PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2008 2009
SUMMARY :
I-TECH will continue to subcontract with the Institut Haitien de Santé Communautaire (INHSAC) and the
François-Xavier Bagnoud Center, UMDNJ (FXB) to develop curricula, clinician support tools and job aids,
and provide training in PMTCT for 200 health workers in Haiti. I-TECH and INHSAC will maintain
collaboration with HIVQUAL to continue to provide leadership on supervision and quality improvement of
PMTCT services, in partnership with the principle service delivery networks in Haiti (MSPP, CRS/AIDS
Relief, GHESKIO, PIH/ZL, and MSH). The Emphasis areas include the following: addressing male norms
and behavior, child survival activities, family planning and safe motherhood. The primary target populations
are as follows: physicians, nurses, auxiliary nurses, community agents including traditional birth attendants,
and trainers from the five national nursing schools and the school of midwifery. Coverage areas of these
activities include all geographic regions receiving PEPFAR support for PMTCT services.
BACKGROUND:
INHSAC is a Haitian non-governmental organization established in 1985 to provide post-graduate training in
public health issues for health care workers (HCW). Under COP06, INHSAC was funded through partner
JHPIEGO to provide initial training in PMTCT for 200 providers from 26 clinic sites. Principle partners in this
effort were Ministry of Health (MSPP) Division of Human Resources (DDRH), MSPP departmental directors,
MSH and CRS/AIDS Relief. Under COP07, INHSAC was funded through I-TECH to provide the 2-week
PMTCT course including a one-week practicum to 55 health care workers from approximately 15 new
VCT/PMTCT/palliative care scale-up sites throughout Haiti. Training participants included physicians,
nurses, and auxiliary nurses from these sites. I-TECH assisted INHSAC to improve the existing curriculum
by adding a practical focus on lessons learned from successful interventions in Haiti including updated
material on infant feeding.
In 2007-08, I-TECH and INHSAC collaborated with HIVQUAL to initiate a quality improvement process
involving key PMTCT delivery sites in Haiti. This process follows the "breakthrough collaborative" model
pioneered by the Institute for Healthcare Improvement (IHI). I-TECH sponsored and facilitated meetings of
the Haiti PMTCT "breakthrough collaborative" to find new ways to address old problems and to share best
practices. The process is one of organizational self-study and learning, where I-TECH and INHSAC
convene leaders from the service networks to learn about the quality improvement (QI) framework, set QI
aims, establish measures to track progress, and select interventions. With coaching from I-TECH
facilitators and their "breakthrough collaborative" peers, the leaders will test the interventions within their
networks through Plan-Do-Study-Act QI cycles, document results, and scale-up successful interventions.
ACTIVITY 1: INHSAC will train 200 HCW in PMTCT by delivering 10 two-week sessions including a one-
week practicum at Hôpital Charles Colimon in Petite Rivière de l'Artibonite. INHSAC will collaborate with I-
TECH and the MOH to prepare the PMTCT curriculum and convene stakeholders for review to validate it as
the national standardized PMTCT curriculum for Haiti.
ACTIVITY 2: INHSAC, with the support of I-TECH, will utilize JHPIEGO resources and partner with the
Ministry of Health to develop a training module on PMTCT for traditional birth attendants (TBA) to be
included in the TBA training package. I-TECH will provide technical assistance on curriculum development,
including instructional design, document production, pilot evaluation, and clinical review. A TOT will be
implemented for 60 nurses and auxiliary nurses who will be responsible to train and supervise the TBA.
ACTIVITY 3: INHSAC will partner with the MOH and other stakeholders to develop a training module on
PMTCT for community health workers (CHW) supporting HIV-infected pregnant women enrolled in PMTCT
programs. The training module will be included in the CHW training package, and a TOT will be
implemented for 50 trainers responsible for the training of CHW involved in PMTCT services. I-TECH will
provide technical assistance on curriculum development, including instructional design, document
production, pilot evaluation, and clinical review.
ACTIVITY 4: FXB will work with two representative PMTCT sites to determine priorities for development of
job aids and support tools to enhance the implementation of national guidelines and to integrate and
coordinate the care of women with care for their infants. Because of the high rate of lost-to-follow up of
infants born to HIV-infected women, an emphasis will be placed on developing tools to support the referral,
follow-up, monitoring and care of these infants. FXB Center staff will then develop and adapt support tools,
potentially including flipcharts on counseling and testing for PMTCT, wall charts of key steps in PMTCT,
algorithms of comprehensive PMTCT services, and pocket cards on antiretroviral drug dosing for mothers
and infants, counseling guidelines on infant feeding, and wall charts on safer delivery practices. These tools
will be tailored to the Haitian clinical setting in accordance with the national guidelines. Draft tools will be
reviewed by the PMTCT working group and the MOH and revised accordingly. This activity will increase the
capacity of physicians, nurses, and counselors to implement and adhere to the national PMTCT guidelines
as the provision of PMTCT services expands throughout the country.
ACTIVITY 5: INHSAC and I-TECH in close collaboration with COAG/MOH will continue implementation of
the Initiative for Improving PMTCT Program Performance in Haiti, a component of the national HIVQUAL
project focused on quality improvement of the national HIV program. Also known as the "breakthrough
collaborative" model pioneered by the Institute for Healthcare Improvement (IHI), INHSAC and I-TECH will
continue to facilitate Collaborative meetings for the teams representing HIVQUAL sites with a PMTCT
program. At each meeting, participants will share their experiences over the past several months in testing
quality improvement strategies, and share their learning about which interventions worked and which
interventions failed. I-TECH will provide a quality improvement specialist who will provide skilled facilitation
as participants analyze the experiences and make decisions about what to do next to reach quality
improvement aims. I-TECH and INHSAC will also assist the participants document their progress in relation
to their established quality measures, and to disseminate information on the results of the process. Ten
PMTCT HIVQUAL sites will participate in the initiative in 2009-2010.
New/Continuing Activity: Continuing Activity
Continuing Activity: 17228
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
17228 9725.08 HHS/Health University of 7698 3142.08 ITECH $300,000
Resources Washington
Services
Administration
9725 9725.07 HHS/Health University of 5151 3142.07 ITECH $250,000
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Reducing violence and coercion
Health-related Wraparound Programs
* Child Survival Activities
* Family Planning
* Safe Motherhood
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
SUMMARY:
I-TECH will continue to develop and update a training package of palliative care, home-based care (HBC),
nutrition services, as well as management and leadership of community-based AIDS Service Organizations
(ASOs). I-TECH will collaborate with the non-governmental training center, Institut Haitien de Santé
Communautaire (INHSAC), to provide training and technical assistance for institutional development of
ASOs in all departments in Haiti.
Since 2004, I-TECH has supported INHSAC to develop an integrated HIV counseling curriculum. I-TECH
has produced a video drama on anti-retroviral therapy (ART) adherence issues (Chans), in partnership with
a local video production company (Agence des Jeunes Producteurs) formed and staffed by people living
with HIV/AIDS (PLWHAs). In 2007, in collaboration with local experts from several partner training
institutions, I-TECH developed and included a module on psychosocial support, case management, and
adherence support strategies within the national the national curriculum on anti-retroviral (ARV)
drugs/opportunistic infections (OI). During 2007-08, I-TECH developed and added modules on nutrition and
palliative care for Version 2 of the national ARV/OI curriculum.
