Expand Maternal Healthcare in Northern Haiti

Over the last couple of months, C2C’s Maternal Health Program has grown in popularity even more--we now have a 1-2 month waiting list for two of the three clinics that offer these services!

Even though the program is already popular, we are always trying to improve its quality and efficiency. Thanks to the support of GlobalGiving donors, we are currently innovating new ways to increase patient throughput and reduce waiting times (especially in the laboratory). One of the first changes we made was to provide our laboratories with a second microscope. From the 25 women we enroll for the day, eight of them are new patients, and the rest are for follow-ups. The newly-admitted patients have ten laboratory tests, which take the most time. The second microscope will reduce the time the laboratory technicians take to deliver critical results. We are also looking at soliciting the expert advice of an OB-GYN specializing in global health to see how we can modify the maternal health protocol and see more patients.

Thanks to the generosity of our GlobalGiving community, since the beginning of 2021, we have had 2,048 antenatal care visits across three clinics! Of those, we have had more than 385 women come for at least four antenatal visits. In addition, we have administered more than 1,000 Diphtheria vaccine shots to maximize the maternal antibody response and passive antibody transfer in the newborn. We have also conducted more than 942 ultrasound tests. 

Furthermore, our community health team is working hard organizing postnatal visits to check on the health status of the new mothers and babies. The team is also encouraging mothers to come to the clinic and get their children vaccinated and do a follow-up consultation with our doctors.

All this cannot be done without the support and generosity of the general population. Still, the Maternal Health Program is a highly in-demand service at all our clinics (currently it is in three of our seven clinics). We are hoping to be able to expand it to the rest of our network of clinics in the near future.

C2C’s maternal health program currently runs at three C2C clinics: Camp Coq, l’Acul du Nord, and, thanks to the support of the GlobalGiving community, Bayeux. Our team is made up of an OBGYN, a midwife, and an auxiliary nurse. The same team works at our three sites, providing consistency and stability across the clinics. As of this month, the team is being managed by our Chief Medical Officer, which provides more accountability and reassurance.

The team goes once a week to each of our three clinics and provides prenatal care to the rural population. We usually have a maximum capacity of 25 patients a day. However, with the increased popularity of our maternal health program in Camp Coq, we had to add two extra days of consultation a month so that we do not have to turn away any women and can consult everyone that enters our clinic. Currently, the total average number of prenatal visits per day is around 22.

The team provides high-quality medical consultation to pregnant women by following an established protocol which defines the visit schedule, systematic preventions, management of complications, and the indications for referral to the hospital. This protocol respects the recommendations of the Ministry of Health and WHO for prenatal follow-up. Also, service providers have at their disposal a brochure that details advice they should give to pregnant women.

In their last evaluation, the maternal health care providers had a very satisfactory rating for the greeting, counseling, and compliance with the protocol. When it comes to the maternal care package that we provide, it includes complete clinic assessment, laboratory tests, obstetric ultrasound, iron, and vitamin supplementation, childbirth planning, follow-up calls, and a postnatal home visit.

The midwife consults all pregnant women after they are registered by the auxiliary nurse. She assesses them, orders lab tests, and prescribes medication. Afterward, she refers them to the OBGYN. Usually, the OBGYN will see all women coming for their first and last visit, all women who need to have an ultrasound, and all women who have complications. The gynecologist manages those cases or refers them to the hospital if necessary. The auxiliary nurse calls the patients to remind them of their visit and check on their status. Then, she gives a list of the women who have given birth to the community health team so they can schedule a postnatal visit.

According to the maternal health staff, the majority of pregnancies monitored in the program are uncomplicated and have good outcomes. The rare complications are linked to early age pregnancies and high blood pressure. We usually can manage these cases in our clinics if detected early and there is almost no need to refer to the hospitals for complications.

In summary, the maternal health program works very well in our three clinics. Our hope for the future is to expand the program to our network of clinics.

THANK YOU! Because of your generous support, we will begin offering comprehensive maternal health services at our clinic in Bayeux later this month. This would not have been possible without your support!

The last time you heard from us, we did not know how Covid-19 would impact Haiti, especially the impact on the health system. Fortunately, average daily cases have dropped significantly--from over 100 at the time of our last report in July, to now less than 20 new cases per day. Through all of these new challenges, we have prioritized the health and safety of our clinical staff and patients above all else; and we now feel confident in moving forward with bringing C2C’s maternal health services to another clinic this month!

Thanks to your generous support, C2C’s Maternal Health Program will begin at our Bayeux clinic by the end of October. Pregnant women in this community will now have access to all necessary antenatal care services that did not exist prior to C2C. Our maternal health package includes everything women need to have healthy pregnancies and healthy babies: consultation with an OB-GYN, education from a midwife on topics such as nutrition, hygiene, danger signs, and breastfeeding, ultrasounds, lab tests, prenatal vitamins, and any other medications. The midwife will also help women put together a birth plan and educate women on the importance of coming to all of their prenatal appointments.

Bayeux will be C2C’s third clinic to offer comprehensive maternal health services. While we celebrate this accomplishment with supporters like you, we also know that there are so many more women in the communities we serve who lack access to essential maternity care. With the highest maternal mortality rate in the western hemisphere at an estimated 521 deaths for every 100,000 live births, these services are in great need and we will continue this campaign in the hopes of bringing the program to every C2C clinic.

We cannot overstate how grateful we are that you have joined us on GlobalGiving. Thank you for supporting mothers and babies in Haiti!

C2C’s Maternal Health Program continues to operate at our clinics in Camp Coq and Acul du Nord. However, due to the uncertainty of the COVID-19 pandemic in Haiti, we are prioritizing the health and safety of our staff by temporarily delaying the expansion of this program to our Bayeux clinic. 

Thanks to the generous support of our donors, we were able to procure an ultrasound system and hire and train the staff that will run the Maternal Health Program at our next clinic. At this time, we are responding directly to the COVID-19 pandemic in the vulnerable communities we serve in Haiti and spreading reliable information about the virus and best practices for prevention through community education activities. If you’d like to help our COVID-19 response efforts, you can visit our GlobalGiving project “Haiti Relief Fund for COVID-19.” We hope to have better news regarding the status of our program expansion in the near future. For now, here is a patient story from our Acul du Nord clinic! 

Angeline, 35 years old, came to our Acul du Nord clinic on March 12, 2020 for her fifth prenatal visit, her last one before delivery. This is Angeline’s third pregnancy and she has been very satisfied with the service she has received from C2C for her prenatal care. “I am always given a warm welcome, especially by the midwife. I will definitely come back after my delivery to thank her again for all she has done for me.” Angeline first came to our clinic for her prenatal care because she was referred by her father and sister who already used C2C’s primary care services. After her first visit, she began to recommend the clinic to other pregnant women she knew, and they came to C2C for their maternity care as well. “The Maternal Health Program is really great,” she says, “I especially like that prenatal care services include all of the labs and meds I need.”

Although this was Angeline’s third pregnancy, it was her first under C2C’s Maternal Health Program. She appreciated how much C2C’s obstetrician cared about her pregnancy by encouraging Angeline to come to all of the recommended prenatal visits to better prepare for a safe delivery and a healthy baby. Other health facilities that she sought antenatal care from in the past did not provide the educational component that C2C does. Even on her third pregnancy, there was so much she could still learn and she felt empowered to make better decisions. This was especially important since her age meant a higher-risk pregnancy. The success of our program is evidenced by our staff’s ability to improve Angeline’s health-seeking behavior compared to her previous pregnancies.

Links:

• Support C2C's Haiti Relief Fund for COVID-19
• C2C's COVID-19 Response