| Course | PU335 Global Health |
|---|---|
| Unit | Unit 6 |
| Paper type | Health systems building blocks comparison |
| Length | About 1,110 words, 7 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BS in Health Science |
| Updated | October 2026 |
Free sample paper for PU335 Unit 6
Six Building Blocks, Two Systems, One Island: A Unit 6 Comparison of the Health Systems of Haiti and the Dominican Republic
[Student Name]
Purdue University Global
PU335: Global Health
Unit 6 Health Systems Comparison
[Instructor Name]
[Date]
The analysis is the student's; the framework, laws and studies cited are real, and system details should be checked against current sources.
The Framework
The World Health Organization's framework for action describes a health system through six building blocks: service delivery; the health workforce; health information systems; access to essential medical products, vaccines and technologies; health financing; and leadership and governance (World Health Organization, 2007). The blocks interact: a financing system shapes whether people use services, and workforce shortages limit what any facility can deliver. The framework is widely used to compare systems because it separates functions that otherwise blur together.
Service Delivery
Haiti. Care is delivered by a mix of government facilities, nongovernmental organizations, faith-based hospitals and private providers. Coverage is uneven, with large rural areas poorly served and services in parts of the capital disrupted by violence in recent years. Many births still take place at home.
Dominican Republic. A national network of public hospitals and primary care units, alongside a large private sector, provides wider geographic coverage. Most births take place in facilities.
Health Workforce
Haiti. Haiti has very few physicians and nurses per person, and many trained professionals emigrate. Community health workers fill part of the gap, especially in programs run by nongovernmental organizations. Training capacity is limited, and graduates often leave for Canada, the United States or France, so the country effectively trains health workers for richer systems.
Dominican Republic. The workforce is larger and more evenly spread, though rural areas and public facilities still report shortages, and quality varies.
Health Information Systems
Haiti. Vital registration is incomplete and many estimates are modeled, as Unit 3 showed. Parallel reporting systems run by different organizations make national data hard to assemble.
Dominican Republic. A national surveillance system and more complete registration provide better data, though coverage of migrants is weaker. The country also takes part in regional reporting through the Pan American Health Organization, which makes its figures easier to compare with neighbors.
Medical Products
Haiti. Supply chains for medicines depend heavily on donors and nongovernmental organizations, and stockouts are common, especially when transport routes are blocked. Cold chain equipment for vaccines depends on fuel for generators, which became scarce during the blockades of recent years.
Dominican Republic. A national program supplies essential medicines to public facilities, with private pharmacies serving those who can pay.
Financing
Dominican Republic. A social security law passed in 2001 created a national health insurance system with contributory coverage for formal workers and a subsidized regime for low-income people, administered largely through a public insurer. Coverage has expanded substantially since, although out-of-pocket spending remains significant and people without documents face barriers to enrollment.
Haiti. Haiti has no national insurance scheme that reaches most residents. Households pay out of pocket for much of their care, and a large share of health spending comes from external donors, often directed to specific programs such as HIV rather than to the system as a whole.
The single sentence that best explains the difference between the two systems is that one country built a national way to pay for care and the other did not.
Leadership and Governance
As Unit 5 showed, and as global studies of national public health agencies suggest (Sasie et al., 2026), Haiti's ministry struggles to coordinate hundreds of independent actors, while the Dominican ministry exercises more central authority. Leadership shapes every other block: without it, donor programs, private providers and public facilities operate in parallel rather than as a system.
How the Blocks Interact
The blocks cannot be strengthened one at a time. In Haiti, a training program can add midwives, but if the facility where they work has no reliable supply of oxytocin, no way for patients to pay and no information system to show where deaths are occurring, the added workforce changes little. In the Dominican Republic, insurance has drawn more patients into public hospitals, which has exposed shortages of staff and medicines that were less visible when fewer people sought care. Each system's weakest block limits the return on investment in the others.
What Patients Experience
For a pregnant woman in rural Haiti, the building blocks translate into a series of questions: whether a clinic is within walking distance, whether a trained midwife will be there, whether the medicines she needs are in stock and whether she can pay. For a pregnant woman in the Dominican Republic, most of those questions have reassuring answers, but if she is a migrant without documents, the financing question may still block her. Looking at the system from the patient's side shows why financing and governance carry so much weight in this comparison.
Which Blocks Explain the Outcomes
Kolivand et al. (2025), ranking the performance of health systems across 31 countries on health outcomes, financing and the response to the COVID-19 pandemic, found that performance varied widely and that strong outcomes tended to accompany sustained financing and effective governance. On Hispaniola, financing and leadership stand out. The Dominican Republic's insurance system and stronger ministry allow the other blocks, workforce, medicines and information, to function as parts of one system. Haiti's reliance on out-of-pocket payment and fragmented donor funding means that even where services exist, the poorest often cannot use them, and the system cannot plan as a whole.
One Priority for Each System
Haiti. Begin pooling financing for a defined package of essential services, starting with maternal and newborn care and child health, funded through a combination of government revenue and donor contributions channeled through the ministry rather than parallel programs.
