Introduction
The current paper shall attempt explore the issue of high adult and child mortality rate in Haiti. The reason why Haiti has been chosen as the country of choice is because it has been categorized by the World Health Organization (WHO) as among the countries in American with high adult and high child mortality rates. In addition, Haiti is understaffed in terms of health care professionals (for example, physicians, nurses, and midwives). The prevalence of AIDS and pulmonary tuberculosis is also higher in comparison with the region average. Moreover, Haiti’s health care system has been underfunded by the government and as a result, most of the Haitians barely get the basic health care services.
Location/Geography
The Republic of Haiti borders the Dominican Republic to the west. It is also located between the North Atlantic Ocean and the Caribbean Sea. In terms of geographical coordinates, Haiti is located at latitude of 19° 00′ north and a longitude of 72° 25′ west (World Health Organization, 2005). The country is very mountainous, and over three quarters of the country lies above 183 m. Haiti enjoys a semiarid and tropical climate. Haiti is separated from Cuba by the Windward Passage.
Population
According to July 2011 estimates, Haiti has a population of 9,719,932. These estimates have explicitly considered the impact of excess mortality as a result of AIDS, something that may lead to higher infant mortality, reduced life expectancy, reduced population growth rates, increased death rates, as well as changes in population distribution on the basis of sex and age (Ivers et al, 2009). 60.0% of the Haitian population is between the ages of 15 and 64 years, while 35.9 % is of between the ages of 0 and 14 years. On the other hand, those above 65 years only account for 3.9 % of the population.
Government
The Haitian government is more of a semi-presidential republic. A multiparty system of government exists, with the President acting as the head of state. The President is often elected directly when the country participates in popular elections. The Prime Minister is usually appointed by the President, and is the head of the government. Both the President and the Prime Minister exercise executive power (Ivers et al, 2009). The government, along with the National Assembly (it has two chambers) enjoy legislative power. Haiti has a unilateral government, meaning that power is delegated to departments by the central government.
Economy
Haiti is ranked as the poorest nation in the Americas. The agricultural sector support two-thirds of Haitians, most of who are involved in small-scale subsistence farming. Compared with similar low-income nations, Haiti has a higher inflation, suffers from a severe trade deficit, and lack of investment. In 2010, the country’s GDP growth was estimated at -8.6% (World Health Organization, 2011). At the same time, Haiti’s GDP per capital was estimated at $ 1900. The agricultural sector accounts for 28% of GDP, while services and industry account for 52% and 20%, respectively. By 2003, almost 80% of the Haitians lived below the poverty line.
State of Health
Health statistics of Haiti are among the worst in the Americas. Among the other countries in the western hemisphere, Haiti has the highest maternal mortality and infant mortality rates, estimated at 60.0 for every 1000 persons, as of 2006 (World Health Organization, 2008). In 2005, the maternal mortality and infant mortality rates were estimated at 670 for every 100 000 live births. Estimates by the WHO indicate that in 2006, the incidence rate of smearpositive pulmonary TB in Haiti was 133 for every 100,000 persons. On the other hand, prevalence was estimated at 402 for every 100 000 persons. Smearpositive pulmonary was identified in Haiti for the very first time in 1981. By 1999, HIV/AIDS had already been identified as a leading cause of death in Haiti. By 2007, the number of Haitian living with AIDS has risen to 120,000 (World Health Organization, 2010). Only about 60 % of the Haitian population had access to health care services by 2003.
The UNAIDS has estimated that the prevalence rate of HIV among adults in Haiti (of between the ages of 15 and 49 years) is between 1.9 and 2.5, with an average of 2.2. A combined report by UNAIDS, the WHO and UNICEF estimates that the antiretroviral therapy coverage in Haiti was 41%, as of 2007 (UNICEF, 2010). On the other hand, the prevalence of Tuberculosis as estimated by the WHO is 366, for every 100,000. The WHO also estimates that in 2006, malaria claimed the deaths of some 741 Haitians. This is about one tenth the current ratios in North America and 1/4th of the global average. There are three medical schools in Haiti and every year, some 300 physicians graduate from these institutions.
