Elimination &Surveillance Bill Brieger | 30 Jul 2013 01:29 pm
Addressing the Barriers of a Malaria Implementation Program in Jacmel, Haiti
Mary E. Schmidt, M.D. has studied the malaria situation in Haiti for her MPH capstone project at the Johns Hopkins Bloomberg School of Public Health. She has shared the abstract of the project with us here.
Background: Hispaniola is the only Caribbean island still endemic for malaria. While the Dominican Republic continues to see improvement in the use of prevention measures and malaria rates, Haiti has been unable to organize, operate and fund a sustainable program. The city of Jacmel in the South East District has the capacity to create a successful program.
Materials and Methods: A literature review was performed of population based surveillance studies to understand the epidemiology of malaria in Haiti and the South East District. Individuals were interviewed to understand the Minister of Public Health and Population (MSPP) malaria policy and the current epidemiologic practices. Haitian physicians and CBO workers were observed and interviewed to understand how malaria is diagnosed and treated, how patients are educated and the current community malaria prevention programs.
A literature review was performed of materials from malaria experts, the World Health Organization (WHO), Pan American Health Organization (PAHO) and The Global Fund to better understand the components of a successful malaria elimination program.
Results: This review focused on the current barriers of a malaria implementation program in Jacmel and the national system that would prevent a successful program.  The review led to the creation of a malaria elimination framework for Jacmel and the South East District.
The framework emphasizes a strong management and operations component. The MSPP office communicates with finance, surveillance, the district health officer, and the operations team. For a functional system, operations and management communicates with the MSPP oversight team and receives input from finance and surveillance in order to manage training, deployment, communications and local surveillance.
Monitoring and Evaluation is done on a district level and reported to district operations to help with managing the program and to the surveillance team. Recommendations for policy development include focus on diagnostics, specific treatment, vector control, education and monitoring. Barriers include funding and implementing an adequate operation and deployment team.
Conclusion: The implementation of an effective malaria elimination program in Haiti will require MSPP leadership oversight and a strong operations and management team in each district. The city of Jacmel in the South East District has the interest and support from local CBOs and business leaders that make it the ideal location to implement the framework and create a sustainable program.