On the front line: Health professionals and system preparedness for Zika virus in Peru.
OBJECTIVES
To analyze the initial healthcare response to the Zika virus in Piura, Peru, and assess the perceptions of midwives and nurses regarding their role in prevention of Zika virus and management of congenital Zika syndrome (CZS).


METHODS
This ethnographic study used a rapid qualitative assessment design. Data were collected through a focus group with midwives and in-depth interviews with midwives (n=11) and nurses (n=5).


RESULTS
The focus of the early Zika virus response in Piura was on pregnant women and vector control. Midwives received some training on Zika-related care during the early response. Nurses did not receive any Zika-specific training. Neither nurses nor midwives were trained in neonatal CZS surveillance. Midwives were clear about the value and feasibility of incorporating Zika virus surveillance in their daily work, however nurses were not. They referred to lack of training and appropriate tools as limitations. Confusion about Zika virus and CZS symptomatology and effects persisted in both groups. Concerns about their own personal risk influenced the ways they engaged with Zika virus prevention in the community.


CONCLUSION
Long-term management of endemic Zika virus in Piura will require the engagement of both nurses and midwives as primary care providers.
['Iguiñiz-Romero|Ruth|R|', 'Guerra-Reyes|Lucia|L|']
D000328:Adult D001291:Attitude of Health Personnel D005260:Female D017144:Focus Groups D006801:Humans D007400:Interprofessional Relations D008880:Midwifery D009726:Nurses D010568:Peru D011247:Pregnancy D011251:Pregnancy Complications, Infectious D011320:Primary Health Care D000071243:Zika Virus Infection
Zika virus Peru Congenital Zika syndrome Surveillance Health personnel