The IMPALA monitoring system leverages machine learning to predict patient deterioration hours before it becomes critical.(Source: Image courtesy of IMPALA)
Malawi is making use of AI in its healthcare system, particularly in pediatric departments to reduce infant and child mortality
The country has adopted Innovative Monitoring in Pediatrics in Low-re, an AI-powered patient monitoring system
TheIMPALAmonitoring system leverages machine learning to predict patient deterioration up to three hours before it becomes critical and can issue an alert long before a patient’s condition worsens.
The IMPALA system was developed byGOAL 3, a Dutch social enterprise operating in health technology, and is currently being used at Mangochi Hospital, Malamulo Hospital and Queen Elizabath Central Hospital amongst others
The IMPALA effect
During the 2023/2024 period two of the hospitals where IMPALA is being used recorded between 40% and 51% fewer deaths compared with the equivalent period in 2022/2023, before the monitoring system was introduced
Blessings Juma, head of the pediatric ward at Mangochi District Hospital, told theEl Paisnewspaper that prior to the use of IMPALA, the hospital could record four deaths in a period of a week to 15 days, but now they record one within the same timeframe
Malawi also grapples with a severe lack of doctors, particularly those who are specialized in pediatrics and child healthcare
According to the Paediatrics and Child Health Association (PACHA), Malawi is one of the countries with the lowest physician to patient ratio worldwide.
“Currently, the estimated ratio of paediatricians to child patients in Malawi is 1:50,000. Less than 40 paediatricians serve in the health system,”PACHA’s website explains.
In addition, PACHA said the severe shortage or absence of healthcare professionals and specialists affects access to, provision of and quality of primary healthcare for children in Malawi
The association said that the number of pediatricians in Malawi is critically limited, which leads to a significant burden in morbidity and mortality among children
However, IMPALA has been able to help fill the void of healthcare professionals particularly when it comes to monitoring and evaluation
Technology’s role
The IMPALA monitoring system includes bedside monitoring units that continuously measure vital signs, a local server for data processing and storage, as well as a tablet-based app that displays patient data of up to 30 patients simultaneously
Furthermore, the IMPALA system’s monitors and tablet app generate visual and audible alerts when predefined thresholds are reached, thus allowing rapid response and patient prioritization.
“Previously, when we talked of vital signs, it was simply just a check of temperature. There was increased workload for nurses and clinicians, because you had to go around all the time being called to see these children,” Gift Mhango, a pediatric nurse at Our Lady of Mount Carmel Community Hospital in Kapiri, shared during a stakeholder meeting with the IMPALA research team
In addition, Mhango said nurses are now capable of multitasking and only focusing on a patient when there is an alert
“With the tablet present, you can be taking care of another child at the same time and have an eye looking at the tablet. If something is going wrong with a child, you can quickly go and respond,” Mhango explained
The use of the IMPALA patient monitor has helped to reduce infant and child mortality rates across hospitals in Malawi
Dr. Jessica Chikwana, a pediatrician at Zomba Central Hospital said the infant mortality rate had significantly reduced due to the IMPALA monitoring system
“Prior to the induction of IMPALA, I could often be in handover in the morning and just be given a file [saying] baby found dead, rest in peace, but I don’t see these things anymore,” said Dr. Chikwana
IMPALA has also been rolled out at hospitals in Rwanda, Kenya and Tanzania
The machine learning approach
The IMPALA monitoring system has reduced child deaths by a third in Malawi, even when hospitals have a higher number of patients
In addition, it also costs 16% less than usual healthcare devices and empowers guardians and nurses when caring for critically ill children
According to William Nkhono, a data manager and a PhD Research Fellow under IMPALA, the machine learning approach can facilitate efficient distribution of re
Nkhono also noted that machine learning systems such as IMPALA have shown advantages in highly innovative fields with large, complex datasets such as omics, radio diagnostics, drug development and personalized treatment.
“Machine learning can contribute to reducing child mortality and morbidity in low- and middle-income countries [LMICs]. Investing in digital infrastructure for providing care, and research and innovation is necessary,” said Nkhono
In addition, he said the use of machine learning can address challenges in Malawi and improve access to high-quality care
“For instance, by leveraging available data, machine learning such as IMPALA has the potential to enhance diagnostic time and accuracy where specialist expertise is scarce – for example, detecting birth asphyxia from infant cries, or identifying diabetic retinopathy,” said Nkhono
In addition, he said countries such as Malawi should prioritize technological development, including data infrastructure, capacity building, regulation and policy to achieve AI’s full potential
HealthtechSouthern Africa
