Factors associated with COVID-19 vaccination in Belize.

Background: We analyzed the factors associated with vaccine uptake, vaccination intention, and reasons for vaccine hesitancy in Belize. Methods: We collected a nationally representative household survey of the population in Belize aged 15 years and older (September-October 2021). We compared potential correlates between vaccinated and unvaccinated people using Chi-square tests. Then, we performed logistic regression analysis to identify factors associated with vaccination uptake among all respondents and vaccination intention among the unvaccinated. Results: Our analysis included data from 1261 interviews. Nearly four out of every five people reported being vaccinated, having received at least one dose. Adolescents and young adults were more likely to be unvaccinated. Significant differences were observed for most behavioral variables. Among the 41.7% of the unvaccinated respondents who said they would probably not or definitely not get vaccinated, the primary reason for their hesitation was fear of side effects. Additionally, almost one third of the unvaccinated individuals expressed a lack of trust in vaccines. Factors associated with increased likelihood of vaccination were efficacy beliefs, self-efficacy and vaccine attitudes. People who believed it was easy to get a vaccine were over 23 times (OR 23.63 [95% CI: 14.21-39.27]) more likely to be vaccinated, while those who believed in vaccine safety were 2.57 times [OR 95% CI: 1.52-4.35] more likely to be vaccinated. Among the unvaccinated, factors associated with intention to get vaccinated were self-identifying as Garifuna and having clear efficacy beliefs. Conclusions: To our knowledge, this is the first study describing factors associated with COVID-19 vaccine uptake and vaccine hesitancy in Belize. Our findings revealed that accessibility has been the primary limitation in increasing vaccine coverage, and <7% of the eligible population have been strong vaccine deniers. To enhance vaccine uptake, targeted outreach efforts are necessary to address access barriers. Our results call for increased efforts improving self-efficacy, efficacy beliefs, and perceived norms.

Voices of those living with type 2 diabetes in Belize: barriers to care before and during the COVID-19 pandemic.

Belize has the highest national prevalence of type 2 diabetes (T2D) of Central and South America, and fifth direst in the world. T2D is the leading cause of death in Belize, a country facing burdens of increasing prevalence with few resources. Since March of 2020, the COVID-19 pandemic has exacerbated the difficulties of those living with T2D in Belize. To address T2D issues in Belize, our interdisciplinary research team explored the barriers to care and self-management for adult patients with T2D in Belize prior to and during the COVID-19 pandemic.Research relationships between Canadian (ARH) and Belizean (LE) authors have been ongoing since 2016. Together we used a qualitative Constructivist Grounded Theory design generating knowledge through 35 semi-structured patient interviews, 25 key informant discussions, and participant observation with field notes between February 2020 to September 2021. We used Dedoose analysis software for a systematized thematic coding process, as well as iterative verification activities. Findings revealed several barriers to care and self-management, including: 1) the tiered health and social care system with major gaps in coverage; 2) the unfulfilled demand for accurate health information and innovative dissemination methods; and 3) the compounding of loss of community supports, physical exercise, and health services due to COVID-19 restrictions. In the post-pandemic period, it is necessary to invest in physical, nutritional, economic, and psychosocial health through organized activities adaptable to changeable public health restrictions. Recommendations for activities include sending patients informational and motivational text messages, providing recipes with accessibly sourced T2D foods, televising educational workshops, making online tools more accessible, and mobilising community and peer support networks.

Plant medicine usage of people living with type 2 diabetes mellitus in Belize: A qualitative exploratory study.

BACKGROUND: Type 2 Diabetes Mellitus (T2DM) is a primary cause of death in Belize, a low-income country with the highest rates in Central and South America. As many people in Belize cannot consistently access biomedical treatment, a reality that was exacerbated by the COVID-19 pandemic, plant medicine usage is estimated to have increased in recent years. This exploratory study seeks to understand which plants are being used, patterns of usage, and the state of patient-provider communication around this phenomenon. METHODS: Implementing a Constructivist Grounded Theory qualitative design, the research team conducted 35 semi-structured interviews with adults living with T2DM, 25 informant discussions, and participant observation with field notes between February 2020 and September 2021. Data analysis followed systematized thematic coding procedures using Dedoose analytic software and iterative verification processes. RESULTS: The findings revealed that 85.7% of participants used plants in their T2DM self-management. There were three main usage patterns, namely, exclusive plant use (31.4%), complementary plant use (42.9%), and minimal plant use (11.4%), related to factors impacting pharmaceutical usage. Almost none of participants discussed their plant medicine usage with their health care providers. CONCLUSIONS: Plant species are outlined, as are patients' reasons for not disclosing usage to providers. There are implications for the advancement of understanding ethnobotanical medicine use for T2DM self-management and treatment in Belize and beyond.

