02/28 Spencer Moros

Post #6

Does your work require IRB approvals? If Yes, articulate your detailed IRB strategy. If No, explain why you don’t need IRB approval and identify situations when you might need IRB approval.

Our work absolutely requires IRB approval from both Lehigh and Sierra Leone. Our strategy involves not including identifiable information from our data collection, although we are collecting biospecimens. Also, we plan to ensure consent is obtained before the tests are administered and before the data is collected.


Develop an outline for your mid-semester presentations. What supporting evidence will you provide for each point?

How will you boost your credibility every step of the way?


  • Explain the problem/opportunity being addressed from a macro perspective – a bird’s eye view can be the world at large, country, region (and/or relevant combinations). Use your judgment.


      • Highest Maternal Mortality rate in the world 
      • Little to no access to easy to read and affordable test strips 


  • Explain the problem/opportunity from a micro perspective – how does the problem affect the individual, the family, or relevant entity? What secondary problems does it cause?


      • Can lead to miscarriages, or even death of the mother/baby
      • May lead to ostracization of the woman because she did not have a healthy birth
      • Mother is undeniably traumatized by the event


  • Explain your approach and exactly how your proposed solution is supposed to work.


      • We plan to take the issue on from a community perspective – important to involve current community structures in the solution
      • Have respected community figures with good reputations recommend the test strips to surrounding health outposts
      • Train health workers in the community to use and read the strips
      • Have the health workers refer the women to the proper healthcare facility


  • What larger context/system does your project exist in? Illustrate how the various constituent sub-systems work together, and how the system interacts with external systems?


      • System of Community Health Posts (CHPs) spread out throughout the region and their associated Community Health Workers (CHWs)
      • Works in tandem with this existing system


  • Summarize what has been done before. What did you inherit this semester?


      • So far permission have been obtained in country to sell the strips
      • Work with World Hope International to educate people in the community about UTIs and preeclampsia
      • Sell strips to CHPs


  • Discuss the results of literature reviews, prototyping, experimentation, interviews, simulation, or modeling. Essentially, any work you have done this semester and plan to do.
  • Work Done


        • Developed a more structured and accessible data structure
        • Making a system of communication for trained health workers


  • Planned Work


        • By summer/July 2021, Ukweli should have a catchment population of 3 million


  • Identify research/design challenges and detailed plans to address them 
    • Compliance in data collection – build incentives into the system
    • Verifying the data which is collected – have a secondary system of scanned hardcopy documents in addition to online forms



02/21 Spencer Moros

Blog #5

1. List ten things that make you feel human.

  • Creating wood burnings (artwork)
  • Sympathizing with other humans or living beings
  • Enjoying listening to music
  • Creating plans to achieve a variety of tasks based on logic and prior experience
  • Learning new information – intellectual wealth
  • Making up my own opinions about various topics
  • Stress about non-life threatening situations (getting schoolwork done, maintaining social relationships, etc.)
  • Determining what my goals are each day as well as longterm
  • Feeling close to someone else
  • Having the freedom to do as I please

2. Articulate your philosophy of engagement as it pertains to your work with the GSIF / LVSIF.

Specifically discuss

1. Why should I engage?

I must engage in order to efficiently and successfully use my skills and effort to give aid to those who need it. If I completely disregard the stakeholders who I am looking to impact then there are two negative outcomes which are negated by successfully engaging. One of these outcomes is that the solution I create is not integrated into the lives of the stakeholders and my efforts in essence were for nothing. The other outcome is that the solution is forced upon those who I believe can benefit and it damages the existing system and creates a feeling of disdain for outside support in general. Thus not only would it negatively impact myself and the community but also the broader swath of individuals looking to provide aid.

2. How must I engage?

I must engage in terms of three perspectives: environmentally, economically, and most importantly socially. To environmentally engage means that whatever my project is it should not negatively affect the environment which would lead to further issues down the line. Economic engagement is ensuring that the solution is financially feasible for the stakeholders, and hopefully even brings economic benefits to the community (jobs, money, etc.). Lastly, social engagement is making sure that the solution and the system which is implemented follows the social values of the community and the method that they things are introduced do not offend any parties.

3. With whom must I engage?

I must engage with other experts in the field which I am working, however the most important population to engage with is the stakeholders who will ultimately be the end user/beneficiary.

4. What kinds of challenges, opportunities, and approaches should I care about?

I should care about the social impact of the project and an essential challenge/opportunity that I must care about is creating a system which is sustainable instead of just developing a technology/practice and throwing it at the stakeholders and expect them not only to use it, but to also develop their own system. An approach I should care about is using local sources and integrating them into the system. This provides legitimacy that I am trying to do good with the stakeholders, and the locals are much more knowledgable than I could ever be.

