Darbonne Maternal and Child Health Clinic

Darbonne DSC_0301 - baby only JB editedDarbonne, Haiti

Overview:

  • Total Staff: 26
  • Outpatient Visits: 22,000
  • Antenatal Visits: 4,200
  • Maternity Deliveries: 916
  • Well baby visits: 6,000
  • Family planning clinic visits: 3,600

Target areas for sustainable impact:

  • Reduce maternal and infant mortality through health education and deliveries attended by medical professionals at a safe inpatient clinic.
  • Reduce child mortality rates through well baby clinics and primary healthcare visits for infants and children under 5 years.
  • Increase both availability of services and demand for services by systematically reducing barriers that keep women from accessing and seeking care.
  • Improve the training of traditional birth attendants, increasing their ability to identify and refer at-risk women for inpatient deliveries.

The Darbonne Maternal and Child Health (MCH) Clinic is a comprehensive, holistic center for maternal health located in the Léogâne district in Southwestern Haiti; it is about a four hour drive west from Port-au-Prince.

Haiti is one of the poorest countries in the world and the most dangerous place for a woman to give birth in the western hemisphere. This small country has the highest maternal and infant mortality rates in the region. A Haitian woman has a lifetime risk of 1:47 of dying in childbirth (as compared to 1:8,000 for women in highly developed nations). By far, the leading cause of these deaths is because a skilled medical professional was not available. According to US Government data, more than 75 percent of Haitian women deliver their babies at home (for women living in rural areas, which is most of Haiti, it is as high as 85%). More than half of all women giving birth at home do so without any skilled birth professional in attendance. Fifty percent of all pregnant women experience anemia; most will go untreated placing both mother and newborn at risk of illness and death. For every 1,000 live births about 63 of these newborns will die before they are one month old; the overwhelming majority of these deaths are preventable through access to maternal health care.

Less than 20 percent of the population uses any method of family planning leading to high fertility rates. The birth rate in Haiti is 23 live births for every 1,000 women; the rate for Haitian teenagers is 69/1,000 – more than double that of teens in the US living just three hours away.

The underlying cause of all these troubling statistics is poverty. Poverty means Haitians lack access to healthcare, especially to well-trained doctors and nurses; they lack the resources to feed their families; they lack the funds to send their children to school. While the median income is about $1,200 annually, most Haitians live on less than $1.25 a day or $456 annually. Without the ability to sustain them, malnutrition is high. Malnutrition impacts everyone, but it is the children who suffer the most. About 25 percent of all children and youth suffer from chronic malnutrition. Malnutrition contributes to high rates of both diarrheal and respiratory diseases among children. All of these problems conspire to prevent most Haitian children from living beyond their fifth birthday. Nearly 60 percent of all Haitian children die before they reach five years of age.

Darbonne Maternal and Child Health Clinic – Darbonne, Haiti2Many factors contribute to when or if a woman seeks professional maternal health care. While the simple availability of services is certainly key, women’s decisions are also greatly influenced by gender inequality, knowledge of health interventions, as well as mutual trust and respect between the woman and the provider established over time.

Establishing a maternal and child health center that is truly embedded into the fabric of women’s lives requires a thoughtful strategy that is both respectful of cultural norms but also capable of overcoming those norms which prove unsafe (such as delivery at home without a trained attendant). MCH has a three-year strategy to increase both availability of services and demand for services by systematically reducing barriers that keep women from accessing and seeking care. The Darbonne MCH Clinic is uniquely positioned for a successful maternal child health program for three reasons. One, the community recognizes the quality of primary care currently offered at this medical facility. Two Darbonne is affiliated with Hôpital Ste. Croix, a well- respected healthcare facility which will ensure the highest quality of medical staffing and training. And, three, Darbonne partners with the local Episcopal Church of the Annunciation, another credible source of compassionate services to the community. MBF is working with the MCH administration on a strategic plan aimed toward sustainability.

To achieve its goals to significantly change the health of women and children in the Léogâne region, the Darbonne MCH Clinic provides:

  1. Community Education to increase knowledge about life-saving maternal and child health interventions.
  2. Community support groups for women that will increase the likelihood of overcoming cultural barriers to seeking MCH services.
  3. Quality and compassionate medical care that includes:
  • Antenatal care
  • In-patient labor and delivery services staffed by a physician and nurse midwife
  • In-home delivery staffed by a well-trained traditional birth attendants
  • Immunization for both pregnant women and infants/children
  • Nutritional therapy for women and children who are malnourished or undernourished
  • Comprehensive pediatric care for infants and children
  • Family Planning Services

Darbonne MCH Clinic also works with 16 traditional midwives in different localities and two mother’s group in the locality of La Coline Deslands. Home deliveries are deeply rooted in the culture. Eliminating home deliveries is neither feasible nor practical. The Darbonne Clinic approach seeks to improve the training of traditional birth attendants, increase their ability to identify and refer at-risk women for inpatient deliveries, and encourage more women to deliver at the clinic to reduce the number of in-home births over time.