Haiti is hampered by some of the world’s worst health indicators. In order to overcome these challenges and strengthen the country’s overall health care network, it is essential that the Government of Haiti improve its capacity to address public health issues. The U.S. Government, members of the international community, and private sector providers are committed to improving the country’s health system in order to expand access to quality healthcare.
While many challenges still remain in the health sector, progress has been made. In July 2013, the Haitian Ministry of Public Health and Population (MSPP), with support from the U.S. Agency of International Development (USAID), released the 2012 Demographic and Health Survey (DHS). Despite significant health issues in Haiti related to the 2010 earthquake and cholera outbreak, a comparative analysis of the 2006 and 2012 DHS surveys revealed positive trends on key healthcare indicators, particularly those related to women and children. For example, the 2012 DHS showed that, between 2005-2006 and 2012 the proportion of children under five years of age with stunting decreased from 23.8 to 21.9 percent; wasting decreased from 9.1 to 5.1 percent; and underweight children decreased from 22.2 to 11.4 percent. The survey also revealed a net improvement in family planning related indicators. The total fertility decreased from four to 3.5 births per woman of reproductive age, and the modern contraceptive prevalence rate increased from 25 to 31 percent.
While this progress indicates that efforts to support and improve childhood nutrition and family planning services are having an impact, other health issues still persist. For example, while 90 percent of pregnant women received antenatal care from a skilled provider, only 36 percent delivered in a health facility. Additionally, only 45 percent of children 12-23 months of age were fully vaccinated, and the under-five mortality rate is high, at 88 for 1,000 live births.
U.S. Government Strategy
The U.S. Government, through USAID and the Centers for Disease Control (CDC), has been providing access to health services for approximately 50 percent of Haitians since before the 2010 earthquake. After the earthquake, the U.S. Government moved quickly to address new health needs, such as disability care and infectious disease outbreaks, while continuing to provide a basic package of health services, including maternal and child health, family planning, and immunization services, as well as the prevention and treatment of HIV/AIDS, tuberculosis, and neglected tropical diseases.
While the U.S. Government is currently providing a basic package of health services, strides are also being made to improve the MSPP’s capacity to take on a larger role in managing the country’s health care services. In June 2012, the U.S. Government and the Government of Haiti signed a five-year Health Partnership Framework to advance the Government of Haiti’s ownership and oversight of an adaptable public health system in Haiti and reduce its dependence on donor support over time. Since the launch of this framework, the Government of Haiti has made significant strides toward assuming primary responsibility for the management and performance monitoring of the overall health system, as well as providing increased financial support.
- Supporting nearly 300 healthcare sites nationwide that provide access to healthcare to nearly 50 percent of the Haitian population.
- Supported a national measles, rubella, and polio immunization campaign that reached over 90 percent coverage.
- Supported the introduction of the Pentavalent vaccine—a combination of five vaccines in one, including: diphtheria, tetanus, whooping cough, hepatitis B, and Haemophilus Influenza Type B—into the routine immunization schedule beginning in April 2012.
- Supported the National AIDS Control Program to advance the goals of universal access to antiretroviral drugs for all eligible patients with HIV and elimination of mother-to-child transmission of HIV. By September 2014, approximately 70 percent of eligible persons were receiving HIV treatment.
- Administered two annual rounds of the medication needed to prevent lymphatic filariasis to 2.2 million Haitians living in Port-au-Prince.
- Supported the expansion of diagnostic tests for tuberculosis, including the introduction of Gene Xpert—a new, rapid test that can confirm a diagnosis of tuberculosis and also indicate drug resistance—and supported the national laboratory in establishing the capacity to perform culture and drug susceptibility testing.
- Work with the National Laboratory to establish surveillance for causes of diarrhea, fever, and respiratory illness.
- Deployed 264 CDC-trained municipal water technicians to monitor water quality in community water systems.
- In close collaboration with the office of Haiti’s Secretary of State for the Reintegration of Persons with Disabilities, USAID issued sub-grants to ten disabled people organizations.
- Expanded disability care through four programs focused on rehabilitating and reintegrating persons with disabilities into society, while building the capacity of governmental and non-governmental institutions to effectively support them in a sustainable manner.
- Reconstruction of the Hospital of the State University of Haiti is currently underway; opened the renovated emergency room in late 2012 and the renovated maternity ward in March 2013.
- Renovated health facilities in Cap-Haïtien, Quartier Morin, Caracol, Ouanaminthe, Saint-Marc, Cabaret, Martissant, and Fort Liberte, as well as the MSPP headquarters in Maisgate.
- Supporting the renovations of the National Campus of Health Sciences, which was destroyed in the earthquake. Designs were completed for Saint Michel de l’Attalaye Community Referral Hospital and Platana Primary Community Health Center, and are in the process of being finalized for the Central Medical Warehouse.
- Socially marketed water treatment tablets, oral rehydration salts, condoms, and other contraceptives, which are now available in 6,000 sales points nationwide.
- Completed the Service Provision Assessment to provide the MSPP with a baseline of services provided and a quality level of service provision at all facilities across the country in October 2013.
- In partnership with the World Bank, introducing the new national results-based financing norms, validated by the Government of Haiti in November 2013. Results-based financing will link payments directly to health outcomes, enabling better governance and accountability in the sector.
- Supported the MSPP on the FY2011-FY2012 National Health Account (NHA) process, which was completed in August 2013. The NHA provides evidence to monitor trends in health spending for all sectors—both public and private. Support has also been initiated for the FY 2012-FY 2013 NHA.
- Provided more than $5 million to private hospitals, including Hôpital Albert Schweitzer, St. Boniface Hospital, and St. Luke Hospital, through USAID’s American Schools and Hospitals Abroad program.
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Last updated: January 28, 2015