The Maternal and Child Survival Program (MCSP) is a global U.S. Agency for International Development (USAID) cooperative agreement aimed at introducing and supporting high-impact health interventions in 24 priority countries. The ultimate goal of MCSP is to end preventable child and maternal deaths (EPCMD) within a generation. In Haiti, the MCSP EPCMD project focuses on providing technical resources to the Ministry of Public Health and Population (MSPP), USAID’s Services de Santé de Qualité pour Haiti (SSQH) projects, and other implementing partners to support the delivery of quality, high-impact reproductive, maternal, neonatal, and child health (RMNCH) services.
The MCSP EPCMD approach in Haiti centers on enhancing the MSPP’s technical leadership and coordination, further developing and testing guidelines for functional Model Referral Networks (MRNs), building the capacity of key national training institutions, and establishing a mechanism and tools for knowledge sharing of best RMNCH practices at the community level. In the first program year, MCSP EPCMD worked to identify necessary policies and national guidelines that required updating to support an enabling structural environment for maternal and child morbidity and mortality reduction.
Two Advisors to MSPP worked with national technical working groups to address and revise gaps in health policy. The Advisors also held several advocacy workshops to gain MSPP approval on piloting high-impact RMNCH interventions, such as the use of misoprostol at the community level to prevent postpartum hemorrhage. Critical steps were achieved in supporting the establishment of a national referral system and operationalizing three Model Referral Networks. MCSP EPCMD worked with DOSS and LMG to pilot and finalize the referral and counter-referral tools, and provided recommendations to MSPP on the National Manual for Referral and Counter Referral Systems.
A national system of offering internationally standardized RMNCH interventions to health providers across Haiti was also developed through the establishment of National Training Centers. These centers were financially and technically supported through subawards and worked with three well-respected hospitals in Haiti to develop a pool of national trainers capable of providing trainings to health providers from MCSP and SSQH sites across Haiti. In the first year, trainers from these NTCs went through a maternal and newborn care skills standardization course, followed by a Clinical Training Skills Training of Trainers.
Training needs assessments were conducted, and each of the NTCs started delivering high-quality trainings to peripheral sites through a training management system that incorporates supportive supervision as well as monitoring and evaluation to track the introduction and impact of the interventions. Skills labs were also procured for each of these NTCs, as well as the National Midwifery School, to allow for hands-on practice. A midwifery workforce analysis was conducted in this first year to inform national recommendations.
MCSP EPCMD also sought to support community health interventions by creating a national platform by which CSOs, NGOs, and other agencies could share knowledge and lessons learned to develop tools for promoting best practices for health interventions at the community level. CSOs around the country were mapped and interviewed to identify areas of work regarding community health projects, and to link these up to national and international resources. Throughout the planning and implementation of activities, MCSP has worked closely with USAID partners, UN agencies, and MSPP to strengthen collaboration across projects and to avoid duplication of efforts.
The major accomplishments under the MCSP EPCMD project in the first program year included the formation of national technical working groups to revise and disseminate policies and guidelines, the development of referral system protocols to be incorporated into the national referral and counter-referral system, and the establishment of National Training Centers to capacitate the health provider workforce in RMNCH interventions.