Charles Lewis has worked for the University of Virginia (UVA) Medical Center for Telehealth for the past decade, first as a video analyst and, most recently, as a senior video systems engineer. At work, he is meticulous in designing and implementing Tele-communications between our patients and providers to ensure access to quality healthcare that would not otherwise be available. This approach has driven Charles's work far from Madison County where he lives, to Lee County in the Coalfields and to the rural Mbujimayi in the Democratic Republic of Congo (DRC). He has worked with faculty leading outreach efforts in Africa to create transformative programs. The Center for Telehealth, with Charles' dedicated work, has embraced the potential that this confluence unleashed and has worked tirelessly to harness the power of telecommunication to extend the latest medical care to those who live at the margins of the healthcare system..

PROSAMI is a non-profit organization which focuses on the promotion of maternal and infant health in the rural areas of the Democratic Republic of Congo (DRC). The name PROSAMI is derived from the French acronym: Promotion de la sante maternelle et infantile. The mission of PROAMI is to provide the rural community with affordable quality health care in order to allow the infant a good start in life and the mother a healthy reproductive life that would benefit the community. Over the last 9 years, PROSAMI has been providing Telemidwifery by advocating for the education of nurses in the DRC to become advanced nurse midwives through sequential didactic and practical clinical training. 19 nurse midwives at the PROSAMI headquarters in Mbuji-Mayi have completed 70% of their didactic and clinical advanced nurse midwifery program, and ongoing teleconferences are held between the Mbuji-Mayi students and professors in Durban, South Africa, Ng’iya, Kenya, New Delhi, India, Staunton, VA, and Charlottesville, VA. PROSAMI has developed a classroom with a free standing electrical source and internet hardwiring, which can easily be converted into a maternal/infant health clinic, and has distributed 16 laptops. Students have assisted with the successful delivery of malpositioned babies, resuscitation of babies, and rescue of mothers who were bleeding from uncontrolled post-partum hemorrhage. In addition, PROSAMI has built a pilot center for the delivery of direct medical and nursing care to women and infants. Over 50 babies and mothers have been saved due to the expertise and presence of a PROSAMI student.

Maya Lezzam is in her undergraduate career at the age of 20 years from the University of Virginia. She is a student delegate for PROSAMI, and is studying Global Public Health and Biostatistics on the Pre-med track. Email: mdl4ac@virginia.edu

PROSAMI is a non-profit organization committed to the reduction of maternal and infant mortality in the DRC. Agnes Kanyanya, founder of PROSAMI, grew up in the Congo and made it her mission to address the high maternal and infant mortality rates. She eventually made her way over to the United States where she became a nurse and created PROSAMI with the help of David Strider. The organization’s objective is to strengthen midwifery education through a training program for rural health care professionals. The program started off with only a few nurse midwife candidates being trained, but the number of candidates being trained is only growing. In the last nine years, with the help of Charles Lewis and UVa Telemedicine, the organization has set up a Telemedicine connection in the DRC which aids in PROSAMI’s ability to train nurses through both video and audio connection. PROSAMI is in the process of updating equipment and renting out a pilot health center so that these nurse midwife candidates can see more patients. Through a research grant from UVA’s Center for Global Health, I will be conducting an archival data analysis of various patient reports to see which aspects of the PROSAMI training appear to be effective when put into practice. The information collected throughout the duration of the research will be helpful in quality control as the NGO continues building upon its training method.

Dr. Lisa Quinn is a 2007 Graduate of Kent State University with a PhD in Health Education/Promotion. She is currently on faculty at Gannon University in Erie Pennsylvania. She teaches both undergraduate, graduate and DNP students. She holds certification as a Women’s Health Nurse Practitioner.

The initial CDC recommendation specific to folic acid was made in 1992. Following decades of intense scrutiny on the relationship between vitamin intake and neural tube defects, the U.S. Public Health Service made the following recommendation: “All women of childbearing age in the United States who are capable of becoming pregnant should consume 400cg of folic acid per day; for the purpose of reducing the risk of having a pregnancy affected with spina bifida and other neural tube defects” (CDC, 1992). Despite increased media campaigns and ongoing educational programs, many women still do not begin taking a folic acid supplement prior to conception. Similar to other relationships between health knowledge and health behavior, there is a gap between awareness of the importance of folic acid supplementation and folic acid use. Specifically, knowledge and awareness of folic acid supplementation does not always guarantee folic acid use prior to conception. Recent literature provides evidence that a majority of women of childbearing age still do not take a daily multivitamin supplemented with the recommended 400cg of folic acid. It is vital to the health of women and their offspring that health care and health promotion professionals identify the most effective strategies for promoting optimal health for this population. A message of daily multivitamin intake for all women initiated by health care providers and reinforced by people in the woman’s support system may be one such strategy. Other strategies supported by this research include identifying creative ways to change a woman’s attitude about multivitamin use.