In 2008, INHSAC created a standardized training package on Community Based Care (CBC), for personnel
from ASOs and other community-based organizations (CBOs) in each department. The curriculum
emphasized linkages between clinical and community services for PLWHAs. The training also highlighted
the importance of establishing community service delivery points in which services such as nutrition,
support for transportation fees for medical visits, medication (not covered by the national HIV/AIDS
program), psychosocial support, and scholarships for the HIV-infected or affected children are provided.
The curriculum also highlights the importance of linkages with already existing community organizations
providing complementary services such as clean water, insecticide-treated bed nets, and income generating
activities.
ACTIVITY 1: In 2009, INHSAC will train 150 people delivering community services to PLWHAs on CBC in
six, one-week training sessions. The training will utilize the standardized training package on CBC and
continue to emphasize linkages between local initiatives in a variety of sectors (microfinance, nutrition,
agricultural development, etc) and patient support initiatives. These initiatives are capable of building
programmatic expertise in HIV/AIDS issues across these local networks and advocating for PLWHAs. I-
TECH will provide technical assistance (TA) on curriculum development, including instructional design,
documentation production, and pilot evaluation. This initiative will support HIV/AIDS program expertise
amongst community advocates in other sectors and will support leadership by and advocacy on behalf of
PLWHAs.
ACTIVITY 2: INHSAC will implement supportive supervision sessions for CBC. This activity will examine the
core services provided by the community service delivery points (home visits, referral system, etc) and the
efficiency of this linkage with other ASOs. This activity will involve training a group of approximately 30
trainees in CBC (three per geographic department) who demonstrated excellence and leadership during the
standard training. There will be at least one PLWHA in each group. INHSAC, with the support of I-TECH,
will develop standardized supervision tools to be used during supportive supervision sessions. Following
training as supervisors, these personnel will visit community service delivery points and any other CBOs
that provides services to PLWHAs. They will observe their peers in practice, provide supportive feedback,
and report to INHSAC on their findings using standardized forms. Prior to including candidates in the
supportive supervision training, INHSAC will coordinate with employers to release the relevant personnel for
one-week per quarter to supervise other trainees. INHSAC will provide planning and coordination of
supervision visits, and will provide output-based stipends and travel expenses for the supervisors. INHSAC
will make at least two visits per department to oversee the program and will convene the group on a semi-
annual basis to identify commonly-observed problems and strategies for improvement. This program will
result in at least one supportive supervision encounter per trainee following CBC training.
Continuing Activity: 18950
18950 18950.08 HHS/Health University of 7698 3142.08 ITECH $450,000
* Increasing gender equity in HIV/AIDS programs
* Increasing women's access to income and productive resources
Estimated amount of funding that is planned for Human Capacity Development $200,000
Table 3.3.08:
I-TECH will provide clinical mentorship training and technical assistance (TA) for high quality HIV care and
treatment across the network of the President's Emergency Plan for AIDS Relief (PEPFAR)-supported
antiretroviral therapy (ART) scale-up sites. I-TECH will support staffing and clinic operating costs at Hôpital
Universitaire Justinien (HUJ) in Cap Haitian.
Since 2004, I-TECH has partnered with the University of Miami (UM) and HUJ to expand HIV clinical adult
care and to serve as a regional center for training and TA in the North Department. Beginning in 2004, I-
TECH contracted with Cornell University to place full-time resident technical advisors at the Haitian Group
for the Study of Kaposi's sarcoma and Opportunistic Infections (GHESKIO), in support of its training and
mobile supervision teams. Beginning in 2005, I-TECH has supported two full-time clinical mentors for the
Hôpital de l'Université d'Etat d'Haïti (HUEH), Haiti's largest facility and primary teaching hospital, to support
antiretroviral (ARV) scale-up. In 2008, I-TECH expanded its team of clinical mentors based at HUEH to a
total of six physician mentors, one psychologist mentor and two nurse mentors. I-TECH's ARV services
extension involves both public and non-governmental organization (NGO) sector facilities, and I-TECH has
collaborated closely with the Ministry of Health (MOH) counterparts in realizing these programs. As of July
2008, at HUEH, I-TECH has supported extension of HIV clinical services to approximately 2200 patients
(with 514 on ART) while also decreasing the number of patients who test positive but do not enroll in care.
At HUJ, I-TECH has supported 1,560 patients (with 946 on ART) through its subcontract with UM. By March
2009, I-TECH will have supported approximately 2940 adult patients in care at HUEH (with 777 patients on
ART) and 2250 adult patients in care at HUJ (with 900 patients on ART).
ACTIVITY 1: I-TECH will continue its contract with UM to extend HIV care and treatment services in the
North Department and to consolidate HUJ as a Regional Center of Excellence for HIV Clinical Training.
Through a subcontract with HUJ to support hospital personnel, supplies, materials, and patient support
services, UM will extend HIV care and treatment to 4000 HIV infected adult patients, with 1200 patients on
ART. UM will provide on-going supervision within the Family Practice Center (FPC) at HUJ, the primary site
for outpatient HIV care, and will provide mentorship and leadership in coordinating program activities within
other units of HUJ, including preventive medicine service (PMS), which is responsible for community-based
care services and ART adherence support. UM will also plan, deliver, monitor, and evaluate HIV clinical
training for health care workers including: 11 family practice residents in a three-year residency program;
five residents (internists/ obstetrics & gynecologist [OBGYN]) through one-month rotations; basic HIV
training for 50 final year nursing students, 35 final-year laboratory technology students, and 80 medical
interns; a one-month rotation in collaboration with I-TECH for 10 generalist physicians enrolled in the HIV
care training program; a basic review course on HIV palliative care training for 10 providers in the North
Department; skills assessments and regular feedback to residents and advanced HIV clinical care trainees;
and an HIV training of trainers course on the National HIV Curriculum for 12 physicians/preceptors. UM will
also collaborate with I-TECH on a joint initiative for advanced HIV/AIDS clinical care training for nurses.
Finally, UM will continue to supervise 10 clinics within the North Department's HIV care referral network.
ACTIVITY 2: I-TECH will continue its contract with Cornell for placement of two resident technical advisors
at GHESKIO, a center responsible for training, on-site TA, and quality assurance (QA) to 14 ARV scale-up
sites in Haiti. One resident technical advisor will split his/her time 50/50 between the National Public Health
Laboratory (NPHL) and GHESKIO focusing on molecular biology and co-management of HIV/tuberculosis
(TB) and HIV/multidrug-resistant (MDR)-TB. The second resident technical advisor will dedicate
approximately 40% of effort to training of physicians from HUEH, and 60% of effort to training biomedical
personnel at GHESKIO. Cornell advisors will reinforce GHESKIO in addressing advanced HIV care issues
(resistance, adherence, chronic illnesses associated with greater survival, integrated care spanning adult,
pediatric and prevention of mother-to-child transmission [PMTCT] services), and in implementing new
laboratory technologies for surveillance of ARV and TB drug resistance in Haiti. Cornell will assist
GHESKIO trainers to improve HIV clinical training courses, will carry out monthly site visits with mobile
supervision teams, and will provide monthly in-service sessions for GHESKIO colleagues. Finally, the
Cornell advisors will provide technical expertise to the MOH in developing national care and treatment
guidelines, protocols, standard operating procedures and training curricula.
