Montevideo, September 6, 2024. On August 27, the webinar Congenital Heart Disease in Latin America and the Caribbean (LAC): Lessons Learned and Challenges in Reducing the Burden of Disease, co-organized by the Pan American Health Organization (PAHO) and USAID MOMENTUM Country and Global Leadership, took place.
The two organizations partnered to systematize and analyze evidence on the results and experiences of countries in the Region in addressing congenital heart defects and reducing the burden of disease in the Americas. The results and specific country cases were presented during the event.
The Director of PAHO's Health Systems and Services Department, James Fitzgerald, and the Director of MOMENTUM Country and Global Leadership, Koki Agarwal, were in charge of opening the event and sharing data on the regional context.
Among the leading causes of newborn and under-five mortality, the second most frequent group is congenital defects. More than 1 in 10 deaths in newborns and children under 5 years of age are due to congenital defects, and among these, congenital heart disease represents the most frequent group.
Fitzgerald said that in order to make progress in meeting the Sustainable Development Goals (SDGs), particularly target 3.2, it is necessary to “transform health systems in the Americas with a focus on Primary Health Care to get back on the path to universal health. The approach must be centered on individuals, families and the communities in which they live".
Agarwal noted that as other causes of neonatal mortality begin to decline, “birth defects are becoming a major cause of mortality and morbidity in newborns, particularly in low- and middle-income countries”.
Analysis for the approach to congenital heart disease in LAC
The results of the study were presented by PAHO's Regional Advisor on Perinatal Health, Pablo Durán; MOMENTUM Country and Global Leadership Advisor, Goldy Mazia, and the consultant, Martin Sabignoso.
The study consisted of mapping successful experiences in current programs and interventions to address congenital heart defects (screening, diagnosis, referral, treatment and follow-up); and the preparation of a technical report to provide resources and guidance for the design, implementation and evaluation of policies and programs aimed at reducing the burden of morbidity and mortality associated with congenital heart defects in LAC.
The countries analyzed were: Argentina, Brazil, Chile, Colombia, Costa Rica, Peru and Uruguay.
A proportion of congenital defects can be prevented during the preconception period, so it is important to continue working to facilitate access to these interventions for all people in all territories.
In particular, the impact of congenital heart disease on the burden of mortality and morbidity can be substantially reduced through the implementation of timely screening and diagnosis, and the consequent response of the network of services within the framework of an integrated and resilient health system.
From what was gathered and analyzed, it was concluded that efforts should be focused on strengthening Primary Health Care and early detection; improving infrastructures; strengthening referral and counter-referral systems; creating care networks; promoting surveillance, research and innovation; developing education and awareness campaigns; strengthening legislative frameworks and financing; and generating strategic alliances that favor international cooperation.
“With joint efforts, significant progress can be made in reducing the burden of congenital heart disease in Latin America and the Caribbean,” said Durán.
National experiences and the global vision of strategic allies
The webinar continued with a presentation on the experience of Argentina by María Eugenia Olivetti, coordinator of the National Congenital Heart Disease Program of the Ministry of Health of Argentina, who focused on the lessons learned during the program's implementation process. In the case of Brazil, Rodrigo Cariri, deputy director of the Specialized and Thematic Care Department of the Specialized Health Care Secretariat of the Ministry of Health, spoke about the situation in the country and the main challenges they face.
Tamara Currin, Director of U.S. Government Affairs at the March of Dimes, focused on the vision and work of the organization to reduce maternal and neonatal mortality, and emphasized the need to incorporate the perspective of families and communities to reduce existing inequities. Among the strategies to be implemented, she highlighted combating racism, improving access to quality health care, promoting social justice, strengthening economic security and developing safe and connected communities.
Finally, Leah Greenspan, Senior Advisor on Newborns for USAID, stressed that universal health coverage is a global imperative to achieve the SDGs. “In many settings, newborns with congenital anomalies do not have access to the care they need to survive and thrive.... This may be due to limited availability of services or aspects of discrimination.”
To conclude, she said that congenital anomalies are not only a problem in LAC, but a worldwide challenge, and stressed the importance of having information and analysis to learn from successful experiences and continue acting to reduce neonatal mortality and improve the quality of life of children.
