Figure 1: Gross Domestic Product, annual growth (%), Haiti, 1991-2000

The population in 2000, based on the census of 1982, was estimated at 7,958,964 for a density of 282 inhabitants per km2. The estimated annual population growth rate during 1995-2000 was 2.1%. Sixty-four percent of the people live in the countryside, 21 % in the metropolitan area of Port-au-Prince , and 15% in other urban areas.

 

Forty percent of the Haitian population is under 15 years old, and only 5% is over 65. The population dynamic has been characterized by a progressive urbanization, emigration to countries abroad and a shifting population toward the neighboring Dominican Republic.

 

A sizable percentage of professionals and qualified technicians contribute to the Haitian diaspora , especially the United States ( Florida and New York ), Canada and neighboring islands. The monthly remittances sent to families in Haiti account for 8.3% of household income.

 

The crude birth rate was 33 per 1,000 population , and the general fertility rate was 4.4 children per woman. Life expectancy at birth was 54.4 years for the general population (52.8 for men, 56 for women).

 

 

The 1990s saw a worsening of poverty for the Haitian population. In 1999-2000, the growth in the GDP was 1.2%, a decrease compared to the previous period that is mainly explained by the decline in the contribution of the agricultural sector (-1.3%).

 

Inflation was estimated at 15% in 1999-2000 and during the same period the price of food increased 10.4%. A survey conducted in 1999-2000 found that 67% of the population was living in poverty, that 31.4% of the households had more than seven members and that 46% of families had only one room to sleep in.

 

The official languages are Haitian Creole and French, the latter being used to a large extent in the cities.

 

Since 1997, the Ministry of Public Health and Population (MSPP) and PAHO have been promoting the certification of deaths. In 1999, a total of 7,997 death certificates were issued, believed to represent 10 % of all deaths.

 

Although almost half the certificates show ill-defined causes of death, the information gained allowed a mortality profile to be defined. Communicable diseases headed the list, representing 37.5% of deaths presenting a defined diagnosis. The second most important group was diseases of the circulatory system.

 

External causes ranked third (4.3%) and neoplasms were in fourth place (2.7%). In terms of specific causes of death, AIDS ranked first, with 5.2% of the total deaths, followed by diarrhea and infectious gastroenteritis (5%) and cerebrovascular accidents (3.5%).

 

Of the 10 leading causes of death in women, the first three coincide with the general pattern, but maternal causes come fourth, with 157 deaths.

 

Specific Health Problems

Children (0-4 years): Infant mortality increased from 73.8 per 1,000 live births in 1996 to 80.3 in 2000. The rise is associated with increased poverty, deficiencies in the health system, and the impact of the AIDS epidemic. Acute diarrheal disease is the number-one health problem in children.

 

The leading causes of death in 1999 were intestinal infectious diseases (12.1%), infections of the perinatal period (10.2%), malnutrition (9.1%) and acute respiratory infections (6.9%).

Schoolchildren (5-9 years): An estimated 20% of the group under 15 years old are in a state of vulnerability, i.e. living in poverty, undernourished, with limited access to education, residing in foster homes where they do domestic work (a situation referred to as restavek ), or else in the street.

 

In the age group 5-14 years, infectious and parasitic diseases accounted for 24% of the registered deaths. External causes represented 10 % of all causes of death.

 

Adolescents (10-14 and 15-19 years): According to death certificates for 1999, adolescents and youth accounted for 8% of the deaths in the country. HIV/AIDS was the leading cause of death in this age group (5.8% of all certified deaths).

 

Among the 10 leading specific causes of death on this population group were assault and homicide, tuberculosis, typhoid, and causes related to maternity (35 maternal deaths in the age group 10-24 years in 1999). The fertility rate in girls aged 15-19 years was 80 per 1,000 in 2000. The prevalence of sexually transmitted infections in adolescent males 15-19 years old was 9.9%.

 

In one survey, 18% of the females and 33% of males stated that they had used a condom in their last sexual encounter. Violence and sexual abuse are very frequent in this population group (70% of adolescent girls and women have been exposed to violence of some sort).

Adults (20-59 years): The fertility rate is in decline, estimated at 4.7 children per woman in 2000. Of all women with a regular partner in 2000, 22% were using a modern method of contraception and 5.8% a traditional method. AIDS is the leading cause of death for the population 15-49 years of age (21.6% of deaths with specifically defined diagnosis).

 

Intestinal infections come second and maternal causes rank third. The maternal mortality rate in 2000 was 523 per 100,000 live births, a 15% increase relative to 1995. Maternal causes of death included problems related to arterial hypertension and eclampsia , as well as complications of labor.

 

Seventy-eight percent of pregnant women had prenatal checkups with a health professional in 2000.

Family health: Constant displacement and migration abroad are causing the family structure to break down in urban and rural areas. There are no programs geared to family health.

Workers' health: The informal sector (mainly women) and the agricultural sector make up 96% of the working class. No services are provided for this informal sector. Government workers have a poorly organized insurance system, while the health of employees in the private sector comes under the responsibility of the Office of Medical Insurance and Maternity.

 

In 1999-2000, the indemnity for temporary incapacity or permanent disability was paid to 559 persons, 90% of them men.