zika: bridging gaps between emergency response and health...
TRANSCRIPT
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Zika: Bridging Gaps between Emergency Response and
Health Systems Strengthening
Andrew J Gall Eric Baranick
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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
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Introduction
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USAID Applying Science to Strengthen and Improve Systems
The Virus
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Transmission Routes
Signs & Symptoms
Complications
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USAID Applying Science to Strengthen and Improve Systems
Interventions
Prevention Detection Treatment
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USAID Applying Science to Strengthen and Improve Systems
Care and Support
Healthcare Community & Social Support
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USAID Applying Science to Strengthen and Improve Systems
Global Spread of Zika
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USAID Applying Science to Strengthen and Improve Systems
Epidemic in the Americas
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Beginning of
ASSIST-Zika
Implementation
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USAID Applying Science to Strengthen and Improve Systems
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
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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
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USAID Applying Science to Strengthen and Improve Systems
Recap: October 2016
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• 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
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ASSIST-Zika Experience: Planning While Doing
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USAID Applying Science to Strengthen and Improve Systems
Emergency Response
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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
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USAID Applying Science to Strengthen and Improve Systems
USAID-ASSIST framework at health care facility
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Prevent Detect Treat
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USAID Applying Science to Strengthen and Improve Systems
Prevent
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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
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USAID Applying Science to Strengthen and Improve Systems
Detect
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Clinical Procedures
Manual for Zika Care and
management
Protocol for newborns
born with Congenital Zika
Syndrome
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USAID Applying Science to Strengthen and Improve Systems
Treat
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Protocol for psycho-emotional care for
pregnant women with suspected cases of Zika
Implement a Zika QI program
QI Coaches
QI Teams
Learning Sessions
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USAID Applying Science to Strengthen and Improve Systems
Linking to Health System Strengthening
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PDSA cycle
Family Planning
Antenatal care
Post partum care
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Disease Outbreak Scenario
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USAID Applying Science to Strengthen and Improve Systems
Preparing for the next Zika outbreak
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Discussion
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Final Thoughts