Haiti continues to face multiple crises, including worsening food insecurity and malnutrition, the Haitian-Dominican migration situation, water-borne disease epidemics and high vulnerability to natural disasters. The situation further deteriorated in 2019 due to the unstable and fragile economic, political and social contexts and recurring civil unrest, which culminated in a countrywide shutdown in September that may lead to increasing needs in 2020. An estimated 3.7 million Haitians are food insecure and over 65,500 children under 5 years are affected by acute malnutrition. More than 850,000 vulnerable people require access to primary health care, including maternal and child health services. With an estimated 10,000 Haitians denied entry to and deported from the Dominican Republic every month, the Haitian-Dominican migration situation remains a concern. Given their legal and social status, children who have been denied entry or expelled may not be able to access services and are vulnerable to violence and exploitation. The cholera epidemic is on the decline, with no confirmed cases since February 2019, and an 80 per cent decrease in suspected cases since 2018. However, continuous progress is required to maintain zero cases, declare the complete elimination of cholera and hand cholera prevention and control over to the Government.
In 2020, UNICEF will strengthen national capacities to manage acute malnutrition, improve infant and young child feeding and prevent micronutrient deficiencies among children in Haiti. UNICEF will continue to support the Government's Plan for Cholera Elimination 2013–2022 through a revised response strategy focused on surveillance and coordination, water, sanitation and hygiene (WASH) prevention and rapid response to diarrhoea cases. Humanitarian WASH activities will include the distribution of household water treatment products, hygiene promotion, water trucking and temporary sanitation. Protection assistance will be provided to children suffering from abuse, exploitation and family separation due to natural disasters, insecurity and/or migration. Schools will be adequately equipped and alternative learning programmes will target migrant children returning to Haiti. UNICEF will maintain contingency agreements with several partners and stocks of pre-positioned supplies to respond to humanitarian situations as they arise. UNICEF will support the Government to strengthen humanitarian coordination and disaster preparedness and response, focusing on mainstreaming climate change adaptation. To enhance efforts to prevent sexual exploitation and abuse, UNICEF will strengthen systems for reporting, as well as survivor assistance, accountability to affected populations and capacity building of staff and partners, focusing on emergency preparedness.