Access to health care is limited as a result of geography, limited expenditure on public health, variable quality of care, high turnover of service providers, a lack of drugs and supplies, and lack of ownership of health programmes by communities.
The topographical barriers combined with limited expenditure on public health, poor quality of care, a high turnover of service providers, a lack of drugs and supplies and a lack of ownership of health programmes by communities all contribute to issues of demand and supply.
In addition, treatment executive and correctional executive versions of the BSOC collected data on number of staff, staff turnover, types of services provided, admissions, caseload, and budget.
Given the complexity of the response in Haiti (and elsewhere), and the rapid evolution and turnover of health services, it would be near impossible to implement an overly comprehensive or complex health information system during the acute phase of an emergency.
The challenges include limited consultation of stakeholders in curricula development, inadequate framework for monitoring the curricula, inadequacy of funding for the projects, high turnover of in-service trainees [ 11], and the paradigm shift in medical education [ 12].
This was thought to be exacerbated by rapid turnover of operational service managers and senior managers within the Trusts that meant progress was lost, in addition to multiple tiers of management with responsibility for approval.
Of these, 11 were general capacity and capability questions addressing the themes of knowledge and awareness, and staffing, and eight were demographic type questions (that is, numbers of staff, turnover, length of service), some of which are also indicators for capability.
Frequent staff turnover and transfer of service providers also adversely affected the referral component of the program, which necessarily depends on the availability of reproductive health services.
Current organisational culture was seen as an inhibitor to care planning; examples of this included pressure to reduce workload (through discharging service users from services), high turnover of staff and fragmentation of services.
Within external services, turnover of clients and personnel turned out not to be relevant.
