In Fiscal Year (FY) 2008, JSI will continue to support the United States Government (USG) country team to

improve health information systems, monitor and evaluate health programs and institute effective

programmatic decision making with the aid of quality data. While the principal emphasis of this activity will

be strengthening health management information systems (HMIS), other important emphasis areas include

support for monitoring and evaluation (M&E), and reporting for the President's Emergency Plan for AIDS

Relief (PEPFAR), and continued development and implementation of an USG reporting system for

community-based programs. The primary target populations include staff at the NACC and the MOH,

health care workers, and program managers within community based organizations (CBOs), faith-based

organizations (FBOs), non-governmental organizations (NGOs) and other PEPFAR implementing partners.

The scope of this support is national as the HMIS extends to all health districts while the community-based

activities are conducted in all provinces.

BACKGROUND: The implementing organization has supported M&E activities in Haiti since 2001. Building

on this experience, the implementing organization will work at the national level coordinating with a variety

of stakeholders such as the Ministry of Health (MOH), UCC (Unité Centrale de Coordination du Programme

de Lutte contre les IST/VIH/SIDA), the Global Fund to fight AIDS, Tuburculosis and Malaria (GFATM), and

PEPFAR implementing partners.

FY 2008 ACTIVITIES AND EXPECTED RESULTS:

Activity 1:Continued reinforcement of archiving and filing systems: The implementing organization will

continue to work closely with IHE to promote efficient archiving and storage of program source documents

and data. Support includes training in appropriate filing and archiving for medical facility staff and the

provision of file folders for storing records. The aim is to ensure continuity of HIV/AIDS care through careful

record keeping/management. In FY 2008 implementing partners (IP) will carry out the following activities:

(1) provide folders to simplify patient tracking and manage work flow; (2) train facility-based staff (doctors,

nurses, data managers, and clerical staff) in coding, filing, and archiving with special emphasis on

confidentiality and record keeping; and (3) conduct field visits in collaboration with IHE to oversee the use of

the folders. The collaboration with Institut Haitien de l'Enfance (IHE), a local NGO, is intended to ensure

sustainability of the activity as IHE becomes a resource for expertise in this important area. Continued

support for this activity is important to ensure adequate coverage as new treatment facilities commence

activities as part of scaling up efforts. There is continual need for training of new staff and refresher training

of existing staff at current program sites. As access to care increases, continued logistical support is

required to accommodate expanded patient rosters.

Activity 2: Development of a paper-based system for monitoring performance of non facility-based

interventions.

Activities in support of community level program information reporting for 2008 is a continuation of a

process begun in 2006. The community based activity reporting system began in 2007 (COP 2006) as a

USG implementing partner reporting system for PEPFAR indicators. Indicators were harmonized among

IPs and standardized forms and reports were created. Training will be conducted for community level staff

in 2007. In COP 2008 the emphasis will be on supervising and enabling the comprehensive roll-out of the

system to all USG implementing partners. Supportive supervision and mentoring will be provided to data

managers and decision makers at the community level to ensure appropriate evidence-based decision

making, use of data for program management, and reporting of quality data. In COP 2008 the implementing

organization proposes to harmonize the information system for community based activities with the Haitian

National AIDS Control Program and programs supported by other international donors (e.g. the Global

Fund, UNICEF). Additionally, the implementing organization proposes to conduct a formal evaluation of the

effectiveness of this novel process for implementing community based information systems. Funding for

this activity will be used for consensus building meetings, site visits, technical assistance visits by

international-based staff as well as salary support for full time in-country and international-based staff.

