Ultrasound for Ugandan midwives

2010-2012

UX lead on a Bill & Melinda Gates-sponsored project focused on designing a low-cost ultrasound device for midwives in developing regions, specifically for women working in rural environments.

UX lead on a Bill & Melinda Gates-sponsored project focused on designing a low-cost ultrasound device for midwives in developing regions, specifically for women working in rural environments.

UX lead on a Bill & Melinda Gates-sponsored project focused on designing a low-cost ultrasound device for midwives in developing regions, specifically for women working in rural environments.

The context and problem

The context and problem

The context and problem

The context and problem

The context and problem

Maternal morality rates in sub-Saharan Africa are unacceptably high. Many factors contribute to this, including the near absence of ultrasound technology, which can potentially decrease deaths by identifying common pregnancy complications.

In 2010 Seattle radiologist Dr. Rob Nathan began donating GE portable ultrasound machines costing $20,000 to small, rural villages in Uganda. This price was unsustainable and the midwives had to train on these devices in Kampala, taking them away for long periods from their desperately needed work in village clinics. I, along with three others in the human-computer interaction and computer science departments at the University of Washington in Seattle, decided to help Dr. Rob Nathan design a low cost portable ultrasound device. 

We were asked to build the device for under $5,000 and to create a simplified UI focused on three common prenatal complications:

1) Multiple gestations (twins)

2) placenta previa

3) breech presentation

 

Field research

Field research

The team first sent surveys to midwives working on the current GE machines, as well as visited local Seattle hospitals to learn about ultrasound technology. We then traveled to Uganda and conducted fieldwork in southern rural Uganda, meeting with midwives doing their best to deliver babies and keep mothers alive.

We learned that the midwives often worked 14 to 18 hours a day without reliable electricity. The donated GE machines had very complicated UIs and were loaded with unnecessary features, and when minor technical issues occurred the midwives often put the device in a corner of the room without further use.

The team first sent surveys to midwives working on the current GE machines, as well as visited local Seattle hospitals to learn about ultrasound technology. We then traveled to Uganda and conducted fieldwork in southern rural Uganda, meeting with midwives doing their best to deliver babies and keep mothers alive.

We learned that the midwives often worked 14 to 18 hours a day without reliable electricity. The donated GE machines were very complicated, and when minor technical issues occurred, the midwives put the device in a corner or closet without further use.

What we built

What we built

We built a simplified ultrasound application that utilized an Interson USB probe attached to a netbook. The most basic interactions were prioritized first, such as filling in the patient record and performing a simple scan. We iterated until radiologists, sonographers, and midwives both in the U.S. and Uganda verified that the device could successfully diagnose the three most common complications.

We were able to get the cost of the device to $3,500 using a modular off-the-shelf approach rather than an all-in-one system. We also added an integrated contextual help feature that helped supplement the limited sonography training received by the midwives.

 

Scanning fetus head

ultrasound1

Browsing ultrasound topics

ultrasound2

Learning topic about sonography

pic2

Comparing ultrasound images

Comparing ultrasound images

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Impact

What we built

I authored three academic papers along with team members Professor Beth Kolko, Dr. Rob Nathan, Alexis Hope, Pratik Prasad, and Wayne Gerard. Ultimately, our work broadened the conversation in the medical community about the needs for simpified lower cost medical technology.

For more about this work, please watch this presentation from HCI professor and now Shift Labs CEO Beth Kolko:

From user research, I learned that people are likely to book directly online if the website content is tailored to their specific age group and if they could easily have their questions answered through an FAQ or in-app messaging. I also learned that more people are likely to book a language course if they don't feel pressured to decide on a course right away, therefore we implemented a feature that allows you to save trips over time called "My Trips".

After research and testing, I worked closely with the engineers to implement the website, which is still a work in progress. We continue to perform user research and testing, as well as using analytics and A/B testing to improve the site.