The SPOtwo Bootie

A low-cost, smart, wearable device, able to provide a reliable measurement and analysis of the vital signs of sick newborns in resource-poor environments.

What is it?

Each year, three million newborns die shortly after birth due to infection, congenital heart disease, and complications of preterm birth. Many of these at-risk newborns could be identified and saved using a wearable device that reliably obtains and assesses heart rate, respiratory rate, and blood oxygen saturation (SpO2). However, in many low-resource environments around the world, this assessment is not yet feasible, especially in the sick neonate with reduced blood perfusion, and thus young lives are needlessly lost.

Our idea it so create the SPOtwo Bootie, a low-cost, smart, wearable device, able to provide a reliable measurement and analysis of the vital signs of sick newborns in resource-poor environments. This simple yet effective device will combine a sensitive and validated pulse oximetry sensor and wearable bootie, a mobile phone app, and a cloud service.

Critical medical abnormalities will be rapidly identified in the field and immediate treatment recommendations will be provided. Additional data-driven diagnostic information will be provided by a cloud service. Emergency referral and transportation will be facilitated based on the diagnostic information.

How is it used?

The sensor bootie will be placed on the foot of the baby. The sensor will be plugged into the audio jack of a smartphone. The results of the test will be provided directly on the phone but also communicated to a cloud service and to other local health facilities if an abnormal result is obtained.

What technologies does it incorporate?

Reliable pulse oximetry is a significant engineering challenge in newborns. Movement artifact is common and sensors must have a lower surface area than in adults. Tissue blood perfusion is often low (and therefore harder to detect) and may change rapidly across disease states. Additionally, tissue blood flow in a tiny hand, finger, foot, toe or earlobe is easily affected by the application of pressure from even a relatively light sensor. The SPOtwo Bootie will overcome these challenges. It will incorporate a neonatal pulse oximetry sensor within a neonatal bootie (consisting of two light emitting diodes and a detector), as well as an accelerometer. Importantly, the sensors within the SPOtwo Bootie can be manufactured at the very low cost of approximately $10 CAD.

How does it work?

Using advanced signal processing, the pulse oximeter will provide a measure of oxygen saturation (SpO2), heart rate, pulse rate variability, pulse pressure variability and respiratory rate. The accelerometer will provide an objective measure of spontaneous muscle activity, as a measure of lethargy. Signals collected by the sensors will be transmitted to the phone for processing via a simple cord that will connect to any mobile device through the universally-available audio port, with no additional hardware needed. This technology is unique to our group, as we have developed and patented the process of creating the Phone Oximeter™, a series of mobile applications that incorporate a proprietary analog-to-digital AC-coupled bridging framework, called the Vital Signs DSP™. Via such technical innovations, and by leveraging the ubiquity of mobile devices and data networks in the developing world, the Phone Oximeter™ has radically reduced the cost of disease diagnosis, making the monitoring of vital signs accessible worldwide. The next important step is to produce a wearable sensor that will properly fit a newborn and produce reliable measurements despite their unique, fragile and technically challenging physiology.

Who uses it?

The first use case will be frontline health workers in low resource settings. They will use the SPOtwo Bootie to:
1. Identify low oxygen saturation immediately after birth, typically due to immature lungs, fluid in the lungs, or infection;
2. Identify newborns with congenital heart disease; and
3. Identify infants with severe infections in the first few weeks of life.

Why does it help?

1. Identification of low oxygen saturation at birth will allow for rapid oxygen administration to improve oxygenation. The specific cause can also be treated (e.g., antibiotics for infection) and rapid referral to health facilities can be arranged when required.
2. More than 40% of infant deaths occur in the first month of life. The majority of these are due to infection. The ability to combine the reliable measurement of vital signs such as oxygen saturation and heart rate with smart applications will allow for the early recognition of newborn infants at risk, in their own community. This will allow for immediate treatment and referral to health facilities.
3. Congenital heart diseases are the most common congenital anomalies. Low oxygen saturation or a difference in oxygen saturation between the hand and foot is now universally recommended for screening newborn infants for heart disease.


Team's Location


Team's Occupation


Team Members

Electrical and Computer Engineering in Medicine (ECEM) Research Group, University of British Columbia, J Mark Ansermino, Guy Dumont

Focus Area(s)


UNICEF Pillar(s)


These pages have been pulled directly from applications submitted to the Wearables for Good Challenge in 2015. They represent the work of the individual teams and have subsequently not been edited.


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