Martel, Lise D. (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/4b29b663h?locale=en


Emergency preparedness plays a crucial role in saving lives and protecting the health of the population during disasters. The Ministry of Health (MOH) plays a central and coordinating role for the health sector in disasters. Efforts to improve emergency preparedness should be based on a systematic evaluation of existing response capacity and gaps in preparedness. In an effort to promote a scientific process, after determining that no existing tool could adequately assess and compare the emergency preparedness of MOHs of Central America, the CDC and COMISCA developed an instrument that could be used in all countries of Central America. The instrument includes questions organized around eight functional areas of public health emergency preparedness. The tool was used to systematically evaluate the emergency preparedness of the MOHs of Central America, and identify areas in which improvements can be made.

Overall, the MOH of Nicaragua was the most prepared and Belize was the least prepared. Each country showed a wide range of variation between scores for the different elements. Overall, Surveillance Systems emerged as the strongest of the elements across countries. Training, Exercises, and Evaluation was the weakest element for all countries but one. Recommendations were made to improve emergency preparedness at the country and regional level.

Table of Contents

Table of Contents

Chapter 1 - Introduction. 9

Overview.. 9

Theoretical Framework. 9

Rationale. 10

Problem Statement. 11

Purpose. 11

Research Questions. 11

Summary. 11

Chapter 2 - Review of the Literature. 12

Overview.. 12

Central America's Vulnerability to Disasters. 12

Belize. 13

Costa Rica. 13

Guatemala. 14

Honduras. 14

Nicaragua. 15

Panama. 15

Measuring Emergency Preparedness. 15

The Emergency Preparedness Assessment Tool for Central America. 17

The International Health Regulations. 19

Summary. 20

Chapter 3 - Methodology. 21

Overview.. 21

Instrument. 21

Quantitative measure. 21

Qualitative measure. 22

Procedures. 22

Data Analysis. 24

Summary. 24

Chapter 4 - Results. 25

Overview.. 25

Public Health Emergency Plan. 25

Quantitative results. 25

Qualitative results. 27

Command and Control 32

Quantitative results. 32

Qualitative results. 33

Communication Infrastructure. 38

Quantitative results. 38

Qualitative results. 39

Public Information and Risk Communication. 43

Quantitative results. 43

Qualitative results. 44

Logistics and Operational Processes. 50

Quantitative Results. 50

Qualitative results. 51

Medical Coordination. 56

Quantitative results. 56

Qualitative results. 56

Training, Exercises, and Evaluation. 59

Quantitative results. 59

Qualitative results. 60

Surveillance Systems. 63

Quantitative results. 63

Qualitative results. 64

Summary. 72

Chapter 5 - Conclusion. 74

Overview.. 74

Discussion. 74

Future Steps. 77

Summary. 79

References. 80

Appendix A: Definition of Terms. 84

Appendix B: Acronyms. 85

Appendix C: Questionnaire. 87

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