Hope Amid Hardship
Strengthening maternal health care in southern Haiti
In the rugged terrain of southern Haiti, access to quality health care is a distant dream for many. Here, health care providers often travel to remote rural communities to deliver primary care, while patients must travel long distances to health facilities or hospitals for more specialized medical care.
This problem worsened in August 2021 when a devastating 7.2-magnitude earthquake rocked Haiti’s southern peninsula, claiming over 2,200 lives. The earthquake damaged or destroyed homes, health care facilities, and infrastructure. Meanwhile, fuel shortages, skyrocketing gas prices, and rising insecurity made travel even more difficult.
As poverty levels surged and safe passage became increasingly scarce, the demand for accessible health care solutions became even more urgent.
Yet, amid formidable challenges, a ray of hope emerged. Matrones are deeply revered within Haitian society and stand as trusted allies. They live and work within the communities they serve. Pregnant women often turn to them for advice on pregnancy and childbirth.
Since they are not formally educated medical providers, matrones are trained — with support from USAID — to refer pregnant women to certified community health workers and health centers for prenatal care, vaccinations, labor and delivery services, and postnatal care. Community health workers also collaborate with matrones to refer pregnant women to hospital facilities when complications arise.
This collaborative effort bridges gaps in access, ensuring expectant mothers receive timely and life-saving interventions, even in the most remote areas.
Melia*, a dedicated matrone living in the Lindor community in the Commune of Petit Trou de Nippes, exemplifies the impact of this synergy. Through USAID-sponsored monthly trainings at a nearby health center, Melia is equipped with the skills to identify early signs of critical childbirth complications and call the nearest certified community health worker.
From January to March this year, 367 matrones were trained across 20 facilities supported by the program, with more rounds of training planned.
At a recent training, Melia learned about life-threatening risks such as neonatal tetanus, a bacterial infection that affects newborn babies, and preeclampsia, a potentially deadly complication caused by high blood pressure during pregnancy.
A few weeks after studying these risks, Melia received a call from Marie*, a pregnant woman showing signs of distress before and during labor. As soon as Melia arrived, she quickly identified the signs of preeclampsia such as headaches, nausea, and vomiting, thanks to her recent training. She also knew that she needed to immediately call the nearest community health worker, Jean*, for clinical support.
Melia reached out to Jean as a first line of support before referring directly to a facility, because community health workers are often more accessible and can quickly provide initial clinical support, which is crucial in emergencies. They are trained to handle immediate complications, stabilize patients, and then determine the most appropriate next steps, such as referring to a health facility if necessary. This immediate response can be life-saving, especially in rural or underserved areas where direct access to health centers may be limited or delayed.
Jean swiftly responded to the call for help. His dedication to his community shines through his words, as he shares his pride in serving as a community health worker.
“I am happy to do my job in the community, and I feel proud of being a [community health worker],” Jean said. “Everyone in the community appreciates my support and calls me for help when needed. I visit them, advise them, screen, and refer them.”
Upon his arrival, Jean assessed Marie’s condition. He confirmed that she was suffering from preeclampsia and was in urgent need of advanced medical care. Despite the late hour and challenging transport conditions, Jean took it upon himself to ensure Marie’s safe journey, driving her to St. Thérèse Hospital an hour and a half away.
Melia’s swift action, coupled with the timely intervention of Jean, ensured Marie’s safe transport to a hospital, where she delivered her baby girl safely.
After the delivery, Marie learned about the importance of visiting a health center for postnatal check-ups and immunizations. Marie’s heartfelt gratitude speaks volumes about the profound impact of Haiti’s health care heroes supported by USAID.
“I am so grateful to [Jean]. It is thanks to his knowledge and service that my baby and I are alive today,” Marie said. “I want him to be the godfather of my baby; he saved our lives.”
For over four decades, USAID has partnered with the Government of Haiti and local organizations to enhance access to and quality of reproductive, maternal, newborn, and child health care, as well as nutrition services.
In 2022, USAID support helped 20,000 pregnant women to deliver in health facilities through the Improved Health Service Delivery Kore Sante program, led by Health Equity International.
USAID remains committed to the work of helping build a strong and resilient health system. USAID works to build a stable and viable Haiti, and provides life-saving humanitarian assistance to Haiti’s most vulnerable and hard-to-reach people.
*All names have been anonymized to protect patient-provider confidentiality.
About the Author
USAID’s Maternal and Child Health and Nutrition Office in the Bureau of Global Health works to ensure that all women and children have the same chance of a healthy life, regardless of where they live or are born.
