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Archives for Health

Launching the Global Social Service Workforce Alliance

During a visit to Zimbabwe last year, I asked a group of teenagers what they wanted to be when they grew up. Some suggested they wanted to be doctors, others said teachers. One outspoken young lady wanted to be a movie star. I asked if any of them dreamed of becoming social workers. They laughed and said that they wanted to get paid. For these kids, being a social worker was not a particularly prestigious profession – and definitely not lucrative.

But it is an important profession – and a profession that I aspired to since I was a little girl. I always wanted to be a helper. But being a helper is hard and I was under no illusions that helping would make me rich.

Now I have the great pleasure of helping the helpers. And with the launch of the new Global Social Service Workforce Alliance, my efforts to help the helpers will now have a global platform.

Group of young adults. Photo credit: World Education

The Alliance, which is funded by PEPFAR through USAID, as well as other donors, asserts that a well-planned, well-trained, and well-supported social service workforce can effectively deliver services to improve the lives of vulnerable populations around the world. However, a number of challenges confront this workforce and limit its ability to create protective environments for children and families who face poverty, discrimination, violence, and exploitation in their daily lives.

In its mission, the Alliance recognizes key challenges facing this workforce and aims to promote the knowledge, evidence, resources, tools, political will, and action needed to address them, especially within low to middle income countries. During the launch webinar held on June 6th, Amy Bess, the Alliance Coordinator, described how to get involved in the work of the Alliance and introduced participants to a website, which will act as a platform for information sharing and advocacy.

I am a member of the Alliance. You can become a member too by registering here. As a member, you can contribute to knowledge on the social service workforce, connect with others through the Alliance Webinar Series and interest groups, and join with me and others to help the helpers through global and more targeted advocacy efforts.

With any luck, we will inspire a new generation of social service workers to follow in our footsteps and social workers will become as popular as movie stars!

New Mobile Clinics Take to the Road in Lesotho

This originally appeared on the Elizabeth Glaser Pediatric AIDS Foundation Blog.

Last month, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) teamed up with the Lesotho Ministry of Health (MOH) to launch two mobile health care clinics that will provide HIV/AIDS and other health care services to residents in Lesotho’s rural communities. On July 11, EGPAF’s Chief Operating Officer (COO) Brad Kiley joined representatives from the Lesotho MOH and other high-level government officials at a ceremony to celebrate the new mobile units and how they will improve access to health care services to people throughout the country. The clinics are made possible thanks to generous support from the President’s Emergency Plan for AIDS Relief (PEPFAR) and the U.S. Agency for International Development (USAID).

Representatives from the Lesotho Ministry of Health, USAID, and EGPAF – including EGPAF COO Brad Kiley (in orange tie) – at a launch for two mobile clinics in Lesotho. Photo credit: EGPAF

Kiley noted that he is particularly proud of EGPAF’s success in Lesotho and is grateful for the kindness and support of the Government of Lesotho and the Ministry of Health. He also acknowledged and thanked USAID on behalf of the Foundation for its generous contributions to the key project of Strengthening Clinical Services in Lesotho.

Speaking at the same ceremony on behalf of the Health Minister, Principal Secretary to the Ministry of Health, Lefu Manyokole, said the mobile clinics come at the right time, when the Ministry is revitalizing primary health care and trying to strengthen the health system. He also commended the partnership and continued support EGPAF is giving to the Government of Lesotho.

He continued by emphasizing the MOH’s commitment to properly maintain and carefully coordinate the use of these mobile clinics so that they are effectively used for strengthening linkages and helping malnourished people in the region.

EGPAF will work with the MOH to provide integrated health services to patients in the remote areas of the mountainous districts of Thaba-Tseka and Mohale’s Hoek, where there is a high prevalence of HIV among pregnant women along with high rates of malnutrition among children and overall limited access to maternal, neonatal, and pediatric care. Each mobile clinic is equipped with two consulting rooms with collapsible examination couches, a metal stairway and emergency/wheelchair pathway, air conditioning, and built-in generators. Initially, services will include HIV/AIDS testing and treatment, prevention of the mother-to-child transmission (PMTCT) services, nutrition counseling, and other maternal and child health services.

These services are part of a larger effort by EGPAF and the Partnership for HIV-Free Survival (PHFS) and Nutrition Assessment Counseling Support (NACS) program to reduce malnutrition in the region, especially in HIV-positive women and children.