Dominican Republic. Extend the subsidized insurance regime explicitly to migrants and their descendants who lack documents, closing the most visible gap in a system that otherwise covers most of the population.
Limits
Building-block comparisons simplify systems into categories, and the blocks overlap. Information on Haiti's system is especially incomplete and changes quickly with political events. Ranking studies use composite indicators that can mask important details. My comparison also relies on published descriptions rather than visits or interviews, so it may miss how the systems work day to day.
Conclusion
Across the six building blocks, the Dominican Republic has a more complete and coordinated health system than Haiti, but the decisive difference lies in financing and leadership: a national insurance system and a ministry that can coordinate, compared with out-of-pocket payment and fragmented, donor-driven programs. Those differences help explain why similar diseases produce different outcomes on the same island.
References
Kolivand, P., Arabloo, J., Saberian, P., Dorooudi, T., Rajaie, S., Karimi, F., Raei, B., Behzadifar, M., Parvari, A., Ehsanzadeh, S. J., Homayoun, S., Salehbeigi, S., Namdar, P., & Azari, S. (2025). Health systems performance in health outcomes, health financing and COVID-19 pandemic: Lessons from 31 countries. PLOS ONE, 20(10), e0334693. https://doi.org/10.1371/journal.pone.0334693
Sasie, S. D., Aragaw, F. M., Gebeyehu, T. A., Shikur, S. A., Fekadu, L., Ali, N. Z., & Argaw, Z. M. (2026). Building systems for preparedness: Global scoping studies on institutional governance and national public health agencies. PLOS Global Public Health, 6(2), e0005427. https://doi.org/10.1371/journal.pgph.0005427
World Health Organization. (2007). Everybody's business: Strengthening health systems to improve health outcomes: WHO's framework for action. https://iris.who.int/handle/10665/43918
What the PU335 Unit 6 assignment asks for
In Unit 6 students compare two health systems using a recognized framework, most often the World Health Organization's six building blocks. Each block should be described for both countries with specific features rather than general impressions. Instructors expect the paper to judge which blocks best explain differences in outcomes, not to give them equal weight. Financing is usually examined through insurance coverage, out-of-pocket spending and the role of donors. The paper should show how blocks interact, since a weakness in one limits the others. Most prompts ask for one or two priorities for each system and a section on limits. A table summarizing the blocks can help, as long as the prose carries the analysis.
How the PU 335 Unit 6 example is put together
The sample introduces the framework from the World Health Organization's framework for action, then compares each block in paired paragraphs. Haiti's workforce loss to emigration, modeled data and fragile cold chain are set against the Dominican Republic's national network and surveillance system. Financing receives the most attention, with the highlighted line that one country built a national way to pay for care and the other did not. Governance draws on Sasie and colleagues. Sections on interaction and on a pregnant woman's experience show why the blocks matter together. Kolivand and colleagues support the weight given to financing and governance. One priority is proposed for each country, followed by limits of the comparison.
Where the points sit in the PU335 Unit 6 rubric
Markers of a systems comparison usually weigh correct handling of the six blocks, depth of comparison, analysis of outcomes and quality of recommendations. Each block should be covered for both countries with specific evidence. Graders reward papers that identify the decisive blocks and explain why. Interaction between blocks shows systems thinking. Financing analysis should go beyond spending totals to who pays and who is covered. Recommendations should address the weakest or decisive block. Peer-reviewed comparisons and official frameworks should be cited in APA 7. Recognizing that frameworks simplify and that data may be incomplete shows critical judgment. Papers that tie at least one block to an individual patient's experience tend to make the analysis easier to follow.
PU335 Unit 6 help: mistakes that cost points
System comparisons often describe each block in turn and never decide which matters most. Another common weakness is relying on general statements, such as "the system is weak," without features or figures. Financing is sometimes reduced to how much a country spends, missing insurance coverage and out-of-pocket costs. Interaction between blocks is frequently left out. Recommendations may be too broad, such as "improve the health system." Before drafting, make a two-column table with one row per block and fill it with specific features for each country. Then circle the rows that explain the outcome gap. That table, with your rubric, is the best starting point to send.
Get a PU335 Unit 6 example written to your instructions
Send the countries and the comparison instructions with the rubric. A custom comparison applies the framework to both systems. It is free the first time and arrives within 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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PU335 Unit 6 questions, answered
What are the WHO building blocks?
Service delivery, health workforce, information, medical products, financing and leadership and governance.
How is financing compared?
Often by spending per person, out-of-pocket share and insurance coverage.
Should outcomes be included?
Yes, linked to how the system is organized.
Where can I find a free PU335 Unit 6 sample paper?
The complete PU335 Unit 6 health systems comparison is on this page, applying the six building blocks to Haiti and the Dominican Republic.
Which building block does the PU335 Unit 6 sample rank first?
Financing, followed closely by leadership and governance, because they allow the other blocks to work as one system.