MCH Program Spotlight
Jhpiego finds a way in Haiti: Meeting the needs of women and newborns during difficult times
Located in Port-au-Prince, Haiti's heavily populated capital, Maternité Isaïe
Jeanty (MIJ) is the second largest maternity hospital in the country. Jhpiego worked at MIJ for
several years—most recently through the
ACCESS Program, training health care providers in the
prevention of mother-to-child transmission (PMTCT) of HIV. In the past year, however, the
sociopolitical unrest that has plagued
Haiti for years has intensified, especially in areas closest to the hospital. "Activity at
MIJ slowed down. Some physicians and residents were coming in, but not on a regular basis,"
explains Jhpiego's country representative, Dr. Lucito Jeannis, adding that the "demand for
services also lessened." Finally, MIJ staff were moved to the Hôpital de la Paix, another
large maternity hospital in Port-au-Prince.
Given such ongoing challenges, Jhpiego has had to find creative ways to carry
out the ACCESS Program’s agenda in Haiti, which is to improve the quality of PMTCT and a
range of reproductive health services. Amy Kleine, Program Officer for ACCESS/Haiti, talks
about the challenging “duality” of programming in Haiti during these difficult times: "If
we pull out because of the dangers posed by the political conflict, we ignore another set
of dangers faced by women and children who are still in need of services." And, according
to recent statistics, this need is dire. An estimated 11,300 HIV-positive women deliver
each year in Haiti, and approximately 30% of their babies will contract HIV. In addition,
the rate of maternal mortality and percentage of unmet need for family planning remain high
among Haitian women.
One way Jhpiego has been able to move forward is to remain flexible and open
to alternatives. For example, recent trainings on PMTCT and counseling and testing (CT) that
were supposed to be held in Haiti were held instead in the Dominican Republic. "Working with
our contact at the USAID/DR Mission," Amy says, "we arranged for our Haitian participants to
travel to Santo Domingo by bus." To maximize the impact of the event, the training was
offered to both health care providers and trainers, so that, immediately upon return to
Haiti, PMTCT/CT services could be offered at key sites while training was replicated with
more service providers. The training sessions also acted as an orientation for several
policymakers from the Ministry of Health. According to Lucito, the event was a huge success:
"The 10 trainers trained at the event have already trained more than 100 providers, and
more trainings are scheduled."
Because of travel restrictions, the Baltimore office has also had to rely more
heavily on the Haiti office. For example, when a consultant who was supposed to oversee
implementation of the PMTCT program was unable to travel there, the responsibility was
given to Dr. Pascale Merlet, a Haitian ob/gyn, who is now conducting the activity in
Haiti's main teaching hospital, l'Hôpital de l'Université d’Etat d’Haiti (HUEH). "By
conducting more activities, local staff have increased their in-country capacity,"
Amy points out, "and are able to function more independently."
As such, efforts to fully establish and legalize Jhpiego's Haiti office
have also gained momentum. "Since October 2004, when Lucito was the lone consultant,"
Amy says, "we have added three people to his team, and are looking to hire two more."
With the long-term goal of registering as an NGO in Haiti, Jhpiego is also working to
develop the necessary financial infrastructure.
Lucito cites "belief in what we are doing" as an essential component in
the success of Jhpiego's ACCESS Program in Haiti, despite these ongoing challenges. And
new hope comes in the form of the Ministry of Health's decision to reinstate services at
MIJ now that the presidential elections are over. There, "we will once again be able carry
out our work," says Lucito—continuing to build a brighter future for women and children
throughout Haiti.
More Information
To read other spotlights, go to Program Spotlights.
For additional resources on maternal and child health, browse
our Information Sheets
and/or go to the MCH section of our
Publications Catalog.
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