Rapid Integration of Zika Virus Prevention Within Sexual and Reproductive Health Services and Beyond: Programmatic Lessons From Latin America and the Caribbean

The emergence of the Zika virus (ZIKV) in Latin America and the Caribbean during the 2015-2016 outbreak has required local health systems to adapt, suddenly and continuously. This field action report explores the outbreak's sexual and reproductive health (SRH) complexities and the experience of the International Planned Parenthood Federation (IPPF) and 4 of its member associations as part of the United States Agency for International Development's rapid response in the region. It outlines approaches and actions that IPPF and its member associations undertook over 3 broad programmatic phases-developing ZIKV protocols and training personnel; delivering ZIKV-integrated services and information; and providing screening, care, and support for children and families affected by congenital Zika syndrome (CZS)-as the project worked to integrate ZIKV prevention, screening, and response within SRH service delivery models. It also describes the challenges and lessons learned in implementing a ZIKV response program in the region and recommendations from a service delivery perspective that can be useful in informing the responses to future rapid onset epidemics with SRH relevance. Challenges identified include adapting to a rapidly evolving evidence base during the early stages of the epidemic; traditional and restrictive regional social norms around gender, sex, and sexuality; the lack of focus on sexual transmission in national ZIKV public health messaging; and a lack of services, government support, and referral pathways for supporting children and families affected by CZS. Some of the key recommendations include finding ways to share rapidly evolving clinical updates conveniently and frequently, such as through digital technologies and platforms; partnering with multidisciplinary organizations, such as disability rights and services organizations, that can fill gaps in needed services; and leveraging the need for urgent action as a catalyst of change around more inclusive and gender-transformative social norms and services.