An Innovative & Effective Model:
Sante Nan Lakou
We focus our disease prevention and health outreach efforts at the level of the lakou, where we can make the most impact and reach those who would otherwise never receive medical care.
H.O.P.E and A.S.B Hospital have worked together to develop a novel multi-pronged, four-tiered public health model referred to as Sante nan Lakou—“health in the lakou.” Lakous are the basic social structure in rural Haiti, comprising an aggregation of family members who live together—typically in multiple dwellings—and share responsibility for child rearing, providing food, and familial tasks. Women and girls are central to the functioning of the lakou and, likewise, are central to our holistic health intervention programs, as is our team of trained community health agents, lab techs, nurses, and doctors.
Community surveillance and health screening at the lakou level allows us to provide a holistic approach to health, beginning at the grass-roots level and flowing up to Alyans Sante Borgne Hospital. This four-tier model is our innovation, and it gets proven results.
We wish it were simple to explain what we do! The truth is, we do a lot, and we do it all “in community” with the residents of beautiful, rural Borgne--a commune in northern Haiti that stretches from the beaches of Fond La Grange to the mountainous communities in Milot.
TIER FOUR: In the Lakou
Principle:
Build on existing community networks and social institutions to extend the reach of medical treatment and preventative services for people in rural northern Haiti.
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Community Health Agents Assigned to Specific Habitasyons and Sections:We employ community health agents who are embedded in specific villages and deeply familiar with the lakou in their area, and are trained to assess basic health problems, such as preeclampsia in pregnant women and early signs of malnutrition in infants and children, and then refer them for clinical follow-up. Community health nurses, who are more skilled at patient assessment and health education, support the community health agents. The community health agents help promote upcoming mobile clinics scheduled for the area. They also promote participation in mothers clubs and other peer support groups we have established. Pregnant mothers, mothers with infants and small children, and the elderly are encouraged to attend one of our mobile clinics, or referred to either the hospital in Borgne, or the clinic in Petit Borgne. Community health agents are responsible for a specific geographic area, and serve as the front-line of our lakou- level surveillance and screening efforts.
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S.E.E Team (Sante (Health) , Edukasyon (Education), Ekonomi (Economy) Team):"To address the environmental and behavioral factors influencing public health, we have created a health outreach team focused on community education. This team is comprised of 3-4 individuals trained in the prevention of malaria, cholera, parasitic infection, and typhoid as well as basic nutrition interventions and methods for assessing community health. This team works across the commune to synthesize commune-wide surveillance data provided by the community health agents and nurses. Together with the health agents, the S.E.E team supports our peer health support groups and provides epidemiologic data and surveillance information to the medical staff. Our medical team is then better able to target interventions and treatment programs and schedule focused mobile clinics in areas where certain diseases or conditions are most prevalent.
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Peer Health Support Groups:Peer support groups such as mothers clubs and girls clubs are a critical aspect of our program. We have established mothers clubs in each of the rural sections of the commune. The clubs provide peer support networks both pre- and post- partum. Our network of mothers clubs has had peak participation of over 460 women across the seven sections. Community health agents and community health nurses support the mothers clubs.
Programs:
TIER THREE: Mobile Health Clinics
Principle:
Mobilize services and resources to better connect with, and truly understand, the community in the socio-economic context in which people live.
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Community Health Agents Assigned to Specific Habitasyons and Sections:We employ community health agents who are embedded in specific villages and deeply familiar with the lakou in their area, and are trained to assess basic health problems, such as preeclampsia in pregnant women and early signs of malnutrition in infants and children, and then refer them for clinical follow-up. Community health nurses, who are more skilled at patient assessment and health education, support the community health agents. The community health agents help promote upcoming mobile clinics scheduled for the area. They also promote participation in mothers clubs and other peer support groups we have established. Pregnant mothers, mothers with infants and small children, and the elderly are encouraged to attend one of our mobile clinics, or referred to either the hospital in Borgne, or the clinic in Petit Borgne. Community health agents are responsible for a specific geographic area, and serve as the front-line of our lakou- level surveillance and screening efforts.
