Abstract

PIP: In Haiti, more than 755 of the children under 5 are malnourished, the infant mortality rate is about 125/1000. In the 70's, the medical community devised centers d'Education et de rehabilitation nutritionelle (CERNs) which focused on nutritional rehabilitation by education of the mothers. CERNS were very expensive and not very effective because mothers rarely returned for follow-up care and because they treated children who were already malnourished. In the mid-70's, Petit Guave attempted to set up an outreach program similar to the one that the Hospital Albert Schweitzer created. This program included preventative care, nutrition, and family planning services. Workers visited individual families to educate them in health care. Petit Guave paid special attention to children under 5 by keeping growth monitoring records. Infant mortality rates fell by almost 25% and child mortality was halved in this time. Growth monitoring was performed monthly. A lack of supervision caused the initially successful program activities to decline severely. In Bell Anse, volunteers monitored villagers weekly by operating rally posts. This program features extensive participation by the mother and nutritional education discussions. Children were immunized at the rallies. After 12 months, death rates decreased and growth rates increased significantly. Further operational research is needed in the form of supervision, community control, effectiveness of workers, and values of the incentives of the program.