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IoT for Development: ColdTrace

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ColdTrace: Real-Time Data for Immunization and Beyond

When engineers tackle a complex problem, their first step is to gather lots of data. Take self-driving cars: What could be more challenging than teaching a car how to navigate a busy city full of obstacles? Engineers tasked with a problem like this start by figuring out how to collect enough data to help them understand the scale and scope of the challenge at hand, as well as to feed into machine learning tools. That’s why Tesla logs millions of miles of human driver data each day to seed their self-driving platform.

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ColdTrace helps health workers get safe, effective vaccines to kids.

Getting life-saving vaccines to every child on Earth is also a massively complex problem. Vaccines have to travel across continents and through difficult conditions in low-income countries, where basic infrastructure is inconsistent or missing. Then those vaccines have to be stored in remote health clinics, some with less than 8 hours of grid power a day. And they have to be kept at safe temperatures until they’re finally administered to kids.

When something goes wrong – a vaccine fridge doesn’t work right, or a clinic loses power – the vaccines stored there can be damaged or even destroyed. Those doses are then wasted, or worse, they’re unknowingly administered to kids despite the damage. And a recent WHO – UNICEF joint statement reveals that 55% of these health facilities have fridges that either perform poorly or don’t function at all. Mothers often travel many miles to make sure their babies get vaccinated. What could be worse than leaving those children unprotected?


Mothers often travel many miles to make sure their babies get vaccinated.
What could be worse than leaving those children unprotected?


Ministries of Health in low-income countries devote tremendous energy and resources to addressing these challenges. But without reliable data on how their vaccine systems are faring, too many problems remain hidden, and too few solutions emerge.

When we learned about the challenges of global vaccination, we realized that identifying solutions would be easier if we first collected more and better data. We set out to design a data-gathering solution that could also serve the dedicated health care professionals working on the ground. We prototyped early, iterated fast, and tested our device in the field over and over.

What's so bad about freezing?

Ever set your fridge too cold and wind up with ruined spinach? That’s because even a short time below freezing can damage the cell walls of delicate green veggies.

Vaccines contain biological material. They must be protected from extreme heat, but freezing can be far more damaging in a shorter period of time. That’s why the WHO says up to 10 hours of moderate heat exposure is okay, but just 60 minutes of freezing exposure is considered potentially destructive to vaccine doses.

 

Our solution, ColdTrace, is a real-time monitoring and data analytics platform that turns any vaccine fridge into a “smart” fridge. If the temperature inside the fridge gets dangerously hot or cold, ColdTrace sends a text message to a nurse who works at the clinic. She can then take action to preserve vaccines, such as checking the latch on the fridge door, or turning on the generator.

ColdTrace gathers real-time data on vaccine fridge temperature and power availability and uploads that data continuously via whatever cellular networks are available, from 2G to 4G. The device can also store data for up to a year, in the event of connectivity disruption. The data gets analyzed in the cloud and displayed on a secure website.

When ColdTrace started sending real-time text message alerts, nurses in clinics responded enthusiastically. Our data shows that, when vaccine fridges call for help, nurses take action to protect vaccines. Text alerts alone reduced vaccine freezing in health clinics by 74%.

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But despite the success of real-time alerts to nurses, many chronically broken fridges kept on failing. Fortunately, ColdTrace data revealed the best path forward for many of those fridges as well. From our offices in Los Angeles, we could suggest the cause of a broken fridge in Africa, just from observing patterns in the data. Two of these Temperature Data Signatures for specific fridge failure types emerged: “incorrectly adjusted thermostat” and “flat solar battery.” For more information on these specific fridge failure scenarios, please see our data-driven report from our collaboration with the Mozambique Ministry of Health and our partner VillageReach, entitled “RTM Data for Maintenance.”

Without real-time data from the ColdTrace dashboard, the overworked regional technician would have no visibility into these problems. Even if clinic workers detected the failure and notified the regional technician, a simple problem would require at least two visits – one for diagnosis and one for repair – which cash-strapped Ministries of Health cannot afford.


What’s more: several fridges were also remotely fixed.


Thanks to ColdTrace data and Temperature Data Signatures, many chronically failing fridges were diagnosed remotely by the regional technician in Mozambique, without a field visit. What’s more: several fridges were also remotely fixed. The technician was able to lead the nurses on site through detailed actions to fix the fridges over the phone. And after each call, the technician could monitor ColdTrace data from the clinic on the dashboard to verify that the fridge had been fixed correctly. In the image below, data from the ColdTrace dashboard shows equipment performance before and after the technician fixed fridges remotely over the phone.

