Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7009, Cincinnati, OH, 45229-3026, USA.
University of Cincinnati College of Medicine, Cincinnati, OH, USA.
BMC Pediatr. 2022 Nov 21;22(1):669. doi: 10.1186/s12887-022-03710-7.
The outbreak and ongoing transmission of Zika virus provided an opportunity to strengthen essential newborn care and early childhood development systems through collaboration with the US Agency for International Development Applying Science to Strengthen and Improve Systems (USAID ASSIST). The objective was to create a system of sustainable training dissemination which improves newborn care-related quality indicators in the context of Zika.
From 2018-19, 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 Essential Care for Every Baby (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 of care was monitored with performance indicators at 134 health facilities.
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.
ECEB can be adapted to incorporate important local practices, causes of neonatal morbidity and mortality, and differing healthcare system structures, which, as one part of a larger technical assistance package, leads to improved performance of health systems.
寨卡病毒的爆发和持续传播为通过与美国国际开发署应用科学加强和改善系统（USAID ASSIST）合作加强基本新生儿护理和儿童早期发展系统提供了机会。目的是创建一个可持续的培训传播系统，以改善寨卡病毒背景下与新生儿护理相关的质量指标。
2018-19 年，USAID ASSIST 支持美国儿科学会（AAP）在四个加勒比国家进行了一系列技术援助访问，通过传播基本关爱每个婴儿（ECEB）、教授质量改进方法、辅导访问和制定临床护理指南来加强对可能受寨卡病毒影响的儿童的临床护理能力。ECEB 经过改编，强调与寨卡病毒相关的体格检查结果。第一系列研讨会由 AAP 技术顾问主持，第二系列研讨会由新培训的当地冠军主持。在 134 个卫生设施中，使用绩效指标监测护理质量。
进行了重复测量（前后）方差分析，结果显示知识检查得分的知识增益具有统计学意义[F(1) = 197.9，p < 0.001]。在四个国家，某些与 ECEB 实践相关的绩效指标在运行图表上显示出显著变化和中线偏移。
ECEB 可以进行改编，纳入重要的本地实践、新生儿发病率和死亡率的原因以及不同的医疗保健系统结构，作为更大技术援助一揽子计划的一部分，这将导致卫生系统绩效的提高。
