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
UNCHANGED FROM 2008
SUMMARY: PEPFAR will support activities to prevent HIV/AIDS and STI transmission among the police
officers of the Haitian National Police (HPN), customs and immigration officers by focusing on partner
reduction and being faithful to one's partner as the most effective prevention behavior among sexually
active adults. In 2009, training of peers will be used to increase self-risk assessment and developing
behavior change strategies in partner reduction, fidelity, changing social norms such as in the reduction of
domestic abuse and increase in partner communications, and utilizing on-site USG supported counseling
and testing in precincts, customs and immigration offices. Audience specific messages will be targeted at
the uniformed services, especially men, to promote healthy sexual behaviors. The peer educators will
continue their geographical scope in FY2009 in all 10 departments of Haiti.
In addition, advocacy activities will be implemented among directors of the police, customs and immigration
in order to integrate HIV prevention messages into the basic training curriculum for uniform services and
promote other prevention activities throughout the forces. Training will be implemented with the HPN and
the United National Stabilization Mission in Haiti (MINUSTAH). The UNAIDS HIV/AIDS training curriculum
has been adapted for use in implementing this activity. About 85% of this activity is funded through the OP
budget.
BACKGROUND: In FY05, FHI in collaboration with MINUSTAH, trained 150 police officers of the HPN in
the West, South, South-East, and North Regional Departments. In FY06 and FY07, FHI continued these
activities in these four departments and trained an additional 150 police officers as peer educators. Over
the past several years, FHI has increased collaboration with the HPN and UN to promote messages for
increasing HIV/AIDS activities among the police.
ACTIVITIES AND EXPECTED RESULTS:
ACTIVITY 1: Using the UNAIDS HIV/AIDS training curriculum and related materials which were adapted
for the HPN in FY07, prevention will continue into be incorporated into the basic training curriculum of the
national police academy. In FY07, 10 HPN Trainers were trained on the implementation of the curriculum;
and in FY08 technical assistance was provided to the HPN Health Unit trainers to refresh their skills in
utilizing the HIV/AIDS curriculum. In FY09 HPN Trainers will be trained in focusing on topics such as partner
reduction, secondary abstinence, fidelity, changing social norms (e.g. reduction of domestic abuse),
discussing various means of entertainment, importance of partner communications, drug and alcohol abuse,
and attending counseling and testing services. Messages will also be tailored to meet the needs of women
in the uniformed services since they are the minority.
ACTIVITY 2: Follow up training and supervision will be provided to 300 police peer educators trained in
FY05 - FY08 to improve their interpersonal communication and counseling skills; 75 new police peer
educators will be trained in FY09. The increase in peer educators in FY09 will allow for expansion of the
peer-to-peer police educators into all 10 departments in Haiti. After training, Peer Educators will conduct
outreach to their peers with target messages to promote behavior change such as fidelity, secondary
abstinence, partner reduction and CT testing. FHI will make regular supervisory visits to oversee the police
peer education program and provide technical assistance to improve outreach activities and to utilize
innovative models to build HIV self risk assessment and behavior change strategies. During these sessions
service men and women will be encouraged to know their status, inform them of where they can find
services and assist them in developing personal risk reduction plans to increase protective behaviors. Peer
educators will also discuss issues related to sexual violence and gender issues, couple communication and
increased responsibility among males in reducing risky behavior and HIV transmission.
Activity 3: FHI will continue advocating for appropriation and promotion of the HIV/AIDS program within the
headquarters (PNH, Customs and Immigration). Quarterly meetings will be held to build upon awareness
raised in previous years for the need of better integration and support of the program within the PNH
network. Main issues to be addressed include anti-discrimination and anti-stigma policies within the
workforce. It is anticipated all 10 departmental heads will participate, and assist with the peer training in
their department.
Monitoring and Evaluation of these activities including data collection, use, quality and feedback will also be
a continued and focused effort in FY09.
