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Mid-Year Grant Report: China Cal

10/11/2016

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Dr. Feng Long He trains doctor how to examine newborn heart using the stethoscope.

​Newborn Congenital Heart Screening Training and Evaluation Program

​The Yunnan Newborn Training Program has the goal of training all rural Yunnan county obstetricians and obstetric nurses to perform proper newborn cardiac examinations. The program, started in 2014, is the largest of its kind in China and one of the largest of its kind in the world. ​
​More than sixty percent of births in rural Yunnan province occur in relatively large county hospitals. This centralization of birthing is the result of a Chinese government campaign to decrease morbidity and mortality during childbirth. County hospital newborn care protocols include testing for metabolic diseases and examination for spinal deformities but do not include routine testing using stethoscope and pulse oximetry for critical congenital heart disease, which is now routine in the United States and in most other developed nations.  

The training program and its evaluation have been successful in completing training in about three quarters of Yunnan county hospitals. Screening rates in almost all hospitals exceed 90%. The program has therefore been overwhelmingly successful. However, there are some important problems detected by the evaluation of the program, which are explained in this report. 
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Rui Zhang trains rural doctors and nurses how to do proper screening of newborn babies.

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China Cal Runs Two Programs in Yunnan Province, China

9/16/2015

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Chao Foundation partners with China Cal to run two programs in Yunnan Province, China focused on treating congenital heart disease.

1) The Yunnan Province Newborn Training Program

This program, initiated in 2012, has a goal of training every obstetrician and obstetrical nurse in all 125 Yunnan county hospitals how to properly examine newborns’ hearts to detect early congenital heart disease, especially critical congenital heart disease of the newborn (CCHD). To train one doctor or nurse costs about $25.

a. Dr. Li Ya Ni, a cardiology resident at Kunming Medical University, trains rural OB doctors and nurses the proper technique for examining hearts of newborns.
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b. Ms. Guo Fang Qi is a PhD graduate student in public health at the University of California, Irvine (UCI). Ms. Guo is from Harbin, a city in the northeast part of China.  She trains OB doctors and nurses how to properly use pulse oximetry to test for abnormal oxygen saturation in newborns. She is also making the evaluation of the training program the subject of her PhD thesis at UCI.

c. Ms. Zhang Rui is a native of Dali, China with a college degree in economics. She assists in teaching nurses and doctors and answering their questions. She also arranges logistics of travel and financial issues regarding the program.
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Partner Update: China Cal Yunnan Province Pediatric Heart Training and Evaluation Program

6/20/2015

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PictureYunnan Newborn
China Cal’s program to train county doctors to properly examine newborns is progressing as planned. With the help of a grant from The Ping and Amy Chao Foundation of Los Altos, CA, China Cal has added an evaluation component and a University of California, Irvine Program In Public Health PhD graduate student. Ms Fangqi Guo, who will be the principal investigator for an evaluative study of the training program, will work with the China Cal team in Yunnan for several months this year. We are also grateful to the Masimo Corporation for their kind gift of 125 pulse oximeters to be used in each of the rural Yunnan county hospitals for screening newborns for critical congenital heart disease.

The following is a summary of PhD candidate Fangqi Guo’s research plan.
Undiagnosed congenital cardiac shunt lesions with pulmonary hypertension and critical congenital heart disease (CCHD) kill 3 to 4 of every thousand children in developing countries. Most of these heart defects are completely curable if discovered early in life. Yunnan Province is a slowly developing province of China. The estimated number of infants that die from these heart defects is about 400 per year. Pulse oximetry is an effective screening method to detect CCHD in very early stage. We will  provide rural Yunnan county hospitals, where most babies are now born, with equipment and training for doctors and nurses responsible for the care of neonates. We will train these doctors regarding proper neonatal cardiac examination. We will evaluate the increased knowledge and change in behaviour of these trainees. Though rural Yunnan is one of the poorest regions of China, both medical insurance options and financial assistance mechanisms are growing and the level of medical care is continuously improving. The conditions for increased awareness and discovery of undiagnosed congenital heart cases are therefore ideal for addressing this problem in Yunnan Province.

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PhD Candidate Fang Qi Guo
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