Globally, pneumonia kills more children than any other illness. In developed countries, pneumonia and other acute respiratory conditions are treated via mechanical ventilators. In resource-constrained settings, however, ventilators are often not available because of their prohibitively high cost. Another approach, which has been used successfully for decades although it is not currently considered standard of care, is bubble continuous positive airway pressure (CPAP). Bubble CPAP delivers a continuous flow of humidified air with a high oxygen concentration via a pressurized breathing circuit and nasal prongs. While bubble CPAP is an effective, low-cost alternative to mechanical ventilators, its use still presents a challenge. Most bubble CPAP systems require oxygen tanks, which are expensive to transport to rural regions. The availability of oxygen is also unpredictable because of unreliable suppliers and poor road conditions. When oxygen tanks are unavailable, doctors cannot provide adequate care to children in acute respiratory distress.
In 2011, a team of Stanford students set out to design a machine that would create the pressurized air of bubble CPAP without the cost, burden, and safety concerns that came with using oxygen tanks. The prototype the group developed was capable of running off a car battery, and, when used without oxygen, cost less than 1 percent of the traditional bubble CPAP treatments. The device’s potential was lauded by advisors at Stanford and physicians at a partner hospital in Bangladesh. However, there was still a great deal to accomplish to turn the prototype into a high-performance, clinically appropriate device. This mini-case study explores the factors that the Inspire team members evaluated in deciding whether or not to take their prototype forward into product development.
This story is part of the Global Health Innovation Insight Series developed at Stanford University to shed light on the challenges that global health innovators face as they seek to develop and implement new products and services that address needs in resource-constrained settings.
Acknowledgements: We would like to thank Pamela Pavkov of Inspire for her participation. This research was supported by the National Institutes of Health grant 1 RC4 TW008781-01.