New/Continuing Activity: Continuing Activity
Continuing Activity: 17911
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
17911 17911.08 HHS/Centers for Family Health 9391 9391.08 FHI $50,000
Disease Control & International
Prevention
Table 3.3.02:
UNCHANGED FROM FY08
reduction and being faithful to one's partner, and correct and consistent condom use as the most effective
prevention behavior among sexually active adults. In 2009, training of peers will continue to be used to
increase self-risk assessment and developing behavior change strategies in partner reduction, fidelity,
changing social norms such as in the reduction of domestic abuse and increase in partner communications,
and utilizing on site USG supported counseling and testing services in precincts, customs and immigration
offices. Audience specific messages will be targeted at the uniformed services, especially men, to promote
healthy sexual behaviors. The peer educators will continue their geographical scope in FY09 to reach all 10
departments of Haiti.
has been adapted for use in implementing this activity. 15% of this activity is funded through the AB
budget, and 85% through the OP.
the West, South, South-East, and North Regional Departments. In FY06 -FY08, FHI continued these
activities in these four departments and trained additional police officers as peer educators. Over the past
several years, FHI has increased collaboration with the HPN and UN to promote messages for increasing
HIV/AIDS activities among the police.
and technical assistance was provided to the HPN Health Unit trainers in FY08 to refresh their skills in
reduction, correct and consistent condom use, changing social norms (e.g. reduction of domestic abuse),
and utilizing on-site USG supported counseling and testing services. Messages will also be tailored to meet
the needs of women in the uniformed services since they are the minority.
ACTIVITY 2: Follow up training and supervision will be provided to police peer educators trained in FY05 -
FY08 to improve their interpersonal communication and counseling skills; 75 new police peer educators will
be trained in FY09. After training, Peer Educators will conduct outreach to their peers with target messages
to promote behavior change such partner reduction, correct and consistent condom use, and CT testing.
Peer educators will ensure police know where local condom outlets are in the community. FHI will make
regular supervisory visits to oversee the police peer education program and provide technical assistance to
improve outreach activities. Technical assistance will also be provided to utilize innovative models to build
HIV risk assessment and strategies to change their behaviors during mobilization session. During these
sessions service men and women will be encouraged to know their status, inform them of where they can
find services and assist them in developing personal risk reduction plans to increase protective behaviors.
Peer educators will also discuss issues related to sexual violence and gender issues, couple
communication and increased responsibility among males in reducing risky behavior and HIV transmission.
It is anticipated that police will target messages to promote OP behaviors, to approximately 3,000 of their
peers.
raised in FY07 and FY08 of the need for better integration and support of the program within the PNH
Continuing Activity: 18080
18080 18080.08 HHS/Centers for Family Health 9391 9391.08 FHI $250,000
Table 3.3.03:
The narrative will be modified in the following ways:
ACTIVITIES AND EXPECTED RESULTS
ACTIVITY 1: Funding will be used to continue upgrading the two palliative care sites (Ti Descayettes and
Laborde) to reach 600 patients. All patients will receive access to laboratory, clinical, nutrition, and psycho-
social assessments and follow up services to prevent and treat opportunistic infections. Additionally, FHI will
provide access to services to address malnutrition, to manage pain and symptoms, to monitor optimal time
for HAART and to create a supportive environment for adherence to long term follow up and care. Funding
will be used to enhance infrastructure and strengthen both clinical and community staff with an emphasis on
nurses so that they may play a greater role in providing clinical care. Through the community, home based
care will be reinforced around these sites to provide PLWHA a package of preventive care, counseling and
education services. FHI will support groups and will provide technical oversight, supervision, and
monitoring of activities.
ACTIVITY 4: To facilitate access and to provide services closer to the population, FHI will identify local
CBOs with the capacity to deliver the community palliative care package. Emphasis will be put on PLWA
support groups and associations that are being expanded and reinforced and on organizations with relevant
experience in providing support to PLWA and/or other social support. Through subcontracts with local
CBOs, FHI will provide financial and technical assistance to upgrade them and provide them with the tools
to offer community support services to PLWA with emphasis on training (e.g. stigma reduction, best health
practices and HIV prevention.)
