Reducing Birth Defects Meeting the Challenge in the Developing World (2003) / Chapter Skim
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4 Incorporating Care for Birth Defects into Health Care Systems
4 Incorporating Care for Birth Defects into Health Care Systems
Pages 122-134
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From page 122... ...
This section describes the steps to achieve this goal, also care for children who have birth defects, and, for countries that have been successful in lowering infant mortality through effective health care services, the introduction of genetic screening and diagnosis for common and severe birth defects. Enhancing Current Reproductive Health Services Primary health care in almost all settings includes maternal and child health (MCH)
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From page 123... ...
The introduction or expansion of prevention and care for birth defects in developing countries is best undertaken in primary health care facilities. Although primary care providers may have rudimentary training and few medications or diagnostic tools, they can nonetheless provide important preventive services, such as family planning, information on the causes of birth defects, micronutrient supplements, immunization, and guidance on avoiding teratogens.
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From page 124... ...
District hospitals can expand the services offered at primary care centers by providing essential medications and vaccinations on-site and by using mobile care teams. Medical professionals from secondary facilities can support and train community health care workers, make regular visits to primary
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From page 125... ...
Tertiary care centers can also serve as facilities for collecting epidemiological data, providing staff training, creating and distributing educational health materials, and conducting clinical and operational research (WorId Health Organization, 19991. Support of primary and secondary health care facilities by tertiary centers can contribute to the development and maintenance of affordable, good-quality health care.
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From page 126... ...
Health education has been incorporated into many school curricula. This should include instruction on reproductive health and wellbeing and the locally relevant risks for birth defects.
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From page 127... ...
Building the capacity of developing countries to provide strong reproductive health care requires international contributions of expertise and resources. Two kinds of international partnership that can be especially effective are professional societies and inter.
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From page 128... ...
To meet broad needs for family planning and other reproductive health measures, child survival, and HIV/AIDS care, five private voluntary organizations ADRA (Adventit Development Relief Agency) , CARE (Cooperative for Assistance and Relief Everywhere)
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From page 129... ...
Strategies for Intervention When an effective program of primary care is in place, even in resourcepoor countries, it can be expanded successfully to incorporate additional interventions (including, where appropriate, genetic screening) into basic reproductive care.
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From page 130... ...
The specific interventions recommended in Chapter 3 that deserve universal implementation include family planning, dietary supplementation with iodine and folic acid, control of infectious diseases, and avoidance of teratogens during pregnancy. Information on locally relevant teratogenic medications to be avoided should be conveyed to primary care providers, as well as to the general public; governments may also consider limiting access to teratogenic medications such as thalidomide.
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From page 131... ...
Since prevention is the most affordable and effective strategy for addressing birth defects, community health workers should be trained in the importance of educating young people, and women in particular, on nutritional, infectious, teratogenic, and genetic risks. Likewise, health care policies that target common, severe birth defects in a community make the most efficient use of limited resources.
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From page 132... ...
It can include recent findings from surveillance and operational research; standardized versions of basic reproductive care, genetic screening and diagnosis, and therapeutic services for common birth defects in different settings; evaluation of interventions for cost-effectiveness; and access to training packages for distance learning. The site can also facilitate communication among health care providers, researchers, and policy makers at national centers and in the communities they serve.
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From page 133... ...
Two principal means of collecting epidemiological data for health care planning purposes are surveys and record keeping at the primary care level. In addition to surveys of the prevalence of specific birth defects among the general population, studies that attempt to describe how people seek family planning assistance or how patients with birth defects make use of different kinds of health care providers could be useful.
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From page 134... ...
The story of CARE's successful integration of family planning and reproductive health services. February.
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