Data Forward Decision-Making to Eliminate Lymphatic Filariasis in Haiti

In 2021, Haiti’s Ministry of Public Health and Population (MSPP) alongside USAID’s Act to End Neglected Tropical Diseases | East (Act |East) program was at an inflection point. Increasing unrest and the COVID-19 pandemic caused extended delays in activities designed to eliminate lymphatic filariasis (LF). Haiti had made great strides in this effort, with only 18 of 140 communes remaining at risk of LF. In these remaining communes, LF prevalence remained at high levels despite years of intervention. Act | East, MSPP, and external partners chose to pivot by investing in a year of “data forward” activities. They focused on operations research, rigorously collected new population data, and assessed gender and social inclusion issues that might affect LF activities. This data was then collaboratively interpreted through a Pause and Reflect meeting, where the government and partners discussed evidence and suggested new adaptations to the LF elimination strategy. In 2022, Act | East implemented these adaptations and integrated new collaborating, learning and adapting (CLA) activities throughout the year to understand their efficacy. After action reviews, “data discovery” interpretation sessions, and secondary analyses of routine data were conducted to understand successes, challenges, and new adaptations that might be needed. To everyone’s excitement, adapted activities overcame some key challenges described in the initial “data forward” activities. New challenges were also identified and discussed alongside evidence-based adaptations for 2023.

As a result, the culture of the LF community in Haiti has become more collaborative. CLA activities, which may have seemed secondary before, have become critical touch points for improvement on Act | East. The investment in this work will be critical to one day eliminating LF in Haiti.