ACTIVITY 3: I-TECH will continue to lead improvements in quality of care and access to HIV services at
HUEH, through placement of nine full- and part-time HIV clinical mentors. I-TECH will support HUEH to
expand HIV services reaching 3600 patients in care with 1150 patients on ART. Clinical mentors will
complete patient rounds, chart reviews, and case conferences with residents, interns, and medical students
in the infectious disease unit and the pediatric unit of HUEH, with emphasis on ART management, TB/HIV
co-infection and prevention of opportunistic infections (OIs). I-TECH will also organize a mobile team to
provide clinical mentoring and assistance to remote sites. As part of this new clinical mentoring outreach
program, I-TECH will conduct mentoring of mentors (MOM) to expand the number of clinical mentors
working to improve the quality of services provided at six additional ART sites. I-TECH will establish a warm
line telephone service to provide expert clinical advice on HIV/AIDS management to health care providers
with limited access to on-site expert consultation for HIV/AIDS care and treatment. The warm line will
facilitate technical assistance to providers working in the field, thus nurturing regular communication
between senior mentors and providers.
I-TECH will produce several short trigger video segments on skills for quality clinical mentoring/practicum
training, in conjunction with facilitation materials. The "trigger" methodology presents brief open-ended
videos featuring real clinical scenarios or acted situations, and asks the viewer to respond. Usually
presented in a facilitated context, these videos will allow mentors to present scenarios to mentees, on video,
which are not encountered in their normal clinical rounds, and facilitate teaching by eliciting their reactions
or analysis of the video, and discussing them.
I-TECH will continue to collaborate with the Center for Information and Training in Health Administration
(CIFAS), an MOH training unit co-located at HUEH, to continue to provide three-week theoretical and
practical training sessions using the newly revised national ART curriculum for junior and mid-level
providers from throughout Haiti. These training sessions will be supplemented by I-TECH's global distance
Activity Narrative: learning initiative, which began in 2007 and provides cutting-edge case-based HIV clinical updates through
videoconference technology. To support professional development among lead trainers at HUEH, I-TECH
will sponsor nine people (both I-TECH clinical mentors and HUEH counterparts) to attend the annual I-
TECH Clinical Summit or another external study tour.
Through its partnership with HUEH, I-TECH will implement a six-month competitive advanced fellowship
course on HIV care and treatment for 10 general practitioners currently working at PEPFAR sites. Fellows
will spend mornings on the wards and in outpatient clinics managing HIV infected patients, including
patients with TB/HIV co-infection, and afternoons rotating through other services or in seminars related to
best clinical practice, management and leadership, quality improvement (QI) strategies, and other topics. I-
TECH will support a visit by Haiti staff to the successful I-TECH India/Tambaram Hospital fellowship
program.
ACTIVITY 4: I-TECH will continue its nursing initiative at HUEH, with the goals of enhancing the role of
nurses within the HIV care team through training advanced practice nurses in a 6-week intensive course.
Following training, these HIV-specialist nurses will be capable of providing primary clinical management of
stable HIV patients. I-TECH's two HIV nurse mentors will continue to collaborate with nursing supervisors at
HUEH to deliver theoretical training sessions on HIV patient management, patient education, nutrition, and
other topics and will supervised practical rotations in the HIV outpatient clinic and other services of HUEH.
As a joint initiative at HUEH, HUJ and the Collaborative Agreement Partner of the MOH, Plan National, I-
TECH will support expansion of this training program to reach 90 nurses. Participants will be drawn from
several scale-up sites in Haiti where I-TECH and Plan National mobile clinical mentoring teams have
established relationships for on-site supervision and follow-up technical assistance; at these sites, health
care human resources are lacking and nurses must step into a lead role in managing HIV patients. I-TECH
will fund partner UM to conduct a parallel program at HUJ in Northern Haiti, and will support two annual
exchange visits between leads of the two programs to share experiences and lessons learned. I-TECH
nurses will also continue to work with the leadership at HUEH to evaluate the role of nurses relative to care
protocols and patient flow patterns in order to optimize the level of nurse responsibility and improve patient
care, and will continue to support training of nursing students completing rotations at HUEH.
Continuing Activity: 17232
17232 5463.08 HHS/Health University of 7698 3142.08 ITECH $2,750,000
9343 5463.07 HHS/Health University of 5151 3142.07 ITECH $2,300,000
5463 5463.06 HHS/Health University of 3142 3142.06 ITECH $1,505,000
* TB
Workplace Programs
Estimated amount of funding that is planned for Human Capacity Development $1,000,000
Table 3.3.09:
In partnership with the non-governmental training center Institut Haitien de Santé Communautaire
(INHSAC), I-TECH will train at least 100 social workers, community health agents, community based
organizations (CBO) and non-governmental organization (NGO) staff, and community leaders from across
Haiti's 10 departments, using the standardized national OVC training package. I-TECH will also enhance
the training package with a drama or set of trigger films and job aids on OVC themes. I-TECH, INHSAC and
the University of Medicine and Dentistry of New Jersey's François-Xavier Bagnoud Center (FXB) will also
provide on-going technical assistance to 10 regional HIV/AIDS service organizations (ASOs) for institutional
development and leadership with respect to OVC services.
In 2008, I-TECH contracted with FXB to develop a standardized orphaned and vulnerable children (OVC)
training package focused on: community mobilization to identify and refer OVC; psychosocial issues for
OVC by age, gender, and caregiver status (covering trauma, grief and loss, and self-esteem issues);
effective programmatic strategies to meet basic OVC needs (food/nutrition, shelter and care, protection,
human rights, health care, education, and economic support); creating effective community linkages with
faith communities, small business/micro-credit, and schools; and empowering caregivers and OVC peer
leaders. FXB and INHSAC collaborated to develop the training package with input and review by a number
of key stakeholders in Haiti including the following: Ministries of Health, Education and Social Affairs, Bethel
Clinic, World Relief, World Concern, Save the Children, Zanmi Lasante, Catholic Relief Services, World
Vision, PLAN Haiti, Family Health International, UNICEF, and Maison Arc-en-Ciel. INHSAC, with support
from FXB and I-TECH, utilized the standardized OVC curriculum to conduct 2 training of trainers (TOT)
sessions for 60 trainers from the above listed agencies and organizations.
