Health Research Program

The purpose of the learning assessment was to understand the effects of the Zika outbreak on Maternal and Child Health (MCH) service delivery in five Latin American and Caribbean (LAC) countries: Colombia, El Salvador, Guatemala, Honduras and the Dominican Republic. The assessment findings and lessons learned serve as a useful reference for donors, governments and implementers to prepare for and respond to future health outbreaks.

Zika Learning Assessment

Photo credit: USAID

On February 1, 2016, the World Health Organization declared the Zika virus a Public Health Emergency of International Concern due to potentially devastating birth defects to  affected children and their families, but also raising many questions for pregnant women and their families across the Americas. In September 2016, USAID initiated a three-year, multi-country health emergency response to Zika and the negative pregnancy outcomes of the virus in Latin America and the Caribbean. In 2019, USAID sought to assess the extent to which the outbreak affected MCH service delivery and the resiliency of the health system in five affected countries: Colombia, El Salvador, Honduras, Guatemala, and the Dominican Republic. The aim was to identify recommendations to improve health service delivery and build more resilient health systems.



Photo credit: Brendan Bannon, USAID

The assessment used a mixed-methods design, and the analysis focused on primary qualitative data collection using an approach aimed at understanding the response (or non-response) within each health system during the Zika epidemic through the perspective of various stakeholders. The case studies were conducted between March-April 2019 with the aim of assessing the adaptability and resiliency of health systems to respond to the unique needs of women and newborns in light of the outbreak. Qualitative data collection consisted of semi-structured interviews and focus group discussions with community leaders and women who were pregnant during the epidemic. A quantitative component relied predominantly on secondary analysis of existing data sources at the national and subnational levels, where these data were available. Quantitative analysis complemented the qualitative analysis by assessing trends and indicators prior to, during and after the outbreak.

The assessment reports were completed in March 2020 and the final Cross-cutting report in English and Spanish are available below.   


Read the Cross-cutting report.

Read the Spanish translation.


View the presentation on the Zika Learning Assessment at the 6th Global Symposium on Health Systems Research (HSR2020)