ACTIVITY 5: FHI will make available through its offices and local CBOs a package of prevention, nutrition
and socio-economic, and education services (see program narrative for details on the package) as directed
by the guidelines. FHI will promote the delivering of integrated and comprehensive care and support
package to PLWA and family (TB, FP, MCH) into the Community Service Delivery point through IMAI
approach. For this purpose, it will reinforce the reference/couter reference system betwee the Community
sites and the Health center. Most of the commodities for the prevention package, such as insecticide
treated nets, safe water products, drinking water bottles and hygiene kits, will be procured by SCMS (see
SCMS narrative). The education materials will be provided by the TBD contractor for community
mobilization (see TBD activity narrative). Food will be made available through the Food Title partner.
Through this funding, FHI will make available resources to cover school fees, and transit housing for PLWA.
BACKGROUND:
In Fiscal Year (FY) 2007, the United States Government (USG) expanded the package of community
palliative care by channeling resources to the 10 departments through a main CBO that will take the lead in
planning and implementing this program with MOH departmental directorates, local CBOs, and grassroots
institutions. The overall strategy is to refer all PLWHA enrolled in care at all HIV sites to the points of service
established by CBOs in order to provide them community and socio-economic support. Family Health
International (FHI) was given FY 2007 resources to be the central CBO for the North and South East
Departments. Last year, FHI was given funds to work with the MOH and other CBOs selected to develop
norms and guidelines for this program. Although the program has not yet been implemented because of
delays in receiving FY 2007 funding, a document detailing guidelines that defines the package of
community palliative care and strategies to deliver has been developed.
Since the launch of PEPFAR in Haiti, FHI has been a key partner in helping expand CT, care and treatment
as well as social mobilization programs, from policy development to implementation of activities at some
sites. With PEPFAR support, FHI launched a model of community CT services in Laborde (South
Department), Ti Descayettes and Campeche (West Department) two years ago. With FY 2007 resources,
two of these institutions (Ti Descayette and Laborde) are being reinforced to offer integrated palliative care
in order to reach 600 PLWA and their families.
With FY 2008 resources, a TBD contractor will reinforce its role as the central CBO in the North and South
East Departments of Haiti to continue delivering community palliative care in these areas. As the central
CBO, the contractor will focus on making links with the HIV sites where PLWHA are enrolled in care,
identifying local CBOs, grassroots organizations and PLWHA associations through which resources could
be channeled around these sites, expanding the package of services to target all PLWHA enrolled in care in
these two departments, connecting PLWHA to Title II food and economic growth programs to provide them
with food, and income generating activities based on needs assessment.
social assessments and follow up services to prevent and treat opportunistic infections. Additionally, the
contractor will provide access to services to address malnutrition, to manage pain and symptoms, to monitor
optimal time for HAART and to create a supportive environment for adherence to long term follow up and
care. Funding will be used to enhance infrastructure and strengthen both clinical and community staff with
an emphasis on nurses so that they may play a greater role in providing clinical care. Through the
community, home based care will be reinforced around these sites to provide PLWHA a package of
preventive care, counseling and education services. The contractor will support groups and will provide
technical oversight, supervision, and monitoring of activities.
Activity 2: The contractor will continue to work with the MOH and other CBOs to reinforce all policy aspects
of the program. As guidelines are being developed, validated and disseminated this year, training and
supervision tools in coordination with I-TECH (see I-TECH PC activity narrative) will be next year's focus.
The contractor will participate in all task force activities aimed at implementing these tools.
Activity 3: The TBD contractor will use resources to maintain and expand office spaces in the North and
Activity Narrative: South East Departments. These offices will be adequately staffed with trained support and psycho-social
staff, as well as with facilitators who are to work with their counterparts at the sites to recruit PLWHA,
establish the social needs of the PLWHA's family and to deliver a package of community palliative care
services. After the expansion, the contractor's departmental offices will have the capacity to provide service
either directly or to channel resources and coordinate activities through local CBOs linked to this program
based on PLWHA needs and geographic location. The community based information system, which is in
development, will be put in place through these offices so that the contractor can provide a track record of
patients enrolled and services offered.
