Henry Perry ^1*, Warren Berggren ², Gretchen Berggren ², Duane Dowell ³, Henri Menager ⁴, Erve Bottex ⁵, Jean Richard Dortonne ², Francois Philippe ⁶, Michel Cayemittes ⁷

¹ Future Generations
² International public health consultant
³ Retired
⁴ Kansas State Department of Public Health
⁵ Harlem Hospital/Columbia University
⁶ Health systems and human resources consultant
⁷ Haitian Child Institute

^* To whom correspondence should be addressed. E-mail: henry{at}future.org.

	Abstract

Objectives. Evidence regarding the long-term impact of health and other community development programs on under-5 mortality (the risk of death from birth until the fifth birthday) is limited. We compared mortality in a population served by health and other community development programs at the Hôpital Albert Schweitzer (HAS) with national mortality rates among children younger than 5 years for Haiti between 1958 and 1999. Methods. We collected information on births and deaths in the HAS service area between 1995 and 1999 and assembled previously published under-5 mortality rates at HAS. Published national rates for Haiti served as a comparison. Results. In the early 1970s, the under-5 mortality rate at HAS declined to a level three fourths lower than that in Haiti nationwide. More recently, HAS rates have remained at one half those for Haiti nationwide. Child survival interventions in the HAS service area were substantially higher than in Haiti nationwide although socioeconomic characteristics and levels of childhood malnutrition were similar in both areas. Conclusions. HAS’s programs have been responsible for long-term sustained reduction in mortality among children aged less than 5 years. Integrated systems for health and other community development programs could be an effective strategy for achieving the United Nations Millennium Goal to reduce under-5 mortality two thirds by 2015.

Key Words: Child and Adolescent Health, Health Service Delivery, Maternal and Infant Health, Mortality

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