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Healthcare in Haiti

Deficient sanitation systems, poor nutrition, and inadequate health services have pushed Haiti to the bottom of the World Bank’s rankings of health indicators. According to the United Nations World Food Programme, 80% of Haiti’s population lives below the poverty line. Consequently, malnutrition is a significant problem. Half the population can be categorised as “food insecure” and half of all Haitian children are undersized as a result of malnutrition. Less than half the population has access to clean drinking water, a rate that compares poorly even with other less-developed nations. Haiti’s healthy life expectancy at birth is only 54 years. The World Health Organisation (WHO) estimates that only 43% of the target population receives the recommended immunisations.

Haiti has the highest incidence of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) outside of Africa. Sex tourism and lack of health education led to the beginning of the epidemic in the early 1980s. Estimates vary, but the United Nations projects the national prevalence rate to be 1.5% of the population. Other estimates place the rate as high as 5% in the urban population and 3% in rural regions. Annually, 5,000 Haitian babies are born infected with the AIDS virus. The disease causes a fifth of all infant deaths and has orphaned 200,000 children.

Haiti’s health system includes the public sector, the semi-public sector and the private sector.

The public sector was seriously affected by the country’s political crisis, which led all foreign aid to be channelled through non-governmental organisations (NGOs). The Ministry of Health is structured into central, departmental and community levels. Through its central directorates and units, it sets standards. Planning, monitoring and supervision are the responsibility of the heads of the nine sanitary departments. One-third of the country’s 663 health institutions belong to the public sector.

The semi-public or mixed sector encompasses non-profit institutions that are supported mainly by NGOs. Staff is paid in whole or in part by the public sector, but is managed by the private sector.

In 1994 there were 49 hospitals and 61 other inpatient facilities, with an estimated 90 beds per 100,000 population. Of the country’s total healthcare facilities, 32% are operated by NGOs. The private, profit-making sector is comprised of physicians, dentists and other private practice specialists who mostly work in Port-au-Prince and in private healthcare facilities. Public and private establishments function completely independent of one another with very little networking. Differences in access to adequate healthcare are further magnified by the uneven geographical distribution of centres and hospital beds.

In terms of healthcare spending, Haiti ranks last in the western hemisphere. Economic instability has limited any growth in this area. Per capita, Haiti spends about $83 annually on healthcare. There are 25 physicians and 11 nurses per 100,000 population. Only one-fourth of births are attended by a skilled health professional. Most rural areas have no access to healthcare, making residents susceptible to otherwise treatable diseases. In 2003, for example, the WHO confirmed an outbreak of typhoid fever in Haiti that, because of a lack of access to doctors and safe water, led to dozens of deaths.





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