Reusable Weight kg 0 25 Year of commercialization Ready to be commercialized Consumables Batteries if used with safety alarm Life time years 5 Retail price USD 500 List price USD 250 Contact details Arezoo Eshraghi Email arezooeshraghi yahoo ca Telephone 60 14 227 5184 Web http bit ly 5zKMwx http www who int disabilities technology 5 Assistive devices Compendium of innovative health technologies for low resource settings 2013
38. claims of product benefits The UV tube was developed by an interdisciplinary team of students and professors who recognize that a wide array of safe water options are urgently needed in order to address the severe and widespread health problems caused by drinking water contaminated with pathogens Through rigorous laboratory and extensive field testing the UV Tube was designed to be an effective easy to use low cost and adaptable point of use safe water solution The dose is more than twice the minimum recommended by the US NSF ANSI Standard 55 providing a safety factor that guarantees its effectiveness even in certain non ideal conditions Operating steps To disinfect water a user has to 1 turn on the switch 2 confirm that the lamp is on 3 open the water valve 4 wait for the safe storage container to fill up 1 minute for each 5 liters 5 close the water valve 6 drain the system 7 turn off the switch No consumables required but every 1 3 years some components need replacement Development stage The product was validated in the laboratory and a prototype tested in 24 households in Mexico in 2005 Positive water quality and user acceptance results led to piloting the technology in 150 households 3 schools and 13 communities between 2007 and 2008 Successful results motivated the development of a scalable model in 2009 In 2010 450 household systems were installed in Mexico as part of a stepped wedge cluster randomized trial I
39. connect via the system and monitor the evolution of their disease remotely Functionality Download APP interface to mobile or computer Enter personal information once height weight etc Enter control blood sugar glucose levels Enter food drink ingested Recommended insulin is calculated Information is synced in real time between diabetic and doctor Alerts are sent to both when a potential problem is flagged Developers claims of solution benefits Existing solutions do not take into account individual differences in people with diabetes The T1D system does and it creates preventive actions before problems occur Other options focus on the now The system focuses on the past present and future TID and T2D costs healthcare systems 471 billion year often in response to complications Our TID system is a call to action for the person with diabetes to self manage their disease and let their doctor be more time and cost effective This can lead to fewer complications so less face time will be needed Future work and challenges The TID system uses metric weights and measures but the United States uses avoirdupois and imperial so there is a potential need to additionally develop to address the US users satisfactorily Future development work includes port to iOS iPhone and an interface with glucometers The TID system puts insulin dosage adjustment and control into the hands of the person with diabetes They become the primary m
40. countries for MDG4 The use of the Simulator was validated in pilot tests in Kenya Tanzania Pakistan and India and is today a fundamental part of several courses in developing countries in basic newborn resuscitation Future work and challenges Financing Although the product is available on not for profit basis individual health care facilities and educational institutions in low and middle income countries often have limited financial resources and may need to obtain funding from governments or international aid organizations Distribution channels Bureaucracy and often prohibitive customs rates render import to countries where the need is greatest difficult User and environment 22222 User Nurse midwife physician course instructors students all other health care personnel needing refresher training Maintenance Any user Environment of use Setting and Requirements The product can be used in any setting there are no specific requirements to the infrastructure Product specifications Dimensions during transport mm 300 x 200 x 70 Other features The simulator is portable und reusable simulator deflated in a kit with accessories Year of commercialization 2009 Dimensions in use mm3 480 x 230 x 120 Currently available in 68 countries identified by UN as Weight during transport kg 0 8 focus countries relative to UN Millennium Development Weight filled kg 2 2 Goal 4 Life time 3 years Retail Price USD 50
41. day a solar panel charges 2 AA rechargeable batteries Once or twice a week one takes out the rechargeable hearing aid battery and puts them in the charger The next morning these batteries are ready to use again One can also charge the batteries using a household light or plug in The batteries fit into 85 of all hearing aids Development stage Countries that receive these rechargeable hearing aids solar charger and rechargeable batteries to do not require FDA or CE approval but all of these component suppliers have FDA CE and are ISO approved Future work and challenges The technology is offered for free to like minded non profit organizations In addition the company helps write the business plans raise money and set up manufacturing operations for others for free User and environment User Self use patient Training None Maintenance Yes 3 5 years change batteries Environment of use Settings Rural urban at home Requirements Sunlight Product specifications Dimensions mm 40 x 20 x 15 Retail Price USD 48 Weight kg 0 3 List price USD 24 Consumables Rechargeable AA and rechargeable Other features Portable reusable hearing aid battery Year of commercialization 2002 Life time 10 years Currently sold in 39 developing countries Shelf life 5 years Contact details Howard Weinstein Email strolltheworld gmail com Telephone 55 11 261 49241 Fax 55 11 261 49241 http wwwwho int di
42. degreees Celsius Product specifications Dimensions mm 150 x 100 x 50 Other features Software use portable capital equipment Weight kg 0 385 telemedicine solution Consumables None Year of commercialization 2008 Life time 5 years Currently sold in All of Europe except for some Eastern Shelf life 10 years European countries Canada United States and many Retail Price USD 110 countries in Asia Contact details Willem Verberk Email verberk gmail com Telephone 31 63 448 6146 http www who int medical_devices 35 Medical devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Oxygen concentrator driven bubble CPAP Country of origin United Kingdom Health problem addressed In 2011 1 8 million children under five died from respiratory complications most in developing countries CPAP Continuous Positive Airway Pressure a form of oxygen therapy for respiratory distress could save many infants and preterm babies However the cost of conventional CPAP is prohibitive in poor countries as a result it is often unavailable even in lifesaving situations Product description Treatment of serious breathing difficul
43. details Silvina Arrossi Email silviarrossi2020 gmail com Telephone 54 11 4342 3470 4342 3484 http www who int ehealth 47 eHealth Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Computer aided detection for Tuberculosis Country of origin The Netherlands Health problem addressed Tuberculosis is the second deadliest infectious disease in the world With early detection and proper treatment most people with tuberculosis can fully recover Combined efforts and investment in Tuberculosis detection can help to save millions of lives worldwide Solution description Digital X rays can efficiently make large numbers of chest radiographs at low cost Computer Aided Detection software CAD can immediately analyse these digital images The CAD software gives a probability percentage normal vs abnormal consistent with TB CAD follows the processing steps e Lung shape analysis e Clavicle detection e Texture analysis Texture within the lung fields and the shape of the extracted lung fields are compared with a training database obtained from thousands of training images Based on this analysis a grade for the image is computed Based o
44. developers WHO will not be held to endorse nor to recommend any technology included in the compendium Solution is used to support mHealth Software Hardware requirements The mobile component of the software runs on either simple Nokia phones or Android Smartphones Cellular data plan is required to transmit data from the field The cloud based platform can be accessed through a web browser via any internet connected computer The software platform is open source and is available to anyone at no cost Organizations with less than 20 users are offered hosting implementation and support for free After 20 users the charge is 0 75 per user month In case the clients want customized project design deployment and support they pay standard software development rates Standards HL7 Currently used in India Tanzania Zambia Malawi Bangladesh Mexico South Africa Afghanistan USA Mozambique Nicaragua Benin Guatemala Evaluation A recent randomized controlled trial in Tanzania showed that a reminder system incorporated into the system with eventual escalation to supervisor notification generated significant results with 85 more timely visits for the groups that received SMS reminders Also a preliminary controlled trial in Tanzania found increased adherence to protocols by over 20 compared to traditional methods Contact details Jonathan Jackson Email jljackson alum mitedu Telephone 1 617 649 2214 Fax 1 617 27
45. developing countries Product description Bedside Newborn Phototherapy is a device designed to treat jaundice in the mother s room in rural clinics The double sided high power LED lighting cures the most severe cases of jaundice and dramatically reduces treatment time Developers claims of products benefits The device is compact intuitive and durable enough to function in the mother s room in a rural clinic reducing staff workload and promoting breastfeeding The reduction in treatment time allows resources to be used to treat more infants and allows the family to go home sooner This can decrease the cost of care reduce loss of income reduce exposure to infection and return mother and baby to the safer home environment to breastfeed Bedside Newborn Phototherapy s design uses energy efficient light emitting diodes LEDs that last 5 years It is completely sealed against dust and bugs and has no moving parts drastically increasing product life Suitability for low resource settings In low resource settings jaundiced infants referred from rural to higher level hospitals risk developing permanent brain damage or dying en route Jaundiced infants are isolated from their mothers in crowded neonatal ICUs hindering breastfeeding in the critical first days Bedside phototherapy enables rural hospitals to treat jaundice which reduces the burden on national level hospitals to treat more serious conditions It is produced locally in
46. evidence provided by the applicant as well as publicly available information In 2013 unlike previous years inclusion in the Compendium for medical devices was restricted to commercialized products with regulatory approval Note that for a selected technology the inclusion in the compendium does not constitute a warranty for fitness of the technology for a particular purpose All innovative solutions in the compendium are presented in one page summarizing the health problem addressed the proposed solution and product specifications based on data information and images provided by the developers of the technologies concerned an oO N 1 N n o0 E b o n o rs 2 ie n ro T gt Ke 2 n 2 o0 Ke fe te YU g j Q o f v 2 a gt fe e e mo f jos ie O an oO N 1 N n 00 Bb o n ps je n o T gt n amp o0 Ke je LE a p Je Q o E o 1 g gt e ea 0 z U f o fai ie U Disclaimer Eligibility for inclusion in the compendium has been evaluated by WHO and external technical advisers listed in the Acknowledgements However the evaluation has been solely based on a limited assessment of data and information submitted in the developers applications and where available of additional sources of evidence such as literature search results or other publicly available informat
47. few drops of blood are dried on filter paper at room temperature 1 1 30 hrs Once dried the sample can be transported by any means to the lab no need for cold chain In the lab a 3mm sample is cut With a single drop two to four parameters HIV Syphilis Hepatitis Cholesterol Glucose etc can be analyzed using an appropriate solvent which extracts the biological material that is required for the test This room temperature extraction stove amp shaker occurs inside a micro plate and read out is done on an ELISA s reader Regulatory status Reagents for infectious diseases and non communicable diseases have approval for use by authorities such as ANVISA in Brazil It has a CE mark for its biochemistry reagents Future work and challenges The business model for this product is based on high volume high quality and affordable cost For this reason the product needs the collaboration of governments that seek data to reduce the burden of disease One way to obtain this data is from large scale blood screening and analysis Use and maintenance User Self use patient physician nurse midwife family member Training One week for laboratory technicians one hour for personnel in the field Maintenance None Environment of use Settings Rural urban settings ambulatory at home primary health post health center secondary general hospital tertiary specialized hospital Requirements Water At field level lancet
48. fo the Hemocue WBC device A Osei Bimpong C Jury R McLean S M Lewis Int Jnl Lab Hem 2009 31 657 664 A Comparison of 2 White Blood Cell Count Devices to Aid Judicious Antibiotic Prescribing Janet R Casey and Michael E Pichichero Clin Pediatr Phila 2009 48 29 World Health Organization 2001 Guidelines for Hearing Aids and Services Novel method for sputum induction using the Lung Flute in patients with suspected pulmonary tuberculosis Fujita et al Respirology 2009 Sarafidis PA Riehle J Bogojevic Z Basta E Chugh A Bakris GL A comparative evaluation of various methods for microalbuminuria screening Am J Nephrol 2008 28 2 324 9 Epub 2007 Nov 29 _X Le C D Ou Z E bb eS O lt D ov O Be gt D 22 83 cv 33 EL E 5 E 5 8 103 O0 EO 0 Uc U oO 2 91 N CI N i N 92 93 94 104 95 ZU Isothermal nucleic acid amplification system for POC diagnosis Manual wheelchairs and mobility devices Newborn simulator for resuscitation training Non pneumatic anti shock garment Oxytocin in prefilled auto disable injection system Parasitological test system Phototherapy for neonatal jaundice treatment Point of use water disinfection system Portable haemoglobin meter CE Mark Our current manufacturing facility capable of 1 million tests per year has been approved by TUV for ISO 9001 and ISO 13485 and our TB tests are CE qualified ISO standard
49. health care facilities in rural and urban settings Requirements Cold chain is ideal but the time temperature indicator on the package allows for brief excursions outside the cold chain like to low resource health posts or to a woman s home Product specifications Dimensions mm foil pouched product 148 x 56 x 10 Other features Portable and single use reservoir height Weight kg 0 0025 filled excluding pouch Shelf life 24 months Retail Price USD Varies by country Year of commercialization 2009 Currently sold in Argentina Guatemala India Contact details Steve Brooke Email sbrooke path org Telephone 1 206 302 4712 Fax 1 206 285 6619 http wwwwho int medical_ devices 92 Medical devices Compendium of innovative health technologies for low resource settings 2011 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Parasitological test system Country of origin Brazil Intestinal parasites types of helminthiasis and protozooses are endemic and afflict more than 1 billion people all over the world particularly affecting the mental and physical development of our children Affected children are unable to develop their abilities which consequently compromises the H
50. is then placed on the other ankle and the procedure repeated Regulatory status The device is both FDA approved and CE marked Future work and challenges Challenges include making doctors and nurses aware that this device is an automated oscillometric device that can reliably assess ABI convincing them that general use of this device will improve awareness of peripheral artery disease and convincing them that cardiovascular screening will lead to the prevention of cardiovascular disease and reduce overall healthcare costs Use and maintenance User Physician nurse technician Training Can be conducted in 20 minutes by the organization company providing the device Maintenance None Environment of use Settings Rural urban settings primary health post health center secondary general hospital tertiary specialized hospital Requirements The device can work on a rechargeable battery but also with electricity When the user has access to a PC the device can be controlled from the PC and a report produced The device can be used with and without the PC software which is included free of charge Ambient temperature for device storage and use should be between 10 and 40 degreees Celsius Product specifications Dimensions mm 200 x 125 x 90 Other features Software use mobile portable capital Weight kg 1 1 including batteries equipment Consumables None Year of commercialization 2008 Life time 5 ye
51. knee joint 7 Polypropylene endoskeletal lower limb nrosthati system 8 Prefabricated components for lower limb orthoses 9 Basic equipment for health facilities and home health care Automated solar powered blood pressure monitor 65 Blood pressure eReader A A H Infrared ear thermometer 30 Oscillometric blood pressure measurement F 35 Prefilled auto disable injection system 97 Self powered pulse oximeter 99 Healthcare management Case based smartphone messaging platform 3 3 3 46 ePharmacyNet system z 12 Health and hospital information system 13 Health workforce information systems 49 Medical cloud 52 Medical data communication system 85 Mobile supply chain management tool 16 Mobile technology to connect patients to remote doctors 86 New media to train health workers 54 Primary health care continuous quality improvement CQI tools n 55 Rapid SMS providing availability of essential medicines 56 Real time measurement of meteorological events on public health a 57 Remote healthcare solution a 7 Telemedicine network F F 61 Teletrauma 63 Treatment response softwar
52. mobile transmitted remote diagnosis in Egypt Ghana Botswana the US We pursue various partnerships Partners include mHealth Alliance BRAC Sajida Foundation Mobinil Egypt Orange Botswana University of Pennsylvania Medical School Harvard MIT American Academy of Dermatology Future work and challenges These applications and corresponding business models were tested through pilots in over 10 countries The basic technology proposition was proven and patient acceptability demonstrated Commercial scalability is now ready to be tested by 1 improving the technology platform to support large scale usage from current 500 000 beneficiaries to gt 1 million 2 expanding distribution channels 3 refining service models to suit our markets User and environment User Patient family member nurse midwife physician Training 30 60 min walk through of the mobile application Maintenance Technician engineer manufacturer Environment of use Requirements Mobile connectivity access to a power source to charge mobile phones Product specifications Dimensions mm 110 x 47 x 14 approx Retail Price USD Varies Weight kg 0 008 Year of commercialization 2009 Life time Varies by phone model Currently sold in US Botswana Bangladesh Contact details Ting Shih Email Telephone 1 202 618 0188 http www who int ehealth 86 eHealth Compendium of innovative health technologies for low resource settings 20
53. of solution benefits A free and open source solution is designed to support full country adoption and ownership The software is cost effective easy to configure and is supported with strong documentation eLearning and other resources This solution also support countries to avoid vendor lock in All data can be exported in a variety of formats at any time for migration to a new solution if desired Future work and challenges The biggest challenge remains whether the users have enough access to the Internet to learn about and access the technology and associated resources As infrastructure continues to strengthen and this situation improves a cloud based version can be offered to minimize initial configuration and set up challenges It is also part of the future plan to move from an HR Information System to an HR Management System which is less about collecting and reporting on workforce data and more on taking consistent and high quality management actions User and environment User health managers supervisors workforce planners and regulators Training administrator training is currently available online and user training is under development Settings rural urban secondary tertiary district management offices Ministry of Health Solution specifications Solution is used to support Decision Support Systems Standards SDMX HD mHealth eLearning mLearning Health Research Currently used in Botswa
54. out remote consultation for the patient at the village using the internet with a doctor sitting anywhere in the world Doctors remotely control the MDAU device to obtain medical parameters provide a prescription to the patient and store medical records The solution also supports supply chain management lab reports and referrals Developer s claims of solution benefits This solution works at extremely low bandwidths 32 kilobits s onwards for real time audio video data tele consultation thereby reaching places where other existing solutions cannot reach It is very easy to use by a village operator is extremely power efficient and works out of USB power and comprehensive solution linking multiple providers doctors pharmacies labs hospitals and addresses 75 of healthcare needs at the point of care at a fee of less than 1 USD Future work and challenges Future work includes working closely with healthcare service delivery partners and e governance players to define and implement large scale projects enhancing the technology with further diagnostics as well as ground level delivery processes to capture them better identifying and building relations with partners having complementary solutions hardware and software integrating a mobile based bluetooth enabled telemedicine solution as even 32 kilobits s bandwidth is not available in all of rural India and changing the business model to include software as a service User and e
55. pressure entirely by pressing release button when the device displays the results Development stage The product underwent field tests in Uganda and Zambia In the evaluation healthcare providers used the product in 700 patients and in comparison with conventional method auscultation 95 of the providers preferred the product with the reasons of easiness solar power and automated measurement The product is approved as medical equipment in Japan Europe and the US based on respective regulatory systems Future work and challenges Currently the price of the product is set relatively high level because of little manufacturing quantity When the product sells more the unit price aims to be much lower User and environment User Self use patient physician technician nurse midwife family member care person Training None Maintenance None Environment of use Settings Rural settings urban settings ambulatory at home primary health post health center secondary general hospital tertiary specialists hospital Requirements None Product specifications Dimensions mm 90 x 75 x 125 Other features Portable hand held reusable Weight kg 0 2 Year of commercialization 2009 Life time 5 years Currently sold in Japan EU Nations Retail Price USD 100 List price USD 100 Contact details Takahide Tanaka Email oshira docomonejp Telephone 81 75 925 2043 Fax 81 75 925 2044 http wwwwho
56. prevalence of cardiovascular diseases resulting in approximately 8 million deaths annually worldwide which can be attributed to high blood pressure Low and middle income countries shoulder 80 of the cardiovascular disease burden more than half of which occurs in people of working age and pregnant women Product description This electronic automated blood pressure monitor operates with solar power alone as well as AC adapter and regular dry battery It is also equipped with ultraviolet tolerant plastic parts and dust preventive structure to bare direct sunlight exposure for battery charge LC Product functionality Functions as a standard blood pressure monitoring system Developers claims of product benefits With progressive integrated circuit technology the electronic circuit of the device consists of an ultimately small number of components resulting in very low energy consumption which can be supplied with a solar panel The chassis of the device is made of ultraviolet tolerant plastic which bare direct sunlight To the best of the submitters knowledge this is the world s first product according to WHO s specifications including solar power and accuracy Operating steps Charge battery by exposing the device to strong light such as direct sunlight Attach blood pressure cuff to upper arm Inflate the cuff by pumping bulb up to estimated systolic blood pressure then the device starts measurement Remove the
57. specifications Dimensions mm 50 x 50 x 20 Retail Price USD 60 Weight kg 0 014 List price USD 60 Consumables None Other features Portable reusable Life time 1 year Year of commercialization 2007 Shelf life 5 years Currently sold in Canada USA Contact details Noel Lindsay Email noel lindsayfamilyorg Telephone 1 415 484 1452 Web http bit ly 7ijJS03 http www who int medical_devices 33 Medical devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Oscillometric ankle arm measurement Country of origin Switzerland Health problem addressed 7 Peripheral artery disease PAD is on the rise in developing countries due to an increase in diabetes mellitus PAD increases cardiovascular risk and is associated with chronic venous ulcers Product description The device is an automated oscillometric blood pressure monitor designed for clinical use The device allows for screening of three major cardiovascular risks PAD AF and hypertension It is equipped with two cuffs for simultaneous double arm measurements and ankle brachial index ABI assessment both of which are recommended screening methods for de
58. suffers the same heat loss as a naked adult at O C This heat loss is even greater for preterm sick and low birth weight babies especially if left wet and uncovered at birth Hypothermia in the newborn can occur in all climates due to a lack of knowledge and or procedure The availability of a very simple low cost device placed either in an axilla above the liver or the great vessels of the neck would empower to maintain the warm chain immediately following birth The device has been designed so that also illiterate mothers can understand and safely use it Operating steps 1 Choose site under an arm or on the right side of the abdomen 2 Clean site with an alcohol 3 Press device firmly into site white dots upright 4 Provided the body temperature is within the safe zone a smiling face will appear on a bright green background Observe every two hours 5 Mothers should seek advice if the smiling face begins to fade or reverts to black 6 The device remains attached for up to a week and can be reused Development stage Published tested clinical trials conducted Commercially available CE No 0434 Future work and challenges Currently the device is difficult to read in poor light and in the dark Getting the device widely established has been unexpectedly slow User and environment User Physician nurse midwife family member Training None Maintenance None Environment of use Sett
59. the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Low smoke stove Country of origin India Health problem addressed Total world deaths from indoor air pollution due to burning solid fuels are estimated at 1 619 000 each year India accounts for 25 of such deaths Product description The stove has a bypass duct for efficient draft soot collector and chimney connector Product functionality The stove can be easy to use and maintain and can be used with indigenous biomass as fuel Cooking time is reduced by 1 5 hours per day and fuel consumption wood and cow dung is reduced by 60 70 Developer s claims of product benefits Most people in the targeted areas don t use a stove but have a three stone cooking setup without any form of ventilation Traditional stoves sold in these regions e g India are monolithic in one piece which makes them more difficult to transport and expensive to replace The developers therefore added a chimney and designed a modular solution It has been designed with respect to Indian cooking needs and in order to accommodate different culinary habits The design of the stove allows the chimney to take exhaust fumes out of the kitchen area As the stove is locally produced and distributed it is relatively cheap and easily available Stove production u
60. young men in Kisumu Kenya a randomised controlled trial Lancet 2007 Feb 24 369 9562 643 56 Gray RH Kigozi G Serwadda D et al Male circumcision for HIV prevention in men in Rakai Uganda a randomised trial Lancet 2007 Feb 24 369 9562 657 66 World Health Organization Progress in scale up of male circumcision for HIV prevention in Eastern and Southern Africa Focus on service delivery 2011 Accessed online 2 3 2012 http whalibdoc who int publications 2011 9789241502511_eng pdf Bitega Jean Safety and Efficacy of the PrePex Device for Rapid Scale Up of Male Circumcision for HIV Prevention in Resource Limited Settings JAIDS Journal of Acquired Immune Deficiency Syndromes 15 December 2011 Volume 58 Issue 5 p e127 e134 Accessed online 2 4 2012 http journals lww com jaids Fulltext 2011 12150 Safety_and_Efficacy_of_the_PrePex_Device_for_Rapid 16 aspx Yin HS Dreyer BP Van Schaick L Foltin GL Dinglas C Mendelsohn AL Randomized controlled trial of a pictogram based intervention to reduce liquid medication dosing errors and improve adherence among caregivers of young children Arch Pediatr Adolesc Med 2008 162 9 814 822 Yin HS Wolf MS Dreyer BP Sanders LM Parker RM Evaluation of consistency in dosing directions and measuring devices for pediatric nonprescription liquid medications JAMA 2010 304 23 doi 10 1001 jama 2012 1797 Point of care method for total white blood count An evaluation
61. 1 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Treatment response software application Country of origin Canada Health problem addressed jz eee Tracking patient response to specific treatments other than measurable ooo physiological changes laboratory test results survival or death remain a oe en ro matter of clinical judgment Diagnostic validity and reliability is an ongoing T a J problem in applying evidence based practice The system application ata presented here provides a gold RCT standard to this problem pl Product description l This application may be used to track and graphically represent individual al a E mt patient responses to treatments over time Additionally patients may o a be assigned to up to four specific treatment groups RCT to compare 3 gt treatments Students can compare the diagnostic accuracy of their U p assessments and interventions with experts Product functionality Download and open this is an Excel VBA based application It may be used to track and represent individual patient responses to treatments over time Additionally patients may be assigned to specific treatment groups User defined variables re
62. 4 8393 http www who int ehealth 53 eHealth Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium New media to train health workers Country of origin United States of America Health problem addressed Frontline health workers need more and better training Current methods lectures and written materials are not effective and often fail to consider the reality of resource poor settings Health worker shortages make it difficult and costly for them to spend time in workshops Current approaches are not able to reach the large numbers who need training Solution description The new media consists of videos that combine live footage with animated segments and are designed and created for playback on portable devices The films are brief vignettes that bring alive international clinical guidelines They cover topics in a simple and concise way with need to know information They are carefully scripted to provide step by step instruction that is easy to understand and put into action They are voiced over to enable narration in different languages and shot and formatted for the small screen of mobile devices Functio
63. 43 259 Fax http wwwwho int medical_ devices 99 Medical devices Compendium of innovative health technologies for low resource settings 2011 Inclusion in the compendium does not constitute a warranty of the fitness of any technology for a particular purpose All the information was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Transcutaneous bilirubin measurement system for infants Country of origin United States of America Health problem addressed F N Hyperbilirubinaemia is a common condition in many newborns affecting nearly 1 in 10 newborns and nearly 90 of premature infants in the first week of life If undetected and untreated the levels of bilirubin may rise high enough to pass through the blood brain barrier and is deposited in the brain causing kernicterus and brain damage the Product description The device provides a numerical measurement of predicted bilirubin count in mg dL or pmol L within a clinically beneficial range that has been correlated with total serum bilirubin concentration measured by High Pressure Liquid Chromatography HPLC LC J Product functionality The device works by directing white light into the skin of the newborn and measuring the intensity of the specific wavelengths that are returned By knowing the spectral properties of the components within the skin one can subtract out the interfer
64. 46 431481225 http wwwwho int medical_ devices 77 Other technologies 2012 Other technologies Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Auto stop electrochlorinator Country of origin United States of America Health problem addressed r S Over 1 billion people worldwide do not have access to safe water Furthermore 1 8 million children under the age of 5 years die annually from diarrheal disease caused by unsafe water in places with poor sanitation The auto stop chlorinator produces chlorine which is a highly effective disinfectant for drinking water Treating drinking water with chlorine has been shown to reduce rates of diarrhea in children by up to 29 Product description The electrochlorinator consists of a salt brine bottle where the salt and water is poured It also consists of power leads to connect to a battery source as well as a control panel at the base of the brine bottle to start and stop the chlorination process ke A Product functionality The auto stop electrochlorinator localizes chlorine production eliminating shelf life and inventory management issues experienced with liquid chlorine and water f
65. 7176 including fire retardant foam and fabric and is ISO 9001 2008 2013 and ISO 13845 2008 2013 certified ISO 9001 2008 ISO 13485 2003 CE mark FDA CE mark A cluster randomized control trial was carried out by UC Berkeley in 2009 2010 in 450 households using the UV Tube The results are expected to be published in 2011 or 2012 BPF ANVISA Brazil registration number 80431950001 http www anvisa gov br datavisa Consulta_ Produto_correlato rconsulta_produto_ detalhe asp For further reading about technologies and respective health problems refer to references provided in the submission documents Neglected diagnostics Nature Methods 4 877 878 2007 Reference s Fang R Li X Hu L You Q Li J Wu J Xu P Zhong H Luo Y Mei J et al 2009 Cross priming amplification for rapid detection of Mycobacterium tuberculosis in soutum specimens J Clin Microbiol 47 845 847 WHO Guidelines on the provision of Manual Wheelchairs in less resourced settings Lawn J E Lee A C Kinney M Sibley L Carlo W A Paul V K Pattinson R Darmstadt G L Two million intrapartum related stillbirths and neonatal deaths Where why and what can be done 1JGO 2009 107 s5 19 Stephen N Wall Anne CC Lee Susan Niermeyer Mike English William J Keenan Wally Carlo Zulfiqar A Bhutta Abhay Bang Indira Narayanan Iwan Ariawan Joy E Lawn 2009 Neonatal resuscitation in
66. D Compendium of innovative heal i ealth technologies for low resource settings Assistive devices eHealth solutions Malr Relier COM O A l S A G World Health SY Organization WAN an al WHO Library Cataloguing in Publication Data Compendium of innovative health technologies for low resource settings assistive devices eHealth solutions medical devices 1 Biomedical Technology 2 Equipment and Supplies 3 Medical Informatics trends 4 Telemedicine 5 Developing Countries 6 Technology assessment Biomedical I World Health Organization ISBN 978 92 4 156473 1 NLM classification WX 147 World Health Organization 2014 All rights reserved Publications of the World Health Organization are available on the WHO website www who int or can be purchased from WHO Press World Health Organization 20 Avenue Appia 1211 Geneva 27 Switzerland tel 41 22 791 3264 fax 41 22 791 4857 e mail bookorders who int Requests for permission to reproduce or translate WHO publications whether for sale or for non commercial distribution should be addressed to WHO Press through the WHO website www who int about licensing copyright_form en index html The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country territory city or area or of its
67. Health Welfare and Sport and the US Agency for International Development Graphic design and layout Jillian Reichenbach Ott Gen ve Design Table of contents Acknowledgements Iv Technologies by health topic viii Introduction Xvi Disclaimer f f f xvii Assistive devices 2013 Artificial prosthetic knee joint Child wheelchair Hollow mattress Magnetic prosthetic suspension system Pen mounted CCTV camera Polycentric prosthetic knee joint Polypropylene endoskeletal lower limb prosthetic system NN OU BB W N Prefabricated components for lower limb orthoses eHealth solutions 2013 Blood pressure eReader D ePharmacyNet system 12 Health and hospital information system 13 Hearing screen eRecord 14 Maternal and child health mobile services 15 Mobile supply chain management tool 16 Remote healthcare solution 17 SMS DMCare 18 SMS service 19 TID system Type 1 Diabetes system 20 TeleOphthalmology aided primary eye care 21 Medical devices 201 3 ND ND Bedside newborn phototherapy 23 Compact portable ultrasound 24 Dry blood spot screening 25 Electro hyperthermia 26 Fecal occult blood test 27 Infant radiant warmer 28 Infant warmer 29 Infrared ear thermometer 30 LED phototherapy for neonatal jaundice 31 Low pressure anaesthesia machine 32 Mandibular repositioning device 33 Oscillometric ankle arm measuremen
68. Internet or WiFi connection for full access to all the features of the system However users without a data connection can still prepare and save case information using an offline mode for later uploading Software is proprietary developed specifically for deployment by the Botswana UPenn Partnership and its physician teams Currently used in Botswana Evaluation No studies have been conducted on the technology yet but the team is in the process of designing a study to evaluate the technology with local partners Contact details Sankalpo Ghose Email sankalpo gmail com Telephone 1 415 273 9648 http www who int ehealth eHealth Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Cervical cancer screening information system Country of origin Argentina Health problem addressed In Argentina cervical cancer is the second most common cause of death by tumours in women from 35 to 64 years old there is a death rate of 71 100 000 and an incidence of ete de mers ie pe 23 2 100 000 Each year in Argentina 1 800 women die and a further motes stenosis seasta DS rare eee 3 000 new cases are diagno
