“Me and my child were saved because of Janitri as I never thought of any complications and believed I will have a normal delivery. I owe our lives to all the good work they are doing.” – Kavita, Sobda Village

In the past 20 years, access to affordable health care has helped reduce maternal and newborn deaths by more than a third. Yet, despite this progress, an estimated 2.8 million pregnant women and newborns continue to die every year and most of these deaths occur in rural areas in developing countries.

Maternal deaths are nearly 50 times higher in sub-Saharan Africa with babies 10 times more likely to die in their first month of life, than in high-income countries. In India, a baby dies every minute (UNICEF).

For Arun Agarwal, founder of the Bengaluru-based start-up Janitri Innovations, the frightening figures are all too real. “Growing up in Alwar, Rajasthan, I used to hear that someone in the neighbourhood lost her baby during childbirth, someone died while in labour.”

Photo credit — Left: UNICEF India / Right: ActionAid UK

Under international human rights law, governments have legal obligations to make sure women go safely through pregnancy and childbirth with the best chance of having a healthy baby. The Convention on the Elimination of All Forms of Discrimination against Women specifically calls on countries to ensure that “women in rural areas have access to adequate health-care facilities, counselling and services in family planning.”

Most of India’s 25 million yearly deliveries happen in rural, low resource settings that lack skilled staff and medical equipment. Nearly half of maternal deaths and 40 percent of newborn deaths occur during the intrapartum period (labour and delivery).

Photo credit: Jonathan Borba

To address this issue, Agarwal decided to design a portable device that can continuously monitor a pregnant woman and her fetus during this intrapartum period. From contraction checks to early detection of fetal distress, the Keyar device and its accompanying mobile app are small and affordable enough to be adopted in remote villages.

By simply entering the data into the app, midwives, nurses, and staff can then forward vital statistics to the obstetrician to read on their mobile phone. The app also puts out alerts when any critical indicators go too high or too low and recommends next steps.

“It helps make labour monitoring easier,” says health care worker Nicki Caput. “Healthcare providers can make more informed and timely decisions about mothers who may be having complications during labour and delivery.”

Photo credit: Janitri

For example, when a rural health centre is not equipped to perform a C-section delivery, staff can use the app to inform a referral hospital. This saves time, explains Agarwal. It also retains records of every diagnosis and action taken.

Keyar monitors the heart rate of a baby in the mother’s womb, as well as the mother’s uterine contractions. Worn around the neck, it extends out to a patch with five surface-electrode-based sensors. This patch is placed over the navel and transmits data to the mobile app, Daksh.

Dr. Shirley George of St John’s Medical College Hospital in Bengaluru says, “preliminary results show that Keyar’s performance is as good as that of the gold standard [the more expensive Cardiotocography or CTG].”

Photo credit: Janitri

Unlike other similar devices found in high-end hospitals that are quite big and restrict women to their beds, Keyar is portable, non-invasive, and easy to use.

“Often, women are restless because of the labour pains, so this gives them the freedom to move around,” Dr. George points out.

Agarwal’s design has helped more than 25,000 women across 115 hospitals in nine states in India. He is now exploring partnerships in Southeast Asia and Africa, to help prevent unnecessary maternal and neonatal deaths in similar low resource settings.

This project aims to address the following UN Sustainable Development Goals: 3.1 Reduce maternal deaths to fewer than 70 for every 100,000 births; 3.2 End preventable newborn deaths to as low as 12 per 1000 births; 3.7 Ensure universal access to sexual and reproductive healthcare services; 5. Achieve gender equality and empower all women and girls

WDO’s World Design Impact Prize™ was established in 2011 to honour and elevate industrial design driven projects that benefit society. The award aims to bring visibility and recognition to socially responsible design initiatives around the world.

View the other World Design Impact Prize 2021 shortlisted projects.

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