title: Addressing the Child and Maternal Mortality Crisis in Haiti through a Central Referral Hospital Providing Countrywide Care.
abstract: 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.
authors.affiliation: President and Chief Executive Officer of Bethesda Referral & Teaching Hospital in Haiti and the Associate Editor-in-Chief of The Permanente Journal. jacobs@securenym.net.
authors.forename: Lee D
authors.initials: LD
authors.lastname: Jacobs
authors.affiliation: National Project Director, Kaiser Permanente Clinical Technology and a Health Technology Advisor for the World Health Organization. judd.tom@gmail.com.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Judd
authors.affiliation: Founding Director of the Centre of Excellence in Women and Child Health at the Aga Khan University in Karachi, Pakistan and the Robert Harding Inaugural Chair in Global Child Health at the Hospital for Sick Children, Toronto, Canada. He is a member of the independent Expert Review Group set by the United Nations Secretary General in September 2011 for monitoring global progress in the World Health Organization's Maternal and Child Health Millennium Development Goals. zulfiqar.bhutta@sickkids.ca.
authors.forename: Zulfiqar A
authors.initials: ZA
authors.lastname: Bhutta
mesh_terms: D046688:Child Mortality / Q000639:trends*; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D008297:Male; D008428:Maternal Mortality / Q000639:trends*; D063728:Secondary Care Centers; D014481:United States