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Before & After Remote Fix

* What is Field Holdover Time?

“Holdover Time” is the amount of time a vaccine fridge is supposed to maintain safe temperatures after a power outage. Holdover Time for every fridge is established through lab testing and published by fridge manufacturers.

Nexleaf’s work has led us to introduce a new metric, which we call Field Holdover Time. Field Holdover Time is the average time a fridge deployed in the field maintains safe temperatures after a power outage. Field Holdover Time can be impacted by human behavior, ambient temperature, or other factors, so it’s a useful metric for Ministries of Health because it shows how the equipment performs in real world circumstances.

After gathering continuous data on fridge performance in clinics for over a year, it came time to report our findings to the Ministry of Health. We prepared a report for their budgetary and planning meetings that provided, for the first time, up-to-date information on:

  • Equipment inventory
  • Power availability in clinics
  • Fridge performance by make and model
  • Field Holdover Time* by make and model

Our report enabled the Ministry of Health to use data to plan and budget for vaccine refrigeration management, including new equipment, maintenance, and spare parts, for the upcoming year.

At Nexleaf, we believe in the power of data to change the world. To see that change through, we engage in data advocacy work to make sure that our analytics are understandable, useful, and utilized. Once data reveals unseen problems, we help our partners – such as Ministries of Health – understand and apply the new information, identify solutions, course-correct, and re-evaluate using the data. This program work is vital to transform traditional interventions into data-informed responsive interventions.

 


At Nexleaf, we believe in the power of data to change the world.
To see that change through, we engage in data advocacy work to make sure that our analytics are understandable, useful, and utilized.


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In 2016, Gavi, the Vaccine Alliance launched its INFUSE platform to identify and accelerate technology innovations designed to improve effective immunization. Through INFUSE and with funding from Google.org and Gavi, Nexleaf is working to bring the power of data to Ministries of Health, to ease the burden of vaccine system management, reveal unseen problems, answer questions, and address the most pressing challenges countries face as they strive to immunize all their children.

Solutions like ColdTrace are part of what’s often called the Internet of Things for Development (or “IoT for Development” for short). While these innovations and their applications are pretty different from the convenience-oriented “smart” devices currently changing our lives here in the US, we see plenty of similarities. The best IoT technologies serve individual users, like the nurses in clinics who respond to text alerts. A strong use-case is the gateway to generating the robust data needed to drive constant improvement at every level of the intervention. And robust data in the development sector means more transparency, greater flexibility, and better outcomes for everyone.

Nexleaf’s technologies and programs support 11 of the 20 Sustainable Development Goals. ColdTrace helps protect vaccines and improve immunization systems. Our StoveTrace platform addresses challenges in yet another global development sector: clean cooking. Click here to find out more about StoveTrace.

Nexleaf’s work is made possible thanks to generous support from and collaboration with our donors and partners.

SAMPLE: Report V1

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When engineers tackle a complex problem,

their first step is to gather lots of data. Take self-driving cars: What could be more challenging than teaching a car how to navigate a busy city full of obstacles? Engineers tasked with a problem like this start by figuring out how to collect enough data to help them understand the scale and scope of the challenge at hand, as well as to feed into machine learning tools. That’s why Tesla logs millions of miles of human driver data each day to seed their self-driving platform.

Enlarge

vaccinesJ-300x202
This is a caption

Getting life-saving vaccines to every child on Earth is also a massively complex problem. Vaccines have to travel across continents and through difficult conditions in developing countries, where basic infrastructure is unreliable or missing. Then those vaccines have to be stored in remote health clinics, some with less than 8 hours of grid power a day. And they have to be kept at safe temperatures until they’re finally administered to kids.

When something goes wrong – a vaccine fridge doesn’t work right, or a clinic loses power – the vaccines stored there can be damaged or even destroyed. Those doses are then wasted, or worse, they’re unknowingly administered to kids despite the damage. And a recent WHO – UNICEF joint statement reveals that 55% of these health facilities have fridges that either perform poorly or don’t function at all. Mothers often travel many miles to make sure their babies get vaccinated. What could be worse than leaving those children unprotected?

 

Mothers often travel many miles to make sure their babies get vaccinated. What could be worse than leaving those children unprotected?

 

Ministries of Health in low-income countries devote tremendous energy and resources to addressing these challenges. But without reliable data on how their vaccine systems are faring, too many problems remain hidden, and too few solutions emerge.