5. What might my epitaph read?

“Pain and challenges in life are a present and not a burden. They are the most transformative events one can experience, and proper understanding and response only positively influences one for the better.”

02/14 Spencer Moros

Blog #4


  1. *Based on your life experience, skills and interests, what would a design process that is both uniquely yours and effective look like? 

My design process is heavy in the area of empathy. By nature I care deeply about others and I find the most important step in the process is empathizing and truly understanding the struggle of those who I want to help. Too often a problem is said to be a problem for someone who really doesn’t see it as such. This leads to ineffective, unnecessary “solutions”. Additionally, approaching the process as such insights that make the remainder of the process much easier. Such an example of this is prototyping. In many cases, the prototype is made then brought to the end user and problems are identified and then the prototype is altered. By incorporating the stakeholder from the start much of these issues are mitigated.

  1. *Identify your three most important stakeholders and list five UNIQUE attributes for each one of them. 

Mothers→ low income, located in rural areas of Sierra Leone, price sensitivity goes up during the wet season, Religions: Islam and Christianity, low education level 

World Hope International→ Organization, Core Values: Transformation, Sustainability, Empowerment, and Collaboration, Christian, Motive: “To empower the poorest of the poor around the world so they can become agents of change within their communities.” (https://www.worldhope.org/about-us/), some staff members located in the U.S. and Makeni, Sierra Leone

The ordinary citizen of Sierra Leone: this is a key stakeholder because of the importance of mothers in the Sierra Leone household. Attributes include: dependence on the mother’s contribution to the household, personal interest/stake in the life of each mother, ability to encourage/support the mother throughout their pregnancy, influence on the mother’s mental well-being, and the motivation they may provide the mothers to seek better health when they think about how their health (the mother’s health) affects the whole family unit.


  1. *Identify three ways in which you will validate your project concept, technology, usability, and business model.

Validate Business Model→ Does it solve a real burning problem? Yes, Sierra Leone has the highest maternal mortality rate in the world.  A lot of women go untested for UTI and preeclampsia which can lead to birth complications. Competitive advantages over other ventures? Strong community connections on the ground, incredibly important for distributing and gaining trust from CHWs. How do they solve the problem now? Currently people in rural areas of Sierra Leone visit Community Health Posts (CHPs) to receive basic medical care, however they are normally not screened by any diagnostic test due to lack of resources.  

Validate Usability→ How does it compare to the user experience of alternative

Approaches? 9 parameter UTI test strip→ much more expensive, more complicated with 9 vs the 3 our strip has (color scheme harder to analyze). How easy/difficult is it for each stakeholder to interact with the product? CHWs are shown how to use it and read the results during training. Will people use your product? Already have UHWs purchasing and using the test strips.


4. Give three examples of something very interesting you learned from a friend that was a completely alien concept to          you.

1: Fraternities

  • Call people you barely know “brothers”
  • Unique power dynamic
  • Only common factor between all is that you are the part of the same organization
  • Pseudo-religious rituals


2: Halal Foods

  • Inability to eat certain foods due to the method of slaughter
  • Concept that restaurants designate themselves as Halal and consumers can only trust that it is true
  • Massive impact on day to day diet of many people


3: Video Games

  • Interact with people through voice and virtual characters without seeing them face to face
  • Relationships are more about the interactions of two characters with personalities than anything else
  • Sitting in front of computer for hours inside
  • Create new persona totally independent of any other aspect of life

02/09 Spencer Moros

Blog #3

List the top 20 questions your team needs to answer to advance the venture forward. Categorize the questions if necessary.

  1. Who are the people we are seeking to impact?
  2. How is the impact distributed across different groups?
  3. How does Ukweli’s success in Sierra Leone impact the international system?
  4. Why do we care about making an impact?
  5. How is this realistically translated into their lives?
  6. How can our model be applied to similar countries?
  7. How is our impact measured?
  8. How does this venture empower women?
  9. What type of connections do we need to branch out of the Bombali District?
  10. What is the future of this venture?
  11. What are the challenges that we are encountering on the ground right now?
  12. How do we leverage our existing social network to expand operations?
  13. What are other ways we can strengthen the CHW network within our control?
  14. How can we organize data in a way that is easy to understand and accessible?
  15. What is some data we already have?
  16. What is some data we still need to collect?
  17. What are some realistic ways we can quantify the success of our project? (e.g. comparing maternal mortality rates in Ukweli vs. non-Ukweli tested mothers and the challenges associated with timely data collection)
  18. How could additional funding assist in our efforts?
  19. How can we construct a reliable and sustainable chain of communication with UHW?
  20. Are there more effective methods to increase accountability/oversight?


