Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016

Li, Rui; Simmons, Katharine B.; Bertolli, Jeanne; Rivera-García, Brenda; Cox, Shanna; Romero, Lisa; Koonin, Lisa M.; Valencia‐Prado, Miguel; Bracero, Nabal; Jamieson, Denise J.; Barfield, Wanda D.; Moore, Cynthia A.; Cara, T.; Korhonen, Lauren; Frey, Meghan; Pérez-Padilla, Janice; Torres-Muñoz, Ricardo; Grosse, Scott D.

doi:10.3201/eid2301.161322

Cited by 34 publications

(24 citation statements)

References 28 publications

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“…Surveying pregnant patients about their use of condoms to prevent ZIKV during pregnancy is also an important aspect to assess in this population. Lastly, formative research is needed to address community engagement and capacity building to leverage resources to improve health promotion interventions and access to LARCs …”

Section: Discussionmentioning

confidence: 99%

“…Lastly, formative research is needed to address community engagement and capacity building to leverage resources to improve health promotion interventions and access to LARCs. [14][15][16] Of paramount importance is the need to extract helpful best practices to inform public health responses for future infectious disease epidemics. Lessons learned from the ZIKV outbreak should be applied to preparations for the next vector-borne disease crisis.…”

Section: Discussionmentioning

confidence: 99%

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Zika virus knowledge, contraception use, and lessons learned from a Dominican Republic pilot study

Shaw

Baker

Jie

et al. 2019

Intl J Gynecology & Obste

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Objective To assess knowledge of the Zika virus (ZIKV), use of contraceptives, and sources of health information in rural communities in the Dominican Republic. Methods Over 4 days in March 2017, a research team traveled to four rural communities in the Dominican Republic to provide healthcare services. Overall, 90 men and women consented to a voluntary verbal 12‐question survey. Results Of the participants, 55% were not certain whether ZIKV is transmitted sexually; 75% of participants were either not sure or thought ZIKV was not present in their community. Charlas (informal discussions led by community health workers) were cited as the most common source for public health information. Prevalence of contraceptive use was 26.6% hormonal and 1.1% long‐acting reversible contraception (LARC); 30.0% cited no use of contraception. Conclusion Significant deficits in ZIKV knowledge, underutilization of LARCs, and socioeconomic factors exist that constrain the application of WHO recommendations for preventing ZIKV infection. Additional and more robust surveys are needed to assess public health education and interventions, critical for disease prevention in communities facing current and future epidemics.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Zika virus knowledge, contraception use, and lessons learned from a Dominican Republic pilot study

Shaw

Baker

Jie

et al. 2019

Intl J Gynecology & Obste

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“…A recent analysis presents strong evidence that increasing access to contraception both reduced the number of Zika-associated microcephaly and healthcare costs. 17 …”

Section: Texasmentioning

confidence: 99%

Access to Contraception in the Context of Zika

Darney

Aiken

Küng

2017

Obstetrics &Amp; Gynecology

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Women in areas of the Americas with endemic Aedes mosquito populations are at risk for exposure to Zika virus, which can cause fetal brain abnormalities and associated congenital microcephaly. Individual health care providers may encounter health systems barriers to providing evidence-based care. We focus on Mexico and the U.S. state of Texas to highlight the role of health system factors in contraceptive access in the context of Zika, and highlight efforts in Puerto Rico as an example of efforts to improve access to contraception. In Mexico, states with the highest unmet need for contraception are low-lying, coastal states. The government recently announced an investment to combat Zika, but made no mention of family planning initiatives to assist women in preventing pregnancy. In Texas, the Department of State Health Services (DSHS) has issued recommendations to help women and men avoid mosquito-bites; the issue of whether women should plan or avoid pregnancy is not addressed. Puerto Rico has the largest number of confirmed cases of Zika virus in the US states and territories. Recently, the CDC Foundation launched the Zika Contraception Access Network (Z-CAN), which provides contraceptives at no cost to participating clinics in Puerto Rico. The Zika virus highlights weaknesses in health systems that make it difficult for women to use contraception if they want to delay births. Women across the globe, with or without Zika, need access to contraception to prevent unintended pregnancy, and providers require functioning health systems that offer the support to ensure access is a reality.

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“…Li et al 8 estimated the total lifetime cost for a surviving infant with Zika-associated microcephaly to be $3.8 million with the potential to reach $10 million for those who survive to adulthood. Therefore, the lifetime medical and educational costs as well as the emotional impact for children and families affected by the Zika epidemic (including the impact beyond microcephaly) are likely to be substantial.…”

mentioning

confidence: 99%

Public Health Approach to Addressing the Needs of Children Affected by Congenital Zika Syndrome

et al. 2018

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We have learned much about the short-term sequelae of congenital Zika virus (ZIKV) infection since the Centers for Disease Control and Prevention activated its ZIKV emergency response in January 2016. Nevertheless, gaps remain in our understanding of the full spectrum of adverse health outcomes related to congenital ZIKV infection and how to optimize health in those who are affected. To address the remaining knowledge gaps, support affected children so they can reach their full potential, and make the best use of available resources, a carefully planned public health approach in partnership with pediatric health care providers is needed. An essential step is to use population-based data captured through surveillance systems to describe congenital Zika syndrome. Another key step is using collected data to investigate why some children exhibit certain sequelae during infancy and beyond, whereas others do not, and to describe the clustering of anomalies and the timing of when these anomalies occur, among other research questions. The final critical step in the public health framework for congenital Zika syndrome is an intervention strategy with evidence-based best practices for longer-term monitoring and care. Adherence to recommended evaluation and management procedures for infants with possible congenital ZIKV infection, including for those with less obvious developmental and medical needs at birth, is essential. It will take many years to fully understand the effects of ZIKV on those who are congenitally infected; however, the lifetime medical and educational costs as well as the emotional impact on affected children and families are likely to be substantial.

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Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016

Cited by 34 publications

References 28 publications

Zika virus knowledge, contraception use, and lessons learned from a Dominican Republic pilot study

Zika virus knowledge, contraception use, and lessons learned from a Dominican Republic pilot study

Access to Contraception in the Context of Zika

Public Health Approach to Addressing the Needs of Children Affected by Congenital Zika Syndrome

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