New Standards for Haitian Health Services
In Haiti, it is a core function of the Ministry of Public Health and Population (MSPP)—through its Directorate of Health Service Organization (Direction d’Organisation des services de la santé, DOSS)—to define the set of health services to which every Haitian must have access and to enable and equip health providers and facilities to effectively, equitably, and accountably provide those services. Unfortunately—especially in the wake of the devastating 2010 earthquake and Hurricane Matthew in 2016—many health centers and hospitals do not provide the required services or meet the varied needs of the populations they serve. Haiti’s health system remains widely dysfunctional, and essential services are not available to many Haitians, despite policies that are in place.
In 2015, the USAID-funded Leadership, Management and Governance Project (LMG/Haiti), led by MSH, supported the DOSS in designing a new Package of Essential Services (PES). The PES and its implementation manual set out norms and standards, defined the roles and responsibilities of health care facilities and providers, and established a new paradigm for health care in Haiti. After its official launch in September 2016, the DOSS’ major challenge was implementing this Package of Essential Services following the aftermath of Hurricane Matthew, and within a health system characterized by inconsistent adherence to national standards. Once again, the DOSS requested LMG/Haiti’s technical and financial assistance to define the best approach to roll out implementation.
Working closely with project staff, the DOSS began implementation in late February 2017, with a participatory workshop for senior MSPP staff from the central health directorates and all ten of the country’s departments.
Dr. Gabriel Timothé, the MSPP’s Director-General, presented the departmental health directors with 1,200 copies of the manual, enough for every health facility in Haiti. He urged the directors to read it carefully, make it their own, and contribute fully to its implementation in their departments.
“This manual,” he said, “lays out the appropriate policies, approaches, and procedures that will enable our Ministry to provide the population with high-quality health care. It is up to us to effectively, progressively implement them….The Government must make the necessary investments to firmly ground the PES in concrete, sustainable action.’’
Three districts in the departments of Artibonite, Grande Anse, and Sud were selected for pilot implementation of the PES. With LMG/Haiti’s support, a PES technical committee used tools in the manual to evaluate 48 facilities against PES requirements. DOSS, the technical committee, and LMG/Haiti are now supporting the districts in developing action plans to quickly bring each facility up to standard. Building on this model, DOSS will then roll out the PES to every district and every facility across Haiti, putting a platform in place to ensure that all Haitians have access to standardized, equitable provisions of high-quality essential health services.