Summer 2019 Issue
Volume 11 | Number 2
1Teixeira G, 2Gilbert D, 1Baxter C, 1Cook N, 1Florent-Carre M
1Nova Southeastern University, Boynton Beach, FL, United States
2Haiti Hartners, Castle Rock, CO, United states
Healthcare in Haiti, a country which holds some of the worst health indicators in the world, is fragmented and inadequate to meet the needs of its people, especially children. This weak health system can have serious implications for children’s health, leading to decreased attendance in school. Chronic absenteeism means students get less education and are at risk of poorer education outcomes. Since education has the power to change generational cycles of poverty and change life for children who might otherwise be exposed to child labor, gangs or trafficking, programs to improve school attendance are critical.
The goal of this study is to determine if implementing preventative and interventional health measures in a primary school setting in Haiti will increase student contact with healthcare para-professionals and improve school attendance.
This quasi-experimental pilot study addresses the impact of implementing a wellness program run by lay school health workers to enhance education and wellness outcomes. This study was approved for an IRB Category 4 exemption. The program is being conducted at the Children’s Wellness Program office, on the campus of The Children’s Academy in Baocia, Haiti. Five lay healthcare workers were trained to oversee classrooms, make home visits for absentees, provide basic wound care, treat common illnesses, and administer over-the-counter medications. All encounters and patient complaints are being documented in an Excel spreadsheet by complaint category. All encounters are also being recorded in a paper file and children are being referred to Haiti Clinic if further care is needed. Absentee rates were measured at baseline (April to September, 2017) and during a follow-up period (April to September 2018) at the start of the program using school records.
The mean absentee rates (based on total number of students absent for five classes each year) decreased for the months of April, May, and June from 7.8% (n=552) in 2017 to 3.8% (n=375 in 2018), p< 0.01 (pearson). Documentation outlining complaints to the Children’s Wellness Program office show 519 encounters, addressing 774 complaints, the most common complaint being “flu-like symptoms,” or the presence of cough, chills, nasal discharge, usually in the absence of fever unless otherwise noted.
The initial decrease in absentee rates may indicate that access to healthcare providers at a primary level facilitates early treatment and prevention of common childhood acute illnesses and decreases absences potentially related to such illnesses. The number of complaints addressed by healthcare workers indicates that children participating in the study had increased access to healthcare providers after the implementation of the pilot program. The findings of this pilot study may provide insight for implementing care in low healthcare access areas across the world. The implications of this program may also provide suggestions for a new hierarchy of care within the school system, in order to increase access to education via decreasing absentee rates and increasing the treatment of common ailments.
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ACOP Pediatric Track at OMED '19