JANMA is a low cost, high quality clean birth kit for use in facility-based settings. The kit contains simple tools and training that empower health workers to provide the “six cleans” of childbirth and prevent infection, one of the leading causes of maternal and infant mortality. JANMA, packaged in a jute bag that mothers can reuse as a purse, is becoming an integral part of delivery rooms as a convenient, cost-effective solution to improve quality of acre and access to essential commodities.
To date, ayzh has sold 250,000 Clean Birth Kits to more than 300 private and public-private medical institutions in India, Haiti, Honduras, Laos, Afghanistan, and several countries in Africa, impacting 500,000 mothers and newborns. Now that we have validated demand for our product and market viability of our model, we are ready to bring our innovation to scale. This involves expanding our following key activities: production, sales and distribution of Janma; product training for health workers; developing “kit extension” products; and monitoring and evaluation of kit impact in heath institution settings (via a cost-consequence analysis in collaboration with DUKE-SEAD). As a company, ayzh has generated 800,000 USD in revenue with a $3 product since beginning sales in 2012, while maintaining a 30-40% profit margin. Through product sales alone, we expect to reach breakeven in 2017 and profitability in 2018.
How does your innovation work?
Janma Clean Birth kits preventsinfection at the time of childbirth. Infection is a leading cause of death and disability for mothers and newborns (accounting for one-third of the 3 million newborns that die each year in the first month of life, and is a leading cause of the 300,000 maternal deaths annually). When sterile supplies are not available at the time of childbirth, infection often occurs. Janma makes essential and sterile supplies available at the right place and right time.
Janma provides the "six cleans" of childbirth. The World Health Organization recommends six simple steps to prevent infection during childbirth. Our innovation – Janma Clean Birth Kit – is a disposable delivery kit that enables healthcare providers to provide good hygiene at the time of birth, giving women and newborns a healthy, happy, infection-free start to life. Components of our basic Janma kit include: (1) gloves (clean hands of birth attendant), (2) soap (clean perineum), (3) blood absorbing under-pad (clean delivery surface), (4) surgical scalpel (clean cord cutting), (5) cord clamp (clean cord tying), (6) baby wiping cloth (clean material for drying baby).
VALUE-ADD OF JANMA:
Allows for a safe, hygienic birth environment regardless of the facility conditions
1 kit for 1 birth saves time and resources for birth preparation and sterilization
Brings comfort to mothers, knowing freshly packed supplies are used only for her
Convenient and cost-effective, kit style solution simplifies procurement, increases efficiency around delivery, empowers health-care providers, and acts as a catalyst for behavior change
Versatile sales and distribution channels ensure kit is present at “point of care” to improve access and service delivery
What Evidence do you have that your Innovation works?
Clean Birth Kits can play an important role in a post-MDG world.
Impact on adherence to clean birth practices (1)
Use of the CDK was associated with better compliance with antenatal care and a variety of infection control practices, including use of clean delivery surface, clean hands, clean perineum, clean umbilical stump tying, and subsequent care
Kit users at the facility were significantly more likely to have appropriately washed the mother's perineum and to have used a sterile cover for the umbilical stump as compared with non-kit users
Impact on neonatal and maternal outcomes (2)
Clean birth practices in a facility were estimated to reduce mortality from neonatal infections by a median of 27 percent and from tetanus by 38 percent.
On average, clean birth kit use has been associated with a 48 percent relative reduction in neonatal mortality – difference largest in India, which saw a 57 percent relative reduction
Clean birth practices with a skilled attendant were estimated to reduce maternal mortality from sepsis by a median of 35% at home and 55% in a facility
By ensuring clean birth practices at the time of childbirth, approximately 108,300 lives could be saved per year at cost per life saved of $215 to $921.
(1) Balsara, Z P, M H Hussein, P J Winch, R. Gipson, M. Santosham, and G L Darmstadt. "Impact of Clean Delivery Kit Use on Clean Delivery Practices in Beni Suef Governorate, Egypt." Journal of Perinatology J Perinatol (2009): 673-79. Web. 16 July 2015. http://www.nature.com/jp/journal/v29/n10/full/jp200980a.html.
(2) Blencowe, Cousens, and L.M. Anne CC Lee, Kate Kerber, Steve Wall, Gary Darmstadt, Joy E Lawn, Hygienic birth and newborn care practices to reduce neonatal deaths from sepsis and tetanus. A review for LiST effectiveness supplement. In press 2010.
(3) Wellcome Trust, Clean delivery kits linked to substantial reduction in neonatal death in South Asia. 2012
Customers: Health Institutions (targeting the private sector and public-private partnerships)
Product Users: Healthcare workers and skilled birth attendants
Target Beneficiaries: Women of reproductive age and newborns
What is your strategy for expanding use of your innovation?
MODEL REPLICATION: Building on our proven model, ayzh is currently exploring growth and scaling for Janma by building a strong manufacturing base and creating “expansion hubs” for regional marketing and production. We intend to replicate our existing production and distribution facility (currently based in Chennai) across India as a way to increase our production capacity and reach, as well as create additional employment and economic opportunity for local Indian women.
NEW PRODUCT DEVELOPMENT: ayzh intends to continue creating “extension products’ to Janma to seamlessly target the reproductive, maternal, child, newborn and adolescent health (RMNCAH) continuum. Extention products include kits targeting newborn health and hygiene around newborn care, post-partum care of the mother, and menstrual management. Through our brand and products, we aim to build demand for health and hygiene from the onset of a woman’s first period all the way through childbirth and care of children through the age of five.
NEW MARKET EXPLORATION: In addition to our intention of establishing a more formal presence in Africa (where 30 percent of Janma sales happen), ayzh is also exploring opportunities for “reverse innovation” in under-served developed world markets, where we see opportunity for our products to prevent infection, promote good communication between health worker & mother, and add more simplicity and dignity to childbirth and transition to newborn care.
ayzh is in a "transition to scale" phase and preparing to raise its next round of investment. Over the next 24 months we intend to use this investment to:
Build internal sales team capacity
Pilot our expansion (model replication model) as pathway to scale
Conduct rigorous impact assessments
Expand our training platform as a value‑added service for Janma (targeting mothers and healthcare workers)
Commercialize at least two new extension products of Janma.