E02 - Federal Initiatives - Part 2a
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Transcript E02 - Federal Initiatives - Part 2a
Building Reproductive Health
Preparedness Science Together
Marianne Zotti, DrPH, MS, FAAN
Lead Epidemiologist
AMCHP Conference February 12, 2012
National Center for Chronic Disease Prevention and Health Promotion
Division of Reproductive Health
Purposes of Workshop
Provide background about disaster and
reproductive health
Describe DRH Program for Emergency
Preparedness and Response
Describe new tools for preparedness and
response
Continue conversation about post-disaster
reproductive health indicators
Pregnant Women and
Catastrophic Events
Classified as ‘at-risk individuals’
Post-event data often not collected
Disproportionate burden known for some infectious
diseases
Few studies examined associations of US disasters
and birth outcomes
Exposure associated with poor birth outcomes
Showed increases in maternal risk factors
Disaster and Women of
Reproductive Age (WRA)
Inconsistent changes in birth rate after disaster
Increases after Hurricane Hugo and OK City bombing
Decreases after Hurricane Katrina and 1997 ND Red River Flood
Little known about disaster effects on WRA in US
No routine surveillance of disaster-affected WRA
Inconsistent reports of intimate partner violence
Inadequate studies on contraceptive use, access to medical and
social services, risk behaviors, etc.
FEMA Photos
DRH Emergency Preparedness and
Response Program
Purpose: Prepare DRH to respond to reproductive health needs of
the US population after natural or man-made catastrophic events
by:
Gathering epidemiologic/surveillance data to guide action
Developing recommendations and tools to guide public health response
specific to pregnant and lactating women and newborns
Developing a plan to reduce fertility risks, infertility, or inadequate
contraception
Developing a plan to communicate with clinical, public health and
government partners and pregnant women regarding preparedness and
response
Developing a human resources preparedness plan for DRH
Target population: Pregnant/postpartum women, infants, women of
reproductive age
DRH Emergency Preparedness and
Response Program (continued)
Definition of catastrophic events
Extraordinary levels of mass casualties, damage, or disruption
Severely affects the population, infrastructure, environment,
economy, national morale, and/or government functions
Pandemic illnesses
Types of Catastrophic Events
Meets at least 1 criteria below:
•
•
•
•
Affect >1 state
Affect a highly populated area
Are major acts of terrorism
Affect a large proportion or a whole state/territory
Unusual public health events that disproportionately affect
pregnancy, infancy, or fertility
CDC Director directs the agency to respond
DRH Emergency Preparedness and
Response Program (continued)
DRH Emergency Preparedness and
Response Program (continued)
Examples of Science/Clinical essential activities
Solicit input from local and state health departments related to
reproductive health needs they have identified after catastrophic
events
Set a research and surveillance agenda related to catastrophic
events and reproductive health
Develop a post-disaster surveillance module and assure funding
that can be used in PRAMS
Prepare background information on basic needs of pregnant
women and infants
Develop recommendations regarding vaccination and/or
treatment for selected bioterrorism agents
Identify availability of and potential needs for Strategic National
Stockpile medications and equipment for women and infants
New Tools & Activities
When There is an Emergency: Estimating the Number
of Pregnant Women in a Geographic Area
Provides estimation tool for a
jurisdiction
Calculates number of
pregnant women at a point in
time
Uses pregnancy rates
Tell us what you think by emailing comments to drhinfo@ cdc.gov
New Tools & Activities (continued)
Reproductive Health Assessment After Disaster (RHAD)
Toolkit
http://cphp.sph.unc.edu/reproductivehealth/
What is Included in the RHAD Toolkit
Pre-tested questionnaires
Pregnant and Postpartum Women
Women of Reproductive Age
Topics include safe motherhood, infant care, family planning,
family stressors and service needs, health and risk behaviors, and
gender-based violence.
Variable codebooks
Sampling instructions
Interviewing training resources
Resources for data collection and analysis
New Tools & Activities (continued)
Development of
PRAMS methodology
for surveillance after a
catastrophic event
Analyses of PRAMS
preparedness
questions
Synopsis of MCH EPI Symposium
Number of Attendees: 25
Reproductive health needs were not a priority or focus of emergency
response experiences
Most participants indicated their organization did not have a disaster plan about
reproductive health
Pregnant and postpartum women should be the focus of any plan
about reproductive health after disaster
MCH EPI Symposium: Topics for Potential Indicators
Pregnant or Postpartum
Women
Access to food and potable water
Access to safe environment—
shelters or other
Access to medications
Access to medical services
Barriers to care
Post-disaster mental health effects
Access to mental health services
Access to STD/STI services
Gender based violence
Access to WIC
Substance abuse
Pregnant women
Access to emergency services,
including delivery
Social networks
Postpartum women
Breastfeeding
Access to clean water, formula,
diapers
Access to contraception
Availability of childcare
Infants
Birth outcomes
Safe sleep environment