Addressing the Child and Maternal Mortality Crisis in Haiti through a Central Referral Hospital Providing Countrywide Care.

The neonatal, infant, child, and maternal mortality rates in Haiti are the highest in the Western Hemisphere, with rates similar to those found in Afghanistan and several African countries. We identify several factors that have perpetuated this health care crisis and summarize the literature highlighting the most cost-effective, evidence-based interventions proved to decrease these mortality rates in low- and middle-income countries.To create a major change in Haiti's health care infrastructure, we are implementing two strategies that are unique for low-income countries: development of a countrywide network of geographic "community care grids" to facilitate implementation of frontline interventions, and the construction of a centrally located referral and teaching hospital to provide specialty care for communities throughout the country. This hospital strategy will leverage the proximity of Haiti to North America by mobilizing large numbers of North American medical volunteers to provide one-on-one mentoring for the Haitian medical staff. The first phase of this strategy will address the child and maternal health crisis.We have begun implementation of these evidence-based strategies that we believe will fast-track improvement in the child and maternal mortality rates throughout the country. We anticipate that, as we partner with private and public groups already working in Haiti, one day Haiti's health care system will be among the leaders in that region.

EHTP: improving health quality through health technology.

Providing health care effectively and efficiently involves putting together a great variety of resource inputs. Inputs or health technologies (HT) are human and physical resources - facilities and equipment, and consumables including pharmaceuticals. In the complex health system environment, this wide range of technologies and related interventions produce an extraordinary array of different service outputs. The World Health Organization (WHO) embarked in mid-1990s on a major research and development initiative to design a methodology and tool that would allow for optimal, rational and systematic planning and management of healthcare technology interventions. These efforts culminated in the development of the Essential Healthcare Technology Package (EHTP),which has since been successfully applied in countries and by several WHO Technical Programs.

The development of an interoperable roadmap for medical devices.

It is believed that interoperability between medical devices and electronic medical records (EMR) is one key to developing a system of higher quality, safer, and efficient healthcare delivery. Interoperability speaks to either wireless or hard-wired streaming of two-way patient and related data between devices and EMRs. An analysis of a large integrated delivery system's medical devices and EMR was conducted to demonstrate this potential. This integration has significant impact on future care delivery processes and cost of health technologies involved.