Access and coverage of malaria services in Haiti in the context of elimination: a scoping review of the literature.

Introduction: Haiti is on the verge of possibly eliminating malaria, an endemic parasitic infection primarily caused by Plasmodium falciparum on the island of Hispaniola. Owing to its associated morbidity and mortality, malaria is a leading public health priority in Haiti. This scoping review aims to identify the scope of research on access and coverage of malaria surveillance, diagnosis, and treatment in Haiti in the elimination setting.

Methods: We compiled, analyzed, and synthesized the literature on access and coverage of antimalarial services in Haiti in the elimination setting based on Arksey and O'Malley's framework for scoping reviews and held a formal meeting with the PNCM leadership and stakeholders of malaria programs in Haiti. Results were reported following PRISMA-ScR guidelines.

Results: We found 376 citations and five technical reports related to our keywords from 2016 to 2023 and retained 225 after eliminating duplicates. Based on our selection criteria, we retrieved 81 citations and excluded 56 after in-depth readings. Therefore, the review includes 26 articles and five technical reports. The Ministry of Health established a strategic plan covering the 2021-2030 period, providing a framework for operational planning to increase efficiency, strengthen the health system, and ensure the sustainability of interventions. However, the current weaknesses in surveillance underline a lack of well-trained personnel, difficulty in establishing the epidemiological profile of malaria, unreliability, lack of completeness of data, and delay in their transmission. In addition, access to malaria diagnosis and treatment in Haiti is limited due to a lack of available state-of-the-art testing modalities, variations in the geographic availability of rapid diagnostic tests and microscopy, and the widespread use of substandard antimicrobial drugs.

Conclusion: Research and reports on malaria surveillance, diagnosis, and treatment access and coverage in Haiti are limited; however, the available sources reveal significant shortcomings and challenges in implementing WHO-recommended policies and strategies for malaria elimination. Future studies should aim to fill this gap and investigate the determinants of the persistence of malaria cases in certain municipalities and departments of the country.