RURAL HEALTH DELIVERY SYSTEM PROJECT IN HAITI; REPORT NO. 5, SOCIAL ANALYSIS FOR STRENGTHENING HEALTH SERVICES III (RHDS) PROJECT PAPER

The study examines Haiti"s rural social organization and gives a socioeconomic profile of the proposed project"s intended beneficiaries. Social indicators for the quality of rural life are presented, such as nutrition and education levels, infant mortality, and housing conditions. The author identifies the following constraints to project implementation: (1) the mistrust of rural people for the methods and manner of modern health practitioners; (2) the opposition of some traditional healers to the introduction of health agents into their area; (3) the traditional perception of life and sickness as controlled by external natural forces such as hot and cold times of the day; and (4) the belief in supranatural causes for illness and reliance on food offerings and other practices to placate spirits. To counteract these real or potential constraints, the author recommends two strategies: First, that health agents and other health personel be familiarized with these beliefs so that they can understand their patients" reactions more sympathetically and increase their own appreciation of modern health care; and second, that health agents adopt a practice of praising clients for using modern methods instead of berating them for following traditional ways. The paper concludes with a discussion of the project"s potential spread effects and impact on women who will both participate in the project as rural health workers and be the project"s primary beneficiaries.