USAID will continue to support Partners in Health to improve linkages and referrals to community and clinical services on both sides of the Dominican and Haitian Border. This mechanism contributes to achieving Goal Area 3: Promotion and Prevention; and Goal Area 4: Integrated Care and Treatment. This mechanism supports work being conducted in the province of Elias Pina with referrals to the regional hospital in San Juan de la Maguana. Partners in Health will complement our support from other sources in order to conduct work in the Central Plateau of Haiti. Rather than implementing parallel programs, Partners in Health will work in close coordination with the government run primary healthcare clinics, municipal hospitals, the provincial hospital, and the regional hospital in order to become more cost effective over time and to ensure sustainability. The project is providing technical assistance to the provincial and municipal hospitals while simultaneously expanding the reach of these hospitals into the communities in order to strengthen HIV prevention, care, and treatment. Partners in Health has an approved Performance Management Plan and will report indicators through the GODR Single Unified Monitoring and Evaluation System. Because of the need to travel to manage multiple local organizations, the project will soon purchase a vehicle.

The project works in coordination with the provincial hospital, municipal hospitals, and primary healthcare clinics in order to strengthen the clinical care component of the project. Furthermore, leveraging the linkages to the community, the project is also implementing community approaches to HIV care and support. A particular target of the care program will be mobile populations. Partner in Healths reach across the border will ensure improved follow-up with patients that frequently move back and forth across the border. Partners in Health will provide active supervision in both facilities and the communities to in order to optimize the quality of care.

The project is in alignment with both the national HIV plan which identifies mobile populations as a vulnerable group and the national TB plan which is looking to strengthen the bi-national component of its strategy. Partners in Health has been impressive in their capacity to screen persons with HIV for TB and enroll those identified as positive on treatment reaching 100% in both components. Partners in Health will continue to employ PITC in order to continue this progress. Partner in Healths reach across the border will ensure improved follow-up with patients that frequently move back and forth across the border. Partners in Health will provide active supervision in both facilities and the communities to in order to optimize the quality of care.

The pediatric care component of the project will focus on providing a continuum of care, with a specific emphasis on children transitioning into adolescence. The project works in coordination with the provincial hospital, municipal hospitals, and primary healthcare clinics in order to strengthen the clinical care component of the project. Furthermore, leveraging the linkages to the community, the project is also implementing community approaches to HIV care and support. Partner in Healths reach across the border will ensure improved follow-up with patients that frequently move back and forth across the border. Partners in Health will provide active supervision in both facilities and the communities to in order to optimize the quality of care.

The project is supporting the implementation of PITC in the clinical context, specifically the integrating HIV testing with MCH and TB services. Furthermore, efforts at the community level increasing demand for HIV testing and counseling as well as being complemented by outreach testing and counseling. Populations being specifically targeted include sex workers and their clients and mobile populations, which are particularly vulnerable to HIV infection along the border region. The project reached 2,300 women in 2011 and will reach 2,490 persons with testing and counseling 1,967 will be women. The project will train 10 people in HIV testing and counseling in order to expand the reach of testing and counseling. The project will leverage linkages to the community and clinical settings in order to provide effective referrals to prevention, care, and treatment programs. The project works in coordination with the provincial hospital, the provincial health directorate (the steward at the local level), and the regional health directorate (responsible for service provision in the region) to strengthen routine collection of data and monitoring quality. Furthermore, the project actively supervises its own community health workers to optimize the quality and robustness of prevention activities.

The populations targeted under this project will be sex workers, clients of sex workers, and mobile populations. Due to the unique dynamic of the border region, all three of these groups are particularly vulnerable to HIV infection and are being targeted with a comprehensive package of prevention services. The project works in coordination with the provincial hospital, the provincial health directorate (the steward at the local level), and the regional health directorate (responsible for service provision in the region) to strengthen routine collection of data and monitoring quality. Furthermore, the project actively supervises its own community health workers to optimize the quality and robustness of prevention activities. The prevention activities will leverage linkages to other community and clinical care and treatment programs in order to provide a more comprehensive package of services.

The PMTCT component focuses on preventing vertical transmission of HIV in the Elias Pina province. The program is strengthened by its cross border reach which ensures continuity of care for persons traveling back and forth across the border. The project aims to reach 920 women with HIV testing and counseling and provide ARVs for 8 women. Partners in Health will work closely with the government run primary health care clinics, municipal hospitals, provincial hospital, and regional hospital in order to improve the quality of care provided. Leveraging Partner in Healths reach into the community, the PMTCT component will be linked to community care and prevention programs. The project will actively monitor PMTCT participation by comparing hospital records to documentation collected by community health workers in order to ensure optimal adherence.

The project works in coordination with the provincial hospital, municipal hospitals, and primary healthcare clinics in order to strengthen the clinical treatment component of the project. Mobile populations are a particular target population of the project. Partner in Healths reach across the border will ensure improved follow-up with patients that frequently move back and forth across the border. Partners in Health will provide active supervision in order to optimize the quality of care. The project will focus on transitioning technical capacity to the Ministry for providing HIV treatment.

The pediatric treatment component of the project will focus on improving child survival, managing co-infections with common under-five diseases, as well as managing the onset of puberty. The project works in coordination with the provincial hospital, municipal hospitals, and primary healthcare clinics in order to strengthen the clinical treatment component of the project. Partner in Healths reach across the border will ensure improved follow-up with patients that frequently move back and forth across the border. Partners in Health will provide active supervision in order to optimize the quality of care.