NeoNurture: Infant Incubator
a cost-effective incubator designed to be easily serviced and repaired in low-resource settings
Of the four million babies worldwide who die in the first month of life, one million die on their first day. Preterm birth is attributed, either directly or indirectly, to at least 25 percent of neonatal deaths.1 About half of the worldwide total, or 1.8 million babies each year, die for lack of a consistent heat source before they have the body fat and metabolic rate to stay warm independently.
Despite the benefits and need for this equipment, incubators are not available in most poor countries. In addition, kangaroo care - regulating infant body temperature with the mother’s body heat through skin-to-skin contact - is often culturally taboo or not feasible due to a mother’s other responsibilities, illness, or death. Conventional incubators designed for industrialized markets can cost up to US$30K, and when donated, are not able to be understood or maintained. According to a Duke University study, up to 98% of donated medical equipment in developing countries is broken within five years.2 Appropriately-designed incubators could help provide millions of at-risk infants with shorter hospital stays and can enable infants who might otherwise have faced a lifetime of severe disability to experience full and active lives.
To create a solution, DtM melded medical best-practices and design for low-resource settings. Based on direct observations of and input from a wide range of stakeholders in rural clinics and hospitals across India, Bangladesh, Nepal, Vietnam, Cambodia, Indonesia, and the U.S., DtM found:
(1) Spare parts are difficult to locate in rural settings, forcing medical staff to forgo regular maintenance. In Nepal, DtM encountered 6-month air filters that had not been changed in 5 years, and a US$0.60 fuse that could only be sourced during semi-annual trips to a larger city.
(2) Intermittent power leaves devices unusable during parts of the day and voltage spikes destroy sensitive equipment. Parts associated with the power supply were the most common incubator repair need DtM encountered.
(3) Infants are at risk of hypothermia beginning immediately after birth, but current incubators are not transportable between a rural home birth and clinic, or even a hospital delivery room and Neonatal Intensive Care Unit (NICU), especially when separated by stairs.
In response to these needs, DtM collaborated with Medicine Mondiale in New Zealand and the Center for the Integration of Medicine and Innovative Technologies (CIMIT) in Boston, Children’s Hospital in Boston, the Harvard Medical School, the Stanford Medical School and many Boston NICUs, as well as a huge crowd of talented students, professional volunteers, and domain experts. NeoNurture is part of Design that Matters’ Newborn Technology Development program, created in response to the need for better tools to address infant morbidity and mortality in the developing world.
NeoNurture takes advantage of an abundant local resource in developing countries: car parts. The incubator leverages the existing supply chain of the auto industry and the technical understanding of local car mechanics. Among other components, it uses sealed-beam headlights as a heating element, a dashboard fan for convective heat circulation, signal lights and a door chime serve as alarms, and a motorcycle battery and car cigarette lighter provide backup power during incubator transport and power outages.
NeoNurture is composed of two distinct parts: the bassinet and the base. The base includes rugged wheels and a storage space for necessary replacement parts. The bassinet has four-sided hand holds and is detachable for transport; can be angled on the base to prevent infant acid reflux; and opens to allow three-sided access for complex procedures or one-sided access to maintain warmth during routine tasks.
DtM’s NeoNurture has fired the imagination of people across the globe through inclusion in multiple exhibits and publications worldwide. Most notably, NeoNurture was listed as #1 in Time Magazine’s 2010 issue, “The 50 Best Inventions of the Year”, was featured on ABC News and CNN, received an honorable mention in ID Magazine’s 2010 Annual Design Review, and was part of the 2010 Cooper Hewitt Design Triennial.