Latin America and Caribbean Zika Extension for Community Healthcare Outcomes Evaluation
The USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project created a Zika Extension for Community Healthcare Outcomes (ECHO) program in Latin America and the Caribbean (LAC) to connect a team of experts with local providers from eight countries who provide care for babies and children affected by the Zika virus. The objective of the program was to increase participants’ knowledge, skills, and self-efficacy to improve care and health outcomes for children and families affected by the Zika virus infection. The American Academy of Pediatrics (AAP) worked closely with the ASSIST LAC ECHO regional team to identify the infrastructure needed to effectively coordinate the ASSIST LAC Zika ECHO program. A total of 15 ASSIST LAC Zika ECHO sessions were held between September 2018 and July 2019. ECHO sessions lasted 1.5 hours and included a brief didactic lecture followed by a presentation and discussion of a de-identified patient case.
AAP commissioned an evaluation of LAC Zika ECHO participants’ self-reported competencies and skills, satisfaction with the LAC Zika ECHO program, and changes in practice following participation in the program. The evaluation was conducted in Spanish by AAP’s partner Project ECHO Uruguay. The evaluation also sought to identify barriers to changing practices and assess providers’ perception of ways to overcome these barriers. Data was collected through a retrospective survey and a focus group discussion.
Participants reported improved knowledge and self-efficacy in key aspects of care including screening for Zika and comorbidities faced by infants and children potentially exposed to Zika as well as high satisfaction with the ASSIST LAC Zika ECHO program. Participants also reported sharing knowledge with coworkers and serving as local resources regarding care of infants and children with confirmed or suspected Zika exposure. Focus group participants described improved outcomes in terms of patient care and provision of services as well as practice- and system-level changes. Participants’ feedback regarding the program include the desire for the program to continue and expand to include other health topics. Specific suggestions include continuing patient case presentations and/or presenting updates on cases previously presented and incorporating the Zika ECHO program into undergraduate and post-graduate student curricula. Many participants noted the lack of specialists in different localities and the potential ECHO offers to create and strengthen health teams.
Overall, the ASSIST LAC Zika ECHO evaluation revealed positive outcomes for ECHO participants, their patients, and the health system in which they care for children, youth, and families. ECHO participants have become an asset that should be leveraged for future knowledge sharing in the LAC region.