GOAL 3 health worker using IMPALA monitor in a hospital ward
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Empowering Health Workers

From reactive care to proactive care in low-resource hospitals.

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GOAL 3 hospital ward context

01 · Contents

Table of Contents

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GOAL 3 hospital ward context
02

Overview of GOAL 3

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​The Plan at a Glance

The problem: lack of resources in hospital settings

Maternal and under-5 mortality remains high in low-resource hospitals with >50% of 5 million global pediatric deaths attributable to substandard care. Root causes are extreme staffing constraints and lack of adequate equipment leading to reactive care. Because deterioration is recognised late, treatments are more costly and time consuming forcing health workers into a vicious cycle of reactive care with increased workloads and inefficient use of scarce resources.

The solution: optimization of current resources through improved technology

GOAL 3 supports frontline health workers to shift from reactive to proactive care through the IMPALA system. IMPALA is a fit-for-context patient monitoring device combined with a data platform that provides a central patient overview, clinical support applications and data dashboards. IMPALA uses robust infrastructure with a battery backup and local networks and is provided with a service model to drive uptime, adoption, and continuous improvement.

Our progress: 45 hospitals & 700+ monitors

GOAL 3 is active in 45 hospitals with 700 monitors+ in Malawi, Rwanda, Tanzania, Kenya and Zimbabwe with 85% have signed service contracts. Scale-up plans are underway with national governments in Malawi and Rwanda. Another 25 hospitals are already funded to be installed.

Our evidence: 40–51% reduced pediatric mortality

In studied settings, IMPALA is associated with: (i) high user acceptance and willingness to continue. with 98% of healthworkers recommending IMPALA, (ii) self-reported time spent on monitoring reduced by 45% from 3.3. to 1.8 hrs (iii) 40-51% reduced paediatric mortality in Malawi (adjusted before–after), (iv) 26-47% reduced critical illness events, and (v) In a cost-effectiveness analysis IMPALA costed $2.90 per patient and led to $10.50 in cost savings in health expenditure and $28.50 cost-savings in societal costs compared to standard of care.

Low-resource hospital ward
03

The Problem

A reactive cycle of care driven by staff shortages, broken equipment, and fragmented systems.

Problems and Challenges

The Problem

Each year, 2,7 million African children die before the age of five, representing 58% of global under-five mortality. More than half of these deaths are attributable to substandard care: children who reach the health system but do not receive the right care in time.

Similarly, 82% of pregnant women deliver in health facilities, yet mortality remains high at 453 per 100.000 live births, causing 182.000 annual deaths. This represents 70% of global maternal mortality and a 1 in 66 lifetime risk for African women to die from pregnancy-related complications.

The vast majority of these deaths are caused by acute conditions which, if recognized and managed in time, can be treated effectively at low cost.

The challenge: a reactive cycle of care

1
Limited time due to staff shortages
Nurse to patient ratios of 1:20 in HDU compared to WHO recommended 1:2.
2
Poor monitoring and risk assessment; respond late to patient deterioration
Estimated that 40–70% of medical equipment is not functioning or used within 2 years
4
Increased workload & decreased quality of care
Staff face mounting pressure as deteriorating patients demand more intensive, reactive intervention.
3
Increased emergency care; poor patient outcomes; increased costs
Every hour delay mortality rate rises by 10% in conditions like sepsis
5
System/market failure

Procurement and financing are often fragmented and device-focused, rather than designed around sustained uptime and adoption. Even effective technologies struggle to scale because implementation and service models are under-designed relative to real constraints (staffing, connectivity, supply chains, and training capacity).

IMPALA in use with health worker and patient
04

Our Solution

A bundled intervention combining product, service, and delivery model.

What we do

Product, service and delivery, built for impact.

GOAL 3 delivers a bundled intervention combining product, service, and delivery model — designed for the realities of under-resourced hospitals, not retrofitted from high-income settings.

IMPALA product

Fit-for-context patient monitoring and an offline-first clinical support system that provides a multi-patient overview and supports structured monitoring workflows.

Service model

Training and onboarding (including local champions), uptime and maintenance support, adoption support, and data-driven quality improvement dashboards. The service layer is designed to maintain performance in routine conditions, not only in pilots.

Delivery model

Implementation in partnership with hospitals, governments, and NGOs, leveraging existing health system structures for operations, training, and scale-up.

Hybrid financing model

To overcome affordability barriers and market failure, third parties fund upfront CAPEX (equipment and initial deployment), while local providers/governments pay recurring service fees to sustain operations. Over time, recurring revenue plus volume is intended to improve cost-to-serve efficiency and strengthen local sustainability.

Theory of change

IMPALA monitor in use on a hospital ward
05

IMPALA

A closer look at our 3-part ward-level monitoring and clinical support solution.

IMPALA

A 3-part ward-level monitoring and clinical support solution

IMPALA combines fit-for-context patient monitoring, clinical support software, and long-term service support to help health workers detect deterioration earlier, prioritize care, and sustain adoption in low-resource hospitals.

IMPALA Monitor product close-up
01

IMPALA Monitor

A continuous vital sign patient monitor that unburdens health workers and brings focus at the right moment.

Central Patient Overview showing multiple patients
02

IMPALA Platform

A Central Patient Overview, Clinical Support Application, and Data Dashboards that enable health workers to monitor and prioritize patient care.

