ABSTRACT
Deaths and their causes in a rural Haitian population of 8820 were studied through hospital records, death registration, a disease survey, and health surveillance. The results were used in selecting eight diseases for the delivery of health services by village-level health workers. The impact of the services was measured by monitoring annual age-specific and disease-specific mortality rates and by comparing them with officially estimated national mortality rates. Mortality rates fell progressively during five years, to levels only one fourth as high as the national estimates. The fall in mortality was associated principally with services that prevented deaths due to tetanus, malnutrition, diarrhea, and tuberculosis. The total program of hospital and village health services saved 495 years of potential life per thousand population per year. Most of the saving was attributable to preventive services. The program eventually served more than 115,000 persons, and it has been replicated by other agencies for an additional 135,000 Haitians.
PIP: Deaths and their causes in a rural Haitian population of 8820 were studied through hospital records, death registration, a disease survey, and health surveillance. The results were used in selecting 8 diseases for the delivery of health services by village-level health workers. The impact of the services was measured by monitoring annual age-specific and disease-specific mortality rates and by comparing them with officially estimated national mortality rates. Mortality rates fell progressively during 5 years, to levels only 1/4 as high as the national estimates. The fall in mortality was associated principally with services that prevented deaths due to tetanus, malnutrition, diarrhea, and tuberculosis. The total program of hospital and village health services saved 495 years of potential life/thousand population/year. Most of the saving was attributable to preventive services. The program eventually served more than 115,000 persons, and it has been replicated by other agencies for an additional 135,000 Haitians.
Subject(s)
Mortality , Primary Health Care/methods , Rural Health/trends , Adolescent , Adult , Allied Health Personnel/statistics & numerical data , Child , Child Nutritional Physiological Phenomena , Child, Preschool , Diarrhea/therapy , Female , Haiti , Health Education , Health Services Needs and Demand , Humans , Immunization , Infant , Infant, Newborn , Middle Aged , Midwifery , Nutrition Disorders/therapy , Parasitic Diseases/therapy , Pregnancy , Primary Prevention/methods , Tuberculosis/therapy , Vital Statistics , WorkforceABSTRACT
Evaluation of the effectiveness of Mothercraft Centers operating in Haiti over the period 1964 to 1975 as a public health measure in private and public health services is reported. For the most part, the data are derived from centers operating routinely in the health services rather than from pilot demonstrations. Their impact in both therapy and prevention of severe malnutrition in preschool children is considered, and it is found that numerically the greater benefit is in prevention. At a total annual cost of $4034 a typical center accomplishes successful therapy and prevents relapse in 105 children. In addition, it provides protection against severe malnutrition to their 306 younger siblings. It is thus estimated that, considering only these 411 children demonstrably benefited from a year's operation, the cost of providing essentially lifetime protection from severe malnutrition is approximately $10 per child.
Subject(s)
Child Health Services , Nutrition Disorders/therapy , Body Weight , Child Health Services/economics , Child, Preschool , Community Health Workers , Costs and Cost Analysis , Diet Surveys , Edema/therapy , Female , Haiti , Health Education , Humans , Infant , Nutrition Disorders/prevention & controlABSTRACT
Tetanus has been a public health problem of major importance in rural Haiti. Energetic preventive measures by a rural Haitian hospital were successful in controlling the problem only after immunization services were made easily available to the entire population served by the hospital. This was accomplished by a program which carried the services to the market places and villages of the region. The program developed several new categories of auxiliary personnel who were recruited locally and trained on the job. These personnel were utilized in a program which incorporated preparatory publicity, timing, handling of large crowds in open surroundings, education, record keeping, follow-up and evulation as well as the technical matters concerning the giving of injections. The program sharply reduced the number of admissions to the hospital for the treatment of tetanus. Evaluated on the basis of hospitalizations avverted the program cost only 1/9 the value of the 50,000 hospital days of care for the tetanus cases it prevented.
PIP: A rural hospital in Haiti -- the Albert Schweitzer Hospital of Deschapelles -- initiated an energetic preventive program to deal with the public health problem of tetanus. The program was successful in controlling the problem only after immunization services were made easily available to the entire population served by the hospital. The program offered services in the market places and villages of the region. Several new categories of auxiliary personnel were recruited locally and trained on the job. The program incorporated preparatory publicity, timing, handling of large crowds in open surroundings, education, record keeping, follow-up and evaluation and the technical administration of the injections. The program was responsible for a marked reduction in the number of admissions to the hospital for the treatment of tetanus.
