Preparing for Maternal and Child Health Crises with Lessons from the Zika Outbreak
July 23, 2024 | Maria Gabriela Ruiz, Ramya Dronamraju
Over the past decade, public health emergencies have challenged state and territorial health agencies but also offered valuable lessons to support future preparedness. The Zika virus outbreak, in particular, changed the landscape of emergency response by highlighting the urgent need for enhanced surveillance and data modernization, rapid response capabilities, and preventive measures to address infectious diseases and their impact on maternal and child health (MCH).
MCH populations are at higher risk of experiencing adverse effects during a public health emergency, making it essential for state and territorial health departments to have an established response plan. States can leverage the lessons learned from previous emergency response plans, such as those implemented during the Zika outbreak, to better prepare for future emergencies.
The Vital Role of Data
Data modernization was critical to the Zika response, requiring jurisdictions to scale up systems to promote innovative surveillance, better understand the virus's impact, facilitate diagnoses, and prepare for lasting effects. The Zika outbreak caused health concerns that led to the development of the US Zika Pregnancy and Infant Registry (USZPIR), which collects data on pregnant women with a possible Zika infection and their infants. Collaboration between state, territorial, local, and tribal health departments, health care practitioners, and hospital systems was crucial for developing and maintaining the USZPIR. Data from this registry allowed states and territories to track Zika transmission and its impact on populations to inform interventions, craft effective public health messaging, and prevent future cases.
The success of the Zika monitoring system highlighted the importance of early detection and intervention to prevent adverse outcomes for mothers and infants. The USZPIR laid the foundation for CDC’s Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET). This preparedness network offers surveillance for health threats such as COVID-19, Hepatitis C, Zika, congenital cytomegalovirus, and congenital syphilis, and plays a pivotal role in understanding infectious diseases that impact populations from pregnancy through childhood. An innovative surveillance approach, SET-NET uses existing data from sources including health and vital records, laboratory results, pediatric well-child visits, and nationally notifiable case report forms.
Comprehensive data collection and analysis increases jurisdictional surveillance capacity by providing insight into epidemiological trends, guiding prevention strategies, and facilitating targeted public health and clinical interventions. This allows healthcare providers to identify at-risk populations, monitor disease prevalence, and track the effectiveness of interventions over time. Future tools can replicate SET-NET’s adaptability and utility by providing readily available data to address emergencies and inform programs and clinical practice.
Recommendations for Future Response Effort
In 2021, with support from CDC‘s National Center on Birth Defects and Developmental Disabilities, ASTHO conducted key informant interviews with 11 former state and territorial health officials (S/THOs) who were active in the Zika response. These interviews revealed barriers and successes, and informed the following recommendations for state and territorial health agencies’ future response efforts.
Use Existing Systems
By leveraging existing initiatives—similar to USZPIR and SET-NET—and scaling up if necessary, agencies can use resources more effectively, reduce redundancies, and maximize the impact of interventions.
“The idea is, have something you can quickly build on for whatever population you need. With Zika, for example, the existing pediatric registries were relatively easily tapped, as we were monitoring for birth defects or disabilities among children. We wanted to know the numbers even if they were small, so it was easier because those systems existed.”
Modernize Medical Records and Communications Systems
This ensures remote access to medical data in emergencies, allowing providers to make informed decisions promptly and enhancing MCH emergency response efficiency and effectiveness. Telemedicine provides essential remote healthcare and support to pregnant women and their families during public health emergencies.
“One of the biggest recommendations I have is that we figure out a better way [for] data management and data utilization.”
Establish Strong Collaboration and Training
Equipping MCH experts with the tools to contribute to emergency preparedness from the beginning, (e.g., training in the Incident Command System) is critical for developing a response that integrates the unique needs of MCH populations throughout the life course. In addition, collaboration among healthcare providers, government agencies, NGOs, and private sector entities is also beneficial for developing a robust response. Intersectoral collaboration can support data sharing and pooling resources to reduce the impact of health threats on MCH populations.
“… during the Zika time, there was at least a pattern there for working across organizational units and focusing. And certainly, that kind of cross-organizational collaboration set the foundation for our COVID response, which was obviously much larger and involved an ‘all of agency’ approach.”
Conclusion
The Zika outbreak was an unprecedented emergency that underscored the importance of data-driven approaches and the integration of MCH agencies in preparedness efforts to mitigate the impacts of infectious diseases. Timely and accurate data inform screening protocols for pregnant individuals, facilitate early detection of infections, and ensure prompt initiation of treatment to prevent adverse outcomes for mothers and infants. Furthermore, data-driven approaches allow health systems to allocate resources efficiently, prioritize high-risk areas, and tailor interventions to meet the specific needs of vulnerable communities. Health departments can invest in initiatives like SET-NET, both in the short and long term, to improve their ability to prepare for and address the next public health emergency.