Building a Stronger Healthcare System
At Konbit Sante, we believe one key to improving access to quality health care for all people in northern Haiti involves supporting sustainable improvements to the Haitian health system. That is our mission. To that end, Konbit Sante staff and volunteers work in collaboration with the Haitian Ministry of Health and other partners to build local capacity in all aspects of the health system - from door-to-door community outreach programs, to strengthening community health centers, to improving care at the regional referral hospital.
We approach our work knowing that we do not have all of the answers, and in fact, Haitian problems need Haitian solutions. We view our Haitian colleagues as full and capable partners, and that by putting our heads together (tèt ansanm) we can make more progress than any of us working alone. Because we believe that our priorities need to respond to local needs, we are guided by assessments and listening to the community, and focus on the areas our Haitian partners have identified and are committed to improve and where we believe we can bring sufficient financial and non-financial resources to help make a real difference. To be sure that our shared investments are bearing results, we are serious about monitoring and evaluation. Without that, there are no lessons learned.
We strive for effectiveness and efficiency by establishing plans with clear objectives, and measurable goals together. These plans focus on the strengthening the “building blocks” that any health system needs in order to provide high quality care to the community it serves; a adequate and well- trained workforce, good quality service delivery, effective management systems, decent infrastructure (water, electricity, and facilities), adequate and appropriate supplies, medicines, and equipment, and a capacity to measure and evaluate progress. All of these building blocks are required for both facility-based and community-based healthcare and public health, and our annual plans reflect that.
The resources that we seek (financial, human, intellectual, material) are procured or specifically recruited to support those plans. For instance, when we send container of supplies, we do not simply collect supplies and send whatever we can find that we think might be useful (what we call a “push” system), but rather response to specific needs and requests (a “pull” system). This is the type of purposefulness and care that we aspire to with the allocation of all of the resources entrusted to us.
Because we believe in sustainability, we try to make sure that all of our activities are integrated into longer term strategic initiatives. For instance, trainings should not be stand-alone presentations but be a part of building institutional capacity to provide for their own future training need (e.g. train the trainer), or augment and support specific initiatives to improve the provision of care. Infrastructure projects should help strengthen local capacity to maintain improvements, and be related to the provision of better quality care.
Because we believe in sustainability, we choose to support Haitian healthcare institutions, rather than create parallel systems of care, because they will ultimately be responsible to care for their own communities. Today we have four principal healthcare partners: a public hospital (Justinian University Hospital) and health center (Hospital Fort St Michel), and a private hospital (Haitian Convention Baptist Hospital) and health center (ULS). We support the country’s efforts to regulate NGOs, and strive to operate in full compliance with the laws and regulations.
One of the most successful strategies we've employed to create positive change is to identify civil servants who are qualified, committed, and honest “champions of positive change” and build administrative capacity around them. Sometimes that has meant hiring them into key positions embedded in the system and give them the kinds of support necessary to help them be successful, and sometimes in means giving that kind of support to visionary leaders and champions that are already there. Staff and volunteers from the US provide technical assistance; assist with identifying needs, brainstorming feasible solutions, providing continued education, and supplying material resources that help our Haitian partners do their jobs effectively. The personal and professional relationships formed are respectful and ideally mutually rewarding.