Reduction of mortality in rural Haiti through a primary-health-care program
Berggren, W.L.; Ewbank, D.C.; Berggren, G.G.
New England Journal of Medicine 304(22): 1324-1330
1981
ISSN/ISBN: 0028-4793 PMID: 7219486 DOI: 10.1056/nejm198105283042203Document Number: 376163
Deaths and their causes in a rural Haitian population of 8820 were studied through hospital records, death registration, a disease survey, and health surveillance. The results were used in selecting 8 diseases for the delivery of health services by village-level health workers. The impact of the services was measured by monitoring annual age-specific and disease-specific mortality rates and by comparing them with officially estimated national mortality rates. Mortality rates fell progressively during 5 years, to levels only 1/4 as high as the national estimates. The fall in mortality was associated principally with services that prevented deaths due to tetanus, malnutrition, diarrhea, and tuberculosis. The total program of hospital and village health services saved 495 years of potential life/thousand population/year. Most of the saving was attributable to preventive services. The program eventually served more than 115,000 persons, and it has been replicated by other agencies for an additional 135,000 Haitians.