69. Vietnam Operating steps Plug it in and press the button Fixed two sided lighting one intensity setting and an easy to clean removable single infant bassinet make this device hard to use improperly thereby reducing incidence of ineffective treatment and cross infection Regulatory status Used IEC 60601 1 2005 and IEC 60601 2 50 2009 standards to guide the design Pending assessment by Ministry of Health in Vietnam recognized by the ASEAN countries Expected date November 2013 Future work and challenges Production of the first 200 Bedside devices is nearing completion The first devices were delivered to hospitals in northern Vietnam during Fall 2013 over the following year the remainder will be distributed to Vietnam Myanmar Cambodia Laos East Timor the Philippines Thailand Malaysia and Ghana The plan is to expand to a total of 1 000 Bedside devices reaching at least 250 000 newborns The next big challenge is to connect with additional organizations who wish to purchase and distribute the devices worldwide to reach millions of beneficiaries Use and maintenance User Physician nurse family member Training Provided by supplying organization Maintenance None Environment of use Settings Rural urban settings primary health post health center secondary general hospital tertiary specialized hospital Requirements Continuous power supply 90 264VAC or a 12VDC input typical of car batteries and s
70. a stable after sales service and technological renewal as soon as improved diagnostic kits are developed Use and maintenance User Physician technician Training None Maintenance None Environment of use Settings Rural urban settings ambulatory primary health post health center secondary general hospital Requirements Product should be stored in a standard household refrigerator between 2 8 C Product specifications Dimensions mm 160 x 115 x 80 per box of 20 cassettes Retail Price USD 2 per test and 20 collector flasks List price USD 2 per test Weight kg 0 3 per box of 20 cassettes and 20 collector Other features Portable single use flasks Consumables None Life time 2 years Shelf life 2 years Year of commercialization 2013 Currently sold in Cuba Contact details Aramis S nchez Guti rrez Email tssubdir cie sld cu Telephone 53 720 8561 http www who int medical_devices 27 Medical devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Infant radiant warmer Country of origin India Health problem addressed Se In under resourced settings hypothermia at birth
71. ability for low resource settings Many low resource hospitals experience power outages and stock outs of compressed gas This device works at ambient pressure and can adapt to loss of compressed gas or electric power Operating steps When the device is operated the oxygen flow rate automatically matches the patient minute volume demand If required room air is introduced To deliver the anaesthetic agent ambient pressures are sufficient and compressed medical gas is not required When required patient ventilation is performed with bellows Regulatory status The machine is CE marked and is produced in an ISO certified factory Future work and challenges The organization providing the device operates as a non profit and sells the device to non profit and government hospitals at a discounted price that covers manufacturing cost and delivery It is distributed through NGOs government tenders sales to donor organizations and direct sales and donations to hospitals The challenges include cost effective distribution in low income countries cost of training users ranging from anesthesia assistants to consultant anaesthetists and provision of service to remote locations The focus is on training users and local technicians and providing backup support when necessary Use and maintenance User Physician anaesthesia clinical office nurse anaesthetist Training Training provided by local or international medical doctor anaesthetists a
72. acity among local trainers Settings rural urban primary secondary and tertiary Reviewers comments The continuous quality improvement CQI system is an innovative approach developed to support high quality primary health care for Aboriginal and Torres Strait Islanders CQI can be adapted and used with limited IT equipment Solution specifications Solution is used to support Decision Support Systems Currently used in Australia Continuous Quality Improvement Cal Evaluation Rumbold A et al Delivery of maternal health Software Hardware requirements In the Australian care in Indigenous primary care services baseline data context it uses customised software to support web for an on going quality improvement initiative BMC based clinical audit tools for the collection of data Pregnancy and Childbirth 2011 11 16 doi 10 1186 to allow reporting of key performance indicators against best practice guidelines The technology is not dependent on this specific software solution Gardner KL Dowden M Togni S Bailie R Understanding uptake of continuous quality improvement in Indigenous primary health care lessons from a multi site case study Microsoft SQL Microsoft ASP Net Menzies proprietary of the Audit and Best Practice for Chronic Disease code project Implement Sci 2010 5 21 Standards Clinical Guideline Standards for Chronic Disease Maternal Preventive Child Health and Mental Health Contact details Mar
73. ail Price USD 25 List price of consumables USD 8 to replace the pot Contact details Susan Murcott Email murcott mitedu Telephone 1 781 631 1161 Fax http www who int medical_devices 105 Appendix Appendix Compendium of innovative health technologies for low resource settings 2011 2012 Appendix All submissions to the call for innovative health technologies for low resource settings underwent an evaluation process The technologies were reviewed by WHO WHO collaborating centres members of EUROSCAN and other relevant stakeholders However no in depth assessments of the technologies were performed and no pre qualification process was done The evaluation relied solely on the material and evidence provided by the applicant as well as publicly available information that served to analyze the potential of the technology to improve health outcome in low resource regions Furthermore prior to 2013 the fact sheets did not include information on regulatory status This appendix provides references and regulatory information for medical devices submitted in 2012 and 2011 2012 For further reading about technologies and respective health problems refer to references provided in the submission documents Paname Regulatory 79 65 80 66 67 68 69 70 Auto stop elecrochlorina tor Automated solar powered blood pressure monitor Birthing simulator for training Interventional cardiovascu
74. al equipment such as a therapy bed and foot blocks are required Maintenance Patient technician Environment of use Requirements The product must be distributed through a service centre where local staff has been trained to assess wheelchair users and assemble and fit the products A workshop and clinical assessment are required The centre will act as a point for clients to return to for follow up and product maintenance or repairs The products are manual and do not have any special operational requirements The ease of use of the product can depend on the local infrastructure i e often buildings are inaccessible so may prevent the user from independently accessing the building Product specifications Dimensions mm approx 1212 x 740 x 865 Currently sold in Argentina Australia East Timor Ethiopia Weight kg 22 Ghana India Kiribati Lebanon Lesotho Liberia Malawi Nepal Pakistan Papua New Guinea Serbia Sierra Leone Solomon Islands South Africa Sri Lanka Sudan Thailand Uganda Zimbabwe Life time 5 years Retail Price USD 171 Year of commercialization 2005 Contact details Natalie Snell Email Telephone 44 1275 464 012 Fax 44 1275 464 019 http wwwwho int disabilities technology eHealth solutions 201 eHealth Compendium of innovative health technologies for low resource settings 201 fitness of any technology for a particular purpose All the information Inclusion in the com
75. al_ devices Medical devices Compendium of innovative health technologies for low resource settings 2011 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Portable haemoglobin meter Country of origin Brazil Health problem addressed Anemia is one of the most common blood disorders globally Iron deficiency anemia is the most prevalent nutritional disorder in the world Anemia diagnosis is frequently not performed or the test results are delayed causing aggravations or even sequels in the most vulnerable population children and pregnant women Product description Portable hemoglobin meters that are user friendly can be a great aid to change the global anemia scenario Avoiding the displacement of patients and shortening the diagnostic process this solution can spread this clinical test to people with low access to health services 4 Product functionality The portable hemoglobin meter is a micro processed photometer In a disposable vial containing Drabkin s reagent 10 uL of blood sample are dropped Reaction follows inside the vial also used as the lecture cuvette Hemoglobin content is read and calculated by a microprocessor and proprietary software Results are presented in a LCD displ
76. alled stationary Reusable Life time 20 years Year of commercialization 2012 Shelf life 10 years Currently sold in Worldwide List price USD 100 Contact details Tim Oriard Email emergingmarkets2 gmail com Telephone 1 206 694 I511 Fax 1 206 694 1559 http www who int medical_devices 79 Other technologies Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Birthing simulator for training Country of origin Norway Health problem addressed r Appropriately skilled birth attendants could save the majority of the annual 350 000 maternal deaths 99 of which occur in low resource settings In order to reduce the high number of unnecessary maternal and newborn deaths on the day of birth there is an urgent need to train birth attendants and other Frontline Health Workers in Basic Emergency Obstetric and Newborn Care BEmOC Product description The birthing simulator supports training in BEMOC in developing countries It enables the instructor to create very compelling simulations of normal to more complex birthing scenarios and is particularly suitable for training control of post partum hemorrhage the leading cause of
77. also used for automatic charts and reports User and environment User physician nurse technician public health or municipal officers Training training by developer through the Internet and simple means such as Beam my Screen duration 1 4 hours Settings rural urban home ambulatory primary secondary tertiary municipalities and civil protection Reviewers comments This innovative approach especially if and when coupled with disease surveillance systems like www healthmap org can start to uncover known and unknown correlations of disease outbreaks as they relate to weather The requirement of technologies is not onerous and easy to learn which makes the use and sustainabiltiy of the system very achievable Solution specifications Solution is used to support Decision Support Systems Standards Open Geospatial Consortium OGC fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Geographic Information System Health Research Health Surveillance Software Hardware requirements personal computer or laptop or network and access to the Internet The application can be installed on a single computer no need for a network It can also be installed on a server and accessed over a Local Area Network the In
78. an Training One to two days blood collection practice by puncture and pipette Maintenance Manufacturer Environment of use Requirements Powered by batteries and designed for a global environment use there are no special requirements The tests are disposable and previously sterilized Product specifications Dimensions mm 167 x 108 x 37 List price of consumables USD 1 0 vial Weight kg 0 358 Other features Portable and reusable Runs on batteries uses software Consumables Hemoglobin meter reagent vial tips Life time several years Year of commercialization 2010 Retail Price USD 1500 Currently sold in Brazil List price USD 1500 Contact details Jair Ribeiro Chagas Email jchagas gmail com Telephone 55 11 4739 1964 55 11 7833 5298 Fax 55 11 4792 4326 http wwwwho int medical_ devices Medical devices Compendium of innovative health technologies for low resource settings 2011 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Portable ventilator Country of origin United States of America Health problem addressed Patient groups most likely to benefit include those with COPD Cardiogenic Pulmonary Edema Immunocompromised patients e g HIV and COPD patients w
79. and can move around manually by pushing the pushrims It fosters independence and social integration and allows the child to leave the house access education and be like other children Developer s claims of products benefits Most of the available wheelchairs in the world are for adults Available child wheelchairs are often the miniature size of adult wheelchairs without valuing children s needs and preferences This product has been specifically designed for children The wheelchair is light weight but durable low cost and can be assembled locally It requires low maintenance and is very attractive to children due its design and colour Development stage The wheelchair was developed and assessed according to DIN ISO 7176 and the WHO Guidelines on the provision of manual wheelchairs in less resourced settings Future work and challenges To establish collaboration with local NGOs and governmental organizations to support training and distribution to provide training to rehabilitation teams and to raise funds to support the wheelchair s production and distribution Use and maintenance User Self use Training 1 day training by physiotherapist occupational therapist or rehabilitation teams Maintenance Monthly adjustments of screws Environment of use Settings Rural urban ambulatory at home primary health post health center secondary general hospital tertiary specialized hospital Requirements
80. and sterile in an injection ready format optimal for low resource settings It is compact and prefilled so generates minimal waste Operating steps 1 Check the time temperature indicator 2 Open the foil pouch 3 Activate the device 4 Remove the needle shield 5 Continue to hold the injection device by the port and insert the needle into the patient 6 Squeeze the reservoir to inject the oxytocin 7 Do not re cap 8 Dispose according to medical waste procedures Development stage Oxytocin in conjunction with described injection device is currently being produced in Argentina and India Oxytocin in Uniject is commercially registered in Argentina Guatemala Honduras Paraguay and India Additional registrations in Latin America and Africa are being pursued Future work and challenges The value of oxytocin in conjunction with described injection system has been demonstrated in the field More and more countries are recognizing the need to reduce maternal mortality and the easy and safe delivery of oxytocin has been identified as an important tool but more must be done to raise awareness The next phase of work will include efforts to raise awareness increase demand and ensure a sustainable supply User and environment User Nurse midwife physician technician Training User instructions are included in the box and on the primary packaging Training requires no more than 1 day Environment of use Setting At home and in
81. ant Women and the form e g Pre Natal for this type of visit The form guides the CHW through a series of questions and education prompts to provide patient specific referrals and counseling The form is submitted to the web interface for monitoring Developer s claims of solution benefits This technology improves care across four areas access to care through client lists on the CHWs phones and SMS reminders when visits are due client engagement through audio and video clips and improved credibility of the CHW quality of care through checklists decision support and delivery of sensitive information through recorded voices and data driven management through real time monitoring of the CHWs activities Future work and challenges The success of this platform is contingent on availability of funding for community health worker programmes using this platform has demonstrated return on investment A dollar for dollar effectiveness ratio of 3 48 is anticipated This will be confirmed through randomized controlled evaluations User and environment User physician nurse midwife community health worker Training our team of field engineers deliver training using field tested methodologies over a two day period Settings rural urban home Solution specifications fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the
82. ars Currently sold in Canada Netherlands Spain United Shelf life 10 years Kingdom United States and some countries in Asia Retail Price USD 1100 Contact details Willem Verberk Email verberk gmail com Telephone 31 63 448 6146 http www who int medical_devices 34 Medical devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Oscillometric blood pressure measurement Country of origin Switzerland Health problem addressed SS Pre eclampsia and eclampsia is the second cause of maternal death 10 15 of all maternal deaths in low and middle income countries Product description This device provides automated oscillometric blood pressure measurement It measures the mean arterial pressure by which the systolic and diastolic blood pressure are then calculated using an algorithm Developer s claims of products benefits The device is accurate in identifying pre eclampsia and requires limited training Studies have shown that it is user friendly and leads to better adherence to measurement at home x Suitability for low resource settings The device only requires batteries and has been validated for u
83. asteners rubber soles adhesives Year of commercialization Concept was introduced in padding foams stockinette rivets screws nuts 2003 it developed further based on the feedback and Life time years 3 5 evaluations and development work on the knee joints Shelf life years 10 was finalized in 2013 The whole system was launched on Retail price USD 60 for the PF KAFO shells and 60 for 30 September 2013 the knee joints Currently sold in Bangladesh Ethiopia India Kenya List price USD 60 for the PF KAFO shells and 60 for Nepal Nigeria Sri Lanka Tanzania Contact details Albina Shankar Email albina mobility indiaorg Telephone 91 80 264 92222 Web http bitly HdhqDR http wwwwho int disabilities technology 9 eHealth solutions 2013 eHealth Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Blood pressure eReader Country of origin Canada and Kenya Health problem addressed a High blood pressure HBP is the leading risk factor for mortality globally WHO 1 in 6 in developing countries has HBP CDC A silent killer symptomless unless measured leads to heart attack stroke and disability f
84. ata to desired physician These methods suffer from systematic insufficiencies and are slow and non traceable Instead this system offers a technically sound and more accessible solution Given the prevalence of cell phone networks and the internet it is easily reachable Operating steps Data is acquired at the point of care and uploaded to a secure server Physician reviews data and has the option to respond back to the point of care or forward to a colleague Physician can review data on their smartphone or PC as convenient Development stage Has been in technically evaluated Has been in production for over two years System is classified as a hospital IT product System conforms to DICOM standards Future work and challenges Product is commercialized User and environment User Nurse physician technician Training Web based and or self training CD Maintenance Technician engineer manufacturer Environment of use Requirements Sending side EKG and or imaging systems and connectivity to internet phone line connection to a laptop preferred Receiving side access to cell phone network on a smartphone and or access to internet and PC Product specifications Dimensions mm N A Other features Portable and reusable Uses software Weight kg N A Telemedicine system Year of commercialization 2009 Currently sold in USA Consumables none Retail Price USD Base 50 000 depends on configuration c
85. authorities or concerning the delimitation of its frontiers or boundaries Dotted lines on maps represent approximate border lines for which there may not yet be full agreement The mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned Errors and omissions excepted the names of proprietary products are distinguished by initial capital letters All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication However the published material is being distributed without warranty of any kind either expressed or implied The responsibility for the interpretation and use of the material lies with the reader In no event shall the World Health Organization be liable for damages arising from its use Printed by the WHO Document Production Services Geneva Switzerland Compendium of innovative health technologies for low resource settings Assistive devices eHealth solutions Medical devices 2011 2013 O World Health Ws WY Organization an oO N 1 N n 00 b o n 9 J je n o T gt 2 n amp o0 Ke je LE a p Je Q o E o 2 g gt e ea 0 z U f 9 os e O Acknowledgements The coordination of the Compendium project and the e
86. ave Country of origin United States of America Health problem addressed gt Healthcare associated infections are the most frequent threat to patient safety worldwide and Surgical Site Infections SSIs are the most common type of infection The effects of SSIs on patients and health systems are both severe and underestimated and the burden of infections falls on the patient population with the highest level of need Product description The pressure cooker autoclave is an affordable easy to use autoclave An electronic sterilization monitor connects to a pressure cooker via an integrated thermal sensor The monitor provides verbal instructions to health post employees in their native language It notifies them when their attention is required and guarantees whether or not instruments were fully sterilized at the _ end of each cycle Information regarding frequency features used and rates of successful sterilization cycles is sent via cellular networks to an online database where location and usage information can be viewed and analyzed Developer s claims of products benefits Medical instrument boilers and autoclaves are available in some regions Boilers are the most common sterilization method used but are ineffective and can leave instruments contaminated The low cost autoclaves that are currently available require electricity which is often intermittent at best and therefore they often go unused
87. ay Developer s claims of product benefits The reagents are stable for a long periods and extreme environmental conditions The use of the injection vial containing the reagent as a cuvette reduces the number of operations reduces costs speeds lecture and allows portability The equipment is battery rechargeable driven allowing the use in any environment Operating steps After cleaning the skin a puncture is done and a 10 uL blood sample is collected with a micropipette and transferred to the reagent vial After 30 seconds of mixing the vial is inserted in the equipment and a button is pressed The sample hemoglobin content is exhibited in the display in g dL Development stage The device is fully developed and extensively tested over 20 000 patients In Brazil validation was performed by PP SUS program a governmental trial of innovative technologies for public health care PAHO and IPTI are performing tests process n BR LOA 1000065 001 Researchers from S lt o Paulo University and FIOCRUZ Foundation are performing tests in anemia trials Future work and challenges For the moment it is commercialized only in Brazil in compliance with the standards from Brazilian national regulatory legal demands ANVISA International certifications need to be performed Additionally there exists a need for investors and or commercial partners interested in business improvement User and environment User Nurse physician technici
88. ble in non cleanable versions and mainly intended for single patient use as it can be easily opened cleaned and boiled for disinfection after use it is made of very durable silicone and withstands several hundred times of reuse The transparent material makes it easy for the user to see whether it has been cleaned since last use situation the price available on a not for profit basis combined with number of use situations dramatically reduces the cost per use compared to existing products Operating steps Ensure that the device is clean before use on patient Squeeze bulb to generate vacuum and place the nozzle tip into the newborn s oral or nasal cavity Slowly release bulb squeeze to extract the mucus discharge contents into a water container towel or similar For repetitive suctioning keep the body squeezed until suctioning again Development stage The product has been available on a not for profit basis for newborn resuscitation projects in developing countries since April 2010 It has been FDA device listed and is developed to applicable standards and regulation required for CE marking Self declaration for CE marking is imminent within March 2011 Future work and challenges Financing Although the products is highly affordable and available on not for profit basis individual health care facilities and educational institutions in low and middle income countries often have limited financial resources and may need to obtain fund
89. cess to adequate emergency surgical services and receive just 4 of 234 million surgical procedures performed each year A major deficiency is the lack of appropriate anaesthesia equipment which can operate despite power outages and shortages of compressed oxygen both of which are required for conventional machines Product description This device allows oxygen from multiple sources includes an integrated concentrator pipeline and cylinder and can also draw in room air if no other source of oxygen is available It can work without power during long outages without any reconfiguration during surgery It is designed for adult pediatric and neonatal patients All disposables are generic LL P Developer s claims of products benefits Conventional anaesthesia machines require compressed oxygen to create the anaesthetic gas mixture Most machines also need electrical power to operate Without compressed gas or power there is no general anesthesia other than the use of ketamine This device however works at ambient pressure and can adapt to loss of compressed gas or electric power If power is available the device creates its own oxygen supply and acts like a conventional machine though saving money on compressed gas If no power or compressed gas is available it automatically draws in room air and continues to safely deliver anaesthetic gas Battery operated patient monitoring provides safe delivery under any circumstances Suit
90. chanism for the plunger ensuring that the correct dose of medication is drawn into the syringe The clips are color coded by dose and can be pre set by a physician do not come into J contact with the medication and can be reused Product functionality The oral syringe dosing clip enables caregivers and patients to deliver accurate doses of liquid medication when using an oral syringe Developer s claims of product benefits It was found in laboratory and community settings that inserting the clip into the syringe enables a greater proportion of users to deliver an accurate dosage of liquid medication when compared to a syringe without a clip and a teaspoon The clips are inexpensive and can be used by caregivers to improve dosing of liquid medication regardless of literacy and numeracy skills manual dexterity and visual acuity The clip may therefore be particularly beneficial in low resource settings Operating steps Pull back plunger Insert clip into syringe barrel Push plunger into barrel Twist and lock clip into place Draw liquid medication into the syringe until the clip stops the plunger preventing further intake of liquid Dispense dose of medication with syringe as normal Development stage The dosing clips are being used by the Swaziland Ministry of Health in its national Prevention of Mother to Child Transmission of HIV AIDS PMTCT program More than 213 000 clips have been distributed to mothers participating
91. considerably lower cost with locally available materials technologies and labor User and environment User Self use patient Training Healthcare professional delivers training written instructions are provided training takes 3 5 min Maintenance None Environment of use Settings Rural urban primary health post health center Requirements None Product specifications Dimensions mm 350 x 60 x 30 Currently sold in Australia Austria Canada Germany Weight kg 0 25 Greece India Italy Japan Lebanon Malaysia Philippines Singapore South Korea Switzerland Turkey United Consumables None States Year of commercialization 2006 Contact details Sandy Hawkins Email kinney matthew hotmail com Telephone 1 716 218 7353 Fax 1 716218 7150 http wwwwho int medical_ devices 76 Medical devices Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Urine albumin test Country of origin Sweden Health problem addressed Chronic kidney disease CKD is common and harmful yet can be easily treated if detected early through a simple urine test and the measurement of low levels of albumin in the urine If not de
92. cription The device consists of an Inner Ring Elastic Ring and Applicator The device applies controlled radial elastic pressure to compress the foreskin and cut off circulation The distal foreskin becomes necrotic and is removed after 5 7 days The procedure takes less than 5 minutes is bloodless requires no injected anesthesia no sutures no sterile settings and can be conducted by low cadre nurses as validated scientifically by the Government of Rwanda Product functionality This simple and scalable device was specifically developed to provide voluntary circumcision to men ages 15 to 49 living in 14 priority nations in Sub Saharan Africa where there are high rates of HIV transmission and limited healthcare infrastructure Developers claims of product benefits Currently the only WHO recommended method for circumcision is surgery which entails skills and infrastructure that are hard to attain in resource scare settings Other devices that were not specifically designed for resource poor settings entail blood albeit less than surgery require injected anesthesia cutting of live tissue and a sterile setting Compared to surgery this device is safer simpler no sutures 3 vs 10 days of training and with low cadre non surgically trained nurses significantly reducing burden to health system and more scalable done in less than 5 minutes vs over 20 It is the only non surgical device in market bloodless no injected anesthesia n
93. ctable contraceptive Cyclofem Contraception 1997 56 310 304 Otto B Suarnawa IM Stewart T et al At birth immunisation against hepatitis B using a novel pre filled immunisation device stored outside the cold chain Vaccine 2000 18 498 502 Sutanto A Suarnawa IM Nelson CM et al Home delivery of heat stable vaccines in Indonesia outreach immunization with a prefilled single use injection device Bulletin of the World Health Organization 1999 77 2 119 126 Lawn J E Lee A C Kinney M Sibley L Carlo W A Paul V K Pattinson R Darmstadt G L Two million intrapartum related stillbirths and neonatal deaths Where why and what can be done IJGO 2009 107 s5 19 WHO Managing Newborn Problems A guide for doctors nurses and midwives WHO Geneva 2003 Stephen N Wall Anne CC Lee Susan Niermeyer Mike English William J Keenan Wally Carlo Zulfiqar A Bhutta Abhay Bang Indira Narayanan Iwan Ariawan Joy E Lawn 2009 Neonatal resuscitation in low resource settings What who and how to overcome challenges to scale up 1JGO 2009 107 s47 64 WHO Guidelines for Drinking Water Quality 3rd Ed 2004 http wwwwho int water_sanitation_health dwq GDWQ2004web pdf amp Compendium of innovative health technologies for low resou Assistive devices eHealth solutions Medical devices World Health ib y PACELLI ISBN 978 92 4 156473 1
94. ctionality Frontline health providers use the mobile application to perform health risk screening and medical triage to identify health concerns The diagnostics application on the phone instructs health providers with immediate actions to care for the patient or transmits the case to remote doctors for further diagnosis and treatment advice Developer s claims of product benefits This solution is cost effective as it requires no additional equipment or infrastructure by using available mobile phones mobile connectivity and local health providers Training for local health providers takes less than an hour because all users are already familiar with the use of mobile phones Maintenance is minimal as local phone stores are capable of maintaining the mobile devices The service reduces travel costs minimizes time to obtain treatment from weeks to minutes and is accessible locally to underserved patients via health workers or close by rural clinics Operating steps Frontline health providers use mobile phones to access the diagnostics application They enter patient symptoms information by going through a series of decision tree based medical algorithm For cases requiring remote doctor consultation the phone transmits the patient symptoms information via mobile broadband or SMS MMS to the remote doctor Development stage The product was technically evaluated and tested for clinical effectiveness via concordance rates between in person and
95. cure web information portal and provides access to weather forecasts historic and real time health and weather indicators alerts and various cartographic data for conducting prevention and emergency measures Currently the heat wave function is fully developed and the floods function will be completed in 2012 Developer s claims of solution benefits No other system is known to offer a dynamic cartographic application showing the urban heat islands and having tools for identifying vulnerable areas using a combination of numerous user selected and user controlled indicators Furthermore all the cartographic layers are available as Web Map Services WMS ensuring better access to the data since they can be reused within other OGC compliant systems without any development effort Future work and challenges As this is not a commercial product the strategy to make the product accessible has been through publications and presentations notably through webinars organized by the Pan American Health Organization the Public Health Agency of Canada etc The implementation of the system in two less developed countries will also serve as a case study in using such a system in countries where the basic data may be less widely available than in Canada Indeed availability of data probably represents the main challenge for such a system Currently the system allows for any type of georeferenced data to be published as a layer of information Other data are
96. cus Goddard Email marcus goddard menzies edu au Telephone 61 88 132 6301 Fax 61 88 363 6002 55 http wwwwho int goe eHealth Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Rapid SMS providing availability of essential medicines Country of origin United States of America Tanzania Malawi Health problem addressed Many public health supply chains in Africa suffer chronic shortages and stock out of essential medicines contributing to high morbidity and mortality rates Decision makers have little access to stock levels rendering them unable to monitor stock availability and address stock outs Solution description At pre scheduled time intervals facility community users send text messages with key data to a toll free short code using their personal mobile phones Data is used to calculate resupply quantities which are sent via SMS to resupply facilities to enable prepacking of orders Reported data items such as stock on hand as well as monthly email summary reports and supply management reports are displayed on an interactive web based interface with varying access levels to enable decision making The solution also alerts hig
97. da Sudan Togo Uganda Zambia Shelf life gt 10 years Retail Price USD 4589 List price USD 4589 Contact details Robert Neighbour Email rneighbour hotmail co uk Telephone 44 015 987 10066 Fax 44 015 987 10055 http wwwwho int medical_ devices Medical devices Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Sputum mobilization device Country of origin United States of America Health problem addressed a E Obtaining a proper deep lung specimen is a critical step in the diagnosis and management of respiratory tuberculosis both for the adult community and pediatric community Neither spontaneous samples which result in many false negatives nor sputum induction using hypertonic saline are practical or optimal Product description A low frequency acoustic wave is generated at the mouth travels retrograde into the lower airways and increases mucociliary clearance This device which is FDA approved produces such a wave with vigorous exhalation to aid in secretion clearance 4 J Product functionality The patient simply needs to blow repeatedly into the device with the same effort as blowing o
98. description The prefabricated plastic Knee Ankle Foot Orthotic PF KAFO system consists of two plastic thermoformed shells one for below the knee and one for above the knee a pair of orthotic knee joints with drop lock and uprights which connect the below knee and above knee shells and accessories such as straps fasteners and rivets The prefabricated plastic shells are available in nine sizes for the left and right leg Orthotic knee joints are available in two sizes for children and adults Product functionality Lower limb orthoses facilitate mobility and prevent secondary deformities Components of suitable sizes are selected from the available range assembled as per measurement of the individual and then fitted to the user The user attaches the orthosis to the leg by means of straps fasteners Locked knee joints facilitates stability during the weight bearing phase and assists in walking despite having weak paralysed legs Unlocked knee joints allow the user to bend his or her knee while sitting Developer s claims of products benefits It is comfortable cost effective and very appropriate for low and middle income countries It requires a minimum of time tools and machineries for assembly It is suitable for a rapid fitting in remote locations It is water proof and has the possibility of using it with or without footwear making the orthosis more culturally appropriate especially inside the house or temple Development stag
99. dium Oxytocin in prefilled auto disable injection system Country of origin United States of America Health problem addressed Postpartum hemorrhage PPH is the leading cause of maternal death worldwide Women delivering outside of health facilities or in facilities with constrained resources may not receive the WHO recommended dose of 10 IU of oxytocin for the prevention of PPH There is a need for an easy to use delivery system for oxytocin that increases access Product description A compact prefilled auto disable injection system is used to deliver Oxytocin A time temperature indicator on each package indicates heat exposure Oxytocin in this device can enable minimally trained health workers to provide the PPH prevention dose in low resource facilities emergency situations or remote locations Product functionality As a prefilled system the easy to use device allows caregivers to safely inject drugs or vaccines with minimal training The system prefilled with Oxytocin ensures that an accurate dose is delivered to a patient with minimal preparation minimum waste and a guarantee that the syringe and needle will not be used again Developer s claims of product benefits Current practice is to use a syringe and two 5 IU ampoules or one 10 IU ampoule of Oxytocin Oxytocin in described injection system is prefilled with 10 IU and ensures an accurate dose by minimally skilled health workers It is individually packaged