GOAL 3 training and implementation session
03

IMPALA Care

A comprehensive service package to ensure reliable, sustainable, and increasing value.

01 — IMPALA Monitor

The IMPALA Patient Monitor

Designed for low-resource settings

A continuous vital sign patient monitor that unburdens health workers and brings focus at the right moment.

IMPALA Monitor product close-up

Ensure patients are always monitored, regardless of external conditions

  • ●10 hour battery life, resilient against power fluctuations
  • ●Durable casing to protect it from UV-light and impacts
  • ●Heat resistant up to 45 degrees
  • ●Dust and insect resistant
Vital signs monitored: HR, RR, SpO₂, NiBP, Temp

Reduce alarm fatigue with a decrease in unnecessary alarms by up to 54%

  • ●5 pediatric alarm thresholds and 1 for adults
  • ●Integrated automated PEWS score
02 — IMPALA Platform

Clear visibility. Confident decisions. Better care over time.

The IMPALA Platform brings together Central Patient Overview, Clinical Support Application, Data Dashboards, and local infrastructure to support ward-level care.

Faster Triage: With >90% health workers reporting improved efficiency

  • Color system stratifies patients according to risk
  • Patient avatars make it easy to see exactly what is wrong with the patient
  • Continues to work without power due to on-premise server with a 24hr battery life

Know the full patient story (not just snapshots)

  • Patient History for up to 7 days
  • Log clinical interventions on the patient
  • Built in PEWS automated scoring

Improve patient care over time

  • Monitor usage and uptime
  • Number of patients monitored
  • Top indications
  • Discharge outcomes
  • Length of stay
Central Patient Overview showing patient risk stratification and prioritization across the ward.
03 — IMPALA Care

Service and support for sustainable success

IMPALA Care is a comprehensive service package that helps hospitals implement, adopt, maintain, and continuously improve the value of IMPALA.

GOAL 3 training and implementation session

Supporting staff

  • ●E-learning (monitor use + clinical)
  • ●Staff onboarding tools
  • ●75$ credit for consumables/monitor

System uptime

  • ●Installation and implementation support
  • ●Remote troubleshooting
Health worker reviewing the IMPALA dashboard
06

Impact & Evidence

Saving lives, time, and costs.

Evidence

Saving lives, time, and costs.

0
patients with improved care annually
0
hospitals
0
IMPALAs
0
health workers trained
0
estimated annual lives saved
Mortality

27–51% reduction in mortality

In pediatric care, mortality reduced by 40–51%. In neonatal care, mortality reduced by 20–27% over 12 months in separate studies in Tanzania and Rwanda. Critical illness events were reduced by 29–32%.

Cost

Reducing health expenditure

The IMPALA monitoring system costs $2.90 per hospitalized patient. IMPALA reduced direct medical, direct non-medical, and indirect costs in two hospitals in Malawi.

Time & wellbeing

45% reduction in monitoring time

Time spent on monitoring reduced from 3.3 to 1.8 hours. 92% of health workers report reduced stress levels. 98% would recommend IMPALA to others.

Mother and child — human story behind the evidence
07

Impact Stories

Human stories behind the evidence.

Voices from the ward

Impact in their own words

Oscar — Nurse, Zomba Hospital, Malawi

Oscar

Nurse, Zomba Hospital, Malawi

While on duty in the Pediatric Ward, we received a 3-year-old child presenting with a Blantyre Coma Score of 3/5. The child had been treated for hypoglycemia and was diagnosed with severe malaria. Upon admission, the patient was transferred to the High Dependency Unit (HDU) for continuous monitoring using the IMPALA system.

A few hours later, while seated at the nurses’ station, an emergency alert appeared on the patient overview dashboard, the child’s heart rate was critically high, and oxygen saturation was dropping despite being on oxygen therapy.

We immediately rushed to assess the child. On the monitor, both ECG and SpO₂ waveforms appeared normal, but the Perfusion Index was alarmingly low (0.1). This guided us to assess for shock and anemia. Our assessment confirmed both: the child was in shock and had a hemoglobin level of 5 g/dl.

A quick and life-saving decision was made to initiate blood transfusion. Shortly after transfusion, the heart rate began to stabilize, and oxygen saturation improved significantly. By the next day, the child was fully alert (BCS 5/5), the feeding tube was removed, and the patient was almost ready for discharge, just kept for another 24 hours of observation.

"Thanks to the IMPALA continuous monitoring system, we detected deterioration early and acted immediately, saving a young life that could have been lost without real-time alerts."
Ellen — Nurse, Queen Elizabeth Central Hospital, Malawi

Ellen

Nurse, Queen Elizabeth Central Hospital, Malawi

While on duty in the pediatric ward, Ellen was moving between patients during a typically busy morning shift. Care was ongoing, and the team was managing multiple cases simultaneously.

During this time, an IMPALA alert was triggered. Ellen turned back to review the monitor. The pulse rate of a 2-month-old infant had risen sharply to 310 beats per minute.

Routine activity paused, and attention shifted immediately to the patient. The team gathered at the bedside, initiated assessment, and began urgent interventions. Care was escalated in response to the critical change in vital signs.

"It was that alarm that saved that baby."
GOAL 3 patient care — thank you
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08 · Thank You

Together, we can raise the standard of care.

Partner with GOAL 3 to help empower health workers and transform patient outcomes.

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