République d’Haïti

Report HAITI MDG a new look Millennium Development Goals

Executive Summary République d’Haïti

Report 3 1 HAITI a new look

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Report 3 1 HAITI a new look

MDG 0 Millennium Development Goals 2

Executive Summary OMD 1 Preface His Excellency, Laurent S. Lamothe, Prime Minister of the Republic of Haiti

n an unprecedented move, in 2000 the Republic of Haiti and 188 other United Nations countries committed Ithemselves to building together a world without poverty that guarantees human development for all, with eight Millennium Development Goals to be reached over the next fifteen years. As that day is fast approaching, Haiti is reiterating its commitment and determination to be part of this joint effort for human dignity. In my address to the 68th session of the United Nations General Assembly in September 2013, I noted that for our Government, combating extreme poverty in Haiti is not an option but rather a commitment to History. Since 2000 our country has made progress on all the key indicators of the MDG framework. Today the proportion of people living in extreme poverty has dropped to 24.7%, and the target of halving the proportion of underweight children under the age of five was reached three years ahead of schedule. More than 88% of children are now attending primary school, and we have achieved boy-girl parity in primary and secondary schooling. Infant and child mortality has dropped dramatically since 1990, faster in fact than the worldwide trend, and we have made significant advances in guaranteeing access to maternal healthcare. We have also managed to stabilize the prevalence of HIV/ AIDS. Nearly 69% of households now have access to an improved source of water. Finally, Haiti is at the core of a fruitful worldwide partnership whose effectiveness we and our partners strive each day to guarantee as we maximize the impact on the population. Yet significant challenges remain. It is unacceptable that more than six million people in our country are still living in poverty. Many efforts remain to be made to provide jobs for our young people, promote political participation by women at all levels of public life, consolidate our healthcare system, and preserve the environment in a sustainable manner. The vision behind the Government’s action perfectly matches the Millennium Development Goals. In May 2014 an Action Plan was launched to speed up poverty reduction. It demonstrates the Government’s ongoing commitment beyond 2015 to achieve concrete results so that each Haitian’s right to a decent life is respected. Future progress will also depend on good governance and on strengthening and consolidating the rule of law. Conscious of the other areas in which we need to make progress, our country is participating in the global forum on the post-2015 agenda and sharing its vision as it is already committed to pursuing efforts to move our nation forward.

Laurent Salvador Lamothe

4 2013 MDG Report for Haiti OMD 1 Preface Sophie de Caen, Senior Country Director of the United Nations Development Program (UNDP)

t the 55th regular session of the United Nations General Assembly held 6–8 September, 2000 in New York, A189 countries approved the Millennium Development Declaration. This was a global vision of a world in which developed and developing countries would work together for the advancement of all, especially the poorest. They committed at the highest political level to set goals that when reached, would put an end to extreme poverty throughout the world by 2015. For the first time, the world agreed on a limited number of goals and targets, with a precise deadline and measurable indicators. On this basis, the MDGs saw the world successfully mobilize around a common development agenda. Today, the high-level panel on the post-2015 development agenda is recommending the continuation of a framework similar to that of the MDGs, albeit more exhaustive and ambitious, in recognition of the progress made in reaching the MDGs in years past. Although an examination of the post-2015 agenda is well under way at the international, regional and national levels, including in Haiti, as described in the final chapter of this report, we still have one-and-a-half years to work toward the current MDGs. That is why I am delighted with this report, which manages to combine a consideration of the future development agenda for Haiti with a progress report on how goals and targets are being met in Haiti and specific recommendations for easing constraints and speeding up the implementation of projects called for in the various strategic sector plans. I am also pleased with the close collaboration between the Government of Haiti and the United Nations System as well as the shared effort made to prepare this exhaustive report. Although the report notes the significant advances and progress made in Haiti to reach the MDGs, it also points out the challenges that remain to be overcome if we are to eradicate poverty and ensure sustainable development. While reducing poverty is first and foremost the responsibility of the Haitian Government, which must expand its mobilization of resources and devote public revenues to priority investments, achieving the MDGs also requires concerted and coordinated action by the United Nations System and bilateral and multilateral donors to build the State’s capacities and facilitate implementation of the projects that are crucial for reaching the MDGs. I hope that this report will contribute to this discussion and encourage renewed efforts on the part of all stakeholders to speed up progress by 2015 and beyond.

Sophie de Caen

5 OMD 1 Foreword

Tracking MDGs in Haiti ince they were adopted in 2000, the progress made in achieving the Millennium Development Goals (MDGs) Shas been tracked in each country jointly by the Government and the UN country team with support from civil society and the private sector. In Haiti, the MDGs are tracked by the National Observatory on Poverty and Social Exclusion (ONPES), which is under the Ministry of Planning and External Cooperation (MPCE). While several MDG analyses have been regularly produced in Haiti, to date, only one national MDG report was issued in 2004. An update therefore was essential, especially in light of the approach of 2015 and because of the availability of new national surveys done in 2012, the Mortality, Morbidity and Use of Services Survey (EMMUS) and the Survey on Post-Earthquake Household Living Conditions (ECVMAS). The 2013 MDG report for Haiti was co-written by the Haitian Government and the United Nations through the ONPES and the United Nations Development Program. It is the result of a participatory process, involving a focal point in each ministry and UN agency and of the sector stakeholders meeting in their technical workshops organized for each MDG. This inclusive process ensures both the reliability of the data and a consensus over the data and analyses presented in this report.

Structure of the 2013 MDG Report for Haiti The 2013 MDG Report follows the guidelines of the United Nations Development Group for the preparation of national MDG reports both in structure and in its analytical approach. The report devotes a chapter to each MDG, for which it analyzes: • The current situation and trends for MDG indicators in Haiti since the 1990 baseline or since the latest year for which data are available. • The policies, programs and projects of the Haitian Government in the concerned sectors. Each chapter analyzes the role assigned to the MDG sector in national planning, then surveys the sector policies, legislation, programs and projects the Government is undertaking. • Bottlenecks and constraints on the implementation of policies, programs and projects is intended to identify and analyze the specific stumbling blocks slowing down or hindering attainment of the MDG. • Practical, targeted recommendations suggesting courses of action to ease the Bottlenecks and speed up MDG implementation. In several chapters, a good-practice standard has been included in a dedicated box regarding the contribution of volunteering in reaching the MDG in Haiti. This approach is in response to the appeal launched at the 2010 MDG summit to include all stakeholders in order to enhance their role in the national development effort and their contribution to achieving the MDGs. Finally, the report’s last chapter presents the results of consultations on the post-2015 agenda, which were conducted in Haiti in February 2014.

6 2013 MDG Report for Haiti MDG Progress and Delays in Haiti Haiti has made significant progress on most of the MDG indicators and has reached all (or almost all) of its targets. The country reached the target aimed at halving the proportion of underweight children under age 5 (MDG 1) three years ahead of schedule, and extreme poverty has declined, to 24.7% in 2012. The most noteworthy progress made was in the field of education, with a net school enrollment of 88% in 2011. In addition, boy-girl parity was achieved in 2000 in primary and secondary schooling (MDG 3). Appreciable progress has also been made in healthcare. Infant mortality has dropped by 44% since 1990, faster in fact than the global trend (MDG 4). In 2010, 90% of women had at least one antenatal care visit during their pregnancy, substantially contributing to reducing maternal mortality, estimated at 157 per 100,000 by the Ministry of Health and Population (MDG 5). The HIV/AIDS epidemic has been stabilized, with an incidence of 0.9% in the population aged 15–24, which in more than 60% of cases uses a condom in high-risk sex (MDG 6). Haiti has virtually reached the target aimed at ensuring access to water, with 64.8% of households having access to an improved water source (MDG 7). Finally, Haiti remains one of the countries in the world receiving the most attention from the international community, with an obvious leap in official development assistance following the 2010 earthquake (MDG 8). However, many challenges remain, and the progress made in some sectors is still too limited to have a major impact on development and poverty reduction. There are significant delays in some sectors. Inequality has skyrocketed, and employment alone is not enough to lift people out of poverty, with 45% of workers living on less than $1.25 a day (MDG 1). In the area of gender equality, it is important to note that only 4% of women are represented in Parliament, and Haiti is one of six countries worldwide in which one of the houses of Parliament is all-male (MDG 3). In the area of sustainable environment (MDG 7), the efforts made to combat deforestation and the loss of biodiversity have not been sufficient to curb this trend. Some of the progress made needs to be consolidated to ensure that it lasts. Positive results in reducing extreme poverty is linked more to external factors, especially official development assistance and transfers from Haitians living abroad than to strong and inclusive economic growth, leaving a large part of the population vulnerable to potential external shocks (MDG 1). In the education sector, a huge amount of work remains to be done to ensure quality education, promote school completion and develop public education (MDG 2), and to ensure gender equality over the long term (the gender-equality index having declined slightly in primary schools in 2012) (MDG 3). Progress on HIV/AIDS must be sustained in order to avoid trivializing the disease and to anticipate any lapses. In fact the proportion of young men with a comprehensive and correct knowledge of HIV/AIDS dropped 13 points between 2006 and 2012, although risky sexual behaviors have declined overall. While international cooperation remains highly dynamic, efforts need to be sustained in order to ensure aid effectiveness and for Haiti to benefit more from the many preferential trade agreements that could contribute significantly to economic growth and job creation (MDG 8).

