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Retrospective estimation of crude mortality in Cité Soleil, Port-au-Prince, Haiti

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A survey estimating retrospective mortality, exposure to violence, and use of basic and obstetric healthcare was conducted between 25 July and 24 August 2023 in Cité Soleil, Port-au-Prince, Haiti. The study took place during the truce negotiated between the rival groups. All group leaders were sensitised, and their agreement was obtained to conduct the survey.

  • The recall period took place between July 7, 2022 and the starting day of the survey;
  • Stratification of the Cité Soleil commune into 2 zones (North and South);
  • Simple random sampling based on the list of GPS coordinates of all Cité Soleil dwellings;
  • 1,357 GPS points studied, 8,202 individuals included from 1,669 households;
  • 176 deaths were reported in a little over a year;
  • Cité Soleil: Crude mortality rate = 0.63 deaths per 10,000 / day [CI95% : 0.54 - 0.73]; crude mortality rate higher in the South zone (0.78 deaths per 10,000 / day [CI95% : 0.64 - 0.94]) than the North zone (0.47 deaths per 10,000 / day [CI95% : 0.37 - 0.60]);
  • Violent deaths accounted for 40.9 per cent of deaths. 57.7 per cent of deaths in the South zone;
  • Residents of the South zone are highly exposed to various forms of violence: 44 percent of sample members have been victims of at least 1 type of violence (against property against people, violent death).
  • 59.3 per cent of deliveries took place at home and 29.8% with complications
  • Self-medication by 48.1 per cent of sick participants in the first half of 2023
  • Diarrheal diseases (and/or cholera) constantly cited as causes of non-violent death and illness.

These results show an extreme level of violence, reflected as much in mortality from violent causes as in direct exposure to violence. Comparison with the latest DHS survey in 2016 highlights a strong excess of mortality, largely due to violence (5-fold increase). The extrapolation of mortality figures for Cité Soleil can be compared with the figures published in the media over the summer: here again, reported mortality is vastly underestimated (~2,327 'violent' deaths for Cité Soleil alone over one year versus 2,400 for all of Haiti over the first 6 months of 2023).

Finally, the survey carried out by MSF in 2007 in the same area and using very comparable tools provides a good point of comparison: while the level of exposure of people to violence (of all types) that we report is slightly lower (54 per cent in 2007 vs. 44 per cent in 2022-2023), the mortality figures are nevertheless higher in our survey (0.4/10000/d in 2007 vs. 0.63 in 2022-2023). 

Retrospective estimate of crude mortality and the level of violence suffered by the population of Cité Soleil, Port-au-Prince, Haiti, between July 2022 and August 2023 pdf — 6.08 MB Download
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