Burnout, mental health, physical symptoms, and coping behaviors in healthcare workers in Belize amidst COVID-19 pandemic: A nationwide cross-sectional study.

BACKGROUND: Healthcare workers are vulnerable to burnout, especially during the COVID-19 pandemic in the low resource settings. Belize is a small Central American developing country known for its chronic healthcare worker shortage and this is the first study to assess burnout prevalence and its associated factors among healthcare workers in Belize. AIM: To evaluate the prevalence of burnout and its associated factors in HCWs in Belize covering multiple domains (mental health, physical symptoms, and coping behaviors) during the COVID-19 pandemic. METHODS: A cross-sectional survey that was developed and validated by a panel of experts was delivered online to all the healthcare workers in Belize from September to November 2021. Burnout was assessed using Copenhagen Burnout Inventory. Depression and anxiety screening was carried out using the Patient Health Questionnaire - 2 (PHQ-2) and Generalized Anxiety Disorder 2-item (GAD-2). Burnout associated factors were estimated using logistic regression models. FINDINGS: Of the total of 263 participants, 27.76% had overall burnout: 56.65% had personal, 54.37% had work-related, and 19.39% had patient-related burnout. Burnout was positively associated with anxiety (OR: 3.14 [1.67, 5.92]), depression (OR: 4.45 [2.30, 8.61]), intentions of quitting their jobs (OR: 2.59 [1.49, 4.51]), health status worsening (OR: 2.21 [1.26, 3.87]), multiple physical symptom presentation (OR: 1.19, [1.10, 1.29]), and use of multiple maladaptive coping behaviors (OR: 1.66, [1.30, 2.12]). INTERPRETATION: Healthcare workers in Belize showed substantial levels of burnout which were significantly associated with using maladaptive coping behaviors, presenting multiple physical symptoms, quitting their jobs, health status worsening, and other mental health issues. These findings should be used to develop and implement programs such as regular health check-ups, health promotion awareness campaigns, and worker recruitment strategies which would improve the working conditions, quality of life, and psychological well-being of our healthcare workers.

Incorporating COVID-19 into Acute Febrile Illness Surveillance Systems, Belize, Kenya, Ethiopia, Peru, and Liberia, 2020-2021.

Existing acute febrile illness (AFI) surveillance systems can be leveraged to identify and characterize emerging pathogens, such as SARS-CoV-2, which causes COVID-19. The US Centers for Disease Control and Prevention collaborated with ministries of health and implementing partners in Belize, Ethiopia, Kenya, Liberia, and Peru to adapt AFI surveillance systems to generate COVID-19 response information. Staff at sentinel sites collected epidemiologic data from persons meeting AFI criteria and specimens for SARS-CoV-2 testing. A total of 5,501 patients with AFI were enrolled during March 2020-October 2021; >69% underwent SARS-CoV-2 testing. Percentage positivity for SARS-CoV-2 ranged from 4% (87/2,151, Kenya) to 19% (22/115, Ethiopia). We show SARS-CoV-2 testing was successfully integrated into AFI surveillance in 5 low- to middle-income countries to detect COVID-19 within AFI care-seeking populations. AFI surveillance systems can be used to build capacity to detect and respond to both emerging and endemic infectious disease threats.

Annual Report 2021. Belize: Responding to COVID-19 and Preparing for the Future

In 2022 the Pan American Health Organization (PAHO) is celebrating its 120th anniversary. Operating as the independent specialized health agency of the inter-American system, PAHO provides technical cooperation to its Member States to address communicable and noncommunicable diseases and their causes, strengthen health systems, and respond to emergencies and disasters throughout the Americas. In addition, in its capacity as the World Health Organization’s Regional Office for the Americas, PAHO participates in the United Nations Country Team, collaborating with other United Nations agencies, funds, and programs to contribute to the achievement of the Sustainable Development Goals (SDGs) at country level. At the subregional level, PAHO works with integration mechanisms to position health and its determinants on the political agenda. The 2021 Country Annual Reports reflect PAHO’s technical cooperation in countries and territories in implementing the Country Cooperation Strategies, responding to their needs and priorities, and operating within the framework of PAHO’s regional and global mandates and the SDGs. Under the overarching theme of Responding to COVID-19 and Preparing for the Future, they highlight PAHO’s actions on the COVID-19 pandemic and its continuing efforts in priority areas such as health emergencies, health systems and services, communicable diseases, noncommunicable diseases and mental health, health throughout the life course, and health equity. They also provide a financial summary for the biennium 2020-2021.