ACTIVITY 1: I-TECH will supplement the national standardized OVC training package by producing a
drama or set of trigger films on OVC themes which can be used to shape attitudes and skills among
professional and volunteer "helpers" and caregivers. I-TECH will conduct an assessment to develop a
production plan appropriate to the training needs of the target audience. I-TECH will produce the video in
collaboration with a local video production company, Agence des Jeunes Producteurs, formed and staffed
by a video producer living with HIV/AIDS (PLWHA). AJP helped I-TECH produce the Creole-language ARV
drama Chans, and the stigma and discrmination trigger scenarios. I-TECH will participate in developing
scripts and story boards with stakeholders (including organizations working with OVC), and conduct target
audience focus groups on the final draft scripts or scenarios prior to filming, as well as audience testing the
edited video. This process will ensure that the final videos appropriately emphasize key messages, are
culturally relevant, and are appropriate to the Haitian context. I-TECH will develop a facilitation guide to
accompany the video(s), completing a video-based training module package of approximately 90 minutes
duration (videos and facilitated discussion), suitable for broad dissemination among partners.
ACTIVITY 2: I-TECH will contract with François-Xavier Bagnoud Center, UMDNJ (FXB) to enhance the
basic OVC training package through the development of additional training support tools. These may
include handouts, posters, and support tools that distill the content of the curriculum and serve as an
enduring resource for end users of the training to support day-to-day activities with OVC. The selection of
tools to be developed will be determined through pilot testing and evaluation of the curriculum, followed by a
needs assessment with trainers and end users to determine how best to enhance the learning objectives
and provide ongoing support for trainees. The draft tools will be reviewed by a core group of the already-
established OVC Advisory Group (AG). The finalized tools will be translated into Creole for ease of
distribution and use.
ACTIVITY 3: I-TECH will contract with training partner INHSAC to continue to conduct regional trainings
using the standardized OVC training package, reaching social workers, community health agents, CBO and
NGO staff, community leaders, and OVC and caregiver peer educators in each department. The I-
TECH/FXB OVC training specialist will reinforce the INHSAC training team in planning, delivering, and
evaluating the trainings. Evaluation will include checklists and matrices to support INHSAC in tracking the
roll-out of the OVC curriculum and assessing its effectiveness in preparing community workers for OVC
care. The training team will deliver OVC training using the standardized package reaching at least 100
participants from across Haiti's 10 departments. The training team will also collaborate to provide quarterly
follow-up technical assistance visits to the main regional HIV/AIDS ASO in each department, with coaching
in effective strategies to identify and serve OVC. With other stakeholders, including various Ministries and
UNICEF, I-TECH will co-sponsor an annual conference on OVC issues to share best practices in serving
this population. This strategy will link with I-TECH's efforts in institutional development of community-based
palliative care services. The departmental training sessions, the quarterly coaching visits, and the annual
conference will support departmental ASOs to develop as strong regional organizations with programmatic
expertise in OVC issues, capable of building linkages with caregivers and community groups to nurture the
healthy development, education, economic support, and social support for this most vulnerable population.
Continuing Activity: 17229
17229 12420.08 HHS/Health University of 7698 3142.08 ITECH $750,000
12420 12420.07 HHS/Health University of 5151 3142.07 ITECH $250,000
* Increasing women's legal rights
Estimated amount of funding that is planned for Human Capacity Development $300,000
Table 3.3.13:
I-TECH will maintain a subcontract with the Institut Haitien de Santé Communautaire (INHSAC) to continue
implementing training in voluntary counseling and testing (VCT) (including rapid testing) and psychosocial
support services for 300 health workers throughout Haiti. With technical assistance from I-TECH on tools
and curriculum development, INHSAC will also train and support a network of personnel to provide
supportive supervision to VCT providers.
During 2004 -05, I-TECH supported INHSAC to develop an HIV counseling curriculum covering VCT, anti-
retroviral therapy (ART) adherence, stigma and discrimination, changing male norms and behaviors for risk
reduction, counseling of victims of sexual abuse and violence, couples counseling, and other areas (key
legislative interest areas). In 2004-07, INHSAC completed a training of the trainer (TOT) sessions for its
trainers, and delivered multiple training courses including: 1) a one-week course on pre- and post-test
counseling and rapid HIV testing for health care workers from VCT scale-up sites; 2) a two-week in-depth
course on integrated HIV counseling for counselors, social workers , psychologists, and other personnel
responsible for psychosocial support programs in clinic and community-based settings; and 3) a two-week
preventing mother to child transmission (PMTCT) course for providers at PMTCT scale-up sites. INHSAC
collaborated with the National Public Health Reference Library (LNSP) for experienced laboratory trainers to
deliver the rapid testing portion of training during the one-week VCT courses. In 2008, INHSAC hired a lab
trainer to deliver this portion of the training in order to develop its own capacity to directly provide rapid test
training. As INHSAC assumes responsibility for this portion of training, the LNSP continues to partner with
INHSAC in a quality assurance role. In 2008, INHSAC continued to implement VCT, in-depth counseling,
and PMTCT courses. By March 2009, INHSAC will have initiated a supportive supervision program, to
reinforce counseling skills among past trainees. INHSAC will have developed standardized supervision
tools and implemented a curriculum with 10 supportive supervisors in counseling, covering quality
standards, supervision skills, motivating staff, documenting feedback, handling stress and burn-out, and
other areas.
Activity 1: I-TECH will continue collaborating with INHSAC to plan, deliver, monitor, and evaluate VCT
training, including rapid testing, for 200 health workers in clinic and community-based VCT settings. I-TECH
will support INHSAC to improve the curriculum based on lessons learned from training evaluations and
feedback from previous implementations of the trainings. INHSAC will continue to collaborate with the
Laboratoire National de Santé Publique (LNSP) as it provides quality oversight of rapid testing training and
applies quality assurance/quality control protocols at trainee sites.
Activity 2: INHSAC will provide in-service training (a two-week course) on in-depth psychosocial support to
PLWHA and their families for 100 psychologists, social workers and other key personnel from clinic and
community-based care and treatment programs. This two-week training will be extended to three-weeks
with a one-week practicum at Hôpital de l'Université d'Etat d'Haiti (HUEH). This curriculum includes content
related to U.S. Legislative interest, stigma and discrimination and reducing violence and coercion.
Activity 3: INHSAC will train 50 PLWHA as lay counselors to address ART adherence issues and post-test
counseling; once trained, these lay counselors would be eligible to work as paid staff within Haiti's various
ART programs. I-TECH will provide technical assistance on curriculum development, including instructional
design, document production, pilot evaluation, and clinical review. This activity relates to U.S. Legislative
interest. It will generate income and increase educational access for PLWHA. Recruitment and training of
the lay counselors will be done in close cooperation with the sites in which they will be working.
Activity 4: INHSAC will continue to implement its supportive supervision program for counselors. The
program goal is to involve a group of approximately 30 HIV counseling trainees (three per department), who
demonstrated excellence and leadership during training. Following training as supportive supervisors, these
personnel visit trainee sites, observe their peers in practice, provide supportive feedback, and report to
INHSAC on their finding using standardized forms. Prior to including candidates in the supportive supervisor
training, INHSAC coordinates with employers to release the relevant personnel during one-week per quarter
to provide supportive supervision sessions to other trainees. INHSAC provides planning and coordination of
supportive supervision sessions, and provides output-based stipends and travel expenses for the supportive
supervisors. INHSAC will make at least two site visits per department to oversee the program, and will
convene the group on a semi-annual basis to identify commonly-observed problems and strategies for
improvement. This program will result in at least one supportive supervision session per trainee following
the training.
