Reduction of Mortality in Rural Haiti through a Primary-Health-Care Program

Abstract

Deaths and their causes in a rural Haitian population of 8820 were studied through hospital records, death registration, a disease survey, and health surveillance. The results were used in selecting eight diseases for the delivery of health services by village-level health workers. The impact of the services was measured by monitoring annual age-specific and disease-specific mortality rates and by comparing them with officially estimated national mortality rates. Mortality rates fell progressively during five years, to levels only one fourth as high as the national estimates. The fall in mortality was associated principally with services that prevented deaths due to tetanus, malnutrition, diarrhea, and tuberculosis. The total program of hospital and village health services saved 495 years of potential life per thousand population per year. Most of the saving was attributable to preventive services. The program eventually served more than 115,000 persons, and it has been replicated by other agencies for an additional 135,000 Haitians.

Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 7. shared characteristics of projects with evidence of long–term mortality impact

“…As a result of the collection of vital events data at the time of initiation of HAS’s community health project in 1967 [21] and the intermittent collection of retrospective birth histories since, it has been possible to monitor the U5MR for the primary health care project area served by HAS and to compare these to data for Haiti as a whole. The HAS project area is similar in socio–economic indicators to rural Haiti as a whole [4].…”

Long-Term Reductions in Mortality Among Children Under Age 5 in Rural Haiti: Effects of a Comprehensive Health System in an Impoverished Setting

“…The findings from the analysis of the most recent HAS survey data were then compared with those from previously published studies on under-5 mortality rates between 1958 and 1992 in the HAS service area [13][14][15] and for Haiti nationwide from 1970 to 1999. 12,[16][17][18] For the periods 1980-1984, 1985-1989, and 1990-1994, there are estimates from the 2 previous national demographic and health surveys (1994-1995 and 2000).…”

Economic hardship and sexually transmitted diseases in Haiti's rural Artibonite Valley.

“…For over 20 years, HAS has conducted health surveillance for the Artibonite Valley. 12 Based on 1995 surveillance data, the population of the zones served by HAS was estimated at 200,000 people with 7,500 pregnancies annually. More than 80% of pregnant women seek antenatal care at the HAS community dispensaries.…”