100. dressed r Coronary heart disease is one of the leading causes of death across the globe Every second in some part of the world a person suffers from chest pain or has a heart attack with lack of early warning systems The problem Q gets compounded by the fact that the ratio of doctors attending patients is Cy far less in lower and middle income regions Remote Physician gt Cardiologist Product description Cardiologist can view BEG The system has been designed to provide a telecardiology platform Seem for remote ECG analysis and real time reporting from the doctor for the attending paramedic or the general practitioner The portable system gives specialists the possibility to interpret ECG s from their mobiles thus C bridging the gap between the patient and the specialist Also the system gives an auditable trail of all the reports right from acquisition to reporting of the patient ECG internet Product functionality Patient details are entered in the device along with taking their ECG 20 ECG s can be stored in the device Each patient details can be transmitted to the doctor in real time Developers claims of product benefits Prevalent solutions use facsimile and dual tone multi frequency solutions to implement transmission of ECG s to the remote doctors These are one way communications without proper platform for digital reporting of diagnosis from the doctor This has been overcome wit
101. dy uchospitals edu Telephone 1 773 307 6336 http www who int ehealth eHealth Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium SMS service Country of origin Kenya Health problem addressed Globally 33 4 million people are infected with HIV AIDS While treatment scale up in sub Saharan Africa has had dramatic public health impacts including reducing mortality sub optimal medication adherence is a barrier to maximing health outcomes Solution description The solution involves a weekly short message service SMS to check in on how patients are doing and provide them the opportunity to identify whether assistance is required Once a week an automated text message is sent to patients asking Mambo Swahili for How are you Participants indicate within 48 hours of receiving the message either that they are well e g OK or Sawa or that they have a problem e g Problem or Shida Clinicians follow up all participants who identify a problem to provide triage advice or general support Participants who do not indicate a problem but fail to respond within two weeks are called by a clinician to inq
102. e nor to recommend any technology included in the compendium Point of care diagnostic device for total WBC Country of origin Sweden Health problem addressed Measuring white blood cells WBC can provide information which may aid in the diagnosis of infection inflammatory diseases or leukemia and aid in judicious prescription of antibiotics A WBC POC will be beneficial in rural settings to increase access of a vital test The system is designed as a P portable device to be used in rural settings or where near patient testing for WBC is of benefit As only a small blood volume is needed it is useful also mm for small children and anemic patients BOI Product description The system consists of an analyzer and single use cuvettes One drop 10uL of capillary or venous blood is drawn into the cuvette by capillary action J The portable analyzer consists of a microscope and a camera and the cells are counted by image analysis Product functionality The microcuvette serves as pipette mixing and reaction chamber and the correct specimen volume is obtained by capillary action Developer s claims of product benefits No similar system exists which can be used by the intended user environment Automated cell counters or manual microscopy technologies are available at laboratories but requires laboratory educated staff and requires specimen to be transported The suggested solution is performed as near pat
103. e The product has been evaluated by the International Society for Prosthetics and Orthotics ISPO in 2003 2004 The second ISPO evaluation was done in Ethiopia during trials in 2005 The third ISPO evaluation was completed in 2006 after more of ten months of use in Ethiopia The findings were presented during ISPO 2007 in Vancouver Based on the feedback better shells and new sets of orthotic knee joints have been developed and the new product was launched during the 7th International Conference of the Federation of African Orthopaedic Technologists FATO Ivory Coast 30 September 5 October 2013 Future work and challenges Future work includes development of an ankle joint introduction of the technology in the Prosthetics and Orthotics Course curriculum and introduction of the PF KAFO system under the assistance to disabled persons of India programme sponsored by the Government of India Use and maintenance User Self use Training Short training on assembly and use Maintenance Daily cleaning and checking for broken straps Environment of use Settings Rural urban ambulatory at home primary health post health center secondary general hospital tertiary specialized hospital Requirements A facility with tools stable power supply and gait training materials Product specifications Dimensions mm Vary by size the knee joints Weight kg 2 4 Other features Portable continuous use Consumables Velcro f
104. e solution has been validated in rural settings in Canada but not in developing countries Solution specifications Solution is used to support Telemedicine Electronic Standards HL7 DICOM Health Record Electronic Medical Record Health Research Currently used in Canada Evaluation Can J Ophthalmol 2008 43 658 68 Software Hardware requirements Any facility with access to a fundus imaging camera and a computer Solution is a web based software application it is proprietary and subject to a license fee Contact details Hamid FotouhiNia Email h fotuhi gmail com Telephone 1 514 344 2692 Fax 1 514 940 0369 http www who int ehealth 62 eHealth Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Teletrauma Country of origin Ukraine Health problem addressed Trauma is the main cause of death for people younger than 40 years old worldwide There are 2 million injured persons per year in Ukraine 4 of population Polytrauma due to industrial disasters and motor vehicle accidents MVAs are a critical problem for Donetsk s large industrial region because 70 are lethal or result in extremely high level of disabilities
105. e 2006 World Health Report identified 57 countries with human resources for health crises that have less than 2 3 health workers per 1000 population It is estimated that more than a billion people do not have access to a health worker Associated challenges include health workforce planning policy training deployment management and retention Solution description The software is an open source LAMP architecture solution Linux Apache MySQL PHP that once established may be accessed via a web browser on the same computer the software is deployed or via a LAN or from anywhere on the World Wide Web The software supports easy configuration of key variables such as job titles cadres competencies and job structures Information is then collected on the health workforce either through a centralized national architecture or a decentralized subnational architecture that can then be aggregated for national analysis The software supports easily customized reports and charts or the exporting of data in many common formats Functionality Typical steps for setting up and using the software include e Adding Geographical Areas e Configure database drop downs e Create a job structure e Create positions Enter employee information including identifying information contact information dependents position qualifications trainings employment and education history e Create and run reports as needed Developer s claims
106. e a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Tele ophthalmology software application Country of origin Canada Health problem addressed Diabetic retinopathy DR is a leading cause of blindness and visual disability in the world Diabetes affects 8 to 10 of the population in the developed countries Approximately 2 of people become blind after 15 years of diabetes Solution description The online screening management application collects captured fundus images patients personal data clinical data and transfers the data for Le reading and reporting medical follow ups This online screening application ve also provides yearly management recall and scheduling quality control and inter professional consultation It maintains complete trackability security confidentiality and easy access to data with without immediate access to the Internet Functionality New patient file nominal and clinical data visual acuity are added Patient s eyes are imaged the images added to the file and uploaded to the server A doctor accesses and reads the file Medical report are generated Patient is given follow up or put on recall list Overview of process with alerts Quality control Data organized at will Developer s claims of solution benefits This solution integrates all aspects of the screening process
107. e application 87 m O D io n o0 b oO n S fe n oO T z n Q eye Ke e LE U g Je Q 0 Je v gt D a gt e E i 0 z TD f Q GL ie Infectious diseases Auto stop electrochlorinator i 79 Biometric technology in healthcare 45 Computer aided detection for Tuberculosis 48 Integrated smartreader amp cloud services 50 Isothermal nucleic acid amplification system for POC diagnosis 90 Non surgical male circumcision device 72 Point of use water disinfection system 104 Smart phones for supportive supervision for TB 59 SMS service i 5 5 19 Sputum mobilization device 76 Telemedicine for HIV AIDS care 60 Water filter 105 Infection prevention Pressure cooker autoclave z 41 Laboratory Dry blood spot screening 25 Fecal occult blood test 27 Parasitological test system 93 Point of care diagnostic device for total WBC 74 Non communicable diseases Cervical cancer screening information system j 47 Electro hyperthermia f 26 Interventional cardiovasc
108. e held to endorse nor to recommend any technology included in the compendium Primary health care continuous quality improvement CQI tools Country of origin Australia Health problem addressed Lack of data on care processes and outcomes in primary care is an on going problem for applying evidence based practice CQI approaches have potential to address this challenge The approach presented provides a flexible and tailored solution facilitating use of local level data and targeted CQI appropriate to the burden of disease Solution description A CQI process developed to assist primary health care services to improve their clinical services and client outcomes by collecting data using specially developed audit tools and protocols The tools are based on best practice standards and recommended scheduled services for a range of clinical services i e child and maternal care Audit data are entered onto a web based database which provides automated real time analysis and generation of a quality improvement report for use at the local health centre level In addition to the audit data qualitative data are collected from the primary health care team through a facilitated discussion using a system s assessment tool for action planning Functionality Training in applied continuous quality improvement and clinical auditing Data collected through clinical audits The primary health care team participates in a system s assessment to collec
109. e important components of health technology which have the potential to save lives and improve quality of life and well being However too many people worldwide suffer because they don t have access to high quality affordable health technology With the problem being more acute in low and middle income countries The objective of the compendium series of innovative medical devices assistive devices and eHealth solutions is to provide a neutral platform for technologies which are likely to be suitable for use in less resourced settings It presents a snapshot of several health technologies which might have the potential to improve health outcomes and the quality of life or to offer a solution to an unmet medical health technology need It is released to acknowledge some success stories and at the same time to raise awareness of the pressing need for appropriate and affordable design solutions and to encourage more innovative efforts in the field This effort also aims to encourage greater interaction among ministries of health procurement officers donors technology developers manufacturers clinicians academics and the general public to ensure greater investment in health technology and to move towards universal access to essential health technologies All submissions to the Call for innovative health technologies for low resource settings underwent an evaluation process technologies were assessed by an expert panel based on the material and
110. e uniformity of light on the patient while a E minimizing unwanted spill and glare outside the treatment surface The device provides the ability to cater the treatment to the patient by allowing the caregiver to choose a high intensity 45uw nm cm 2 or low intensity 22 uw nm cm 2 setting Developers claims of products benefits Most phototherapy devices on the market use tubelights or compact fluorescent CFL bulbs to provide phototherapy Many of these do not provide adequate intensity or uniform coverage Moreover these tubelights have to be replaced frequently every 1000 hours This is often not feasible due to high replacement costs and availability in markets This device is easy to use for the caregiver has a low total cost of ownership is designed to be rugged and reliable and provides excellent clinical outcomes The uniformity intensity and wavelength of emitted light results in a 28 increase in bilirubin breakdown It utilizes only 20W of power which is great for electricity savings as well as for the environment It can be used with most commercially available photovoltaic systems or potentially car batteries connected to inverters It is simple to use with only two buttons on off and high low Lamps last for 50 000 hours which provides 6 years of night and day use Suitability for low resource settings The device is specifically designed for low resource settings It is designed to be rugged e g all mov
111. eaning from mechanical ventilation COPD is one of the fastest growing causes for death today worldwide Over the next 20 30 years it is poised to become the 3rd or even 2nd leading causes of death Product description The device is a small size portable versatility and can run on batteries gt A ey D Product functionality The device s primary innovation is owed to its use of micro blower 2 Lx technology and unique gas control algorithms In combination the device is i able to meet the needs of a wide variety of ventilatory demands including high leaks seen in noninvasive ventilation while still maintaining patient ventilator synchrony Developer s claims of product benefits By costing a third of other ICU ventilators and offering both invasive and noninvasive capabilities the device is ideally suited for patients in respiratory distress no matter what their location or severity Operating steps The device employs a micro blower to generate airflow and connects directly to oxygen supplies to provide between 21 100 oxygen enriched pressurized gas Pressure and flow sensors provide signals to a very sophisticated controls algorithm to precisely meter pressure flow and volume even in leak prone noninvasive applications Development stage gt The device was market released July 2010 and is sold worldwide Several investigators have compared the device s performance to other ven
112. ears Retail Price USD 11 500 List price USD 11 500 Year of commercialization 2010 Currently sold in US Eastern and Western Europe all Scandinavia most countries in Asia Pacific India Africa Japan Latin America and Middle East Contact details Vance Wilson Email Telephone 1 760 918 1077 Fax 1 760 918 7435 http wwwwho int medical_ devices 96 Medical devices Compendium of innovative health technologies for low resource settings 2011 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Prefilled auto disable injection system Country of origin United States of America Health problem addressed Solutions are needed in low resource settings to increase access to drug and vaccine delivery It is also necessary to prevent reuse of syringes helping to prevent transmission of bloodborne disease and to minimize waste in these settings Product description The device developed to address this health problem is a compact sterile prefilled nonreusable injection system for delivery of vaccines or drugs Product functionality The prefilled sterile injection system may allow minimally trained health workers to accurately inject drugs or vaccines that they would not otherwise be allowed to del
113. econdary general hospital tertiary specialized hospital Product specifications Dimensions mm Variable Retail price USD 25 without the cost of cushion Weight kg 7 8 List price USD 25 without the cost of cushion Consumables No Other features Mobile continuous use Life time years 5 Year of commercialization 2008 Shelf life years 5 Currently sold in Bangladesh Contact details Iffat Rahman Email rimon_physio yahoo com Telephone 880 27 745 464 Web http bit ly dll t lt A http www who int disabilities technology 4 Assistive devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Magnetic prosthetic suspension system Country of origin Malaysia Health problem addressed A prosthesis is used as part of amputee rehabilitation and the suspension system is an important feature that affects prosthesis users quality of life Individuals with lower limb amputation need to wear prosthesis to perform activities of daily life especially walking Product description The magnetic suspension system is a magnetic coupling device which holds the residual part of the limb stump inside the prosthe
114. enowned academic institutions Future work and challenges In Ghana the current challenge is to build a self sustaining enterprise This effort has taken 6 years and there are still struggles to reach those who lack improved water at an affordable price Willingness to pay ranges from 2 15 but the product price is 25 Moreover emergency distribution of the product is free which distorts the market further even while making the product familiar to a wider customer base There is a need for a reliable stream of buyers support for technical training human resources and financial management and support for further R amp D to improve the product User and environment User Self user family member Training Each filter comes with an educational sticker Hands on demonstration training takes 1 hour in groups Maintenance Self user Environment of use Requirements This filter removes microbes from unclean water It does not require any power supply internet cell phone etc There is no specialized personnel needed to operate the filter Product specifications Dimensions mm 500 x 42 diameter element after three years Weight kg 7 Other features Portable and reusable Consumables The ceramic pot filter element needs Currently sold in The filter is commercialized in certain replacement after 2 3 years countries Guatemala Cambodia and largely promoted by Life time 3 years NGOs in other countries Ret
115. environment User Patient Training None Maintenance None Environment of use Settings Urban rural at home primary health post health center Requirements Laptop access to Internet Product specifications Dimensions mm 80 x 110 x 40 Retail Price USD 2000 Weight kg 0 3 List price USD 2000 Consumables None Other features Mobile reusable uses software Life time 3 years Year of commercialization 2010 Shelf life 3 years Currently sold in Malaysia Contact details Kok Beng Gan Email gankokbeng ukm my Telephone 60 12 780 4622 Fax 60 38 921 6856 http wwwwho int medical_ devices 71 Medical devices Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Non surgical male circumcision device Country of origin Israel Health problem addressed Three randomized controlled clinical trials in Africa showed that male circumcision can reduce risk of HIV transmission among heterosexual men by as much as 60 Public health leaders aim to circumcise 20 million men by 2015 in 14 nations in Sub Saharan Africa Africa has reached less than 5 of its goal with existing surgical methods Product des
116. er User and environment User self use patient physician nurse midwife family member technician community health worker Settings rural urban home ambulatory primary secondary schools and training programmes Solution specifications Solution is used to support eLearning mLearning Evaluation Videos have been shown to be effective mHealth instructional tools and are commonly used to teach medical practices and skills in high income countries however they remain vastly underutilized and unavailable in the developing world The content is based on best practice standards and is subjected to rigorous review by global content experts Content is field tested for effectiveness in teaching and for comprehension and relevance Software Hardware requirements A basic viewing device is required for example a battery powered DVD player As access to more sophisticated devices the Internet and stable power supply increases more options for viewing the videos become available Currently used in India South Africa Contact details Peter Cardellichio Email card3 comcastnet Telephone 1 617 876 0778 http www who int ehealth 54 eHealth vative health a rce settings Compendium of inn technologies for low 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not b
117. ers are neonatologists and pediatricians including those in government hospitals who will use the warmer as a critical component of providing neonatal care for low birth weight infants starting with those in India Different strategies have been implemented to reach out to these practitioners including establishing a direct sales team and partnerships with pharmaceutical medical device companies for distribution Use and maintenance User Physician nurse Training No intensive training required Basic instructions included with device in pictorial form Maintenance None Environment of use Settings Rural urban settings ambulatory primary health post health center secondary general hospital tertiary specialized hospital Requirements Intermittent supply of electricity limited supply of water and sanitizer to clean the sleeping bag before placing newborns Second version of the warmer meant for in home use uses boiling water instead of electricty Product specifications Dimensions mm 440 x 290 x 70 Retail Price USD 250 Weight kg 4 1 List price USD 250 Consumables None Other features Portable reusable Life time 3 years Year of commercialization 2011 Currently sold in India Contact details Krishnakanth Balam Email krishnakanth careers gmail com Telephone 91 99 000 35964 Web http bitly TyZeEb http www who int medical_devices Medical devices Compendium of
118. es diabetes and other health conditions Modern above knee prosthesis are prohibitively expensive especially due to the cost of the knee joint which is the most complex component of an above knee prosthesis Product description It is a polycentric prosthetic knee joint which mimics the movement of a normal knee joint while walking At the same time it provides stability C during the weight bearing phase to ensure the person can walk with their artificial limb without falling Product functionality A prosthetic knee joint is the connector between below and above knee prosthetic components to provide knee movement like a normal knee It usually gets attached to a modular component or a pylon at the lower end which ultimately connects to a prosthetic foot On the other end it connects to a prosthetic socket again through a modular attachment Developer s claims of products benefits Prosthetic clinics in the developing world typically recycle used donated prosthetic knees or use locally made single axis knees Donated knees are cost prohibitive to maintain and perform poorly in rugged environments Single axis knees are unstable and can buckle especially when walking on uneven surfaces The polycentric prosthetic knee joint provides increased stability for uneven and unpaved terrain withstands high usage by using an oil filled nylon polymer which self lubricates with use it can be used in humid and wet environments and it i
119. es for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Polypropylene endoskeletal lower limb prosthetic system Country of origin Switzerland Health problem addressed a 3 Due to road traffic injuries wars and conflicts non communicable diseases and other health conditions many people with disabilities have limited mobility and are in poor health Nearly 35 million people in the world are in need of orthopaedic prosthetic orthotic devices to improve mobility and their overall health Among them only 5 15 in low and middle income countries have access to one Product description The system is a set of specially designed polypropylene components to fabricate fit lower limb prosthesis artificial limb for people with lower limb amputation Usually it comes in two varieties 1 Trans tibial below knee o and 2 Trans femoral above knee amputation The system consists of a foot piece convex ankle two concave cylinders convex disc cylindrical TT cup flat steel washer and countersunk head bolt lock washer and a knee unit in case of Trans femoral above knee prosthesis a Product functionality The modular endoskeletal components are mostly made out o
120. et water disinfection technology Journal of Water and Health 6 no 1 3 53 Stoltzfus R J J Defining lron Deficiency Anemia in Public Health Terms A Time for Reflection J Nutr 131 565S 567S 2001 Juliana CT et al Prevalence of anemia among preschoolers and response to iron supplementation Jornal de Pediatria vol 87 1 2011 96 Portable ventilator Appendix 97 Prefilled injection system Compendium of innovative health technologies for low resource settings 98 Reusable neonatal 2011 2012 100 Transcutaneous bilirubin measurement system for infants 105 Water filter auto disable suction device IEC 60601 1 Medical electrical equipment Part 1 General requirements for safety IEC 60601 1 2 General requirements for safety collateral standard Electromagnetic compatibility requirements and tests IEC 60601 2 12 Medical electrical equipment Part 2 12 Particular requirements for the safety of lung ventilators Critical Care ventilator The Product is FDA device listed and CE marked The product has been developed in accordance with ISO 9001 and ISO 13485 FDA 510K KO10052 Tsu VD Sutanto A Vaidya K et al Oxytocin in prefilled Uniject injection devices for managing third stage labor in Indonesia International Journal of Gynaecology and Obstetrics 2003 83 1 103 111 Bahamondes L Marchi NM Nakagave HM et al Self administration with Uniject of the once a month inje
121. ext step User and environment User Interventional cardiologist and interventional radiologist Training Required Maintenance Annually Environment of use Settings Rural settings urban settings secondary general hospital tertiary specialists hospital Requirements Stable 120 kVA power supply and good earthing Procedure room should be semi sterile Lead shielding on doors and windows should be present to protect from scattered radiation Technician operating the system needs to be trained Temperature range is 15 35 C and humidity range is 30 75 Product specifications Dimensions mm 2000 x 1000 x 2000 Year of commercialization 2010 Weight kg 300 Currently sold in India Nepal Egypt Turkey Chile Retail Price USD 180000 250000 Columbia Peru Poland List price USD 180000 250000 Other features Software use installed stationary reusable Contact details Lori Shamroth Email LoriGayle 23 gmail com Telephone 1 978 659 3776 Fax 1 978 975 1285 http wwwwho int medical_ devices 66 Medical devices Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Intramedullary nail and interlocking screw
122. f innovative health eHealth technologies for low resource settings 2012 mHealth platform for community health workers Country of origin United States of America Health problem addressed r High infant and maternal mortality in developing countries are a major public health concern Community health programmes have been effective in reducing mortality but their effectiveness is limited due to lack of sufficient training absence of performance evaluation and feedback absence of standardized protocols and ineffective care coordination Solution description The platform has a mobile app and a Health Insurance Portability and Accountability Act HIPAA compliant cloud based platform with web interface Community health workers CHW use mobile phones in the field to capture data educate patients and provide case management The web interface is used for monitoring the program and generating reports In the field patient data can be stored on the phone or sent to the server The platform supports audio images video data and also uses GPS and bar code data The platform can also send reminder SMS messages emails or generate other alerts required in the workflow Through active monitoring of data timely interpretable reports and targeted follow up actions can be created for CHWs and the supervisors a Functionality The CHW logs into CommCare using a username and password The CHW selects the module e g Pregn
123. f polypropylene and available in different sizes It also comes with a prosthetic foot and other necessary materials for fabrication of the socket and cosmetic cover A trained prosthetist fabricates the socket selects the needed components assembles those to make the prosthesis as per measurement and then does the fitting Developer s claims of products benefits The product is affordable durable comfortable easy to use and to maintain It has a long shelf life and at the same time recyclable It is compatible with different climatic regions of the world Development stage Products are available on the market and are being used in more than 100 projects all around the world The product has the ISO Norm 10328 certificate by C E R A H The product has been evaluated by the International Society for Prosthetics and Orthotics ISPO Future work and challenges Future work includes development of an advanced prosthetic foot knee and a hip joint Use and maintenance User Self use Training Short training on use and maintenance Maintenance On site every 1 2 years Environment of use Settings Rural urban at home for indoor and outdoor use Product specifications Dimensions mm Components come with different List price of consumables USD Foot consumables 80 sizes to accommodate all age groups Other features Portable continuous use Weight kg Trans tibial 2 kg Trans femoral 5 kg Year of commercialization
124. ficult situations R Tully R Eltringham IA Walker AJ Bartlett Anaesthesia and Intensive Care 2010 38 6 1085 9 The Diamedica Draw Over Vaporizer a comparison of a new vaporizer with the Oxford Minature Vaporizer WA English R Tully GD Muller amp RJJ Eltringham Anaesthesia 2009 64 84 92 Modification of a draw over vaporizer for use with sevoflurane T Payne R Neighbour amp R Eltringham British Journal of Anaesthesia 2012 108 5 763 72012 http www thelancet com journals lancet article PIISO140 6736 10 60518 1 abstract http wwwwho int mediacentre factsheets fs317 en WHO Global Status Report on Road Safety 2009 e WHO Global Burden of Disease Study 2004 Ikem IC Ogunlusi JD Ine HR Achieving interlocking nails without using an image intensifier SICOT 2007 31 487 490 e Calafi LA Antkowiak T Curtiss S et al A biomechanical comparison of the Surgical Implant Generation Network SIGN tibial nail with the standard hollow nail Injury 41 2010 753 757 e Young S Lie SA Hallan G Zirkle LG et al Low infection rates after 34 361 intramedullary nail operations in 55 low and middle income countries Acta Orthopaedica 2011 82 6 727 743 e Sekimpi P Okike K Zirkle L Jawa A Femoral fracture fixation in developing countries an evaluation of the Surgical Implant Generation Network SIGN intramedullary nail J Bone Joint Surg Am 2011 Oct 93 19 1811 8 Green D A Kumar A Khanna R Neonatal hyp
125. g adherence to antiretroviral therapy in patients with HIV infection Cochrane Database Syst Rev 2012 Contact details Richard Lester Email rlesterid gmail com Telephone 16 04 707 5606 http www who int ehealth eHealth Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium TID system Type Diabetes system Country of origin Spain Health problem addressed People with diabetes have to eat according to a fixed pattern depending on the insulin dose prescribed by the doctor Any change in intake sport or other daily event cannot be safely managed by patients Solution description This is a mobile technology to better self manage type 1 diabetes mellitus TID Factors like food intake and exercise are logged into the system by the patient The TID system takes the insulin pattern determined by their doctor and recalculates the recommended insulin dose based on the parameters introduced by the patient in their individual daily context By personalizing data management the system can prevent for example hypoglycemia during sleep Patients gain flexiblity over their diet and security in their treatment Patients and their doctors can
126. g countries require the use of prosthetic and orthotic devices Individuals who have had their leg s amputated above the knee joint due to trauma disease or a congenital reasons and are unable to walk without the use of a lower limb prostheses are the target population for this product With an above knee prosthesis people with above knee amputations will be able to walk remain independent productive and healthy Product description The artificial knee joint is an integral part of the above knee prostheses The knee unit is simple in design and made of fiber reinforced polymer construction The lower end connects to a modular prosthetic system which ultimately connects to an artifical foot The upper end connects to a prosthetic socket with an attachment Product functionality The knee unit utilizes a proprietary stance phase control mechanism termed the Automatic Stance Phase Lock ASPL It is composed of a knee lock that is automatically engaged as the knee becomes fully extended thus preventing the knee from bending A combination of a hip flexion moment and loading of the forefoot unlocks the knee This is a natural sequence of events that occurs at each step of walking and allows the knee to be stable as needed while facilitating natural swing phase flexion The knee joint is fitted by a trained technician during the fabrication of the above knee prostheses Developer s claims of products benefits One of
127. ging Solution description A mobile medical platform that 1 connects resident physicians to their peers amp faculty for timely team based case consultations related to patient care 2 provides access to a global network of physicians via Swinfen Charitable Trust s Telemedicine programme for external referrals and 3 enables easy centralized access to important medical resources relevant to Botswana Users can e Complete case forms including images amp videos and send to colleagues for consultation Send messages to the entire team or individuals e Search message history e Share geographic location e Search and share references such as local treatment guidelines and PubMed Functionality Users sign on and set their status as on call or online and indicate their location They can see others status and location Users complete a case consult form attach media such as photos or videos and share with team members for comments Users are notified of news messages amp replies via notifications on their device and in the app Developer s claims of solution benefits The application provides an integrated platform for physicians to communicate efficiently about patient care and to access and share reference information through a single app on a mobile device Users benefit from telemedicine consults amp searchable message threads thereby learning through a shared case based model and have access to c
128. h comprehensive auditable online storage This device has been so designed keeping in view the ease of use adaptability and scalability The device can be used not only as an emergency single point of care but with its local and cloud printing capabilities it also means that the same device can replace a conventional ECG machine Operating steps 1 Connect the patient cable to the ECG connector at the bottom of the device 2 Clean the skin surface before after applying electrodes 3 Connect the electrodes to the patient 4 Attach the patient cable leads to the electrodes placed on the patient s skin surface 5 Switch on 6 Follow the process on device as mentioned in section 7 2 in manual Development stage The unit was tested and deployed at a renowned 800 bedded multi specialty hospital and a cardiac critical care center in Mumbai Further in the first 12 months the devices has been used in cardiac screening camps at multiple remote rural locations within India with more than 10000 ECGs being taken and reported in this period Certified for CE 1293 Future work and challenges 1 Availability of reliable communication networks electrical power for device charging in remote rural locations doctors to report the ECGs on timely basis 2 Seamless integration of various emergency response teams to take follow actions 3 Developing and managing software clients for various different smartphones 4 Slow adoption by medical profess
129. he compendium Telecardiology Country of origin France Health problem addressed Chronic cardiovascular disease Product description The system consists of a 12 lead electrocardiograph ECG that transmits its recordings via satellite or any solution available on site 2G 3G ADSL WiFi to a web platform where data is accessible An elastic belt facilitates operation by eliminating the installation of 10 ECG electrodes Developers claims of products benefits This device is easy to use and can even be operated by the patient without the support of a health professional It also provides quick medical advice through the development of an online medical file that simplifies the relationship between health professionals L ae Suitability for low resource settings The device prevents the need for patient transport when monitoring chronic cardiovascular disease and it allows for specialist advice in areas far from specialized healthcare facilities Operating steps The stretch belt equipped with the pre placed electrodes is placed on the patient s chest The recorded data is directly sent to a specialist The data is stored remotely and the cardiologist performs the reading on a smartphone or computer via the Internet Regulatory status The product is CE marked and manufactured by an ISO 13485 certified company Data transfer is secure and compatible according to Telemedicine laws Future work and chal
130. health technologies for low resource settings 2011 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Non pneumatic anti shock garment Country of origin United States of America Health problem addressed Postpartum hemorrhage PPH in developing countries continues to be the single most common cause of maternal morbidity and mortality accounting for approximately 25 percent of maternal deaths globally Over 90 percent of these deaths occur in developing countries Product description For women suffering from uncontrollable PPH a method to control the bleeding reverse the shock and stabilize the patient for safe transport to a comprehensive obstetric care facility could be lifesaving One method to manage PPH is the use of a non pneumatic anti shock garment NASG Product functionality The NASG is a lightweight neoprene garment that is made up of five segments that close tightly with Velcro The NASG applies pressure to the lower body and abdomen thereby stabilizing vital signs and resolving hypovolemic shock When fitted correctly the reusable NASG forces blood to the essential organs heart lungs and brain Developer s claims of product benefits This garment provides an improvement over existing p
