The MCSP Community Health Contributions Series in Haiti aimed to strengthen community health structures and improve access to quality health care. The project, known as Services de Santé de Qualité pour Haiti (SSQH), was implemented from 2014 to 2018 with funding from the US Agency for International Development (USAID). SSQH collaborated closely with the Haitian Ministry of Public Health and Population (MSPP) to support the country’s journey to self-reliance.
The project’s community health component focused on reducing maternal, newborn, and child morbidity and mortality. SSQH worked with the MSPP to ensure the delivery of the Ministry’s essential health package through a cadre of community health agents (ASCPs). The project implemented an assortment of activities at various levels of the ecosystem to strengthen community collective action and increase demand generation and uptake of services.
SSQH’s global community health strategy was based on three pillars: community service delivery, community capacity strengthening, and community social and behavior change. In Haiti, the project undertook various activities to enhance community engagement, including establishing mutual solidarity funds, training ASCPs and their supervisors, and using the community action cycle (CAC) model to establish community mobilization teams. The CAC model reinforced the capacity of communities to resolve their own health-related challenges, particularly around uptake of quality health services and healthy behaviors at the household and community levels.
The project’s community mobilization officers (CMOs) played a key role in supporting ASCPs and their supervisors to better organize and execute quality community-level education and home visits. CMOs also attended community health posts to ensure that ASCPs were following MSPP standards for cold chain storage, immunizations, nutrition screening, and RMNCH consultations. The project’s supportive supervision provided by CMOs was important to address identified quality issues.
SSQH’s community health approaches in Haiti included establishing commune-level mobilization teams, providing microloans to community members, training ASCPs and community health center personnel to deliver the MSPP’s essential health package, and establishing a system of information and health data management at the community level. The project also trained ASCPs on integrated community case management and improved related tools and job aids.
The project achieved significant results, including increased social and community support for women and families for seeking RMNCH services, including Zika. Networks of structured, trained community leaders and health committees were established to address RMNCH and Zika prevention issues. The project also trained 571 facility staff and community leaders, 10 departmental teams, 35 commune-level teams, and 59 health committees on how to work through the CAC process.
In terms of normative changes, the project contributed to the institutionalization of community health as part of national health systems in Haiti. The project’s community health approaches were integrated into the country’s health systems, and the project’s findings and recommendations were used to inform policy and programming decisions at the national and local levels. The project’s achievements demonstrate the potential of community-based approaches to improve access to quality health care and reduce maternal, newborn, and child morbidity and mortality in low-resource settings.