U.S.-Zambian Collaboration Receives $4 Million From Bill & Melinda Gates Foundation

The Seattle-based Bill & Melinda Gates Foundation has announced a $4 million grant to the Zambian Ministry of Health and the Center for Research in Women's Health at the University of Alabama at Birmingham (UAB) to develop a state-of-the-art, electronic obstetric and newborn medical record system in Lusaka, Zambia.

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. 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.

"There are almost 50,000 babies born in Lusaka each year," noted Dr. Moses Sinkala, director of the system of health 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."

According to recent UNICEF estimates, the lifetime risk of death in pregnancy for a given Zambian woman is 1 in 25, while 2 of 10 Zambian newborns do not live to their fifth birthday.