Belize Covid-19 report for November 1-7, 2022, having 15 new cases, confirming 68,972 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for November 1-7, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for November 8-14, 2022, having 16 new cases, confirming 68,988 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report update on Covid-19 consisting of PCR and rapid tests done in Belize for November 8-14, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for November 15-22, 2022, having 24 new cases, confirming 69,012 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for November 15-22, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for October 25-31, 2022, having 14 new cases, confirming 68,957 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for October 25-31, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Ministry of Health & Wellness Commemorates World Mental Health Day 2022 October 6, 2022 / Ministry of Health & Wellness Commemorates World Mental Health Day 2022 October 6, 2022

On October 10, 2022, the world will commemorate World Mental Health Day under the theme "Make mental health and wellbeing for all a global priority." The theme was chosen to address the inequalities exposed by the COVID-19 pandemic and its impact globally on people's mental health.

Belize Covid-19 report for October 1-4, 2022, having 30 new cases, confirming 68,884 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for October 1-4, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for October 5-11, 2022, having 25 new cases, confirming 68,909 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for October 5-11, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for October 12-17, 2022, having 24 active cases [17 new], confirming 68,926 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for October 12-17, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for October 18-24, 2022, having 17 new cases, confirming 68,943 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 report for October 18-24, 2022

Two (2) new infographic daily report updates on Covid-19 consisting of PCR and rapid tests done in Belize for October 18-24, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for September 24-27, 2022, having 42 new cases, confirming 68,826 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for September 24-27, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Belize Covid-19 report for September 28-30, 2022, having 28 new cases, confirming 68,854 cumulative positive cases since the first case in March 2020 with two (2) descriptive infographics / Belize Covid-19 Report

Two (2) new infographic report updates on Covid-19 consisting of PCR and rapid tests done in Belize for September 28-30, 2022 depicting the heat map by districts, cumulative and daily statistics, hospitalizations, new positive cases and vaccination rate.

Impact of COVID-19 on Human Resources for Health and Policy Response: the Case of Belize, Grenada, and Jamaica

Health workers are crucial in the preparedness and response to COVID-19, but the pandemic has evidenced the shortage of human resources for health (HRH) in certain countries, reduced or lack of protective equipment, and timely protocols to address occupational, health and safety issues. Health workers have been infected by the virus with consequences in terms of morbidity and mortality. Consequently, available staff workload is expected to increase. While the COVID-19 pandemic has stressed health workforce shortages in countries, it has also led to identifying ways to rapidly hire and train the health workforce. The recognition and understanding of the mechanisms used by countries (such as recruitment processes, type of redeployment, incentives) will provide evidence on ways to address health worker shortages during such outbreaks and therefore implementation gaps will be reduced. This report informs and analyzes the impact of COVID-19 on health workers' occupational health and safety concerns, working conditions, as well as policy responses to address these issues and to increase HRH surge capacity in Belize, Grenada, and Jamaica. The report also describes elements related to HRH and COVID-19 vaccination in selected countries and shares the experiences from Belize, Grenada, and Jamaica (members of CARICOM), which represent different areas of the Caribbean. The report will also inform the HRH Action Task Force and its contribution to technical cooperation and HRH management support. The target audience includes policy-makers, academics, and researchers on addressing health worker issues during health emergencies.

Annual Report 2020. Universal Health and the Pandemic. Resilient Health Systems. Belize

Founded in 1902 as the independent specialized health agency of the inter-American system, the Pan American Health Organization (PAHO) has developed recognized competence and expertise, providing technical cooperation to its Member States to fight communicable and noncommunicable diseases and their causes, to strengthen health systems, and to respond to emergencies and disasters throughout the Region of the Americas. In addition, acting in its capacity as the World Health Organization’s Regional Office, PAHO participates actively in the United Nations Country Team, collaborating with other agencies, the funds and programs of the United Nations system to contribute to the achievement of the Sustainable Development Goals (SDGs) at country level. This 2020 annual report reflects PAHO’s technical cooperation in the country for the period, implementing the Country Cooperation Strategy, responding to the needs and priorities of the country, and operating within the framework of the Organization’s regional and global mandates and the SDGs. Under the overarching theme of Universal Health and the Pandemic – Resilient Health Systems, it highlights PAHO’s response to the COVID-19 pandemic as well as its continuing efforts in priority areas such as communicable diseases, noncommunicable diseases, mental health, health throughout the life course, and health emergencies. It also provides a financial summary for the year under review.

Belize Covid-19 daily report for April 7, 2021 confirming 12,485 cumulative positive cases since the first case in March 2020 with three (3) descriptive infographics

Three (3) infographic daily report updates on Covid-19 and SARSCoV 2 lab screenings done in Belize for April 7, 2021 depicting the heat map by districts, total persons tested, negative persons, new positive cases, cumulative reports, those under investigation and overall percentages