When we learned about the challenges of global vaccination, we realized that identifying solutions would be easier if we first collected more and better data. We set out to design a data-gathering solution that could also serve the dedicated health care professionals working on the ground. We prototyped early, iterated fast, and tested our device in the field over and over.

 

We prototyped early, iterated fast, and tested our device
in the field over and over.

What’s so bad about freezing?

Ever set your fridge too cold and wind up with ruined spinach? That’s because even a short time below freezing can damage the cell walls of delicate green veggies.

Vaccines contain biological material. They must be protected from extreme heat, but freezing can be far more damaging in a shorter period of time. That’s why the WHO says up to 10 hours of moderate heat exposure is okay, but just 60 minutes of freezing exposure is considered potentially destructive to vaccine doses.

 

Our solution, ColdTrace, is a real-time monitoring and data analytics platform that turns any vaccine fridge into a “smart” fridge. If the temperature inside the fridge gets dangerously hot or cold, ColdTrace sends a text message to a nurse who works at the clinic. She can then take action to preserve vaccines, such as checking the latch on the fridge door, or turning on the generator.

ColdTrace gathers real-time data on vaccine fridge temperature and power availability and uploads that data continuously via whatever network is available: 4G, 3G, 2G, or cellular. (The device can also store data for up to a year, in the event of connectivity disruption.) The data gets analyzed in the cloud and displayed on a secure website.

When ColdTrace started sending real-time text message alerts, nurses in clinics responded enthusiastically. Our data shows that, when vaccine fridges call for help, nurses take action to protect vaccines. Text alerts alone reduced vaccine freezing in health clinics by 74%.

IMG_8978@03x.jpg

But despite the success of real-time alerts to nurses, many chronically broken fridges kept on failing. Fortunately, ColdTrace data revealed the best path forward for many of those fridges as well. From our offices in Los Angeles, we could correctly guess the cause of a broken fridge in Africa, just from observing patterns in the data. Two of these Temperature Data Signatures for specific fridge failure types emerged: “incorrectly adjusted thermostat” and “flat solar battery.”

* What is Field Holdover Time?

“Holdover Time” is the amount of time a vaccine fridge is supposed to maintain safe temperatures after a power outage. Holdover Time for every fridge is established through (independent?) lab testing and published by fridge manufacturers.

Nexleaf’s work has led us to introduce a new metric, which we call Field Holdover Time. Field Holdover Time is the average time a fridge deployed in the field maintains safe temperatures after a power outage. Field Holdover Time can be impacted by human behavior, ambient temperature, or other factors, so it’s a useful metric for Ministries of Health because it shows how the equipment performs in real world circumstances.


 

Without real-time data from the ColdTrace dashboard, the overworked regional technician would have no visibility into these problems. Even if clinic workers detected the failure and notified the regional technician, a simple problem would require at least two visits – one for diagnosis and one for repair – which cash-strapped Ministries of Health cannot afford.

Thanks to ColdTrace data and Temperature Data Signatures, many chronically failing fridges were diagnosed remotely, without a technician field visit. What’s more: several fridges were also remotely fixed. The technician was able to lead the nurses on site through detailed actions to fix the fridges over the phone. And after each call, the technician could monitor ColdTrace data from the clinic on the dashboard to verify that the fridge had been fixed correctly.

After gathering continuous data on fridge performance in clinics for over a year, it came time to report our findings to the Ministry of Health. We prepared a report for their budgetary and planning meetings that provided, for the first time, up-to-date information on:

  • Equipment inventory
  • Power availability in clinics
  • Fridge performance by make and model
  • Field Holdover Time* by make and model
DDR_010_NL-MOH@03x.jpg

Enlarge

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This is a caption

Our report enabled the Ministry of Health to use data to plan and budget for vaccine refrigeration management, including new equipment, maintenance, and spare parts, for the upcoming year.

At Nexleaf, we believe in the power of data to change the world. To see that change through, we engage in data advocacy work to make sure that our analytics are understandable, useful, and utilized. Once data reveals unseen problems, we help our partners – such as Ministries of Health – understand and apply the new information, identify solutions, course-correct, and re-evaluate using the data. This program work is vital to transform traditional interventions into data-informed responsive interventions.

 
 

At Nexleaf, we believe in the power of data to change the world. To see that change through, we engage in data advocacy work to make sure that our analytics are understandable, useful, and utilized.

