世界银行-伯利兹初级卫生保健系统在流行病防范和应对中的作用：一项定性研究（英）-2023-74页_7mb

Report Summary: The Role of Belize's Primary Health Care System in Pandemic Preparedness and Response

This qualitative study analyzes Belize's Primary Health Care (PHC) system's preparedness, response, and recovery during COVID-19. The study highlights that prior to the pandemic, Belize had a relatively strong PHC infrastructure, including four health regions with various health facilities, though challenges existed in emergency planning and workforce availability.

Key Findings

Preparedness

• The Ministry of Health and Wellness (MoHW) had emergency plans like the All-Hazards Emergency Action Plan and Influenza Pandemic Plan, but no dedicated COVID-19 plan existed.
• Essential medicines, PPE, and staffing were generally available, however, the workforce shortage was a significant concern.
• Service delivery was disrupted early on due to cancellations of essential services like NCD and mental health care, leading to gaps in continuity of care.

Response

• The pandemic response relied heavily on the surge capacity plan, which involved canceling, reducing, or postponing services.
• Routine services were replaced with emergency protocols, including shifting to remote consultations and increasing contact tracing.
• Challenges included insufficient human resources, supply chain issues, lab capacity limitations, and coordination gaps between different funding sources (MoHW vs. NHI).
• Burnout among staff was a major issue due to increased workloads.

Recovery

• Essential services have been restored, but infrastructure and staffing remain inadequate to handle both routine and emergency demands.
• The establishment of flu clinics improved capacity but required additional human and financial resources.
• Opportunities for leveraging new technologies like Tele-Rawa and improving PHC workforce competencies were identified.

Recommendations

1. Develop a comprehensive, evidence-based Pandemic Preparedness Plan.
2. Invest in training and retain human resources through financial incentives and career pathways.
3. Strengthen health information systems and interoperability between MoHW and NHI.
4. Scale up communication channels and tele-consultation platforms to improve outreach.
5. Enhance laboratory capacity to improve rapid testing and contact tracing.

Conclusion

The COVID-19 pandemic exposed gaps in Belize's PHC system, particularly in emergency preparedness and human resources. Building on existing strengths, the system can be transformed to better prepare for and respond to future health emergencies.