Continuing Activity: 17231
17231 12424.08 HHS/Health University of 7698 3142.08 ITECH $900,000
12424 12424.07 HHS/Health University of 5151 3142.07 ITECH $400,000
Estimated amount of funding that is planned for Human Capacity Development $400,000
Table 3.3.14:
The bulk of I-TECH activities will be continuation of customization and deployment of a laboratory
information system (LIS) within the network of USG-supported ART sites. I-TECH also has a lead role in
promoting training and retention of laboratory professionals through development of pre-service curricula for
medical technologists, supporting in-service training, and a strong collaboration with the Haitian Association
of Laboratory Professionals.
In 2007, I-TECH initiated the process of identifying an appropriate LIS for Haiti. In collaboration with a
laboratory information specialist from CDC Global AIDS Program, I-TECH reviewed with stakeholders the
process of requirements gathering and the LIS selection process following the APHL Guidebook for LIS
Implementation in Resource Poor Settings. In December 2007, I-TECH posted a Request for Information
on limsfinder.com to explore and evaluate commercial and open source LIS options. Criteria for evaluation
included functionality, flexibility and customization to meet Haiti's priority needs, opportunity for local
partnership and capacity development, and cost. A national consensus meeting including representatives of
the NPHL, CDC/Haiti, and I-TECH was held in March 2008. The decision was made to pursue adaptation
of OpenELIS, an open source product that can be customized to meet the unique needs of Haiti's clinical
laboratories and NPHL. OpenELIS has already been implemented in Vietnam using PEPFAR funds.
Beginning in March 2008, I-TECH provided technical assistance to NPHL in collaboration with CDC to
develop, print, and disseminate nationally standardized paper-based tools for laboratory information
management. Such tools are needed to support best practices in management of lab information and to
improve efficiency at sites, which in many cases use improvised hand-written lab order slips, lab results
forms, and results registers/notebooks. I-TECH supported training of laboratory personnel on the use of
these tools. Importantly, these paper tools also lay the foundation for development and roll-out of the
electronic LIS, both by standardizing data management processes among clinical labs prior to adoption of
an electronic system, and informing the OpenELIS development team on how to automate these laboratory
workflows.
By March 2009, I-TECH will have developed a standardized curriculum on LIS, have a pilot-ready version of
the Haitian version of OpenELIS, and support pilot testing of this system in 4 clinical laboratory sites and at
the NPHL. The pilot phase of LIS implementation will include ensuring site readiness through hardware and
software installation, providing user training, incorporating feedback and recommendations for continuous
improvement, and planning for rollout to 10 additional departmental reference hospital sites. I-TECH will
also develop an interface for data exchange between OpenELIS and the national MSPP HIV Electronic
Medical Record (iSanté). I-TECH has worked closely with CDC and MSPP since 2005 to develop and
implement the iSanté system, used by 41 sites with records for approximately 24,200 patients as of July
2008.
I-TECH is committed to supporting laboratory professionals in Haiti. In 2007, I-TECH hosted a 10-week
course through the University of Washington's Laboratory Technologist Training Program for 4 Haitian
laboratory professionals from NPHL to attend training on use and maintenance of the PointCare automated
CD4 analyzer. I-TECH also provided technical assistance to develop and deliver a laboratory equipment
maintenance course to be integrated into the standardized pre-service laboratory curriculum. By March
2009, I-TECH will have sponsored an additional 8 laboratory personnel from Haiti to attend 2 study tours; 1
focused on laboratory management and the other on laboratory equipment maintenance and use.
ACTIVITY 1: I-TECH will continue collaboration with CDC/Haiti, CDC/GAP Atlanta, and Haiti MSPP to
implement OpenELIS in a total of 14 sites by March 2010. I-TECH is diligently working to ensure that at
least 3 clinical labs of the initial 5 pilot sites (4 clinical labs plus NPHL reference lab) will "go live" by March
2009. Adaptation of OpenELIS to meet the specific needs of NPHL will be a critical component of this task.
Among the unique business processes of the NPHL that go beyond requirements for the clinical labs are:
statistical analysis and surveillance, training and resource management, and national level laboratory
reporting. Equally important, I-TECH will design and develop an interface between OpenELIS and iSanté to
enable efficient, electronic data exchange. Another long-term objective will be interfacing the systems with
the national pharmaceutical data management system.
Through on-going partnership with the University of Washington's Clinical Informatics Research Group and
expert consultants, I-TECH will continue to collect and incorporate user feedback from the initial sites to
improve the system for replication throughout Haiti. I-TECH will ensure procurement and installation of
necessary hardware (servers, backup power supplies, local area networks, etc.) for new implementation
sites, in collaboration with CDC's Regional Information Officers (RIOs) and site personnel. I-TECH will
maintain the LIS implementation support of 4 in-country staff members (1 part-time health information
system manager, 1 part-time laboratory advisor, 1 information technology advisor, and 1 full-time LIS
trainer).
In close collaboration with NPHL, I-TECH will develop a training of trainers (TOT) module on OpenELIS
functionality along with a user manual, and provide technical assistance for delivery of this TOT to
departmental level laboratory technologists. These departmental laboratory technologists will be responsible
for the training and oversight of clinical lab technologists on the use of OpenELIS. I-TECH staff will provide
follow-up observation of trainers and further on-site training assistance for successful use of the system.
Training and technical assistance will emphasize use of OpenELIS to improve quality of lab services and to
aid decision-making for lab program management. I-TECH will be responsible for developing and
disseminating SOPs for specimen tracking and results reporting.
ACTIVITY 2: I-TECH will continue to promote the laboratory technician profession in Haiti through a
partnership with the Haitian Association of Laboratory Professionals. I-TECH will provide technical
assistance and funding to the Association to develop and disseminate a quarterly newsletter and to host an
annual conference. The goal of both activities will be to provide scientific updates and to instill a culture of
professional excellence. I-TECH will assist the Association to sponsor an award for professional
Activity Narrative: excellence, with a structured application and selection process. Donations of laboratory equipment will be
made to the 2 national laboratory schools in honor of the awardees.
To ensure achievement of a major aim of the National Lab Strategic Plan, I-TECH will continue to take the
lead in standardizing pre-service curricula for the medical technologist training programs at the 2 public
national laboratory schools in Haiti. The focus has been on establishing a 3 year diploma curriculum, but
the National Plan calls for a transition into a 4 year BS degree program. I-TECH will also support other
partners engaged in delivery of in-service training (eg, assist ASCP with rollout of the Basic Lab Operations
Training to all 10 Departments in Haiti).
