Haiti has a long history of instability and is currently in economic decline. It has been ranked by the United Nations as the poorest country in the Western Hemisphere. The United Nations Development Program estimates that nearly 54 percent of Haitians live on less than $2 per day and more than 45% of the total population lives under $1.25 per day.
Human resources for health services are very limited, with 1 doctor and 5.5 nurses or nurse auxiliaries for every 12,000 people. In rural Crochu, Haiti, when Medical Teams International arrived in 2013, only 7% of births were attended by a skilled birth attendant, compared to 99% in the US. Government expenditures on health care account for only 4.5% of the government’s overall budget, and 79% of health expenditures are out-of-pocket.
Underlying factors of Haiti's recent cholera epidemic include 74.3% of the population without adequate sanitation, 35% without potable water and 46% without access to health care.