Rice University President Reginald DesRoches joined Rice360 Institute for Global Health Technologies Co-Director Maria Oden and Rice360 supporters on a trip to Africa this summer marking significant milestones on the road to ending preventable newborn deaths in the sub-Saharan region. Rice360 is one of 22 organizations in the Newborn Essential Solutions and Technologies (NEST360) international alliance, and this trip signified Rice's continued collaboration in the program.
After an initial visit to Malawi, where the NEST360 bundle has been implemented in hospitals across all 28 districts, the group traveled to Tanzania. There the first stop on the itinerary was Mwananyamala Hospital ⎯ one of several primary care, Level 2 hospitals established as a NEST360-implementing site during Phase 1 of the program in Tanzania.
Next, the group traveled to Ubungo Hospital, a future NEST360-implementing site, where DesRoches, Tanzanian Ministry of Health representatives and key local and international partners participated in a formal event celebrating the launch of Phase 2.
"It is truly my distinct honor to be here today to celebrate the launch of NEST360 Phase 2 and the commitment to increased newborn survival in sub-Saharan Africa," DesRoches said, highlighting NEST360's demonstrated commitment to work collaboratively with governments in the region. "To be able to solve the world's most pressing problems, you have to collaborate and partner. It's one thing to develop the technologies in the lab, but if you don't have the partnerships that understand the societal issues, the cultural issues, the economic issues, the problems won't be solved adequately."
As part of Phase 2, NEST360 aims to deliver and sustain lifesaving innovations, provide hands-on education for health professionals and use data for action, improving quality and learning among the country's partners in newborn and maternal health care. During the Phase 2 launch, the Tanzanian government announced its plan to invest an additional $7.1 million to improve the infrastructure of newborn wards in 25 hospitals across four mainland regions and three hospitals in Zanzibar, which aligns with the government's efforts to reduce neonatal deaths. The Tanzanian government also "plans to spend over $50 million on infrastructure, equipment, and capacity building for newborn care" over the next three years, said Dr. Felix Bundala, assistant director for newborn, child and adolescent health with Tanzania's Ministry of Health.
The current mortality rate for newborns in Tanzania is 24 per 1,000 live births with over 46,000 newborn deaths each year. The government hopes to cut that number in half, in line with the United Nations' Sustainable Development Goals (SDGs), which set a target for infant mortality at rates no greater than 12 per 1,000 live births.
Tanzania has made concerted efforts in recent years to improve its health care system and has successfully moved the needle on maternal and child mortality. In a statement given during the launch, Dr. Grace Magembe, deputy secretary general in the Tanzanian Ministry of Health, cited an 80% decline in the number of maternal deaths and a 36% decline in mortality for children under 5 as examples of effective government initiatives advancing strategic national interests and global sustainability goals.
However, Magembe pointed out that despite significant gains on these related SDG benchmarks, newborn mortality registered only a 4% decrease over the same period. "As a country, we feel that we have a lot to do in terms of reducing the death of newborns," Magembe said, adding that current improvements, however small, are the result of NEST360 collaborative efforts.
NEST360 is a true partner to this government because they're really contributing towards the vision of this country."
Dr. Grace Magembe, deputy secretary general, Tanzanian Ministry of Health
In Phase 1, NEST360 and the Ministry of Health designed a package of evidence-based, locally relevant interventions for small and sick newborn care that was implemented in Muhimbili National Hospital, the largest public hospital in Tanzania; three regional referral hospitals, including Mwananyamala; and several facilities in rural areas.
These additional NEST360-implementing sites helped ease congestion in neonatal care units at Muhimbili. Prior to NEST360 implementation, it was not uncommon to find one baby cot with six to seven newborns at this hospital, whereas today, "one baby cot is for one baby," Magembe said.
A critical part of the NEST360 impact in Tanzania is the focus on evidence-based solutions. Dr. Nahya Salim Masoud, NEST360 steering committee deputy chair and a clinical pediatric specialist at the Muhimbili University of Health and Allied Sciences (MUHAS), said that one of the reasons efforts to improve newborn survival in Tanzania faced a much slower rate of progress than other SDG benchmarks was the lack of data on neonatal health and survival as a distinct area of intervention. NEST360-implementing medical facilities established in the country during Phase 1 enabled program and government officials to leverage data in support of continued coordinated planning to strengthen health systems in Phase 2.
"Our data shows that focusing on inpatient care facilities can yield an impact," Masoud said. "We currently have all the ingredients in place [to make a difference]."
In addition to Rice leadership and Tanzanian government officials, present at the event were representatives of key NEST360 collaborators in Tanzania, including Rice360, Dar es Salaam Institute of Technology (DIT), Ifakara Health Institute and MUHAS.
The trip continued with site visits to MUHAS and DIT. DesRoches signed a memorandum of understanding between Rice and MUHAS to establish a collaboration that focuses on training, research, innovation and biomedical engineering. MUHAS will also establish a new design studio as part of the partnership.
DIT is one of the NEST360 educational partners in Tanzania and home to an engineering design studio that provides students with the tools and environment to engage in hands-on, experiential learning. The design space highlights an important feature of the NEST360 approach, which views the establishment of an education ecosystem that fosters innovation as a critical part of sustainable, long-term global impact. The goal of this ecosystem is to develop a skilled workforce that can develop and maintain solutions to location-specific problems.
"Locally, the design studio has solved so many challenges," said John Msumba, director general of DIT. "Our students have been visiting hospitals, and they try to identify problems with the biomedical equipment. They bring [the devices] to the design studio, and they fix them." Msumba said the goal is for the design studio to serve not only as a training and maintenance site but also as a springboard for medical technology innovation.
"Investing in engineering and engineering students here in Africa is critically important in order to address health care challenges," said Oden, who is also a teaching professor of bioengineering and director of Rice's Oshman Engineering Design Kitchen. "Rice360's mission is to innovate for global impact, and we do this in two ways. We transform students into innovators … and when those students have amazing ideas, we work to transform those ideas into actual solutions.
"Part of how we've worked with African institutions is that we've partnered with faculty and engineering schools to support them in achieving these two objectives so that engineering students come out of university ready to solve real-world challenges and to make a difference, to become the leaders of the future right here in their home countries."
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