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I Introduction

The Association of the medical coverage COMENAH has been adopting since 1996 all possible strategies to offer services of quality in the sphere of health for impoverished people of the country. So, through rural areas, the institution has opened mobile clinics. Transport of health personnel and medicines has done on back of animals toward far-flung zones of difficult access of the country.


Since some time, COMENAH in a larger context in the sphere of medical coverage would like to enlarge setting of its services from which necessity to raise the association in the rank of NGO, non governmental organization. Moreover, in its continual concern to reach the greatest number, the association had directed its activities to curative and preventive cares. Education of health workers and matrons, information of 500 voodooists feminine associations and community leaders are elements not to be neglected.



Justification of the project

 Haïti is a country composed of 565 communal sections whose a very small part is covered by community medical cares. Rational distribution of medical cares in slums remains a challenge to take up by department of Health and Population. It is a sad notice that in a general way the community medicine and even specialized medicine has not yet reached countrymen’s door, while “Push button” world invaded us through well, definite concepts materialized in the process of globalization and integration. Peasants do not know mode of transmission of tuberculosis and sexually infectious diseases. Notions of body dental hygiene do not enter their daily life activities. Pathologies, even the most curable ones, stay and remain for peasants’ bad luck thrown by “loas spirits” and impure spirits. Natural deaths sometimes coming form their ignorance and negligence are caused by sending devil on other people considered as enemies or envious of their economic welfare situation. Medicine in all scientific discoveries remains for them empiric and doubtful science whose some positive and concrete realizations are clearly hazardous. This project will enable to reach a large number of people or countrymen constituting living and productive strength of the country through organizational, hierarchical and disciplined structure. Educated and informed workers in the sphere of pathologies principally communicable and family planning will represent a back of skilled human resources to solicit and use for all form of integrated projects in their affectation zones. Not convicted refusing to invest in the sphere of health constitutes a lack in disfavor of the population. In a more specific extent, community leaders, pastors, voodooists and health workers will enable to become potential, through rural communities relevant to their residence zones, information services for larger number.



Objective of the project or principal objective

 The project is intended to contribute improving the state of health of Haitian population in genera by healing persons suffering curable pathologies and preventing expansion of communicable diseases particularly tuberculosis and AIDS

Specific objectives

a)        Sensitize, educate, from and inform.

b)       Decrease the rate morbidity and mortality trough rural areas and impoverished class of country.

c)        Increase the contraceptive prevalence at the level of population living in our intervention areas.

d)       Decrease the risk of population of sexually communicable diseases specially ADIS.

e)        Improve nutritional state of infants from 0 to 6 years of age.



Intervention zones


This project will cover the whole country, namely: dropped out rural and urban zones. Three Zones of reference will be used for execution of the project whose quantitative and quantitative evaluation from sensitive parameters will enable adoption of a more efficient politics in the stage of expansion.

a)        9th section in Bainet where a health a center capable of covering 19.000 persons.

b)       Mr. Guilloux Street where already working a health center for 10.000 inhabitants.

c)        St. Martin Street where evaluation of beneficiaries will do from specialized polyclinics in ORL and ophthalmology.

The number of program beneficiaries in all forms of activities may be already evaluated at more than 40.000 people about.



Planning of Execution


The association will have to execute short middle and long-term project.

a)        Short term project

Curative and preventive cares in phase of execution in the association

          b)     Make functional after physical restructure, if there is need, health centers built by non-governmental organization                         

        on request of community organizations that have taking charge.

c)     Middle term project

        Establishing nutrition centers and school canteens.

d)       Long term project

Building health centers through rural areas and provide them in human, material and financial resources for their full functioning.





                   They are of two orders: institutional and community.

                   A.- Institutional

1)       Creating a system to welcome clients

2)       Educational session of institutional and community group, either a minimum of 6 sessions for the year by promoter with groups of 15 people.

3)       Session of counseling for acceptant of MPI/FP and for people suffering immunodeficiency syndrome or HIV or positive Elisa Test.

4)       Preparing medical records for all patients needed medical and surgical cares for FP clients and pregnant women.

