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Haiti
Key	
  Problems	
  faced	
  by	
  the	
  Na3onal	
  Healthcare	
  System	
  (NHS)	
  
Overview	
  
• 

Haiti’s Healthcare Background

• 

Vodou religion as a system of healthcare

• 

Problems faced by Haiti’...
Hai)’s	
  Popula)on	
  Pyramid	
  
Hai)’s	
  Popula)on	
  Sta)s)cs	
  
• 

Ranks :149 out of 182 on the United Nations Human Development Index.

• 

Populati...
Hai)	
  and	
  Poverty	
  
• 

Haiti is the third hungriest country in the world after Somalia and Afghanistan.

• 

The r...
Comparing	
   H ai)	
   a nd	
   t he	
   D ominican	
   R epublic	
   	
  

• 

Haiti and the Dominican Republic are neig...
Comparing	
   H ai)	
   a nd	
   t he	
   D ominican	
   R epublic	
   	
  

Life Expectancy (2011) - 62

Life Expectancy ...
Hai)’s	
  Health	
  Issues	
  
• 

Top 3 causes of death (across all ages):
- Infectious and parasitic diseases (e.g. pneu...
Current Healthcare Capacity
Tents used as makeshift hospitals.
Hai)’s	
  Current	
  Healthcare	
  Capacity	
  
• 

0.25 docs per 1000, rural 0.02

• 

USD 65 per head

• 

4% of nationa...
Cultural Beliefs about Illness
Vodou	
  
• 

Religion plays a crucial role in the life of Haitians

• 

Vodou: the prevalent religion among the society

...
Aspects	
  of	
  social	
  structure	
  &	
  culture	
  affec)ng	
  
types	
  and	
  use	
  of	
  services	
  
• 

Traditio...
How	
  Hai)an’s	
  choose	
  Healthcare	
  
• 

Location, religion, social class

• 

Most medical centres located at more...
Key Problems (NHC)
Key	
  Problems	
  faced	
  by	
  Hai)’s	
  NHS	
  
•  Healthcare financing
•  Healthcare Privatization
•  Inadequate and u...
Recipients	
  of	
  Humanitarian	
  Funding	
  
Haiti’s leaders have limited
influence over the planning
and activities of the numerous
foreign actors in the health
sector...
Key Problems

Caused by the Privatization of Healthcare
Problems	
  caused	
  by	
  Priva)za)on 	
  
Increasing Privatization
= Lack of Medical Capacity in the Public Sector
= In...
The Haitian community wants to
alleviate itself from a system that
cannot rely on its public sector and
has too much depen...
Grassroots	
  Movements	
  and	
  CHWs	
  differ	
  from	
  NGOs	
  
• 

Ground up initiatives driven by the politics and s...
Grassroots and Community Health
Ame Sade community health workers

Sacre Coeur Hospital in Milot

The Papaye Peasant Movement
“Road to Life yard” in Centr...
Healthcare in Haiti and How NGOs threaten the National Healthcare System
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Healthcare in Haiti and How NGOs threaten the National Healthcare System

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Healthcare in Haiti, how NGOs threaten the National Healthcare System, Vodou Beliefs about illness and how grassroots organizations help.

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Healthcare in Haiti and How NGOs threaten the National Healthcare System