EGPAF has been active in promoting the use of mobile clinics throughout Africa. To learn more, click here.

To learn more about our work in Lesotho, click here.

Mapalesa Lemeke is Communications Officer for the Foundation, based in Lesotho.

Let’s Talk About HIV: The Importance of Dialogue and Information in Adolescent HIV Care

In recognition of International Youth Day, AIDSTAR-One Senior Treatment Officer discusses the importance of dialogue and information in adolescent HIV care. 

Imagine you are 15. It is your first year at a new school. You have to make new friends, meet all new teachers, struggle through your classes, and find a date for weekend parties. You want freedom and independence from your parents and caregivers. You want to be like everyone else. You worry about having cool clothes and fitting in.  You want to have a boyfriend or girlfriend. You want your friends to like you. You worry about getting in to university and what your future will be like.

Now, imagine you are 15 and you are HIV-positive. You have the same thoughts and concerns that your peers have, but you also have to worry about your health. HIV only makes being an adolescent harder. You wonder if you will still fit in if you have HIV, so you hide this information from your friends. When you start dating someone, you wonder if your boyfriend or girlfriend will still like you if you tell him or her your status. The pressure of getting good grades and planning a successful future is heightened by having to miss school for medical appointments or not feeling well.

Teen Talk, a new tool from AIDSTAR-One and BIPAI, is a resource for young adults living with HIV. Photo credit: AIDSTAR-One

Teen Talk, a new tool from AIDSTAR-One and BIPAI, is a resource for young adults living with HIV. Photo credit: AIDSTAR-One

Through advances in antiretroviral therapy (ART), children born with HIV are growing up, living, and thriving. In addition, UNAIDS reports that youth between the ages of 15-24 account for almost half of all new HIV infections. These youth are in need of comprehensive, youth-specific education to empower them to make responsible and informed decisions regarding disclosure of their HIV status, sexual behavior, and their health.

So, how do we help youth living with HIV adjust to the growing pains of adolescence, while also maintaining their health? We talk to them. Just as with any teenager, it is important for youth living with HIV to learn how to be responsible young adults, realize how their actions affect those around them, and know who they can talk to when they need help. For teenagers who are HIV-positive, it is also important to help them manage their health. They need to know how to remain healthy by eating well and remembering to take their medicine, how and when to talk to peers and teachers about their status, and why drinking or taking drugs could be particularly harmful to them.

It is hard for youth living with HIV and those who care for them to know the answers to all of these questions. AIDSTAR-One in partnership with Baylor International Pediatric AIDS Initiative (BIPAI) created Teen Talk: A Guide for Positive Living, a resource written for teens to use on their own, or for use in consultation with medical providers or caregivers. Covering issues such as adherence, nutrition, and safe sex, Teen Talk helps youth living with HIV think through their concerns and make healthy decisions. Teen Talk offers specific tools such as a calendar to help adolescents remember to take their medicine, a list of common medication side effects and possible solutions, and a question and answer guide about sex and sexual health.

With such a large population of youth living with HIV, it is increasingly important to help adolescents address their HIV status, manage their own medical care, and live a healthy life.  Living with HIV will always be a challenge. However, with tools such as Teen Talk, youth living with HIV can thrive and remain healthy in their adolescent years, bringing us one step closer to reaching the global goal of an AIDS-free generation.

AIDSTAR-One is funded by PEPFAR through USAID’s Office of HIV/AIDS. The project provides technical assistance to USAID and U.S. Government country teams to build effective, well-managed, and sustainable HIV and AIDS programs.

Learn more about youth programming at USAID. Join the conversation on Twitter using #IYD2013. 

Youth, Urbanization and Health

In celebration of International Youth Day, Global Health Youth Advisor discusses U.S. Government and USAID’s health programs impacting urban youth. 

In 2010 I took a bike tour of Dar es Salaam’s slums. Over tea and chapattis my young guide told me he had lost both parents to AIDS. As the eldest, he had to ensure the education of his younger siblings. He dropped out of high school and migrated to Dar to work. Now at 24 with a good job, his siblings had finished school, and he was ready to return to school himself.

This glimpse of the vibrant yet chaotic life in Dar’s slums is one that we rarely see. I was struck by the large numbers of school-age youth in the streets working as petty traders: selling bananas, phone cards, sunglasses and pirated DVDs.

