CIDA in Haiti: Free obstetric care saves lives

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Every year in Haiti, more than 2,000 women die in childbirth.

One of the strategies to reverse this trend is to encourage women to deliver their children in health facilities, attended by qualified personnel.

Unfortunately, most Haitian women cannot afford to pay for institutional care.

That is why the Canadian International Development Agency supports the Free Obstetrical Care project (Soins Obstétricaux Gratuits, or SOG), which seeks to eliminate this financial obstacle to health care.

Canada implements this project with the Haitian Ministry of Public Health and Population, and with technical support from the Pan American Health Organization (PAHO/WHO).

Dr. Laurent Stien, Project Coordinator, Pan American Health Organization (PAHO/WHO): "It has been estimated that 630 women die for every 100,000 babies who were born alive. This is a considerable rate. When mothers die, it is usually within 42 days after giving birth. The Free Obstetric Care project aimed to combat one of the highest maternal mortality rates in the Americas. The project also aimed to give pregnant women access to institutional care. In Haiti, more than three out of four women give birth at home. This may explain why so many die."

Dr. René Pascal Resident, Isaïe Jeanty Maternity Hospital: "There are too many risks, especially if a woman bleeds heavily after childbirth. Sometimes, after a woman gives birth at home, she experiences bleeding she cannot control. That is why we encourage women to deliver in a hospital."

Dr. Lauré Adrien, Executive Director, Société Haïtienne d'Obstétrique et de Gynécologie: "This program has resulted in considerably fewer obstacles caused by inability to pay. Women used to worry about how they would find the money to pay for admission to a maternity hospital. This program allows women to come to a maternity hospital, and to receive services provided by qualified staff, without having a penny in their pockets, or at least without having to pay anything."

Dr. Laurent Stien: "This national program began with more than 40 institutions throughout Haiti. The program immediately showed that eliminating this obstacle allowed many women to come to institutions, when they used to stay away—not because of the quality of care, not because of the distance, but because they could not afford it. "

Since the beginning of the project in 2008: Over 70,000 women and their newborns had access to skilled care during pregnancy, childbirth and the postnatal period.

The maternal mortality rate in participating institutions is about 135 deaths per 100,000 live births, compared to 630 deaths per 100,000 live births at the national level.

Florian Fabiola, Beneficiary: "When I came here for the first time, I was seven months pregnant. My medical care started in my seventh month. A friend referred me to this hospital. She said it provided excellent services. She even came with me, because I was in pain. They gave me an admission card and told me I would need a caesarean. Then I came for follow-up visits. They asked me to have an ultrasound every month to monitor the baby's development. The doctor who examined me told me there was a problem involving a ruptured placenta. My baby was due April 11 but I went into labour early, on March 19. My older sister brought me here. When I arrived, they welcomed me, laid me on the delivery table, and took care of me without any problems. I am very lucky to be alive, because I was bleeding quite a bit."

Dr. Lauré Adrien: "We do not just provide women with free medical care. We also provide support after their babies are born, after they are released from hospital and return to their communities. We also try to provide medicine in order for them to continue their treatment."

Dr. Camille Figaro, Medical Director, Isaïe Jeanty-Chancerelles Maternity Hospital: "This helps women make informed choices with full knowledge of what they are doing. It also enables women to improve their health. The Free Obstetric Care project has played a major role, and I hope this will continue and get even better."

Dr. Laurent Stien: "The next phase is to expand this medical care package, to provide free health care for children under five as well." On September 15, 2011, the Haitian Ministry of Public Health and PAHO/WHO launched the "Manman ak timoun an sante" (Mother and Child Health) project.

Canada has provided $20 million to support this project. The project aims to improve maternal and child health by offering pregnant women free prenatal care, as well as health services for children under five.

In the next five years, Canada will invest $50 million in projects to improve maternal, newborn, and child health in Haiti.