5)       Compulsory medical exam for each new acceptant of hormonal methods.

6)       Organizing prenatal and clinics

7)       Compulsory weighing and vaccinating of pregnant women and infants from 0 to 3 years of age

8)       Realizing club of satisfactory clients of the year.

9)       Examining detection of cervix and breast

10)     Extraction of dental prophylaxis.

11)    ORL and ophthalmology.

12)    Monthly planning of FP activities at the level of each sector used.

(Drop out to reactivate, determination of number of acceptants’users)

       13)    Monthly preparation and in case of need of medical staff for evaluation, correction of deviations in   

                         relation to that is planned or study of changes in the planning.

14)     Planning of supervision by taking account of performance of the sector.

15)    Preparing at the beginning of each month planning of institutional and community activities.

16)    Specialized exams by voluntary foreign physicians, Haitian physicians used or active voluntary members.

17)    Systematic and orientated detection of tuberculosis from defined priority criteria.


                   B.- Community


1)       Distributing contraceptives for FP clients.

2)       Distributing condoms within AIDS prevention or other sexually communicable diseases.

3)       Realizing session of sanitation education and information each year by promoter.

4)       Identifying and reactivating cases of dropout and family planning and for tuberculosis.

5)       Using check-lest pills by promoters.

6)       Referring pregnant women to clinics, potential acceptant of FP and users under hormonal methods.

7)       Censing matron’s formation and integration of educational motivation system in FP and in AIDS prevention.

8)       Preparing monthly activities reports and stock administration of medicines and contraceptive material or others.

9)       Creating clubs of mothers (1 club by sector or promoter).

10)    Participating of promoters in debates or on evolution of programs.

11)    Programming activities to accomplish by personnel depending on performance of sector and determination monthly objectives of each promoter.

12)    Organizing mobile clinics in churches, schools, squares such as markets, gaguere or under a big, large and shady tree.


Human Resources

a)        General Director

b)       Technical Director

c)        Administrative Director

d)       Specialized physicians

e)        General practitioner

f)        Dentists

g)       Accountants

h)       Lab Technicians

i)         Pharmacists

j)         Auxiliaries

k)       Heath workers

l)         Drivers

m)      Mechanics

n)       Maids

o)       Washerwomen

p)       Office boys

q)       Security officers

r)        Licensed nurses

s)        Engineers


Description of tasks


A.- General Director


1.- Supervise evolution of the project.

2.-   plan institututional and community politics.

3.-   Serve transmission belt between organization and funds donors.

4.-   Take part in the staff meeting


B.- Technical Director


Properly speaking, Technical Director is the Medical Director, the 3rd technical and administrative authority of the non-governmental organization COMENAH.

1.- Organizing monthly staff meeting to discuss performance and constraints and constraints and definite activities of the


2.- Supervising FP activities not only at institutional level also at community level.

3.- Elaborating at the beginning of each month a planning of institutional and community activities.

4.- Inventorying education needs.

5.- Participating at periodical progress of programs.

6.- Elaborating monthly with the supervisor of promoters planning taking account realizations of the sector.

7.-Transporting monthly statistic reports.



C.- Administrative Director


1.- Plan work of people who are under his responsibility.

2.- Organize personnel’s works by providing necessary tools in order that objectives settled by manager’s office are reached.

3.- That care of institution’s progress by taking account of respect of hierarchy and administrative norms.

4.- Answer positively to invitation of meeting organized periodically by General Director.




D.- FP/OBGN physicians


1-Supervise and guide auxiliary’s and nurse’s work.

2.-Supervise promoter’s work on quantity and quality point of view.

3.-General consultation and gynecological consultation of clients of family planning and prenatal clinics

4.-provide services of family planning.

5.-Realizing sterilizer ; insertion of Norphant/VCC





1.-Take care of repartition auxiliaries’ work.

2.-Help doctors in planning activities.

3.-Watch execution programmed activities.

4.-Collect complaints of ground personnel.

5.-Assist the doctor in realization of FPM/FP program.




