Paper short abstract:

Based on observations of daily life, interviews, and focus group discussions with community women and staff from a local hospital in rural Northern Haiti, we sought to understand what health issues are important and the perceived facilitators and barriers to address those health issues.

Paper long abstract:

The voices of rural Haitian women are not often heard in the design and implementation of programs. We assessed women's perspectives on the challenges they and their families face in the rural-mountainous region of Borgne, Haiti. Based on observations of daily life, interviews, and focus group discussions with women and the staff of Alyans Sante Borgne (a partnership between Haiti Outreach-Pwoje Espwa (H.O.P.E) and Haiti's Ministry of Health), we ascertained common themes and salient points through thematic analysis and iterative discussion with partners.

Women eloquently described the nexus of challenges they and their communities face. Women were concerned about their economic situation, including job opportunities, education, and access to affordable credit. Migration was one solution they discussed but often this came with negative outcomes. "[Their partners] come back sick from the Dominican Republic with death—HIV/AIDS and syphilis." Women were also concerned with their health but had limited understanding of how the diseases worked. They absorbed the health messages and interpret them in light of their culture and situation. Culture and tradition often challenge change. Some older women, who delivered at home, didn't see the value of a hospital birth, although they know many women who died in childbirth at home.

Findings illuminate the process of social change, behavior modification, and the way poverty acts as a barrier to health. H.O.P.E is listening and working with the women to provide culturally-tailored health education and to increase access to quality care and economic opportunities.