Evaluation of AID child survival programs : Haiti case study

The infant mortality rate has dropped from 144 per 1,000 live births in the early 1970"s to roughly 100 per 1,000 live births in the late-1980"s. In some areas where A.I.D. funding is concentrated, such as the Cite Soleil slum in Port-au-Prince, infant mortality rate declines have been especially dramatic. These improvements have occurred despite zero or negative economic growth, a decaying public sector infrastructure, and social and political instability and decline, and are therefore attributable to efforts in health education and promotion, and increased access to primary health care, with a particular focus on outreach and child survival interventions. Some of A.I.D."s notable contributions include the following: (1) support of public and private policy formulation that established child survival as a health priority; (2) development of a new outreach approach to health service delivery that has expanded access to care, particularly in rural areas; (3) financial support of an array of PVO"s that now provide health services to roughly 30% of the population; (4) fostering of a partnership between public and nonprofit health sectors; (5) establishment and support of a core of indigenous organizations that provide research, training, and technical assistance to the health sector; and (6) human resource development training for health care providers and managers within the public and private sectors. (Author abstract, modified)