The HealthyActions program in Liberia, under the Advancing Youth Project and in partnership with EDC delivers an HIV and family planning curriculum in alternative high schools for youth that have left the formal education system. Photo credit: USAID

The HealthyActions program in Liberia, under the Advancing Youth Project and in partnership with EDC delivers an HIV and family planning curriculum in alternative high schools for youth that have left the formal education system. Photo credit: USAID

Dar is not unique. Rural to urban migration is accelerating, yet governments are ill-prepared to deal with it. In Timor L’este, I heard that that the capital’s population was growing by 10,000 people every year. Poorly serviced squatter settlements, slums, and camps are the norm in many cities, which are increasingly populated by youth seeking opportunities.

In Latin America and Asia, young female urban migrants outnumber young males. Many migrate to escape forced marriage or abusive relationships. UNICEF data from 12 countries show one in five migrant children aged 12–14 and half of those aged 15–17 move without a parent. Young urban migrants often find themselves in violent, stressful and unhealthy environments.

Migration displaces and separate youth from their homes and the protective structure and guidance of families and communities. Separation from sources of learning, recreation, and support; alteration of community routine, normalcy; and lack of positive alternatives contribute to the exploitation and abuse of young people. Young people also engage in risky behaviors, including sexual ones with dire consequences.

Developmentally appropriate reproductive health and family planning information and youth friendly services can prevent poor health outcomes, and can ensure young people receive adequate care and  support for pregnancy, unsafe abortion, STIs/HIV, and violence.

Youth face many challenges to obtaining reproductive health services. Youth migrants are doubly challenged, since slums have limited health services. Urban programs must address and involve youth. Collaboration across sectors is essential to improving the health and opportunities of urban youth migrants.

U.S. Government and USAID’s health programs impacting urban youth:

  • Young Tanzanian women who migrate to the city are susceptible to the lure of a “sugar daddy.” The Fataki radio campaign (PDF) uses humor and familiar stories to foster dialogue around the dangers of intergenerational sex, empowering community members to intervene.

  • Fourteen years of civil war in Liberia displaced much of the population. Population Services International provides HIV and FP education in alternative high schools for youth now returning to Monrovia, with increased uptake of HIV testing and contraceptives.

  • One third of the 6 billion mobile subscribers are under the age of 30. Mobile for Reproductive Health (m4RH) is an on-demand SMS system with information about contraception and nearby clinics. Young Kenyans liked the simple language and confidentiality of the service. Tanzanian and Kenyan users reported increased contraceptive knowledge and use. FHI 360 and the Rwandan Ministry of Health are adapting m4RH with additional information for young people.

Globally, young people under 18 are considered children, and younger migrants are at especially high risk. The U.S. Government’s Action Plan for Children in Adversity recommends that U.S. Government assistance support and enable families to care for their children; prevent unnecessary family-child separation; and promote appropriate, protective, and permanent family care.

Learn more about youth programming at USAID. Join the conversation on Twitter using #IYD2013. 

HIV+ and Pregnant: A Deadly Combination?

Since 1990, the global number of maternal deaths has declined by almost half to 287,000 per year. Increased access to family planning and improved maternity care, including emergency care when needed, have played a significant part in this reduction. At the same time, the number of people dying from AIDS-related deaths has been declining since the 2000s because of access to life-saving antiretroviral therapy (ARVs) and a decline in HIV prevalence. Nonetheless, these positive trends are masking a troubling reality for many women in Sub-Saharan Africa. According to new estimates, HIV-positive pregnant women had 8 times the risk of death during pregnancy than HIV-negative pregnant women.

A couple from Nigeria holds their 5-month-old HIV-negative baby. Photo credit: Deidre Schoo, International Center for AIDS Care and Treatment Programs, Columbia University School of Public Health

A couple from Nigeria holds their 5-month-old HIV-negative baby. Photo credit: Deidre Schoo, International Center for AIDS Care and Treatment Programs, Columbia University School of Public Health

It’s a sobering statistic, and it calls both the HIV and maternal health communities to joint action. But what can be done? How can we improve HIV and maternal health programs to save the lives of these women? Unfortunately, the answer is unsatisfying. We just don’t know the solution…yet. Certainly the provision of ARVs to HIV-positive pregnant women for her health and the health of her child is a vital piece of the puzzle. Many countries are shifting their strategies to reach these women by providing lifelong treatment for pregnant women living with HIV. However, ARVs are probably not the entire answer as HIV-positive pregnant women also have an increased risk for complications relating to other co-infections like tuberculosis, sepsis, and pneumonia. Questions remain, and more research on the nexus of HIV and pregnancy is necessary.

