Initiating a community health worker network within tent communities in post-earthquake Haiti

In May 2010, a few months after the devastating earthquake in Haiti, a Maternal and Child Health and Nutrition (MCHN) program was started by Samaritan's Purse for pregnant and lactating women living in the transient tent communities. After working in partnership with a Ministry of Health still struggling to recover from the earthquake, the MCHN project staff used adult learning methodologies to train groups of mothers on maternal and child health and nutrition issues (for twelve hours during the course of one week) and also provided micronutrient supplements for the mothers and their children. The peer support inherent in the Mother's Support Group model was incorporated into each training. At the end of each week, four mothers were chosen to be community health workers (CHWs) to follow up with the women in their class, using a one-on-one timed and targeted counseling approach. Mothers were followed up during key times in their pregnancy and in their child's life, and messages were promoted that were specifically tailored to their phase of life. Over the course of the next two years, CHWs were continually trained to provide health and nutrition counsel for their communities, reinforcement of behavior change messages, and advice on when the mother or child should be referred to the local hospital. Key informant interviews demonstrated that the 925 CHWs in this project model developed into leaders in their respective communities, were empowered to change their behaviors and became advocates for change in the midst of great transition and upheaval.