 

In 2016, Gavi, the Vaccine Alliance, launched its INFUSE platform to identify and accelerate technology innovations designed to improve effective immunization. Through INFUSE, Nexleaf built a partnership with Gavi. With funding from Google.org, we are now working to build a global analytics tool that will aggregate fridge data from all around the world. This tool, designed to serve Ministries of Health, will ease the burden of vaccine system management, reveal unseen problems, answer questions, and address the most pressing challenges countries face as they strive to immunize all their children.

Solutions like ColdTrace are part of what’s often called the Internet of Things for Development. While these innovations and their applications are pretty different from the convenience-oriented “smart” devices currently changing our lives here in the US, we see plenty of similarities. The best IoT technologies serve individual users, like the nurses in clinics who respond to text alerts. A strong use-case is the gateway to generating the robust data needed to drive constant improvement at every level of the intervention. And robust data in the development sector means more transparency, greater flexibility, and better outcomes for everyone.

Nexleaf’s technologies and programs support 11 of the 20 Sustainable Development Goals. ColdTrace helps protect vaccines and improve immunization systems. Our StoveTrace platform addresses challenges in yet another global development sector: clean cooking. Click here to find out more.

Nexleaf Data in the Journal Vaccine

A research paper co-authored by Nexleaf’s ColdTrace Program Director Shahrzad Yavari is featured in a special edition of the journal Vaccine, “Building Next Generation Immunization Supply Chains.”

With partners PATH and VillageReach, Nexleaf conducted small-scale studies to evaluate the performance of vaccine cold chain equipment (CCE) in Uganda and Mozambique and to unearth underlying causes for equipment failures. By monitoring eighty-six failing refrigerators and freezers in selected locations, the project teams acquired revealing, actionable information that led to immediate and long-term vaccination systems improvements. This is an exciting example of how collaborative efforts to systematically collect and communicate data can improve the efficiency and reach of immunization programs in low- and middle-income countries.

Read the full paper.

Learn more about our ColdTrace program.

Google.org & Gavi Announce Partnership with Nexleaf

Gavi has announced a partnership with Google.org, with a matching donation contributed by the Bill and Melinda Gates Foundation, to work with Nexleaf to help countries to make evidence-based decisions on the purchase and maintenance of vaccine refrigerators. Nexleaf will contribute tech development and analytics know-how, as well as lessons learned from our years working on the ground in countries. Nexleaf’s data and analytics tools are designed to engage vaccine delivery stakeholders at every level, from nurses in the clinics all the way up to national Ministries of Health, to maximize performance of the critical equipment that forms the foundation of immunization systems. This new partnership will capitalize on everything that real-time data can do to improve vaccination system strength around the world. Read more from Gavi here.

The Financial Times Features Nexleaf’s StoveTrace Program

An article and video featured in the Financial Times address Nexleaf’s StoveTrace program in Notarpalli, a rural village in India. Following an eight-month trial, in which Nexleaf provided villagers with modern, clean cookstoves with attached data-monitoring devices, Notarpalli has experienced full adoption of clean cookstoves.

By analyzing data collected from the monitoring devices, Nexleaf was able to identify problems associated with the stoves and provide impactful solutions to ensure integration of the stoves into daily life.

Read the full article to learn how Nexleaf’s StoveTrace program is affecting rural communities.

Click here to learn more about StoveTrace.

Nature Climate Change Highlights the Power of Nexleaf Data

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Rural Women in India Gain Access to Climate Financing with Nexleaf’s StoveTrace Technology

An article published in Nature Climate Change this week demonstrates how data from Nexleaf’s StoveTrace platform is helping break down barriers to achieving safe, clean, modern energy access for all.

The method described in the article, which is called Sensor-Enabled Climate Financing (SCF), brings together cutting-edge climate science, rugged StoveTrace wireless sensors, and market-based mechanisms to make clean cooking affordable for the poorest 3 billion. With this method, a rural woman receives a small loan to procure a clean cookstove. StoveTrace sensors then collect real-time data on her cookstove usage, and the woman receives usage-based payments from a climate fund for the carbon emissions she mitigates by using the clean cookstove. The SCF method enables even extremely low-income women to afford clean cookstoves.

Nexleaf gathered the clean cookstove usage data featured in the Nature Climate Change article from very low-resource areas of Odisha, India, where there is little modern infrastructure. “We’ve been working on this problem since we started,” says Martin Lukac, CTO of Nexleaf. “We struggled to build a robust sensor. Our early probes burned off. But we knew it was important to get data flowing in these remote areas, to connect rural women to climate financing, and also to make sure that the clean cookstoves continue to work for the women over time.”

