Pwojè Kore Fanmi: An innovative community health project in Haiti

Partners In Health/Zanmi Lasante (PIH/ZL), is the lead partner of an exciting new project in Haiti called Pwojè Kore Fanmi – Haitian Creole for the Family Strengthening Project. In partnership with the World Bank, the Haitian Ministry of Finance’s Fund for Economic & Social Assistance, and World Vision, PIH/ZL is training a cadre of Household Development Agents (HDAs) whose job it will be to connect poor and vulnerable families – nearly all living in rural communities – with local resources and refer those in need of medical attention to health centers and hospitals.

Part of what makes Pwojè Kore Fanmi unique is its explicit focus on helping families restore and fulfill their human rights. To meet that goal, the Pwojè Kore Fanmi trains HDAs to master a breadth of knowledge significantly larger than previous training models.

In late January, PIH/ZL began training the first 55 women and men as Pwojè Kore Fanmi HDAs. The HDAs will soon begin working in the countryside, providing services to families who have been targeted as needing assistance. In past models, community agents would provide similar services to all families. This new model tailors services, addressing each family's specific needs. The HDAs will return every month through September for further training and support.

If all goes as planned, the government hopes to scale up this pilot project to the national level in the near future. Because of this, many eyes – including those of Haiti’s president Michel Martelly – will be watching Pwojè Kore Fanmi’s progress over the coming year.

Training the next generation of HDAs

During their first training, HDAs discussed how by providing health care and helping families access good nutrition, education, clean water, housing, and economic opportunities, they are helping to restore families' human rights. They worked through case studies in small groups to explore how being denied these human rights affects families’ health and well-being and makes them more vulnerable. They also role-played for their colleagues.

In one of the role-plays, a mother sends her daughter to work for a wealthy family in Port-au-Prince because she is very poor and cannot feed her children. This generated a heated discussion about the poverty that makes this practice a common problem in Haiti, one that often that leads to child labor and abuse.

These participatory training activities are designed to elicit and build on training participants’ experience and knowledge, promote discussion and reflection on key issues, provide hands-on practice of content learned, and help participants learn from each other.

Once fully trained, the HDAs will assess for health problems, provide education about health issues, promote healthy behaviors, distribute health products such as bed nets and micronutrient powders, and refer people to health centers or social services as needed. The HDAs will lead monthly mothers’ clubs, youth clubs, and neighborhood meetings to promote dialogue and support among community members as they address health issues in their communities.

HDAs will also run monthly “rally posts” in the community in order to administer vaccinations, weigh and measure children, and carry out other health campaigns.

Leveraging years of experience

With more than two decades of experience and expertise developing community-based health initiatives in Haiti, PIH/ZL was chosen to develop all of the training materials for Pwojè Kore Fanmi. Working closely with staff in both Haiti and Boston, PIH/ZL is developing trainings and program structures that are realistic and sustainable. 

This project is funded by the World Bank and is a collaborative effort among the World Bank, the Haitian Ministry of Finance’s Fund for Economic & Social Assistance, UNICEF, the World Food Program, UN Population Fund, International Labour Organization, and World Health Organization, with World Vision and Partners In Health as the implementing partners.