Activity 4: To facilitate access and to provide services closer to the population, the contractor will identify
local CBOs with the capacity to deliver the community palliative care package. Emphasis will be put on
PLWA support groups and associations that are being expanded and reinforced and on organizations with
relevant experience in providing support to PLWA and/or other social support. Through subcontracts with
local CBOs, the contractor will provide financial and technical assistance to upgrade them and provide them
with the tools to offer community support services to PLWA with emphasis on training (e.g. stigma
reduction, best health practices and HIV prevention.)
Activity 5: The contractor will make available through its offices and local CBOs a package of prevention,
nutrition and socio-economic, and education services (see program narrative for details on the package) as
directed by the guidelines. Most of the commodities for the prevention package, such as insecticide treated
nets, safe water products, drinking water bottles and hygiene kits, will be procured by SCMS (see SCMS
narrative). The education materials will be provided by the TBD contractor for community mobilization (see
TBD activity narrative). Food will be made available through the Food Title partner. Through this funding,
the contractor will make available resources to cover school fees, and transit housing for PLWA.
Activity 6: The success of this program will depend upon strong relationships that the contractor and its local
CBO network will continue to establish with HIV sites and community support organizations. For example,
Title II Food program partners will continuously work with HIV sites to update the lists of PLWA enrolled in
care to get them enrolled in community support services. Formal agreements and referrals will be
established between the contractor and community support organizations to ensure quality and continuity of
services. For example, the contractor and its CBO will provide guaranty/warranty funds for micro-credit.
They could also provide funding for transportation fees for churches groups that will conduct home visits to
PLWA and their families.
EMPHASIS AREAS:
- Community mobilization/Participation
- Development of Network/linkages/referral systems
- Human resources
- Linkages with other sector and initiatives
- Local organization capacity development
- Food nutrition and support
TARGETS FY 2008
- 3 new sites providing palliative care
-15,000 individuals provided with community palliative care
- 600 individuals provided with clinical palliative care
-100 individuals trained/recycled to provide palliative care
COVERAGE AREAS
- West, North, South and South East Departments
Continuing Activity: 18947
18947 18947.08 HHS/Centers for Family Health 9391 9391.08 FHI $900,000
Emphasis Areas
Gender
* Increasing women's access to income and productive resources
Health-related Wraparound Programs
* Family Planning
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Estimated amount of funding that is planned for Economic Strengthening $50,000
Education
Water
Table 3.3.08:
The narrative has been modified in the following ways:
Last year, FHI used the President's Emergency Plan for AIDS Relief's (PEPFAR) Fiscal Year (FY) 2007
funds for Orphan and Vulnerable Children (OVC) to address the community-based care component of the
program and support activities targeting OVC related to HIV/AIDS in the South East and North departments.
This intervention aimed at improving the well being of OVC related to HIV/AIDS through increasing
accessibility to school for OVC. Additionally, the program trained care givers, care workers, orphanage staff
in how to deliver psychosocial support to OVC in target areas. Further more the project distributed minimum
basic needs such as beds, mattresses, sheets, tables etc. to OVC. Collaborative partners has been create
with the Ministry of Social Welfare (MSW) - IBESR (Social Welfare Institute) and Ministry of Health (MSPP)/
North and South East Regional directorates.
For 2008, FHI will conduct same activities by additing health care, legal assistance and economic
opportunity for OVC. Through a partnership with MSPP/South and North Regional directorates, 500
affected children will receive ambulatory care and hospitalization fees will be covered for 200 OVC.
Additionally, FHI improved tracking systems and referral networks to maintain continuity of care for newborn
of HIV infected Mothers enrolled in PMTCT services in the target areas. To accomplish this goal, FHI
worked with PMTCT sites, MSH and AOPS/JHPIEGO to track the newborn, create an OVC new born
network. OVC had access to existing health and education services such as Integrated Management of
Childhood Illnesses (IMCI) services.
