Globally, it is estimated that 5.9 million children under 5 years old died in 2015 and 5.3 million babies did not survive the first month of life in 2018. Most of these deaths occurred in low-income settings such as sub-Saharan Africa, where 1 child in 12 dies before their fifth birthday. Sierra Leone is among the countries in the world with the highest infant mortality rates, estimated at 39 per 1000 live births – this is three times higher than the Sustainable Development Goal (SDG) target of 12 infant deaths per 1000 live births by 2030.
Lack of access to and low utilisation of effective and efficient health systems, aggravated by a range of factors, such as inequity in coverage, inadequate human resources and weak infrastructure, referral information and community health systems, are major contributing factors for high infant deaths. New and innovative strategies involving the use of appropriate digital technologies to address these challenges are needed.
Digital technologies such as mobile, IoT and internet solutions are recognised as essential drivers for accessing and using high-quality child health interventions, with significant potential to strengthen information and timely decision making and provide effective routes for remote monitoring and early diagnosis, detection and treatment of leading causes of under-five and neonatal deaths such as tetanus, fevers, measles, diarrhoea and organ failure.
This project explores the potential of wearable Internet of Things (IoT) solutions to remotely monitor and capture several parameters and data for detecting and preventing many health conditions (e.g., preterm, tetanus, fevers, measles and diarrhoea) in infants in Sierra Leone.
The main aim of this project is to assist efforts to reduce infant deaths through developing culturally appropriate, people-led design of wearable IoT solutions to:
- facilitate remote monitoring of infant health (vital signs such as temperature, pulse rates, respiration blood pressure, etc.) and detection of critical illness in non-clinical settings and
- improve healthcare access and ethical and FAIR data sharing between parents and health workers in Sierra Leone.
Research shows that miscommunication of information and delay in treatment stemming from the problem of timely access to primary healthcare services or a delay in the transmission of clinical information to doctors are among the major causes of preventable deaths of infants in poor resource settings.
New-born infants, especially those with health complications or born prematurely, require constant monitoring, detection and prevention of major causes of infant deaths ranging from asphyxia, sepsis, pneumonia, congenital to vital organs failures and other signs (e.g. temperature, pulse rate and pulse oxygen concentration).
This project collaboratively brings together an interdisciplinary team and potential end-users to design the SMILE prototype.
Project activities include:
- state-of-the-art research to review existing infant monitoring wearable devices and identify advantages, limitations and challenges faced by such systems for implementation in Low and Middle-Income Countries (LMIC;
- stakeholder consultative workshop to understand socio-technical contexts, technology needs, facilitators, risk factors and conceptual design ideas; and
- development and feasibility analysis of SMILE to assess the usability and potential for learning, scalability and sustainability of the system.
The project lays the foundation for strong partnerships and provide critical learning for collaboratively designed wearable technology solutions for remote monitoring of infant health in developing countries.
The project will contribute towards the Sierra Leone government's human capital development efforts in reducing infant death rates by improving automatic remote monitoring, detection and prevention of life-threatening diseases in infants.
High infant death rates are identified as a major challenge undermining the development effort in achieving its human capital development strategy 2024 and the Sustainable Development Goal 3, which aims to prevent the death of newborns and children under 5 years of age by 2030.
SMILE will be the first infant wearable technology system in Sierra Leone, with a contextually sensitive and user-centred design approach, to offer remote health monitoring and a range of support features for effective communication and clinical information and data sharing among health workers.
SMILE will replace or complement the infrequent, clinic-based measurements with unobtrusive, continuous sensing, monitoring, and assessment, allowing the collection of rich personalised information.