US-Zambian Collaboration Receives $4 Million To Establish Electronic Obstetric And Newborn Medical Record In Lusaka, Zambia

LUSAKA, Zambia -- Investigators from the Center for Research in Women's Health at the University of Alabama at Birmingham (UAB) and the Zambian Ministry of Health will receive $4 million from the Bill & Melinda Gates foundation to develop a state-of-the-art, electronic obstetric and newborn medical record in Lusaka, Zambia. The initiative represents a major commitment to technological infrastructure enhancement in the linked Lusaka District Health Clinics and the University Teaching Hospital. 

"Our UAB team, consisting of Drs. Robert Goldenberg, Dwight Rouse, Sten Vermund, and myself, will collaborate closely with Drs. Ben Chirwa, Elwyn Chomba, Moses Sinkala and others from the Zambian Ministry of Health in order to build this system," says Dr. Jeffrey Stringer, a UAB obstetrician stationed in Zambia. "Our intention is that this database-driven, electronic record will serve both a clinical care and research function, and result in sustainable improvements in health for mothers and their infants in Zambia. We are tremendously excited about the potential of this project, and extremely grateful to the Bill & Melinda Gates foundation for their generous funding."

The central idea behind the collaboration is that automated recording and assessment of obstetric and newborn care delivery, coupled with computerized surveillance of birth outcomes, will result in better individual patient care, as well as systematic improvements in obstetric and newborn outcomes.

"In individual pregnancies, the ability to document processes and recognize deficiencies of care in an ongoing fashion should be of immediate benefit," says UAB's Dr. Dwight Rouse. "Furthermore, the data that the system will provide to health policy makers in the Central Board of Health on the frequency and severity of adverse birth outcomes will be invaluable as they allocate scarce health care resources in Lusaka."

The system will be modeled after a similar electronic perinatal record established in the early 1970s by Dr. Robert Goldenberg and others at UAB. That electronic record, which continues to serve as the information backbone of UAB's current system of clinical care, has been fundamental to substantial improvements in pregnancy outcomes in Jefferson County, Alabama, and to UAB's emergence as a premier center of perinatal research.

The burden of disease in Zambia and throughout sub-Saharan Africa, especially among women and children, is substantial. According to recent UNICEF estimates, the lifetime risk of death in pregnancy for a given Zambian woman is 1 in 25, and 2 of 10 Zambian newborns do not live to their 5th birthday.

"There are almost 50,000 babies born in Lusaka each year," says Zambian physician Dr. Moses Sinkala, director of the system of clinics in which much of the system will be situated. "Because of this sheer volume, we have found it almost impossible to systematically assess care delivery. Moreover, our surveillance data has been limited to simple cross-sectional statistics, such as how many stillbirths or pregnancy-attributable maternal deaths occur in a given month; and, at present, even these statistics are suspect. The database generated by this system will dramatically enhance our ability to manage, analyze, and interpret clinical data. Our ultimate goal is to create a sustainable electronic record that will harness reliable data in the service of better pregnancy outcomes not only in Zambia, but in the wider developing world as well."  For more information on the Center for Research in Women's Health, visit them on the web