Innovations in Health Care How a CRS program reduced child malnutrition in Southern Haiti Background Haiti’s child malnutrition rates are among the highest in the Caribbean. Before the earthquake in 2010, about one in three children under age five wasn’t getting enough to eat on a daily basis. Today, the destruction of the earthquake combined with hurricanes and cholera have pushed the rate to well over 30 percent. In the rural areas near the seaport town of Les Cayes, as in much of Haiti, low education levels and a shortage of health care clinics and workers mean high death rates for women during pregnancy and delivery, and for children under five. To tackle these issues, CRS is working with a network of community volunteers to support an integrated approach to set up rally posts, strengthen health centers and create mothers’ clubs. Since the start of the program, known as the Maternal and Child Health Nutrition Program (MCHN), the malnutrition rate in the target communities has been reduced from 14 to 8 percent. Throughout these communities, people have improved their health and prevented needless deaths.
Mothers bring their children to monthly rally posts for regular checkups and vaccinations. Community health agents and CRS staff manage this program. Photo: Benjamin Depp for CRS
The program combined two approaches to reduce child malnutrition: a recuperative and a preventive approach. The preventive approach, Preventing Malnutrition in Children Under 2 (PM2A), targets all pregnant women, mothers of children 0-23 months old, and children under two in food-insecure areas. So far, the program has reached more than 12,000 mothers and 29,000 children. Community members have driven the program, contributing more than 175,000 volunteer hours per year.
Health centers CRS is working with 22 health centers to strengthen the health care system in Southern Haiti. The centers provide pre- and post-natal care, immediate care, testing, diagnosis and food rations. The MCHN program provides equipment, materials, training, and on-site mentoring and coaching to staff to improve availability and quality of service for patients.
A CRS health agent speaks to pregnant mothers at a community health center.
Photo: Benjamin Depp for CRS
Rally posts CRS has helped establish an extensive community nutrition surveillance network by supporting more than 650 health rally posts. Each post is led by a community health volunteer. The volunteers live in the communities where they work, reaching families at rally posts who do not have regular access to health care facilities. The community volunteers and health centers maintain a cross-referral system so that there is a strong tie between the doctors and mother/child units in very remote areas.
The program has helped women establish 250 mothers clubs. Club members grow vegetables gardens to ensure their children receive well-balanced and nourishing meals. Photo: Ashley Rytter/CRS
Mothers’ clubs The MCHN program helped women establish 250 mothers’ clubs, which community members are now running by themselves. Each time the mothers meet, they reinforce their knowledge, practices, and understanding of child health and nutrition. They also form savings groups to increase their incomes and grow vegetable gardens to ensure their children receive well-balanced and nourishing meals. Any remaining vegetables are shared with neighboring families and sold in local markets to supplement household incomes.
A mother brings her child to a community rally post to be weighed. Photo: Benjamin Depp for CRS
Looking ahead CRS and its partners have made large investments in this program, and although it is scheduled to end in September 2013, community members overwhelmingly want to continue the work and the Haitian government plans to provide additional support after the program ends. When that time comes, a much smaller investment would allow CRS to follow up in these communities and lock in our gains. Meanwhile, we are looking to replicate this program in other parts of Haiti.
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