Emergency Healthcare Support in Haiti

Executive Summary

Zanmi Lasante (ZL) is Haiti’s largest healthcare provider following the Haitian Ministry of Health (MSPP), serving a population of 1.3M across the Central Plateau and lower-Artibonite departments. Since the tragic assassination of the former President of Haiti in 2021, the country has been plagued by violence, insecurity, forced internal displacement, and socio-economic downfalls. March 2025 marked a pivotal moment for ZL, when its flagship hospital, Hôpital Universitaire de Mirebalais (HUM), was forced to close due to gang attacks in the commune. The closure signifies an immense gap in Haiti’s health system, leaving thousands of citizens without quality healthcare in the region. Through the GlobalGiving platform, ZL launched the “Emergency Healthcare Support in Haiti” project to respond to the increased need in health services within its catchment area. Within this scope, ZL focused on the delivery of maternal and child healthcare, nutrition, mental health services and other initiatives to reduce the barriers of healthcare to those affected by violence. This life-saving work is only made possible with the unwavering support of its dedicated and generous partners.

Challenges

The closure of HUM created unprecedented disruptions to patient care, forcing ZL to rapidly adapt operations to ensure continuity of services across its network. To protect the continuum of care, many staff were relocated to other facilities—an essential but difficult measure given the ongoing insecurity. The escalation of armed violence, particularly in the Artibonite department, has compounded these challenges, leading to repeated displacements, restricted patient mobility, and interruptions in supply chains. Healthcare facilities in violence-affected areas have been forced to close or scale back services, while threats to staff further strain operations. Despite these barriers, the need to maintain essential services has never been greater. The combination of funding shortages, insecurity, and population displacement continues to pressure an already fragile health system. For ZL, the critical challenge remains sustaining operations across its network of 16 sites so that lifesaving care—including emergency, maternal, and infectious disease services—remains accessible to Haiti’s most vulnerable populations.

Zanmi Lasante’s Response

Women and children are at most risk during times of crises, highlighting the urgent need for comprehensive and targeted services to meet the increased health, nutrition and psychosocial needs. The project team's ability to sustain services is credited to the safety measures implemented by the ZL operations and security teams, ensuring the well-being of patients and staff.

Maternal and Child Health

ZL strives to achieve zero maternal deaths during childbirth and zero transmission of HIV from mother to child by focusing on the following objectives:

• Ensure trained healthcare providers are present during childbirth; births requiring emergency obstetric care are moved to a reference center
• Access to family planning services for men and women of reproductive age
• Prevention of mother-to-child transmission of HIV or other sexually transmitted infections.

The Women’s Health (Sante Fanm) program provides comprehensive services to ensure all mothers are well informed and supported throughout their pregnancy. An integral part of the comprehensive health care model throughout all ZL sites, Sante Fanm provides care in maternal and child health, in addition to family planning and gender-based violence (GBV) services. During this reporting period, Zanmi Lasante reported 14,000 consultations and 336 assisted births, showcasing unwavering support even in the complex security environments. In addition, ZL’s community health team passes key messaging on the prevention and response around gender-based violence, where 20 survivors of violence received critical clinical care and assistance.

The Journey to 9 Plus (J9 Plus) program is an innovative group- based model of comprehensive care for pregnant women and their newborns. The program is designed to improve uptake of maternal and pediatric services through group antenatal and postnatal care, and home visits from community health workers. Within the J9 Plus program, antenatal groups have a 98% attendance rate and 100% of enrolled women have received at least one ultrasound. These are key contributors to why 95% of women enrolled in the J9 Plus program deliver at a health facility. It’s estimated that 36% of births country-wide are attended by a health professional. During this period, the J9 team graduated more than 300 mother-baby dyads from the program in Hinche and Cange.

Nutrition

Malnutrition is one of the most urgent and heartbreaking health crises in Haiti. One in five children dies from hunger. Since 2022, severe malnutrition has surged by 19% due to insecurity and displacement. The Integrated Food Security Phase Classification (IPC) reports that 5.7M people are facing high levels of acute food insecurity driven by ongoing violence. Lack of economic opportunities across the country, including the Central Plateau, create a vicious cycle of poverty. Zanmi Lasante serves children aged 6 to 59 months, women of childbearing age, pregnant and breastfeeding women, and adolescent girls. Its network of Community Health Workers (CHWs) identify and monitor children in remote areas, while educating and monitoring caregivers on nutrition and health practices.

From July-September, ZL admitted 1,000 new children into the nutrition program and 154 children were given Vitamin A supplement. A total of 460 education sessions were held, where community members were educated on nutrition, breast-feeding, and water and sanitation (WASH). Forty-nine (49) pregnant and/or breastfeeding women were admitted into the nutrition program. The nutrition team organized 27 mothers clubs, created to be a support group for mothers whose children are malnourished. ZL produces Nourimanba, a free, life-saving Ready-to-Use Therapeutic Food (RUTF) for moderate malnutrition in children. Nourimanba is a ready-to-use, high- calorie, high-protein paste that only has five ingredients: peanuts, milk powder, canola oil, sugar, and vitamins. During this period, 26,571 kilograms of Nourimanba was distributed free of charge to patients in need across the network.

Mental Health

Zanmi Lasante began providing mental health services to patients in 2005. Since then, ZL’s mental health team broadened its scope in close collaboration with the Haitian Ministry of Health to create a comprehensive community-based model for mental health care service delivery. In 2012, ZL expanded its mental health program, with a set curricula, applied tools, and protocols to various providers, across five care pathways: depression, epilepsy, psychotic disorders, and child and adolescent mental health. Given the ongoing and deep worsening of security in Haiti, mental health services is extremely needed. ZL’s metal health team recently trained 34 new teachers in Hinche on mental health illnesses to identify potential cases in their classrooms and refer students to ZL facilities for psychological follow-up. This is in addition to the 31 teachers who completed training at another school in the region. Overall, 500 mental health consultations were recorded, offering hope and vital psychosocial support to vulnerable populations affected by the ongoing crises.

Community Health

Community health remains the backbone of Zanmi Lasante’s work across the Central Plateau and lower-Artibonite departments. Community health activities includes routine visits and targeted visits (postnatal and prenatal visits, visits for people with diabetes, high blood pressure, and tuberculosis, visits for people suffering from depression and children under five suffering from malnutrition); demographic reporting; education sessions on various programs and services; rally posts with minimum package of services offered; mothers’ clubs, youth clubs, community meetings, family planning, and malaria control and/or surveillance. Nearly 18,000 individuals acquired enhanced knowledge on best hygiene practices through WASH community initiatives, mitigating the risk of waterborne epidemics. In addition, through various mobile clinics, 17,800 community members across the network were reached through education sessions.

Conclusion

During these difficult times, Zanmi Lasante remains deeply grateful for the steadfast support of our partners. While many facilities across Haiti have been forced to close due to insecurity or funding cuts, ZL continues to stand as a reliable partner of the Ministry of Health and a leader in delivering essential services. Despite insecurity, travel barriers, and resource shortages, our clinics and hospitals in the Central Plateau and Lower Artibonite remain operational, providing life-saving care to the most vulnerable. Sustained financing is critical to safeguard these gains and expand coverage in high-risk areas. Your support empowers us to uphold our values of resilience, compassion, and solidarity, ensuring that thousands of Haitians continue to access the care they deserve.