131. her level staff via SMS if stock levels are limited or depleted Functionality Refer to solution description Developer s claims of solution benefits In Tanzania evaluation results indicated that 88 of facilities improved on time stock report submission rates and 93 improved stock counting exercises because of receiving routine mobile alerts 45 of facilities reported improved product availability In Malawi community health worker CHW logistics reporting rates grew to 97 from 43 and lead times were reduced The group messaging feature enables managers to reinforce skills and procedures Future work and challenges Some challenges include maintaining the system and solving software problems when they occur Timely resolution of problems is key to maintaining user confidence in the system Common human resources challenges also can occur such as turnover of trained staff Additionally transitioning the system to full Ministry of Health ownership can be a challenge if they are not engaged from the outset in the technology development Future challenges include how to continue to ensure increased product availability use of data for decision making and determining to what extent it can supersede the existing paper based system rather than be a supplement User and environment User community health worker health facility staff district health staff and national health staff Training training is conduct by trained trai
132. households showed a 2 3 log E coli reduction against controls Lab testing found greater than 4 log reduction of virus and 6 log reduction of bacteria Device conforms to US EPA guide standard and protocol for microbiological water purifiers as tested in house Future work and challenges Challenges include cost distribution and appropriate support Efficient manufacturing process that reduces costs and ensures high quality is required to reach target sale price Partnerships with local and international NGOs implementing water and health programs is required to develop implementation support materials to ensure successful sustainable use of technology in different scenarios User and environment User Self use patient physician technician nurse midwife shop owner Training Training can be conducted programmatically in under 30 minutes with instruction manual and device Maintenance None Environment of use Settings Rural settings Urban settings primary health post health center secondary general hospital tertiary specialists hospital Requirements This product requires a minimally trained operator and a charged 12V battery It also requires a power supply for recharging Product specifications Dimensions mm 100 x 77 x 122 List price of consumables USD 0 05 1000 liters of Weight kg 0 2 water treated Consumables Salt Water Battery Power Other features Software use Inst
133. hs are in developing countries and 2 7 million are due to congestive diseases that result in hypoxemia Early detection of hypoxemia is essential in reducing mortality and morbidity SPO2 monitoring facilitates this SPO2 monitoring is also essential during anesthesia It is called the 5th vital sign Product description This pulse oximeter is a portable easy to use monitor that measures blood oxygen saturation levels and the pulse rate It is designed for use in low resource settings is rugged and has its own on board human powered energy source Product functionality The oximeter offers the highest quality pulse oximetry on the market It analyses the entire plethysmographic wave form locating the onset of a pulse and resulting in extreme pulse detection It has excellent low perfusion and motion compensating performance warning the user and preventing inaccurate readings Developer s claims of product benefits This is a monitor specifically designed for use in low resource settings or where electricity supply is a problem The SPO2 monitor is rugged and reliable and has its own on board power generator Human energy is converted into electricity and saved in rechargeable batteries The monitor gives 10 15 minutes of monitoring per minute of winding The monitor may also be recharged using grid power when available The pulse oximeter is designed to be compatible with a wide range of probes to take advantage of generic offerings whe
134. http www who int ehealth eHealth Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Remote healthcare solution Country of origin India Health problem addressed 70 of the rural population in India has very poor access to healthcare 76 of the medical facilities are concentrated in urban areas and there is an overall shortage of medical personnel Thus rural patients are left to semi and non qualified practitioners creating a huge disease burden Solution description The technology enables rural patients to reach urban doctors through a telemedicine solution This comprises of a modular data analysis unit MDAU a USB powered multiparameter diagnostic device which captures ECG temperature heart amp lung sounds SPO2 and BP and communicates with the remote doctor through a low bandwidth audio video data conferencing The solution allows for the integration of the whole healthcare delivery ecosystem to provide meaningful service The solution also captures the workflow of delivery processes and enables resource optimization by capturing and analysing operational service delivery data Functionality A rural operator carries
135. ian nurse midwife Training Required provided by device distributors Maintenance Minimal cleaning Environment of use Settings Rural urban ambulatory primary health post health center secondary general hospital tertiary specialists hospital Requirements Power supply Product specifications Dimensions mm 120 x 135 x 183 List price USD 624 50 Weight kg 0 6 Other features Portable single use consumables and Consumables Yes reusable device Life time gt 7 years Year of commercialization 2008 Shelf life gt 7 years Currently sold in US Europe Contact details Lena Wahlhed Email wa live se Telephone 46 43 148 1311 Fax 46 43 148 1225 http wwwwho int medical_ devices Medical devices Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Portable anaesthesia machine Country of origin United Kingdom Health problem addressed In remote locations anaesthesia may be non existent or unreliable which can prevent emergency surgery For instance millions of mothers and babies die from birth complications many of which could be saved by C sections if safe anaesthesia were available Anaesthe
136. ical test system 5 93 Phototherapy for neonatal jaundice treatment f 94 Portable haemoglobin meter 95 Portable ventilator f 96 Prefilled auto disable injection system 97 Reusable neonatal suction device 98 Self powered pulse oximeter f f 99 Transcutaneous bilirubin measurement system for infants 100 Ventilator using continuous positive airway pressure 101 Other technologies 201 02 Newborn simulator for resuscitation training 103 Point of use water disinfection system f 104 Water filter 105 Appendix 106 m oO N 1 N n 00 E b oO n S rs ie n oO T 3 2 n 2 o0 Ke fe te YU oO p j Q oO f v 2 a gt fe ue oO z mo f 0 Qa ie O Technologies by health topic Assistive devices for hearing and vision Hearing screen eRecord 14 Pen mounted CCTV camera x 6 Solar charger for hearing aid i 43 TeleOphthalmology aided primary eye care s DI Assistive devices for mobility Artificial prosthetic knee joint 2 Child wheelchair 3 Hollow mattress 4 Magnetic prosthetic suspension system 5 Manual wheelchairs and mobility devices f 83 Polycentric prosthetic
137. ician nurse technician self use patient Training Minimal training is required Settings Rural urban primary health post health center secondary general hospital tertiary specialized hospital Solution specifications Solution is used to support Decision support systems Standards HL7 Diagnostis and treatment Electronic Health Record au ei Currently used in South Africa eLearning mHealth Patient monitoring Telemedicine Evaluation International Journal of Audiology Vol 51 No Software Hardware requirements A touchscreen 8 p 606 610 August 2012 device headphones Screening Apparatus iOS plan to add Android platform developed using open source software Contact details Michael Melvill Email melvills mweb co za_ Telephone 27 84 585 2246 http www who int ehealth Compendium of innovative health eHealth technologies for low resource settings 2013 Maternal and child health mobile services Country of origin India Health problem addressed Mobile services were developed to address some of the highest rates of maternal neonatal and infant mortality MMR 305 100 000 NMR 35 1000 IMR 55 1000 in India by helping community health workers CHWs in Bihar to communicate crucial information on health behaviours to pregnant women and mothers of infants Solution description CHWs refresh and expand their knowledge of family health using an Interactive Voice Response IVR training cour
138. ient testing The WBC system will provide rural areas with increased availability to one of the most frequently used lab parameters Instant results of the white blood cell count will facilitate more well informed decisions in several clinical situations and facilitate monitoring of diseases and treatment for example in infections HIV inflammatory diseases etc Making the WBC more rapidly accessible to rural settings will improve healthcare as well as save costs and transportation time Operating steps 1 Fill the cuvette 2 Place it in the analyzer 3 Result is available lt 3 min Development stage The device is CE marked and FDA 510 k cleared Besides internal evaluations the accuracy of the device has been validated in 2 published studies a study by Osei Bimpong et al Osei Bimpong Int Journal of Laboratory Hematology 2008 and a study by Casey et al Casey et al Clinical Pediatrics 2009 Future work and challenges The company will use its well established distribution network to make the system available to the intended user Through an extensive network the hemoglobin systems have been made widely available in developing regions and has proved experience in bringing POC tests to rural settings including set up and local training The main challenge lies in introducing and getting local acceptance of a new test and challenges regarding local decision making policies User and environment User Physician technic
139. ifications Dimensions mm 105 x 32 x 25 Other features Portable reusable Weight kg 0 038 Year of commercialization 2012 Consumables None Currently sold in China List price USD 76 Contact details Satoshi Kikuchi Email earthermometer gmail com Telephone 81 36 742 8216 http www who int medical_devices 30 Medical devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium LED phototherapy for neonatal jaundice Country of origin India Health problem addressed SSS N Neontal jaundice hyperbilirubinemia occurs in at least 60 of term infants If untreated it can cause irreversible brain damage Phototherapy equipment for treatment currently available have frequent bulb replacement needs expensive bulb replacement costs and experience frequent breakdown in remote rural areas Product description The device emits light through an array of high powered light emitting diodes LEDs These LEDs have been specifically selected to emit a narrow wavelength of blue light dominant wavelength 458nm that maximises the rate of bilirubin breakdown The arrangement of the LEDs along with the optics have been designed to provid
140. ility serial monitoring plotting and printing of results quality assurance and remote expert support 3G data connection integrated SIM card is necessary if remote expert support is desired Developer s claims of products benefits 2D ultrasound with Doppler mode are available at secondary and tertiary care facilities in South Africa but operation requires sonography skills and training Sonographers are expensive are scarce in South Africa This system is based on continuous wave technology which is easier to use and already proven to be as reliable as the more expensive and larger duplex mode machines found in ultrasound units By introducing the simple to use Doppler to primary antenatal care it is anticipated that this device could significantly reduce the numbers of referrals to a higher level of care Suitability for low resource settings The system requires little management and few consumables apart from the gel to operate the probe and thermal printer paper if maternity case records are to be maintained The system is rugged as well as water and acid resistant It has demonstrated that simple PC based continuous wave Doppler ultrasound device operated by a midwife at the antenatal study clinic is effective in identifying patients at risk for placental insufficiency and in excluding pregnant women from additional tests for fetal well being Operating steps Enter patient details palpate to determine fetal orientation apply gel to probe
141. ility for low resource settings The device is intended for use in low income countries and remote areas where gas cylinders are expensive and difficult to transport The device needs no compressed gases It delivers both oxygen and air at 8 L min and costs just 70 pence per day Equivalent use of compressed gas costs 70 per day It delivers safe affordable reliable CPAP Operating steps Plug in and run oxygen concentrator Fill the bubble bottle with boiled cooled water and connect the breathing circuit Adjust the level of CPAP required using a simple dial control on the bottle Flow of air and oxygen can be seen in the bottle as bubbles in the water Connect nasal prongs or mask to the patient and continue to monitor signs of respiratory distress Regulatory status The oxygen concentrator and CPAP system incorporated in this device have CE mark and FDA approval The device is provided by an ISO 13485 registered company Future work and challenges The device will be demonstrated at forthcoming exhibtions and conferences in Africa Asia and the Middle East Peer reviewed clinical trials are underway in Papua New Guinea Intention is to co author papers for publication in peer reviewed journals Use and maintenance User Physician nurse Training Not required Device comes with a manual with full instructions for operation and maintenance It has successfully been used by medical staff without any additional special training in lo
142. ilters while requiring little maintenance The intended kiosk model centralizes water treatment to trained operators and can treat water for 200 people per day Developer s claims of product benefits Drinking water can be treated by many methods including boiling chemical disinfection filtration and UV light All methods have their advantages and drawbacks mostly related to cost ease of use and appropriateness for the source water conditions This device is innovative because of its low capital and recurring costs income generation potential and its relative ease of use The chlorinator is durable has no moving parts and very minimal maintenance requirements Disinfection of clothing hard surfaces and medical equipment is greatly simplified With a low wholesale price and high chlorine generation rate it is an excellent candidate for microloan supported entrepreneurial programs The kiosk model also provides financial incentives to operators Operating steps Add salt and water to the indicated lines in the salt brine bottle Shake until all salt is dissolved Attach the power leads to a 12 V battery Fill the device with 50 mL of salt brine and press start Wait about 5 minutes until the device beeps and the light flashes Dose chlorine into drinking water storage containers Development stage The device has been proven for its simplicity and has undergone many field trials without incident In field trials random checks of participating
143. in villages or living far from a pharmacy may receive a prescribed medicine within two days We can thus reduce the waiting time by up to 90 Also the transport expenses can be reduced The system would help to increase the quality of care provision by improving the access to pharmaceutical products Future work and challenges Future work includes spreading the system to all African countries and working with the pharmaceutical industry in developed countries to increase access to orphan medicines with regards to the African market Furthermore we plan to manage logistics problems by developing a RFID based transport box thereby increasing security for the patient and products and avoid fraud during the transportation of medicine The box can also help to keep medicine at the right temperature during transportation User and environment User Physician nurse midwife self use patient family member Training Local EpharmacyNet system IT professionals can deliver required training within a one week period Settings Rural urban at home ambulatory primary health post health center secondary general hospital tertiary specialized hospital Solution specifications Solution is used to support Decision support systems Standards HL7 diagnosis and treatment Electronic Health Record Electronic Medical Record Geographic Information System Health research mHealth Management of Evaluation The study has been conducted in
144. ing components and determine the concentration of bilirubin Developer s claims of product benefits The technology of the device evaluates melanin collagen hemoglobin and bilirubin in a patient s subcutaneous tissues through a proprietary algorithm and optics system Existing technologies measure the yellowness of the skin as it relates to jaundice Operating steps Simple button push for calibration place on infants head or sternum and press the measurement button 5 times in succession and the results appears on the screen Test taken in minutes Development stage This product has been sold globally since 2002 To date over 5000 units have been delivered to hospitals clinics physicians and community health workers Technical evaluation and health technology assessment review FDA 510K k010052 Regulatory approval complete Conformity assessment has been carried out USA Future work and challenges The product is not registered as a medical device in all countries Depending on the country of use the product may need to be registered before it is used User and environment User Nurse midwife physician Training Technique education on how to properly take a measurement Maintenance Manufacturer Environment of use Setting Rural and urban health care facilities Requirements Power supply to charge the battery disposal of calibration tip and cleansing products for pre patient use Product specifications
145. ing event in Kenya in hospitals in Kenya in a large screening program in Morocco and Mexico in the Nordic Countries in the US and in Europe Future work and challenges The scope of the problem and the need is huge but the awareness of it and the priority on health care are limited The subjects who are not detected early may face a devastating future as the treatment in the later stages such as dialysis and transplantation is not available or very expensive However through early detection and cost effective treatment a near normal life can be lived User and environment User Physician technician nurse midwife anyone also without laboratory education Training Easy to follow documentation is provided with the analyzer Distributors can support training Maintenance Minimal maintenance cleaning Environment of use Settings Rural urban ambulatory primary health post health center secondary general hospital Requirements Continuous power supply Product specifications Dimensions mm 170 x 115 x 66 List price USD 600 device 2 99 3 99 consumables Weight kg 0 350 Other features portable single use Consumables Urine Albumin Microcuvettes Year of commercialization 2006 Life time gt 7 years Currently sold in US Europe Mexico Kenya South Shelf life gt 7 years Africa Russia Retail Price USD N A Contact details Lena Wahlhed Email lwa live se Telephone 46 4 31481311 Fax
146. ing from governments or international aid organizations User and environment User Family member midwife nurse physician Training None Maintenance Any person responsible for disinfection Environment of use Requirements The only requirement is that it must be possible to clean and disinfect the device before first use and between patient uses Cleaning can be performed by boiling the one piece device in water or by more advanced methods Product specifications Dimensions mm 40 x 40 x 130 List price USD 3 Weight kg 0 06 Other features Portable and reusable Consumables None Year of commercialization 2010 Life time 5 years Currently available in 68 countries identified by UN as Retail Price USD 3 focus countries relative to UN Millennium Contact details Ingrid L rdal Email suctiondevice gmail com Telephone 47 5151 1855 47 9514 5168 Fax 47 5152 3557 http wwwwho int medical_ devices Medical devices Compendium of innovative health technologies for low resource settings 2011 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Self powered pulse oximeter Country of origin United Kingdom Health problem addressed 10 8 million children die every year 99 of these deat
147. ing mechanical parts such as fans have been removed from the lamphead The cost of ownership is highly minimized by having LEDs that last 50 000 hours 6 years of night amp day use and 50 times that of bulbs It also uses only 20W of power Over 2000 units have been deployed in low resource settings Almost one third of the device s sales in India have been to Tier 2 or 3 towns It has been awarded the Oxford Analytica validation Healthymagination certificate for product that improves access betters quality and reduces cost of care The Federation of Indian Chambers of Commerce and Industry have awarded it the prestigious Healthcare Excellence Award in 2012 for innovation to solve pressing healthcare challenges in India Operating steps The device is simple to use After installation it has to be plugged into mains power 100 240V There are then only two buttons On Off and High Low to vary the intensity Black screws on top can be unfastened to remove the lamp head for placement on an incubator The height of the lamp can be adjusted by unscrewing a ring in center of the pole Regulatory status It conforms with the requirements of Medical Devices Directive 93 42 EEC BSI CE 0086 mark It is also certified ISO 13485 It has US FDA 510K clearance K120168 It is ROHS compliant and a WEEE certificate is available Use and maintenance User Physician nurse midwife Training None Maintenance None Environment of use Set
148. ings Rural urban ambulatory at home primary health post health center secondary general hospital tertiary specialists hospital Requirements Storage in cool dark location out of direct sunlight Product specifications Dimensions mm 80 x 20 x 0 001 Weight kg 0 002 Consumables Disposable alcohol wipes transparent medical tape List price USD 0 40 Other features Portable reusable Year of commercialization 2010 Currently sold in India Russia USA UK Haiti Australia Canada Cyprus Egypt Kenya Netherlands Papua New Guinea Peru Tanzania Zimbabwe Life time 5 years Shelf life 2 years Contact details John Zeal Email temperaturedoc aol com Telephone 44 125 884 0732 Fax 44 125 884 1032 http wwwwho int medical_ devices Medical devices Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Non invasive vascular age risk prediction Country of origin Malaysia Health problem addressed According to WHO 17 3 million people died from cardiovascular diseases CVD in 2008 and over 80 of CVD deaths are in low and middle income countries Over the past 10 years the trend of hospitalizat
149. innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Infrared ear thermometer Country of origin China Health problem addressed Body temperature measurement is used to assist in disease diagnosis Product description The device has a sensor inside that detects infrared emitted from the tympan It provides the body temperature based on the calculation of the amount of emittance This ear thermometer does not require a protective cover for the sensor and the sensor can be cleaned by wiping it directly with ethanol Developers claims of products benefits Other body temperature measurement options take a long time and other ear thermometers usually require a protective cover to prevent the invasion of foreign matter These covers may affect the accuracy of the measurement cause infection when inappropriately used and increase maintenance costs The design of this device enables fast measurement only one to two seconds requires no protective cover allows for easy cleaning of the sensor wiping directly with ethanol and has a low maintenance cost The compact design allows for portability Suitability for low resource settings This device is suited for
150. int medical_ devices 65 Medical devices Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Interventional cardiovascular lab Country of origin India Health problem addressed Cardiovascular diseases CVDs are the number one cause of death globally An estimated 17 3 million people died from CVDs in 2008 Out of that more than 80 of CVD deaths take place in low and middle income countries due to lack of access to affordable equipment for diagnosis and treatment Product description The catheterization lab has a high power 80 KW generator digital X ray system a patient table and a gantry stand with varying degrees of movements and different X ray modes Product functionality The X ray system provides real time images which help to visualize and identify blocks in blood vessels and makes it possible to treat them by means of stenting coiling etc The patient table and gantry stand allows imaging that makes it possible to view blood vessels in different parts of body in real time Different X ray modes facilitate the imaging Developers claims of product benefits The economy catheterization lab is tailored f
151. ion Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Umbilical artery doppler analyser Country of origin South Africa Health problem addressed SSS 4 Placental insufficiency is a major cause of intrauterine growth restriction Doppler ultrasound to assess the flow velocity of the umbilical artery of the fetus with poor growth is the only method of antenatal surveillance that has significantly improved perinatal outcome but Doppler technology is often unavailable at the primary care level Product description The technology uses Doppler waveform analysis for reliable and cost effective antenatal screening in low resource environments The technology measures blood flow in the umbilical artery of the fetus at greater than 24 weeks gestation From such a measurement decisions can be made about the ability for the placenta to provide sufficient nutrients and oxygen in order to sustain adequate fetal development The ultrasonic Doppler probe connects to the USB port of a standard Pentium PC or laptop on which proprietary software is installed The product consists of a graphic user interface operational software and the physical mechanical parts of the probe hosing acoustic nose etc The external speakers printer and notebook are off the shelf products The system allows for a database fac
152. ion There has been no rigorous review for safety efficacy quality applicability nor cost acceptability of any of the technologies Therefore inclusion in the compendium does not constitute a warranty of the fitness of any technology for a particular purpose Besides the responsibility for the quality safety and efficacy of each technology remains with the developer and or manufacturer The decision to include a particular technology in the compendium is subject to change on the basis of new information that may subsequently become available to WHO WHO will not be held to endorse nor to recommend any technology included in the compendium Inclusion in the compendium solely aims at drawing stakeholders attention to innovative health technologies either existing or under development with a view to fostering the development and availability of and or access to new and emerging technologies which are likely to be accessible appropriate and affordable for use in low and middle income countries WHO does not furthermore warrant or represent that 1 the list of innovative health technologies is exhaustive or error free and or that 2 the technologies which are included in the compendium will be embodied in future editions of the compendium and or that 3 the use of the technologies listed is or will be in accordance with the national laws and regulations of any country including but not limited to patent laws and or that 4 any prod
153. ional local administration agencies User and environment User Patient physician technician nurse Training 3 hrs delivered by company technician Maintenance Preventative once per year Environment of use Settings Urban rural ambulatory at home primary health post health center secondary general hospital tertiary specialists hospital Requirements Access to cellphone network power supply for recharging Product specifications Dimensions mm 140 x 97 x 43 Retail Price USD 1000 1200 Weight kg 0 65 List price USD 1400 Consumables ECG gel reporting paper Other features Portable reusable uses software Life time 7 years Year of commercialization 2010 Shelf life 5 years Currently sold in India Mauritius Contact details Vinayak Deshpande Email vinayak bb 5 gmail com Telephone 91 932 321 0142 Fax 91 222 762 2153 http wwwwho int medical_ devices Medical devices Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Multi parameter remote diagnostic kit Country of origin India Health problem addressed 70 of the rural population in India has very poor access to health care
154. ions and death due to cardiovascular and circulatory diseases has increased from 13 in 2008 to 16 in 2009 as reported by Malaysian Ministry of health Product description Photoplethysmography PPG is a non invasive technique to detect blood volume changes Analysis of the PPG signal can provide sufficient information on the cardio vascular related performance The proposed simple user friendly and operator independent vascular risk prediction method is a non invasive quantification of hemodynamic vascular properties Product functionality The system utilizes PPG to assess cardiovascular health in a non invasive inexpensive manner The advancement of the Information Technology enables the medical personnel access the clinical data irrespective to the geographical location and reduces the number of visits to hospital as well as consultation costs The portability and server based processing features allow its use in low resources settings Developer s claims of product benefits The conventional technique to assess the cardiovascular health is to measure the thickness of the carotid artery wall CIMT The CIMT technique is ultrasound based costly and requires expertise in measurements PPG is a non invasive and low cost optical technique to detect blood volume changes in the micro vascular bed of tissue The system can be a part of standard health screenings in public and private medical sectors for general vascular risk assessmen
155. is one of the most important risk factors for newborn morbidity and mortality 99 of newborns that die globally are in such settings It is vital to keep newborns warm and help them achieve thermoregulation in order to prevent and minimize morbidities and mortalities due to hypothermia Product description The device consists of a biocompatible bed on which to place the infant and an overhead heater that delivers radiant heat A skin temperature probe monitors infant temperature Heat output can be controlled manually or through baby mode feedback mode for thermoregulation Visual and audio alarms are present for safety An APGAR timer helps to efficiently take APGAR scores _ post delivery Developers claims of products benefits Current radiant warmers have heaters typically made from quartz or ceramic These heaters tend to breakdown faster as well as take a much longer time to heat up up to 13 minutes in some cases Each additional minute of cold stress can lead to increased morbidity for an infant This device gives better clinical results because it provides uniform heating across the bed as well as a much faster warmup time 4 minutes only that reduces the time to warm a hypothermic infant Furthermore the lower power consumption and long life of the heating element Calrod heater lead to considerable cost savings Suitability for low resource settings The device uses less power at startup and during operation c
156. itness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Reusable neonatal suction device Country of origin Norway Health problem addressed a N Nearly 1 million newborns in developing countries die from birth asphyxia each year A similar number are disabled due to compromised breathing at birth To stimulate spontaneous breathing or bag mask ventilate effectively an open airway is mandatory Often this requires clearing the mouth and nose of mucous and meconium using vacuum Product description The proposed solution is a bulb suction device that is particularly suitable for use in developing countries It is easy to use and reusable when disinfected in accordance with instructions over the product s lifespan Product functionality 3 E The product benefits newborns suffering from birth asphyxia and in need of clearing the upper airways Squeezing the bulb generates vacuum so that the birth attendant can extract mucus and meconium from the baby s mouth and nostrils Developer s claims of product benefits This product is clinically effective easy and safe to use It is an improvement over the neonatal suction devices typically used in low resource settings i e mouth suction or hand bulb suctions availa
157. itted with the wheelchair or mobility device If necessary adjustments can be made to maximize comfort for example the footrest backrest height or seat depth can be altered Once the client is happy he or she is then able to self propel manually or can be assisted by an attendant Development stage The first product commercialized is the wheelchair for rough terrain on the market since 2005 However design reviews and upgrades are carried out periodically Studies were carried out in South Africa to measure the impact the product has had on the quality of life of users Two international NGOs have performed their own successful trials in Angola and the Philippines over a six and two months period respectively The product is distributed to over 20 countries The range includes other commercialized mobility devices and accessories The product has regulatory approval Future work and challenges Challenges include Provision of products to the end user client is heavily dependent on donated funds competition from other products on the market that are donated to organizations and end users free of charge capital to maintain stock of products to enable quicker dispatch from factory User and environment User Patient family member clinician technician Training Training is required to assess the client and assemble the product Training for the full product range is a minimum of three days Basic workshop hand tools and clinic
158. ive This device is a mass produced MRD that is custom fitted with nothing more than boiling water Suitability for low resource settings MRDs such as this device require no electricity and unlike most other MRDs which must be individually fabricated in a manually intensive process the device is inexpensively mass produced and may be custom fitted using nothing more than a pot of boiling water and a spoon The device may be produced anywhere using basic injection molding equipment available worldwide Operating steps After immersing the device in boiling water for a minute remove and allow it to cool a bit Then while holding the jaw forward bite down molding it to the teeth To use merely put the device in the mouth at bedtime and it holds the jaw in the same forward position opening the airway and allowing more unobstructed breathing Regulatory status It has been cleared by the FDA K113022 as a Class II medical device for the treatment of obstructive sleep apnea OSA as well as snoring Future work and challenges The challenge is to familiarize the requisite agencies with the device so that they understand how it can help many people Use and maintenance User Self use patient physician technician nurse Training None Maintenance None Environment of use Settings Rural urban settings at home secondary general hospital tertiary specialized hospital Requirements Boiling hot water Product
159. iver The auto disable feature prevents reuse helping prevent transmission of bloodborne disease between patients The compact prefill device also minimizes waste Developer s claims of product benefits Compared with standard syringes and ampoules depending on the drug delivered the developed injection system is prefilled ensuring an accurate dose by minimally skilled health workers It is individually packaged and sterile in an injection ready format optimal for low resource settings It is compact and prefilled so generates minimal waste Operating steps 1 Open the foil pouch 2 Push the needle shield into the port 3 Push until you close the gap between needle shield and port 4 Remove the needle shield 5 Hold the device by the port and insert needle into patient 6 Squeeze reservoir firmly to inject Discard according to medical waste procedures Development stage The injection system was developed around 15 years ago and as a viable container for drugs is fully developed The availability of important drugs in the injection device for use in low resource settings is established in some areas and developing in others Oxytocin hepatitis B vaccine and tetanus Toxoid vaccine are available in some countries other drugs and vaccines are in early stage development Injectable contraceptives are in their final stage of regulatory approval Betamethasone and gentamicin are still in research stages The unfilled device is a
160. ives without doctors Future work and challenges The fetal heart rate monitor is currently available and in production User and environment User Nurse midwife physician Training None Maintenance Technician Environment of use Setting Rural primary health post health center secondary general hospital Requirements None Product specifications Dimensions mm 170 x 85 x 75 Other features Portable and reusable Runs on batteries Weight kg 0 7 Uses software Year of commercialization 2010 Consumables None Currently sold in United Kingdom South Africa and other African countries Life time 5 years Shelf life 3 years List price USD 350 Contact details James Briaris Email james briaris gmail com Telephone 44 7595 943 259 http wwwwho int medical_ devices 89 Medical devices Compendium of innovative health technologies for low resource settings 2011 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Isothermal nucleic acid amplification system for POC diagnosis Country of origin China Health problem addressed One major limitation of effective tuberculosis control is the lack of a suitable diagnostic technology Current technologies such as sputum smear mic
161. lar lab Intramedullary nail and interlocking screw system Mobile ECG with web based telemedicine platform Multi parameter remote diagnostic kit Non invasive hypothermia indicator for newborns Conforms to US EPA guide standard and protocol for microbiological water purifiers as tested in house The product is approved as medical equipment in Japan Europe and the US based on respective regulatory system CE marked product Compliance to European Medical Directive Directive MDD 93 42 EEC Manufacturing facility is ISO 13485 certified FDA cleared for use in the USA Regulation Number 888 3020 Certified for CE 1293 IEC60601 1 compliance completed IS013485 manufacturing process compliance CE marking process underway CE No 0434 Arnold BF Colford JM Jr Treating water with chlorine at point of use to improve water quality and reduce child diarrhea in developing countries a systematic review and meta analysis Am J Trop Med Hyg February 2007 vol 76 no 2 354 364 e Gianfranco Parati Eoin O Brien et al A New Solar Powered Blood Pressure Measuring Device for Low Resource Settings Hypertension Nov 8 2010 Hofmeyr GJ Haws RA Bergstr m S Lee ACC Okong P Darmstadt GL Mullany LC Oo EKS Lawn JE Obstetric care in low resource settings What who and how to overcome challenges to scale up IJGO 2009 107 s21 s45 e The portable Glostavent a new anaesthetic machine for use in dif