Culture/Traditional Medicine
The Haitian culture is mainly based on certain superstitious and religious beliefs. These superstitious and religious beliefs are important to the medical profession. The medical system in Haiti consists of traditional medicine as well as modern medicine. Under traditional medicines, we have domestic medicine, such as the one administered by the herbal Doctor. We also have spiritual medicine, including Christian-based healing and Vodun-based healing. Nearly 40 percent of the Haitian still rely on traditional medicine, due to poor access and affordability of public health care (World Health Organization, 2010). A large percentage of the rural population in Haiti still relies heavily on medicinal plants because this is usually the first form of treatment that they have access to.
Healthcare System and Delivery
The public sector in Haiti accounts for nearly 35.7 % of the country’s health infrastructure. Other formidable players in the sector include the for-profit organizations that targets urban professionals, mixed non-profit facilities, such as the personnel from the Ministry of Health working in religious organizations or private institutions. In addition, non-profit organizations are also actively involved in the provision of health care in Haiti. By and large, the health care system in Haiti has been doing poorly (World Health Organization, 2011).
Health care professional do not usually receive salaries from the government on time. In addition, many public sector institutions usually demands user fees from patients even to provide the most basic of care. Most Haitians earn less than 1 USD per day, and as such, user fees have reduced the utilization of public institutions. Moreover, the user fee is not even enough to enable these institutions to offer basic health care services. The main providers of health services in Haiti are the over 600 charitable non-governmental organizations in the country. However, the MSPP does very little in the way of directing the operations of these charities.
The Ministry of Health in Haiti is charged with the responsibility of coordinating all the health institutions in the country. However, in the past few years, the Ministry of Health has failed to deliver as expected due to an economic embargo slapped on the country. As a result, resources have now been channeled to the nonprofit sector. Several central bureaus in Haiti these are charged with the responsibility of executing the health programs (save for tuberculosis and AIDS, which are coordinated by the Office of the Director General (World Health Organization, 2009).
Health legislation in Haiti has been slow, owing to the country’s political problems. The organization of health regulatory actions in the Haitian health care system has made little progress owing to insufficient legal framework that has hindered the formulation of strategies, as well as the implementation of activities in order to ensure that Haitians receive basic health care services (World Health Organization, 2008).
The Haitian laws that govern the efficacy and safety of drugs were ratified between 1948 and 1955. In 1997, they were drafted into new law but sadly, they are yet to be approved owing to political problems. Communication activities in health promotions services have been integrated into several MSPP programs. In turn, the MSPP programs should liaise with the health media (World Health Organization, 2005). Although the government has been frequently increasing its budgetary allocation to the health sector, however, these funds are still not enough, in comparison with the government’s contribution in the 1980s, mainly as a result of inflation. At the moment external sources cater for 18.9% of Haiti’s health budget.
The total number of health care professionals in Haiti is estimated at 5400, which translates to about 2.6 heath workers for every 1000 inhabitants. This means that there is one physician in Haiti for every 10,000 persons in the population. On the other hand, the midwifery and nursing density in Haiti is 1.8 for every 10,000 Haitians (World Health Organization, 2009). The country has five leading nursing schools where about 300 nurses graduate every year. However, within five years, nearly half of the graduates will have left the country due to limited job opportunities as well as poor working conditions. It is believed that the United States has a larger number of Haitian physicians than those in Haiti.
The nursing population in Haiti is among the lowest in the Americas. Estimates show that Haiti has about 1400 nurses. The MSPP has employed nearly 1000 nurses and an additional 1500 auxiliaries (World Health Organization, 2012). Some additional 400 nurses are believed to be working in the private sector. About seventy percent of the entire nursing population in Haiti works in Port au Prince. Nearly a third of the Haitian population lives in Port au Prince. Over the past couple of years, PEPFAR has provided the largest health assistance to the Haitian health care system, and more so in as far as HIV treatment is concerned. Another valuable source of help to the Haitian health care system has been the Cuban medical brigade. Already, the Cuban medical brigade is training thousands of Haitian medical professionals in the country, with an additional 200 physicians receiving training in Cuba each year.
Haiti’s troubled economic and political past is largely responsible for the country’s health crisis. These past events have disrupted the country’s health care infrastructure to the point where Haitians suffer and succumb to readily treatable and preventable illnesses. In order to build the country’s health care the international community shall have to provide a lot of technical and humanitarian assistance.
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