In an effort to move the HIV and maternal health communities to action, USAID, CDC, and the Maternal Health Task Force convened a meeting in early June on “Maternal Health, HIV and AIDS: Examining Research through a Programmatic Lens.” We brought together technical experts from around the world who have been investigating the intersection of HIV and maternal health. We were electrified by the dynamic group and the data presented on topics ranging from causes of maternal deaths, stigma and discrimination in health services, and tough considerations around Option B+. A smaller group committed to develop a formal research agenda to outline the priority questions that remain.

This meeting was just the beginning of the dialogue, and we’d like to invite you to participate in the conversation and add to the evidence base as we move forward. The full content of the meeting is available online at the Maternal Health Task Force’s website. We continue to seek the latest resources, research findings, and publications from around the world on this topic. To read more on the subject, find relevant news and publications, and suggest additional resources, see here. Finally, watch for more news from USAID as we continue these important discussions and learn more from sub-Saharan African countries that are tackling this issue.

Coordinated Efforts Needed to Combat Infant Mortality in Africa

At the Africa regional conference of the International Confederation of Midwives (ICM) held last month in Nairobi, Kenya, one thing was clear. In order to meet the United Nations Millennium Development Goal (MDGs) of reducing infant mortality by two thirds before 2015, birth attendants in large numbers must acquire the basic skills and equipment to help newborns breathe.

The WHO estimates that one million babies die each year from birth asphyxia, the inability to breathe immediately after delivery. Simple means to stimulate breathing that could easily be done by a birth attendant could save a majority of these babies. However, such lifesaving care is not available in much of the world’s poorest regions.

Attendees at the session get a primer on the HBB program. Photo credit: Johnson & Johnson

Attendees at the session get a primer on the HBB program. Photo credit: Johnson & Johnson

As part of its MDG commitment, Johnson & Johnson is working with USAID and many partners globally to address birth asphyxia through its support of the Helping Babies Breathe (HBB) program in a number of developing countries where infant mortality from birth asphyxia is still high. HBB is a global public-private partnership working towards achieving a significant reduction in newborn mortality by increasing the availability of skilled birth attendants at every birth. Nurses and midwives with HBB training have the skills to save over 90% of babies with birth asphyxia.

The ICM meeting dedicated a core session to HBB, including providing attendees hands-on HBB introductory training and a related symposium that debated why little progress has been made in combating infant mortality in Africa.

The discussion continued at the stakeholder consultation meeting the morning after the conference ended, with a more specific focus on Kenya, where five babies die every hour. These discussions were attended by representatives from the HBB global alliance, including USAID, AAP, AMREF and Johnson & Johnson. Dr. Santau Migiro, head of reproductive health in Kenya’s Ministry of Health (MOH), was also in attendance.

What became increasingly evident was that to accelerate progress, all HBB activities need to be implemented in coordination. Rather than small scale activities done in isolation, the key to making a high impact is to address the issue on a much larger scale. Collaboration and synergy among players is important to maximize efforts, funding and resources, and to advocate for policy change.

To that end, all stakeholders agreed that the best way to push HBB forward in Kenya is to work under the MOH umbrella, making it part of the overall MOH maternal and child health strategy. Already, the Kenyan MOH has made HBB competency part of the core curriculum of medical training, recognizing that all health workers have a role in impacting maternal and neonatal health.

In addition to making the most effective use of resources and funding, a harmonized approach lends itself to better monitoring and evaluation. Standard guidelines for implementation will provide more meaningful data about the results of the program.

While the immediate focus of the stakeholders meeting was implementing HBB effectively in Kenya, there was general consensus that this direction is the right way to move the HBB initiative forward across the continent.

The evidence that HBB can be effective in Africa is there already. Tanzania, where over 3000 health care workers have been trained, has seen a drop of over 47% in infant mortality.

The conference was an opportunity to get all players in the region, including over 400 midwives from 20 African countries, on the same page. While recognizing that a lot more needs to be done, attendees left with a feeling of optimism, celebration and camaraderie overall.