162. lator an instructor can simulate three vital signs Crying spontaneous breathing and palpable umbilical pulse Depending on how the learner assesses the situation and acts the instructor can easily provide feedback to the learner by changing the vital signs Developers claims of product benefits The simulator facilitates effective and affordable simulation training in low resource settings that can improve quality of neonatal resuscitation as it is Very low cost available at USD 50 Allows assessment of key competencies e g ability of trainee to ventilate adequately Durable easy to take apart reassemble transport Culturally sensitive available in dark or light complexion The simulator is also highly realistic It has the size and appearance of a newborn baby and natural weight feel and touch when filled with water As it comes deflated in a compact container and can be emptied between uses distribution and transport of the simulator is convenient Operating steps The simulator is easily prepared for use by filling the body with 2 liters of water alternatively by air An instructor can simulate vital signs by squeezing the simulation bulbs The simulator facilitates practice in effective bag mask ventilation as the chest only will rise with correct technique Development stage The product was introduced in 2009 It is available on a not for profit basis for projects in the 68 developing countries identified by UN as focus
163. lenges Future work includes the addition of new sensors e g spirometry SpO2 blood pressure balance thermometer and the generalization of the service platform to meet the increased need for prevention and management of chronic diseases while allowing a reduction in health care costs Use and maintenance User Self use patient physician nurse family member Training The training can be done by locals familiar with the device Training time is about 15 minutes Maintenance Yearly maintenance by technician Environment of use Settings Rural urban settings ambulatory at home primary health post health center secondary general hospital tertiary specialized hospital Requirements Power supply for recharging and access to the internet Product specifications Dimensions mm 270 x 150 x 140 List price USD 1500 Weight kg 1 54 Other features Software use portable capital equipment Consumables None telemedicine solution Life time 10 years Year of commercialization 2011 Shelf life 5 years Currently sold in France and in Francophone African Retail Price USD 2000 countries Contact details Jean Luc Rebiere Email jl rebiere gmail com Telephone 33 68 766 8311 Web http bit ly I bClve9 http www who int medical_devices 37 Medical devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the informat
164. llenges Remote clinics typically do not have the funds necessary to purchase their own equipment In order to reach the intended users governments or other health administration bodies will first purchase the autoclaves to distribute to intended consumers Governments often have little incentive to be early adopters of new technology Finding the correct strategy to move the product to the intended users is the primary challenge facing the pressure cooker autoclave User and environment User Nurse health post employee Training None Maintenance None Environment of use Settings Rural urban settings primary health post health center secondary general hospital tertiary specialized hospital Requirements Almost no infrastructure requirements are necessary to operate this autoclave Fresh water should be used each time new instruments are sterilized A heat source capable of boiling water must be employed Whatever is typically used to cook food can be used including gas coal electric or solar Product specifications Dimensions mm 300 x 300 x 500 Retail Price USD 250 Weight kg 3 List price USD Consumables None Other features Software use mobile capital equipment Life time 10 years Year of commercialization Awaiting CE mark Shelf life 15 years Contact details Mark Maples Email suecho87 gmail com Telephone 1 415 952 5458 Web http bit ly axAwxl http www who int medical_devices
165. lopment investment Contact details Lushen Wu Email rufus wu gmail com Telephone 17 01 330 5589 http www who int ehealth eHealth Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Medical cloud Country of origin United States of America Health problem addressed Picture Archiving and Communication Systems PACS represent the gt integration of medical diagnostic images and records playing a critical LL Facility Login role in patient diagnosis and outcome Traditionally only medical centres in developed countries have been benefactors leaving a significant disconnect globally for resource poor locations to also benefit Solution description Patient information regardless of the imaging modality ultrasound x ray and beyond and or digital medical records are scanned and uploaded by an authorized medical professional Automatically the information is sent through a secure Digital Imaging and Communications in Medicine DICOM process over a standard web browser from a digital device the user is accustomed to using such as any smart phone or mobile computer Physicians teams of specialists and qualified medical professionals acro
166. low in rapid succession e g HIV dengue hepatitis wi Le Via standard web browsers the portal provides health managers and funders with a host of cloud information services including data management and reporting mapping and surveillance based on data captured by smartreaders Managers can connect with workers in the field to implement quality control measures and disseminate clinical and operational guidelines Functionality Smartreader software guides the user through RDT processing steps and data entry interprets test results and automatically transmits patient and worker activity data GPS image of RDT over cell networks to the cloud Managers log into the portal to view create reports query real time data disseminate messages and content to readers Developer s claims of solution benefits This solution transforms infectious disease healthcare delivery and healthcare management by enabling e high quality healthcare delivery by minimally trained health workers at point of care e real time monitoring and analysis of point of care data for resource management and timely response to outbreaks e evidence based resource allocation and investment decisions by healthcare funders and industry Future work and challenges Distribution via franchises with local entrepreneurs thus not only contributing to local economies and skill development but also accelerating sales User and environment User physician
167. low resource settings What who and how to overcome challenges to scale up IJGO 2009 107 s47 64 World Health Organization WHO Department of Reproductive Health and Research Maternal Mortality in 2000 Estimates Developed by WHO UNICEF and UNFPA Geneva WHO 2004 Hensleigh PA Antishock garment provides resuscitation and haemostasis for obstetric haemorrhage BJOG December 2002 109 1377 1384 Miller S Ojengbede A Turan J Ojengbede O Butrick E Hensleigh P Antishock garments for obstetric hemorrhage Current Women s Health Reviews 2007 3 3 11 Miller S Martin HB Morris JL Antishock garment in postpartum haemorrhage Best Practice amp Research Clinical Obstetrics and Gynaecology 2008 22 6 1057 1074 Tsu VD Sutanto A Vaidya K Coffey P Widjaya A Oxytocin in prefilled Uniject injection devices for managing third stage labor in Indonesia International Journal of Gynaecology and Obstetrics 2003 83 1 103 111 Martins BM de Carvalho M Moreira ME Lopes JM Efficacy of new microprocessed phototherapy system with five high intensity light emitting diodes Super LED J Pediatr Rio J 2007 83 3 253 258 WHO Diarrhoeal disease Programmes and projects Media center Fact sheets Vol 2010 2009 Brownell Sarah A Alicia R Chakrabarti Forest M Kaser Fermin Reygadas Micah J Lang Lloyd G Connelly Rachel L Peletz Daniel M Kammen and Kara L Nelson 2008 Assessment of a low cost point of use ultraviol
168. lows it to be used in any setting and also facilitates that it can be purchased and distributed in large quantities so that health providers in even the most rural areas can access it for the important frequent refresher training that will enable them to maintain skills learnt during the initial training course The device was designed to be highly realistic where essential particulary in feeling of the fundus and cervical vaginal angle culturally adapted flat packed for easy transport and storage highly affordable durable and easy to use In addition it is designed to facilitate role play and efficient training Operating steps The product is easily prepared for use by one quick step and is fully manually operated Regulatory status Not applicable It is classified as a training device Future work and challenges In order to achieve efficient implementation of better quality postpartum uterus care and postpartum IUD insertion the product should be available for health care workers during their initial training and importantly also for subsequent regular refresher training Ideally there should be a simulator available in every health facility The greatest barriers for widespread implementation are believed to be financing although highly affordable funding may be needed from governments or aid organizations and distribution due to bureaucracy and often prohibitive customs rates Use and maintenance User Physician nu
169. lthcare facilities across India Doctors and nurses have given extremely positive feedback about the device s ease of use resulting in reduced workload and high quality healthcare that may otherwise not be easily available in these settings The device has been functioning well in these settings and is in frequent use The technology is currently being produced locally The heater requires basic electronic components which are readily available locally The sleeping bag is made locally using a tailor The pouch of phase change material is also packaged locally Operating steps Sanitize all 3 components Insert the phase change material pouch into the heater Close the lid of the heater and push button In 30 minutes the alarm will ring A green light indicates that the phase change material pouch is ready and remains lit to indicate that the heater is keeping the pouch warm Remove pouch check temperature indicator and use only if indicator bar is in OK region Place the pouch of phase change material correctly into the sleeping bag Wrap the newborn and tighten straps to prevent the newborn from slipping Monitor the newborn s temperature once every hour for the next 4 6 hours When the temperature indicator on the pouch slips into the TOO COLD region remove the newborn Remove the pouch and reheat as needed Regulatory status A draft CE Mark has been received Internal processes are ISO 13485 certified Future work and challenges The target us
170. lthcare facilities and educational institutions in low and middle income countries often have limited financial resources Distribution channels bureaucracy and often prohibitive customs rates in importing such material to the countries where the need for these products is greatest User and environment User Family member midwife nurse physician Training None required Maintenance Instructor in courses Environment of use Settings Rural urban health post health center general hospital specialists hospital Requirements No specific infrastructure requirements Access to 3 4 liters of water would be desirable to create simulated blood and to fill the newborn simulator with water Product specifications Dimensions mm 500 x 350 x 200 List price USD 100 Weight kg 4 5 filled with simulated blood Other features Portable and reusable 3 5 empty Year of commercialization 2011 Consumables None Currently sold in 68 countries that have been identified by Life time 3 years UN as focus countries relative to MDG 4 and 5 Shelf life 3 years Retail Price USD 100 Contact details Ingrid L rdal Email birthingsimulator gmail com Telephone 47 51 511 855 Fax 47 51 523 57 http www who int medical_devices 80 Other technologies Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in
171. ly sold in Vietnam Laos Cambodia East Timor Retail Price USD 2 500 Contact details Gregory Dajer Email gregory dajer mtts asiacom Telephone 84 43 766 6521 Fax 84 43 766 3844 http wwwwho int medical_ devices 101 Other technologies 201 Other technologies Compendium of innovative health technologies for low resource settings 2011 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Newborn simulator for resuscitation training Country of origin Norway Health problem addressed UN Millennium Development Goal MDG 4 aims at reducing child mortality by 2 3 from 1990 2015 To date the improvement is far from sufficient particularly for neonatal mortality To reach MDG 4 there is an urgent need to train large numbers of birth attendants in developing countries in neonatal routine care and resuscitation Product description The proposed solution is a highly realistic and affordable newborn simulator The baby s status can be simulated as desired to facilitate role playing in relevant scenarios covering basic newborn care as well as standard resuscitation measures The simulator is available with therapeutic tools Product functionality By squeezing the bulbs connected to the simu
172. m Mobile ECG with web based telemedicine platform Multi parameter remote diagnostic kit Non invasive hypothermia indicator for newborns Non invasive vascular age risk prediction Non surgical male circumcision device Oral syringe dosing clip Point of care diagnostic device for total WBC Portable anaesthesia machine Sputum mobilization device Urine albumin test Other technologies 2012 Auto stop electrochlorinator Birthing simulator for training Low smoke stove m j D io n o0 b oO n S fe n oO T z n o0 Ke e LE e g je lo Co Je o D a gt e j E i 0 z TD Q jae e U 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 Assistive devices 201 82 Manual wheelchairs and mobility devices 83 eHealth solutions 20 84 Medical data communication system 85 Mobile technology to connect patients to remote doctors 86 Treatment response software application z i 87 Medical devices 201 88 Fetal heart rate monitor 89 Isothermal nucleic acid amplification system for POC diagnosis 90 Non pneumatic anti shock garment f f 91 Oxytocin in prefilled auto disable injection system f 92 Parasitolog
173. maintenance User Self use Training Not required Maintenance Not required Environment of use Settings Rural urban settings at home Requirements Continuous power supply for the PC laptop or monitor and camera Product specifications Dimensions mm 200 x 20 x 20 Retail price USD 20 Weight kg 0 5 whole system excluding monitor List price USD 20 Consumables No Other features Portable continuous use Life time years 5 Year of commercialization Ready to be commercialized Shelf life years 5 Contact details Vijayaraghavan Srinivasan Email srinivasan 936 dataone in Telephone 91 94 433 68731 Web http bit ly I ShCrQ http www who int disabilities technology 6 Assistive devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Polycentric prosthetic knee joint Country of origin United States of America Health problem addressed a Around 9 5 million people with an above knee amputation living in low and middle income countries need a prosthesis to regain mobility for livelihood employment and social integration Most of the amputations are due to injuries especially road traffic crash
174. management of patient and hospital information This solution provides a platform that optimizes and improves the patient and hospital information management using free software Solution description It is free software and is designed to be multi platform so it can be installed in different operating systems GNU Linux FreeBSD MS Windows It uses Python as the programing language PostgreSQL as the Database engine and Tryton as the development framework Functionality The health documentation portal explains how the solution works and is available at http en wikibooks org wiki GNU_Health Developers claims of solution benefits It is an eco friendly solution 100 paperless Its free software policy is a warranty of cost reduction and sustainability basic features needed in emerging economies Future work and challenges The main challenge of the project is to continue raising awareness for the use of free software in public health User and environment User Physician nurse midwife self use patient family member technician Training United Nations University IIGH will deliver training in a 5 day duration course Settings Rural urban at home ambulatory primary health post health center secondary general hospital tertiary specialized hospital Reviewer s comments This solution is applicable for low resource settings as it is free works in different operating systems and with the modular approach is cus
175. maternal deaths Product functionality Behind the birthing suit the instructor can manually control cervical dilation position of the baby delivery of the baby delivery of placenta bleeding amount and nature uterus condition and fetal heart sounds Developer s claims of product benefits The simulator is distinctively different from other birthing simulators available on the market It aims to respond to the needs of a supportive device that can improve quality of BEmOC as presented in International Journal of Gynecology amp Obstetrics by being highly realistic where essential particularly in simulating post partum hemorrhage and uterus contraction and culturally adapted It facilitates effective communication training and integrated training with newborn routine care and resuscitation It is flat packed for easy transport and storage highly affordable durable and easy to use Operating steps The simulator is strapped onto the instructor who acts as the mother and creates and controls the various scenarios and situations directly with his hers hands Development stage It is offered on a not for profit price to the 68 countries that have been identified by UN as focus countries relative to MDG 4 and 5 It has been field tested in several countries including USA Norway Tanzania and Ethiopia Future work and challenges Financing Although the product is available on a not for profit basis hea
176. medicine itg be discussion forum using an electronic format available on the telemedicine website Developer s claims of solution benefits ITM Telemedicine is one of the very few long running telemedicine networks delivering humanitarian services to physicians working in resource limited settings Telemedicine is a possible way to offer support mentorship and supervision to physicians working in developing countries A web based approach helps to learn from others experiences submitting cases and questions and to be aware of other ways to manage patients Future work and challenges Telemedicine is a powerful educational method A follow up users survey showed that telemedicine advice was valuable in the management of specific cases and significantly influenced the way that clinicians managed other similar cases subsequently Despite this success a trend of decline in use of service has been recognised Sustaining the interest of users remains a key challenge and further information is required about users satisfaction and network performance In addition anchoring the service to partner institutions or regional partnerships needs to be explored Collaboration with larger groups to address these challenges has begun User and environment User physician Alumni of the Institute of Tropical Medicine in Antwerp Settings rural urban home primary secondary tertiary Solution specifications Solution is used to suppo
177. mmend any technology included in the compendium Mandibular repositioning device Country of origin United States of America Health problem addressed gt Over 20 million people in the U S have obstructive sleap apnea OSA yet 85 have not received treatment The condition is even less frequently treated in developing countries Continuous positive airway pressure CPAP is the usual treatment but it is expensive and requires electricity People with untreated OSA are many times more likely to die of a stroke heart attack or car crash because of chronic severe sleep deprivation Product description For decades dental devices called mandibular repositioning devices MRDs have been an effective treatment option for OSA They need no electricity but are typically fabricated in a dental lab and fitted by a dentist making them expensive This device is an MRD that may be fitted with nothing more than boiling water Its mechanism of action is the same as any other MRD and can therefore treat OSA Developer s claims of products benefits CPAP machines are typically used to treat obstructive sleep apnea but they are expensive have poor patient compliance and require an electrical outlet frequent maintenance and disposable supplies MRDs enjoy good patient compliance are smaller lighter tougher and they don t require electricity maintenance or supplies However most are individually fabricated and therefore very expens
178. mortality worldwide Product description CPAP is one of the methods used to support infants with respiratory distress and assist them in maintaining continuous positive airway pressure while breathing on their own This solution is customized for the use in hospitals with basic infrastructure and limited resources It is simple in use with only short training required C Product functionality CPAP provides mixed gas flows down the inspiratory limb to nasal cannula while expired gas returns via the expiratory limb to the pressure bottle The medical staff is able to control appropriate mix of gases as well as desired temperature humidity and flow Developer s claims of product benefits The Complete CPAP system is designed to be used in the low resources settings The only requirement is power supply and oxygen The system provides its own air compressor humidifier oxygen and air blender air heater All the functions can be controlled by the user through simple interface requiring minimum training The system is fully reusable and washable limiting the need for consumable parts to nasal connectors It allows the user to keep running expenses at very low level keeping the treatment costs at less than a few dollars per patient Operating steps Connect the system to oxygen and power source Connect the tube circuit to the patient Turn the system on Set the desired oxygen concentration and flow rate set the temperat
179. n 2011 the UV tube will be installed in at least 8 schools and 38 community systems serving approx 10 000 people Future work and challenges As most water treatment technologies seeking to make real improvements the device must be implemented as part of a program that allows for needs assessment adaptation to local conditions hygiene education operation and maintenance training For this reason we see the UV tube being scaled up through partnerships with institutions organizations and or companies that have local presence and are committed to improving the health of the populations they serve User and environment User Self user family member nurse technician Training Although the system is easy to use and most people can learn how to operate it from a manual it is recommended that they participate in a basic 20 30 minute training session Maintenance Trained nurse community member technician Environment of use Requirements Access to electricity The product consumes 20 watts To disinfect 1 000 liters it only uses O1 kilo watt hours of electricity The source can be direct current e g 12 24 volts from a solar powered battery or alternate current e g 110 220 volts from the grid If water is turbid or contaminated pre disinfection filtration is required Product specifications Dimensions mm 600 x 150 x 150 Weight kg 3 Other features Reusable can run on batteries Year of commercialization 2009
180. n available Unlike monitors designed for mainstream medical markets it is very simple to use at low cost Operating steps The SPO2 monitor is a solution to the problem of measuring blood oxygen saturation in developing world health environments By turning the crank human energy is efficiently converted into electricity and stored in rechargeable batteries Generic probes ranging from pediatric to adult provide accurate pulse and saturation levels Development stage The pulse oximeter is currently available and in production It is manufactured in India Pilot field testing was carried out in South African secondary hospitals and its performance was congruent with gold standard high end pulse oximeters Regulatory approval is completed Future work and challenges Product is commercialized User and environment User Nurse midwife physician Training None Maintenance Nurse physician technician Environment of use Setting Rural Ambulatory primary health post health center secondary general hospital Requirements none Product specifications Dimensions mm 170 x 85 x 75 List price USD 600 Weight kg 0 7 Other features Portable and reusable Runs on batteries Uses software Consumables None Life time 5 years Year of commercialization 2011 Shelf life 3 years Currently sold in South Africa Contact details James Briaris Email james briaris gmail com Telephone 44 7595 9
181. n of modules on breast and colon cancer screening diagnosis and treatment User and environment User physician technician nurse midwife administrative staff Training none Settings rural urban ambulatory primary tertiary Reviewers comments This system is deployed nationally for cervical cancer screening treatment and capturing of data It is also being developed and used localy and requires very low resources A formal evaluation of this program would be helpful to contribute evidence and this would form a basis upon which other countries might want to consider adopting it Solution specifications Solution is used to support Decision Support Systems Currently used in Argentina Electronic Health Record Electronic Medical Record Evaluation Arrossi S Paolino M Proyecto para el Software Hardware requirements Access to a computer mejoramiento del Programa Nacional de Prevenci n connected to the Internet It uses the database engine de Cancer de Cuello Uterino en Argentina Informe SQL Server ASP programming language The ministry of Final Diagn stico de situaci n del Programa Nacional health has licenses for using them so it was decided to y Programas Provinciales Buenos Aires Organizacion develop the described tool on this platform The software panamaericana de la Salud 2007 page 33 development is an open source and it belongs to the ministry of health Standards ICD 10 Bethesda Contact
182. n the grade and the expected prevalence in the population the probability that the image contains signs of TB is calculated Functionality The software can be configured to run automatically after a digital X ray has been made the image is sent automatically to a separate computer on which the CAD software is installed the program performs the quality check and the image analysis steps and the result is stored on disk Developer s claims of solution benefits Present technologies are time consuming and quality temperature sensitive or costly for hundreds of tests With a portable digital X ray even remote groups can be screened at low cost as the incremental costs of digital X ray and CAD are very low Studies done by universities and Zambart show that the sensitivity and specificity of the software to diagnose culture positive TB from chest radiograph is the same as done by clinical officers and CRRS certified human observers no significant difference in performance Future work and challenges Challenges ahead 1 Creating a computerized decision support by combining X ray signs with clinical symptoms 2 Evaluate CAD with GeneXpert cartridge based automated diagnostic test as an efficiency filter in TB screening to determine who gets GeneXpert 3 Regulatory approval User and environment Users physician technician Training a 3 hours training is provided on a laptop or PC Settings rural urban ambulator
183. na Ghana India Kenya Software Hardware requirements At minimum a Lesotho Mali Nigeria Rwanda Sierra Leone Tanzania computer running Linux with Apache MySQL and PHP Togo Uganda installed is required The solution offers a preconfigured appliance that has everything ready to plug into a LAN It can also be run from a flash drive or freely downloaded and configured as a Linux install package LAN WAN or Internet access is needed for remote data entry or reports Evaluation An extensive independent evaluation has not been done Contact details Dykki Settle Email hris intrahealth org Telephone 1 919 313 9100 Fax 1 919 313 9108 http www who int ehealth Compendium of innovative health eHealth technologies for low resource settings 2012 Integrated smartreader amp cloud services Country of origin Canada Health problem addressed Fa Two of the biggest problems in infectious diseases are inadequate diagnosis and case management at point of care POC by health workers and inadequate resource allocation and monitoring by health managers and funders ET W Solution description The smartreader is a rugged companion device for use by health workers at POC that captures and transmits a broad range of data to the cloud via local cell networks The reader currently interprets commercially available malaria rapid diagnostic tests RDTs Additional infectious disease targets are to fol
184. nality Operation consists of standard procedures for video viewing Varies based on available technology 1 offline on video capable phones using memory cards or computers where the Internet connectivity or electricity is limited 2 on basic video equipment portable players or TVs using DVDs 3 on smartphones or computers with live streaming Developer s claims of solution benefits New media can deliver step by step instruction on clinical skills and procedures in an effective and efficient way With expansion of the Internet access and the proliferation of mobile devices this solution can reach far more people with better health care information than was conceivable only a few years ago New media for medical training is still in its infancy in resource poor countries but it is readily scalable and can help better train providers at much lower cost than traditional methods Future work and challenges The intention is to make this new media accessible to any and all frontline health workers who need better training thus the plan is for an open access model that makes the videos freely available to users The challenge is to obtain funding that will make this goal feasible Other challenges related to its adoption include 1 environmental and hardware constraints access to viewing devices power supply and the Internet 2 modification of the videos for use across many regions accurate translation of languages and effective voice ov
185. nd biomedical technicians Maintenance Daily checklist for user with occasional replacement of the oxygen sensor and air filter Environment of use Settings Rural urban settings primary health post health center secondary general hospital tertiary specialized hospital Requirements Intermittent access to electrical power to charge battery Stable power connection to use optional oxygen concentrator Product specifications Dimensions mm 1460 x 530 x 690 Retail Price USD 15 000 Weight kg 130 List price USD 15 000 Consumables 80 USD year including 60 USD for oxygen Other features Software use mobile capital equipment fuel cell replacement every 12 to 18 months and 20 USD for Year of commercialization 2010 primary air filter replacement every year Currently sold in Ghana Haiti Jordan Kenya Malawi Life time 15 years Nepal Nigeria Rwanda Sierra Leone Somaliland South Shelf life 15 years Africa Tanzania Uganda United Kingdom Zambia Contact details Stephen Rudy Email info gradianhealth org Telephone 1 212 537 0340 Web http bit ly I bCEB3M http www who int medical_devices Medical devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to reco
186. ners using phones and training manuals for one or two days Settings rural urban primary secondary tertiary and national level Reviewers comments Very good use of SMS a well used feature by cell phone users to trace medication stock and also analyse their use and distribution The pilot of this tool has shown promising results with high comfort of use and also good results not only on replenishing medications but also tracking usage and reminders to restock Solution specifications Solution is used to support Decision Support Systems Standards HL7 mHealth Supply Chain Data Currently used in Tanzania Malawi Software Hardware requirements Requirements include simple mobile phones for health workers and access to network coverage and electricity to recharge phones Health centre and district staff reviewing the data dashboard online need regular access to a computer with the Internet access Evaluation In Tanzania of the 5 district users and 17 facility users surveyed 100 indicated that they preferred SMS based reporting and 88 of the facility users further said that the stock reporting system has also helped improve their reporting rates and adherence to reporting groups At the facility level the stock The software is open source and built on the rapid SMS reporting system has increased the attention of health platform The source code is available for any user that workers on their reproductive health c
187. nment User Physician orthopaedic surgeon Training Yes training and tools are given by surgeons familiar with the technique over 10 surgeries Maintenance Yes periodic replenishments by nurse technician manufacturer physician Environment of use Settings Rural urban secondary general hospital tertiary specialists hospital Requirements Operating room with sterile conditions anesthesia personnel and machines well trained nurses and sterilizing personnel are all required Product specifications Dimensions mm 8 12 x 8 12 x 280 420 Other features Portable Weight kg 0 118 0 389 Year of commercialization 2002 Consumables Surgical supplies Currently sold in United States Vietnam Iran Retail Price USD Varies Guatemala amp Indonesia Donated to 48 other countries List price USD Varies Contact details Jeanne Dillner Email jeanne diliner gmailcom Telephone 1 509 371 1107 Fax 1 509 371 1316 http wwwwho int medical_ devices Medical devices Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Mobile ECG with web based telemedicine platform Country of origin India Health problem ad
188. nnovative health technologies for low resource settings 2011 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Phototherapy for neonatal jaundice treatment Country of origin Brazil Health problem addressed Neonatal Jaundice Hyperbilirubinemia is a frequent issue in newborns Approximately 60 of newborns become clinically jaundiced It is a clinical condition generally benign and reversible if properly treated but its exacerbated intensification may generate serious sequelae into the central nervous system which may lead patient to death Product description Phototherapy is an efficient mean to treat Hyperbilirubinemia By emitting blue light over the patient s skin it converts toxic bilirubin molecules in the blood into less toxic isomeric forms by photo oxidation and photoisomerization The device uses high power LEDs for treatment and negligible emission of UV IR radiation J Product functionality The phototherapy uses a set of 5 high power LEDs positioned 30 cm above the patient The treatment uses high radiation emitted at the blue range of the spectrum from 400 to 550 nm the most recommended for Jaundice treatment The device also provides extra functions such as i
189. ntact details Leah Ekbladh Email abtassoc gmail com Telephone 1 617 520 2804 Fax 1 617 386 8019 http www who int ehealth eHealth Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Telemedicine for HIV AIDS care Country of origin Belgium Health problem addressed ra 3 The policy of scaling up antiretroviral therapy for HIV patients coupled with the increasing availability of generic HIV drugs have been effective in achieving the target of four million HIV patients under treatment in developing countries However one of the main obstacles to that has been the workforce shortage and lack of training and continuing professional development CPD Solution description The HIV AIDS telemedicine referrals are managed through a web site discussion forum http telemedicine itg be based on a free open source package which allows registered users to follow and contribute to discussion of referrals both online and by email Functionality The patient s history physical examination non identifying pictures laboratory findings and questions to be answered are posted on the http tele
190. ntegrated radiometer and treatment time counter Developer s claims of product benefits Traditional devices use fluorescent or halogen lamps or many conventional LEDs Lamps may require filters to attenuate UV IR rays and have a low life expectancy around 2 000h Conventional LEDs are low power devices To work effectively hundreds of LEDs must be used making the phototherapy complex and prone to failure The proposed technology uses only 5 high power LEDs which is equivalent to more than 250 conventional LEDs The result is a compact highly efficient long life time 20 000 h and low cost phototherapy It provides new resources output radiation level adjustment embedded radiometer and irradiance measurement reports In addition it is compact saving space in the intensive care unit Operating steps Place the device over the newborn 30 cm away Turn it on and press Menu to go to the irradiance level screen Set the irradiance using the up down keys and press Enter to confirm Be sure the newborn is exposed to the light at the chest and abdomen area Protect the newborn s eyes Development stage The product is being manufactured and commercialized It has been fully validated and clinically tested Studies verify that the blue high power LEDs are more efficient for Jaundice treatment The market confirms those studies It has the Brazilian ANVISA regulatory approval the CE marking and it is currently obtaining
191. nvironment User Physician nurse midwife technician community health worker self use patient Training On site individual group training video conferencing desktop sharing application based e training that takes 2 to 4 hours Settings Rural urban primary health post health center secondary general hospital at home Solution specifications Solution is used to support Decision support systems resource and low skillset environment e g video Diagnosis and treatment Electronic Health Record conferencing and real time data transfer can work at a Electronic Medical Record eLearning mLearning Health bandwith as low as 32 Kbps The license fee depends on research mHealth Patient monitoring Telemedicine number of clients and scale of the network Software Hardware requirements Medical device Standards HL7 ICD10 connected to USB port of PC Laptop Windows operating system on the PC Laptop an internet connection for telemedicine Minimum 32 kilobits s internet speed for real time audio video data tele consultation Fixed static IPs at both ends for professional edition and at server in enterprise edition Currently used in Primarily in India few countries in Africa Central amp South America and Southeast Asia Evaluation IEC60601 1 compliance completed 1S013485 2008 AC 2010 and ISO9001 2008 manufacturing process compliance CE marking process underway The specific software that comes as part of the solu
192. o electrodes The electric field passes through the patient s body moving through the pathways with the lowest impedance The malignant tissue has lower impedance due to the increased ion concentration in the highly metabolic tumours as seen on PET scans The tumour acts as a capacitor it stores a charge and is safely and selectively heated sensitizing it to the chemotherapy or radiation therapy treatment Hyperthermia damages the cell walls slows protein DNA and RNA synthesis repair increases blood flow drug delivery oxygen metabolism and drug reaction rate and sensitizes hypoxic tumours to radiation Developer s claims of products benefits The only technique other than electro hyperthermia used in the region is interstitial hyperthermia South Africa Although effective interstitial hyperthermia is complex expensive has high risks and requires specialized staff and facilities Various technologies are available internationally but they are expensive and impractical for Africa It is safer even for the brain due to non invasive selective and deep heating The safety simplicity and practicality of the device make it more cost effective to use with a capital price as much as 10 times lower than some devices It is far more practical in limited resource settings as the treatments are only 30 90 minutes and dedicated specialized staff facilities are not required unlike other devices which require bunkers MRIs etc It is reliable and ea
