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|dc.identifier.citation||Abreu, A. (2020, July 23). Close collaboration while socially distant: A multi-sectoral response to COVID-19 in Haiti. https://moderndiplomacy.eu/2020/07/23/close-collaboration-while-socially-distant-a-multi-sectoral-response-to-covid-19-in-haiti/|
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|dc.description.abstract||Emerging Infectious Diseases (EID) are considered to be a major public health problem because of their potential to be used as biological warfare agents, their unpredictable nature, and their potential to become pandemic. During an epidemic or pandemic scenario if the health system is not well prepared it could be overwhelmed, and the outcomes could be worse than predicted. Therefore, prior preparedness plans, response protocols are needed. This dangerous new member of the coronavirus family was first identified in Wuhan, China in December 2019. Since then the WHO-named COVID-19 has spread to more than 200 countries and territories worldwide. In March 2020, the government announced two first confirmed cases of COVID-19 in Haiti becoming one of the latest countries to be affected by the virus. The cholera epidemic in Haiti recently proved that the country is not sufficiently prepared to face a pandemic of this magnitude. Haiti’s health system is ill-prepared for the looming catastrophe. Objectives: This study aimed to assess the capacity, quality, and preparedness of the Haitian health system against pandemics looking at how they manage to combat the current COVID-19 pandemic. And also, to suggest some strategies and recommendations to strengthen their preparedness protocols using the Taiwan health system as a model. Methods: We used the Donabedian approach to analyze the resources and their effectiveness, and the Global Health Security index (GHS index) to evaluate the capacity and preparedness of the Haitian Health system to cope with this ongoing pandemic, finding what is missing and what could be changed. A qualitative approach was used, and the main method of data collection was the documentation analysis. Result: The result showed as of September 30, 2020, 8792 confirmed cases, and 229 deaths from COVID-19 were registered in the country. Only 37 COVID-19 treatment centers were operational in Haiti for 1011 beds. Borders control is well organized but still has illegal entries. The country doesn’t possess a health emergency plan, and biosafety and biosecurity regulations, 9 laboratories have the capacity to test for COVID-19 across the country and are partly understaff and centralize. Lack of human resources and personal protective equipment (PPE) led to a decrease in primary care (vaccination, institutional birth, and chronic disease). Which can also be explained by the lack of communication, rumors, fake news that are circulated, stigmatization caused distrust and decreased the number of people seeking health care. Only 5.9 million of 11.8 million inhabitants received awareness messages about COVID-19. Conclusion: The study revealed that the Haitian healthcare system is still not prepared to combat this pandemic. Nevertheless, compared to the neighboring country the Dominican Republic which scored higher in the GHS index than Haiti and Cuba, has much worse COVID-19 outcomes than those countries (Haiti, Cuba). However, Taiwan with an almost perfect GHS index score has even better outcomes. Additional models should be coupled with the GHS index to evaluate health systems capacities and health outcomes. We suggested the development of a national public health emergency response plan that includes EID by the Haitian government.||zh_TW|
|dc.description.abstract||Emerging Infectious Diseases (EID) are considered to be a major public health problem because of their potential to be used as biological warfare agents, their unpredictable nature, and their potential to become pandemic. During an epidemic or pandemic scenario if the health system is not well prepared it could be overwhelmed, and the outcomes could be worse than predicted. Therefore, prior preparedness plans, response protocols are needed. This dangerous new member of the coronavirus family was first identified in Wuhan, China in December 2019. Since then the WHO-named COVID-19 has spread to more than 200 countries and territories worldwide. In March 2020, the government announced two first confirmed cases of COVID-19 in Haiti becoming one of the latest countries to be affected by the virus. The cholera epidemic in Haiti recently proved that the country is not sufficiently prepared to face a pandemic of this magnitude. Haiti’s health system is ill-prepared for the looming catastrophe. Objectives: This study aimed to assess the capacity, quality, and preparedness of the Haitian health system against pandemics looking at how they manage