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After Haiti's 2010 earthquake, over half of U.S. households donated to thousands of nongovernmental organizations (NGOs) in that country. Yet we continue to hear stories of misery from Haiti. Why have NGOs failed at their mission?Set in Haiti during the 2004 coup and aftermath and enhanced by research conducted after the 2010 earthquake,Killing with Kindnessanalyzes the impact of official development aid on recipient NGOs and their relationships with local communities. Written like a detective story, the book offers rich enthnographic comparisons of two Haitian women's NGOs working in HIV/AIDS prevention, one with public funding (including USAID), the other with private European NGO partners. Mark Schuller looks at participation and autonomy, analyzing donor policies that inhibit these goals. He focuses on NGOs' roles as intermediaries in \"gluing\" the contemporary world system together and shows how power works within the aid system as these intermediaries impose interpretations of unclear mandates down the chain-a process Schuller calls \"trickle-down imperialism.\"

Eventually, this took on a formal structure of a four-week in-patient rotation with second-year internal medicine residents at the Partners in Health hospital, Hôpital Universitaire de Mirebalais (Mirebalais, Haiti)—a 300-bed facility that provides care to some 185 000 people in the surrounding areas. In 2015, Berkowitz helped to establish the first-ever neurology fellowship programme in Haiti with the support of Partners in Health and Brigham and Women's Hospital, as well as collaboration with key individuals, including Michelle Morse, the Assistant Program Director for the Internal Medicine Residency at Brigham and Women's Hospital and Kerling Israel, the Senior Advisor for Medical Education at Partners in Health. At L'Hospital Bernard Mevs, neurosurgical trainees receive formal education with a curriculum that mirrors that of the Accreditation Council for Graduate Medical Education International. [...]the number of neurosurgical procedures have nearly quadrupled from 2015 to 2017, with the majority of cases related to trauma or hydrocephalus.

Background Uncontrolled hypertension is the leading modifiable risk factor for cardiovascular disease mortality and remains high in low-middle income countries like Haiti. Barriers and facilitators to achieving hypertension control in urban Haiti remain poorly understood. Elucidating these factors could lead to development of successful interventions. Methods We conducted semi-structured interviews with healthcare providers (10) and patients with hypertension (10) from the Haiti Cardiovascular Disease Cohort, using guides developed using the Consolidated Framework for Implementation Research. Participants were recruited using purposive sampling, and thematic content analysis was conducted in NVIVO software. Results At the individual level, barriers to hypertension control included hypertension is asymptomatic, hypertension is due to stress, difficulty changing behaviors within shared households, and fear of becoming dependent on medications. Facilitators included spiritual faith in doctors, high awareness of diet and exercise, belief in medication effectiveness, and family as motivation to treat hypertension. At the inner setting clinic level, barriers included limited physician–patient time during visits, residual stigma around cardiovascular services located on same campus as HIV care, and patient preference for physician guidance. Facilitators included patients treated with respect at clinic, and strong provider-patient rapport. At the outer setting societal level, only barriers were mentioned, including extreme poverty, civil insecurity, and stress making hypertension worse. Conclusions These findings can inform the development of future efforts to design interventions to improve hypertension control in Haiti.

Background Helping Babies Breathe (HBB) is an American Academy of Pediatrics neonatal resuscitation program designed to reduce neonatal mortality in low resource settings. The 2017 neonatal mortality rate in Haiti was 28 per 1000 live births and an estimated 85 % of Haitian women deliver at home. Given this, the Community Health Initiative implemented an adapted HBB (aHBB) in Haiti to evaluate neonatal mortality. Methods Community Health Workers taught an aHBB program to laypeople, which didn’t include bag-valve-mask ventilation. Follow-up after delivery assessed for maternal and neonatal mortality and health. Results Analysis included 536 births of which 84.3 % (n=452) were attended by someone trained in aHBB. The odds of neonatal mortality was not significantly different among the two groups (aOR=0.48 [0.16-1.44]). Composite outcome of neonatal health as reported by the mother (subjective morbidity and mortality) was significantly lower in aHBB attended births (aOR=0.31 [0.14-0.70]). Conclusion This analysis of the aHBB program indicates that community training to laypersons in low resource settings may reduce neonatal ill-health but not neonatal mortality. This study is likely underpowered to find a difference in neonatal mortality. Further work is needed to evaluate which components of the aHBB program are instrumental in improving neonatal health.

