Every minute around the world, a woman dies from complications related to pregnancy or childbirth, and 70% of these deaths occur in developing countries. Uganda has one of the highest maternal mortality rates in the world, with less than 40% of expectant mothers gaining access to prenatal care. Typically, clinics and hospitals are too far for travel, and rural locations don’t have proper equipment such as ultrasounds. It is also common for women to be unable to afford services; a prenatal visit can cost about 20,000 Uganda shillings ($10 US). In 2012, three students from Makerere University in Uganda recognized the need for improvement in these low-resource environments and founded a start-up called Cipher256 that uses old technology in a new way.
Cipher256, founded by Josiah Kavuma, Aaron Tushabe, and Joshua Okello, has designed a new technology called the WinSenga. It is based upon the Pinard horn, a 19th century listening device that is placed on a woman’s abdomen to determine position, age, heart rate, and overall health of the fetus. It is widely used in Uganda, but takes many years of practice to operate effectively. Instead, the WinSenga connects a Pinard horn to a smartphone app that does the listening. This allows health care workers to get accurate and in-depth results from the app, and it also allows untrained workers to get consistent and reliable readings.
The app also uploads data to the cloud, which can be accessed anywhere by a doctor, and recommendations can be made quickly, even in remote areas. Kavuma, Tushabe, and Okello presented their idea at Microsoft’s 2012 Imagine Cup and won the Eastern and Southern Africa competition, using the resulting $50,000 grant to fund their start-up. The ‘Win’ part of the product’s name comes from the name of Microsoft’s product, while ‘Senga’ refers to the local name for a woman who helps with birth and prenatal care. The app primarily runs on a Windows Phone but will soon be available on Android, and an iOS version is in the works.
Affordability and Access
The makers of Winsenga stress that they are working to improve affordability and access for pregnant mothers in Uganda. It is estimated that the WinSenga will be 80% cheaper than an ultrasound machine, which costs around $3,000, and requires trained operators and technicians. The WinSenga can also improve access through health workers who travel to rural regions on specific days and meet expectant mothers at central locations to administer a diagnosis. Obstetricians in Uganda also speculate that the product could be used during labour to help monitor fetal health, especially when medical workers have high patient loads.
Kavuma, Oshabe, and Okello have recently partnered with the Ministry of Health and Mulago Hospital School of Public Health in Uganda to work on a nationwide clinical trial. They believe that their product takes a proven technology already in use in Uganda and modifies it to solve problems in a new way. Their aim is to sustainably solve the problem of poor prenatal health care and lower the barriers to access for all women. The three hope that one day, their product will be available in other developing countries, and maybe even used at home by pregnant women themselves.