  1. 1. Haiti Key  Problems  faced  by  the  Na3onal  Healthcare  System  (NHS)  
  2. 2. Overview   •  Haiti’s Healthcare Background •  Vodou religion as a system of healthcare •  Problems faced by Haiti’s National Healthcare System (NHS) •  NGOs and Healthcare Privatization •  Grassroots Healthcare
  3. 3. Hai)’s  Popula)on  Pyramid  
  4. 4. Hai)’s  Popula)on  Sta)s)cs   •  Ranks :149 out of 182 on the United Nations Human Development Index. •  Population: 10,173,775 •  Ethnicity: 95% Black; 5% Mulatto and White •  Urban-rural proportion:: 53% - 47% •  Life expectancy: 62 (total);  64 years (women); 61 years (men)
  5. 5. Hai)  and  Poverty   •  Haiti is the third hungriest country in the world after Somalia and Afghanistan. •  The richest 1% of the population controls nearly half of all of Haiti’s wealth. •  The poorest country in the western hemisphere and one of the poorest countries in the world. •  Poverty 78% of Haitians live on less than $2 US per day.
  6. 6. Comparing   H ai)   a nd   t he   D ominican   R epublic     •  Haiti and the Dominican Republic are neighboring countries that occupy the same island, Hispaniola. •  Exposed to similar level of natural hazards (earthquakes and tropical storms). •  Politically, underwent a series of regime changes (but have different outcomes).
  7. 7. Comparing   H ai)   a nd   t he   D ominican   R epublic     Life Expectancy (2011) - 62 Life Expectancy (2011) - 73 Death Rate (2011) - 9 Death Rate (2011) - 6 Infant Mortality (2011) - 53 Infant Mortality (2011) - 21 Access to improved drinking water resources (2010) – 69% Access to improved drinking water resources (2010) – 86% Access to improved sanitation facilities (2010) – 17% Access to improved sanitation facilities (2010) – 83%  
  8. 8. Hai)’s  Health  Issues   •  Top 3 causes of death (across all ages): - Infectious and parasitic diseases (e.g. pneumonia, tuberculosis) - HIV/AIDs - Cardiovascular diseases (e.g. stroke)
  9. 9. Current Healthcare Capacity
  10. 10. Tents used as makeshift hospitals.
  11. 11. Hai)’s  Current  Healthcare  Capacity   •  0.25 docs per 1000, rural 0.02 •  USD 65 per head •  4% of national budget •  Private insurance is rare •  Haitians have to pay for healthcare “Out-of-Pocket”. •  70% of the health budget in Haiti is funded externally by these NGOs under the coordination of WHO, with more NGOs per capita than any developing country apart from India.
  12. 12. Cultural Beliefs about Illness
  13. 13. Vodou   •  Religion plays a crucial role in the life of Haitians •  Vodou: the prevalent religion among the society •  Definition of illness: religious versus medical •  Maladi Bondyè (visible or ordinary physical illnesses), Maladi fè-moun mal or maladi diab (invisible, secret or magic), and Maladi lwa (spiritual) •  Stigmatisation & taboo: mental illness and HIV/AIDS •  Vodou religion as a system of healthcare •  Health is dependent on the connection of an individual and their religion and morality
  14. 14. Aspects  of  social  structure  &  culture  affec)ng   types  and  use  of  services   •  Traditional versus modern medical services. •  Cost of consulting a traditional healer can be up to a thousand times more than that of a professional medical practitioner. •  Deep-rooted trust in the cultural healing practices among the people. •  Help-seeking behaviour heavily influenced by family, especially since most of the Haitians live together in small communities.
  15. 15. How  Hai)an’s  choose  Healthcare   •  Location, religion, social class •  Most medical centres located at more urban areas, thus rural populations would have difficulties accessing them. •  Access to clean drinking water •  HIV patients tend to move away from alternative healing practices after their interaction with the professional doctors. •  Patients with mental distress decides their choice of healers by the quality of care given •  The elites of the Haitian society do not engage in religious practice of Vodou
  16. 16. Key Problems (NHC)
  17. 17. Key  Problems  faced  by  Hai)’s  NHS   •  Healthcare financing •  Healthcare Privatization •  Inadequate and underpaid workforce •  Disruption to medical supply routes after the 2010 earthquake •  Subsequent cholera epidemic and food and water insecurity
  18. 18. Recipients  of  Humanitarian  Funding  
  19. 19. Haiti’s leaders have limited influence over the planning and activities of the numerous foreign actors in the health sector.
  20. 20. Key Problems Caused by the Privatization of Healthcare
  21. 21. Problems  caused  by  Priva)za)on   Increasing Privatization = Lack of Medical Capacity in the Public Sector = Inability to provide competent healthcare treatment, coverage + inability to retain workforce Private healthcare providers “compete” with local healthcare providers.
  22. 22. The Haitian community wants to alleviate itself from a system that cannot rely on its public sector and has too much dependence on foreign aid.
  23. 23. Grassroots  Movements  and  CHWs  differ  from  NGOs   •  Ground up initiatives driven by the politics and social conditions of a community •  Important because they are able to reach the chronically poor majority •  Seek support to replace the need for a government funded public sector and more autonomy from a system dependent on international support •  Besides basic healthcare, address problems like food security, deforestation and poverty, and fill the need for leadership, employment and social support. •  Role is to put in place local initiatives and programs that could work with and possible be absorbed by the Haitian State.
  24. 24. Grassroots and Community Health
  25. 25. Ame Sade community health workers Sacre Coeur Hospital in Milot The Papaye Peasant Movement “Road to Life yard” in Central Plateau’s Eco Village

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