In 1967, the Hospital Albert Schweitzer (HAS ) developed an innovative census-based community health care program that registered all mothers and children in the population and provided them with basic services, including immunizations. Health Agents visited all homes and promoted attendance at Rally Posts where maternal and child health services were provided. These same activities have continued at HAS for the past 34 years and have become integrated into a comprehensive system for health and development serving 300,000 persons at a cost of US$ 16 per year.
In order to assess the current impact of the program on children less than five years of age, the retrospective reproductive health histories were obtained from a sample of 3,500 women in the HAS service area. These were compared to findings from Haiti's most recent demographic and health survey.
The overall 0-4-year mortality in the HAS service area is currently half that for rural Haiti (68.2 versus 144.3 deaths per 1,000 live births) and the 1-4-year mortality is only one-quarter that for rural Haiti (16.0 versus 60.8).
The experience of HAS demonstrates that improvements in child survival can be sustained at an affordable cost through the linkage of a strong community outreach program with hospital backup and community development services. The establishment of similar integrated programs for health and development in extremely poor populations should enable continued progress in reduction of mortality in young children at an affordable price.
Learning Objectives: none
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
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.