Activity 3: Data Demand and Information Utilization (DDIU)

There are four distinct steps in facilitating data demand and information use: (1) perform a DDIU

assessment; (2) use the information from Step 1 to identify and define strategic opportunities in terms of the

entry point of DDIU activity, beneficiaries, and stakeholders and anticipated results; (3) select the DDIU

tools and approaches that will be applied; and (4) document the impact of DDIU activities in terms of the

anticipated results from Step 2. These steps are budgeted and will be implemented in 2007. In 2008, the

implementing organization proposes to support the extension of the DDIU curricula to the level of the health

care facility/implementing site. In addition, the implementing organization proposes to identify needs for

secondary data analysis of PEPFAR program data and develop the capacity within local organizations to

conduct such analyses. Funding for this activity in 2008 will be designated for conducting regional trainings

for data use, conducting site visits, and evaluations of information needs at the organizational level and for

preparing guidelines for secondary data analysis of PEPFAR data. Support for in-country and international-

based salaries will also be required.

Activity 4: Strengthening the integration of HIV/AIDS HIS into the overall HIS.

This activity was suspended in FY 2006 due to a lack of support by the MOH and re-prioritization of needs

by USG. It is hoped that in accordance with a renewed emphasis on health information system

strengthening by the Office of the Global AIDS Coordinator (OGAC), this activity will have the necessary

support for revival in FY 2007. The COP 2007 proposes implementing a strategic plan to integrate

HIV/AIDS data into the overall HMIS in Haiti. USG support enables the HIS system to meet both short and

long term HIV/AIDS health information goals, including meeting the information needs of diverse

international donor organizations, including PEPFAR, GFATM, UNICEF, and the MOH, in a harmonized

system (the "Three Ones"). In FY 2007 the implementing organization planned to 1) ensure that the HIS

regularly reported quality HIV/AIDS data to PEPFAR and GFATM, 2) implement and monitor performance

of the patient referral system within the health care system; and 3) provide technical assistance to the 10

health departmental offices to strengthen their capacity to validate, analyze, and use data. In FY 2008, the

implementing organization proposes to follow-up on the work conducted in FY 2007 by: 1) monitoring the

quality of HIV/AIDS data in the Regional Health Information System (RHIS) and intervening appropriately

where poor quality is found, 2) continue to support the MOH to collect, synthesize and disseminate RHIS

data (via targeted TA and supportive supervision), 3) promote the appropriate use of HIV/AIDS data by

policy makers (through targeted TA and data use workshops) and, 4) work with USG to integrate existing

HIV/AIDS reporting systems (e.g. MESI) into the national HMIS.

Activity 5: General HMIS Strengthening

The development and strengthening of facility-based health information system (HIS) is a full part of the

Activity Narrative: strategic information plan. The USG will assist Haiti in building a sustainable HIS that will permit generation

of necessary information for rational decision making at each level of the health system, from the facility to

national and international donor levels in concurrence with a national or regional HIS. Towards

accomplishing this, MEASURE Evaluation will carry out the following in FY 2008: 1) Assist the MOH to

strengthen the capacity at the National Health Information System Service through focused technical

assistance, in an effort to better coordinate all aspects of the HMIS in Haiti. Technical assistance will

consist of database development and management, data analysis, monitoring and evaluation, and

reporting; 2) Assist the MOH in the elaboration of the Haiti Annual Report (annual activity); 3) Organize

workshops on data review, use and dissemination (including department newsletters, feedback reports), to

enhance data evidence based decision making (refresher training for existing staff, orientation for new

staff); 4) Organize training sessions for facility personnel on how to fill out the data collection forms (e.g.

registers, monthly report form) and refresher training for existing staff, and orientation for new staff; 5)

Facilitate participation of selected MOH personnel to relevant international short term trainings.

, Expected Results: These activities are not expected to contribute directly to PEPFAR's 2-7-10 goals.

Rather the objective is to support the USG/SI team to ensure that all data required todemonstrate results in

Haiti are available and are good quality such that they support sound management of PEPFAR resources.

EMPHASIS AREAS:

Strategic information: HMIS, HIV surveillance

TARGETS:

Number of local organizations provided with technical assistance for strategic information activities: 50

Number of individuals trained in strategic information: 200.

COVERAGE AREAS: national