193. o sterile settings offering a viable solution for resource poor settings Operating steps Clients are measured to select ring size The circumcision line is marked based on WHO guidelines The inner ring is inserted An elastic ring is aligned with the inner ring to compress the foreskin and stop blood flow Verification thread is then cut Ischemic necrosis is initiated Device remains in situ for 5 7 days and is then removed Development stage The device is FDA cleared K103695 and certified CE Mark Class lla and is manufactured using USP Class VI biocompatible elastomeric materials compliant to ISO 13485 Medical Devices Quality Management systems and FDA 21 CFR177 2600 The device is currently undergoing clinical trials by the government of Zimbabwe and Rwanda To date the device was studied in 3 independent clinical trials in Rwanda on over 880 subjects Future work and challenges The challenges are scalability uptake and government commitment If governments have a viable and sustainable solution with minimal burden to the health system they are more likely to commit resources enable task shifting policies and achieve the national and regional HIV prevention goals User and environment User Nurse community health workers Training Yes will be provided by Rwandan Centers of Excellence Maintenance None Environment of use Settings Rural urban primary health post health center secondary general hospital
194. of commercialization 2008 transportation and installation Currently sold in India Kenya Laos Guatemala Peru Contact details Lori Shamroth Email LoriGayle 23 gmail com Telephone 1 978 659 3776 Fax 1 978 975 1285 http www who int medical_devices 81 Assistive devices 201 Assistive devices Compendium of innovative health technologies for low resource settings 201 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Manual wheelchairs and mobility devices Country of origin United Kingdom Health problem addressed An estimated 20 million people in need of a wheelchair in low income countries do not have one Many donated wheelchairs are unsuitable for the local terrain do not fit properly and do not provide adequate comfort or postural support These factors can restrict a person s mobility hinder their health and well being and even cause life threatening secondary complications such as pressure sores Product description The technology encompasses a range of 3 wheel and 4 wheel wheelchairs sports wheelchairs supportive seating and tricycles specifically designed for use in less resourced settings The products are available in a range of sizes and have many adjustable features Each product i
195. olar power systems Product specifications Dimensions mm 660 x 380 x 495 List price USD 1500 Weight kg 11 8 Other features Mobile capital equipment Consumables None Year of commercialization 2011 Life time 5 years Currently sold in Cambodia East Timor Ghana Laos Shelf life 5 years Malaysia Myanmar Philippines Thailand and more Retail Price USD N A Contact details Timothy Prestero Email info designthatmatters org Telephone 1 617 682 3621 Web a a http www who int medical_devices Medical devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Compact portable ultrasound Country of origin United States of America Health problem addressed 7 The device addresses the issues of maternal death maternal near misses newborn death and stillbirths Obstetric complications that may be detected by ultrasound include placenta previa fetal malposition multiple gestations ectopic pregnancy retained placental products fetal anomalies and fetal demise Product description As a compact portable visualization tool with ultrasound technology this device provides a non invasive look inside the bod
196. old in Germany and used in Chile Myanmar Shelf life years 10 Tanzania India Nicaragua and Canada Retail price USD NA Contact details Jan Andrysek Email jan andrysek utoronto ca Telephone 1 114 164256 220 Web http bit ly dtYLko http www who int disabilities technology 2 Assistive devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Child wheelchair Country of origin Israel Health problem addressed F N About 70 million people have different health conditions ranging from spinal cord injury to birth defects requiring a wheelchair for mobility Among them only 5 15 have access to one and out of this population 25 are children with disabilities Wheelchairs can assist these children to be mobile independent and healthy Product description The wheelchair consists of two large rear wheels with pushrims two small swiveling front wheels castors a metallic frame plastic seat footrest and a cushion It is modular in design its components come in three separate boxes and need to be assembled as per the need of the child C Product functionality The user sits in the wheelchair
197. ommodities and would like to adopt and adapt the system for their use as a result improved the timeliness of ordering and stock management Contact details Marasi Mwencha Email info ilsgateway com Telephone 1 703 548 7474 Fax 1 703 528 7480 http www who int ehealth 56 Compendium of innovative health eHealth technologies for low resource settings 2012 Real time measurement of meteorological events on public health Country of origin Canada Health problem addressed A changing climate leads to changes in the frequency and intensity of extreme weather events Deaths injuries diseases and mental health problems related to extreme weather events result from the exposure and vulnerability of human systems The average number of people killed by natural disasters for 1972 1996 was about 123 000 year worldwide Solution description The objective of this integrated web application system is to provide in real time a complete meteorological picture actual conditions forecasts and alerts and population s health status on relevant indicators Other environmental and spatial information is also provided for preventive purposes and for supporting emergency preparedness The system comprises four functions F1 Data acquisition and integration F2 Risk analysis and alerts F3 Cartographic application and F4 Climate change and health information Functionality The system is available through a se
198. ompared to other radiant warmers It is designed for infection control e g non stitch biocompatible mattress for no infections in stitches plus no need for a mattress cover It has a faster warmup time for high volume environments with little pre warming Over 1500 warmers have been deployed in low resource settings The device has been designed developed and manufactured in India based on extensive customer input in India and similar countries It has been adopted in Tier 2 and 3 towns in India as well throughout the country of Myanmar by the Ministry of Health Testing of the device includes protocols that try to simulate low resource setting issues such as voltage fluctuations high humidity etc Operating steps The device is usually pre warmed in manual mode for at least four minutes The infant is then placed on the bed mattress and the skin temperature probe is attached The operator then switches to baby mode feedback and enters the desired baby temperature The APGAR timer and observation light can be switched on as needed Regulatory status It conforms with the requirements of Medical Devices Directive 93 42 EEC BSI CE 0086 mark It is also certified ISO 13485 It has US FDA 510K clearance K121625 and it is ROHS compliant Use and maintenance User Physician nurse midwife Training Initial training by manufacturer and operator manual Maintenance Annually by technician engineer or manufacturer Environment of use
199. on of hospital beds The IM nail interlocking screw technique is globally recognized as the preferred treatment for long bone fractures This system makes it possible for surgeons to use this treatment on patients who couldn t afford it otherwise Total cost is less than other systems of equivalent quality Operating steps During surgery the fracture is reduced and the stainless steel IM nail is placed through the canal of the bone A target arm and special instruments are used to place screws through the slots in the nail and through the bone to stabilize the tibia femur or humerus fracture No electricity or x ray imaging is necessary for the surgery Development stage FDA cleared for use in the USA The stainless steel alloy composition is approved for implantation in humans The associated online database has over 50 000 entries and is the largest database of treatment of long bone fractures in the world This has been reviewed by surgeons and reported in peer reviewed medical journals Biomechanical tests have been obtained as noted in listed articles Future work and challenges Though the product is comparatively low cost and available on a not for profit basis it is a challenge to keep up with the increasing number of requests for the IM nail and interlocking screw system as financing is limited Continual updating of technique is also a challenge due to the increasing number of hospitals which have this system User and enviro
200. onitor not their doctor Their disease reacts and responds to them the individual It does not act generically So the TID system treats the individual as such by reacting and responding to them the individual It s a fundamental shift in responsibility to self manage a unique life and lifestyle User and environment User Physician self use patient Training Training is not needed The system is very user friendly but training videos are being produced Settings Rural urban at home ambulatory Reviewer s comments This software available for free or at an additional cost with the premium version can help motivate patients behavioural change in several ways 1 By tracking food intake and caloric intake it helps patients to understand the type of food that they eat vis a vis the caloric count something health professionals cannot be too specific about For example a doctor in Spain would be hard pressed to articulate what a 1500 Calorie diet for his her African or Asian patients Patients can take responsibility and fully understand their intake and sensibly alter patterns Recent studies suggest that the general population has difficulty accurately estimating their food intake and this applies both to adults and even more so to teenagers 2 Tracking food intake and setting goals are powerful ways to motivate patients to change This system would encourage that 3 Being able to have communication with their doctors providing s
201. onitoring University of Chicago in which 70 patients with diabetes fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Telemedicine Treatment compliance Software Hardware requirements Remote health workers require a computer with an Internet connection and stable power supply However patients only need access to a cellular phone and mobile network The software is proprietary but will be licensed freely to public and nonprofit health organizations for use in low resource settings Currently used in Pilot study conducted in 2010 demonstrated the feasibility and acceptability of the product in low income African Americans in the U S Currently a single arm clinical trial is underway at the are receiving the intervention for 6 months Although the results are not yet published preliminary analysis demonstrates an improvement in glycemic control hemoglobin Alc and in diabetes self care activities such as treatment compliance Evaluation Dick JJ Nundy S Solomon MC Bishop KN Chin MH Peek ME Feasibility and usability of a text message based program for diabetes self management in an urban African American population J Diabetes Sci Technol 2011 Sep 1 5 5 1246 54 Contact details Shantanu Nundy Email hantanunun
202. oped exclusively with open source monitor the extension to 75 health centres in 2012 software The operating system is a customized Linux Contact details Thierry Agagliate Email tag tdh ch Telephone 22 65 036 9182 Fax 22 67 005 3076 http www who int ehealth eHealth Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Smart phones for supportive supervision for TB Country of origin United States of America Health problem addressed Nigeria ranks 4th among the 22 high TB burden countries in the world The TB burden is further compounded by the high HIV AIDS prevalence The HIV prevalence for Nigeria is 4 4 2005 National sentinel survey There is low capacity to provide high quality TB DOTS and TB HIV services in public and private sector facilities Solution description Introduced Smartphones for data collection and analysis Built a real time feedback mechanism on Android Smartphones platform coded on Pendragon Forms and EpiSurveyor Created an excel based tool that allows transfer of forms from one mHealth tool to another Created forms and connected the forms to the users Distributed the forms wirelessly via Wi Fi or SIM cards
203. or the economy section as it has the flexibility to perform a wide variety of procedures Infrastructure requirements are also lesser as the system has a small footprint which makes it possible to fit it in even small hospitals emerging economies Low cost of ownership maintenance makes the product ideal for low and middle income sections The lab requires less training to operate as it has an intuitive user interface and simple workflow User manual and localized software interface helps ensure the product is well suited for different countries Overall it is a robust product and withstands high workload demand which is typical for resource constrained countries Configurable options and mobile table allow a variety of procedures in cardiac and vascular areas Operating steps The principle of operation is that of a general x ray system For specifics the user manual reference needed Development stage Internal verification and validation testing completed External evaluations done at hospitals globally CE marked product Compliance to European Medical Devices Directive MDD 93 42EEC Manufacturing facility is SO13485 certified The catheterization lab has been commercially released and is in use in various markets like India Nepal Egypt Turkey Latin America and Eastern Europe Future work and challenges Availability of trained interventional cardiologist and radiologist is one of the major challenges and targeting this would be the n
204. othermia detection by ThermoSpot in Indian urban slum dwellings Arch Dis Child Fetal Neonatal Ed 2006 91 f96 F 98 doi 10 1136 adc 2005 078410 http wwwwho int reproductivehealth publications maternal_perinatal_health MSM_97_2 en index htm Thermal protection of a newborn a Appendix Compendium of innovative health technologies for low resource settings 2011 2012 CIE 72 73 74 43 76 Ti Non invasive vascular age risk prediction Non surgical male circumcision device Oral syringe dosing clip Point of care diagnostic device for total WBC Solar charger for hearing aid Sputum mobilization device Urine albumin test FDA cleared K103695 Certified CE Mark Class lla Compliant to ISO 13485 Medical Devices Quality Management systems and FDA 21 CFRI77 2600 Medical products Agency FDA 510 k Clearance Ref 7 Certificate of Registration LV Ref 8 k 053253 USFDA 501k KO91557 KO60439 Class CE mark CLIA waiver certificate Ref 7 k530253 A002 Medical products Agency FDA 510 k Clearance Ref 9 Certificate of Registration LV Ref 10 k 053253 Yusuf S Reddy S Ounpuu S amp Anand S 2001 Global burden of cardiovascular diseases Part 1 General considerations the epidemiologic transition risk factors and impact of urbanization Circulation 104 22 2746 53 Vintro IB 2004 Control and prevention of cardiovascular disease around the world Editorials
205. ountry of origin Benin Health problem addressed This technology is designed to solve the poor accessibility of medicine in pharmacies for patients in developing countries like Benin It is often difficult for people in rural as well as urban areas to buy all medicine on a prescription in only one pharmacy Usually they have to try several pharmacies Solution description The system intends to help a patient to discover available pharmacies in his area with a list of available medicine in stock The patient can use any 2G 3G enabled device to communicate with the EpharmacyNet system That system contains a localisation based database with a real time description of available stock of all pharmacies within a region Then the system replies back to the patient s request with the pharmacies in an area of 10km of diameter that have the target list Interactions between both parties in the mobile network can be done via USSD SMS voice or data connection depending on the patient device The system aims to provide home delivery and online payment Functionality A patient gets a prescription from a physician He she uses the ePharmacyNet system to enter all the medicine listed on that prescription The physician can also use the system to check availability The system uses the central database to help the patient find the nearest pharmacy with all medicine available in stock Developer s claims of solution benefits Using the system patients
206. ountry specific guidelines amp journal abstracts The product captures usage data allowing for analysis and is designed for low resource marginal connectivity settings Future work and challenges The challenges and the opportunities for solutions are spread across a number of categories namely Software gt Hardware gt Personnel gt Programs Given that each of these category silos have their own unique set of issues e g design amp development of information architectures optimized for low bandwidth settings procurement at a cost effective price of smart devices for Sub Saharan Africa recruitment training amp engagement of field pilot professionals and administrative management of multiple groups through protocols feedback amp study design it is essential to operate across categories in an integrated and iterative manner User and environment User physician Training an initial two hour training session including demonstrations and cases Settings rural urban home ambulatory primary secondary and tertiary Solution specifications Solution is used to support Telemedicine eLearning The product is still in Field Pilot R amp D phase and has not mLearning mHealth Geographic Information System yet been commercialized Software Hardware requirements Use of this product Standards It adheres to HIPAA security amp privacy rules requires an Android mobile device and access to mobile for PHI data
207. particular purpose All the information was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium and low birth weight babies are especially at risk The effect for a newborn that has suffered from hypothermia and survived is poorly researched and is in need of urgent attention SEVERE HYPOTHERMIA Outlook grave bed MODERATE HYPOTHERMIA Danger warm baty BRIGHT GREEN START The safe none or normal rome hg 375 C are wrpestiy needed PALE GREEN ne Product description The hypothermia indicator is a 12mm diameter disc with a black face with two small white dots on one side the other side has a self adhesive facility This device comes in a strip of 5 units Liquid crystal technology provides a function for it to perform reliably and accurately within an operating tolerance of 0 5 degree Celsius 36 5 75 oo Product functionality When in situ on a healthy newborn temperature 36 5 37 5 C the device shows a bright green background with a smiling face clearly visible which is the safe zone for the average normal temperature Should the temperature drop below 36 5 C the color fades to a pale green before a red brown color is displayed At 35 5 C the black color shows Developer s claims of product benefits A naked newborn exposed to an environmental temperature of 23 C
208. pendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Medical data communication system Country of origin United States of America Health problem addressed a Access to medical opinion by cardiovascular specialists can be difficult to obtain in rural or poor areas As a result medical data obtained at the point of care such as EKG s medical images lab results or any other type of information cannot be adequately reviewed by the required clinicians and appropriate treatment cannot be prescribed Product description The medical communication system is a technology that allows any type of medical data to be transmitted from the point of care to the desired specialist s The data is transmitted securely and rapidly for delivery to mobile devices or computers so that physician s can review the data and LC provide opinions Product functionality The system is a proprietary push delivery and review platform allowing remote review using the internet and cell phone network of EKG s medical images Medical data is recorded at the point of care and then uploaded to the system s server from which it is then delivered to a physician s smartphone or PC The transaction is fully traceable and secure Developer s claims of product benefits Current practice includes mailing video tapes DVD s or faxing d
209. porting the REC to tactile devices It would ease the learning curve and limit the number of devices to one for easier maintenance With the improvement of the telecommunication networks a wireless data synchronization would make data centralization seamless and ease the integration of the REC to national health systems User and environment User nurse physician midwife Training a 2 day session to learn the use of the computer and the REC Settings rural urban ambulatory primary Reviewers comments IMClis known to be difficult to implement in primary care settings and this tool provides guidance and learning opportunities for healthcare professionals and improves continuity of care thanks to a basic electronic medical record module Solution specifications Solution is used to support Decision Support Systems providing the environment necessary to run a web server Electronic Health Record Electronic Medical Record locally eLearning mLearning Currently used in Burkina Faso Software Hardware requirements Netbook The REC operates in rural areas with a solar panel Electricity is required for at least a couple of hours per day in order to recharge the batteries of the netbook Evaluation The pilot implementation period Oct 2010 Oct 2011 was documented by the University of Geneva A baseline study is currently in progress with the London School of Hygiene and Tropical Medicine in order to The REC was devel
210. presenting treatment and response parameters may be defined across clinically relevant domains Developer s claims of product benefits The application is intended to support physicians or nurses in tracking patients responses to treatment It will permit outcome measurement for any treatment for any disease or health concern The application and manual are available free of charge Operating steps This is a Microsoft Excel software program that is user completed Development stage The current program is complete and self contained Regulatory approval status of the product is completed Conformity assessment has been carried out in Canada Future work and challenges Since posted on the web approximately 1000 individuals have either visited or downloaded the application Future versions will have more robust operability e g automated amalgamation of data from individual cases User and environment User Nurse midwife physician Training Manual 1 hour Maintenance None Environment of use Requirements A compatible computer is required Visual Basic for Applications Microsoft Excel 11 0 Object Library OLE Automation Microsoft Office 11 0 Object Library Microsoft Forms 2 0 Object Library Microsoft Calendar Control 11 0 Product specifications Consumables None Year of commercialization 2010 Retail Price USD O Currently sold in Available for all List price USD O Contact details Dr David Caw
211. quires a finger prick Developers claims of products benefits The current blood diagnosis industry which is based mainly on venous puncture is oriented towards developed markets where costs of logistics refrigeration and transportation are expensive but do not represent the highest burden However in developing economies these costs are unaffordable for the system or individuals and families This test eliminates cold chain requirements which results in major cost savings and makes a step towards universal lab blood service coverage It also makes it possible to remove the key impediments to population monitoring through massive screening to inform health policies The strategy is based on maintaining a solution at very low cost so that it can be offered to all people including those that have very limited financial resources Suitability for low resource settings The test has been implemented in several countries It has been used successfully in the favelas of Rio where only 30 of the pregnant women have access to a antenatal care to prevent vertical transmission However with the device samples were collected in the hospital and sent to a lab with 100 coverage of the 84 000 women in the catchment area ensuring that there was no vertical transmission from these women to their children The system has also been tested in In Alta Verapaz Guatemala with coverage for 1 500 pregnant women who live in the forest Operating steps A
212. raining A clinician will instruct the patient on using the system upon registration 10 min Settings Rural urban primary health post ambulatory Reviewer s comments Although the given mHealth solution is not unique and similar SMS solutions have been implemented in low resource settings this implementation in Kenya has been successful based on the evaluation that has been done It uses the existing infrastructure is a simple and a low cost intervention that has proved effective in a low resource setting Solution specifications Solution is used to support Diagnosis and treatment Currently used in Canada Kenya Health research Patient monitoring Evaluation 1 Lester R et al Effects of a mobile phone Software Hardware requirements The service requires short message service on antiretroviral treatment a stable power supply cellular network a clinician to adherence in Kenya WelTel Kenyal a randomised trial operate the system and a cell phone for the clinician A Lancet 2010 376 9755 1838 1845 laptop or desktop computer is required with the WelTel platform Smartphone application to stay in touch with patients taking antiretroviral medications to treat HIV AIDS installed a SMS gateway and a GSM Global System for Mobile Communications modem connected to the computer to send and receive messages The application is open source customized software 2 Horvath T et al Mobile phone text messaging for promotin
213. rce settings 2013 fitness of any technology for a particular purpose All the information was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Infant warmer Country of origin United States of America Health problem addressed There are over 20 million premature and low birth weight babies born each year globally with more than 95 born in developing countries Three million babies die within the first 28 days of their life with more than a quarter of these deaths occurring in India alone Those who survive often grow up to have lifelong problems such as low IQ early onset of diabetes and heart diseases Hypothermia is a significant problem faced by many of these babies Product description The infant warmer works without a constant supply of electricity It has no moving parts and is safe and easy to use It is also portable enabling newborns to be kept warm during transport One of the other big advantages of the device is that it complements Kangaroo Mother Care KMC It consists of three parts a sleeping bag to place the baby a pouch of phase change material and an electric heater The pouch is heated for 30 mins in the heater second version uses boiling water instead of electrcity to heat and then placed in the sleeping bag It maintains the WHO recommended temperature of 37 deg C for 4 6 hours after which it can be reheated Developer s claims of prod
214. referred research only 6 8 of the population who need eye care attend eye camps a temporary service offered a maximum of twice per year Primary eye care centres in rural areas are a permanent setup to provide primary eye care diagnostic services and delivery of the services They helped to reach 25 of the community in 4 years in support of universal coverage Using tele ophthalmology will enable services to treat 90 of the patients visiting the centre without any visits to the base hospital Future work and challenges As such there are no major challenges in the technology Today the majority of the eye care providers are concentrating on secondary and tertiary eye care services This tool will enable the promotion of primary eye care In order to implement this system the service should be designed in such a way that the primary eye care centres are connected to secondary and tertiary centres in order to handle the patients that could not be handled at their level User and environment User Technician opthalmic technician Training Trained users handle training either onsite or remotely for 3 to 7 days Settings Rural primary health post health centre Solution specifications A Primary Eye Care Centre offers the following facilities The only functionality of the tool is to transmit video and 1 400 sq ft of space to accommodate various audio Any software could be designed around this tool examination rooms like o
215. riser reservoir and breathing system the product is ready for use The product is intended for use by medical personnel trained in delivery of draw over anaesthesia e g anaesthesia physician nurse or officer It is designed to be easy to operate and require little maintenance Development stage The product was developed at the request of and with feedback from those operating in the field The product is in use in 15 low income countries and feedback from operators confirms its ease of use Future work and challenges This product will be promoted at existing training courses for anaesthetists in North America UK Africa and Australia It will be demonstrated at exhibitions worldwide and published in international peer reviewed journals User and environment User Anaesthesia physician nurse officer Training None Maintenance None Environment of use Settings Rural settings ambulatory primary health post health center secondary general hospital tertiary specialists hospital Requirements None Product specifications Dimensions mm 470 x 330 x 170 Other features Portable and reusable Weight kg 9 5 Year of commercialization 2010 Consumables Inhalational anaesthetic agent Currently sold in Sold from UK for use in Australia Life time gt 10 years Bangladesh Burma Canada Democratic Republic of Congo Fiji Gabon Guatemala Haiti Honduras India Kenya Mexico Nepal New Zealand Rwan
216. roducts in that is a validated low cost high quality garment This is achieved by providing direct access to qualified manufacturers who can supply the garment at the price of US 54 purchaser is responsible for freight forward from China and import regulations minimum order is 1 000 units Operating steps 1 Place NASG under woman 2 close segments 1 tightly around the ankles 3 close segments 2 tightly around each calf 3 close segments 3 tightly around each thigh leave knees free 4 close segment 4 around pelvis close segment 5 with pressure ball over the umbilicus 6 Finish closing the NASG using segment 6 Segments 1 2 3 can be applied by two persons simultaneously segments 4 5 6 should only be applied by one Development stage Clinical trials led by Suellen Miller at the University of California San Francisco are on going Currently the large size device is cleared by the US Food and Drug Administration and has been tested in low income settings The device is ready for manufacturing and sale in China Future work and challenges NASG Sizes The NASG is not a one size fits all PPH tool Three sizes small medium and large of NASG have been developed to accommodate the significant population dependent anthropomorphic variations around the world In our interviews in Nigeria it was also clear that an extra large size NASG was desired to accommodate larger women in that region Only the large size NASG has been qualified
217. roscopy are insensitive immuno tests are indirect and the available molecular tests are complex and expensive It is the responsibility of scientific and business communities to provide rapid simple accurate and affordable technologies and products Product description This TB diagnostic is based on 5 core technologies 1 Glass transition of reagents for ambient temperature transport storage 2 Instrument free sample preparation 3 Isothermal Nucleic acid amplification 4 Visual read out a DNA lateral flow device LFD 5 Cross contamination control device The TB DNA test with these integrated technologies can be delivered and performed at almost any location Product functionality Sample preparation using syringe and a membrane unit no centrifugation Amplification proprietary Cross Priming Amplification CPA technology water bath is the only instrument needed Lateral flow strip detection visual readout in an enclosed device cross contamination proof Glass transition of reagents the entire kit can be transported stored at ambient temperature Developer s claims of product benefits The amplification method CPA and cross contamination proof detection device are the primary inventions The glass transition method and sample preparation device are improvements on existing technology Cost effectiveness No setup cost almost no instrument cost Ease of use and Maintenance Single test package simple operation Reduced
218. rse midwife instructors and students in courses for postpartum interventions Training None Maintenance General cleaning of training product after use by wiping with a moist cloth and drying Environment of use Settings Rural urban settings ambulatory primary health post health center secondary general hospital tertiary specialized hospital Requirements The product is operational in any setting and environment There is no need for electricity or other advanced infrastructure Product specifications Dimensions mm 350 x 200 x 175 List price USD 50 Weight kg 0 65 Other features Portable reusable Consumables None Year of commercialization 2013 Life time 3 years Currently sold in It is offered on a not for profit price to Shelf life 3 years the 75 countries that have been identified by UN as focus Retail Price USD 50 countries relative to MDG 4 and 5 Contact details Ingrid L rdal Email pputerustrainer gmail com Telephone 47 515 11855 Web http bitly coebYB http www who int medical_devices 40 Other technologies Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Pressure cooker autocl
219. rt Telemedicine Software Hardware requirements Personal computers with access to the Internet Standards DICOM Currently used in 42 countries Evaluation Telemedicine in HIV AIDS care a users satisfaction survey Proceedings Med_e tel_2011 Contact details Maria Zolfo Email mzolfo itg be Telephone 32 3 2476 364 Fax 32 3 2161 431 http www who int ehealth 60 eHealth Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Telemedicine network Country of origin Switzerland Health problem addressed Continuing education of healthcare professionals and access to specialized advice are keys to improve the quality efficiency and accessibility of health systems In developing countries these activities are usually limited to capitals and remote professionals do not have access to such opportunities Solution description A suite of software tools specifically designed to work in low bandwidth low infrastructure settings to provide distance education Dudal module and tele expertise consultations Bogou module These software modules are developed in Java and deployed using Java Web Start technology Func
220. rtension in different regions and whether monitoring longitudinally would reduce these rates and improve outcome of decreased sequalae of hypertension e g stroke heart attacks etc Solution specifications Solution is used to support Decision support systems Currently used in Canada Diagnosis and treatment Electronic Health Record Evaluation The technology has been validated through eLearning mLearning Public health surveillance independent published clinical trials The research has Software Hardware requirements The facility will determined that the equipment conforms to AAMI require access to the Internet access to a mobile phone US FDA and BHS UK guidelines for device accuracy use of a computer and a stable power supply which will Software will be developed to be used with the device be solar powered to interprete readings in local language and transmit the Standards ICD10 readings in the local language to the health provider Contact details Pamela Muthuuri Email pmuthuuri gmail com Telephone 1 240 515 6364 http www who int ehealth eHealth Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium ePharmacyNet system C
221. s By the patient Open the vial and with the help of a spoon provided collect a portion of feces and put it inside the vial directly into the preservative liquid Close the vial and bring it to the laboratory By the Technician Homogenize the sample by shaking the vial turn over the vial and put it in the tray provided for 15 minutes Place two drops directly on glass microscope plate Development stage The product is on the market since 2007 and it number of laboratories that choose this method is growing Conformity assessment ISO 9001 2008 ISO 13485 2003 CE Mark FDA Future work and challenges The technology is ready to be used in any country It is accessible affordable available and applicable The company needs to find funding to move to the next stage supply worldwide User and environment User Patient technician Training None Maintenance None Environment of use Requirements Product should be stored at room temperature 15 C to 30 C Product specifications Dimensions mm 35 x 35 x 70 Other features Portable Single use Weight kg 0 02 Year of commercialization 2007 Consumables None Currently sold in Brazil Saudi Arabia United Arab Emirates Shelf time 3 years Retail Price USD 1 5 Contact details Jos Carlos Lapenna Email jlz globo com Telephone 55 11 40233888 Fax 55 11 40233888 http wwwwho int medical_ devices Medical devices Compendium of i
222. s Entry approval from individual governments is still needed requiring time and resources Network A network for distribution and demonstration covering health centers in developing countries needs to be established User and environment User Nurse physician technician Training Product brochure instruction for use actual testing kits Training takes about 3 hours Maintenance Nurse physician Environment of use Setting Rural and urban health care facilities Requirements The assays can be used at community health centers with minimal or no lab infrastructure and can be performed by personnel with minimal training water and method to boil for bacteria decontamination water bath to maintain temperature between 58 to 65 C and temporary electricity battery solar are required Long term storage at larger clinics would need to transport the devices to hard to reach areas Product specifications Weight 500g 20 tests Other features The diagnostic test is portable and single Shelf time 1 year use Consumables Pipette tips Year of commercialization 2009 Retail Price USD 6 including sample preparation Currently sold in China Thailand Singapore Taiwan amplification and detection Canada and USA research only Contact details Qimin You Email qiminyou2000 163 com Telephone 86 571 8893 9366 Fax 86 571 8893 9356 http wwwwho int medical_ devices 90 Medical devices Compendium of innovative
