1. Market Study: Low Cost Incubator Tiger Teams Project Team

2. India versus Nepal Very similar markets – good proxies for each other

3. The Indian Market Infants born/year: 26M LBW/year: 2.6M Would have bad outcomes without incubators: 1.8M Will die without incubators: 0.8M 1.8M babies need incubators in India alone

4. Market Types and Size Hospitals (41%; 0.74M)At home (59%; 1.06M) Two distinct markets for incubators Tertiary care Secondary care Community health center Primary health center Requires 48,000 stationary incubators for use in NICU – both private & public Requires 133,600 portable incubators Demand currently unmet IMPACT: Can save at least 1.06M lives Demand ~10% met IMPACT: Can save at least 0.67M lives

5. Market Size for NICU Incubator Average life of the incubator Average life of the incubator –10 years –4800 per year Indian government goal: By 2015, 80% of deliveries in HCF Indian government goal: By 2015, 80% of deliveries in HCF If realized, market would essentially double If realized, market would essentially double Huge potential for growth

6. Required Features Reliable temperature regulation & monitoringReliable temperature regulation & monitoring Servo controlServo control Access to alternate sources of energy*Access to alternate sources of energy* User friendlyUser friendly Ability to monitor the babyAbility to monitor the baby Sturdy but sleek designSturdy but sleek design Durable & easy to maintainDurable & easy to maintain ISO/ WHO /UNICEF certifiedISO/ WHO /UNICEF certified Battery life: 2 hrsBattery life: 2 hrs Unit weight: n/aUnit weight: n/a Minimum portabilityMinimum portability Battery life: 4-6 hrsBattery life: 4-6 hrs Unit weight: 15-50kgUnit weight: 15-50kg Can be carried on a cart, car, or by 2 adultsCan be carried on a cart, car, or by 2 adults NICU incubator Transport incubator * Solar, Manual etc. IMPACT: These will save 0.8M lives in India

7. NICU Incubator – Desirable Features Temperature monitoring Temperature monitoring –Servo control  Base model air temp based servo control  Upgrade skin temp based servo control Modular construction Modular construction Built-in scale Built-in scale Humidity control with indicators to signal water change Humidity control with indicators to signal water change Conversion to radiant warmer Conversion to radiant warmer Phototherapy Phototherapy Allows for elevation of baby’s head Allows for elevation of baby’s head

8. Current State of Market Indian incubators: Indian incubators: –Plus: Low cost (priced around $1000) –Minus: Poor reliability, poor durability, challenges in maintaining temperature Foreign incubators: Foreign incubators: –Plus: High quality –Minus: Very expensive Market ripe for an affordable but reliable incubator delivering critical care

9. Pitfalls of Current Use Lack of uniformity in incubator models within a single NICU Lack of uniformity in incubator models within a single NICU Lack of adequate training of nursing staff to operate incubators Lack of adequate training of nursing staff to operate incubators Lack of spare parts and maintenance Lack of spare parts and maintenance Process of birth is considered “unclean” and midwives looked down upon Process of birth is considered “unclean” and midwives looked down upon Incubators intimidate nursing staff, who sometimes don’t use them Incubators intimidate nursing staff, who sometimes don’t use them

10. Information Sources Interviews: Interviews: –Dr. Bob McKersie  MD in Chicago, author of “In the Foothills of Medicine” –Dr. Ashok Dutta  Professor and Head of Department, Kalawati Saran Children’s Hospital –Dr. Vinod Paul  Professor and Head of Department, Department of Pediatrics, All India Institute of Medical Sciences  WHO Collaborating Centre for Training & Research in Newborn Care  Former Secretary of Health in Central Indian Government –Dr Shabnam Lainwala  Director Nursery, Care New England, RI Literature Study Literature Study NICU Visit: NICU Visit: –Kent County Hospital, Warwick, RI