Human milk donor app to reduce child mortality and under nutrition

A team from the University of KwaZulu-Natal’s (UKZN) Department of Paediatrics and Child Health has won an international award for its work on a mobile system designed to reduce child mortality and under nutrition.

The team has been developing a network of human milk banks, into which mothers can donate their milk to be stored and used to feed other babies. While the clinical benefits of breast feeding are widely known, the problem facing many South African communities is that in some cases it’s just not possible – such as when a mother is HIV positive and may pass the disease on to her baby. Formula milk is often not a safe option in these circumstances due to the high cost, which often leads to it being over-diluted.

In response, an organisation called the Human Milk Banking Association of South Africa (HMBASA) has been establishing a network of small scale facilities where mothers can store milk donations. This then raises the issue of how milk is treated and reheated without becoming contaminated with bacteria.

Enter the team from UKZN, headed by Professor Anna Coutsoudis. Together with colleagues in the US and funding from the Bill & Melinda Gates Foundation, they’ve been working on an Android app calledFoneAstra, which guides milk bank staff through the low-cost process of flash-heat pasteurisation of donated breast milk in hospitals.

The team was among four African initiatives chosen out of 100 projects from around the globe to be awarded the GlaxoSmithKline (GSK) and Save the Children Healthcare Innovation Award, a $1m (R11.7m)  initative that gives grants and support to projects that have proven successful in reducing child deaths in developing countries.

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A joint first prize grant of $370 000 (around R3.9 million) was awarded to the UKZN FoneAstra team, along with ColaLife from Zambia.

The two other award recipients were The University of Nairobi and Living Goods from Uganda.

The first version of FoneAstra was originally developed during an internship at the Microsoft Research India group hosted by Microsoft Research India and taken on by UKZN in partnership with the University of Washington’s Department of Computer Science and Engineering and US health NGO PATH.

The system is not available on any app store as yet. It connects an Android phone to a probe that monitors the temperature of the donated breast milk. It provides step-by-step guide for health workers through the pasteurisation process and makes it easier to track and trace donor milk for increased quality control and assurance.

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Data is sent to FoneAstra which can be viewed on the phone, labels for milk bottles can then be printed from a mini label printer used together with the system and be stuck on bottles or jars of milk for reference.

Donating breast milk is a practice that has been around from as far back as the late 70s and early 80s. Today, it’s used in hospitals around the world but is yet to be properly formalised in many developing countries. South Africa opened its first formalised milk bank around 2001, beginning as a small initiative which grew over time.

One of the pros of human milk banks and the FoneAstra system is that it doesn’t always require the use of electricity and can be operated using gas stoves whenever there is low or no electricity.

Any healthy mom can donate breast milk, whether she is at home or in a hospital, but mothers first have to go through a screening process to ensure eligibility before they can donate.

FoneAstra is currently being used in four district hospitals in Durban and will be rolled out to five additional district hospitals in KwaZulu-Natal, as well asthe rest of South Africa, using the money received from the award. The FoneAstra team is always working on making the system better and its developers are also in the process of making FoneAstra accessible to feature phone users.

The long term goal, however, is to get it out to remote areas, where 1 000 community workers and mothers will be trained and given a simplified version of the system with mothers in their communities. The broader plan is to re-instill a culture of breastfeeding among South Africans, a culture that sadly has been lost over time in the country, according to Professor Coutsoudis.

“Breastfeeding is one of the key strategies in South Africa for reducing infant mortality,” Professor Coutsoudis said. “Babies have a right to receive human milk, which is best for them.”

“As part of this award and the work we do with PATH and the Department of Health, there’s a component purely for communication awareness. We’ve got to change the mindset around breastfeeding by empowering mothers to get involved and learn more about it.”

Coutsoudis also mentioned that FoneAstra has already been requested in Ethiopia, Kenya and Cameroon and UKZN has already earmarked three hospitals in Ethiopia to start off the expansion in the near future.

“Our vision is to inspire breakthrough in the way a country treats its children,” said Gugulethu Ndebele, CEO of Save the Children South Africa. “Through the recognition and funding from this award, FoneAstra can make a bigger impact for some of the most vulnerable children.”

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