Foreword 7 National Strategic Planning for Development in Haiti To meet the challenges of development, in 2007 Haiti adopted a National Strategy Paper on Growth and Poverty Reduction (DSNCRP) for a three-year period (2008–2010). Drafted in a participatory process, the DSNCRP was the first overall reference framework for the Haitian Government’s public policy and development programs. The long-term objective of the DSNCRP was to get Haiti out of the category of less developed countries, appreciably by improving the population’s living conditions and reducing poverty. Beyond the management of the emergency situation caused by the January 2010 earthquake, the Government intends to pursue its efforts to develop the country by relying on the DSNCRP, among other things. The Action Plan for the National Recovery and Development of Haiti (PARDH) was launched in March 2010. This plan consists of four major components: land reform, economic reform, social reform and institutional reform. Additionally, the Government expanded the four focal areas of the PARDH as part of the Strategic Plan for the Development of Haiti (PSDH), a planning document but also a vision of development aiming to make Haiti an emerging country by 2030. The PSDH is accompanied by a framework for accelerated and balanced economic growth and poverty reduction, an implementing tool for the 2014–2016 period. While the strategic planning framework in Haiti is not aligned directly with the MDGs, most MDG sectors are nonetheless included in the Government’s priorities, for example through the “Five Es” of education, employment, environment, energy and rule of law [état de droit].

Principal Impediments to MDG Implementation For each MDG, the report identifies the constraints that slow down or limit implementation of the Government’s projects. These constraints are of several different types. They may be associated with a lack of political will among the stakeholders, whether the Government, Parliament, the local authorities or the implementing agents in ensuring fast and effective implementation of a policy or program. In some cases, the desire to support a sector is affirmed, such as social protection and employment (MDG 1), education (MDG 2) and habitat (MDG 7), while sometimes there is no follow-up to ensure fast, effective implementation with a lasting impact on the population. In addition, some sectors suffer from a lack of attention to achieving convincing results, as is the case of access to sanitation systems (MDG 7) or of ensuring equal participation among men and women (MDG 3). There may also be a lack of specific public projects or policies that could move a sector forward or insufficiently detailed policies that do not necessarily meet the need. Policies must also be consistent with one another as well as ambitious but realistic. While a planning effort was recently undertaken in Haiti, some sectors still have no strategic policy. For example, today there is no employment policy (MDG 1) and no policy on urban planning or land-use planning (MDG 7). In other cases, such as education (MDG 2), policies exist but are so comprehensive and ambitious that they suffer from a lack of prioritization and coherence. Finally, some sectors suffer from an outmoded legal framework poorly suited to contemporary issues, such as the business environment and legislation on new information and communication technologies (MDG 8).

8 2013 MDG Report for Haiti Projects are often poorly implemented because of budget constraints. Many sectors, such as healthcare (MDGs 4, 5, and 6) or education (MDG 2), are unable to implement large-scale, lasting policies because of the lack of financial resources. The share of the national budget allocated to the various sectors often reveals the political arbitrage engaged in upstream. Furthermore, problems are frequently encountered in executing budgets or in absorbing official development assistance (MDG 8). The impediments identified are often based on problems of governance of sectors and of implementing capacity. The institutional weakness of many ministries, for example in the environmental sectors (MDG 7), women empowerment (MDG 3) or public institutions, sometimes make it difficult to implement projects quickly and effectively. Often the lack of qualified, available staff willing to work in remote areas of the country limits the reach of policies, especially in healthcare (MDGs 4, 5, and 6) and education (MDG 2). Practical and logistical issues owing to the poor road network and the lack of infrastructure limit the implementation of high-impact programs, especially for access to public services such as water and sanitation (MDG 7). In some cases policies do not deliver the expected results because of inadequate attention to the demand for services. Cultural practices as well as logistical or financial constraints on the targeted beneficiaries may limit the reach of projects, for example in the area of maternal health (MDG 5). In other cases, the lack of information and public awareness make it impossible to completely change practices, as is the case in the struggle against HIV/AIDS (MDG 6) or in gender-equality policies (MDG 3). Finally, some constraints are multi-sector and often have to do with a lack of coordination and liaison between sectors, among public policies and among the stakeholders implementing the MDG framework, whether the Haitian Government or the international partners, but also the private sector, civil society and non-governmental organizations (NGOs). This problem is especially critical in terms of the effectiveness of foreign aid (MDG 8).

Practical, Specific, and Targeted Recommendations The recommendations made in the MDG report come from the sector workshops that brought together the decision makers, operators and specialists in each sector. They seek to be specific and targeted, proposing courses of action to speed up implementation of MDG policies from now until 2015 or to include these policies in a long-term approach. These recommendations are aimed at providing keys for understanding a more flexible implementation of public policies as well as policy levers for ensuring their implementation. They are often aimed at decision makers (Government, Parliament) as well as at key stakeholders in each sector concerned. In response to each of the impediments cited above, there are several types of recommendations, some of which call for the passage or promulgation of a pending bill, the formulation of a sector policy or the training of qualified staff. These recommendations may also encourage the adoption of more inclusive measures aiming to give greater consideration to regional disparities or socioeconomic inequalities among the population.

Foreword 9 MDG 1 ERADICATE EXTREME POVERTY AND HUNGER

n Haiti, the incidence of poverty is 59%, or 6.3 Imillion people. In addition, 24.7% of the popula- Extreme Pauverty Rate (%) – by Department

tion lives in extreme poverty, or 2.5 million people. Key Port-de-Paix Under 10 In 2012, poverty remained severe (24%). Poverty is NORD-OUEST 10 to 25 43 Cap-Haïtien mainly rural, at 75.2%, vs. 40.8% in urban areas. The 25 to 35 NORD 35 to 45 36 Fort-Liberté poverty gap also takes these disparities into account, NORD-EST National capital Gonaïves 44 with 12.5% in urban areas compared to 35.6% in ru- Department capital Department boundary ARTIBONITE ral areas. The high degree of vulnerability remains a 22 Hinche concern, as about a million Haitians would fall into 0210 040 CENTRE poverty in the wake of a natural disaster or econo- Kilometres 34 mic shock. Moreover, inequalities remain high, with

the Gini index stagnating at 0.61 since 2001. Jérémie PORT-AU-PRINCE The informal sector remains a major employer, but GRANDE-ANSE Miragoâne OUEST 37 NIPPES 9 provides little job security to its workers. The pro- 30 SUD SUD-EST portion of self-employed (34.7%) and family workers 25 25 Jacmel (7.8%) in the working population is especially signi- Les Cayes ficant, with 42.5% of workers having an insecure job. Employment is not enough to enable individuals to went from 27.5% in 1995 to 11.4% in 2012, a re- meet their own basic needs, as 44.9% of workers live duction of nearly 60%. As a result, Haiti reached this on less than $1.25 a day. target three years ahead of the 2015 deadline, even if Significant progress has been made in ensuring food it remains far above the average of 3% estimated for security. The percentage of children under the age Latin America and the Caribbean. of 5 who are moderately or severely underweight

Summary of Sector Policies and Programs Measure Goals Current status Poverty reduction Action Plan to reduce poverty Implement the Government’s poverty reduction policies Plan launched in May 2014 by the and programs; improve project effectiveness and (PARP) (2014–2016) consistency Government Program under way, 3.7 million Promote the economic and social inclusion of Ede pèp social assistance strategy beneficiaries and develop human capital interventions between 2012 and 2014 National registry of beneficiaries Identify the poorest households for effective and Program under way (RUB) transparent targeting of beneficiaries Harmonize and improve the delivery of basic services for Kore fanmi (2013–2017) the most vulnerable families Program under way

10 2013 MDG Report for Haiti Employment New Commercial Code Revise the legal framework for business Under way

Single electronic window Speed up registration of joint-stock companies Window online soon Creation of a center for enterprise Provide technical assistance to small and medium and entrepreneurial development CDEE operational enterprises (SME) (CDEE) Industrial micro-parks Develop local economies and pool SME resources Program to be implemented soon Inventory of typical products by Typical products Create lasting jobs and protect cultural heritage department completed Food security Aba grangou – COLFAM Combat hunger and malnutrition Program under way