223. s There is interest in taking the mobile services to other Indian states and countries The technology is scalable however a challenge in taking the services to new regions is the additional investment required to adapt the content to new cultural and language contexts User and environment Users Nurse midwife self use patient community health worker Training CHWs are trained by a local NGO partner for approximately 4 days Settings Rural primary health post at home Solution specifications fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Solution is used to support eLearning mLearning mHealth Software Hardware requirements The infrastructure required is the same as required for access to basic mobile phone functions i e relatively stable power supply and access to a cellular mobile network It is available on any mobile handset and across all the six major network providers in the state It uses open source software MOTECH Currently used in India Evaluation The services deliver health education rather than clinical services thus clinical trials are not applicable However extensive user testing was carried out to assess the usability and accessibility of the services with CHWS across Bihar
224. s a dose the counselor receives a text message and must follow up with the patient within 48 hours to take their medication Developer s claims of solution benefits The eCompliance initiative is the first to apply biometric attendance monitoring to tuberculosis treatment No other TB control system can provide verifiable evidence to back up their TB statistics The innovation s transparency and accountability are two of its strongest aspects While other TB programs have digitized their systems these programs rarely cater to impoverished areas relying on the Internet or 3G networks to relay information Future work and challenges Funding is needed for operations of the system and the ever changing field of technology User and environment User technician counselors Training training on the system takes 3 4 hours and is given by one of the biometric team members Settings rural urban home ambulatory primary secondary and tertiary Solution specifications fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Solution is used to support Electronic Health Record Electronic Medical Record mHealth Software Hardware requirements Netbooks for use in the treatment centers and access to SMS network
225. s flat packed requires local assembly and must be distributed through a wheelchair service Product functionality Products in the range require assembly by trained local staff Basic hand tools are required and pictorial assembly instructions for each product are provided Once assembled to the client s prescription the client is fitted comfortably and given instructions on how to use the product safely and carry out basic maintenance The products are manual and easy to maneuver by the client or an attendant Developer s claims of product benefits The complete product range can be uniquely shipped in any volume to service centres around the world and provides a mean to facilitate and expedite the provision of appropriate manual wheelchairs in low income countries Providing a range promotes choice for people with disabilities and ensures they receive a product that is most suited to their need and aids their rehabilitation The products are affordable high in quality and durable and use locally available components The adjustable features optimize comfort The majority of products are supplied with a pressure relieving cushion a life saving device that is often not provided with other donated wheelchairs Training is provided to local staff to ensure they have the skills to assemble fit and adjust the products correctly and competently Operating steps The products are assembled according to the assembly instructions Once set up the client is f
226. s low cost It provides 165 range of motion at the knee which is critical for low and middle income countries especially for kneeling squatting biking and agricultural work Development stage The knee has been fit on over 4 600 patients primarily in India In 2013 the latest version of the product was tested to ISO 10328 Prosthetics structural testing of lower limb prostheses Future work and challenges Successful outcomes depend on availability of trained prosthetists who can fabricate a custom socket to fit over the patient s residual limb Scaling is currently limited to areas with established prosthetic clinics capable of providing a proper fitting Use and maintenance User Self use Training Instructions for use comes with the product fitting training is required for prosthetists Maintenance Not required Environment of use Settings Rural urban settings at home Requirements A trained prosthetist to fit the product Product specifications Dimensions mm 60 x 80 x 140 Retail price USD 80 Weight kg 0 68 List price USD 80 Consumables None Other features Single use portable Life time years 5 Year of commercialization 2008 Currently sold in India Contact details Krista Donaldson Email affordableknee gmail com Telephone 415 642 1143 Web http bitly W6jIM http wwwwho int disabilities technology 7 Assistive devices Compendium of innovative health technologi
227. sabilities technology 43 eHealth solutions 2012 Compendium of innovative health eHealth technologies for low resource settings 2012 Biometric technology in healthcare Country of origin India Health problem addressed Tuberculosis TB is one of the biggest public health problems in India The country holds one fifth of the global TB burden with nearly 2 million new cases and 330 000 TB caused deaths every year Patients who do not complete the entire course of treatment often develop drug resistance Solution description The system utilizes a simple interface with minimal text and color coding for ease of use in low literacy areas The system synchronizes up to date reports with a central Electronic Medical Record EMR database located at the office headquarters The application uses NET Framework and runs locally on any Windows machine Primarily an offline application it sends daily attendance reports through SMS to an online server through the USB modem When the patient registers onto the system they provide a fingerprint which is used throughout their course of treatment to track their treatment schedule If a patient misses a dose an SMS is sent to their counselor by the end of the day Functionality Patients registered at the terminal log their visit to a TB center on a fingerprint reader At the end of each day the attendance record is compressed into a text message and sent to an online server If a patient misse
228. se among pregnant women and women with pre eclampsia In addition cuffs are available in S M L L XL sizes in both resusable and disposable varieties Operating steps Place the cuff on the upper arm press the on off button and the device automatically measures blood pressure and presents the measured blood pressure value on the LCD screen Regulatory status The device is both FDA approved and CE marked Future work and challenges Challenges include making doctors and nurses aware that this device is an automated oscillometric device that can reliably measure pregnant women with high blood pressure and pre eclampsia and that patients can screen themselves at home with this device Use and maintenance User Self use patient physician nurse midwife technician Training Only in the case of patient self use Training can be provided by the midwife nurse or physician Maintenance None Environment of use Settings Rural urban settings ambulatory at home primary health post health center secondary general hospital tertiary specialized hospital Requirements The device can work on batteries but also with an adapter and electricity When the user has access to a PC the device can be used as a telemedicine device and the data uploaded to the PC and transferred via the internet to a hospital or general practitioner However this is optional Ambient temperature for device storage and use should be between 10 and 40
229. se that they can bookmark and complete at their own pace over a period of up to one year Additionally CHWs use a second mobile service a job aid which is complemented by a deck of colour coded and illustrated cards bearing life saving information to reinforce the information that they share with families on routine visits The services are available on any mobile handset and any network in the state are voice based and are accessible via common mobile short codes that bring listeners directly to training content and job aid Functionality Job aid When the CHW counsels family members she dials a unique short code listed on any of the 40 cards while showing the illustrated card to the family The call takes her to the voice of a doctor character who reinforces the health message on the card She plays the message to the family Training aid CHW completes mobile course at her own pace Developer s claims of solution benefits Training is cheaper 1 50 for full course and more accessible than face to face training the content is specifically designed for local context in simple and suitable language and therefore more engaging and easy to remember The services use available cheap mobile phones that are light and easy to carry and an accompanying deck of cards containing dial codes and additional information is light and waterproof The services are easy to use by anyone who can dial out on a mobile phone Future work and challenge
230. security skills 3 6 academic hours Settings rural urban primary and secondary Reviewers comments The organizational aspects for using ICT meaningfully to address the management of trauma patients are good and have demonstrated convincing results Solution specifications Solution is used to support Telemedicine eLearning Evaluation Vladzymyrskyy AV Klymovytskyy mHealth V G Kalinovsky D K et al Clinical Efficiency of Telemedicine in Trauma and Orthopaedics Med e Tel 2008 Luxembourg 2008 P 87 88 Software Hardware requirements standardized equipment PC digital camera printer web camera and IP data transfer protocol based on principles of low resource telemedicine iPath Standards DICOM Currently used in Ukraine Russia Contact details Anton Vladzymyrskyy Email doctelemed gmail com Telephone 380 50 755 6794 Fax 380 62 311 0507 http www who int ehealth Melle Meier 2012 Medical devices Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Automated solar powered blood pressure monitor Country of origin Japan Health problem addressed a There is a progressive increase in the
231. sed Women of low socioeconomic status are TT en ee D more vulnerable due to lack of access to screening H msn PTE DR eme Solution description b ee Craie The national information online system of screening allows for the a z monitoring and appropriate treatment of affected women by providing nominalized lists of women included in the national prevention programme The national information system identifies women with pathological paps for their diagnosis and treatment It also provides indicators to monitor and evaluate the prevention programme Functionality The national online information system allows for coordination of health services that are involved with uterine cervical cancer prevention serving as a support of the monitoring of health services It is used at the primary care level cytology laboratories gynaecology services and central level Developer s claims of solution benefits It is an online information system that links services and users so that the information related to screening diagnosis and treatment supports the management of the service network It allows for the flow of information among different health services and country areas allowing the monitoring of women in all stages of prevention even those living in remote areas It has an alert system that allows for faster detection of problems with women in need of diagnosis and treatment Future work and challenges Incorporatio
232. services also have significant variations across regions and between rural and urban settings There is a challenge of access A shortage of ophthalmologists restricts the provision of services in rural areas Solution description It isa web based comprehensive software solution for primary eye care services that records the registration of patients records systemic diseases and clinical findings captures images and integrates teleconsulting equipment so a base hospital ophthalmologist can review the findings and discuss the problem It also generates prescriptions manages the inventory of optical and medical supplies includes financial details and tracks the patients referred to the base hospital to ensure compliance with the recommended treatment Ophthalmologists have access to the medical record entered at the rural centre from the base hospital and interact with the patient and provide consultancy services to the patient Functionality The rural centre coordinator registers the patient by asking their demographic and systemic condition details and generates an ID Card A vision technician examines the patient enters the findings and passes a message to the base hospital ophthalmologist to come online for a consultation The ophthalmologist consults and advises on the treatment accordingly Developer s claims of solution benefits Community outreach programs have been the traditional approach to reach the rural community As per the
233. ses local materials and processes and also allows for easy installation Operating steps Operates like a traditional stove Development stage This product has been used successfully mostly in India but also in countries like Kenya and Laos It s technical performance has been assessed and certified by the College of Engineering Pune and Approvecho Pondicherry India Future work and challenges To take the next step in empowering local entrepreneurship and enabling NGOs to implement the solution the company has set up a webpage The corresponding online platform aims to support the dissemination of the stove by free distribution of the design specifications It also enables networking with other involved stakeholders and facilitates transfer of knowledge User and environment User Self use patient Training Training can be conducted by local entrepreneurs who produce and install the stove and explain about use and cleaning Maintenance Chimney and soot collector cleaning once per month Environment of use Settings Rural settings Requirements Low tech manufacturing using only cement and clay Product specifications Dimensions mm 800 x 450 x 270 List price USD Approximately 20 including product Weight kg 90 transportation and installation Consumables Biomass fuel wood or cow dung Other features Installed stationary reusable Retail Price USD Approximately 20 including product Year
234. sia is also vital for treatment of traumas hernias animal bites burns infections and congenital deformities Product description This device is a complete inhalational anaesthesia system that is suitable for a variety of settings It includes a valve with a circuit removing the valve a reservoir unit for pre oxygenation a vaporiser for consistency over a wide temperature range and is calibrated for Halothane Isoflurane or Sevoflurane to overcome possible supply problems Product functionality The device is used for spontaneous breathing or assisted ventilation and drawover or continuous flow inhalational anaesthetics Developer s claims of product benefits Most anaesthetic machines are designed to function in high resource environments by specialized operators and require skilled technical support and maintenance Current solutions require compressed gases and stable electricity supplies which are not suitable for rapid response in austere environments This device is robust affordable lightweight and easily transportable It is easy to operate and virtually maintenance free making it suitable for use by local personnel It is extremely cost effective and economic to use as there is no requirement for expensive consumables Supremely safe it can be used where supply of electricity and medical gases are unreliable or non existent Operating steps Following the rapid assembly of the three principal components vapo
235. sis artificial limb It consists of three parts a metal plate inside the socket which is attached to a prosthetic soft liner a magnetic assembly the source of magnetic power which remains outside of the socket positioned between the prosthetic socket and the pylon internal frame of the prosthetic leg and a switch which connects or disconnects the coupling device The soft liner acts as a sort of second skin between the movable soft tissue of the stump and the hard shell of the socket The soft liner provides comfort and holds the stump inside the prosthesis with the help of the magnetic coupling device Product functionality After donning the prosthetic soft liner the user puts the stump inside the prosthesis The mechanical switch is positioned in the On mode The magnetic field will hold and retain the stump within the prosthesis While removing the user needs to position the switch to the Off mode which will then allow the user to withdraw the stump from the prosthesis The system comes with an optional acoustic safety alarm which can warn the user about imminent possibilities of suspension failure Developer s claims of products benefits The system is easy to fabricate cheaper than other suspension systems more durable and easy to use It requires less maintenance reduces pain in the residual limb decreases interface pressure and reduces pistoning Development stage The system patent is pending
236. ss yet only fewer than 10 seek professional help due to the inaccessibility and high cost of treatment WHO 2012 Hearing loss has also been described to be the most prevalent disability in developed countries Davis 1997 Solution description The technology seamlessly integrates 1 Optimised screening enabled by an application that provides an accurate accessible and affordable audiogram screen 2 Optimised diagnosis enabled by effective data management analytics automated reports and remote review 3 Optimised care enabled by patient remote review e referral tracking engagement and eLearning Functionality Instructions on the touchscreen are intuitive clear and simple Developer s claims of solution benefits Audiology services currently rely largely on unwieldy expensive dedicated equipment requiring skilled personel to conduct testing Few devices used in the field for screening are web enabled This device offers improvements in that it uses existing widely available touch screen mobile phones or tablets thus vastly reducing the cost of screening equipment It is very simple to operate eHealth records are immediately captured Future work and challenges Adoption of technology requires regulatory approval Initial capital for handsets or computer tablets and headphones needs to be raised Local policy and remote evaluation of screening outcomes needs to be developed User and environment User Phys
237. ss the globe have on the go access through a log in user name and password with access to review patient medical information providing accurate diagnosis and second opinion reports Functionality The DICOM sender module offers a zero foot print viewer system that allows for images to be viewed on the web This cloud based approach requires no additional hardware or software to be purchased Native studies are sent directly to fully functioning PACS systems or viewed through a log in user name and password over any personal digital device Developer s claims of solution benefits Physicians will have access to images and reports allowing them to take their services to patients who could not be reached previously Informed patient care decisions allow for a faster accurate diagnosis from anywhere in the world that has access to the Internet Statistics show there are 2 2 billion mobile phones in the developing world while some parts have a patient doctor ratio of one in 20 000 A mobile cloud service enables better care to be provided to more patients at a lower cost The fundamental financial and operational model has a primary focus on the healthcare industry one known to be cautious with technology Future work and challenges Confusion hinders adoption and there is some confusion about what Cloud computing can do User and environment User physician nurse technician authorized medical professionals and health care providers
238. stability in the region is the largest challenge The most unstable countries do not have oncology facilities offering radiation and chemotherapy thus these countries will not be included in the target market until such time as facilities are available and technical staff are able to move safely in the countries In countries in which facilities are available the public health sector will be targeted as this is where the most benefit will be gained from the technology Use and maintenance User Physician nurse radiation therapist Training One day on site conducted by distributor Maintenance Every 6 months by local distributor technical staff Environment of use Settings Rural urban settings secondary general hospital tertiary specialized hospital Requirements The work area should be 4m x 4m safe for consulting areas no shielding required The electricity supply should be 230V 50Hz device includes surge protector and 30 minute battery back up The device should be keep within 10 C to 30 C 20 60 humidity and 700 hPa 1060 hPa Product specifications Dimensions mm 585 x 2062 x 920 Other features Software use installed stationary capital Weight kg 500 equipment Consumables None Year of commercialization 1996 Life time 10 years Currently sold in Australia Austria Belgium Canada Retail Price USD 303 000 China Denmark Germany Greece Hungary Israel Italy Lis
239. support of national coordination teams Settings rural urban secondary and tertiary Solution specifications Solution is used to support Telemedicine eLearning Evaluation Bagayoko CO et al Deploying portable mLearning ultrasonography with remote assistance for isolated Software Hardware requirements The software tools physicians in Africa lessons from a pilot study in Mali require low bandwidth Internet access which can be Stud Health Technol Inform 2010 160 554 8 provided by DSL 3G or satellite links Uplink bandwidth Bagayoko CO et al Can ICTs Contribute to the Efficiency of 20 kbps and downlink bandwidth of 40 kbps are and Provide Equitable Access to the Health Care System sufficient to run all services Year Med Inform 2011 6 1 33 8 Dudal and Bogou modules are Java applications based on open source libraries freely available with no license fee Standards DICOM Currently used in Mali Mauritania Senegal Burkina Faso Niger lvory Coast Chad Cameroon Congo DRC Guinea Madagascar Liberia Ghana Tanzania Egypt Tunisia Morocco Bolivia Laos Contact details Antoine Geissbuhler Email antoine geissbuhler hcuge ch Telephone 41 22 372 6201 Fax 41 22 372 6255 http www who int goe eHealth Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitut
240. sy to maintain with a 10 year life span Suitability for low resource settings In oncology funding resources staff and facilities are limited The device is safe for patients and staff easy to use and very reliable 10 year life span It does not require specialized facilities equipment consumables staff It comes with a UPS protects against power surges in the region and it is affordable and cost effective to run and maintain only 2 services a year It can improve treatment efficacy and lower the costs of the treatment It has been in use in a private facility in South Africa for four months Reports from doctors and patients confirm the safety feasibility and practicality of the device Operating steps Switch on the device Let the self test run Choose the correct size electrode Fix the electrode to the adjustable arm and plug in the cable to the bed Lay the patient on the bed Place the electrode over the treatment area Set the treatment parameters time power Press start Device will signal end of treatment Press stop remove electrode and assist patient off the bed Regulatory status Approved by European Union EU European Medical Device Directive CE Germany Technischer Uberwachungs Verein TUV Australian Registrar of Therapeutic Goods South Africa Department of Health Directorate of Radiation and Hazardous substances Russia Korea KFDA Turkey Canada Health Canada Future work and challenges The economic in
241. system Country of origin United States of America Health problem addressed According to WHO statistics road traffic accidents RTAs cause about 25 4 million severe injuries per year RTAs are projected to become the third leading cause of DALYs lost worldwide by 2020 Developing countries lack the surgical tools to treat severe fracture injuries effectively Those who live in poverty cannot afford the cost of surgical implant they need in order to quickly recover and provide for their dependents Product description The intermedullar IM nail and interlocking screw system is designed to be used without electricity or x ray imaging in the operating room The system consists of stainless steel nails which are placed down the middle of the bones with screws that are placed through the bone and nail to stabilize the fracture Product functionality This method allows patients to walk using crutches the day after surgery and be discharged usually three days after surgery The same instruments and implants of different sizes are used to treat fractures of the femur tibia and humerus Results are recorded on an online database to ensure the proper technique is being followed and to learn more about fracture healing Developer s claims of product benefits The IM nail and interlocking screw system s cost effectiveness is reflected in less disability after the fracture ability to return sooner to work and more efficient utilizati
242. t 34 Oscillometric blood pressure measurement 35 Oxygen concentrator driven bubble CPAP 36 Telecardiology 37 Umbilical artery doppler analyser 38 J O Other technologies 201 3 Postpartum uterus trainer AS Pressure cooker autoclave m oO c N n 00 E b oO n S rs fe n oO T 3 2 n 2 o0 Ke fe te YU oO p j Q oO f v 2 a gt fe ue oO z mo f 0 Q ie UO Assistive devices 2012 Solar charger for hearing aid eHealth solutions 2012 Biometric technology in healthcare Case based smartphone messaging platform Cervical cancer screening information system Computer aided detection for Tuberculosis Health workforce information systems Integrated smartreader amp cloud services Maternal health Tanzania Medical cloud mHealth platform for community health workers New media to train health workers Primary health care continuous quality improvement CQI tools Rapid SMS providing availability of essential medicines Real time measurement of meteorological events on public health Registre electronique de consultation REC Smart phones for supportive supervision for TB Telemedicine for HIV AIDS care Telemedicine network Tele ophthalmology software application Teletrauma Medical devices 2012 Automated solar powered blood pressure monitor Interventional cardiovascular lab Intramedullary nail and interlocking screw syste
243. t and as a cost effective and efficient alternative to current methods of screening The system is applicable in rural and mobile clinics due to its convenience and portability Operating steps a Upon arrival verify patients fasting status b The patients need to rest for 10 minutes before data recording c PPG signal will be recorded for a duration of 90 seconds at a room temperature of 24 25 C Recording is done at a sampling rate of 50 Hz and saved in ASCII format d Subject to be in supine position with arms rested on pillows during the data recording session PPG to be obtained from tip of the left index finger Development stage gt In 2010 the clinical trials and community health screening program have been conducted in several places including universiti kebangsaan Malaysia medical center UKMMC Taman Melewar Gombak urban and Felda Sungai Tengi Kuala Kubu Baru sub urban Approximately 370 subjects participated The study was granted the Ethical Committee approval from the UKMMC Research Ethical Committee Future work and challenges Vascular age is a newly develops concept and technology which have a great potential to improve the health care services especially in CVD screening The main challenge is the acceptance among the medical personals The vascular age model is the ethnic and population dependent Therefore data acquisition across the nations would help to establish and improve the existing model User and
244. t price USD 303 000 Japan Jordan Lebanon Netherlands Poland Romania Russia South Korea Turkey Ukraine South Africa Contact details Janina Leckler Email c_minnaar icon coza Telephone 49 22 413 199 223 Web http bitiy larzl 1Q http www who int medical_devices 26 Medical devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Fecal occult blood test Country of origin Cuba Health problem addressed Cancer is one of the main causes of death in the world It is expected that death by cancer worldwide will grow to reach 131 million in 2030 Colon cancer is among those with the highest death rate However the success rate of treatment is also high when detected at early stages and properly treated Product description The device enables fast qualitative detection of occult blood in feces It consists of a sandwich type chromatographic immunoassay and makes use of a combination of monoclonal and polyclonal antibodies for the detection of human hemoglobin with a high degree of sensitivity In five minutes levels of human hemoglobin as small as 0 2 Qg mL can be spotted in feces and positive results are visually evident The
245. t quantitative data All data are entered into a web based database and reports are generated The team sets goals and action plans for the next 12 months Developer s claims of solution benefits This approach comprehensively addresses the development of capacity to apply CQI in a health service context starting at the stage where the health service is at It embeds ownership of the process by the health service staff It uses systems currently in place to collect health data It provides tools to measure health service practice against accepted best practice It encourages the process of quality improvement in steps to address areas identified as priorities by the health service Future work and challenges The existing technology is modelled on Australian terminology and best practice for disease which is not necessarily suitable for other settings Recommended changes include tools abbreviated to include key disease outcomes and corresponding modification to electronic database interface including capacity for local users to edit specific field options e g drug doses ethnicity and download upload capacity to support off line use Coordinators should be trained and supported to maintain the technology locally User and environment User physician nurse midwife technician health workers indigenous other health workers Training training is required and is given initially by an Australian team who can build more sustainable cap
246. technology simply winding a handle will charge the batteries Each minute of winding provides about 10 minutes of monitoring time Developer s claims of product benefits Fetal monitoring methods in low income countries are limited to Pinard fetal stethoscopes Current availability of monitoring in the majority of primary and district care facilities in middle and especially low income countries being limited makes this monitoring unreliable The accuracy of the Pinard is without much evidence indicating improved outcomes in situations of fetal distress Doppler ultrasound fetal heart rate monitors are recommended but only 1 of these devices worldwide are available in low income countries This device aims at a reduction in perinatal mortality and neonatal encephalopathy The majority of the midwives who used the monitor preferred it to the Pinard as the device was easy to charge it was very easy to obtain a reading and quick to identify the fetal heart rate within 30 seconds Operating steps The powerful narrow beam Doppler head is placed on a pregnant woman s abdomen The fetal heart rate is delivered as an audio signal and displayed as a number in beats per minute Development stage This fetal heart rate monitor won the Index Global Design Award in 2009 and has the potential to dramatically improve health outcomes especially for babies Pilot field testing was carried out in 9 South African primary care maternity facilities run only by midw
247. tected it may escalate to end stage renal disease ESRD which requires expensive treatment and risk of poverty due to inability to work Product description This devices uses a quantitative rapid turbidimetric immunoassay of albumin in human urine using a specially designed analyzer eons o Product functionality The system can be used for the quantitative determination of low levels of a A albumin in human urine for the purpose of screening diagnosing monitoring and to supplement the clinical evidence in the treatment of microalbuminuria Developer s claims of product benefits Current devices are semiquantitative dipsticks some with visual reading only In comparison this new system provides lab equivalent results in 90 seconds and is easy to use by anyone It requires minimal maintenance since it is factory calibrated does not require any further recalibration and results can be compared between sites The system makes it possible to perform large screening programs in rural settings as long as power supply is available Operating steps The microcuvette serves as pipette mixing and reaction chamber and the correct specimen volume is obtained by capillary action First the cuvette is filled then it is placed in the analyzer The result can then be read Development stage The system has not been part of any clinical studies but has been evaluated The system has been used during a World Kidney Day screen
248. tection of peripheral arterial disease PAD The ABI is automatically calculated by the device The device can also be used as a regular clinical blood pressure monitor Since it is _ J also equipped with an atrial fibrillation AF detection system it automatically screens for AF during routine blood pressure measurement Developer s claims of products benefits The procedure to test for PAD is commonly performed with Doppler which requires skill is liable to observer bias and is time consuming This device is easy to use the procedure is conducted faster and is less liable to observer bias The device can also be used with minimal training Suitability for low resource settings The device is portable and can also be used as a regular blood pressure monitor Because of its relative low price and multiple configurations with and without software it is suitable to be used in small hospitals or healthcare centers Once fully charged many measurements can be taken making the device portable and easy to travel with e g to screen in small villages The device can diagnose PAD hypertension and atrial fibrillation in a small amount of time Only limited training is required Operating steps First a patient is measured simultaneously at both arms in the supine position to determine the arm with the highest BP Thereafter a cuff is placed around the arm and ankle to perform the ankle arm measurement simultanously The ankle cuff
249. ternet or a cellular mobile network standards Currently used in Canada Evaluation Bustinza R Toutant S B langer D Gosselin P Syst me int gr des donn es de vigie et surveillance des al as hydrom t orologiques et g ologiques valuation de l utilisation du volet chaleur au cours de l t 2010 Contact details Pierre Gosselin Email p_gosselin videotron ca Telephone 1 418 650 5115 t5205 Fax 1 418 654 3144 http www who int ehealth 57 eHealth Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Registre electronique de consultation REC Country of origin Burkina Faso Health problem addressed In Burkina Faso 1 in 6 children die before the age of 5 The Integrated Management of Childhood Illness IMCI protocol was developed by WHO to reduce child mortality but its implementation is difficult due to an insufficient number of trained health workers and because arduous working conditions increase the lack of rigor and motivation Solution description The registre electronique de consultation REC is an offline web application that guides the health professionals throughout the consult to help them s
250. test is used for annual screening of colorectal cancer in people above age 50 and it is useful for the early diagnosis and follow up treatment of gastrointestinal disorders that cause bleeding The product is supplied in boxes of 20 cassettes and 20 collector flasks Developer s claims of products benefits The test can provide highly sensitive and rapid detection of human blood in the feces The technology uses a detection method that is specific to human hemoglobin so the patient does not need to stop eating meat two or three days earlier as there is no interference with animal hemoglobin Suitability for low resource settings Standard household refrigeration is the only requirement It has been used successfully in Cuba Operating steps A small amount of feces should be taken as a sample by using the applicator incorporated to the top of the collector flask Afterwards the top is wound and the flask content agitated A diluted sample will be placed on the cassette by using the collector flask dropper In five minutes the result can be read from the device Regulatory status The test is registered in Cuba and Peru and is GMP compliant It has been evaluated by Cuba s CECMED Centro Estatal para el Control de Equipos M dicos y Medicamentos and Peru s DIGEMID Direcci n General de Medicamentos Insumos y Drogas Future work and challenges The strategy is to provide a stable supply of consumables diagnostic kits
251. th post health center secondary general hospital tertiary specialized hospital medical stores Reviewer s comments gt The system is simple and meeting a well known challenge in the health system in low resource settings The system has been piloted in three relevant countries and is now in use Solution specifications fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Solution is used to support Decision support systems Geographic Information System mHealth Management of hospital information Logistics and supply chain management Software Hardware requirements Mobile workers require a mobile phone with SMS capability or a mobile application and network coverage Supervisors use a personal computer with an internet connection As open source software anyone is free to download and modify the code Additionally the hosted version provides a reports customization layer which allows any developer to generate custom views reports dashboards and forms while at the same time leveraging the common shared software repository used by a community of other projects Currently used in Ghana India Malawi Tanzania Uganda Contact details Rowena Luk Email rluk berkeleyedu Telephone 1 617 649 2214
252. the UL recognition approval Future work and challenges Promoting the technology s ease of use efficient treatment system and affordable cost in low and middle income countries is the greatest challenge Assistance herein is required e g through workshops by professionals to explain the importance and advantages and to make users familiar with new functions that improve the treatment quality like the embedded radiometer and the timer User and environment User Nurse physician Training Concept presentation 2 hours training Maintenance Technician Environment of use Setting Secondary general hospital tertiary specialists hospital Requirements Power supply 100 to 240 Vac 50 or 60Hz ambient temperature between 18 C and 28 C air humidity between 10 and 95 eye protection for the patient Product specifications Dimensions mm 230 x 116 x 50 Currently sold in Algeria Australia Bolivia Brazil Weight kg 1 Colombia Costa Rica Ecuador Spain Finland France Indonesia Iran Iraq Jamaica Lithuania Malaysia Mexico Nicaragua Paraguay Peru Poland Portugal Russia Syria Sudan Sweden Uruguay Venezuela Vietnam Yemen Consumables Eye protector Other features Portable and reusable It utilizes software Year of commercialization 2005 Contact details Djalma Luiz Rodrigues Email rukarin massaro uol com br Telephone 55 11 2412 3743 Fax 55 11 2412 3743 http wwwwho int medic
