Increased Access to Family Planning Services: A Community-Based Approach in Rural Haïti
In rural Haiti, the fertility rate is 3.9 children per woman (1). The Family Planning (FP) coverage in Haiti is the lowest in the western region, with only 34.5% of women (1) having their needs for FP satisfied. The gap in unmet FP needs has been estimated at 35% by the Haitian Ministry of Health (MSPP) (1). MSPP states that the repositioning of FP constitutes one of the strategies to achieve the objective to reduce maternal mortality which is 359 /100 000 live births. (2) As part of this strategy, emphasis has been placed on improving access to FP services. (3)
1. Meetings with institutional and community leaders to obtain their commitment to FP.
2. Trained 50 staff from 12 institutions
3. Monthly mobile clinics in 30 communities in remote areas to improve access to FP services
4. Increased staffing in FP in 9 clinics.
5. Adopted an expanded FP strategy, also increased availability and access to FP care in other services in hospital wards: pediatrics, internal medicine, infectious diseases, nutrition, and post-partum maternity wards.
6. Continuous availability of FP methods.
Mobile FP clinics were held in 30 zones across two departments of Haïti. Churches, schools, homes, outdoor meeting areas, etc. were accessed for this purpose.
Data was reported on a monthly basis to the Zanmi Lasante / PIH M & E team. The program ran from January 2017 through June 2018.
During the course of the program, there was: (4)
• 51% increase in all FP methods
• 135% increase in long-term methods
• 33.2% increase in short-term methods
• 110% increase in community-based distribution of FP methods
• 10.3% increase in facility-based distribution of FP methods
• 55% increase in newly-accepting FP clients
• 135% increase in long-term methods (88% Jadelle, 8% tubal ligation and 4% IUD)
• 935 implants were inserted at the community level
The innovative program expanded community-based distribution of FP from short-term methods, now making available long-term methods to clients in remote communities. Implants have been inserted in churches, schools, outdoor meeting areas, and private homes with no reported complications to date.
1. RÉPUBLIQUE D’HAÏTI Ministère de la Santé Publique et de la Population (MSPP), 2016. Enquête Mortalité, Morbidité et Utilisation des Services EMMUS-VI. https://dhsprogram.com/pubs/pdf/FR192/FR192.pdf (accessed 6 Nov 2018).
3. RAPPORT STATISTIQUE 2016 . http://mspp.gouv.ht/site/downloads/Rapport%20Statistique%20MSPP%202016.pdf (accessed 6 Nov 2018).
4. ZL Women’s Health Statistics, 2016-2017. Zanmi Lasante, Haïti.