Adaptation of Essential Care for Every Baby Educational Program to Improve Infant Outcomes in the Context of Zika

Abstract

Background: The outbreak and ongoing transmission of Zika virus provided an opportunity to strengthen essential newborn care and early childhood development systems through assistance by US Agency for International Development Applying Science to Strengthen and Improve Systems (USAID ASSIST). There is an evidence gap on the impact of Helping Babies Survive educational programs, including Essential Care for Every Baby (ECEB), beyond early mortality. The objective was to create a system of sustainable training dissemination which improves newborn care-related quality indicators in the context of Zika.Methods: USAID ASSIST supported a series of technical assistance visits by the American Academy of Pediatrics (AAP) in four Caribbean countries to strengthen the clinical capacity in care of children potentially affected by Zika through dissemination of ECEB, teaching QI methodology, coaching visits, and development of clinical care guidelines. ECEB was adapted to emphasize physical exam findings related to Zika. The first series of workshops were facilitated by AAP technical advisors and the second series were facilitated by the newly trained local champions. Quality care was monitored with performance indicators at 134 health facilities.Results: A repeated measures (pre-post) ANOVA was conducted, revealing significant pre-post knowledge gains [F(1)=197.9, p<0.001] on knowledge check scores. Certain performance indicators related to ECEB practices demonstrated significant changes and midline shift on the run chart in four countries.Conclusion: ECEB can be adapted to incorporate important local practices, causes of neonatal morbidity and mortality, and differing healthcare system structures, leading to improved performance of health systems.

Dengue, chikungunya and zika arbovirus infections in Caribbean children

“…In Antigua and Barbuda, St Vincent and in the Grenadines, St Kitts and Dominica, neurodevelopmental stimulation of zika-exposed infants has been successful in improving language and positive behaviors. [70 ▪▪ ]. In Grenada, a controlled neurodevelopment stimulation intervention for ZIKV-exposed children who were born with normal head circumference and who were older than 2 years, showed subsequent improved language development and positive behaviors in preparation for school readiness [71 ▪▪ ].…”