F.-Medical Auxiliary IEC


1.-Execute counseling of family planning clients.

2.-Supervise with FP responsible promoters’ work.

3.-Promote continuing education of ground personnel.

4.-Watch holding of education sessions; the quality of messages transmitted by promoters during

      home visits and education and motivation sessions.                      



G. - Medical Auxiliary FP


1.-Help the doctoc in prevision of pre and post natal FP services.                                                                                                  

2.-Responsible of monthly bill of calendars super vision and institutional and community activities.

3.-Administration and supervision of contraceptive material stockage.

4.-Picking up to date card-index file

5.-Preparing requisition in contraceptives.

6. -Realizing monthly inventory of contraceptives warehouse


H. -Supervisor-promoter

1. -Verifying and regular and correct utilization of contraceptives.

2, -Verifying reliability of data.

3. -Controlling quality of messages transmitted by promoters.

4. -Collecting intermediary reports.


I.-FP and health promoter


1.-Promote planning methods.

2.-Recruit new acceptant of family planning.

3.-Refer to center clients under hormonal method.

4.-Visit people at home.

5.-Realize sanitation education sessions and grouping education in FP;SCD;AIDS.

6.-Creating mother’s clubs or other clients satisfied of medical cares+.

7.-Census of matrons at the level of work zone.



J.- Accountant

1.-Check entering and coming out money.

2.-Make payment and financial report.

3.-Give an account of expenses at the end of the end.

4.-Hold the account book in better conditions of financiary administration.




1.-Receive telephone call.

2.-Transmit messages.

3.-Type documents.

4.-Responsibility of mailing.

5.-Classifying documents.

6.-Convoke meeting on authorized instructions; assist; and take notes and minutes.



L.- Archivist- Statistician


1.-Collect statistics reports; treat and keep them.

2.-Responsible of classifying and holding records.

3.-Organizing archives following alphanumeric classification.



M.- Lab Technician



Responsible of biological and paraclinic exams.



N.- pharmacist



1.-Responsible of stock.

2.-Control and have executer prescriptions.



O.- Responsible of stock



1.-Responsible of entry and coming out of medicine consumable products and materials.

2.-Submit each week a report to the accountant.



P.- constructing engineer or architect


1.-Being responsible of restructure and maintenance of health centers.

2.-Making relevant plans and estimate before implantation new health centers.   

3.-Preparation of calendars of work and costs of construction for information and discussions for

     general assembly.

4.- Be responsible directly of personnel or operators working under his supervision



Needs of information



      1.- Medical and surgical spcialties in post graduation

       2.- Sanitation; hospital and community administration                  

       3.- Education in Norplant



B.- Nurses


      1.- Contraception technology

      2.- Education of educators

      3.- Education in pre and postnatal cares and SCD - AIDS

      4.- Education in hospital administration of nurses cares.

      5.- Formation in education of community



C.- Auxiliaries


      1.-Contraception technology

      2.- Formation in pre and postnatal caress



D.- Promoters



     1.- FP contraceptive technology

    2.- Nutrition and pregnancy hygiene

    3.- Formation in SCD/AIDS




E.- Responsible of stock


      Education  in  stock administration



F.- Supervisor


       Formation in technics of supervision




G.- Engineer


 e) Convince authorities of concerned instances at different levels necessity to moral support and offer a legal basis to medical and paramedical members of COMENAH working in intervention zones.              

f) Look at possibility of free distribution of medical cares and medicine at 80% of peasants and slums inhabitants of very weak economic resources.

g) Recruit after well done sensitization campaign of active members and observers of COMENAH, medical and paramedical personnel of public HEALTH Department working in difficult conditions in hospital and dispensaries of some commune towns.

h) Make expansion of distribution of medical cares of needed people an act of civism and professional conscience of high level, thanks to the use of sensitization sessions through media of the capital and provinces.

i) Inform and convince the countryman of specialized consultations for some pathologies of fearful complications.

j) Conceive and execute latrine programs




Impact of project


COMENAH, from opinion of founders’ members is a positive answer to economic and social bad results in the development of country. Reduction of morbidity and mortality rate through rural areas by putting in place mobile clinics will be an unprecedented gain for Department of public Health and population whose contribution is strongly desirable. Countrymen for healing from pathologies as curable as malaria, typhoid, parasitosis and others don’t need to walk several kilometers either, either on animals back or by trucks before reaching health centers where they would enable to spend the day before to be a physician or a nurse or in default by an auxiliary.  