ACTIVITY 3: I-TECH has played a key role in supporting the NPHL in establishing its 5 year Lab National
Strategic Plan (2008 - 2013). As of October 2008, endorsement of the lab strategic plan by stakeholders is
in its final stages. Fulfillment of this goal is a major milestone, as it is considered high priority by the
CDC/GAP International Laboratory Branch and the PEPFAR Laboratory Technical Working Group. A
strategy needs to be in place to ensure that elements of the plan are actually implemented according to a
defined timeline. A key component of the National Plan is to develop a rigorous monitoring and evaluation
protocol. I-TECH is uniquely qualified to serve as NPHL's primary partner in coordinating these M&E
Continuing Activity: 17233
17233 3886.08 HHS/Health University of 7698 3142.08 ITECH $535,000
9340 3886.07 HHS/Health University of 5151 3142.07 ITECH $544,000
3886 3886.06 HHS/Health University of 3142 3142.06 ITECH $1,000,000
Program Budget Code: 17 - HVSI Strategic Information
Total Planned Funding for Program Budget Code: $5,400,000
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
The Health information system in Haiti has reached a turning point whereby sufficient progress has been made with regard to its
HIV/AIDS component to uplift the others. In less than five years the HIV/AIDS information system has gotten off the ground to lay
a foundation, which is now serving as a diving board for a complete overall of the HMIS. Indeed, the dynamic which has played for
the standardization of HIV indicators at the inception of this program is spilling over into other areas. Lessons taken away from the
HIV program are now helping to carry out a similar process for the overall HMIS. Some of the data collection reporting and
monitoring tools developed for this program, such as prenatal and maternity registers are helping to fill existing data gaps in
maternal care. The patient medical record developed for the monitoring of AIDS cases is now being adapted to generate a chart
for the monitoring of pregnant women. The infrastructure developed to support monitoring, reporting and surveillance for HIV are
now being tapped to revitalize the same functions in other areas. The best illustration comes from the fact that the post-disaster-
surveillance system put in place on the heels of the recent hurricanes is being supported by field data personnel and makes use
of IT infrastructure supported by this program. The M&E training curricula supported by this program incorporates notions and
applications that can easily be adapted to other areas; and the training sessions are attended by all types of health workers.
Nonetheless, several pieces remained to be put in place for the system to become fully inclusive, and perform at a level where
quality can be completely guaranteed and where data can be made readily available in desired formats to allow evidence based
decisions across the board. The main challenges lie in the development of capacity to: integrate the HIV system into the overall
HMIS; perform seamless routine data validation; monitor and evaluate effectively various emerging components of the HIV
program such as OVC, nutrition, PMTCT, CBO activities; establish close linkages between community-based and facility based
information systems; facilitate data exchange among the multiple electronic applications developed by the HIV program; expand
surveillance to specific groups such as the MARPS, and pregnant women; map out supply of services .
The plan in FY09 is to leverage existing capacity of the USG team and the partners to take on those challenges and ensure that:
() all facility-based and community-based point of services have access and use the data collection, and reporting tools
countrywide () in service and pre-service training are available to capacitate health professionals to perform their data functions ()
reports and analysis can be generated and data used to inform decision making. The following are specific activities to achieve
those overarching goals. The USG team staff is currently constituted by 1 SI liaison and 5 regional officers detailed to backstop
implementation of SI activities on the field. A new position will be added to assist with M&E activities, surveillance and behavioral
surveys. Tulane University will continue to hold its 101 M&E training sessions and will add this year an intermediate course,
through which it will be possible for trainees to integrate in their practicum M&E studies designed for the program and constitute
the manpower to carry out these studies. ITECH which has developed the Electronic Medical record (EMR) will initiate the
process of adapting it to serve patient data management needs in primary care settings to include both HIV-infected and non HIV-
infected patients. This move is expected to ease up surveillance and seal the integration of HIV into the overall HMIS.
SOLUTIONS, a local firm which has developed the web-based aggregate reporting system (MESI) through which HIV reporting is
being carried out, will work with the three implementers of Electronic medical record on a data exchange program to harness the
massive amount of individual data collected on 73 % of patient in care in the country to generate surveillance data. JSI-
MEASURE will ensure the full scale roll out of the community based information system, which is currently being piloted on a
selected number of sites. NASTAD will continue to provide technical assistance and training for surveillance, case notification,
along with the integration of HIV into the HMIS. SCMS will upgrade its application for drug management to allow the
interconnection with other applications such as the EMR and MESI. It will also complete the development of its Program
management System built with the idea of giving to the USG and Global Funds partners a tool for planning, management and
coordination of their activities. The MOH will continue to ensure the role that it has started to play since last year with regard to
data validation, supply of data collection and reporting tools.
Table 3.3.17:
I-TECH will support extension of the MOH electronic medical record (iSanté) system for data management
and reporting on HIV care services, and initiate adaptation of iSanté for primary care. I-TECH will continue
targeted program evaluation on transfer of learning following in-service training of physicians at HUEH, and
on process and outcomes of a curriculum strengthening and faculty development process at the four
national nursing schools. I-TECH will initiate targeted program evaluation on transfer of learning following
pre-service training of psychologists and social workers at FASCH.
Beginning in 2005, I-TECH collaborated with MOH, CDC, and other partners in the development of a
standardized set of paper-based adult and pediatric HIV medical record forms. I-TECH then launched a pilot
version of the electronic medical record (EMR) system, and built in enhancements through successive
release versions. As of July 2008, 41 ART sites in Haiti had begun to use the system, with data for more
than 24,200 patients. The system is designed for flexible use, with ability to use the system via the web or
through hosting on a local server. It includes an automated replication function so data from sites hosting
the system on local servers are replicated to a central back-up server. The central back-up server provides
access to de-identified data for national program reporting. As of July 2008,13 clinics were using the system
through local servers, meaning they could use the system without being dependent on sporadic internet
connections. I-TECH and CDC continue to support further deployment of the system on local servers.
I-TECH has reorganized and improved user interface of iSanté. By March 2009, I-TECH will have identified
methods for data exchange between the EMR and several other information tools in Haiti: a laboratory
information system (LIS) currently under development; the pharmacy information tool supported by Supply
Chain Management Systems (SCMS); and the MESI system for presentation of aggregate health program
data. The interfaces will minimize duplication of effort by site personnel in managing patient information and
reporting.
Since 2005, I-TECH has collaborated extensively with local partners, such as CDC, Institut Haitien
d'Enfance (IHE), and HUEH to provide training on use of the EMR system to clinicians, data clerks and data
managers. I-TECH's HIV clinical mentors train fellow clinicians on the relevance of complete patient data for
quality HIV care, on appropriate use of the medical record, and on how to interact with the EMR system to
obtain summary information useful for patient care. I-TECH's iSanté team provides training to data
management personnel through workshop-based and on-site training, supports configuration and
installation of local servers, and provides other computer maintenance support at sites using the system. I-
TECH has also initiated development of a standardized, national training curriculum on data management
and the EMR system.
