My second chance for a field visit for the BEMPU Research Award came with the start of a study at Swami Dayanand Hospital (SDN) in Delhi. The doctors working on the study, Dr. Bisht and Dr. Azad, are looking at whether the BEMPU Bracelet, a hypothermia monitoring and alert device for neonates, is more effective at correctly detecting temperature than the hand-touch method, a common way mothers determine if their baby is too hot or too cold. They’re also evaluating the bracelet’s impact on Kangaroo Mother Care (KMC) performed, and whether babies wearing BEMPU have shorter hospital stays than infants without the bracelet.
I went to SDN Hospital in April to provide training to the staff on proper use of the bracelet, as well as to see the setting where the study is being conducted and offer support where needed. SDN is a government hospital run by the East Delhi Municipal Corporation that largely serves a low-income population from East Delhi and the western area of neighboring Uttar Pradesh. Like many other government hospitals, the lines are long, hallways and courtyards are crowded, and the waiting rooms were noisy. Upon my arrival, I found Dr. Bisht, Dr. Azad, and their colleagues seeing patients in the busy OPD (outpatient department). After I was introduced to the team, I had the privilege of seeing the Neonatal Intensive Care Unit and the KMC ward (where the study will be conducted), and meeting many of the dedicated doctors and nurses who take care of mothers and babies at this busy facility.
In the KMC ward, I learned a lot about the realities of conducting clinical research in a low-resource context. A KMC ward is a dedicated space where caregivers can spend extended amounts of time providing a baby with skin-to-skin care. At SDN, I found out that babies may be in the KMC ward after their discharge from the NICU, or babies who are low birth weight but otherwise healthy may also be receiving this care to stay as healthy as possible. I met a few of the nurses who work in the ward and learned about the work they do to train and support mothers in providing KMC. On average, there is just one nurse available for every 56 mom-baby dyads in the KMC ward, so they have their work cut out for them. Space constraints mean that many mothers in the ward must share beds, which is not ideal for encouraging correct KMC practice. To monitor KMC outcomes for this study, mothers with different levels of literacy will be supporting each other in tracking and recording their daily hours of KMC performed. The staff offered some insight on how this setting affects mothers’ practice of KMC: In a setting with very little privacy, where hospital staff, visitors, and others are constantly in and out, most women aren’t even comfortable providing skin-to-skin until the evening when things have quieted down and there is less traffic through the KMC ward. It was interesting to see the number of barriers that exist to KMC practice; this highlighted the importance of cultural context in understanding the appropriate implementation of a public health intervention such as KMC.
Through this study and others, BEMPU is working to build clinical infrastructure. Five additional studies are launching as part of the BEMPU Research Award, and results will offer insight on how the bracelet affects infants’ temperature adaptation, parents’ Kangaroo Mother Care compliance, and newborn weight gain, the bracelet’s utility during infant transport, and more. BEMPU has traditionally been focused on research and development as well as product design, but as the company’s portfolio of neonatal health products grows and scope expands to reach a wider range of populations, clinical evaluation of products is a priority. BEMPU’s other products, including a device to detect and resolve neonatal apnea and a home-monitoring cradle for high-risk newborns, are currently undergoing clinical investigation in hospitals and community settings, respectively, in Karnataka and in Hyderabad. By promoting innovations research around India, as well as in other low-middle income countries, BEMPU hopes to contribute to scientific understanding of the health conditions these products address, and how technology can be appropriately employed to improve outcomes for newborns.
 Welcome to Swami Dayanand Hospital, Swami Dayanand Hospital, 2015. Accessed at: sdnhospital.edu.in