Success of the whole activities of COMENAH will contribute to improve medical and sanitary conditions of countrymen and make them productive in the agriculture domain.


Project made written by Dr. Denis Cyrille


Read and approved by other members.



Board of Directors


General Direction

             General Secretariat                                    Advisory Members

Technical Direction

Administrative Direction




Community Health Centers


Formation in technics of supervision



G.- Engineer

       Education in hospital building



Organization and proceeding


Execution of this project will depend on contrivance used in relation with organizational structure for responsibility of powers according to command and authority lines. Macro and micro administration manuals previewing other functions will be written to this end. However, conjugation of intrinsic and extrinsic motive will improve to positive working conditions and increase quality and quality of medical cares. COMENAH as non-governmental institution and no profit organization will adopt in a long term the same technical, administrative and sanitary structure as the public Health Department. These structures will be only for supervision of development that reinforcement structures.





Community health centers on Monseigneur Guilloux street on 9th section of Bainet, places such as gaguere and markets, community Schools given to COMENAH by casecs members or quarter leaders, shadow spaces arranged by branches of strong and thick trees are many as physical resources offering space of general consultation to poor peasants asking not better than to ease them from their morbid suffering. Several other small dispensaries or centers are already giving to us by community groupings to make them functional Health centers, according to already convened plans and studies will be built in long terms through rural areas.






Supplying in medicine, lab materials, X-RAY and different consumable products will assure by supply section of COMENAH from subscription of founder members and especially from donations of overseas and national benevolence organizations .Pre project requisition will be studied to this end, will be of all utility. 

a)Rolling stocks

b)Animals such as horses and mules for transport of medical, paramedical personnel and materials from tows to rural areas through paths. Due to the of mountainous nature of the Republic of Haiti, helicopter-borne mobile clinics would enable to become true.





Donations from some NGO, working on the spot at the first time then subscription from founder members on the second time have made possible several mobile clinics through rural areas. National and foreign slipping partners will solicit in short time solicitude for the expansion stage of association. Checking account named COMENAH account will be opened at any bank of the Republic of Haiti. Budget will be an annual budget at renewable zero basis. Time and experience will allow necessary adjustments to integration of resources. Availability on the budget question, economic situation of the country and collective aspiration are as many factors to consider.





Multidisciplinary committee formed by direction central committee will assure project coordination and supervision of he project. That multidisciplinary committee can be provisional and permanent, according needs and profit.





Project will be evaluated from results obtained to aimed objectives during evolution of action programs. Specific evaluations with submission of activities reports will be done for all foresaid programs executing in COMENAH. An annual general balance sheet of project will be made and submitted to concerned authorities.





Activities to build up enabling to reach its objectives are:

a) Elaborating a work plan and a calendar of activities

b) Realizing sensitizing and information sessions

c) Equitation sessions

d) Realizing education sessions on SCD/AIDS and family planning for medical members of

Medical and paramedical personnel of COMENAH.

e)Regular providing in medicines, contraceptive and condoms in health centers

f)Imprinting and distributing education material (bills, booklets, etc. )

h)Collecting statistic data.

I) preparing reports of quarterly and annual activities.






a) COMENAH will undertake some steps near slipping partners to find necessary support for functioning the activities of the project.,

b) Executing the project in the inaugural stage will be held on December 1st

c) Sensitize community leaders and responsible of places of mobile clinics in order the that the transport of personnel medical has done as usual through all rural areas on animal back.

d) Dates of rendezvous in mobile clinics must be respected


Centre de Santé Communautaire
Rue Mgr Guilloux # 556
B.P. 1382, Port-au-Prince, Haïti (W.I)