Impact of natural disasters on a health program for women and children: Lessons learned from Haiti

Haiti suffered from 3 major natural disasters in the past year—an earthquake, a destructive tropical storm, and a cholera epidemic. These events affected the entire country. In the southwest area of the Haitian Health Foundation (HHF), there was a 15% increase in population through migration from Port-au-Prince post earthquake. HHF has provided community based primary health care (CBPC) to a remote rural population since 1987. Maternal and child health (MCH) was affected in the following ways: a census was conducted to register migrants post-earthquake documenting an increase of 18,066 people; 29% of households took in migrants including 6048 women of reproductive age and 1499 children, needing new health cards and vaccinations; migrant children <5 were less malnourished than resident children; and, women were more likely than men to be unemployed post-migration. These communities are served by HHF community health workers (CHWs) who each cover 2000 people; the in-migration was the equivalent of 9 CHWs. There was a 20% increase in child pneumonia, a 4% decrease in child vaccinations, and an increase in prenatal care. HHF's CBPC was able to document the impact of in-migration post-earthquake based on its strong health information system. Since many migrants were returning, activation of old records prevented unnecessary revaccinations. HHF was faced with increased needs and no increases in staff. This meant fewer child vaccinations were completed because more children were sick. This CBPC program effectively mobilized for all three disasters, providing a model for other programs for sustainable relief, health care and development.