Develop and Visualize the Theory of Change (Logic Model) for your venture. 


Inputs Outputs Outcomes
Money/operations funding

Partnerships w/ health workers + World Hope

# of women tested positive

# of women tested in general 

# of UHWs trained

# of boxes bought by UHWs

The maternal mortality rate of women tested vs not tested 

*Lower maternal mortality rate alongside tangible data

Establish a network outside of our current base of operations

Start mobilizing Ukweli beyond Bombali district



  • Bylaws on the roles/responsibilities of UHWs: Zach 
  • Organize a data collection method that creates an easy way to compile relevant data in a way that can be easily presentable: Spencer, Noah, Anneke
  • Establish a chain of communication with Ukweli Certified Health Workers via WhatsApp: Skyler
  • E4C Systems approach article: Zach 
  • Proposals/abstracts submitted to IEEE
  • IRB approvals finalized/submitted/approved for US and Sierra Leone: Rohan
  • Service Level Agreement (SLA)
  • Submission of Grants to external funding sources: Anneke
  • Presentation of quality control outcomes of test strips: Rohan
  • Implementation of PHU Data collection books
  • Create database of each form to observe trends and running total of # of CHWs trained, amount of strips sold, $ which has been invested



  • Finalization of IEEE Paper 
    • Idea: discussing leveraging the existing social network and the outreach of CHWs and associated training successes/pitfalls in the process
  • Implementation of By-Laws to the UHWs by Hassan
  • Submission of grants to external funding sources: Anneke 
  • Implementation of PHU Data collection books 
  • Establish connections/possible operations outside our current realm of operations (Bombali District)
  • Initiating the proposed chain of communication with the UHW
  • Utilize data from the fieldwork to generate more marketing to support project, specifically $ / lives saved (culmination of other data = number of positive tests, referrals given out)


01/31 Spencer Moros

Blog #2

1. Give three compelling examples of how cultural issues affect your project.

One example which affects my project is gender in Sierra Leone. In the country there is a clear distinction between men and women and what can be expected from them. The most prevalent form of medical professionals are Community Health Workers (CHWs) which work in undersupplied outposts. Most of these volunteers are male which poses a clear conflict for women. Many of the women don’t feel comfortable in telling these men about potential symptoms which may be a result of a UTI. Therefore if a culture of silence persists because of gender the women will be unable to utilize our test strips and therefore unable to receive the proper medical care.

Another example is the concept of time in Sierra Leone. Western culture observes very strict adherence to punctuality. A common phrase is “5 Minutes early is on time, on time is late. Late is unacceptable.” This way of thinking is not observed in Sierra Leone. A potential problem is scheduling meetings while in the country. Due to this it is important that our team remains flexible and has alternative plans if the schedule is to change in order to avoid wasting precious time.

Lastly, many people in Sierra Leone practice traditional medicine. This form of medicine relies on the use of herbs and other rituals. Although this could be used in conjunction with Western medicine, the use of traditional medicine in place of Western medicine could prove harmful. In order to navigate this particularly difficult area we must negotiate with the patients to gain their trust.

2. Have you experienced or observed any of these social situations at home? Describe at least three such situations.

I have personally observed the first example of gender roles posing clear roadblocks to medical care. I am not only an EMT but I have done an internship under the supervision of a OBGYN. In both cases it is extremely difficult for the patients to describe their symptoms in their entirety and with comfort. This results in less effective medical interventions which may not even be addressing the underlying ailment.

Additionally, I have encountered situations where religion has prevented me from rendering medical care. One case I had a patient who when asked if she had any religious observations which may change the plan of care she stated she was a Wiccan. Although at first I did not know what that meant I probed her further and she told me it was a modern form of Pagan witchcraft. Throughout the experience I had to maintain my composure although many of her beliefs I was confused and somewhat shocked by. Regardless I changed my plan of care accordingly and attempt to persuade her to allow me to conduct the typical medical interventions that her condition called for.

Lastly, time is something I have struggled with myself. When I went to Germany as part of an exchange program I had no idea how much earlier was considered “on time.” When I was told to be ready at 1200 and I was still getting ready at 1130 my host family was flabbergasted. However, I successfully shifted my schedule to follow their lead.