With existing I-TECH staff and consultants and in partnership with CDC Regional Information Officers
(RIOs), Tulane UTAP, and others, I-TECH is focusing on reinforcing data quality and data completeness
among users of the system, through system modifications, training and on-site technical assistance. I-TECH
supports data analysis and dissemination of findings on key questions of interest. For example, iSanté is
reporting on quality of care indicators as defined and utilized by MOH and HIVQUAL, and I-TECH is
collaborating with MOH and WHO to analyze early warning indicators for ARV drug resistance.
As of March 2009, iSanté will include VCT and PMTCT modules to support improved continuity of care for
patients identified as HIV positive, as well as more efficient data management and reporting for VCT and
PMTCT programs.
ACTIVITY 1: I-TECH will initiate the process of adapting iSanté to serve patient data management needs in
primary care settings to include both HIV-infected and non HIV-infected patients. This process will begin
with primary care site evaluations to determine the top priority and high impact functions of primary care
data management. Following the assessment, I-TECH will collaborate with key stakeholders within the
MOH and CDC to establish a software development and implementation plan to include primary care
standardized paper form development, pilot testing, evaluation and national validation of the paper forms,
development of a training module on use of the paper forms, and delivery of training at the 10 departmental
level hospitals in conjunction with paper form dissemination. The paper forms will inform development of the
modified primary care version of iSanté, which will be ready for implementation by March 2010.
ACTIVITY 2: I-TECH will engage key stakeholders and provide technical assistance on the development of
a minimum-data-set version of the medical record and EMR application for HIV patient care. This
enhancement will allow decentralized satellite care sites to interact with the national network and patient
data system. I-TECH will work with MSPP and other partners to identify and implement cost-effective
innovative technologies for incorporation of these sites (for example, through off-site data entry, use of
mobile phone technology for relay of data, or use of mobile computers to periodically capture data from
sites). I-TECH will develop training modules on the minimum-data-set version and deliver training for 60
personnel from decentralized care sites.
ACTIVITY 3: In collaboration with HIVQUAL, WHO and MESI, I-TECH will continue to strengthen data
management and data analysis capacity in Haiti. The I-TECH team will assist the MOH to refine protocols
for data quality assurance at site, regional, and national levels and provide technical assistance to the MOH
and key partners such as IHE to apply these protocols. I-TECH will also provide leadership on using iSanté
data for patient- and program-level decision-making, through analysis of patient health outcomes related to
HIV treatment programs. I-TECH will continue to incorporate user feedback from clinicians, administrators,
and other iSanté users to modify system features in iterative design and development cycles.
ACTIVITY 4: Through regular training site visits, the I-TECH team will orient clinic users on new system
features and optimal use of the system at their sites. I-TECH will also continue to collaborate with CDC,
IHE, Tulane University, and other partners to provide training to users at all existing and newly established
iSanté sites. I-TECH will reinforce IT support for the iSanté system including on-site and remote training and
support for hosting the application on local servers, supporting replication of data to the central data
Activity Narrative: repository, executing regular system maintenance functions, and making minor modifications of the EMR
application to meet changing local needs. I-TECH will sponsor and conduct an in-depth workshop at I-
TECH/UW to teach about the iSanté software system, the data model, reporting and data access, and
backup and maintenance procedures (how to rebuild servers, reinstall software reload data from backup,
and other failure recovery strategies).
ACTIVITY 5: I-TECH will complete development of a standardized, national curriculum on data
management and the EMR system, as well as an improved and updated user manual for the system to
support training activities. I-TECH will support adaptation and implementation of the curriculum for pre-
service and in-service training for personnel working in VCT, PMTCT, ARV, and non-ARV (palliative care)
settings, including clinicians, social workers and psychologists, and data management personnel. I-TECH
will support training on the MOH"s National Health Data Management (HSIS) system. I-TECH will develop
and implement a TOT for MOH and partner training staff with the goal of increasing capacity for delivering
high-quality and technically sound training.
ACTIVITY 6: I-TECH will undertake a targeted program evaluation measuring transfer of learning among
residents, junior, and mid-level physicians trained at HUEH. Evaluation of transfer will address whether
learners apply skills to the workplace, measuring training outcomes. Training participants will be contacted 6
-12 months after participating in training. Methods may include observation of providers by trained mentors,
a follow-up survey of trained providers, or patient exit interviews. This will yield valuable information about
the quality of the training program and the conditions necessary for transfer of learning into practice.
ACTIVITY 7: I-TECH will conduct a second targeted program evaluation on the process and outcomes of
the integration of HIV/AIDS into the curriculum of the five national nursing schools (ENI). A standardized
student knowledge assessment based on core competencies and reflective of the new HIV/AIDS content
will be developed and used to collect baseline data from nurses currently completing degrees at the ENI.
During the implementation of new HIV content in the curriculum, I-TECH will work with the ENI faculty and
administration to systematically monitor the changes made to methods, materials, and content, and student
and faculty reactions to these changes. This information will be used to document lessons learned and
recommendations for improvement in the curriculum and teaching. Each cohort of nursing students will be
assessed as they complete the program. Student exam results will be compared over time, and triangulated
with process evaluation data on implementation of the curriculum. I-TECH proposes to conduct follow-up
observational assessments of nursing skills in practice among recent graduates after 2 and 4 years, to
identify outcomes of the initiative.
Continuing Activity: 17234
17234 3910.08 HHS/Health University of 7698 3142.08 ITECH $700,000
9341 3910.07 HHS/Health University of 5151 3142.07 ITECH $550,000
3910 3910.06 HHS/Health University of 3142 3142.06 ITECH $360,000
I-TECH will continue working with Haiti's public-sector schools for health professionals (medicine, nursing,
laboratory, social sciences, pharmacy, and dentistry) to integrate HIV/AIDS-related content into
standardized curricula, to build teaching capacity through faculty development activities, and to develop
standardized student evaluation tools and processes based upon mastery of core competencies. I-TECH
will collaborate with the Université d'Etat d'Haïti to develop and integrate a basic HIV/AIDS course for all
freshmen students. I-TECH will also develop the capacity of the Ministry of Health (MOH) to guide health
worker training programs in HIV care and treatment. Geographic coverage area of this activity includes Port
-au-Prince/West Department, Les Cayes/South Department, and Cap Haitien/North Department.
In 2005-2006, I-TECH launched curriculum development processes with Haiti's professional schools in
nursing, medicine, social sciences, and laboratory. This work involved close collaboration with the MOH. In
2007-2008, I-TECH launched a guide for integration of HIV content into the four-year nursing curriculum,
including competencies, learning objectives, and supporting content. I-TECH held a faculty development
training of trainers (TOT) for first-year nursing school faculty, aiming to support integration of HIV content
and improve faculty teaching skills.
By March 2009, I-TECH will have conducted a TOT for laboratory instructors from the two national
laboratory schools, and implemented a pilot and evaluation of the newly developed first year laboratory
technician curriculum. I-TECH collaborated with the Faculté de Sciences Humaines (FASCH) to incorporate
culturally relevant materials on OVC into the required curriculum for psychology and social work students.