-
S.E.E Team (Sante (Health) , Edukasyon (Education), Ekonomi (Economy) Team):"To address the environmental and behavioral factors influencing public health, we have created a health outreach team focused on community education. This team is comprised of 3-4 individuals trained in the prevention of malaria, cholera, parasitic infection, and typhoid as well as basic nutrition interventions and methods for assessing community health. This team works across the commune to synthesize commune-wide surveillance data provided by the community health agents and nurses. Together with the health agents, the S.E.E team supports our peer health support groups and provides epidemiologic data and surveillance information to the medical staff. Our medical team is then better able to target interventions and treatment programs and schedule focused mobile clinics in areas where certain diseases or conditions are most prevalent.
-
Peer Health Support Groups:Peer support groups such as mothers clubs and girls clubs are a critical aspect of our program. We have established mothers clubs in each of the rural sections of the commune. The clubs provide peer support networks both pre- and post- partum. Our network of mothers clubs has had peak participation of over 460 women across the seven sections. Community health agents and community health nurses support the mothers clubs.
Programs:
TIER TWO: TiBouk Clinic
Principle:
Counter the highly centralized nature of Haitian structures.
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Program:
About 10 years into our partnership with the Haitian government, we independently rebuilt a health clinic in the market town of TiBouk, the second largest population center in Borgne. This secondary level provides the only medical care in the mountainous rural areas of the commune and offers families who live too far from the village of Borgne access to testing, treatment, and vaccines as well as maternal care and nutrition. This clinic serves as a literal and symbolic bridge from the farthest corners of this mountainous commune to the administrative center in the town of Borgne, --which is at sea level and near to paved roads that lead to Cap-Haitien.
TIER ONE: Alyans Sante Borgne Hospital
Principle:
Promote a holistic vision of community health by integrating the physical, environmental, social, cultural, psychological, and economic dimensions of community well-being.
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Program:
A.S.B., or the Health Alliance of Borgne Hospital, is a high-capacity, expertly staffed hospital just outside the town of Borgne that H.O.P.E. has built and assumes high levels of responsibility for funding-- in partnership with the Haitian government. The hospital provides basic services, such as an in-patient facility, internal medicine, women's health, maternity, delivery, and prenatal and postnatal services, as well as a dental clinic, TB and HIV/AIDS programs, a lab, and pharmacy. This hospital moves nimbly to respond and provide large-scale interventions from a cholera outbreak in 2012 or a global pandemic in 2021. The medical team who runs this hospital sees over 20,000 patients a year and we estimate that this addresses only about 15% of the medical needs in the commune of Borgne, even as it is the only no-cost health care system in northern Haiti.
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Community Health Agents Assigned to Specific Habitasyons and Sections:We employ community health agents who are embedded in specific villages and deeply familiar with the lakou in their area, and are trained to assess basic health problems, such as preeclampsia in pregnant women and early signs of malnutrition in infants and children, and then refer them for clinical follow-up. Community health nurses, who are more skilled at patient assessment and health education, support the community health agents. The community health agents help promote upcoming mobile clinics scheduled for the area. They also promote participation in mothers clubs and other peer support groups we have established. Pregnant mothers, mothers with infants and small children, and the elderly are encouraged to attend one of our mobile clinics, or referred to either the hospital in Borgne, or the clinic in Petit Borgne. Community health agents are responsible for a specific geographic area, and serve as the front-line of our lakou- level surveillance and screening efforts.
-
S.E.E Team (Sante (Health) , Edukasyon (Education), Ekonomi (Economy) Team):"To address the environmental and behavioral factors influencing public health, we have created a health outreach team focused on community education. This team is comprised of 3-4 individuals trained in the prevention of malaria, cholera, parasitic infection, and typhoid as well as basic nutrition interventions and methods for assessing community health. This team works across the commune to synthesize commune-wide surveillance data provided by the community health agents and nurses. Together with the health agents, the S.E.E team supports our peer health support groups and provides epidemiologic data and surveillance information to the medical staff. Our medical team is then better able to target interventions and treatment programs and schedule focused mobile clinics in areas where certain diseases or conditions are most prevalent.
-
Peer Health Support Groups:Peer support groups such as mothers clubs and girls clubs are a critical aspect of our program. We have established mothers clubs in each of the rural sections of the commune. The clubs provide peer support networks both pre- and post- partum. Our network of mothers clubs has had peak participation of over 460 women across the seven sections. Community health agents and community health nurses support the mothers clubs.
