Haiti remains the poorest country in the Latin America and Caribbean region and among one of the poorest countries in the world. The nation has endured devastating challenges in the past two decades with 2016's Hurricane Matthew causing extensive destruction and loss only a few years after the 2010 earthquake killed an estimated 250,000 people and decimated the Haitian economy.
In 2021, amidst the backdrop of the global COVID-19 pandemic, Haiti was thrown into political turmoil with the July 7th assassination of President Jovenel Moise. One month later, on August 14, a 7.2-magnitude earthquake hit the southern regions of Haiti, exacerbating the existing complex humanitarian crisis that Haiti faces due to back-to-back emergencies, increased violence from armed gangs, and growing political and civil unrest.
Addressing immediate needs with humanitarian assistance and WASH
The earthquake toppled health facilities, health infrastructure and networks in a country that was already facing some of the highest rates of infant and maternal mortality, malnutrition and HIV/AIDS infection in the Americas. Having worked to strengthen health systems in Haiti since 1998, IMA World Health's longstanding presence in the country enabled our emergency response team to reach the Grand'Anse department, one of the hardest-hit areas, days after the earthquake and long before most other humanitarian efforts. We immediately distributed water purification tablets and tarpaulins and launched a comprehensive assessment of 82 primary health care facilities to evaluate critical needs and establish action plans.
In collaboration with partners and stakeholders, including Haiti's Ministry of Health, IMA World Health has identified key short-term measures:
- Distribute tarpaulins and water purification tablets to prevent the spread of water-borne diseases, including Cholera, and COVID-19 and to provide temporary shelter to those who lost their homes;
- Support structural assessments of primary health care facilities to enable improved health service delivery and reinstate displaced services inside facilities;
- Identify and support the reestablishment of water points and water reservoirs allowing health facilities and compounds to manage water supply and prevent infection;
- Extend key health and WASH messaging to the local population about available services, existing referral systems and preventative measures to minimize the spread of COVID-19 and Cholera;
- Assess the feasibility for restoring livelihoods through cash transfers and capacity strengthening pending local market functionality.
Supporting long-term resilience through health systems strengthening
It is paramount that we are coordinating our ongoing emergency response with efforts to drive long-term sustainability in Haiti's health sector. We prioritize health systems strengthening to build resilience now and for the future. In our early work in Haiti, we partnered with the Haitian Ministry of Health to open a clinic to treat lymphedema, one of the debilitating symptoms of the neglected tropical disease (NTD) lymphatic filariasis, or LF. Since then, we have been successfully partnering with national and local government and civil society organizations in Haiti to support local capacity strengthening among service authorities and providers across health, WASH and emergency response with particular focus on NTD elimination and mitigation and improved health service delivery.
For example, through our recent NTD programming – with funding from USAID and led by RTI International - we achieved the following in Haiti:
- 7.3 million Haitians are no longer at risk for LF;
- 61% decrease in the number of children with intestinal worms between 2002 and 2019;
- 87% of communes no longer require LF treatment.
Our approach in Haiti encompasses the World Health Organization’s six building blocks of health systems strengthening to meet both Haiti’s immediate needs and long-term objectives:
- Improved health service delivery
IMA World Health has extensive experience working in 9 of Haiti's 10 departments supporting the Ministry of Health to improve health service delivery in the implementation of NTD and malaria control programs. Technology is a key part of our interventions with the collection of real-time service delivery information and collection of comprehensive data on target populations using satellite generated maps as well as door-to-door censuses. Working through community partners, we identify high risk and vulnerable populations, ensuring they are registered for health interventions. We increase the knowledge and strengthen the capacity of health personnel and community health volunteers, local government representatives (such as the mayor, deputy mayor, and other municipal representatives) and key community leaders for improved health service delivery and community engagement.
- Health workforce development
IMA World Health strengthens the capacities of Haiti's health workforce through training, mentoring, and the provision of equipment and other resources. Over the past two decades, we have developed a robust network of more than 30,000 trained collaborators living in every commune in 9 departments, including nurses, health agents, community leaders, promoters and others. With investment and relationships across such a vast network, we are uniquely positioned to rapidly mobilize across public health activities in close collaboration with the Ministry of Health.
- Information systems
IMA World Health helps the Haitian government and health facilities utilize human resources and reporting software to manage their health workforce more effectively as well as make data-driven decisions to improve their health service delivery. We also use evidence-based monitoring and evaluation interventions that include digital microplanning with Geographic Information Systems (GIS). Together with the Ministry of Health, we employ information collected in disease assessment surveys to evaluate Haiti’s progress toward elimination or control of targeted diseases.
- Access to essential medicines
IMA World Health also strengthens Haiti’s medicine distribution system. We manage the shipping, customs, storage and last mile delivery logistics for required drugs, equipment and materials to all communes of 9 departments in Haiti as part of our NTD programming. We specialize in supply chain logistics for targeted health campaigns, and our locally tested capabilities can be easily leveraged and adapted for critical public health commodities, including medicine and vaccines.
- Health system financing
IMA World Health works at all three levels in Haiti’s health system – government, providers, and recipients – to support access to essential services and protection from financial hardship. We work with the Ministry of Health to create efficiencies in the use of resources, promoting transparency for and accountability from stakeholders, while striving towards affordable and accessible health coverage for all.
- Leadership and governance
IMA World Health supports Haitian health facility leadership in strengthening their management capacities and utilizing the information systems they need to be effective. We also partner with the Ministry of Health in its coordination role by providing regular implementation data and progress updates to ensure timely course corrections and learnings. At the national level, we also support the ministry with its annual NTD program planning exercises.