What will it Take to Maintain the Maternal and Child Health Gains Made in Haiti Prior to the 2010 Earthquake?

Abstract

This report assesses the commendable progress made in maternal and child mortality reductions in Haiti prior to the January 2010 earthquake. Suggested measures that the Haitian government and international donor community can take to maintain these gains are also made. With the Millennium Development Goals (MDGs) deadline of 2015 drawing nearer, the likelihood that Haiti will achieve MDG's 4 and 5 of reducing child and maternal mortality by two-thirds and three-quarters, respectively, by the end of this target year, remain questionable. In particular, the destruction inflicted on the country's health care system and health infrastructure by the 2010 earthquake have already resulted in a slowing of these gains and could potentially threaten an actual reversal of these trends. The country's Soins Obstétricaux Gratuits and Soins Infantiles Gratuits schemes established in 2008 and 2010, which provide free health care to women, newborns and children under 5, represent examples of measures that will need to be sustained and scaled up if the country is to meet its MDG 4 and 5 targets. The Haitian government's endorsement of an increased continuum of care approach to maternal and newborn health will also be vital for future initiatives. Post-quake public health and social service reconstruction efforts will need to incorporate maternal and child health-friendly services into their designs. It also remains critical that international donors continue to meet their pledges to Haiti. The Haitian government should also take more strides to clearly delineate the maternal and child health interventions it implements, both in order to facilitate greater national learning, as well as to improve the likelihood of future replication.

Estimating risk factors for three negative outcomes in pregnant women admitted to the Centre de Références et Urgences Obstétricales (CRUO) and their neonates in Port-au-Prince, Haiti between January 2013 and June 2018

“…It is estimated that almost 50% of the Haitian population lack access to health care because of nancial and geographical barriers [4]. Infrastructure is poor and the effects of urban congestion contribute to the inability of seeking health care [8]. Other limitations to improve maternal and neonatal health and reduce mortality are inadequate health care facilities and the shortage of health workers [4,9,10].…”

“…Other limitations to improve maternal and neonatal health and reduce mortality are inadequate health care facilities and the shortage of health workers [4,9,10]. In only 16% of births in Haiti a skilled birth attendant was present during delivery [8].…”

Combining task shifting and community-based care to improve maternal health: Practical approaches and patient perceptions

“…Coordination of care between organizations or individual providers tends to be lacking or non-existent. Some regions have varying degrees of healthcare access, due to a lack of infrastructure and accessibility in rural areas (Amibor, 2013; Kligerman, Walmer, & Bereknyei Merrell, 2017). Notably, the 2010 earthquake disrupted the healthcare landscape and complicated systemic coordination across Haiti’s public, private, and non-profit sectors of care (Amibor, 2013; Durham et al, 2015; Kligerman et al, 2017).…”

Use of Rapid Ascertainment Process for Institutional Deaths (RAPID) to identify pregnancy-related deaths in tertiary-care obstetric hospitals in three departments in Haiti

“…In 2015, the maternal mortality ratio (MMR) in Haiti was 359 per 100,000 live births, the highest ratio in the Western Hemisphere [14]. While Haiti’s MMR declined by 43% from 1990 to 2010, it has since plateaued [15]. Additionally, MMR estimates in Haiti are actually based on routine reporting of pregnancy-related deaths, not definitive maternal deaths, and the accuracy of those estimates have not been validated since the Haiti national Demographic Health Survey of 2005–2006.…”