Kore lavi Reduce food insecurity Program under way Three-year agricultural stimulus Combat food insecurity and extreme poverty among Program under way plan (PTRA) farmers and rural producers

Bottlenecks and Recommendations for Implementation of Policies and Programs Bottlenecks identified Recommendations Poverty reduction Lack of updated national social protection policy; no Formulate a consensual national social protection policy among the active sector working group various stakeholders Lack of sustainable funding and problem with fiscal Identify a sustainable, independent financing mechanism; optimize tax prioritization collection Identify the root causes associated with problems in identifying Problem with targeting and identifying beneficiaries beneficiaries; develop a community targeting pilot program Develop innovative implementation mechanisms and involve local Implementation problems communities Weakness of monitoring and evaluation mechanisms Boost monitoring and evaluation mechanisms for better goal planning Employment Poor operationalization of political will for Formulate a national employment compact with the private sector and all employment; no sector policy stakeholders; identify the institution in charge of employment Redevelop apprenticeships alternating with accreditation; expand access Inadequate, costly and inflexible vocational training to certificates for working craftsmen Dichotomy between business climate promotion and Employment compact giving priority to lifting workers out of poverty social legislation for workers Strengthen the Haitian Institute of Statistics and Information Technology Lack of up-to-date employment data (IHSI) for the production of employment statistics Low budget for vocational schools Support schools and/or companies that train apprentices Food security No prioritization, harmonization or conceptual Build a political consensus for a consistent framework framework Lack of lead institution for food security Establish an internal government coordinating body

Fragmented funding; multiple small-scale projects Prioritize projects according to the poverty map; improve coordination

Executive Summary 11 MDG 2 ACHIEVE UNIVERSAL PRIMARY EDUCATION

lear progress has been made in the area of edu- C cation, with the Net enrollment rate in pri- Net primary school enrollment rate in 2012 – by Department mary education rising steadily from 47% in 1993 to 88% in 2011. However, the target of 100% primary Key Port-de-Paix 69.7 à 75 NORD-OUEST enrollment will probably not be reached by 2015, and 75 à 80 82.3 Cap-Haïtien 80 à 85 NORD disparities remain between rural areas (73%) and ur- 85 à 86.3 79 Fort-Liberté NORD-EST ban ones (86%) and according to household income. National capital Gonaïves 75.9 Department capital

Furthermore, greater efforts are needed to ensure ac- Department boundary ARTIBONITE 69.8 cessible education for all and to promote the retention Hinche 0210 040 CENTRE of students in the school system. In 2011, the comple- Kilometres 75.2 tion rate in primary education was 68%. Finally, is- sues remain in ensuring quality education in a system METRO AREA Jérémie 86.3 in which nearly 88% of available places in 2010–2011 PORT-AU-PRINCE GRANDE-ANSE Miragoâne 80.5 were held by the private sector. NIPPES 85.7 OUEST OUTSIDE METRO SUD 69.7 SUD-EST 79.5 Significant progress has been made in ensuringlite - 77 Jacmel racy. In 2012, 73.6% of women and 78.7% of men Les Cayes aged 15–49 were literate. These advances are espe- cially encouraging among young people since literacy rates are 85.1% for women and 84.2% for men aged 15–24. Literacy rate - Men/Women - by age bracket 100 Men 90 86.2 85.8 82.9 85.6 83.4 79.6 Women 80 79.9 74.2 69.9 70 64 60.4 60 58.5 52.1 50 85.1% 40 40 of the 15-24 age group 30 is literate (2012) 20 10

15-19 20-24 25-29 30-34 35-39 40-44 45-49

Summary of Sector Policies and Programs Measure Goals Current status Education

Radical reformation of the Haitian educational system through: 2010–2015 Operational -- Improvements in availability Plan (OP) of the Ministry of -- Cost reduction Background paper; Education and Vocational -- Improved quality of teaching and governance of the essential implementation under way Training (MENFP) subsector -- Support for demand

12 2013 MDG Report for Haiti Provide schooling for 1,500,000 children over the 5-year period through: Free mandatory universal -- State support for educational expenses in public primary schooling program (PSUGO) schools for the first two years of primary schooling Implementation under way (2011–2016) -- Subsidies to non-public schools -- Creation and construction of public schools Literacy Wi mwen kapab literacy Implementation under way but Eradication of illiteracy in people aged 16–50 campaign (2007–2015) impact still limited

Bottlenecks and Recommendations for Implementation of Policies and Programs Bottlenecks identified Recommendations Education Implementation of OP too slow to reach goals by Maintain the Government’s commitments and efforts to speed up the second 2015 phase of the OP Lack of geographic prioritization in the OP Develop a school map in order to target the most disadvantaged areas Absence of targeting of the most vulnerable groups (street children, children working as Institute a proactive school enrollment policy for the most vulnerable children servants, orphans) in the OP Problem with identifying the agencies Affirm the MENFP’s leadership in implementing the OP; clarify national strategic responsible for implementing educational plans programs Prioritize the strategic priorities of programs Problems with organizing, planning and Improve consistency among the various programs (OP, PSUGO, PSDH). prioritizing the various plans, strategies and programs Reference the PSUGO in a detailed implementation plan Consult the working paper of the UN special envoy for world education Enable the State officials concerned to appropriate the various national strategies Weakness of OP monitoring and steering bodies Offer better administrative and pedagogical training to school principals Weak capacities of teaching body Combat high absenteeism among teachers Move the MENFP reform ahead and set up the National Office of Education Inadequate human and institutional resources Partnership Bill to establish the National Education Fund not Support the legislative process yet passed into law Allocate a more substantial portion of the national budget to education to bring Low budget allocated to education it closer to international standards Literacy Institutional weakness of the Secretariat of State for Literacy Enhance the technical, human and financial capacities of the Secretariat of State for Education Risk of blockage of financing mechanisms

espite its limited resources, the commit- D ment shown by the Haitian Government to provide sufficient resources to promote universal education has been solid over the years.

Executive Summary 13 MDG 3 PROMOTE GENDER EQUALITY AND EMPOWER WOMEN

lthough parity was reached in primary and se- Indice de parité des sexes dans l’enseignement condary education in 2000, with a gender parity A primaire et secondaire index of 0.93 and 1.08 respectively, gender inequa- 1,1 Primaire 1,08 1,08 lities persist. In fact, there has been a regression in Secondaire 1,05 Parité: 0,97-1,03 1,02 primary education in 2012, and the lack of data does 1,01 1 0,99 not allow a clear assessment of the situation in higher 0,95 education. In the area of employment, while women 0,93 are relatively present in the non-agricultural sector, 0,9 they mainly hold jobs that are paid less than men. 0,85 2000 2006 2012 Moreover, the vast majority of working women are employed in the informal sector or for themselves, in the Senate. Haiti is one of six countries in the world raising the problem of access to secure, decent jobs where one of the houses of Parliament has no female for women. Finally, the political representation of representation. women in Haiti is among the lowest in the world, with 4% of members of the Haitian Parliament being women, with5.3% in the Chamber of Deputies and 0 4.3% of members of the National Parliament are women Summary of Sector Policies and Programs Measure Goals Current status Gender equality Policy finalized by the Ministry for Implement a policy of gender equality to ensure gender Women’s Affairs and Rights (MCFDF) but Gender equality policy integration for sustainable development not yet endorsed by the Government and Parliament Reports from 1982 to 2008 completed; CEDAW Reports Measure the progress made in applying the CEDAW Report covering the period 2008–2014 under way Law on paternity, maternity Ensure equal rights for all children, including those born out Bill passed but not yet promulgated by and filiation of wedlock; make fathers take responsibility the Government Law on domestic working Bill passed but not yet promulgated by Ensure the rights of domestic workers conditions the executive Education Revision of textbooks Strategic action formulated by the Combat gender stereotypes conveyed by teaching materials (2013–2015) PSDH, not yet implemented Specific study and advocacy Strategic action formulated by the Keep girls from dropping out, and promote higher education campaign PSDH, not yet implemented

14 2013 MDG Report for Haiti Economic Participation Facilitate women’s economic activities in rural areas through Pilot program implemented in the Kredi fanm lakay (2012) microcredit municipality of Hinche Political Participation Ensure a minimum of 30% female representation in all Quota enshrined in the Constitution 30% gender quota (2012) elective and appointed positions in Government and public but as yet, no legal instrument for institutions systematically implementing it

