In the first months of the COVID-19 pandemic in the Dominican Republic, the support and accompaniment of the United States Government was key, offering technical assistance to the Dominican Government for the development of essential measures and processes to face the pandemic and design guidelines for the reopening of health services considered non-essential.
With a view to a gradual and safe reopening of the country’s economic activity, on April 7, 2020, the Ministry of Public Health requested technical assistance from the United States Government for the preparation of a document with standard and enhanced guidelines for prevention and control of COVID-19 towards a normalization and reintegration of health personnel into economic activities, guaranteeing safe environments and risk control. This document would serve as the basis for organizing a progressive reintegration of health personnel to their work.
To this end, a technical work and coordination group was created made up of the Ministry of Public Health, the United States government through the United States Agency for International Development (USAID), and the U.S. Centers for Disease Control and Prevention (CDC), the Pan American Health Organization (PAHO) and other public health sector institutions. The team of consultants from the non-governmental organization Management and Innovation in Health (GIS) worked together with the multidisciplinary technicians of the Ministry of Health and the cooperation agencies in the development of the standardization document by stages.
The United States government, through its CDC and USAID, offered essential support in the preparation of opening plans called “guidelines for the normalization of the provision of health services in the face of the Covid-19 pandemic”, through continuous technical assistance and making support material available, which was used as the basis for the drafting of these guidelines. Subsequently, the United States government followed the accompaniment by reviewing these drafts, sharing the protocol implemented in the United States, as well as in other countries, which allowed the Dominican government to learn about best practices and adapt the plan to the specific conditions of the country.
Dr. Bianca Álvarez, CDC epidemiologist in the Dominican Republic, who led the CDC’s efforts in this area, assures that “the preparation of this guide was testimony to a great effort on the part of the Ministry of Health in conjunction with the various consultants that included PAHO, USAID, and us as CDC. It was an exceptional experience to work hand in hand with colleagues from different areas on an issue of such importance as the reopening of health services during a global pandemic. ”
Dr. Claudia Valdéz, who directs the Health Management and Innovation (GIS) entity, responsible for the preparation of these guidelines, states that “it was a pleasure to be able to share this experience, which It was an excellent coordination job and of a very high technical level between various agencies ”.
These general guidelines synthesize the best available evidence for the prevention and control of the transmission of COVID-19 in health sector institutions. The recommended sanitary measures incorporate the human rights approach and emphasize the operational actions that public and private health sector institutions must take to minimize the risks of contagion in their work environment and guarantee services to the vulnerable population.
Protocols for health workers and health centers in the face of COVID-19
In the first weeks of the impact of the pandemic in the country, the United States Government, through the U.S. Centers for Disease Control and Prevention (CDC), supported the Dominican government in the creation of protocols for the prevention of contagion by the virus in health workers, and in the case of contagion, the effective identification and monitoring of these cases. Likewise, the CDC provided the guidelines for the elaboration of protocols for the monitoring of health centers, to have control and ensure the appropriate conditions in equipment and materials, in favor of the country having the capacity to offer efficient health services to cope with the pandemic.
These protocols were carried out through the design of control forms, which were carried out with the accompaniment of specialized personnel from the United States Government, through its CDC, who also provided reference models for these controls in the EE. .UU.
Similarly, the experience of the CDC contributed to the process of strategic management of resources to send them to the areas of greatest health need, given the risk of saturation of the health system due to many infections.
These controls were carried out through the design of the following forms:
– General Information by COVID-19 center
– Follow-up of Hospitalized Patient for COVID-19
– Monitoring of Health Personnel COVID-19
– Form for evaluation of availability and proper use of PPE and application of biosafety measures
The technical support of the CDC constituted the face-to-face support of its specialists for one month, and feedback and follow-up for two months, until the final documents were achieved.