Rene Kiamba manages the Johnson & Johnson Family of Companies corporate contributions community support programs and initiatives in sub-Saharan Africa.

From the Field in Zimbabwe: Unexpectedly HIV-Free

For a pregnant woman, it takes courage to visit Epworth Clinic in Harare, Zimbabwe. Many must travel long distances to get there, but that is not the only reason. They come to the clinic to learn their HIV status or to receive antiretroviral (ARV) medication, and when they first arrive, many of the women have little hope of giving birth to a healthy child. Once they get there, however, they learn that although they have HIV, they do not need to pass it to their children.

I visited the clinic to learn how USAID is supporting the delivery of high-quality HIV/AIDS services in Zimbabwe.

Rosemary proudly holds her HIV-free baby after receiving prenatal treatment from a USAID-sponsored clinic outside Harare, Zimbabwe. Photo credit: Zoe Halpert, USAID intern

In the waiting room, I spoke with Rosemary, a 40-year-old, HIV-positive mother who was holding an 8-month-old baby. Rosemary came to the clinic for the first time several years ago when her husband’s health began to deteriorate and she suspected that they might both be HIV-positive. She was right; she tested positive for HIV and began ARV treatment several weeks later. While I was talking with Rosemary, her baby sleepily opened her eyes and chewed her blanket. She was born healthy and HIV-free.

The prevention of mother-to-child transmission of HIV-AIDS program at Epworth clinic started in 2001. USAID provides infant HIV test kits and ARVs to many clinics throughout Zimbabwe, including Epworth. USAID’s partner, the Organisation for Public Health Interventions and Development (OPHID), provides training and supervision to the health-care workers in the clinic.  With support from USAID, this local organization is quickly increasing its ability to better address the HIV-AIDS epidemic in Zimbabwe.

Epworth clinic sees about 80 pregnant women and nursing mothers each day. When they first arrive at the clinic, they are tested for HIV and educated about family planning. As a result of the support the clinic has received from USAID, through OPHID, the number of HIV-positive babies has gone down significantly. Today, 98 percent of babies that are part of the program test negative.

When I talked with the clinic’s nurses, they told me, “If we didn’t have the USAID program, 98 percent of our patient’s babies would be HIV positive.” They also acknowledged that there would be a significant population decline.

As my visit came to a close, I asked Rosemary what advice she would give to other pregnant women. “Every woman should know her HIV status,” she said. She has found the courage to tell some of her friends her status, and strongly encourages them to get tested for their entire family’s benefit.

Visit OPHID for more information about OPHID.

Learn more about USAID’s work in Zimbabwe

From the Field in South Sudan: Mother of Nine Helps Rural Women Deliver Safely

At age 38, Mary Konyo has nine children, including a set of twins. She has been a traditional birth attendant since 1997, before South Sudan became independent, and has helped 23 women deliver children safely women in the last 16 years. Two years ago, she decided to stop having children so she could focus more on helping other pregnant women in distress.

I was touched by Konyo’s story when I heard it at a public forum in Juba (South Sudan’s capital), and I contacted her to learn more about her work to save the lives of pregnant women in her community.

Mary Konyo (right) testifies on the benefits of using misoprostol to reduce severe bleeding after childbirth.  Photo: Victor Lugala

Mary Konyo (right) testifies on the benefits of using misoprostol to reduce severe bleeding after childbirth. Photo credit: Victor Lugala

Her personal experiences with childbirth have inspired her. “When I delivered my first child, I bled excessively for three days. I was very weak,” Konyo told me.

A majority of rural South Sudanese women deliver at home, mostly without the help of a midwife, and some of them die from complications. Excessive bleeding after childbirth, or postpartum hemorrhage (PPH), is one of the leading causes of maternal death in South Sudan.

In recognition of her community work, Konyo was among a few women nominated from her community to attend a USAID-funded workshop on reducing PPH. Workshop participants gained knowledge and skills to help them talk with their communities about the importance of using misoprostol — a medicine that can prevent severe bleeding — to prevent PPH. They also learned what to do when a woman experiences PPH.

In addition to practical skills, the workshop emphasized the need for community outreach to help people understand the importance of giving birth in a health facility, where it can be easier to address complications. Konyo returned to her community as a home health promoter and started a door-to-door awareness campaign. She advises pregnant women to regularly attend antenatal clinic to help ensure that they have safe deliveries. “I particularly tell them about the dangers of excessive bleeding after birth,” Konyo said.

