The first results of the implementation in Malawi

June 2023

In January 2023, we implemented IMPALA systems at St. Lukes Hospital in Zomba, Malawi. This is the first hospitals where our systems are used outside of a research setting. Our colleagues from Malawi, together with AMREF Malawi and the hospital staff, compared the results of the past period with the results of the same period a year earlier, when the hospital did not yet have IMPALA systems. We are very proud of these first results and we would like to share them with you.

In the pediatric ward, we achieved an outstanding 61.7% reduction in mortality (p-value 0.05) and a remarkable 26% reduction in admission time (p-value 0.09). The data from the nursery did not show a relevant difference in mortality. Despite that the increasing usage and positive user feedback make us believe that we will find a positive change over time. These findings align with early evidence from the IMPALA study and highlight the potential impact of our intervention.

But what does this really mean? Let's talk cost-effectiveness, the ultimate measure of value in healthcare interventions. Our analysis reveals that the cost per life-year saved is approximately $5. (seriously, not a typo) To put it into perspective:

- Vaccines for childhood diseases: $30 per life year saved

- Oral rehydration therapy: $50 per life year saved

- Prevention of mother-to-child HIV transmission: $80 per life year saved.

And guess what? The Netherlands sets the threshold for a new intervention at $80,000 per life year saved.

It's important to note that this analysis only considers the direct costs of our intervention, without factoring in potential cost savings in healthcare delivery and long-term outcomes. By reducing morbidity and shortening admission time, we have the potential for even greater savings. There's even a serious chance that the savings will outweigh the costs of the system itself.

Of course we acknowledge that it's still early to make sweeping claims based on this first pilot. At the same time, there are also good reasons to believe that we will be able to deliver on the potential as this was the first pilot and we are improving on both implementation and technology. (In other words: we are only getting started!). And honest truth - Even if we achieve half of what our pilot showed now, we are still the happiest people on earth.