Our work in Haiti is focused on improving the health of children.

 

PRIORITIES

  • Continue supporting vitamin A supplementation (VAS) program through routine and community-based distribution, with specific attention to monitoring of coverage, stock management and social mobilization.
  • Support a diarrhoea pilot project that promotes the efficient use of zinc and oral rehydration salts (ORS) aimed at children under five. Recommendations on the pilot will support national scale-up of this treatment.
  • Provide technical support to partners, other NGOs and the Haitian government on a renewed Iodine Deficiency Disorders (IDD) control strategy.
  • Assess the feasibility of distribution of multiple micronutrient powders through community health workers. Recommendations will be used for national scale-up.

RESULTS

  • A national Child Health Weeks event was launched in all 10 departments of Haiti between November 2010 and January 2011 with the support of MI and other partners.
  • After MI supported and placed a Child Health Week Coordinator position in the Ministry of Public Health, the position was absorbed as a full-time staff position into the Ministry as of September 2010.
  • With MI´s technical support, and financing from the Pan American Health Organization (PAHO) and the Inter-American Development Bank (IADB), Haiti´s Ministry of Health was able to provide vitamin A and deworming tablets to children under the age of five during its national immunization campaign in April 2012.
  • Child Health Weeks held in November 2012 and June 2013 ensured delivery of vitamin A supplements, de-worming, and zinc & ORS for diarrhoea treatment to children under five.
  • In 2014, with MI’s support, the Ministry of Health and local NGOs were able to set up a pilot project to increase vitamin A supplementation coverage through community-based delivery, reaching 80% of children under the age of five in four out of 10 departments of the country.
  • Through MI technical and financial support provided to local partners in 2014, 38,000 cases of diarrhea were treated with zinc and ORS
  • MI’s partners in Haiti have distributed 1,2 million sachets of multiple micronutrient powders to children under the age of five, helping to improve nutrition for Haiti’s most vulnerable

OUR WORK

Vitamin A

MI has supported the distribution of twice annual vitamin A supplementation (VAS) to children under five in Haiti for nearly a decade. Working with partners, including UNICEF, World Food Programme, World Health Organization and local NGOs, MI has helped to reinforce Haiti’s Ministry of Health’s Vitamin A Strategy.

The Strategy is currently focused on delivering VAS through the routine public health system, with additional emphasis on community outreach as well as key periods throughout the year via health volunteers. In demonstration phases, this approach has shown a tremendous increase in the number of children reached.

Prior to this strategy, MI teamed up with partners to support the Ministry of Health’s Child Health Week Strategy – which provided life-saving interventions such as vitamin A and de-worming tablets to children under five – and inclusion of vitamin A in collaboration with immunization campaigns.

With support from UNICEF and funding from the Inter-American Development Bank, we were able to add a vitamin A and a deworming community team member to every immunization team as well as a health worker to update each child´s health card. This was crucial given not only how important these interventions are, but how key it is to keep track of what interventions children receive.

Other improvements upon previous Child Health Weeks included use of the door-to-door strategy to make sure no children were missed after the first week of fixed site distribution. A total of 1.2 million children under the age of five were targeted for VAS.

MI placed a senior experienced Haitian as a Child Health Weeks Coordinator within the Ministry of Health in 2009/2010, to support new donor efforts and help the Ministry coordinate efforts between the many NGOs in Haiti. This Coordinator worked with sub-committees to plan and implement bi-annual Child Health Week events. The position has since been integrated into the normal functions of the Ministry of Health and is supported by national budgets.

Zinc

In past years, Child Health Weeks have sometimes included zinc and oral rehydration salts (ORS) to treat diarrhoea in children under five. As a result of the 2010 cholera epidemic following the earthquake, MI worked with partners to assess the need for zinc to treat choleric diarrhoea in children in this age group and provided the technical assistance to include it. MI supported UNICEF in developing communications and training materials about the use of zinc and ORS to treat choleric diarrhoea.

MI is now working with the Ministry of Health and local partners to implement a pilot diarrhea treatment project (which includes zinc and ORS) in the North and North-West departments – a project that includes in-depth research on caregivers’ care-seeking behaviours for diarrhea, health worker training, monitoring and reporting tools, and the development of a behaviour change strategy and materials. Following the pilot project, we will be making recommendations for scale-up to the Ministry of Health and NGO partners

Multiple Micronutrient Powders

MI supported the distribution of multiple micronutrient powders, called Bebe Vanyan, via the World Food Program Haiti, which reported 96% of the sachets were distributed to over 58,000 children aged 6-24 months through health centers and food aid programs.

MI worked with WFP and UNICEF to ensure consistent product packaging and messaging to provide three million sachets to approximately 50,000 children under the age of five living in earthquake affected areas, from 2010-2012.

In 2014, MI began assessing the feasibility of community health workers distributing multiple micronutrient powders to children under the age of five living in the North department. Expected results will be forthcoming, with the goal of reaching more children in need.

Salt Iodization

MI focuses regional salt iodization efforts on Haiti as iodine deficiency disorders (IDD) remain a major public health problem in this country. Less than 20 percent of households consume iodized salt, with some estimates indicating less than five percent of households, compromising the health and development of the population, particularly children and mothers.

MI has worked with the World Food Programme (WFP) on improving layouts for salt ponds and mapping salt production in Haiti. MI also participated in a multi-agency advocacy mission and the development of an iodization work plan with local officials. We continue our support to agency partners, NGOs and the Haitian government that is working on a renewed national IDD control strategy, taking into consideration quality control, distribution mechanisms, social marketing and pricing.

Iodized Oil Capsules

Given the obstacles to iodizing salt in Haiti, MI arranged through WFP for iodized oil capsules to be distributed to women of child-bearing age along with children under the age of two in late 2008 and in 2009. MI also advocated for the Inter-American Development Bank to include the procurement of iodized oil capsules in their three year project plan, which ended in 2013.

MI will continue to advocate for iodized oil capsules to be distributed through health campaigns to reach women of reproductive age and children under the age of two. The Nutrition Directorate of the Ministry of Health has adopted iodized oil capsules into the minimum package of services for Child Health Weeks in Haiti, though the cost of the capsules remains an issue.