A 20-cent tube of antiseptic ointment that prevents newborn deaths. An effective, low-cost cervical cancer screening test. A monitor that alerts health workers when a vaccine has been damaged by heat.
At PATH (formerly known as Program for Appropriate Technology in Health), a Seattle-based nonprofit global health organization, scientists and researchers dedicate their time to designing innovations that improve the health of the world’s most vulnerable people, especially women and children in developing countries.
As the head of PATH’s maternal and child health technologies group, Dr. Patricia Coffey leads the organization’s work on ideas aimed at lowering maternal and infant mortality rates. One of her team’s recent successes is the NIFTY cup, a 1.3oz (40ml) soft silicone $1 receptacle that helps infants sip breast milk at their own pace. For the 7.6 million premature babies born in Africa and Asia each year who haven’t developed the reflex to breathe, feed or swallow properly, along with those born with cleft palates or cleft lips, the cup (whose name stands for neonatal intuitive feeding technology) could be the difference between life and death.
Coffey spoke with Women & Girls Hub about the NIFTY cup and how other simple, easy-to-use innovations can help change the world.
Women & Girls Hub: How exactly does the NIFTY cup work, and what are the benefits of using it?
Dr. Patricia Coffey: Pre-term babies are born early, so they can be very low birth weight and they can have some developmental issues. They are often choking and aspirating milk as they’re trying to drink it. The WHO and UNICEF both recommend hand expression of breast milk and the use of a cup to feed breast milk to infants who are unable to breastfeed. We made this specifically for that purpose.
There’s a little reservoir at the top that looks a little like a spoon hanging out of the cup. That allows the milk to sit in that little reservoir, and you put that little part into the infant’s mouth. The infant can use their tongue and jaw to bring the milk into their mouth by moving their tongue and jaw around.
They will determine how fast and how slow that milk flows. And they’ll do that on their own initiative, which is really great, because that allows the infant to be ready and not get confused about when it needs to suck and when it needs to breathe. Then the infant is happier, because they’re actually getting the milk they want. They will be able to thrive better when they’re using a cup like this.
It also has a nice ergonomic feel to it, so your wrist doesn’t get tired while feeding the baby. And since the cup is made of silicone plastic, it can be cleaned and sterilized easily. We made sure there aren’t any crevices or parts on the device where bacteria could hide.
Women & Girls Hub: The nonprofit company Laerdal Global Health will manufacture and distribute the NIFTY cup in Africa soon. But where did the idea first come from?
Coffey: The NIFTY cup is a labor of love. A few years ago, I met a researcher at the University of Washington School of Dentistry. She had done her PhD dissertation on kids who had cleft palates and cleft lips, and learned how much difficulty they have with feeding. She realized they needed to create a cup, or something that could help these babies get the nutrition they need.
She started working with another colleague at the Seattle Children’s Hospital Craniofacial Center, and together they had ideas about a design for a cup that they thought would work. So, since we’re all based in Seattle, a colleague said you should take the idea to PATH, so we all got together and brainstormed.
Women & Girls Hub: How did you take the concept from an idea to a real product?
Coffey: We had a really innovative engineer, who went to [sporting goods store] REI, a Seattle institution, and he bought all the different camping cups, flexible little collapsible cups and all sorts of things. We got a ton of sippy cups and breast pump cups, and we just had this whole table full of them.
We also brought a lactation specialist and occupational therapist from Seattle Children’s Hospital onto the team. She knows the physiology of how babies suck and swallow and breathe at the same time. It was really a great team, and we were able to brainstorm different aspects of the cup.
Women & Girls Hub: Can you also tell me about the uterine balloon tamponade device that PATH has helped develop?
Coffey: This is a way to prevent postpartum hemorrhage during childbirth, which is the leading cause of maternal death worldwide. When a woman has a postpartum hemorrhage, the capillaries in her uterus have not closed. One way of dealing with that is to insert a balloon into the uterus and fill it, usually with water or saline.
As the balloon expands inside the uterus, it just uses compression to stop that bleeding. It’s left in the uterus for up to 24 hours until the bleeding is completely stopped.
This type of product has been used in high-resource settings for a long time. But the problem is it’s quite expensive, and costs over $200 each. Our goal was to create a product that could be used in an affordable way. This is going into into clinical trials to test effectiveness in South Africa this year.
Women & Girls Hub: What else is different about this new version of the device?
Coffey: One of the exciting parts about this product is that it has a little bit of an innovation. The pressure in the balloon is regulated based on the flow of the gravity feed. It is correlated with the systolic blood pressure of the woman at the time.
So, you have to take her blood pressure, and then based on what her blood pressure is you hang this device at a certain height. That will regulate the amount of drip and ultimately the amount of pressure that is used to [expand] the balloon in the uterus.
Women & Girls Hub: Where is this product manufactured?
Coffey: We are really pleased to be collaborating with a company called Sinapi in South Africa. One of the things that’s really exciting about this is that PATH has been working with the South African government to create an innovation hub over the past few years, and our collaboration with Sinapi is a result of that process.
The focus for the market originally is in sub-Saharan Africa, so it’s really great to have a manufacturer based in Africa because all the transport costs and logistics are so much easier.
Women & Girls Hub: What other new PATH innovations are you excited about?
Coffey: One is our female condom product, which we call the woman’s condom. Male condoms can pose a challenge for some relationships because men don’t always like the way that they feel, and they don’t also want to have to take the responsibility for using a condom. We’re giving women some power over their ability to protect themselves.
Women & Girls Hub: How does this condom work?
Coffey: It consists of a condom pouch inside a capsule made of polyvinyl alcohol, which dissolves as soon as it’s inserted into a woman’s vagina. With sexual intercourse, that pouch opens up and on the sides of the pouch are four hydrophilic foam shapes, which allow a small bit of adherence to the walls of the vagina.
Women & Girls Hub: How is it different from other female condoms on the market?
Coffey: During sex, this condom remains stable and the plastic doesn’t make a lot of noise like other female condoms. We wanted a product that was easy to insert and easy to take out. We wanted a product that gave good sensation, was comfortable and that also was aesthetically pleasing.
We’ve made it a little more flexible, and we’ve made it in the softer material. It’s been called the “champagne of female condoms.”