The USAID/Haiti Maternal and Child Health and Family Planning Portfolio Review and Assessment was conducted in August 2008. The assessment team consisted of Agma Prins, Adama Kone, Nancy Nolan, and Nandita Thatte. The report was made possible through support provided by the US Agency for International Development, under the terms of the Leadership, Management and Sustainability (LMS) Program.
Demographic factors contribute to poor maternal and child health in Haiti. The country has a high population growth rate, with a total fertility rate of 4.2 children per woman. Poverty is widespread, with approximately 80% of the population living below the poverty line. Governance is also a significant challenge, with a weak and unstable government. The role of donors is crucial in addressing these issues, but societal dysfunction, including violence and family instability, hinders progress.
Infrastructure and services are inadequate, with limited access to transportation, water, and sanitation. Health care facilities are scarce, and health personnel are in short supply. The maternal mortality rate in Haiti is high, with an estimated 530 deaths per 100,000 live births. Prenatal care is often inadequate, and obstetrical care is limited. Postnatal and neonatal care are also inadequate, leading to high rates of maternal and neonatal mortality.
Family planning is critical in addressing maternal and child health issues in Haiti. However, the use of contraceptives is low, with a contraceptive prevalence rate of 22%. Fertility patterns are high, with an average of 4.2 children per woman. Knowledge of contraceptives is limited, and unmet need and demand for family planning services are high. Postpartum family planning is also a critical issue, with many women not receiving family planning services after childbirth.
Child health is a significant concern in Haiti, with high rates of childhood illnesses and mortality. The integrated management of childhood illness is critical in addressing these issues. Immunization is also essential, but coverage is limited, with an estimated 80% of children under the age of 5 receiving at least one dose of vaccine.
The health sector logistics management system is critical in ensuring the effective delivery of health services in Haiti. However, the system is often inadequate, leading to stockouts and delays in the delivery of essential medicines and supplies. Indicators and the use of data are essential in monitoring progress and evaluating the effectiveness of programs.
Donor programs play a critical role in addressing maternal and child health issues in Haiti. The US Government supports several programs, including the Maternal and Child Health/Family Planning Flagship and the Title II Maternal, Child Health, and Nutrition Programs. Other donors, including the Canadian International Development Agency, UNFPA, UNICEF, PAHO/WHO, International Development Bank, Global Fund, European Union, and France, also provide significant support.
The assessment team identified several strengths, including the commitment of the Haitian government to improving maternal and child health and the significant support provided by donors. However, several challenges remain, including the need for improved donor coordination, increased geographical coverage of USG-supported MCH/FP projects, and additional funding needs for child survival and family planning programs.