In Haiti in 2010, many agencies engaged in the emergency response to the earthquake struggled to adapt to the urban context. Shelter programs struggled to deal with complex situations related to rubble removal, perceptions of land tenure, and lack of space and hundreds of thousands of households were housed in camps, many for up to five years, where they were unable to adequately start the recovery process and rebuild their lives and livelihoods. A study conducted by John Hopkins found that households that were able to return quickly to their neighbourhoods benefitted from greater economic and food security and were ready to start the recovery process sooner.
In the wake of the earthquake, PCI Global, with funding from USAID, developed draft guidelines for the Neighborhood Approach, to meet the need for a more integrated, holistic, and inclusive approach to humanitarian programming. However, despite an emerging consensus among humanitarian actors on the importance of taking a settlements approach to humanitarian assistance, its application has been limited and inconsistent.