Bottlenecks and Recommendations for Implementation of Policies and Programs Bottlenecks identified Recommendations Gender equality Non-promulgation of key laws relating to gender Promulgate the laws already passed by Parliament (responsible fatherhood, domestic work) No systematic deployment of gender focal point in all Reestablish a gender focal point in all ministries, with real decision- ministries, and extremely limited power of influence making power MCFDF has little power; limited human, technical and Strengthen the MCFDF financial capacities No systematic mainstreaming of gender in strategic Make gender equality a universal target for steering development and planning, programming and budgeting reducing poverty Education Operational Plan for education does not include any Develop an annex to the OP to include the matter of maintaining gender-sensitive provision parity and combating stereotypes Lapsed memorandum of understanding between MENFP Reactive agreements between the MENFP and the MCFDF and MCFD for the joint revision of textbooks rliament Lack of updated statistics and data, especially for the Organize regular surveys to enhance the statistical data, broken down university sector by gender Economic Participation No systematic consideration given to the issue of gender in Include provisions specific to economic participation and economic development policies entrepreneurship by women in future employment policy

Weak impact of microcredit policies Scale-up microcredit initiatives to the national level

Women’s lack of knowledge and training in Include in vocational training curricula courses on economy, entrepreneurship and business management entrepreneurship, and business management Political Participation Election law and law on political parties do not Initiate a debate in Parliament on creating legal tools requiring that the systematically and effectively meet the constitutional quota be met; provide sanctions for political parties if they fail to meet obligation of the 30% gender quota the 30% quota Majority electoral system not very favorable to the Start a national debate on the various types of electoral systems effective, consensual implementation of the gender quota Lack of interest of political parties in promoting female Develop economic incentives for political parties participation Lack of technical support for female candidates or women Set up mentoring for women candidates starting out in politics wanting to enter politics Lack of financing for women’s election campaigns Set up a basket fund to finance the campaigns of women candidates

Executive Summary 15 MDG 4 REDUCE CHILD MORTALITY OF CHILDREN UNDER-FIVE

ll indicators associated with reducing infant Vaccination of children - Percentage of children aged 12-23 Aand child mortality have improved over the past months fully vaccinated twenty years. The proportion of children dying before the age of five, or infant and child mortality, has drop- Key Port-de-Paix Under 35 NORD-OUEST ped 44% since 1990, faster in fact than the worldwide 35 to 45 40 Cap-Haïtien 45 to 55 NORD trend, and in 2012 represented 88 deaths per 1,000 55 to 65 60 Fort-Liberté NORD-EST live births. Despite this, the rate remains below ave- National capital Gonaïves 56 Department capital rage for Latin America and the Caribbean of 19 per Department boundary ARTIBONITE 44 1,000. While the infant (children under one year of Hinche 0210 040 CENTRE age) mortality rate has also declined since the 1990s, Kilometres 59 going from 109 to 59 deaths per 1,000 live births in

2012, mortality in newborns in their first month is up M ETRO AREA Jérémie 34 slightly and will make it difficult to reach the target by PORT-AU-PRINCE GRANDE-ANSE Miragoâne 2015. Acute respiratory infections (flu, pneumonia), 45 NIPPES OUEST OUTSIDE METRO 65 38 malnutrition, diarrhea and infectious gastroenteritis SUD SUD-EST 51 34 Jacmel are among the leading causes of death in children. Les Cayes

The proportion of one-year-old infants vaccinated 40 points against measles is also up, and was 65.1% in 2012. separate the mortality rate for children under 5 However, major disparities persist in vaccination co- whose mothers have an educational level equi- verage from one department to another, by birth order valent to secondary education from those whose and by mother’s educational level. Nationwide, only mothers have received no education. 45% of children aged 12 to 23 months have been fully vaccinated.

Summary of Sector Policies and Programs Measure Goals Current status Infant and child mortality National strategic plan on integral child Reduce mortality in children under age Implementation under way healthcare in Haiti (2013–2022) 5 by 50% Implementation under way: 1,500,000 Integrated support for childhood diseases Improve child health children covered by the PCIME strategy (PCIME) (since 1995) (according to UNICEF data) Rehabilitate healthcare centers Creation and enhancement of obstetric and to provide support for obstetric neonatal emergency care, basic (SONUB) 49 SONUBs rehabilitated complications, neonatal resuscitation and complete (SONUC) and neonatal distress

16 2013 MDG Report for Haiti Increase the number of institutional Project finalized in 2013; free services offered Manman ak timoun an sante births and access to healthcare for to 200,000 children under age 5 children under age 5 Guarantee access to national health Implementation under way; pilot project National social protection system: Konbit insurance that would cover child carried out in West and Northwestern solidarite healthcare in particular departments Vaccination Implementation under way; introduction Expanded vaccination program (PEV) Promote vaccination against of pentavalent vaccine in 2012 and anti- (2011–2015) vaccination-controllable diseases rotavirus vaccine in 2014

Bottlenecks and Recommendations for Implementation of Policies and Programs MDGs 4, 5 and 6 relating to the healthcare sector share several constraints that impede implementation of health policies and programs. Haiti’s healthcare system remains relatively weak, directly affecting advances in the struggle against infant-child mortality, maternal mortality and infectious diseases. These main challenges are summarized in the following table.

Bottlenecks identified Recommendations Improve the civil registration system Design studies of the causes of mortality among children under age five Lack of regular national health data and of mortality in women of reproductive age (RAMOS). Include an evaluation of the key indicators in each edition of the EMMUS

Lack of leadership, monitoring and follow-up among Ensure that Parliament passes the new MSPP organic law stakeholders by the Ministry of Public Health and Population (MSPP) Enhance the MSPP’s monitoring of all stakeholders Reform the status of healthcare personnel and their compensation system Improve the system of supervision of healthcare personnel Lack of qualified and mobile healthcare personnel Implement the national plan aimed at strengthening human resources in the healthcare sector Create healthcare centers in unserved rural areas and reinforce the first-tier healthcare institutions Omission of geographic disparities in access to care Strengthen the network of healthcare agents in order to make services and waiting times at healthcare centers available at the community level Redistribute the available resources (financial, equipment, human resources) Pass the bill to create the national health solidarity fund (FSNS) Give healthcare a larger portion of the national budget Dependence on international aid Distribute resources more evenly to the various programs and according to the healthcare priorities identified by the MSPP Avoid implementing top-down programs Strengthen communication and collaboration among the various MSPP offices Lack of collaboration within the various MSPP offices Implement initiatives to address common problems (e.g., high rate of neonatal mortality and low percentage of in-hospital births) Conduct an ongoing public awareness-raising campaign; strengthen health Lack of public awareness education in schools

Executive Summary 17 MDG 5 IMPROVE MATERNAL HEALTH

espite the various methodologies used and the Deliveries attended by skilled health personnel, Dsometimes differing estimates of the mater- by Department (2012) nal mortality rate, all the studies carried out show a significant improvement in this indicator since Key Port-de-Paix 18 to 20 NORD-OUEST 1990. According to the Ministry of Public Health and 21 to 30 26 Cap-Haïtien 31 to 50 NORD Population (MSPP), the maternal mortality rate was 51 to 64 79 Fort-Liberté NORD-EST 157 per 100,000 in 2013. This figure is probably not National capital Gonaïves 75.9 Department capital exhaustive, as it is based solely on reported deaths. Department boundary ARTIBONITE 69.8 In 2012, 37.3% of births were attended by skilled Hinche 0210 040 CENTRE health personnel, or 1.5 times more than in 2000, Kilometres 26 but with strong disparities in place of residence, edu- cation level, and economic situation among women. M ETRO AREA Jérémie 64 Although a majority of women continue to give birth PORT-AU-PRINCE GRANDE-ANSE Miragoâne unattended by skilled health personnel, 90% of them 18 NIPPES OUEST OUTSIDE METRO 28 28 have at least one medical visit during their pre- SUD SUD-EST 79.5 25 Jacmel gnancy, and 67% have at least four. Les Cayes

Access to family planning has also improved steadily since 2000. In 2012, 31% of women used a modern method of contraception, representing nearly 10 57% points higher than in 2000. The prevalence of contra- of 15-19 year old girls have unmet needs for family planning ception varies from a minimum of 15% among wo- men with no children to a maximum of 40% for those with more than three. In 2012, 35% of Haitian wo- men have unmet needs for family planning. The fertility rate among adolescents from 15 to 19 Fertility rate trend in adolescent females years of age is now estimated at 66% and has declined (per 1,000 live births) 100 only slightly since 1994. In Haiti as in the Latin Ame- rican and Caribbean countries, reproductive health 90 policies and programs have succeeded in reducing 86 80 fertility in partnered women but have not had a major 76 70 impact on the fertility of adolescents. Furthermore,

68 66 fertility varies greatly according to place of residence. 60 For adolescents living in camps after the 2010 earth- 1994 2000 2006 2012 quake, the rate reaches 107‰.