She is also able to give pregnant women misoprostol to take immediately after giving birth. But, she added, “I always tell women to deliver safely in the clinic.” Aware of rural poverty, Konyo advises pregnant women to save a little money for their transport to the hospital for delivery. In her community, women in labor are often transported to the nearest clinic on motorbike taxis, called boda-bodas.

Konyo told me she also encourages husbands to accompany their wives to the clinic, adding that men are expected to pay the hospital bills when their wives give birth.

She believes misoprostol will help drastically reduce severe bleeding immediately after childbirth in her community, pointing out that women who take misoprostol regain strength on the third day after delivery and can return to their everyday activities more quickly. Konyo says the men whose wives have used misoprostol are also happy: “Now they are asking for a ‘wonder medicine’ that will reduce birth pangs and hasten childbirth.”

Learn more about USAID’s work in South Sudan and follow USAID South Sudan on Facebook and Twitter (@USAIDSouthSudan)!

River Blindness Eliminated in Colombia

Today, Colombia celebrates a great milestone. According to the World Health Organization (WHO), out of 38 endemic countries worldwide, Colombia is the first to eliminate river blindness, a disease transmitted through infected flies that can cause chronic skin lesions, irreversible blindness, or severe visual impairment.

In Naciona, Colombia, a child is measured for treatment with the drug Mecitzan®, donated by Merck. The village of Naciona's close proximity to the river meant that, in the past, residents were exposed to the bites of flies that carried river blindness. Now, thanks to the work of the national program and the Carter Center OEPA Colombia has eliminated river blindness nationwide. Photo Credit: Carter Center

Approximately 123 million people are at risk of infection of river blindness and at least 25.7 million people are currently infected of which 1 million suffer from blindness or visual impairment. River blindness is traditionally controlled via mass drug administration given to affected communities. Fortunately, since 1987, the drug needed to control this disease has been donated free of charge by Merck.

In Colombia, river blindness affected a single community in the municipality of Lopez de Micay in the Cauca State. A remote location reachable only by a 10-hour trip in a small motorboat. In 1996, Colombia began an intensive public health campaign to break the transmission cycle by administering treatment for river blindness to this entire community. These efforts were sustained until 2007 when it was determined that the cycle of transmission had been broken. Mass drug administration was halted in 2008.

In order to receive certification of elimination, Colombia had to undergo a 3-year post-treatment surveillance period where data is collected and analyzed to determine if river blindness is still present in the community. In addition, Colombia had to submit a country dossier to WHO describing the entire history and achievements of their country program.

After a visit by a team of international experts and an extensive review, WHO verified the elimination of river blindness in Colombia and was announced earlier today by Colombia’s President Juan Manuel Santos.

This milestone could not have been achieved without the work of many organizations. Merck’s drug donation program has been key in the success of controlling and beginning to eliminate river blindness from the world. The leadership and technical assistance from the Pan American Health Organization (PAHO) and the Carter Center’s Onchocerciasis Elimination Program for the Americas (OEPA) to the six affected countries in the Americas has been essential to reach this milestone.

For USAID, river blindness elimination from the Americas was a specific target set when the Global Health Initiative was launched in 2009. Since then, USAID has worked in close coordination with the Centers of Disease Control and Prevention, and currently funds PAHO and OEPA’s work.

In the Americas, Ecuador is expected to be the next country to receive verification of elimination and Guatemala and Mexico are soon to follow. In the western hemisphere, only one remote area at the border between Brazil and Venezuela continues to be affected by river blindness.

The efforts and success seen in Colombia serve as a model for countries globally and paves a way toward a world free of river blindness.

Demographic and Health Survey Show Positive Results in Haiti

A newly released nationwide health survey of Haiti shows continuing positive trends on key health-care indicators in particular those of Haitian women and children. The latest survey, undertaken by the Haitian Ministry of Public Health and Population, was conducted in 2012 and compares with the prior survey done in 2006. It shows steady improvements among key indicators despite significant health challenges in Haiti due to the 2010 earthquake and cholera outbreak. Of note were improved indicators for child vaccination and malnutrition, infant and child mortality, women’s health and contraception use. The report indicated no increase in HIV prevalence, which remained steady.