For FY08, FHI have also supported OVS's clubs to develop common project depending on what is available
in each area. FHI provided input allowing OVC to realize theirs projects.
FHI has encouraged the community point services to create a link with the civil state office in order to
facilitate access to this important document.
Activity 1: In FY 2007 FHI worked in four sites in the South East and has been extended this activity in FY
2008 to four sites in the North, mainly through the social service structure existing at those new sites (social
workers and community health agents). The goal is to identify dependants of PLWHA in orphanages and
those attending voluntary counseling and testing (VCT) and anti-retroviral (ARV) clinics, post test clubs, and
PLWHA Association meetings in order to enroll them in the program. In FY09 FHI will continue to train and
mentor social workers and community health agents based at the site to equip them to address OVC related
issues. FHI will maintain contact with established community organizations working in other domains to
educate them to identify and refer OVC to the sites.
Activity 2: In collaboration with the departmental directorates of the Ministry of Health and Population
(MSPP) in the South East and North, some sites of services in strategic areas will be created in the North
and continue in the South East to deliver a package of community based services. FHI will work with local
organizations (e.g., post test clubs, support groups, PLWHA Association) to establish outlets for the
provision of a package of psychosocial and material support to OVC. FHI will hire trained personnel at each
new delivery point to manage the operations, organize the delivery of services and engage other specific
manpower based on the nature of services they will deliver. A core set of services will be provided at each
facility and will include psychosocial support for OVC and their families or caregivers, educational activities
for groups, school fees, non formal education, support for birth registration, and referral for prevention and
curative health care services. FHI will also support OVS's clubs to develop common project depending what
is possible in each area. Additionally, FHI will improve tracking systems and referral networks to maintain
continuity of care for newborn of HIV infected Mothers enrolled in PMTCT services in the target areas. To
accomplish this goal, FHI will work with PMTCT sites, and other partners to track the newborn and create
an OVC new born network. FHI is strongly encouraging use Community Integrated Management of
Childhood Illnesses (C-IMCI) approach at the household and community level.
The President's Emergency Plan for AIDS Relief's (PEPFAR) Fiscal Year (FY) 2008 funds for Orphan and
Vulnerable Children (OVC) will be used by TBD to address the community-based care component of the
program and will support activities targeting OVC related to HIV/AIDS in the South East and North
departments. This intervention will aim at improving the well being of OVC related to HIV/AIDS through
increasing accessibility to school, prevention and curative health care services, economic opportunity and
psychosocial support. Additionally, the program will train care givers and aid families to acquire minimum
basic needs such as beds, mattresses, sheets, tables etc. Collaborative partners will be the Ministry of
Social Welfare (MSW) - IBESR ( Social Welfare Institute ) and Ministry of Health (MSPP)/ North and South
East Regional directorates.
BACKGROUND
TBD's mandate in FY 2005 was to work in four departments (South, South East, North and Grand-Anse.)
with the staff of the Ministry of Social Work at the central and regional level and train them on orphan care
and strengthen psychosocial services for OVC. Over 150 IBSER staff members were trained in HIV/AIDS
basic information and children's rights and benefits. They were also given awareness sessions on potential
links between MSW systems and the health system for the benefit of OVC. Additionally, 1300 OVC were
supported (scholarship, training etc) in FY 2005.
For FY 2006, TBD continued its basic health care and support activities focused on OVC related to
HIV/AIDS in the South and South East departments. Thus far in 2007, TBD has worked in the area of OVC
around a network of four health centers in the South East department. TBD's efforts to date have been
successful. The lessons learned from this project taught us how to apply what we did in one area to the
entire system. TBD proposes to continue the project in the South East and to extend it in the North in FY
2008.
Activity 1: In FY 2007 TBD worked in four sites in the South East and will extend this activity in FY 2008 to
Activity Narrative: four sites in the North, mainly through the social service structure existing at those new sites (social workers
and community health agents). The goal is to identify dependants of PLWHA in orphanages and those
attending voluntary counseling and testing (VCT) and anti-retroviral (ARV) clinics, post test clubs, and
PLWHA Association meetings in order to enroll them in the program. TBD will continue to train and mentor
social workers and community health agents based at the site to equip them to address OVC related issues.