18 2013 MDG Report for Haiti Summary of Sector Policies and Programs Measure Goals Current status Réduire le taux de mortalité maternelle Plan directeur de santé (2012-2022) Mise en œuvre en cours de 50 % d’ici à 2022

Reduce the maternal mortality rate; National strategic plan for reproductive offer integrated reproductive health Implementation under way health and family planning (2013–2016) services to the entire population

Give the Haitian Government the inputs Global Program to Enhance Reproductive necessary for sexual and reproductive Implementation under way Health Commodity Security (GPRHCS) health and technical support

National Institute of Nurses and Midwives Train midwives First generation of midwives still in training

Rehabilitate healthcare centers to offer SONUB/SONUC 49 SONUBs rehabilitated emergency obstetric and neonatal care

Increase the number of institutional Free obstetric care Project finalized in 2013; free services offered births and access to healthcare for to some 71,000 pregnant women Manman ak timoun an sante children under age 5

Inform the population; ensure family National family planning campaign planning services in 90% of healthcare Implementation under way (launched in 2014) institutions; train staff

Guarantee access to national health National social protection system: insurance that would cover obstetric Project pilot conducted in western areas Konbit solidarite care in particular

Bottlenecks and Recommendations for Implementation of Policies and Programs Bottlenecks identified Recommendations Lack of harmonization of goals to be reached in Revise and harmonize goals when midway revisions are being made in reproductive health and family planning in national plans plans and strategies and strategies

Lack of funding for SONU rehabilitation Resource mobilization

Develop an approach to raise the awareness of citizens and members Criminalization of abortion of Parliament on the effects of illegal abortion, and propose legalization of medical abortion

Conduct studies on birthing knowledge, attitudes and practices in Cultural factors not considered in procedures associated Haiti, and reproductive health, particularly giving greater consideration with monitoring pregnancy and delivery to the role of community nurses

Midwives omitted from the repository of jobs and skills Review and update the REC (REC)

Multipurpose community healthcare agents not available Mobilize resources to set up 10,414 multipurpose community in sufficient numbers healthcare agents

Executive Summary 19 MDG 6 COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES

aiti has managed to stabilize the prevalence Hof HIV/AIDS, which was 2.2% over the last HIV prevalence in 15-24 years-old (%) six years for the entire population. However, major 1.6 1.5% 2006 2012 disparities in this disease exist between men and wo- 1.4 1.3% 1.2 men: for women aged 15–24, the prevalence is 1.3%, 1% 1 0.9% compared with 0.4% for men. Condom use also varies 0.8 0.6% greatly by gender, with 55.5% of women and 66.3% 0.6 0.4% of men aged 15–24 stating that they used a condom 0.4 at last high-risk sexual encounter. The proportion of 0.2

young people aged 15 to 24 with a comprehensive MenWomen Both correct knowledge of HIV/AIDS follows an inverse trend. In fact, the percentage of young women with In 2012 the incidence of tuberculosis cases was 213 a comprehensive correct knowledge of HIV/AIDS new infections per 100,000 inhabitants, with a pre- increased slightly, going from 32% in 2006 to 35% in valence of 296 infections per 100,000 inhabitants. 2012, while for men, it declined considerably, going Today, Haiti is on a list of high-prevalence countries from 41% to 28% for the same period. in the Americas, and the mortality rate for this disease was estimated at 25 per 100,000 in 2012. Moreover, Haiti increased coverage of the DOTS anti-tubercu- losis treatment from 55% to 80% between 2006 and 46% 2009. of women know that HIV could be transmitted through breastfeeding Ownership of insecticide-treated nets (ITN) Percentage of households with at least one ITN

Key Port-de-Paix 9 to 15 NORD-OUEST With regard to access to antiretroviral therapy, the 15 to 20 17 Cap-Haïtien 20 to 25 percentage of adults and children at an advanced stage NORD 25 to 37 19 Fort-Liberté NORD-EST of HIV infection under antiretroviral therapies went National capital Gonaïves 19 from 49% to 67.7% between 2006 and 2013, well be- Department capital Department boundary ARTIBONITE 9 low the MDG target of 100% to be reached by 2010. Hinche 0210 040 CENTRE Haiti and the Dominican Republic are the two Kilometres 14 countries in the Caribbean where malaria has not

been eradicated .Each year, malaria affects nearly M ETRO AREA Jérémie 25 500,000 people, or one in 20. Only 23% of children PORT-AU-PRINCE GRANDE-ANSE Miragoâne 18 NIPPES under age 5 sleep under a treated mosquito net, and OUEST OUTSIDE METRO 37 14 SUD SUD-EST among children under age 5 who have had a fever, 19 26 Jacmel 2.5% had taken an appropriate antimalarial drug, Les Cayes or half the number in 2006.

20 2013 MDG Report for Haiti Summary of Sector Policies and Programs Measure Goals Current status Reduce incidence and prevalence of HIV/AIDS by Health master plan 2012–2022 2022; reduce prevalence of tuberculosis by 25% Implementation under way by 2022 Reduce the proportion of new HIV infections by 50% by 2018; reduce the proportion of National Anti-HIV/AIDS Program – National seropositive infants born of mothers living with Implementation under way strategic multi-sector plan 2012–2015 HIV by at least 2% by the end of 2018; reduce the impact of discrimination and stigmatization of people living with the AIDS virus Make condoms available and accessible; promote 100% of transfused blood bags Prevention of HIV/AIDS transmission voluntary screening; improve transfusion safety have been tested for HIV/AIDS Strengthen and unify the national framework for Publication of a bulletin on HIV/ HIV/AIDS epidemic monitoring monitoring, follow-up and evaluation AIDS DOTS Strategy: increase in Detect 70% of estimated cases of pulmonary coverage from 55% to 80% National Anti-Tuberculosis Program – 2009– smear-positive TB 2015 Strategic Plan The number of cases detected is Successfully treat 85% of them increasing gradually and reached 76% in 2012

Bottlenecks and Recommendations for Implementation of Policies and Programs Bottlenecks identified Recommendations Have Parliament pass the new MSPP organic law; clearly redefine the Leadership not assigned to MSPP, and problems in roles of the NGOs, develop a framework for collaboration and technical coordinating the efforts of the various partners assistance Logistical problem in the supply of inputs (tests, drugs, Improve planning and coordination equipment) Lobbying to raise awareness among members of Parliament awareness Lack of a legal framework to protect infected people and of discrimination against people living with HIV/AIDS affected families (HIV/AIDS) Pass the prepared bill Provide a system for implementing this law Lack of programs supporting people living with HIV/AIDS Explore possible collaboration with existing social protection programs and TB so as to support people living with HIV/AIDS and TB Free healthcare services, especially for care associated with Make certain that this healthcare is provided free of charge HIV/AIDS and TB Lack of funds allocated to operational research Develop research programs in universities and medical schools

aiti has made remarkable progress in combating H VIH/AIDS over the last 10 years; however much remains to be done to improve prevention, access to care and support to people living with HIV/AIDS.

Executive Summary 21 MDG 7 ENSURE ENVIRONMENTAL SUSTAINABILITY

aiti’s progress on environmental issues remains Hvery uneven, and the country remains particular- ly vulnerable to natural disasters. Deforestation is still among the leading threats to the environment, with 16,000 ha hectares of forest planted the proportion of natural forests estimated at 2.6% since 1990 of the territory in 2010, compared with 5.5% in 1956. The significant increase in forest planting is not yet Haiti is facing the depletion of available water in both sufficient to reverse the trend, especially as 92.7% of quality and quantity, with 8.6% of total renewable Haitian households use wood or charcoal for cooking. water resources taken between 2003 and 2012. Despite the country’s rich biodiversity, with many Proportion of households using an improved source endemic species, more than 19% of all plant and of drinking water and sanitation infrastructure animal species are today threatened with extinction. Proportion of households using Proportion of households using improved source of drinking water improved sanitation infrastructure While access to water is increasing, with 64.8% of MDG water trajectory MDG sanitation trajectory 80 Haitian households having access to improved 72.7% 70 drinking water sources, access to sanitation services 64.8% 62.6% 67.8% 61.6% 60 has been stagnant since 1995 at around 25% of 50 households. 40 36.5% Taking the absence of at least one decent-housing 30 23.9% 25.7% criterion as the definition of slum,62% of urban 25.2% 20 16.5% population live in slums, as they do not have access 1995 2000 2005 2012 2015 to improved sanitation.

