Zika: Bridging Gaps between Emergency Response and Health...

1

Zika: Bridging Gaps between Emergency Response and

Health Systems Strengthening

Andrew J Gall Eric Baranick

USAID Applying Science to Strengthen and Improve Systems

Session Learning Objectives

• Understand key challenges facing Zika

Response programs

• Identify core components of emergency

response and health systems strengthening

approaches

• Learn how quality improvement methodology

can be applied to health program planning

2

3

Introduction


The Virus

4

Transmission Routes

Signs & Symptoms

Complications


Interventions

Prevention Detection Treatment

5


Care and Support

Healthcare Community & Social Support

6


Global Spread of Zika

7


Epidemic in the Americas

8

Beginning of

ASSIST-Zika

Implementation


Assessment of Quality of Zika Health Services

• Healthcare providers were not properly

screening pregnant women for Zika

• Healthcare providers were not

consistently counseling women about

Zika during antenatal care sessions

• Healthcare providers were not providing

condoms to pregnant mothers during

antenatal care sessions

• Service users had low knowledge of

sexual transmission of Zika virus

• Service users had low knowledge of

condoms as a preventive measures

9

14.7%8.8%

2.4% 3.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Knowledge ofSexual

Transmissionof Zika

Knowledge ofCondoms asPreventiveMeasure

El Salvador N=116*

Guatemala N=206


Recap: October 2016

10

• Severe disabilities are being spread by mosquitos and sex

• Zika virus is a mystery; most cases are asymptomatic; there

is no vaccine; there is no treatment

• Zika is misdiagnosed as dengue or chikungunya; most

healthcare providers do not know how to screen for Zika or

complications; screenings for complications are inconclusive

• Knowledge of sexual transmission is extremely low; health

promotors tell couples to use condoms during pregnancy

11

ASSIST-Zika Experience: Planning While Doing


Emergency Response

12

Barriers to care

Vector control tools

Guidance and protocols

Risk communication

Emergency Response Center

Business Continuity

Laboratory standardization

Laboratory capacity

Surveillance

Engaging and mobilizing

communities

Capacity and worker

training

Health education


USAID-ASSIST framework at health care facility

13

Prevent Detect Treat


Prevent

14

Zika Curriculum for

university professors

Educational

Materials for Zika

Counseling and

psycho-emotional

care

Accredited course

on Zika-related

health care

0

500

1000

1500

2000

2500

3000

3500

4000

4500

Nov Dec Jan Feb March April May June

Health care providers trained

Monthly Total Cumulative


Detect

15

Clinical Procedures

Manual for Zika Care and

management

Protocol for newborns

born with Congenital Zika

Syndrome


Treat

16

Protocol for psycho-emotional care for

pregnant women with suspected cases of Zika

Implement a Zika QI program

QI Coaches

QI Teams

Learning Sessions


Linking to Health System Strengthening

17

PDSA cycle

Family Planning

Antenatal care

Post partum care

18

Disease Outbreak Scenario


Preparing for the next Zika outbreak

19

20

Discussion

21

Final Thoughts

Zika: Bridging Gaps between Emergency Response and Health...

Documents

Transcript of Zika: Bridging Gaps between Emergency Response and Health...