January12th marks the one year anniversary of the 7.0 earthquake that devastated Port-au-Prince and the surrounding area of Haiti. With the popular press flooded with stories of the shortcomings of disaster relief and what isn’t working, it can be easy for donors to overlook the progress that has been made and the successful models that are improving the lives of Haitians each day. Given where Haiti was before the disaster, it will take time (years) to build the human and physical capacity for real growth and development. What’s important for donors is to focus on models and programs with the most potential for long-term impact. In this series, we highlight approaches that are already working in Haiti that need to be strengthened and scaled-up. More in-depth analysis of these can be found in our guide Haiti: How Can I Help? Models for Donors Seeking Long-Term Impact which provides guidance for donors looking to invest in Health, Livelihoods, and Education.
Opportunity 1 – Health: Supporting Community-Based Primary Care Systems
Even before the earthquake, almost half of Haiti’s population lacked access to healthcare. Yet a proven, cost-effective model exists for bringing healthcare to even the poorest, rural communities. Community-based primary healthcare systems reach people where they live. They provide access to essential prevention and treatment, health education, advanced hospital care and essential surgery in emergencies, and programs addressing the root causes of poor health (e.g. access to clean water and nutrition). Hôpital Albert Schweitzer (HAS) Haiti and Partners In Health are two examples of nonprofits with over two decades of results from successfully implementing this model in Haiti. Their experience demonstrates how this comprehensive approach can create a sustainable system. By supporting models such as these, you can ensure the health of Haitians, not just after the earthquake, but for generations to come. In addition to the larger organizations we’ve mentioned, smaller local organizations such as Haitian Health Foundation (HHF) in the rural city of Jérémie in southwestern Haiti and Promise for Haiti in the Pignon region in northern Haiti also implement the community health model. For donors interested in supporting this model in Haiti or in other parts of the world, here are tips on what to look for in order to have the most potential for impact.
Tips to Assess Community-Based Healthcare Projects
The best programs will have:
- Preventive care and treatment services that reach people where they live. These are often delivered to households by community health workers, mobile clinics, and health educators. Links to a referral system including basic hospital care and essential surgery. It is the presence of this entire comprehensive system that produces results.
- Focus on capacity development of the local community through training and employing members of the area as nurses, community health workers, and staff. Organizations build the capacity of the public medical system for long term sustainability rather than acting as a parallel system through activities such as improving the infrastructure of public facilities and serving as a training site for healthcare workers.
- Track record of experience and trust working with the target population as evidenced by community feedback surveys and documented use of health services offered. Organizations use knowledge of the local health situation to select and deliver the most needed prevention and treatment (e.g., clean water, immunizations, and prenatal care).
- Partnerships and networks to address the root causes of ill health. Health systems that link to programs in literacy, improved agricultural and food security, clean water and sanitation, and income generation activities will have the greatest long-term impact.
- Feedback system to assess the quality of program implementation and evidence of its impact. Organizations do this through the use of household census, tallies of the use of key health services, and surveys of community health.