As a non-profit organization grounded in field engagement, Nexleaf strives to create low-cost technology and data analytics tools that address the needs of people living and working on the front lines of global public health and climate change. “Connecting women to climate financing gives them a way to afford to pay for their clean cookstove,” says Tara Ramanathan, StoveTrace Program Director at Nexleaf and primary author of the Nature Climate Change article.  “They become actively engaged in the cookstove value chain, improve their quality of life, and protect the planet.”

A view-only copy of the full text of the article can be accessed here.

SCF was developed by Project Surya, an international collaboration among the University of California at San Diego, Nexleaf Analytics, and The Energy and Resources Institute of Delhi. Project Surya partners tested the SCF model in 4,038 Indian households with funding from Leslie & John “Mac” McQuown. Nexleaf’s first StoveTrace funder was Qualcomm Wireless Reach, which continues to support the program. StoveTrace has also received support from Beneventures Foundation, Mulago, The World Bank, Ellen Lehman & Charles Kennel, Joy & Ed Frieman, and Henning Rodhe.

Learn more about Nexleaf’s StoveTrace program here.

Nexleaf Data Enables Financial Inclusion for Rural Indian Women through Vodafone mPesa in Odisha

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Nexleaf’s StoveTrace platform, in collaboration with Vodafone M-Pesa, has enabled 22 women in rural India to begin receiving climate credits: payments made directly to women’s mobile phones every month in exchange for their climate stewardship. The purpose of this new program is to allow rural women to afford and to use the cleanest cooking technologies. Through introductory sessions, women are informed that the more they use clean cookstoves, the more money they will receive via payment to their mobile phones.

The StoveTrace platform allows for data calculation of household-level stove usage every month to measure exactly how much each woman should be paid for her clean cookstove use. This program was launched in Notarpalli village in Nayagarh District in Odisha, India. Nexleaf aims to get 1,000 women enrolled in the M-Pesa program by next year.

Nexleaf is partnering with several local NGOs to make this program possible: the Saunta Gaunta Foundation and Sambhav in Odisha, India, Hand in Hand in Tamil Nadu, India and the Renewable Energy Programme (RUWES) in Nigeria. Nexleaf Analytics wishes to extend a special thank you to our long-standing supporters: Qualcomm Wireless Reach, Leslie and Mac McQuown, and Beneventures Foundation for making this innovative program possible.

Click here to learn more about StoveTrace.

Nexleaf’s ColdTrace Is a Gavi INFUSE Pacesetter Technology

infuse-iconNexleaf’s ColdTrace innovation has been selected as one of seven Gavi INFUSE Pacesetters that will work with Gavi in its mission to increase access to immunization around the world. With its INFUSE initiative, Gavi seeks to identify the most promising technologies that improve vaccine access and efficacy in low-income countries, with particular emphasis on data-driven innovations. 60 companies and entrepreneurs applied to the program after it was announced at this year’s World Economic Forum; 18 projects were selected for a final round of pitching to evaluators from both private companies and international organizations like the World Health Organization (WHO) and UNICEF. The panel chose seven Pacesetters that will work with Gavi on scaling up their work and serving more countries.

Learn more about INFUSE Pacesetters from The Verge, and read more about ColdTrace here.

ColdTrace 5 Now Has WHO PQS Approval

ct_5ColdTrace 5 received Performance, Quality and Safety certification on July 20th, 2016 from the World Health Organization (WHO) and is now listed in the WHO’s PQS Catalogue as number E006/039. This certification is a significant step forward, as it gives national Ministries of Health an easier path to procuring and utilizing our ColdTrace technology to protect vital vaccines.

ColdTrace 5 is a wireless remote temperature monitoring (RTM) solution for refrigerators that are used to store vaccines and other temperature-sensitive products. The GSM-based ColdTrace 5 system goes far beyond temperature alerts and alarms. ColdTrace 5 also collects critical data and provides customizable analytics to empower health workers, inform country-wide maintenance strategy, and improve overall cold chain performance, resulting in a measurably increased ROI for immunization programs.

Nexleaf contributes chapter to Broken Pumps and Promises

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Based on work developed in partnership with Project Surya, Nexleaf published a chapter in the book Broken Pumps and Promises available at Springer.com. Co-authored by Tara Ramanathan, Nithya Ramanathan, and Erin Ross, Chapter 11 “Innovations in Payments for Health Benefits of Improved Cookstoves” discusses how results-based financing for improved cookstove usage financially empowers women in rural communities.