3. Give three examples of cultural practices that can be leveraged to addressed community / market problems.

One cultural practice is that of the social hierarchy in Sierra Leone. If we are able to successfully sway an individual who is held in a high regard this can prove very helpful since others are likely to listen to what he/she has to say. This is currently in place with our on-the-ground asset Hassan, however we could achieve even more by getting someone of even higher regard on our side.

Similarly the tendency of many people of Sierra Leone to form very tight knit communities could further strength the group mentality which will further progress the reputation of the test strips by word of mouth.

Lastly, we are able to leverage the cultural practice of many CHWs being volunteer. Although they do this work out of their love for those in their community fiscal incentives would prove even more effective. A possible form of this is a stipend for being trained or a potential profit to be made off of the test strips. Even though theoretically a CHW could abuse this system and overcharge or over distribute the strips they are not likely to do this since as I mentioned before the communities are very close and these volunteers are working to better their community rather than make a living.

01/24 Spencer Moros

Blog #1 

Why did you enroll in this course (motivation, prior interests)?

Doing good work does not ensure the work is impactful. I have already done plenty of good work for the betterment of health. However, these projects only result in posters and publications, which are important, but they do not directly benefit anyone. I crave something with a larger, more tangible impact outside of the frequently secluded universe of academia. I want to work on a project that I believe is working towards a more grandiose goal and one which has a force pushing towards this goal with real world deliverables. Ukweli satisfies this craving for me with its goal of ending maternal mortality. Also, I enjoy learning new skills and being thrown into the fray. This project gives countless opportunities for me to learn about things which I have zero experience. I am slightly concerned, but also excited to learn about systems engineering, marketing, and other business aspects of the project. Also, even though I am standing on the shoulders of giants I hope to make significant progress in advancing the project to expand into other countries and continue to improve the systems which are in place.

How do you envision this course making you a better () student?

I envision this will make me a better student by breaking down the walls of the box that years of education has built around me. This freedom will allow me to approach every problem from now on with a new, broader perspective. Challenges which one seemed impossible will be possible for me. Even though most of college is self-driven, this project takes this up a notch and has real world implications if I don’t complete the task and it does not matter the amount of effort I put in because in the end the task is still left incomplete. This will help me continue to improve my time management and become acclimated to real world pressure. My hope is that this project and the learning curve that comes with it will help me improve my resilience. In the past, I have dedicated myself to solving difficult problems, but I always had the comfort of being able to find the answer and work backwards if I got stuck. This project has no answer key and there are infinite ways to achieve a goal and the only way to find out if it’s a good plan is to put it into action. Another thing which I think this project will improve is my teamwork with people from very different backgrounds. Since I am encountering most of what I am doing for the first time asking for help is essential. Lastly, I believe this course will make me a better student through the connections I make with professors and other individuals who I normally would not have contact with.

The World Health Organization estimates that over one billion people who need eyeglasses do not have access to them. The vast majority of these people live in developing countries like Kenya where there is barely one optometrist per one million people. Given the high poverty levels, access to eyeglasses is almost nonexistent. Lack of proper eyeglasses severely impacts people and their livelihoods by decreasing their productivity at work, limiting or eliminating new opportunities, affecting their quality of life, deteriorating their general health and possibly leading to (preventable) blindness. What solution do you propose to address this problem?

The solution to this problem was developed a few years back by Josh Silver who invented a pair of plastic glasses with lenses that consist of a thin membrane which contains water instead of a lens which must be ground to specific specifications. Using the magnifying capabilities of water they function as a normal pair of glasses would. Due to the materials these glasses are a fraction of the price of normal glasses and since each pair is the same and only requires an adjustment of the amount of water which is present in the lenses they can be mass produced on a massive scale. Additionally, this solution also addresses the problem of the lack of trained specialists and proper medical facilities. These glasses are inherently able to be adjusted by any layperson. In contrast to normal glasses which cannot be easily altered and requires special tools to find the correct prescription, these glasses are much more simple. They only require a screwdriver and a syringe and there is no need to have one’s eyesight measured because water is just added or removed until the wearer sees the most clearly. In order to make this product more sustainable the factories should be located in country. Due to the low technical requirements to produce them all that is needed is electricity and water. This also presents an opportunity for employment of locals, making buying the glasses without relying on donations possible. Additionally, providing employment will increase the standard of living, thereby improving many other factors of life as well such as housing, food, and medical treatment. In order to jumpstart this an initial fund must be generated to construct the factory and provide the raw materials needed to make the glasses. The glasses can be sold anywhere and help generate income while also improving the quality of life of many.