For medical school faculty and students, I-TECH supported the installation of an electronic resource library
at the Faculté de Medecine. I-TECH also implemented a TOT for 80 trainers within the MOH.
In 2007-08, the MOH validated the national ARV/OI curriculum, developed by I-TECH in partnership with
local content experts. I-TECH disseminated the curriculum in print and electronic formats, and carried out a
"Teachback" TOT course for trainers from key HIV clinical training institutions in Haiti. I-TECH also
disseminated several Creole-language training videos in partnership with the MOH, including stigma and
discrimination trigger scenario, and a 40-minute drama on ART (Chans). By March 2009, I-TECH will have
revised the national ART curriculum to include new, updated content, disseminated the revised materials,
and conducted additional TOT; it is anticipated that 300 health care providers from Haiti's 10 departments
will be trained.
The above-mentioned activities are part of I-TECH's global strategy for decentralization of curriculum
development capacity to country offices, health ministries, and other in-country partners. In 2007, I-TECH
hired an in-country training manager to be mentored by the Seattle-based Training Development Team
(TDT) and, in turn, to lead mentoring of I-TECH Haiti curriculum development staff and MOH counterparts.
In 2008, I-TECH hired a curriculum developer and funded INHSAC to hire a curriculum developer to further
transition capacity to Haiti, with technical assistance from the Seattle-based TDT. I-TECH continues to
engage the MOH in the formative development and final validation of all I-TECH training products.
ACTIVITY 1: In partnership with the medicine curriculum working group, I-TECH will finalize the integration
of HIV/AIDS content into the curriculum of at least one nationally recognized school of medicine, and
conduct pilot evaluation of the use of the new content. I-TECH will continue to host quarterly faculty
development workshops and provide continued support for the electronic resource library installed at the
Faculté de Medecine.
ACTIVITY 2: I-TECH and INHSAC will collaborate to continue to provide mentoring of nursing school faculty
through three one-week visits to each of five nursing schools and the national school of midwifery, to assure
successful use of HIV curriculum material as well as teaching and assessment techniques. Additionally,
INHSAC will deliver two faculty development sessions aiming to improve teaching skills of 40 nursing faculty
members. I-TECH will continue to facilitate a working group to develop and validate standard student
evaluation tools and processes, linked to graduation requirements. The evaluation tools will use a
competency-based framework and will be closely tied to learning objectives. I-TECH and INHSAC will
continue the year-by-year integration of HIV content into the nursing school curriculum, and INHSAC will
deliver a TOT for instructors of the third year curriculum. I-TECH will support and evaluate implementation
of the third year nursing curriculum while developing the fourth year curriculum. INHSAC will develop and
deliver two faculty development TOT sessions for third-year nursing faculty.
ACTIVITY 3: I-TECH will collaborate with FASCH to ensure validation and dissemination of the revised
social science curriculum, provide faculty mentoring, and assist to develop and validate student evaluation
tools that include HIV-related competencies. I-TECH will also assist FASCH faculty to continue to revise
content for a university prerequisite social sciences course which addresses: HIV/AIDS transmission,
prevention, stigma, gender, and testing and treatment issues. The goal of this core course is to broaden
access to state of the art HIV/AIDS training resources and to shape the knowledge and attitudes of future
opinion leaders in Haitian society.
ACTIVITY 4: In partnership with the laboratory curriculum working group, I-TECH will evaluate
implementation of the first year basic-level lab curriculum, and finalize a revised, standardized year two
curriculum which harmonizes training programs and student evaluation standards of the two national
laboratory schools for the basic-level laboratory professionals. I-TECH will continue to host quarterly faculty
development workshops to address key competencies for laboratory educators. To facilitate successful
delivery of the new courses added to the laboratory curriculum, I-TECH will provide resources to support
recruitment of teachers for the national laboratory schools.
ACTIVITY 5: In partnership with local universities and teaching institutions, I-TECH will continue to work on
the development of a competitive one-year program for students who have successfully completed the
basic-level laboratory training. This one-year program will be the final year of a new four-year bachelor
degree curriculum for advanced laboratory professionals intended to expand the pool of highly skilled lab
personnel in Haiti. The curriculum will include theoretical and practical components, and will be piloted at
the national laboratory school in Cap Haitien.
Activity Narrative: ACTIVITY 6: I-TECH will convene curriculum working groups in for the pharmacy, dentistry and ethnology
schools to launch the process of integrating HIV content into their programs and support for faculty
development activities, including a TOT to support strong teaching skills.
ACTIVITY 7: I-TECH will continue to provide technical assistance to the Training Cluster within the MOH
Coordination Unit for AIDS/TB/Malaria on developing standardized HIV/AIDS clinical training materials,
TOT, and monitoring and evaluating training. I-TECH will conduct a follow up on the TOT "Teachback" to
ensure the proper utilization of the methodology by the participants and reinforce their capacity through
refresher training if needed.
ACTIVITY 8: I-TECH will initiate training and technical assistance for national roll out of the Training System
Monitoring and Reporting Tool (TrainSMART), I-TECH's open-source, web-based training data collection
system. TrainSMART will allow users, including all PEPFAR-supported training organizations in Haiti, to
accurately track training, trainer and trainee data in a consistent manner. Additionally, TrainSMART has a
reporting module that allows users to run various automatic reports, as well as create and save customized
reports that can be run at any interval. TrainSMART will facilitate planning, monitoring and reporting on
training outputs at the departmental and national levels.
ACTIVITY 9: I-TECH will provide funding and technical assistance to establish a regional HIV clinical
training center (RTC) in the South Department. Following launch of the RTC, I-TECH will provide quarterly
visits to mentor local trainers in delivery of high-quality didactic, skills-building, and clinical practicum
training.
ACTIVITY 10: I-TECH will work with various local medical associations to adapt a curriculum for training
healthcare providers working in the private sector. The goals of delivering this training are to reinforce
capacity within the private sector to provide quality care to HIV patients, and to foster a broader network of
clinicians who have received state of the art training in HIV/AIDS care and treatment.
ACTIVITY 11: In 2008, INHSAC and I-TECH conducted a training needs assessment for Disease Reporting
Officers (DRO) and Site Managers (SM) of ART scale-up sites. Based on this assessment, INHSAC and I-
TECH collaborated to develop a leadership and management curriculum to build DRO and SM capacity in
team building, monitoring and evaluation, budgeting and computer literacy. In 2009, INHSAC will provide
this training for 25 DRO and SM from Haiti's 10 departments.
ACTIVITY 12: I-TECH will continue to disseminate and monitor use of the stigma and discrimination trigger
scenario, including adaptation and implementation of TOT developed by the CHART network on training
using the scenarios. I-TECH will continue to integrate the scenarios into its training curricula and activities,
and will advocate and support their use in MOH and partner training.
Continuing Activity: 17235
17235 4617.08 HHS/Health University of 7698 3142.08 ITECH $715,000
10240 4617.07 HHS/Health University of 5151 3142.07 ITECH $800,000
4617 4617.06 HHS/Health University of 3142 3142.06 ITECH $0
Table 3.3.18:
