At a glance: Haiti

In Haiti, emergency clinics help reduce maternal and neonatal deaths

UNICEF Producer Michelle Marrion reports on a pilot project to expand emergency obstetric care in Haiti.

 

By Chloe Sydney

In Haiti, clinics providing emergency obstetric and newborn care are working to reduce maternal and neonatal mortality rates.

MARIGOT, Haiti, 25 July 2013 – Madette Perrique let out a heart-rending wail. She was in labour, and in pain. Only a few minutes after we had arrived at the clinic in Marigot, she was rushed into the delivery room by a crew of nurses in blue. Moments later, we heard a baby cry.

Welcome to the world!

In the waiting room, her sister-in-law Elmate Jean-Louis shed tears of joy and relief at the arrival of her niece. Ms. Perrique was lucky: Her family had accompanied her to the clinic, saving her from a potentially life-threatening birth at home.

High mortality rates

According to the findings of Haiti’s Enquête Mortalité, Morbidité et Utilisation des Services 2012 (a national survey of mortality, morbidity and service use), less than 36 per cent of births take place in health facilities.

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Four pilot clinics are working to reduce Haiti's maternal and neonatal mortality rates by providing basic emergency obstetric and newborn care.

As a result, Haiti’s maternal and neonatal mortality rates are high. For example, maternal mortality in 2010 was estimated at 35 per 1,000; and as of 2012, statistics indicated that 3.1 per cent of newborns died within a month.

These figures represent a significant decrease from previous years, but no mother should die giving life, and no child should die discovering it – especially considering that five of the major causes of maternal mortality can be treated at a well-staffed, well-equipped health facility.

Initiative

Four pilot clinics across Haiti are working to reduce maternal and neonatal mortality rates by providing basic emergency obstetric care, or BEmOC. These clinics came about through a partnership of the Ministry of Public Health and Population, the United Nations Office for Project Services (UNOPS), the United Nations Population Fund (UNFPA) and UNICEF.

While the BEmOC initiative has led to the creation of other clinics in urban areas like Port-au-Prince, the initiative is particularly important in rural areas where there is little access to health care.

Marigot is just such a place, 80 mountainous kilometres south of Port-au-Prince, sitting by the sparkling Caribbean Sea.

The BEmOC clinic in Marigot opened its doors in October 2012 alongside an existing health centre, and offers free 24-hour health care. Its green and white walls are topped with vibrant flowers, and the Haitian flag flies proud. 

According to Dr. Andre Misnick, director of the clinic, 89 births took place here between October 2012 and May 2013, and mothers and babies all left in good health. Ms. Perrique and her daughter are no exception.

Transport and tradition

In addition to offering obstetric and newborn care, Marigot’s BEmOC clinic meets community leaders to explain the importance of quality care and provides training for matrons – traditional Haitian birth attendants who usually have no formal training. 

Although the clinic’s services are free, Nurse Johanne Guillaume says, “There are many who give birth at home with help from a matron, because they lack the means to travel to the clinic.”

Without help from her sister-in-law, it is likely that Ms. Perrique would have done the same.

Dr. Misnick explains that traditional cultural practices are one explanation for the country’s high rate of non-clinical births.

“Trusted local matrons are often preferred to professionally trained midwives, with childbirth practices often passed down through generations,” she says.

These matrons can offer helpful assistance, especially in remote areas with little access to transport. On the other hand, the lives of the mother and child can be threatened if a matron is untrained to recognize the warning signs of complications – hence the importance of training. 

Saving lives

UNICEF Health Manager Dr. Francine Kimanuka says that UNICEF hopes to expand the BEmOC initiative in the near future.

“The combination of on-site obstetrical and newborn care and the provision of training to matrons in remote areas should strongly contribute to reducing neonatal and maternal mortality rates,” she says. 

Indeed, thanks to the BEmOC clinic in Marigot, Ms. Perrique gave birth to a healthy baby girl.


 

 

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