Haiti has the highest maternal mortality rate in the Western Hemisphere, ranging 456 to 1000 / 100,000 live births yearly. In Jeremie, Haiti, while the Haitian Health Foundation (HHF) has well documented progress in child survival, maternal mortality remains high. The purpose of this study was to assess and describe how and to what extent the HHF in Jeremie implements the strategies of the Safe Motherhood Initiative (SMI) to reduce maternal mortality. The framework included improving quality, increasing access to care, providing education. Effective programs require: 1) community-based health care; 2) continuum of care from community to first-referral level; and 3) an education, information, and communication system. A descriptive study interviewing eight key informants, from the community and HHF, while observing mothers’ clubs, nursing students, health agents, and prenatal education classes was conducted. In the service area of HHF, eclampsia, followed by obstructed labor, were the leading causes of maternal death. Risk assessment, information on complications, accessing appropriate services was evidenced during prenatal and home visits, with informal methods of education observed during community gatherings. While a first-level referral hospital is available, interviews generated a pattern focusing on access: with high-risk pregnant women 8 to 12 hours walking distance from the hospital; treacherous mountain roads and lack of transportation. Distance and delay in treatment was identified as a main factor affecting maternal death. A proposal was made to establish a Maternity Waiting Home bringing high risk pregnant women from remote areas closer to first level obstetrical services around the time of delivery.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1. List 3 components of the Safe Motherhood Initiative that contribute to decreasing maternal mortality in developing countries. 2. Describe 3 criteria that must be implemented for an effective community health program to reduce maternal mortality and morbidity. 3. Name an intervention or plan that may be implemented to breach the gap between the continuum of care from community to first level care
Keywords: Maternal Morbidity, Developing Countries
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Haitian Health Foundation, Norwich, CT
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.