The DHS Program

Calverton, MD - Maternal and child health in Haiti have improved only slightly in the last twenty years, and many health indicators remain troubling, according to the latest Demographic and Health Survey, released in May.

The 2005-2006 Enquête Mortalité, Morbidité, et Utilisation des Services IV (EMMUS-IV) is the fourth DHS survey in Haiti, and it is based on a nationally representative sample of 10,757 women and 4,958 men. The results show that fertility rates for women and vaccination rates for children have improved, but many other maternal and child indicators remain low.

The fertility rate in Haiti is high: women give birth to an average of four children. Prenatal care has improved slightly, with 85 percent of women benefiting from prenatal care in 2005-2006, compared to 68 percent in 1994-1995. Only half of Haitian women, however, have the four prenatal visits recommended by the World Health Organization. Only one in four births takes place in a health facility and is assisted by a trained health professional. In rural areas, only 15 percent of births are assisted by a trained health professional.

The nutritional status of Haitian women is low, and is getting worse. In 2000, 12 percent of women suffered from malnutrition. Today, 16 percent of women do. On the other extreme, 21 percent of women in Haiti – and one third of women in Port-au-Prince – are too heavy or obese.

Fewer than half of children under age one (41 percent) have received all their recommended vaccinations against tuberculosis, measles, polio, diphtheria, tetanus, and pertussis. Although this coverage is weak, it is an improvement from the 2000 survey, which showed 34 percent of children were completely vaccinated.

Malnutrition is also increasing among children. About 10 percent of children are too thin, compared to 5 percent in 2000. Almost a quarter of children under five are too small for their age. This varies regionally within the country. In the Southeast and Center regions, about half of children are too small, and in Artibonite, one child in five is too thin.

Anemia is also a serious problem in Haiti. Two thirds of children under age 5, almost half of women, and almost a third of men are anemic.

In addition to health indicators, the EMMUS-IV also surveyed Haitians’ use of health facilities. Only one fourth of seriously ill or injured people are taken to a health facility, for the most part because of cost. Almost half of those who do go to a facility spend over an hour traveling to reach the facility. In half of the cases, however, people do not visit the closest facility, either because it is not well equipped, the staff is not competent, or because it is too expensive.

The EMMUS-IV survey also provides nationally representative data for Haiti on fertility, family planning, HIV/AIDS, domestic violence, the status of women, and the situation of children, including orphans and vulnerable children due to HIV/AIDS.

The survey was commissioned by the Haiti Ministry of Health (Ministère de la Santé Publique et de la Population, MSPP), with assistance from Macro International, Inc. It was implemented with the cooperation of the Haitian Institute of Statistics (l’Institut Haïtien de Statistique, IHSI), and the institute for Infection Disease and Reproductive Health (l’Institut des Maladies Infectieuses et de la Santé de la Reproduction, IMIS/GHESKIO), and benefited from the financial support of the U.S. Agency for International Development, the President’s Emergency Plan for AIDS Relief, the Centers for Disease Control and Prevention, the Canadian international Development Agency, the Sogebank Foundation/World Bank, UNICEF, and UNFPA.