• More than 3,000 children in more than 40 Lusaka schools were screened for RHD using portable echocardiography. Children identified to have signs of RHD were started on treatment according to national guidelines. • An open-source m-Health platform (the “eRegister”) is being deployed to help doctors and nurses improve patient management. • Multiple trainings were conducted involving healthcare staff at local clinics, at Lusaka University Teaching Hospital, and for teachers at schools. • The partners helped to support development of an RHD policy roadmap for Africa. • Zambian RHD week launch video released on “YouTube,” which includes an address by the Minister of Health.

We identified a challenge with safeguarding fidelity of key educational messages for healthcare staff in clinics. A key educational message is that RHD can follow bacterial pharyngitis specifically, but does not follow viral infection. Therefore, only patients who have apparent bacterial infection (not viral) require treatment with antibiotics. We found that staff in clinics sometimes had difficulty retaining this key message. The partners responded to this challenge by revising the education and follow-up program for staff in clinics and regular mentorships visits.

• Enroll 8 additional Lusaka health clinics in the RHD program by middle of 2016. • Initiate scale-up to multiple provinces and districts in Zambia by end of 2016. • Conduct a RHD public awareness campaign to coincide with “World Heart Day” in September 2016. • Convene the first-ever Zambian RHD patient support group at University Teaching Hospital. • Facilitate successful use of eRegister in Zambia and scale up in multiple African countries. • Provide additional educational materials on flip charts, talking walls, and computer tablets.

Patients, nurses, doctors, radiographers, students • More than 50 nurses and doctors in Lusaka trained in RHD program. • More than 2,500 patients with sore throat treated as a result of the RHD program in Lusaka clinics. • More than 3,000 school children screened for RHD. • Radiographers trained in baseline echo skills. • Medical and nursing students taught on RHD prevention.