09/25 Spencer Moros

Spencer Moros, Noah Weaver, Anneke Roy, Skyler Martinez

Blog #5

20 FAQs Ukweli Test Strips


  1. What makes your product better than any competitors in the region?
    1. The product itself isn’t any better: it’s the system created around the product that makes Ukweli better. By integrating the strip into the pre-existing community health worker system, a method of distribution and trust with individual participants is established. The bare bones approach of the 3 parameter strip (instead of the standard 9-parameter) ensures that the strip is more affordable and accessible to underserved communities.
  2. How does the 3-parameter test compare to the standard 9-parameter test in terms of specificity and sensitivity? 
    1. Utilize same mechanism as FDA approved test strips in US; same specificity and sensitivity – unable to get testing for our own produced strips due to expense
      1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408713/
    2. Repeated testing throughout pregnancy helps to reduce low specificity of the test
  3. How do you establish trust with the communities you deserve? Do they have a distrust of Westerners?
    1. The CHWs (which are certified UHWs) are nominated by their communities to serve in such a capacity, and using Lehigh’s relationship with the non-profit WHI within Sierra Leone, we are able to establish as much trust as possible while maintaining accessibility to the strip.
  4. How do you plan to establish relationships with other government agencies beyond Sierra Leone?
    1. We are utilizing our network as well as the network which our partner World Hope International currently has in other countries. We hope to leverage the support from the government of Sierra Leone and success on the ground to support the adoption of our venture elsewhere.
  5. What are the preliminary results from the WhatsApp Communication Study Interviews?
    1. Currently, we are still working on transcribing and coding the interviews but as a group we have noticed some trends already. For example, cultural and language barriers have been a very common issue that’s come up when talking about educating women.  This can help us understand how we can shape our WhatsApp messages to be specific for the UHWs and the problems they’re facing. 
  6. How do you choose participants for the WhatsApp Communication Study?
    1. Our distribution manager goes to the PHUs and recruits specific healthcare workers.
  7. What metrics are you planning to measure during the WhatsApp Communication Study?
    1. The metrics themselves are partially shaped by the participants themselves. The overall goal of the study is to identify emerging themes through messages sent between the UHWs and the interviews of each participant. Such examples of what we might identify would be encouragement, clinical questioning, and advice, and then those would fall under the larger category of teamwork, and we can do those for multiple themes.
  8. What issues have you identified during the WhatsApp Communication Study?
    1. Within the study, issues we have identified primarily revolve around internet connectivity concerns and reliable access to the internet for our UHWs. From the UHW perspective, we have come to reinforce our understanding of the challenges women of Sierra Leone face when seeking medical treatment (traveling distance, lack of time, lack of money).
  9. How do you stay within the scope of your project without the “white savior” complex? 
    1. We seek to ensure that any aspect of operations incorporates the collaborative nature and overall focus on the women, other locals, and government/medical operatives of Sierra Leone. For example, are pre and post-WhatsApp survey questions are designed to encourage honest and genuine answers from the UHWs who are involved to give us direct feedback. This would be opposed to pressuring them to falsely believe their feedback may influence or hinder they ties to Ukweli, this way we create a comfortable environment for all parties. 
  10. Where are the test strips produced? 
    1. Our test strips are produced by an OEM in China. 
  11. Does your OEM engage in unethical treatment of minority populations? How do you address this from your perspective of a social venture?
    1. Beyond the fact that our OEM has all necessary regulatory approvals and meets all legal requirements set forth by China to operate, we don’t know. Besides that, it is not clear what demographic works for our OEM. As a social venture, we are only able to tackle so much at a given time, and our efforts need to remain concentrated on the exceedingly high maternal mortality rate in Sierra Leone and beyond.
  12. How has COVID-19 impacted your venture? What adjustments have you had to make?
    1. I would say the biggest impact was on the new team because they were unable to travel to Sierra Leone this year.  It made it hard to really communicate and gain the trust of our distribution manager.  On the distribution of the test strips, the impact was pretty minimal besides a temporary price reduction in March from $50,000 to $30,000 due to economic hardships that CHWs and frankly everyone was experiencing.
  13. How do you validate your data?
    1. In order to validate our data after paper copies are collected by our distribution manager from each PHU, our distribution manager enters these values into a google forum. This data automatically is populated into our data backbone. Additionally, the paper forms are scanned and emailed providing a redundant system to check the data through regular auditing by the Lehigh Team.
  14. How do you know which specific Ukweli operations enhance screening participation
    1. We have performed an analysis of our data using a method known as multiple linear regression analysis. This type of analysis allows us to find which metric(s) are the most influential on increased screenings. We looked at the data on a monthly basis between PHUs with a minimum number of x screenings, and found (insert here).
    2. *We still have to finish the write-up of the paper doing this analysis, but we will be able to answer this question fully by the time our presentations are due for submission.
  15. Have you considered looking at other metrics? If so, why/why not did you decide to evaluate them further?
    1. We have considered metrics such as the rate of follow-up care received by women who screened positive for any of the parameter within our test strip, but we have chosen to forego some valuable metrics because of the inconsistencies and lack of reliability associated with gathering them. In an LMIC setting, it is already difficult enough to gather reliable data on the strip itself where it’s a “once-and-done” situation (i.e. was the screening positive? If so, what?). However, following up with those same participants is an entirely different challenge by itself.
  16. You mentioned in previous presentations that you were having some difficulties coordinating with your employee in Sierra Leone. How have you progressed since
    1. Yes, we have. We have increased the frequency of our communications with our onsite employee and in the process have allowed a stronger bond and trust between the Lehigh team and him. Even through technical difficulties, he understands the importance of completing his duties given specific circumstances, as we develop a better understanding on ways we need to accommodate to his circumstances.
  17. How do you incentivize UHWs to participate in the Ukweli screening program?
    1. The UHWs are able to buy the test strip boxes (50 strips in each) for roughly 25,000 SLLs, and they each can be sold at around 50,000 SLLs for them to turn a profit.
  18. How do you know the venture has actually had an impact on maternal mortality?
    1. Determining Ukweli’s actual impact on the maternal mortality rate in Sierra Leone is nearly impossible due to the lack of regularly collected census data as well as the numerous ventures in the area that have the same goal as us.  However, we can look at our own personal metrics of success, like number of boxes sold and number of women screened and treated, in order to determine how successful the venture has been.   
  19. What was the regulatory approval process to sell test strips in Sierra Leone? 
    1. We were required to complete a Service Level Agreement (SLA) between Ukweli and Ministry of Health and Sanitation which allows the venture to operate in Sierra Leone’s healthcare industry. Also, we obtained a Marketing License from the Pharmacy Control Board of Sierra Leone by providing information about the test strips and allowing us to sell the strips commercially.
  20. Where do you plan to get more funding from?
    1. We are looking to a variety of charities which support initiatives and research for preeclampsia and maternal health.

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