What accounts for coordination problems? Many mechanisms of coordination exist in both organizations and networks, yet despite their widespread use, coordination challenges persist. Some believe the challenges are growing even more serious. One answer lies in understanding that coordination is not a free good; it is expensive in terms of time, effort, and attention, or what economists call transaction and administrative costs. An alternative to improving coordination is to reduce its costs, yet there is little guidance in the literature to help managers and researchers calculate coordination costs or make design decisions based on cost reductions. This article explores two cases—the U.S. Patent and Trademark Office's Peer-to-Patent pilot program and the online relief effort in Haiti following the devastating earthquake there in 2010—to illustrate the advantages and constraints of using Web 2.0 technology as a mechanism of coordination and a tool for cost reduction. The lessons learned from these cases may offer practitioners and researchers a way out of our \"silos\" and \"smokestacks.\"

Background Haiti and the Dominican Republic (DR) are targeting malaria elimination by 2022. The private health sector has been relatively unengaged in these efforts, even though most primary health care in Haiti is provided by non-state actors, and many people use traditional medicine. Data on private health sector participation in malaria elimination efforts are lacking, as are data on care-seeking behaviour of patients in the private health sector. This study sought to describe the role of private health sector providers, care-seeking behaviour of individuals at high risk of malaria, and possible means of engaging the private health sector in Hispaniola’s malaria elimination efforts. Methods In-depth interviews with 26 key informants (e.g. government officials), 62 private providers, and 63 patients of private providers, as well as 12 focus group discussions (FGDs) with community members, were conducted within seven study sites in Haiti and the DR. FGDs focused on local definitions of the private health sector and identified private providers for interview recruitment, while interviews focused on private health sector participation in malaria elimination activities and treatment-seeking behaviour of febrile individuals. Results Interviews revealed that self-medication is the most common first step in the trajectory of care for fevers in both Haiti and the DR. Traditional medicine is more commonly used in Haiti than in the DR, with many patients seeking care from traditional healers before, during, and/or after care in the formal health sector. Private providers were interested in participating in malaria elimination efforts but emphasized the need for ongoing support and training. Key informants agreed that the private health sector needs to be engaged, especially traditional healers in Haiti. The Haitian migrant population was reported to be one of the most at-risk groups by participants from both countries. Conclusion Malaria elimination efforts across Hispaniola could be enhanced by engaging traditional healers in Haiti and other private providers with ongoing support and trainings; directing educational messaging to encourage proper treatment-seeking behaviour; and refining cross-border strategies for surveillance of the high-risk migrant population. Increasing distribution of rapid diagnostic tests (RDTs) and bi-therapy to select private health sector facilities, accompanied by adopting regulatory policies, could help increase numbers of reported and correctly treated malaria cases.

Due to the shortage of occupational therapists (OTs) in Haiti and over 800,000 individuals with disabilities, most occupational therapy assessments and interventions are provided by OTs on short-term medical missions (STMMs). Learning which methods OT use to provide assessments and interventions during these STMMs is the first step to understanding how to facilitate follow-up and carry-over for clients and ensure longevity for STMMs in Haiti. This study used a cross-sectional, descriptive design to gather data on methods used by OTs. Thirty-three OTs, who travelled to Haiti on STMMs, completed a 16-question, online survey. The most common method provided by OTs was education to patients, caregivers, and local providers. Training of Haitian rehabilitation technicians was also prevalent. There was an association between the years of the OTs’ clinical experience and the effort of OTs to train local providers, but this result was not statistically significant. Further research should be implemented on specific methods that can be used in the absence or shortage of Haitian OTs to ensure follow-up for Haitian clients. The sharing of data regarding OT methods on STMMs will promote evidence-based, client-centered, and cost-effective therapy to enhance effective client outcomes.

To effectively attenuate cancer disparities in multiethnic, medically underserved populations, interventions must be developed collaboratively through solid community–academic partnerships and driven by community-based participatory research (CBPR). The Tampa Bay Community Cancer Network (TBCCN) has been created to identify and implement interventions to address local cancer disparities in partnership with community-based nonprofit organizations, faith-based groups, community health centers, local media, and adult literacy and education organizations. TBCCN activities and research efforts are geared toward addressing critical information and access issues related to cancer control and prevention in diverse communities in the Tampa Bay area. Such efforts include cross-cultural health promotion, screening, and awareness activities in addition to applied research projects that are rooted in communities and guided by CBPR methods. This article describes these activities as examples of partnership building to positively affect cancer disparities, promote community health, and set the stage for community-based research partnerships.

The report, part of Merlin's \"Hands up for health workers\" campaign, says that although it was \"welcome and vital,\" the international response-with 600 international organisations becoming involved in the health sector-\"failed to support the existing health capacity, staging a 'take-over' and undermining Haiti's capacity to respond and coordinate.\" The report also criticises the lack of preparedness for and containment of the recent cholera epidemic: \"Despite the constant threat of disease due to the still cramped...

Hispaniola's fledging program to eliminate malaria, now sidetracked by the earthquake, illustrates the difficulties that arise when ambitious goals collide with reality. There is absolutely no reason for malaria to persist on the island of Hispaniola, given that all the other islands in the Caribbean have rid themselves of this mosquito-borne disease. And the Dominican Republic, which shares the island with Haiti, has driven cases to remarkably low levels. By many counts, the country is well on the path to elimination, its stated aim. But it can't get there unless Haiti, where malaria is rife, achieves the same goal. Hispaniola's fledging program to eliminate malaria, now sidetracked by the earthquake, illustrates the difficulties that arise when ambitious goals collide with reality.