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Universidad Peruana Cayetano Heredia

BRIGHTER FUTURES Improving maternal and child health through innovative models for the uptake of POCTs. Universidad Peruana Cayetano Heredia. Why focus on mothers and children?. Every year more than half a million women die from complications related to pregnancy and childbirth

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Universidad Peruana Cayetano Heredia

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  1. BRIGHTER FUTURES Improving maternal and child health through innovative models for the uptake of POCTs Universidad Peruana Cayetano Heredia

  2. Why focus on mothers and children? • Every year more than half a million women die from complications related to pregnancy and childbirth • This means that one woman dies every minute • Women are the foundation of their families, the educators and often, the only economic support

  3. Simple actions can improve MCH • Good antenatal care (ANC) is key • ANC requires a basic diagnostics package: HIV, syphilis, anemia, glucose, malaria, protein and leukocytes • In developing countries, there is poor ANC coverage and poor quality ANC • Accompanying tests are often not available and results are not given in an opportune manner

  4. POCTs could help, but… • They are not available for the conditions needed or they are too complex • We still don’t understand: • People’s needs, communities’ needs • Interface with IT (e.g. cell phones) • How to involve communities in implementation • How to implement in different environments • How to broaden their use (expansion) • Sustainability and costs

  5. Brighter Futures: Project goals • To identify needs, costs, barriers and opportunities for the introduction of POCTs in ANC and child health care. • To develop and evaluate a social business model for the introduction of POCTs, which could work in different environments, is designed for sustainability and has a positive impact on communities

  6. Health providers Framework Community Policy Makers Environment and structural support for introduction of POCTs in maternal & child health Policy, laws, regulatory, surveillance, logistics Technologies New POCTs IT (cell phones) Health guidelines • Understand: • Demand • Supply • Facilitators and challenges Market opportunities (Private sector) Model Innovative model “Brighter Futures” Improvement of MDG 4, 5 and 6 Validation Point of care diagnostic tests (POCTs) could help, but…

  7. Sites • 3 sites • Ventanilla (Coast) • Alt: 55m/a.s.l • Mat mortality: 55.3 • Population 75,000 • Quispicanchis (Andes) • Alt: 3158 m/a.s.l • Mat mortality: 271.2 • Population 30,000 • Yurimaguas (Jungle) • Alt: 148 m/a.s.l • Mat mortality: 180.1 • Population 63,000 Total Population 28 807 034 76% urban

  8. Methodology • Census of health establishments: services, tests and flows • 23 focus groups (10 MH, 13 CH) with 153 community members • 32 in-depth interviews with local health providers • 6 workshops with experts in maternal and child health • 15 interviews with local entrepreneurs • 2 workshops with entrepreneurs at national level • Household survey with 1,200 community members • Critical review of international and national MH/CH guidelines

  9. Opportunities • Health providers believe in technologies • Communities believe in diagnostics (hx. and payment) • Access through health centers and local posts • Local champions • High penetration of cell phones • Success with POC syphilis • Private sector & Public sector • Some POCs in development

  10. Barriers • Regulatory Issues • Requirement of local “distributors” : increase prices! • Logistic issues • purchase system • Distribution • Waste management • Health workers´ “fears” • Roles, power, costs • Limited knowledge about diagnostics and attributes • Guidelines do not include POC/dx • Lack of POC now for the Maternal package!!!

  11. The most important diagnostic testsneeded for maternal health Local health providers • Anemia • Urinary infx (E.coli) • Preeclampsia • Syphilis&HIV National experts • Preeclampsia • Urinary infx (E.coli) • Asymptomatic bacteriuria • A package with all ANC tests as POCT: • HIV, Syphilis, Hto, Glu, Urine & preeclampsia Community members Anemia Urinary infection Hepatitis

  12. Allow Beauty consultants to improve their income and status Explore needs of their clients Offer orientation and counseling POCs: Sample, testing and results Refer for management Pregnant women: beauty and healthy! Beauty consultants Medical support Referral POCs & Electronic support cel phones/tabs Transmission of results in real time Result interpretation, support for health consultants, recommendations Beauty consultant business model in process Beauty consultant business model in process Beauty consultant business model in process

  13. Muchas Gracias!!

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