In general, sanitation facilities in Haiti are among the poorest in Latin America. Haiti lacks water in both quantity and quality, with only 46% of the urban population having access to safe water in 2000. City sewerage systems are inadequate and business and residential areas often make use of septic tanks. In 2000, only 28% of Haiti's population had access to adequate sanitation.
The number of physicians increased from 412 in 1972, to 887 in 1988, to 5,287 in 2000, when there were 1,957 registered nurses and 581 dentists. As of 1999, there were an estimated 0.2 physicians and 0.7 hospital beds per 1,000 people. Half the doctors are in Port-au-Prince and a fourth are in other principal towns, leaving a minimum of medical services for the rural population. In 1999, the government entered into an agreement with Cuba under which 120 Haitians are studying medicine in Cuba, while 500 Cuban health care professionals provide services to Haitians.
Malaria and yaws have been combated by the World Health Organization, while other health programs have been conducted by the Rockefeller Foundation and the American Sanitary Mission. Tuberculosis has long been a serious health problem; in 1999, there were about 361 reported cases of tuberculosis per 100,000 inhabitants. Malnutrition and gastrointestinal diseases are responsible for more than half of all deaths. Children may receive vaccinations, but the statistics are very low. As of 1995, Haiti's government did not pay for routine vaccines. In 1997, children up to one year old were vaccinated against tuberculosis, 40%; diphtheria, pertussis, and tetanus, 35%; polio, 32%; and measles, 30%. Goiter was present in 12.4% of school-age children in 1996. Some 27% of children were underweight between 1989 and 1995. In the early 1980s, Haitians were named among the groups that had high risk factors for contracting acquired immune deficiency syndrome (AIDS), but as of late 1987, it had not been ascertained what those risk factors are. Haiti has one of the highest HIV infection rates in the Americas. As of 1999, the number of people living with HIV/AIDS was estimated at 210,000 and deaths from AIDS that year were estimated at 23,000. HIV prevalence was 7.7 per 100 adults.
The fertility rate has declined from 6.3 in 1960 to 4.3 children per woman in 2000. An estimated 15% of all births in 1999 were considered low birth weight. Haiti has the highest maternal mortality rate in the Americas, with 525 maternal deaths per 1,000 live births occurring in 1998. The infant mortality rate fell from 182 per 1,000 live births in 1960 to 73 in 2000 and the general mortality rate was estimated at 14.8 per 1,000 in 2002. During 2000, the average life expectancy was 53 years. The birth rate was an estimated 31.4 per 1,000 people in 2002. As of 2000, 28% of women (ages 15 to 49) used some form of contraception. In 1993, still less than half the population (45%) had access to health care services. As of 1999, total health care expenditure was estimated at 4.2% of GDP.