Feasibility and acceptability of NoviGuide – a mobile health device for the management of neonates in resource-constrained settings of sub-Saharan Africa

Investigator: Theodore Ruel, MD
Sponsor: UCSF Preterm Birth Initiative (PTBi)

Location(s): Uganda


Despite recent progress in reducing deaths among children under age 5 years, a significant number of infants continue to die in the first month of life, exceeding 2.8 million worldwide in 2013. The highest rates of neonatal deaths occur in sub-Saharan Africa (SSA). Approximately 44% of all under-5 deaths in SSA occur in the neonatal period (first month of life), with about 75% of deaths occurring within the first week of life.

Simple neonatal care protocols, such as those described in the World Health Organization (WHO) Essential Newborn Care guidelines, can lead to significant improvements and form the core of current global efforts to reduce neonatal mortality. However, implementation of evidence-based protocols has been hampered by significant challenges: in-person training does not reliably lead to changes in workplace behavior, medical errors are common, changes in practice are lost quickly without reinforcement, and performance is difficult to monitor.

NoviGuide is a tablet-based training and decision-support tool, to optimize the hospital-based care of newborns by nurses in resource-limited countries.

In essence, NoviGuide translates WHO guidelines into case-specific clinical instructions that focus on

  • respiratory support,
  • glucose, fluid and feeding, and
  • infection risk and management.

NoviGuide aims to address current barriers to neonatal care improvement by offering increased fidelity to guidelines, efficiency with streamlined decision support algorithms, accuracy with automatic medication and fluid calculations,reinforcement of skills learned in standard training, and monitoring using seamless cloud-based usage data uploads.

Global Strategies is excited to join the Preterm Birth Initiative at UCSF. As part of that effort, NoviGuide will be field-tested in Tororo, Uganda.