Universal health coverage of five essential health services in mothers before and after the Haiti 2010 earthquake: a retrospective cohort study using difference-in-difference

Background: In January 2010, Haiti was hit by a 7.0-magnitude earthquake. The impact of the earthquake on Universal Health Coverage in mothers remains unclear. This study explores the association between the 2010 Haiti earthquake and access to the five quality essential health services among women who gave birth in the two years before and after the earthquake. Methods From the Sixth Demographic and Health Survey in Haiti, we extracted data for women aged 15–49 who had reported a live birth in the two years before and after the 2010 Haiti earthquake. We used difference-in-difference analyses for antenatal care, delivery care, and vaccination and multivariate logistic regression analyses for family planning and malaria prevention to assess the impact of the acute physical damage of the earthquake on these mothers’ access to quality essential health services. Results Mothers who had not suffered acute physical damage were more likely to live in rural areas and had less education and household wealth. The difference-in-difference and multivariate logistic regression analyses did not show strong evidence of any significant association between acute physical damage and access to quality health services. However, after the earthquake, access to quality health services deteriorated for both mothers with and without acute physical damage (-5.6% and − 6.2% for antenatal care, -6.5% and 0% for delivery care, and − 9.5% and − 13.1% for vaccination, respectively). Conclusions The earthquake adversely affected mothers’ access to quality essential health services regardless of their exposure to acute physical damage. Mothers in rural areas who avoided such damage might also have experienced long-term negative effects from the earthquake, which was likely exacerbated by other structural factors such as lower education and economic status.