Social Enterprise Pitch – Ibrahim Mohedas

and we're not done yet we have two more contestants for today's series of pitches and I'm gonna bring up our next speaker it is Ibrahim mojitos who is from sub-q assist and if everyone could please give him a round of applause [Applause] thank you very much my name is Ibrahim mojitos I am from the University of Michigan and today I'm going to be talking about the sub-q Assist a device we developed with st. Paul's Hospital in Addis Ababa Ethiopia aimed at increasing access to long-acting contraception globally 225 million women have an unmet need for contraception and because of this every year there are over 50 million unintended pregnancies moreover due to this lack of access women have trouble safely spacing their pregnancies and every year this causes over 1 million infant deaths now there are many barriers to increasing women's access to contraception and getting global access one of the major barriers is a lack of trained providers in low and middle income countries for example in Ethiopia where we're working with clinicians there are over just two thousand physicians for a population of a hundred million this means that contraceptives that require a high level of skill to administer are simply not as accessible as as they should be in rural areas on the other hand however there are over 40,000 community health care workers in Ethiopia if we could leverage community health care workers to administer long-acting contraceptives this would go a long way towards establishing them as a very accessible means of safely spacing pregnancy and postponing pregnancy and that's exactly what we're looking to do with the sub-q assist the sub-q assist is a simple injection molded device acts like a assistive device for community health care workers in low and middle-income countries allowing them to administer long-acting contraceptive implants as effectively and as safely as physicians and OBGYNs it acts like a template for a community health care worker they simply clip it on to any standard blood-pressure cuff wrap it around a woman's upper arm and then inflate the cuff to approximately 15 millimeters of mercury this stabilizes the skin and tissue in a cavity on the underside of the device the healthcare worker then simply needs to insert the contraceptive implant through a guide on the front of the device and this ensures that the implant goes in just underneath the skin every time as accurately and as safely as a physician or a trained ob/gyn we've shown this through both our preclinical and clinical testing in our preclinical testing we've compared the sub-q assists to an expert OBGYN and have found that the implants are embedded as accurately as those done by the expert OBGYN furthermore we've begun our clinical trial where we were looking to see if the sub to assist can place our implants in this ideal placement zone just underneath the skin and what we found is that the implants are going in consistently and accurately we believe that this makes a major difference to the contraceptive landscape that we have today currently there are short acting contraceptives that can be administered by minimally trained providers but because they are short acting they're not as effective for safely spacing pregnancy on the other hand there are long-acting contraceptives that are great for safely spacing pregnancy but because they require a higher level of training are not as easily accessible therefore there's a major gap in the market for a long-acting contraceptive that can be easily administered by a minimally trained provider and that's where we think the sub to assist Falls it can allow a community healthcare worker to administer contraceptive implants as easily and as safely as an expert OBGYN we think that this makes a real difference in the rural marketplace for contraceptive implants we calculate that in sub-saharan Africa alone broad use of the sub-q assist could increase implant use by over 4.5 million implants per year because it leverages this massive health care workforce of community health care workers and allows them to easily and safely administer contraceptive implants moving forward from our clinical trial we are looking to partner with a implant developer or distributor that could Co package our device with implants and make them available if for community health care workers in rural areas furthermore we are looking to move on to a field trial with a partner that is in rural areas and working with community healthcare workers and wants to task shift implant administration to these minimally trained providers we really believe that the sub-q assist could have a major impact on access to contraceptive implants in low and middle income countries and I'd like to thank you for your time and now we'll open it for five minutes of questions from our judges I'll hand it over to you thank you Brian for your presentation subtool administration in Ethiopia the community's huacas farah we're trained they have a program which has been going on for a long time but do you worry that as you go more rural that the quality of service may be less than what you have more in the urban areas yeah that is a that is a great point and so Ethiopia was where we originally saw the need for our device and we were we saw the healthcare system best poised to take up our device however it could be implemented at different levels in different countries so in some places community health care workers might be voluntary education based but if you move to other countries this might be very appropriate for midwives or nurses that have a higher level of training but this device would bring a higher level of accuracy and consistency how many Theo pians are on your team so we are working with the clinicians in the ob/gyn department at st. Paul's Hospital and Addis Ababa and we're also working with public health researchers at the University of Gondar so anywhere between five to twenty five have worked our project okay and I just want to be clear how long is this contraception good for the implants we're working with last three to five years and are they reversible at all you as soon as you remove the implant fertility returns within 30 days can you tell us a little bit more about the product itself how many times can the sub-q assist the cuff be used before the efficacy or the safety is reduced and what is the cost or what do you project the cost will be to the health provider to actually purchase the device compared to other injectables so our device works with a standard blood pressure cuff so we wanted to work within the constraint constraints of the equipment typically used by community healthcare workers so it uses a standard blood pressure cuff the device itself is disposable in order to again fit within the rural context since reusability is an issue with cars contamination the device itself can be manufactured at scale for less than 25 cents and based on some of our studies have seen price ranges up to a dollar when you you work in the rural areas how is how is it to dispose of these products that you use how do they community focus the disposal for their syringes that they are using in the community yes so our device is really meant for community health workers or medical providers that are already providing depo-provera the injectables and so they would be disposing of our devices in exactly the same way that they would dispose of their vaccination equipment and things like that I have one more question it went thinking about your financial modeling and thinking about the countries on your hopeful list of implementation many countries do authorize community health workers to do injections while many other countries do not presently allow that's not part of their national health policy have you sort of taken and it can be a long process for these countries to start to authorize injections done by community health workers have you taken that into account and your projections and in your planning and how are you thinking about that yeah definitely so there is definitely a large disparity between different countries and what they allow or don't allow community health care workers to do so within some context our device would be more appropriate for midwives or nurses and just allow for an increase in quality and easier removal at a later date whereas in other countries that have a more professionalized community health care worker we would be enabling them so it really comes down to different countries implementing our product in different ways fantastic our time is just about up here let's get a round of applause to Ibrahim [Applause]

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