to combat the current COVID-19 pandemic. And also, to suggest some strategies and recommendations to strengthen their preparedness protocols using the Taiwan health system as a model. Methods: We used the Donabedian approach to analyze the resources and their effectiveness, and the Global Health Security index (GHS index) to evaluate the capacity and preparedness of the Haitian Health system to cope with this ongoing pandemic, finding what is missing and what could be changed. A qualitative approach was used, and the main method of data collection was the documentation analysis. Result: The result showed as of September 30, 2020, 8792 confirmed cases, and 229 deaths from COVID-19 were registered in the country. Only 37 COVID-19 treatment centers were operational in Haiti for 1011 beds. Borders control is well organized but still has illegal entries. The country doesn’t possess a health emergency plan, and biosafety and biosecurity regulations, 9 laboratories have the capacity to test for COVID-19 across the country and are partly understaff and centralize. Lack of human resources and personal protective equipment (PPE) led to a decrease in primary care (vaccination, institutional birth, and chronic disease). Which can also be explained by the lack of communication, rumors, fake news that are circulated, stigmatization caused distrust and decreased the number of people seeking health care. Only 5.9 million of 11.8 million inhabitants received awareness messages about COVID-19. Conclusion: The study revealed that the Haitian healthcare system is still not prepared to combat this pandemic. Nevertheless, compared to the neighboring country the Dominican Republic which scored higher in the GHS index than Haiti and Cuba, has much worse COVID-19 outcomes than those countries (Haiti, Cuba). However, Taiwan with an almost perfect GHS index score has even better outcomes. Additional models should be coupled with the GHS index to evaluate health systems capacities and health outcomes. We suggested the development of a national public health emergency response plan that includes EID by the Haitian government.||en|
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|dc.description.tableofcontents||Table of Contents|
Table of Contents IV
List of tables VI
List of figures VII
Acronyms and Abbreviations VIII
Chapter 1. Introduction and Background 1
1.1. Introduction 1
1.2. Study purpose 7
1.3. Research questions and objectives 10
1.3.1. Research Questions 10
1.3.2. Objectives 10
Chapter 2. Literature review 11
2.1. Introduction 11
2.2. Overview of Haiti 11
2.2.1. Geographic and Demographic context 11
2.2.2. Economic context 13
2.2.3. Social, historical, and political determinants of health 14
2.3. The Haitian healthcare system 16
2.3.1. Organization of the Health Sector 16
2.3.2 Human Resources in the Health Sector 19
2.3.3. Health and epidemiological situation 20
2.4. An overview of COVID-19 in Haiti. 24
2.5. Theoretical/Analytical framework 28
2.5.1 DONABEDIAN model 28
2.5.2. Global Health Security Index 30
Chapter 3. Methodology 33
3.1. Introduction 33
3.2. Research methodology 33
3.3. Data collection 34
3.4. Data Analysis 35
Chapter 4. Results 38
4.1. Introduction 38
4.2. Analysis of the structures/ resources used for COVID-19 38
4.2.1. Physical healthcare facilities allocated to COVID-19 management and care 38
4.2.2. Financial resources 45
4.2.3. Human resources for COVID-19 48
4.3. Analysis of process and results (use of resources, outcomes) 48
4.3.1. Haiti’s situation/COVID-19 (Figure 6) 49
4.3.2. Haiti’s Healthcare system situation during COVID-19 55
4.3.3. Borders surveillance 56
4.3.4 International Comparison (Taiwan, Dominican Republic, Cuba) 58
Table 6: International comparisons (Taiwan, Dominican Republic, Cuba), October 2020. 63
4.4. Discussion 64
4.4.1 Capacity to prevent EID (biosecurity, biosafety). 64
4.4.2 Capacity to detect and report EID (laboratory systems, real-time surveillance, and reporting, epidemiology workforce) 66
4.4.3 Capacity to respond rapidly to an EID outbreak (emergency preparedness and response planning, risk communications, access to communications infrastructure, trade, and travel restrictions) 68
4.4.4 Capacity of the health system 71
4.4.5 Finance 73
4.4.6 Lessons learned 74
4.4.7 Implications 77
4.4.8 Limitations 78
Chapter 5. Conclusion and Recommendations 79
5.1 Conclusion 79
5.2 Recommendations 81
5.2.1 To GHS Index 81
5.2.2 To the Haitian government 81
|dc.title||Assessment of functional capacity and preparedness of the Haitian healthcare system against potential pandemics: the COVID-19 case||en|
|dc.contributor.oralexamcommittee||林先和(Hsien-Ho Lin),陳秀熙(HSIU-HSI CHEN)|
|dc.subject.keyword||COVID-19,Emerging Infectious Diseases,Health Emergency Preparedness,Pandemic,||en|
|Appears in Collections:||全球衛生碩士/博士學位學程|
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