Patients get laboratory work done at a USAID-supported health clinic in Ouanaminthe, Haiti on May 15, 2013. Photo credit: Kendra Helmer/USAID

The Morbidity, Mortality, and Service Utilization Survey measures progress and setbacks in health outcomes over the years. The results were announced July 9 by Dr. Florence Guillaume Duperval, Haiti’s Minister of Public Health and Population. The survey has been administered in Haiti five times since 1994.

The previous survey was administered in Haiti between 2005 and 2006; this latest survey was conducted from January 2012 to June 2012. Over 13,000 households participated in the current survey, representing rural and urban areas in all of Haiti’s 10 departments, including camps for people displaced by the January 2010 earthquake. The results were eagerly anticipated by health experts concerned of possible setbacks brought on by the devastating quake, which killed more than 230,000 people and displaced more than 1.5 million.

However, the survey results show that many health outcomes have improved in Haiti. The data collected in the survey show improvements in women’s health, improved nutritional status among the population, and an increase in use of contraceptive methods. Currently, more than two-thirds of pregnant Haitians have made the recommended number of antenatal visits, an increase from 50 percent in 2006; the prevalence of anemia among women has declined from 55 percent in 2000 to 49 percent in 2012; and the use of modern contraceptive methods among married women has increased from 22 percent to 31 percent between 2000 and 2012.

Health data for children also showed positive results. Childhood vaccinations increased from 53 percent in 2006 to 62.5 percent in 2012. With regard to nutrition, the survey showed that 22 percent of children under 5 suffer from chronic malnutrition, a decrease from 29 percent in 2006. The survey also revealed a decrease in acute malnutrition from 10 percent in 2006 to 5 percent in 2012 and a decrease in percent of children underweight from 18 percent to 11 percent.

Childhood mortality has decreased in Haiti over the last 15 years. Survey results show that infant mortality has decreased from 79 to 59 deaths for 1,000 live births. In addition, mortality for children under 5 has also decreased from 112 deaths to 88 deaths per 1,000 live births.

Among other results, the survey revealed that the HIV prevalence among those ages 15-59 have remained the same:  2.7 percent among women and 1.7 percent among men.

USAID is working closely with the Government of Haiti to continue to improve health outcomes for all Haitians. “The information in this survey forces us to continue to work together, to strengthen our interventions and our methods so that progress in the health sector in Haiti is sustained,” said Marc Desjardins, Deputy Chief of Mission of the U.S. Embassy in Port-au-Prince, during the July 9 event.

USAID’s goal is to improve access to health care services and build the Government of Haiti’s capacity to manage and oversee its health programs. Currently, about 50 percent of the population has access to a vast network of USAID-sponsored health facilities throughout the country that provide core health services such as maternal and child health, family planning, and nutrition. In addition, diagnostic and treatment services for tuberculosis and HIV and AIDS services can be accessed at these health facilities. HIV and AIDS services include access to antiretroviral therapy, prevention of mother-to-child transmission, palliative care, and voluntary testing and counseling. USAID programs aim to reduce risky behaviors and maintaining people living with HIV and AIDS on treatment.

Much remains to be done in Haiti. For example, despite high levels of knowledge of family planning, only 35 percent of married women are using any method and 31 percent are using a modern method. However, the positive health trends revealed by this data shows that Haiti continues to move forward despite the earthquake, the ongoing cholera epidemic, and many other challenges that threaten health outcomes. These results are a testament to the hard work and strong commitment of all of those who work to build a better Haiti.

This survey was funded by USAID, the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA) and the Global Fund the Global Fund to fight AIDS, Tuberculosis, and Malaria through the United Nations Development Fund (UNDP), and the Canadian International Development Agency (CIDA).

The fifth Morbidity, Mortality, and Service Utilization Survey combined with the Multiple Cluster Indicator Survey (MICS) was conducted by the Haitian Childhood Institute [l’Institut Haïtien de l’Enfance (IHE)] in collaboration with the Haitian Statistical and Information Technology Institute [l’Institut Haïtien de Statistiques et d’Informatique (IHSI)]. This survey was supported by the Ministry of Public Health and Population [Ministère de la Santé Publique et de la Population (MSPP)], benefited from the technical assistance of the Demographic and Health Surveys program (MEASURE DHS), which is implemented by ICF International.

Resources:

  • Read the full DHS report.
  • See photos of USAID’s health-related programs in Haiti.
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