When Jeffrey Stringer was in the middle of his medical program at Columbia Presbyterian Hospital in the mid-1990s, one of his patients died. She was surrounded by her grieving family, and Stringer could feel their pain. He shared what happened with his chief resident, the sadness on his face palpable.“Come with me,” she said.
She led Stringer down the long hospital corridors until they arrived at a large window. On the other side were numerous newborn babies, their faces still pink and crinkly.
“It was a circle of life moment,” Stringer says. “It was so renewing to see new life. And I decided I’d rather be on that side of medicine.”
Since then, Stringer has delivered hundreds of babies — including his second child, Wilson.
“It’s just magical,” he says, smiling.
Today, he is an obstetrician and gynecologist (OB-GYN) within the UNC School of Medicine, where he also leads the Global Women’s Health division. This group of more than 150 clinicians, researchers, and public health practitioners are actively addressing women’s health issues around the world. They tackle a range of topics from birth outcomes to contraception to HIV prevention.
Stringer, specifically, is interested in capturing better obstetric ultrasounds. These exams enable health care providers to determine how far along a pregnancy is, assess whether the baby is developing properly, and identify any potential risks.
He and his team are developing a portable ultrasound device that plugs into a phone or tablet and uses artificial intelligence (AI) to interpret the scans captured. This reduces the need for a large, high-end ultrasound machine, which can cost upwards of $40,000, and trained sonographers and radiologists — all of which can be hard to come by in many places around the world including rural parts of the U.S. Nearly 65% of people in North Carolina, for example, live in areas lacking access to primary care physicians — so this technology could make a big difference for small clinics.
“My lifelong goal is to build something that’s going to improve health care for women around the world,” he says. “I think this technology could be transformative.”
Impact Report
Nearly 65% of North Carolinians live in areas lacking access to primary care physicians and trained technicians. A portable ultrasound device could help monitor pregnancies in this region and beyond.
Federal funding helps push projects like this forward. Foundational funding for the UNC Global Women’s Health division comes from the National Institutes of Health.
A late bloomer
Stringer is very open about the fact that it took him eight years to earn his undergraduate degree. Even though he was raised by two college professors — his dad taught English and his mom music — he struggled to find his footing.
“I was just too immature, didn’t study much, and wasn’t very serious about it,” he admits. “I actually dropped out for a couple of years and was working on my own. Once I was responsible for myself, I figured I probably should return to classes and study.”
Jeffrey Stringer (photo by Alyssa LaFaro)
In the late 1980s, Stringer went back to college and settled on a degree in English. He enjoyed reading Shakespeare and discussing the human condition in the many humanities classes, like philosophy and history, he took as part of his major. When thinking about the future, he saw throughlines from his readings and conversations to health care — and decided he wanted to pursue medicine.
“I think the humanities provide insights into human beings and how we interact with each other,” he says. “They encourage us to see people as multi-dimensional, complicated human beings with conflict and simultaneously good and bad characteristics. I think that’s really important to the care of patients. They are complex human beings, and we have to consider all those different aspects.”
Upon graduation, Stringer enrolled into the medical program at Columbia University. After finishing his degree in 1995, he became a resident within the obstetrics and gynecology program at the University of Alabama at Birmingham. This is where he’d meet his wife, Elizabeth — also an OB-GYN — and where he’d deliver his son Wilson because their doctor was seeing patients in clinic.
“Our doctor was a notoriously well-dressed woman who would wear these stilettos,” Stringer recalls. “She was running from clinic to try to meet Elizabeth in time, and she didn’t make it. So the nurse turned to me and said, ‘Well, you can deliver this baby or I’ll do it, but one of us has got to do it.’ So I put on the gown and delivered him.”
A global health advocate
In 2001, just three months after Wilson’s birth, Stringer and his family moved to Lusaka, Zambia. At the time, he felt he needed a change. He found himself reflecting on his residency, when he had the opportunity to work on an HIV research project in Thailand.
“I wanted to work in places where patients really needed me, where it would make a big difference,” Stringer says. “And I realized that I could probably make a career in global health. At that time, there were very few OB-GYNs doing that kind of thing.”
In Zambia, he collaborated with the government to implement a pilot project focused on mother-to-child HIV transmission. Eventually, it grew and transformed into the Centre for Infectious Disease Research in Zambia (CIDRZ), a non-governmental health organization focused on improving health care access through research and public health programs.
As CIDZR continued to expand, Stringer saw fewer patients and dug his heels into being the organization’s CEO, spending most of his time managing staff, forming partnerships, and writing grants. What was intended to be a one-year research project in Zambia became 11 years of life for Stringer and his family. By 2012, CIDZR employed over 700 people and brought in over $30 million per year in funding for research, training, and clinical work.
During this time, Stringer uncovered a major barrier to care for pregnant women: access to ultrasounds. They were available at private — and pricy — facilities, but not public health clinics. The machines were too expensive, there weren’t enough trained sonographers to do the scans, and there were even fewer radiologists to interpret them.
This stayed with Stringer as he transitioned back to the states in 2012, when UNC-Chapel Hill recruited him and 30 of his team members to create the Global Women’s Health division.
“We came here because of the excellent global health program, school of public health, and OB-GYN department,” he shares. “We felt like it would be a place where we could really thrive.”
A tech innovator
Since returning to the U.S., Stringer has taken advantage of recent innovations in ultrasound to build better machines and techniques. For example, portable probes — handheld devices that send sound waves into the body and pick up the echoes to create images of a baby during pregnancy — have decreased in cost. And he wondered if there was a way to combine that technology with an AI-based app that could reduce the need for trained staff and doctors to conduct the scans in low-resourced countries.
Portable ultrasound probes like this one from Butterfly Network plug into smartphones and tablets, making the technology more accessible in remote areas. (photo by Alyssa LaFaro)
He assembled a team of clinicians, computer scientists, biostatisticians, and data scientists to get to work. Today, they’ve developed a suite of AI algorithms that can interpret a woman’s ultrasound scan. This technology has already undergone rigorous clinical trial testing for how well it can determine gestational age — or how long a person has been pregnant.
To do this, Stringer and his team spent years collecting ultrasound data from clinical trials. To date, they’ve uploaded over 21 million images to their AI model to train it to read sonograms accurately. While they’ve validated their AI model to determine gestational age, they’re testing others that can diagnose multiple births like twins and triplets, the baby’s orientation in the uterus, amniotic fluid levels, and abnormalities in the fetus and placenta.
The app can also track patients who visit a clinic multiple times, connecting their scans and storing them in the patient’s file, and it can sync data to either a private server or a cloud to comply with governmental regulations for patient privacy and data security. In addition to creating the AI models, Stringer’s team has developed protocols that allow untrained users to capture professional scans.
In collaboration with the UNC Gillings School of Global Public Health, they are implementing the app in public sector sites in Zambia to see how it works. They want to know if providers are using it, if patients like it, and how it affects flow and time in the clinic.
Stringer hopes to get FDA approval for the device by the end of 2025. While his focus has been on global health settings, he now sees how beneficial it could be across rural regions in the U.S.
“When you’re working in resource-limited settings, the solutions have to be smarter,” he says. “You have to think more creatively, and you have to make decisions based on what you do have available. This device could be a game-changer for women’s health.”