Summary of Sector Policies and Programs Measure Goals Current status Environment Determine the outline of the national environmental protection Plan in effect, expiring in Environmental Action Plan (PAE) policy 2014 Framework Decree for the Define nine priority action programs for managing the Reference document, but Environment (2006) environment difficulties in application National System of Protected Areas Develop and strengthen an effective and financially sustainable Project under way (SNAP) SNAP for effective protection of protected areas Program to Develop Rural Develop agricultural water infrastructure; protect ravines and Under way for 25 degraded Infrastructure riverbanks; manage watersheds watersheds Ensure sustainable development and reduce vulnerability in South Coast Initiative (ICS) Under way since 2011 the south Water and sanitation 300,000 beneficiaries in Consolidation of distribution systems Develop and rehabilitate the drinking-water system 2013

22 2013 MDG Report for Haiti Structure of data collection on water Improve the understanding of needs and users throughout the Initiative implemented in access and use country rural areas Sewage and wastewater treatment Develop a sanitation system throughout the country Five stations implemented Housing Currently being National Housing Policy Improve housing and develop a supply of housing units implemented Project 16/6 Rehouse the affected populations from six camps Project under way Upgrading of the Martissant and Urban development combining infrastructure social Projet en cours Baillergeau neighborhoods engineering and institutional support Promote controlled urban development; provide future Program to be Creation of sites and services residents basic services and technical assistance for building implemented soon housing Bottlenecks and Recommendations for Implementation of Policies and Programs Bottlenecks identified Recommendations Environment Lack of political will for making formative Support implementation of the January 2006 framework decree on environmental decisions institutionalization of the National Environmental Management System (SNGE); Little consideration given to the cross-cutting Include environmental policy in all sector policies; create a framework for aspect of environmental problems training in environmental issues Lack of capacities in the Ministry of the Equip the MdE with an organic law; make a political decision to distribute the Environment (MdE); responsibility of each institution Expiration of PAE 1999–2014 Formulate a new plan in concert with all social and economic sectors Reinforce the system for monitoring and generating scientific data; strengthen Poor environmental monitoring, especially in the National Observatory on the Environment and Vulnerabilities (ONEV); protected areas clarify responsibilities and coordination between ANAP and the Office of Environmental Inspection and Monitoring Operationalization of the Haitian Environmental Rehabilitation Fund (FREH) as Lack of lasting financing mechanisms called for in the framework decree of January 2006 Failure of policies to take into account links Implement public environmental policies based on the population’s rights and between environmental degradation and poverty needs Poor coordination among the various institutions Revive and strengthen the sector working group on the environment Water and sanitation Lack of political will for initiating a far-reaching Affirm the political will to achieve the goals for water and sanitation; give the water and sanitation policy DINEPA the technical and financial resources Lack of strategic policy in the sector Develop a national policy on water and sanitation Legal framework not geared to the rights of users Reform the legal framework by adopting a policy based on citizen rights to of public water and sanitation services access to public water and sanitation services Difficulty collecting payments from users; lack of Develop payment-collection capacities, especially through the deployment of qualified technicians trained technicians all over the country Housing Overlapping institutional mandates and non- Affirm and strengthen UCLBP leadership by ensuring that all concerned alignment with the sector policy implemented by institutions are working in the same direction the UCLBP Lack of national policy on urban development In consultation with all sectors, formulate a national policy on urban and land use planning development and land use planning Poor capacity of households to access mortgage Explore innovative funding and credit access mechanisms in concert with the loans private sector

Executive Summary 23 MDG 8 DEVELOP A GLOBAL PARTNERSHIP FOR DEVELOPMENT

fficial development assistance (ODA) in Haiti Haiti benefits frommany trade partnerships and Owent from $167 million in 1990 to $1.3 billion preferential agreements such as the Caribbean Com- in 2012, with a peak of $3 billion after the 2010 earth- munity and Common Market (CARICOM), the Eco- quake. In 2011, Haiti’s ODA represented 16% of the nomic Partnership Agreement (EPA) with the Euro- GDP. Data from the past five years show that only pean Union and the Hope legislation with the United 5% of ODA went to education, 9% to health, and States. 14% to other social sectors. There is an important gap Debt service is down significantly since the earth- between pledges and the payments actually received. quake and in 2012 represented 0.3% of the country’s Of more than 4 billion in promised donations in 2010, exports of goods and services. The country’s bor- only around 2.5 billion was collected. rowing conditions have improved, in particular thanks to the debt-easing initiatives granted by the main cre- ditors. While the number of telephone landlines and the ODA disbursement by sector, 2008-2012 average number of Internet users are among the lowest in the Programme assistance : 7.7% Not allocated / not speci ed : 0.3% region, with 0.49 lines per 100 and 10% of Haitians Production sectors: 3.9% using the Internet, in recent years mobile telephony Debt relief has become one of the most dynamic sectors in the Other social 20% sectors Administrative costs: 0.2% Haitian economy. 13.6% Economic infrastructure and services: 8.2% Multi- sector/cross-cutting: Education : 4.8% 4.2% Humanitarian aid 27.6% Health and population: 9.5% 6 million additional mobile telephone subscribers since 2000

Summary of Sector Policies and Programs Measure Goals Current status Official development assistance (ODA) Framework for coordination Set up an aid coordinating mechanism; CAED in place since 2012 under the aegis of the MPCE. of foreign aid to Haitian ensure that the aid aligns with national Joint aid effectiveness program with upgradable development (CAED) priorities guidelines for all approved partners Online External Aid Increase transparency; facilitate decision MGAE operational, single national tool for collecting Management System making on public investments and following up on outside investments (MGAE) Sector and thematic Promote planning of projects among Working groups established but do not systematically working groups ministries, donors and civil society achieve project consistency

24 2013 MDG Report for Haiti Market access Have preferential access to the US market for Most exports go to the United States but do not reach HOPE – USA textiles and clothing the authorized quotas Have duty-free access to exports of non- The share of Haitian exports going to Canada is low LDC – Canada agricultural products compared those going to the United States Have duty-free access to the markets of 27 APE – European Union This agreement is underexploited European countries

Bottlenecks and Recommendations for Implementation of Policies and Programs Bottlenecks identified Recommendations Official development assistance (ODA) Formalize donor commitments when the framework agreements are Varying degree of commitment by donors to provide data signed; disseminate the system for ranking data provided by donors; on aid develop other incentives for using MGAE data Lack of will among donors to finance the MGAE Develop collective funding until the system has been made permanent Poor appropriation of the CAED by donors and the Simplify the CAED’s operating mechanisms and determine the results Government expected; implement the guidelines (PCEA) Difficulty measuring the real impact of aid on the Develop tools for assessing qualitative impacts on recipients; improve recipients the system for monitoring and evaluating the Government’s programs Analyze donor presence by sector; suggest readjustments to the donor Donor fragmentation and concentration in certain sectors portfolio according to needs and performance Excessively slow disbursement by certain donors Support donor disbursement performance by harmonizing project associated with conditions and challenges involved in procedures and boosting the absorption capacities of State formulating and executing them counterparts Market access Outdated legal framework for business Update and strengthen legislation on trade and business law Formulate an industrial and trade policy in partnership with the Lack of a national industrial and trade policy chambers of commerce and the private sector Few benefits from trade agreements and preferential Strengthen competitiveness by promoting local production, measures developing infrastructure and reinforcing worker productivity Problem with land law and land registry; administrative Revitalize the national land registry office; institute a uniform difficulty in obtaining construction permits procedure for accessing construction permits Major dependence on the textile assembling sector Develop the potential of sectors with a comparative advantage Lack of inter-ministerial coordination Clarify each ministry’s scope; revise the organic laws New information and communication technologies (NICT) Lack of national policy on NICT Formulate a national NICT policy Update and unify the legal framework to meet current needs and align Weak legal framework; lack of regulation of the sector with current international agreements (WTO, CARICOM) Lack of measures to stimulate demand to make NICT more Develop easy-to-access technological tools, develop centralized access accessible technically and financially to remote public services Poor regulation of the sector, especially in combating Develop tools for the Government to regulate the sector monopolies Technological limitations; little capacity and few Strengthen public investment in NICT training qualifications in the NICT sector

Executive Summary 25 8 POST-2015 IN HAITI

ess than two years before the deadline for rea- universal access to education, all supported by a Lching the MDGs, the debate over priorities for unified, strong, and responsible State.” These regio- the post-2015 agenda is already under way. This new nal, economic, social and institutional reforms aim development program is the result of the 2010 top-le- at common goals of job creation, local and regional vel plenary meeting at the Annual Meeting on MDGs development, improvement in access to basic social and the Rio +20 Conference on development. On that services and social inclusion. occasion, it is necessary to raise new questions, par- The implementation of the PSDH is supported by sec- ticularly in regard to political, sociological and eco- tor planning documents, some of them already cove- nomic evolution, climate change, financial crises and ring the post-2015 period. The new policy on gender population dynamics that characterize the global en- equality will be accompanied by a six-year national vironment fifteen years after the launch of the MDGs. action plan covering the period from 2014 to 2020 The United Nations and its member States have (MDG 3). The national strategic plan on integral agreed to carry out an inclusive, participative process child healthcare covers the period from 2013 to 2022 to formulate the post-2015 agenda through national and is aimed at reducing mortality in infants under and worldwide consultations. Haiti has seized this age 5 (MDG 4). The Health Master Plan, which ex- opportunity to take part in the international debate tends from 2012 to 2022, is part of a dual approach to and to reiterate its commitment to reaching the MDGs reorganizing the national healthcare system and rea- so that Haitian priorities are taken into account in the ching the MDG relating to maternal health (MDG 5), new vision of development that will come from these whereas the policy on combating HIV/AIDS has just international discussions. been extended to 2018 (MDG 6). For the time being, the sectors associated with poverty reduction, educa- tion, combating TB, and the environment will not be Post-2015 in National Planning the subject of planning going beyond 2015–2016. As part of its national-planning process, Haiti is already identifying its development priorities for post-2015. The Haiti Strategic Development Plan Consultations on Post-2015 in Haiti (PSDH) covers the period from 2010 to 2030 and In Haiti, the consultation process was conducted lays out the country’s long-term vision, with the ob- according to an inclusive methodological approach jective to make Haiti an emerging country in fifteen through workshops bringing together all sectors and years through four major projects to radically reform individual interviews with sector specialists or reco- the nation. This Strategic Plan is intended to create “a gnized figures in Haiti. The objective was to achieve just society, with a modern economy, in which all an inclusive process ensuring ownership by the stake- of the population’s basic needs are met, especially holders of the forthcoming development agenda.