253. the most common types of knee joints used in low resource settings is the manually locking knee that requires walking with either a straight leg or an unlocked one that is very unstable This product provides a high level of stability during weight bearing and at the same time a high level of mobility It is easy to assemble can be used in water and wet environments without being damaged and is also low cost Development stage Independent product evaluations and clinical trials have been conducted in Canada Chile El Salvador Germany India and Myanmar It was tested as part of the ISO 10328 standard Prosthetics structural testing of lower limb prostheses Future work and challenges There is a need to establish a partnership with an international distributor In addition finalization of negotiations in regards to production is required in order to decrease further the product cost while ensuring high and consistent quality Use and maintenance User Self use Training Not required Maintenance On site as needed Environment of use Settings Rural urban ambulatory at home Requirements A facility with tools and materials and trained clinical technical personnel to fit the product into a prosthesis Product specifications Dimensions mm 60 x 80 x 180 List price USD 100 Weight kg 0 7 Other features Reusable Consumables None Year of commercialization Premarket launch 2013 Life time years 3 5 Currently s
254. thorpe Email cawthord ucalgary ca Telephone 1 403 955 8760 Fax http wwwwho int ehealth 87 Melle Meier 201 Medical devices Compendium of innovative health technologies for low resource settings 2011 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Fetal heart rate monitor Country of origin United Kingdom Health problem addressed Every year 1 million babies die during childbirth Complications during childbirth kill half a million mothers and a further 1 million babies within a month of birth Over 99 of these deaths occur in the developing world and many are preventable with timely detection of complications Product description Using advanced Doppler ultrasound technology the monitor detects and measures the fetal heart rate This vital indicator of fetal stress allows rural healthcare workers to make life saving decisions during childbirth Destined for use in low resource settings its design focuses on simplicity of use durability and electrical power independence Product functionality The fetal heart rate monitor is designed for ruggedness and simplicity of use but its most distinguishing element is the human powered electricity solution By using the self powered
255. ties requires the continuous delivery of a mixture of oxygen and air to the lungs This device generates and delivers a safe easily controllable mixture of humidified oxygen and air for CPAP treatment It is driven by an oxygen concentrator that generates oxygen from atmospheric air eliminating the need for expensive cylinders of compressed gases The device delivers flows of up to 8L min of both oxygen and air Pressure in the system is controlled by a bubble bottle that depends on the depth of tubing under water and is set by a simple dial on the bottle top An oxygen air mixing chart provided means there is no need for an oxygen analyzer Developers claims of products benefits Most CPAP devices available are designed for use in resource rich countries and are inappropriate for low resource settings A few devices have been designed to make CPAP more widely available in low resource settings but these still require an external oxygen source making them expensive to run This device is unique in being driven by its own oxygen concentrator a cost efficient method of generating oxygen This makes it possible to deliver low cost reliable CPAP treatment in low resource or remote areas where gas cylinders are not an affordable or practical option The model of oxygen concentrator used in this CPAP device was selected for its durability and performance in tests The device is robust simple to operate and requires only minimal maintenance Suitab
256. tilators in various patient populations and under different clinical conditions such as leak prone noninvasive applications The results of such studies show the relative superiority of the device s design elements and precise gas delivery One bench study demonstrates the unique ability of the device to maintain accurate volume control mode delivery even while using cheap and simple intentional leak breathing circuits Future work and challenges None User and environment User Nurse physician technician Training Interactive CD ROM self paced User s Manual reference material various slide presentations Maintenance Technician engineer manufacturer Environment of use Settings Ambulatory secondary and tertiary health care facilities Requirements Basic electrical power 100 240 VAC 50 60 Hz 21 A 5 40C temperature range and high pressure oxygen source 40 87 psi via compressed gas tanks or wall outlets Optional available equipment to disinfect breathing circuits if reusable circuits are preferred Product specifications Dimensions mm 21 3 x 28 5 x 23 5 List price of consumables USD 80 Std Adult reusable Weight kg 5 6 including batteries circuit 14 disposable circuit Other features Portable and reusable Runs on batteries uses software and is compatible with telemedicine systems Consumables Breathing circuit and patient interface artificial airway or facemask Life time Several y
257. ting anywhere with an internet connection The doctor remotely controls the device to obtain medical parameters and to provide prescription to the patient while medical records are stored The solution also supports supply chain lab reports and referrals Development stage More than 850 devices have been operational in the rural areas of India with low bandwidths mostly over 64 kilobits s bandwidth and semi skilled village operators and more than 100 000 tele consultations have been carried out successfully IEC60601 1 compliance and 1SO13485 manufacturing process compliance have been completed CE marking process is underway Future work and challenges Implement large scale projects with healthcare service delivery partners and e governance players Enhance technology with further diagnostics and better ground level delivery processes Develop mobile Bluetooth based solution for places lacking 32 kilobits s bandwidth Build relations with partners having complementary solutions Modify business model to include software as a service User and environment User Self use patient physician technician nurse midwife family Training On site individual group training videoconferencing teamviewer based e training 2 4 hrs Maintenance Annual Preventive To be conducted by Manufacturer Environment of use Settings Rural settings urban settings at home primary health post health center secondary general hospital
258. tings Rural urban settings primary health post health center secondary general hospital tertiary specialized hospital Requirements Continuous power supply 100 240V Product specifications Dimensions mm 530 x 550 x 1700 maximum height Other features Mobile capital equipment Weight kg 10 Year of commercialization 2011 Consumables None Currently sold in 122 countries Emerging market countries Life time 7 years include Bahamas Bolivia Costa Rica Czech Republic Shelf life 2 years 6 months without any operation Ecuador Egypt Gabon Ghana Hungary India Indonesia Retail Price USD 1200 with considerable variation Mexico Moldova Myanmar Peru Philippines Poland between cotintries Romania South Africa Thailand Tunisia Vietnam List price USD 1500 Contact details Ashish Gupta Email lowresourcesetting gmail com Telephone 91 80 408 85941 Web duo http www who int medical_devices Medical devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Low pressure anaesthesia machine Country of origin United Kingdom Health problem addressed 7 More than 2 billion people lack ac
259. tion is proprietary It has been optimized for usage in low Contact details Sameer Sawarkar Email sameersawarkar gmail com Telephone 91 80 411 10450 http www who int ehealth 1 7 Compendium of innovative health eHealth technologies for low resource settings 2013 SMS DMCare Country of origin United States of America Health problem addressed Diabetes is now a major health concern in low and middle income countries Patient education and training is a cornerstone of effective diabetes care yet is rarely available in low resource settings Many providers lack basic training in diabetes and health systems are poorly equipped to provide nutrition exercise and medication education Solution description The product provides patients with diabetes a mobile phone based coaching program Patients receive automated SMS messages on their cell phones that provide education and reminders about diabetes self care and SMS back responses to questions Their responses help dynamically tailor the program to meet their individual needs and enable remote health workers to monitor their adherence and health needs Functionality Patients are enrolled over the phone by a remote health worker using a web based system The following day patients begin receiving automated SMS messages on their phone tailored to their health condition If patients responses suggest the need for more individual attention an alert is sent to a remote health
260. tion Performance was validated for 7000 patients by 50 health workers at 30 sites in four countries Diagnostic accuracy studies fully blinded and expected to be submitted for publication in peer reviewed journals in 2012 Contact details Adam Liederman Email adam liederman gmail com Telephone 1 416 558 8517 Fax 1 416 368 9882 http www who int ehealth 50 eHealth Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Maternal health Tanzania Country of origin Tanzania Health problem addressed Maternal and neonatal healthcare in Africa faces well documented challenges including 1 Limited qualified health staff 2 Ineffective referral systems for triage to urban higher facilities 3 Inadequate diagnostics at point of care 4 Limited community level data and connectivity 5 Uninformed patients 6 Limited Public Private Partnership PPP financial models Solution description The platform is accessed through the Internet by a netbook computer smartphone or other modern web device Users submit patient data which is validated before being sent via encrypted connection to a central database The platform features sending
261. tionality For distance education slide presentations are converted using open source office automation software OpenOffice into a webcastable format The webcasting environment includes an instant messaging tool for interactivity The tele expertise environment uses a PKI infrastructure to secure information exchange and a forum interaction paradigm Developer s claims of solution benefits Most existing tools are not designed and optimized to work in low infrastructure environments They lack the ability to connect to medical information sources e g DICOM and have insufficient security for exchanging sensitive medical information Future work and challenges The main limiting factor for mainstreaming is the availability of the Internet connectivity in remote settings The situation is rapidly evolving with the deployment of mobile networks and related GPRS 3G 4G connections in particular in East Africa In West Africa satellite connections are still needed and remain expensive thus limiting the economic sustainability of these tools to larger hospitals Other challenges include the necessity to anchor these services in the institutional framework of each country which is facilitated if countries have a eHealth strategy and related policies and coordination structures User and environment User physician nurse midwife technician Training training is required and is provided by online documentation and through the
262. to work with the netbook The software is open source and can be downloaded from the website for free Country used in India Evaluation There has been one pilot study at the treatment centers and a follow up of a qualitative study in 25 centers in two states Over 2 300 patients have been registered The qualitative study interviewed 8 health workers 4 center owners and 23 patients Findings suggest that the terminal helps draw patients to the center by incentivizing health workers and convincing patients to come Contact details Sandeep Ahuja Email sandeep ahuja opasha org Telephone 91 931 0398 004 http www who int ehealth eHealth Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Case based smartphone messaging platform Country of origin United States of America Health problem addressed This technology is focused on addressing the diagnostic treatment support and information resource needs of healthcare providers in Botswana a country with the 2nd highest prevalence of HIV and 4th highest prevalence of TB There are about 40 physicians per 100 000 people and access to physician care outside of city centers remains challen
263. tomizable to the local needs of hospitals and health centers It is available in English French Spanish and can be easily translated to local languages via the tryton module translator Solution specifications Solution is used to support Decision support systems Standards ICD10 ICD10 PCS Diagnosis and treatment Electronic Health Record Electronic Medical Record Geographic Information System Management of patient information Management of hospital information Public health surveillance Country used in partial list of government portals organizations and health centers involved with GNU Health http health gnu org community html Software Hardware requirements Server and client workstation laptop mobile devices and stable continuous supply power supply Free Software licensed under GNU Public License Contact details Selene Cordara Email scordara gnusolidario org Telephone 34 902 702 143 http www who int ehealth eHealth Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Hearing screen eRecord Country of origin South Africa Health problem addressed 15 20 of the world s population suffers from hearing lo
264. training Requirements No highly trained personnel required Labour and time saving Sample to result in 2 hours Reduced resource Requirements The only equipment needed is a water bath maintaining a temperature around 63 C Technical superiority Detected 10 or less pathogens with high specificity Better accessibility Shipped and stored at ambient temperatures Cross contamination control Sealed cartridge ensuring amplicon is never exposed DS ______sz Step 1 Sample preparation Use our instrument free nucleic acid extraction device The process takes 15 minutes after sputum specimen liquefied and boiled Step 2 Amplification Amplification can be accomplished with any incubator that keeps a constant temperature CPA takes 60 minutes at 63 C Step 3 Detection and read out Place the CPA reaction tube into the cartridge and lock Read result in 10 minutes Development stage __ The Isothermal Amplification Diagnostic Kit was approved by TUV for CE marking Our manufacturing facilities are EN ISO 9001 2000 and EN ISO 13485 AC 2007 approved One example of product trials conducted was at Taipei Medical University Municipal Wan Fang hospital sensitivity 99 specificity 94 PPV 97 and NPV 97 Future work and challenges Market education The technologies are new and little known It requires significant effort to educate users promote products and gain acceptance Regulatory approval The CE mark has been obtained for the TB test
265. trictly apply the IMCI A step by step approach allows for determining in real time the illnesses of the patients as the health worker identifies the symptoms Once the diagnostic is established the REC identifies the appropriate treatment and the medicines to be prescribed with their dosages The diagnostic and treatment data are centralized and restored via a secured synchronization procedure via USB drives The REC allows agents to easily create a personal file for each patient with the history of diagnostics and treatments administered Functionality Users launch the REC or synchronization process through a single main menu The diagnosis is in 3 simple steps 1 Search if the patient already has a file in the system 2 Evaluate each question of the IMCI protocol is answered sequentially 3 Treat follow the identified treatment and medicines Developer s claims of solution benefits The REC addresses key problems of the implementation of the IMCI protocol The guided step by step approach ensures that the protocol is correctly applied It avoids diagnostic errors as long as symptoms are correctly identified Since little computer training is required to use the application even health workers without IMCI training can safely apply the protocol The user interface also allows for a quick data entry reducing the time of consult per patient Future work and challenges The global user experience could be improved by
266. uct that may be developed from the listed technologies will be successfully commercialized in target countries or that WHO will finance or otherwise support the development or commercialization of any such product WHO disclaims any and all liability and responsibility whatsoever for any injury death loss damage use of personal data or other prejudice of any kind whatsoever that may arise as a result of or in connection with the procurement distribution and or use of any technology embodied in the compendium or of any resulting product and any future development thereof Developers whose technology has been included in the compendium shall not in any statement of an advertising commercial and or promotional nature refer to their participation and or inclusion in the compendium In no case shall the latter use the WHO name and or the emblem or any abbreviation thereof in relation to their business or otherwise Assistive devices 2013 Assistive devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Artificial prosthetic knee joint Country of origin Canada Health problem addressed Over 25 million people living in developin
267. ucts benefits In low resource areas in developing countries common infant warming methods include blankets hot water bottles hot coals amp light bulbs These methods are ineffective and unsafe often causing burns on babies Some hospitals use a device called a radiant warmer which is expensive needs a constant supply of electricity and is complicated to use This innovative infant warmer is much lower cost less than half of other devices mostly radiant warmers available to treat hypothermia in low birthweight infants It also has much lower running costs since it does not require a constant supply of electricity and faces a much lower incidence of breakdowns almost zero In addition it is much easier to use and reduces the load of nurses doctors In comparison to make shift solutions such as light bulbs this is safer and effective Suitability for low resource settings The technology is meant for use in low resource and remote primary and secondary healthcare facilities These facilities have intermittent access to electricity and very low doctor nurse to patient ratio With just 10 20 beds these facilities may administer over 200 deliveries a month This infant warmer works well with intermittent electricity in these settings reduces the load of nurses doctors due to ease of use and quicker monitoring and does not occupy much physical space The device has been deployed in more than 50 low resource and remote primary secondary government hea
268. uire as to their status Functionality A health care worker registers patients in the system on a laptop at the clinic The system sends registered patients a weekly text message A clinician reviews the incoming text messages and instances of non response The clinician calls patients who responded indicating a problem Non responders are contacted after two weeks Developer s claims of solution benefits One of the advantages of the proposed text message support is that it is has a strong evidence base In a randomized controlled trial it demonstrated effectiveness at improving self reported treatment adherence and viral load suppression at 12 months Other advantages of the service include its use of existing technology its simplicity low cost and proven health care provider and patient acceptability in the local context Future work and challenges Part of our strategy includes the development of a sustainable business model to scale up the service which we are doing in our ongoing project Moving from Evidence to Action Challenges in making the technology available to our intended user group include i despite high cell phone penetration in the region not everybody who may benefit from the service has cell phone access ii ensuring interoperability with existing clinic systems and iii despite low costs securing sustainable financing in resource limited settings User and environment Users Nurse self use patient T
269. ular lab 66 Low smoke stove 81 Mandibular repositioning device 33 Mobile ECG with web based telemedicine platform 68 Multi parameter remote diagnostic kit 69 Non invasive vascular age risk prediction gt 7A Oscillometric ankle arm measurement 34 Portable haemoglobin meter 95 Portable ventilator 96 SMS DMCare 18 T1D system Type 1 Diabetes system x 20 Telecardiology i z ot Tele ophthalmology software application 62 Urine albumin test i s 77 Ventilator using continuous positive airway pressure s 101 m oO c N n 00 E b oO n S rs fe n oO T 3 2 n 2 o0 Ke fe te YU oO p j Q oO f v 2 a gt fe ue oO z mo f 0 Q fe UO Reproductive maternal neonatal child health Infant warmer f 29 Bedside newborn E 1 25 Birthing simulator for training 80 Compact portable ultrasound P 24 Fetal heart rate monitor 89 Infant radiant warmer x 28 LED phototherapy for neonatal jaundice Si Maternal and child health mobile services
270. uman Development Index of the respective country Health problem addressed a i S Product description This solution allows the user to easily detect the extent of parasite t infestations The product allows for economic analysis integration into national health plans in communities of low and medium incomes The product is a prefilled container used for filtering concentrating and LC J recovering parasites from fixed preserved body waste Product functionality In a vial with preservative solution a stool sample is collected by the patient At the laboratory the technician places the vial upside down in a tray and waits for 15 minutes allowing the preserved sample to pass through the filter system Subsequently the sample can be directly analysed under the microscope Developer s claims of product benefits This product unlike other methodologies does not need any equipment or reagents to perform the parasitological examination of feces The system includes a special filter inside made of polyester with 266 micra which renders the sample much cleaner and makes it easier to find the parasites In just one step the sample is ready to be analysed under the microscope Another important difference is the new preservative liquid that does not use formalin or any other toxic and aggressive reagent an exclusive development to preserve the environment and the people that work directly with this kind of process Operating step
271. upport and the ability to take the power of control of how much insulin to use gives the motivated patients incentive change take to make positive changes Solution specifications Solution is used to support Diagnosis and treatment Electronic Health Record Electronic Medical Record Health research Management of patient information Patient monitoring Public health surveillance Telemedicine Currently used in Worldwide Evaluation Currently 2 900 active users Rating for ease of use and effectiveness between 4 51 5 0 highest f satisfaction 5 0 out of 5 0 Software Hardware requirements Access to a cellular mobile network via mobile personal computer tablet or SmartTV Android platform App is free Premium version license at 19 25 year Contact details Maria Salido Email georginatremayne gmail com Telephone 34 69 336 5318 http www who int ehealth eHealth Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium TeleOphthalmology aided primary eye care Country of origin India Health problem addressed 1 of the population are blind and 80 of these cases are treatable or preventable As with other health care eye care
272. ur auroPECS 2 Trained vision technician and coordinator of ophthalmic equipment like slitlamp refraction trial set and drum 3 Computer 512 Kbps Internet connectivity webcam Contact details Ravilla Thularsiraj Email thulsi aravind org Telephone 91 45 243 56526 http www who int ehealth Medical devices 20 3 Medical devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Bedside newborn phototherapy Country of origin United States of America Health problem addressed Global health experts estimate 10 of all newborn mortality can be attributed to jaundice An excess of the chemical bilirubin in the blood approaches dangerous levels in more than 10 of all newborns The result can be kernicterus lifelong disability severe brain damage and death placing an extreme burden on families and communities Every year in South Asia and Sub Saharan Africa more than 5 7 million jaundiced infants need treatment but do not receive simple phototherapy There currently is no durable and easy to use phototherapy device for rural facilities so newborn jaundice accounts for 20 33 of admissions to national level hospitals in
273. ure and humidity Development stage The device is based on the concept of the CPAP technology developed by Colin Sullivan at Royal Prince Alfred Hospital Australia 1981 To this the adaptation element to low resource settings was added The system has been proven by extensive use in countries such as Vietnam Laos Cambodia and East Timor following initial studies at National Hospital of Pediatrics in Hanoi in 2006 2007 By now it is a national standard in countries mentioned above being used in over 200 public hospitals treating thousands of patients every year Future work and challenges Due to a lack of funds in public healthcare barring commercial ventures the strategy is to introduce the technology using charity money and leverage from such demonstration in the future The biggest challenge is to convince local authorities to start spending public funds on such solutions which could make the whole system sustainable User and environment User Nurse physician Training CPAP set 3 days Maintenance Nurse physician technician Environment of use Settings Rural as well as urban secondary and tertiary health care facilities Requirements Stable power supply oxygen supply wall cylinder concentrator Product specifications Dimensions mm 330 x 330 x 1400 List price USD 2 300 Weight kg 15 Other features Reusable Uses software Consumables None Year of commercialization 2006 Life time 5 years Current
274. use in areas where the healthcare system is less developed given its ease of use and low maintenance costs It is also designed for home use especially for infants This device is already registered and well accepted in China Operating steps Switch on the power and check the display Pull the ear backwards insert the ear thermometer straight into the ear path make sure the sensor reaches the tympan and press the start button to measure Measurement is complete when an audible beep is heard and the indicator is on Read the result Clean the sensor after use Regulatory status The device has a Republic of China Measuring Device Manufacturing License and a Republic of China Medical Device Registration Future work and challenges The price of this device is still quite high compared with normal thermometers which limits its distribution However the production cost will decrease with an increase in production quantity Use and maintenance User Self use patient physician technician nurse midwife family member Training None Maintenance Cleaning of probe at fixed intervals Environment of use Settings Rural urban settings ambulatory at home primary health post health center secondary general hospital tertiary specialized hospital Requirements Requires batteries of type CR2032 with an environment of use between 16 and 35 degrees Celsius and 30 85 relative humidity without condensation Product spec
275. ustomization and other charges may apply Contact details Mark Irish Email Telephone 1 215 776 0975 Fax 1 856 513 0724 http www who int ehealth 85 eHealth Compendium of innovative health technologies for low resource settings 201 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Mobile technology to connect patients to remote doctors Country of origin United States of America Health problem addressed The bottom of the pyramid population in the developing world continues to face fundamental challenges in healthcare due to lack of access low affordability low quality and exploitative care and a reactive emergency driven system Existing solutions lack financial and human resources and show sub optimal use of limited resources Product description This product is an Integrated Mobile Health Technology Platform that enables frontline health providers community health workers rural nurses and doctors to connect patients to remote doctors in order to obtain timely medical diagnosis and administer effective treatment for underserved patients Selected awards Winner at the 2008 MIT 100K Entrepreneurship Competition and Best Telemedicine Innovation at the 2009 World Health Care Congress Product fun
276. ut a candle The secretions mobilizes within 5 15 minutes after the therapy session ends Its simple design and operation result in high compliance Developers claims of product benefits Existing technology is a spontaneous sputum sample This does not produce the deep lung secretion required The preferred method is hypertonic saline sputum induction This method though effective is not widely used in the field because of complications and discomfort to the patient Reducing the number of inadequate sputum samples and thus the frequency of false negatives The device presented here is highly effective at producing a deep lung secretion sample which saves times and is very easy to use with no counter indications Operating steps The patient sits upright leaning forward slightly The devices works in 2 blow repetitions blow out with enough force to activate the reed and repeat steps to complete 2 repetitions After two blow repetitions the patient removes the mouthpiece inhales normally and repeats the above steps to perform up to 20 cycles After 5 10 minutes the patient coughs and collects sputum Development stage As published in a 2009 study use of this device enabled rapid diagnosis of TB in 47 of confirmed TB patients who had produced no sputum prior to using the device The device was user friendly as assessed by a questionnaire completed by the patients Future work and challenges This device could be manufactured at
277. vailable for purchase by pharmaceutical manufacturers worldwide Future work and challenges The injection system itself is designed to be portable and requires minimal resources for preparation Depending on the drug or vaccine applied cold chain may be needed Some applications can include a time temperature indicator which allows brief excursions out of the cold chain like to low resource health posts or for rural home delivery User and environment User Patient family member nurse midwife physician Training User instructions are included in the box and on the primary packaging Environment of use Setting At home and in health care facilities in rural and urban settings Requirements The device itself is designed to be portable and requires minimal resources for preparation Depending on the drug or vaccine applied cold chain may be needed Product specifications Dimensions mm max 100 excl pouch x 23 x 10 Other features Portable and single use reservoir height Year of commercialization 1998 Weight kg 0 002 0 0025 filled excluding pouch Currently sold in Indonesia India Argentina Belgium Shelf life 5 years Retail Price USD Varies by drug vaccine and country Contact details Rod Hausser Email Telephone 1 201 8475185 Fax 1 201 847 4847 http wwwwho int medical_ devices 97 Medical devices Compendium of innovative health technologies for low resource settings 2011 f
278. valuation of the submissions were managed by the Medical Devices team Policy Access and Use unit of the Essential Medicines and Health Products department under the direction of Adriana Velazquez Berumen coordinator and Jennifer Barragan technical officer the Disability and Rehabilitation team of the Violence and Injury Prevention and Disability department under the direction of Chapal Khasnabis and the eHealth unit of the Knowledge Management and Sharing department under the direction of Diana Zandi and Misha Kay For the evaluation of submitted medical devices assistive devices and eHealth solutions we thank e Aurora Llanos M ndez from Agencia de Evaluaci n de Technologias Sanitarias de Andalucia AETSA Seville Spain e Antonio Migliore and Maria Rosaria Perrini from the Agenzia Nazionale per i servizi sanitari regionali Agenas Rome Italy e Gaizka Benguria Arrate I aki Guti rrez lbarluzea and Nora Ibargoyen Roteta from the Basque Office for Health Technology Assessment Osteba Vitoria Gasteiz Spain e Debra Kriger and Andra Morrison from the Canadian Agency for Drugs and Technologies in Health CADTH e Alexandre Barna Martin Blachier Emmanuel Charpentier Bjorn Fahlgren and Marc Vanicatte from the Committee for Evaluation and Diffusion of Innovative Technologies CEDIT Paris France e Kees Groeneveld and Cees A Postema from the Health Council of the Netherlands GR The Hague The Netherlands e Brendon
279. w resource settings in rural hospitals in Kenya Papua New Guinea Sierra Leone the Solomon Islands and Uganda Maintenance Minimal maintenance by nurse physician or technician Environment of use Settings Rural urban settings primary health post health center secondary general hospital tertiary specialized hospital Requirements The device requires a stable electricity supply to run Nasal prongs and tubes are reusable and autoclavable thus they need to be sterilized between patients Boiled water for the bubble bottle valve is required Product specifications Dimensions mm 390 x 440 x 840 List price USD 2400 Weight kg 26 Other features Mobile reusable Consumables None Year of commercialization 2012 Life time gt 5 years Currently sold in Sold in the United Kingdom for use in Shelf life gt 5 years Afghanistan Congo Kenya Malawi Papua New Guinea Retail Price USD 2400 Sierra Leone Solomon Islands Uganda Contact details Robert Neighbour Email rneighbour hotmail co uk Telephone 44 15 987 10066 Web pe ae http www who int medical_devices Medical devices Compendium of innovative health technologies for low resource settings 2013 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in t
280. with manufacturers Cleaning of the NASG Cleaning is another challenge There is no established method of accurately tracking the number of uses and cleanings thus it is difficult to identify when sufficient degradation has occurred to retire the NASG and replace it with a new one User and environment User Family member nurse midwife physician technician Training Pathfinder International has developed course curriculum and training materials which vary in length depending on target audience and whether the intended user is applying or removing the garment Maintenance Hospital orderlies are generally responsible for cleaning Environment of use Setting At home and in health care facilities in rural or urban settings Requirements Water and bleach for cleaning Product specifications Life time Approx 40 uses Other features Portable and reusable List price USD 53 76 Currently sold in United States of America Contact details Paul LaBarre Email plabarre path org Telephone 1 206 285 3500 Fax 1 206 285 6619 http wwwwho int medical_ devices 91 Medical devices Compendium of innovative health technologies for low resource settings 2011 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compen
281. worker who then calls the patient Developer s claims of solution benefits The product has several advantages over existing solutions It leverages a commonly used platform for communication SMS as a means of health education As a software solution it provides a low cost scalable model for improving diabetes self management in low resource settings The product is based on a novel model for behavior change that has been developed by researchers at the University of Chicago and is currently being evaluated in a clinical trial Future work and challenges The biggest barrier to this product is that it requires trained health workers to provide exception based care by telephone Training and supervision of these health workers may be challenging in low resource settings Another challenge is in adapting the product to other languages and customs The behavioral model was developed in a specific cultural context inner city Chicago and may not fully translate to other settings Finally while SMS is an increasingly common mode of communication between health workers in low resource settings their use in provider patient communication is largely unexplored User and environment User Self use patient low skilled health worker Training Patients require no training Remote health workers need training in diabetes coaching 4 weeks Settings Rural urban at home Solution specifications Solution is used to support Patient m
282. y primary and secondary Solution specifications Solution is used to support Telemedicine Electronic Currently used in Zambia South Africa The Gambia Health Record Electronic Medical Record mHealth Evaluation The CAD software is currently used Health Research prospectively in clinical trial to make a selection with Software Hardware requirements Laptop or computer TB suspects should undergo other more expensive and with MS Windows Intel Pentium preferably i7 8 GB time consuming further testing RAM 120 GB HDD Calculation time depends on amount of RAM and type of processor CAD4TB is proprietary software that runs on any laptop or PC that meets the above specifications Standards DICOM HL7 The partners CIDRZ and Zambart in Zambia are using the CAD software as a filter in TB screening to determine who gets GeneXpert Contact details Harro Nip Email cad4tb gmail com Telephone 31 31 858 3490 Fax 31 31 858 3491 http www who int ehealth eHealth Compendium of innovative health technologies for low resource settings 2012 fitness of any technology for a particular purpose All the information Inclusion in the compendium does not constitute a warranty of the was provided by the developers WHO will not be held to endorse nor to recommend any technology included in the compendium Health workforce information systems Country of origin United States of America Health problem addressed Th
283. y for immediate visual validation of what a clinician can feel or hear The additional information facilitates optimization of the course of treatment for the patient and reduces time required for diagnosis thereby reducing patient wait times and improving _ clinical workflow The device is small and lightweight which makes it easy to carry and its battery capacity provides over one hour of scanning on a single charge giving it enough power for a full day s worth of patient exams af Developer s claims of products benefits While ultrasound forms an integral part of pregnancy management in developed nations the technology is highly inaccessible and underused in resource poor settings The need for trained health professionals a certain level of infrastructure and a continuous power source limits ultrasound access in many regions Unlike most available ultrasound devices this compact ultrasound device is portable easy to use and is battery operated The device can also be charged with solar power to enable its use in areas that do not have regular grid power supply Suitability for low resource settings The technology is suitable for use in health centres in low resource settings where electricity is irregular or unavailable It is ideal for attracting more mothers to the formal health system increasing antenatal attendance and institutional delivery The device has been used in low resource settings by health paraprofessionals in

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