NACCHO Surveys Local Health Departments’ Capacity to Respond to Zika Infections in Pregnant Women

A newly released study of local jurisdictions developed by the National Association of County and City Health Officials (NACCHO), in partnership with the Centers for Disease Control and Prevention (CDC), and the National Center on Birth Defects and Developmental Disabilities (NCBDDD) discovered that while local health departments have responded diligently to Zika outbreaks in their communities and are heavily engaged in protecting maternal child health, there is room for improvement. Importantly, continued federal funding to support these efforts is vitally needed to safeguard the nation’s health. Congress has proposed eliminating the Prevention and Public Health Fund (PPHF), which provides funding to local jurisdictions through the CDC.

The assessment, Maternal Child Health Capacity for Zika Response surveyed local health departments in 10 priority states: Alabama, Arizona, California, Florida, Georgia, Hawaii, Louisiana, Mississippi, New York, and Texas, and showed:

- Maternal Child Health (MHC) programs are deeply vested in multiple areas of the Zika response. LHDs are providing a high rate of education and provider engagement.

- There are strong formal and informal processes both internally between programmatic areas and externally with key community providers.

- Opportunities for action around infrastructure support include access to electronic lab results, which increase reporting and developing resources for strengthening networks of community providers and LHDs, focusing on birth defects and pregnancy-related conditions.

“The CDC recently reported that about three of every 1,000 babies born had a birth defect potentially related to Zika,” said NACCHO executive director and chief of government affairs Laura Hanen, MPP. “They also identified a 21 percent increase in the birth defects most strongly linked to Zika in areas with local transmission in the second half of 2016, compared to the first half of the year. Therefore, the need for local health departments to increase their capacity is more urgent than ever. Local health departments are on the front lines of public health response to Zika infections in their jurisdiction. If they lose Prevention and Public Health Fund support, the results could be dire for pregnant women and their families. It will cost millions for families of babies with Zika-related birth defects to care for them over their lifespan. It is much wiser if we spend the money on prevention and fund local health department activities as they collaborate with maternal child healthcare providers.”

Here are the study’s key findings:
- More than 80 percent of LHDs have formal and/or informal communication and referral mechanisms between their MCH programs and key programmatic areas within their agency.
- A total of 78 percent of LHDs have access to electronic lab results.
- LHDs are actively engaged in community-level response activities.
- LHDs are less likely to provide screening and testing services to identify potential birth defects in infants.

NACCHO recommends:

- Increasing LHD training and support for MCH reporting and surveillance, including training in how to engage pediatric clinicians and sub-specialties on the risks of Zika exposure in the community.
- Enhancing LHD capacity for both formal and informal, internal and external referral processes by supporting LHDs in identifying pediatric clinicians, specifically subspecialties, to support Zika response and follow-up activities.
- Increasing local support for LHD engagement in MCH Zika response to ensure LHDs have access to resources and information that can be tailored to individual needs, or risks of their communities.
- Encouraging LHDs to engage local, state, and federal partnerships to stay abreast of Zika exposure risk for vulnerable populations.

Source: National Association of County and City Health Officials (NACCHO)