Evaluating and strengthening the health system of Curaҫao to improve its performance for future outbreaks of vector-borne diseases
Abstract Background Vector-borne diseases (VBDs) such as dengue, chikungunya, and Zika pose a significant challenge to health systems in countries they affect, especially countries with less developed healthcare systems. Therefore, countries are encouraged to work towards more resilient health syste...
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | Parasites & Vectors |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13071-021-05011-x |
| _version_ | 1819020386972467200 |
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| author | Vaitiare Mulderij-Jansen Izzy Gerstenbluth Ashley Duits Adriana Tami Ajay Bailey |
| author_facet | Vaitiare Mulderij-Jansen Izzy Gerstenbluth Ashley Duits Adriana Tami Ajay Bailey |
| author_sort | Vaitiare Mulderij-Jansen |
| collection | DOAJ |
| description | Abstract Background Vector-borne diseases (VBDs) such as dengue, chikungunya, and Zika pose a significant challenge to health systems in countries they affect, especially countries with less developed healthcare systems. Therefore, countries are encouraged to work towards more resilient health systems. This qualitative study aims to examine the performance of the health system of the Dutch Caribbean island of Curaҫao regarding the prevention and control of VBDs in the last decade by using the WHO health system building blocks. Methods From November 2018 to December 2020, a multi-method qualitative study was performed in Curaçao, applying content analysis of documents (n = 50), five focus group discussions (n = 30), interviews with experts (n = 11) and 15 observation sessions. The study was designed based on the WHO framework: health system building blocks. Two cycles of inductive and deductive coding were employed, and Nvivo software was used to analyse the data. Results This study’s data highlighted the challenges (e.g. insufficient oversight, coordination, leadership skills, structure and communication) that the departments of the health system of Curaҫao faced during the last three epidemics of VBDs (2010–2020). Furthermore, low levels of collaboration between governmental and non-governmental organisations (e.g. semi-governmental and private laboratories) and insufficient capacity building to improve skills (e.g. entomological, surveillance skills) were also observed. Lastly, we observed how bottlenecks in one building block negatively influenced other building blocks (e.g. inadequate leadership/governance obstructed the workforce's performance). Conclusions This study uncovers potential organisational bottlenecks that have affected the performance of the health system of Curaҫao negatively. We recommend starting with the reinforcement of oversight of the integrated vector management programme to ensure the development, implementation and evaluation of related legislation, policies and interventions. Also, we recommend evaluating and reforming the existing administrative and organisational structure of the health system by considering the cultural style, challenges and barriers of the current health system. More efforts are needed to improve the documentation of agreements, recruitment and evaluation of the workforce's performance. Based on our findings, we conceptualised actions to strengthen the health system's building blocks to improve its performance for future outbreaks of infectious diseases. Graphical abstract |
| first_indexed | 2024-12-21T03:50:24Z |
| format | Article |
| id | doaj.art-78ac001e170f405cafecf45b7418f916 |
| institution | Directory Open Access Journal |
| issn | 1756-3305 |
| language | English |
| last_indexed | 2024-12-21T03:50:24Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Parasites & Vectors |
| spelling | doaj.art-78ac001e170f405cafecf45b7418f9162022-12-21T19:16:58ZengBMCParasites & Vectors1756-33052021-09-0114111710.1186/s13071-021-05011-xEvaluating and strengthening the health system of Curaҫao to improve its performance for future outbreaks of vector-borne diseasesVaitiare Mulderij-Jansen0Izzy Gerstenbluth1Ashley Duits2Adriana Tami3Ajay Bailey4Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center GroningenDepartment of Epidemiology, Curaçao Biomedical & Health Research InstituteRed Cross Blood Bank FoundationDepartment of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center GroningenInternational Development Studies, Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht UniversityAbstract Background Vector-borne diseases (VBDs) such as dengue, chikungunya, and Zika pose a significant challenge to health systems in countries they affect, especially countries with less developed healthcare systems. Therefore, countries are encouraged to work towards more resilient health systems. This qualitative study aims to examine the performance of the health system of the Dutch Caribbean island of Curaҫao regarding the prevention and control of VBDs in the last decade by using the WHO health system building blocks. Methods From November 2018 to December 2020, a multi-method qualitative study was performed in Curaçao, applying content analysis of documents (n = 50), five focus group discussions (n = 30), interviews with experts (n = 11) and 15 observation sessions. The study was designed based on the WHO framework: health system building blocks. Two cycles of inductive and deductive coding were employed, and Nvivo software was used to analyse the data. Results This study’s data highlighted the challenges (e.g. insufficient oversight, coordination, leadership skills, structure and communication) that the departments of the health system of Curaҫao faced during the last three epidemics of VBDs (2010–2020). Furthermore, low levels of collaboration between governmental and non-governmental organisations (e.g. semi-governmental and private laboratories) and insufficient capacity building to improve skills (e.g. entomological, surveillance skills) were also observed. Lastly, we observed how bottlenecks in one building block negatively influenced other building blocks (e.g. inadequate leadership/governance obstructed the workforce's performance). Conclusions This study uncovers potential organisational bottlenecks that have affected the performance of the health system of Curaҫao negatively. We recommend starting with the reinforcement of oversight of the integrated vector management programme to ensure the development, implementation and evaluation of related legislation, policies and interventions. Also, we recommend evaluating and reforming the existing administrative and organisational structure of the health system by considering the cultural style, challenges and barriers of the current health system. More efforts are needed to improve the documentation of agreements, recruitment and evaluation of the workforce's performance. Based on our findings, we conceptualised actions to strengthen the health system's building blocks to improve its performance for future outbreaks of infectious diseases. Graphical abstracthttps://doi.org/10.1186/s13071-021-05011-xCaribbean regionDengueZika virusChikungunya virusMosquito controlCommunication |
| spellingShingle | Vaitiare Mulderij-Jansen Izzy Gerstenbluth Ashley Duits Adriana Tami Ajay Bailey Evaluating and strengthening the health system of Curaҫao to improve its performance for future outbreaks of vector-borne diseases Parasites & Vectors Caribbean region Dengue Zika virus Chikungunya virus Mosquito control Communication |
| title | Evaluating and strengthening the health system of Curaҫao to improve its performance for future outbreaks of vector-borne diseases |
| title_full | Evaluating and strengthening the health system of Curaҫao to improve its performance for future outbreaks of vector-borne diseases |
| title_fullStr | Evaluating and strengthening the health system of Curaҫao to improve its performance for future outbreaks of vector-borne diseases |
| title_full_unstemmed | Evaluating and strengthening the health system of Curaҫao to improve its performance for future outbreaks of vector-borne diseases |
| title_short | Evaluating and strengthening the health system of Curaҫao to improve its performance for future outbreaks of vector-borne diseases |
| title_sort | evaluating and strengthening the health system of curaҫao to improve its performance for future outbreaks of vector borne diseases |
| topic | Caribbean region Dengue Zika virus Chikungunya virus Mosquito control Communication |
| url | https://doi.org/10.1186/s13071-021-05011-x |
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