Improving Health Care Efficiency in Haiti: Proposal of a Health Policy & Lessons Learned from the Response to a Major Disaster

The effectiveness of a response to the emergency health care needs of a population, during a major disaster, depends on multiple factors. Some of these factors are external to the health care system, such as geography and demography, but others are intrinsically related to the structure and organization of the health care system.

This study reviewed the health care system and policies before the earthquake, the response during the quake, and the situation in the aftermath. Prior to the earthquake, the Haitian health care system was very fragmented, inefficient, disorganized, and lacked planning and coordination of services, leading to unequal distribution. Approximately 47 % of the population (Rand , 2010) does not have access to health care, and NGOs play a fundamental role in the provision of health care services. The present study proposes the development of administrative structures and policies that can improve the efficiency of the health care system, especially in the area of coordination of services.

We propose the creation of a Coordination Unit, which will strengthen the government's management capability to provide appropriate oversight of policies and regulations. The middle level of the government should be in charge of policy development and oversight of implementation and performance of these plans and regulations. Institutional capacity building is one of the priorities the Haitian government should address in its Rebuilding Haiti Strategy. Coordination units are essential administrative structures that will help to considerably improve the performance and efficiency of the health care system.