26 2013 MDG Report for Haiti The general aspirations expressed during this process • Make gender equality a goal in itself and a cross- are summarized below in terms of goals: sector theme to be mainstreamed in all sectors and public policies • Consolidate strategy and projects for poverty reduction • Ensure good governance, strengthen the rule of law and develop reporting mechanisms • Standardize the school system to ensure the right to an equal education MY WORLD is a • Improve physical and geographic access to heal- worldwide survey thcare centers offering everyone a chance to participate • Develop a policy for energy and access to basic in drafting the post-2015 agenda. This inclusive, participatory services process supports the various mechanisms for international dialog under way that should lead to new global development goals. • Develop a land use plan and an urban develop- In this sense, survey results will reflect the opinion of the most ment policy marginalized and be helpful in international decision making regarding the future development agenda. • Combat economic and social inequalities and In Haiti, the MY World survey has tallied up more than 4,000 geographic inequalities responses since the process was launched in 2013. In May 2014, • Ensure the inclusion of all population categories, the three sectors chosen as priorities by the voters are education, health and jobs. especially the more vulnerable groups and young A good education 3,335

people Better healthcare 2,933 • Continue and speed up efforts for sustainable Better job opportunities 2,640 management of the environment A ordable and nutritious food 1,993 Support for people who can’t work 1,758 • Implement an employment policy targeting A honest and responsive gouvernment 1,664

young people and meeting the needs of the pri- Protection against crime and violence 1,531

vate sector. Access to clean water and sanitation 1,516 • Institute public policies in support of the agricul- Better transport and roads 1,438 tural sector Protecting forests, rivers and oceans 1,015 Freedom from discrimination and persecution 840 • Respond adequately to new population dynamics Phone and Internet access 806 (demographics, migration) Equality between men and women 754

Reliable energy at home 749

Action taken on climate change 598

Political freedoms 550

5001,000 1,500 2,000 2,500 3,000 3,500 4,000

Executive Summary 27 RGPH EMMUS ECVMAS ECVMAS ECVMAS ECVMAS Sources

2015 Target Target

1

(2003) 24% 7.8% 30 % 24.7% 24.5% 44.9% 34.7% 11.4% (2012) Current indicators Baseline 27,5 % (1995) consumption (PPP) per day employment of age years of dietary consumption energy 1.1 Proportion of population below $1 (PPP)per day $1 (PPP)per day below of population 1.1 Proportion of GDP per person employed rate 1.4 Growth ratio 1.5 Employment-to-population 1.2 Poverty gap ratio 1.2 Poverty in national quintile of poorest 1.3 Share $1 people living below of employed 1.6 Proportion employment in total of own-account 1.7 Proportion in total family workers of contributing Proportion of underweight under-five children 1.8 Prevalence minimum level below of population 1.9 Proportion Data available for 2012, otherwise refer to the reference year. the reference 2012, otherwise to for refer available Data MDG Monitoring in Haiti MDG Monitoring poverty and hunger extreme Goal 1: Eradicate 1990 between 1A : Halve, Target and 2015, the proportion of is less than people whose income one dollar a day full and 1B : Achieve Target and employment productive including all, for work decent people and young women Target 1C : Halve, between 1990 between 1C : Halve, Target and 2015, the proportion of hunger from people who suffer 1

28 2013 MDG Report for Haiti IPU EVCH, MENFP EMMUS EMMUS ECVMAS 1 30 % 100% 100% 100% 0,93 1,08 4.3% 66.2% 85.1% 88% (2011) 0,01 0,99 (2000) 68% (2001) 2.7% (1995) 47% (1993) 32.3% (2000) primary education: in secondary education: - - last grade of primarylast grade sector non-agricultural parliament - - 2.1 Net enrolment ratio in primary ratio 2.1 Net enrolment education of pupils starting2.2 Proportion 1 who reach grade and men women of 15-24 year-olds, 2.3 Literacy rate in boys 3.1 Ratios to of girls in the employment in wage of women 3.2 Share in national women held by of seats 3.3 Proportion Goal 2: Achieve universal primary universal education Goal 2: Achieve 2015, by that, 2A : Ensure Target and everywhere, boys children complete will be able to alike, girls of primarya full course schooling women gender equality and empower Goal 3: Promote gender 3A : Eliminate Cible disparity in primary and secondary 2005, and by preferably education, no later of education in all levels than 2015

Executive Summary 29 MSPP MSPP EMMUS EMMUS EMMUS EMMUS EMMUS EMMUS EMMUS EMMUS, Sources

0 % 100% 100% 100% 2015 100 % 50,4‰ 36,4‰ Target Target

2 5 % 90% 67% 85% 157 31 % 35 % 35 % 88‰ 59‰ 66 ‰ (2013) (2013) 37,3 % (2012) Current indicators indicators

3% 22% 79% 25.8% (1990) (1990) (1987) 24,2 % 156.1‰ 109.1‰ Baseline 22% (2000) 44% (2000) 86‰ (2000) 40 % (2000) Condom: Modern method: method: Any least one visit: at visits: least four at - - - - - against measles personnel - - - - - 4.1 Under-five mortality4.1 Under-five rate mortality5.1 Maternal births) (per 100,000 live ratio birth5.4 Adolescent rate coverage care 5.5 Antenatal family planning 5.6 Unmet need for 4.2 Infant mortality rate immunized of 1 year-old4.3 Proportion children of births 5.2 Proportion skilled by health attended rate prevalence 5.3 Contraceptive Source: Ministry of Public Health and Population. To the extent that the MSPP is for the first time producing statistical data on maternal mortality, the figure remains limited and shows a significant difference with the annual difference a significant and shows remains limited the figure mortality, on maternal data statistical the first time producing the MSPP is for that the extent To MinistrySource: Health and Population. of Public of the 2013 MDG Report the MDG 5 chapter consult Haiti.. of the data, used and on the limitations details on the methodologies for more For WHO. the by produced estimates MDG Monitoring in Haiti MDG Monitoring child mortality 4: Reduce Target two-thirds, by 4A : Reduce Target 1990 and 2015, the between mortalityunder-five rate health maternal 5: Improve Target quarts, de trois 5A : Réduire Target 1990 et 2015, le taux de entre mortalité maternelle Target 5B : Rendre l’accès à la l’accès 5B : Rendre Target universel médecine procréative à 2015 d’ici 2

30 2013 MDG Report for Haiti OMS OMS PNLT MSPP- EMMUS EMMUS EMMUS EMMUS EMMUS EMMUS EMMUS

100% 100% 100% 100% 25 213 296 35% 23 % 0,9% 2,5 % 91.8% 67.7% (2013) 5.7 (2010) Men 66.3% 80% (2009) Women 55% Women

32% 49% 76.7% (2006) (2006) (2006) 1% (2005) 5 % (2006) 247 (1990) 376 (1990) 55% (2006)

cured under directly observed treatment short under directly observedcured treatment course years available for the 15–24 age bracket) for available correct knowledge of HIV/AIDS comprehensive of non-orphansattendance aged 10-14 years drugs antiretroviral to infection with access insecticide-treated bednets anti-malarial drugs with appropriate treated Mortality (per 100,000): tuberculosis due to rate 6.1 HIV prevalence among population aged 15-24 among population 6.1 HIV prevalence last high-risk (indicator sex use at 6.2 Condom with aged 15–24 years of population 6.3 Proportion school of orphans to 6.4 Ratio of school attendance HIV with advanced of population 6.5 Proportion 6.6 Incidence of malaria with malaria (per 100,000) associated rate Death under 5 sleeping of children 6.7 Proportion are who fever with 5 under children of Proportion 6.8 (per 100,000): 6.9 Incidence of tuberculosis (per 100,000): of tuberculosis Prevalence cases detected and of tuberculosis 6.10 Proportion Goal 6: Combat HIV/AIDS, malaria and other diseases Goal 6: Combat 2015 by halted 6A : Have Target of the spread reverse and begun to HIV/AIDS Target 6B : Achieve, by 2010, by 6B : Achieve, Target for treatment to access universal all those who need it HIV/AIDS for by halted 6C : Have Target the reverse 2015 and begun to of malaria and other incidence major diseases

