Posted on January 30, 2002 at 11:35 a.m.
BIRMINGHAM, AL — UAB researchers and the Zambian Ministry of Health have received a $4 million grant from the Bill and Melinda Gates Foundation to develop a state-of-the-art, electronic obstetric and newborn medical record system in Lusaka, Zambia.
“The database-driven electronic record will serve a clinical care and research function, and should result in sustainable improvements in health for mothers and their infants in Zambia,” said Dr. Robert Goldenberg, one of the UAB researchers.
The central idea behind the collaboration is that automated recording and assessment of prenatal care and computerized surveillance of birth outcomes will result in better individual patient care, as well as systematic improvements in obstetric and newborn outcomes.
The computer record system will be modeled after the famed OBAR system, developed by Goldenberg and other researchers in the 1970s for use in Jefferson County. 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 and to UAB’s emergence as a premiere center of perinatal research. It also was part of an effort to develop a statewide regional care system that included the delivery of prenatal care to every county and an organized referral system. Once established, the state’s infant mortality rate fell by nearly 50 percent.
The scientists with the Center for Research in Women’s Health at UAB — including obstetrics and gynecology faculty Goldenberg, Jeffrey Stringer, M.D., and Dwight Rouse, M.D., and UAB Division of Geographic Medicine Director Sten Vermund, M.D. — are hoping to see the same dramatic results in Lusaka. The Lusaka system will cover nearly all of the 50,000 annual births in the capital city, located in the southern part of Zambia, formerly known as Northern Rhodesia.
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 one in 25, and two of 10 Zambian newborns do not live to their fifth birthday.
“In individual pregnancies, the ability to document processes and recognize deficiencies of care in an ongoing fashion should be of immediate benefit,” Rouse said. “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.”
This is one of several UAB research projects in Lusaka, most of which are designed to develop low-cost methods to reduce infant mortality and maternal-to-infant HIV transmission.