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Women and Maternal Health

Globally, 18.5% of maternal deaths are related to hypertension. Pre-eclampsia and eclampsia are two common pregnancy-specific hypertensive disorders. These conditions disproportionately affect developing countries: the risk of dying from pre-eclampsia or eclampsia in the developing world is 300 times higher than in the developed world. Diagnosis of pre-eclampsia requires measurements of blood pressure and proteinuria. In situations in high income countries where pre-eclampsia is severe, blood pressure may be monitored as often as every 15 minutes. Hospitals in low-resource settings are limited by the number of clinical staff available to manually take frequent blood pressure measurements. Automated blood pressure monitors serve as a less time-intensive alternative; however the cost of these devices is prohibitively high for most low-income settings. Furthermore, there is an absence of inexpensive blood pressure monitors with ambulatory features and alarms that allow for automatic, frequent monitoring and notification.

The WHO estimates that 50,000 women worldwide die annually as a result of pre-eclampsia or eclampsia, specifically in developing countries. Here, the standard treatment of magnesium sulfate is hindered due to complexities and costs of IV delivery of the drug. The side effects and increased danger of MgSO4 in intramuscular injections deter some doctors in low-resource settings from using MgSO4 to treat pre-eclampsia and eclampsia. Syringe pumps are used to administer IV medication and fluids at carefully controlled rates. Syringe pumps are considered standard equipment in hospitals in the developed world, and a recent review of core equipment necessary in developing world hospitals identified syringe pumps as key to providing effective care in the newborn nursery, the maternity ward, and outpatient clinics. Unfortunately, commercially available syringe pumps are costly, fragile, complex, and may require external power, which limits their usability in the developing world.

HPV vaccines have been developed to protect against HPV, however one challenge in implementing them in LMICs is a lack of medical records. Without a patient’s medical history, a doctor may choose to vaccinate eligible women without knowing their vaccination status. This can lead to vaccination of individuals who have previously received the vaccine. Vaccination of individuals who have already been immunized will drastically reduce the cost efficacy of vaccination programs. Currently, HPV immunization status can be determined using assays that traditionally require sophisticated laboratory equipment.

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