Executive Summary 31 HDR HDR UNEP UNEP UNDP, UNDP, UNDP, CDIAC EMMUS V EMMUS V EMMUS V Sources UNEP, FAO UNEP,

Min. 62% 72.7% 62.6% 2015 Target Target

2012) (2010) and 4% 2.12 5.15 64.8% 25.7% 0.2121 (2012) Current 19% (2013) 6.2% (2014) 8.6% (2003- Between 2% Between indicators indicators 0.2138 (2010)

(1956) 5.5% 0.994 0.1395 0.2 (1990) 169 (1995) Baseline 36.5% (1995) 25.2% (1995) total (in millions of tons) total per capita (metric tons) per $ 1 GDP (PPP) (in kg) - - - total renewable resources) renewable total (hydro chlorofluorocarbons (HCFC),tons of chlorofluorocarbons in (hydro ODP) limits (% of territory)protected (% of all species) drinking-water source facilitysanitation - - - 7.5 Proportion of total water resources used (% of resources water of total 7.5 Proportion 7.1 Proportion of land area covered by forest by covered of land area 7.1 Proportion emissions 7.2 CO2 of ozone-depleting7.3 Consumption substances biological within safe of fish stocks 7.4 Proportion and marine areas of terrestrial 7.6 Proportion with extinction of species threatened 7.7 Proportion using an improved of population 7.8 Proportion using an improved of population 7.9 Proportion living in slums of urban7.10 Proportion population MDG Monitoring in Haiti MDG Monitoring a sustainable environment Goal 7: Ensure the principles 7A : Integrate Target of sustainable development countryinto policies and the loss and reverse programmes resources of environmental biodiversity 7B : Reduce Target 2010, a by achieving, loss, of reductionrate in the significant loss 2015, the by 7C : Halve, Target proportion of people without drinking safe to sustainable access and basic sanitation water 7D : By 2020, to Target a significant achieved have least of at in the lives improvement 100 million slum dwellers

32 2013 MDG Report for Haiti ITU ITU ITU WB HDR HDR DCD UNEP UNEP OECD OECD UNDP, UNDP, UNDP, CDIAC OECD/ ITC, WTO ITC, UNCTAD, UNCTAD, EMMUS V EMMUS V EMMUS V Sources UNEP, FAO UNEP,

Min. 62% 72.7% 62.6% 2015 Target Target

2012) (2010) (2013) 0.5 9.8 and 4% 2.12 5.15 59.4 16% 10% 64.8% 25.7% 0.2121 (2012) Current 1.3 billion 1% (2011) 19% (2013) 6.2% (2014) 0.3% (2013) 8.6% (2003- Between 2% Between indicators indicators 0.2138 (2010)

(1956) (1990) 5.5% 0.994 0.1395 0.8 (2000) 0.6 (2000) 0.2 (2000) 4% (1996) 0.2 (1990) 169 (1995) Baseline 17% (2009) 119% (1990) 167.4 million 36.5% (1995) 25.2% (1995) total (in millions of tons) total per capita (metric tons) per $ 1 GDP (PPP) (in kg) inhabitants - - - total renewable resources) renewable total (hydro chlorofluorocarbons (HCFC),tons of chlorofluorocarbons in (hydro ODP) limits (% of territory)protected (% of all species) drinking-water source facilitysanitation (in USD) countries basic social services to Haiti devoted to income national Haiti products and textiles from on agricultural trade capacitytrade and services - - - 7.5 Proportion of total water resources used (% of resources water of total 7.5 Proportion 7.1 Proportion of land area covered by forest by covered of land area 7.1 Proportion emissions 7.2 CO2 of ozone-depleting7.3 Consumption substances biological within safe of fish stocks 7.4 Proportion and marine areas of terrestrial 7.6 Proportion with extinction of species threatened 7.7 Proportion using an improved of population 7.8 Proportion using an improved of population 7.9 Proportion living in slums of urban7.10 Proportion population the least developed and to total 8.1 Net ODA, sector-allocable ODA bilateral, of total 8.2 Proportion of gross Haiti as percentage by received 8.3 ODA countries by developed imposed tariffs 8.5 Average 8.4 Proportion of Haiti’s exports duty-free admitted of Haiti’s 8.4 Proportion help build to provided ODA of Haiti’s 8.6 Proportion of exports8.7 Debt service, as percentage of goods 8.9 Number of land lines per 100 inhabitants a mobile phone service,8.10 Subscribers to per 100 8.11 Number of Internet users per 100 inhabitants MDG Monitoring in Haiti MDG Monitoring a sustainable environment Goal 7: Ensure the principles 7A : Integrate Target of sustainable development countryinto policies and the loss and reverse programmes resources of environmental biodiversity 7B : Reduce Target 2010, a by achieving, loss, of reductionrate in the significant loss 2015, the by 7C : Halve, Target proportion of people without drinking safe to sustainable access and basic sanitation water 7D : By 2020, to Target a significant achieved have least of at in the lives improvement 100 million slum dwellers partnership development 8: Establish a worldwide for Target further 8A : Develop an Target open, rule-based, predictable, non-discriminatory and trading financial system the special 8B : Address Target needs of the least developed countries the special 8C : Address Target needs of landlocked developing and small island countries States developing 8D : Deal comprehensively Target of with the debt problems through countries developing and international national make debt to in order measures sustainable in the long term Target 8F : In cooperation with 8F : In cooperation Target make available sector, the private technologies, the benefits of new and especially information communications

Executive Summary 33 Coordination of the MDG Report National Observatory on Poverty and Social Exclusion (ONPES) Ministry of Planning and Outside Cooperation (MPCE) United Nations Development Program (UNDP)

Partners Government of Haiti and National Institutions Ministry of Justice and Public Security (MJSP) Ministry of Planning and External Cooperation (MPCE) Ministry of Public Health and Population (MSPP) Ministry of Agriculture, National Resources and Natural Development (MARNDR) Ministry of Economics and Finance (MEF) Ministry of Women Affairs and Women’s Rights (MCFDF) Ministry of National Education and Vocational Training (MENFP) Ministry of the Environment (MdE) Ministry of Social Affairs and Labor (MAST) Ministry of Public Works, Transport and Communications (MTPTC) Ministry of Trade and Industry (MCI) Office of the Minister delegated to the Prime Minister in charge of Human Rights and Combating Extreme Poverty Office of the Secretariat of State for handicapped integration National Office of Potable Water and Sanitation (DINEPA) National Food Security Coordination (CNSA) National Observatory on the Environment (ONEV) National Pension Insurance Office (ONA) Haitian Institute of Statistics and Information Technology (IHSI) National Telecommunications Council (CONATEL) Coordination of Foreign Aid to Haitian Development (CAED) Bank of the Republic of Haiti (BRH) National Identification Office (ONI) Inter-ministerial Committee on Land Management (CIAT)

2013 MDG Report for Haiti United Nations System World Bank (WB) Office for the Coordination of Humanitarian Affairs (OCHA) United Nations Office for Project Support Services (UNOPS) United Nations Entity for Gender Equality and the Empowerment of Women (UN Women) International Monetary Fund (IMF) United Nations Children’s Fund (UNICEF) United Nations Population Fund (UNFPA) International Fund for Agricultural Development (IFAD) Global Fund to Fights AIDS, Tuberculosis and Malaria United Nations Office of the High Commissioner on Human Rights (UNHCHR) United Nations High Commissioner for Refugees (HCR) United Nations Mission for Stabilization in Haiti (MINUSTAH) United Nations Food and Agriculture Organization (FAO) United Nations Organization for Education, Science and Culture (UNESCO) International Labor Organization (ILO) International Organization for Migrations (IOM) World Health Organization (WHO) World Food Program (WFP) Joint United Nations Program on HIV/AIDS (UNAIDS) United Nations Environment Program (UNEP) United Nations Human Settlements Program (UN Habitat)

This report can be accessed on the Internet site of: - Ministry of Planning and External Cooperation (MPCE): www.mpce.gouv.ht - National Observatory on Poverty and Social Exclusion (ONPES): www.onpes-haiti.ht - United Nations Development Program (UNDP Haiti): www.ht.undp.org United Nations Development Programme

République d’Haïti