TBD will maintain contact with established community organizations working in other domains to educate
them to identify and refer OVC to the sites.
and continue in the South East to deliver a package of community based services. TBD will work with local
provision of a package of psychosocial and material support to OVC. TBD will hire trained personnel at
each new delivery point to manage the operations, organize the delivery of services and engage other
specific manpower based on the nature of services they will deliver. A core set of services will be provided
at each facility and will include psychosocial support for OVC and their families or caregivers, educational
activities for groups, school fees, support for birth registration, and referral for prevention and curative
health care services.
Activity 3: In each department, a link will be created between the local organization that provided services to
OVC, the health site and birth register office working in the coverage area to provide prevention services
(e.g., immunizations), curative care (e.g., opportunistic infections) and birth certificates to those in need.
Linkages will also be created between the local organization and Title II program and micro-finance
institutions to cover other basic needs.
Activity 4: In collaboration with the MSW, MOH/ South East, and the North directorates department,
trainings session will be organized for those responsible for orphanages as well as those employed as
orphanage caregivers. .
Emphasis areas:
Community Mobilization/Participation
Development of Network/Linkages/Referral Systems
Training
Linkages with others Sectors and Initiatives
TARGETS:
3000 OVC supported/served
500 providers/caretakers trained
Targets Populations:
Community Based Organizations
Orphans and Vulnerable Children
Caregivers
Key Legislative issue:
Increasing gender equity in HIV AIDS
Stigma and discrimination
Food
Microfinance/microcredit
Coverage Areas:
Southeast and North
Continuing Activity: 17899
17899 17899.08 HHS/Centers for Family Health 9391 9391.08 FHI $600,000
* Increasing gender equity in HIV/AIDS programs
* Child Survival Activities
Estimated amount of funding that is planned for Education $50,000
Program Budget Code: 14 - HVCT Prevention: Counseling and Testing
Total Planned Funding for Program Budget Code: $4,490,000
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
The number of people tested has risen sharply by an increment of more than 100,000 new tests yearly. About half a million
people had been tested in FY08 through the 138 sites offering the services.
From a rapid scale up in the number of sites in the early years of the program, the overall strategy has shifted the last two years
toward the reinforcement of capacity at the sites to offer the services to more individuals and meet the demand for services. To
that effect two major changes had been brought by the program to existing practices : (i) training curriculum have been revamped
to allow trainees to acquire skills to use provider-oriented-counseling approach and perform testing themselves when needed, as
opposed to a client-initiated-approach and testing performed only by lab personnel in the early years of the program(i) multiple
points of rapid testing services have been created within facilities to reduce the burden for already over crowded laboratories
Nonetheless serious challenges continue to get in the way of the program and prevent it from reaching its full potential: (i) High
staff turn over creates an ongoing unmet need for training at the sites. (i) Loss to follow-up, although reduced in scope over the
years continue to be a significant problem in some sites, (iii) Lack of information and education continue to forestall high risk
groups from having access to services despite efforts to create more specialized clinics to address their needs. The plan to
address these challenges in FY09 is the following:
Services will continue to be integrated into facilities in the five USG partner facility networks: Ministry of Health (MOH), GHESKIO,
Partners in Health (PIH), Catholic Relief Services (CRS) and Management Sciences for Health (MSH). Focus will be paid to wards
with high-risk patients (tuberculosis (TB) or sexually transmitted infection (STI) units, in particular) and the prevention of mother-to
-child HIV transmission (PMTCT) services. Efforts will also be deployed to ensure that HIV-positive persons identified in the
individual hospital departments are referred and accompanied to the HIV/AIDS care and treatment center in the hospital, where
palliative care and ARV treatment or only palliative care is available, depending on the site.
For those populations outside the clinic environment, the USG will continue to support client-initiated CT in community outreach
efforts as well as mobile services. For instance CT services for men who have sex with men (MSM) and other persons with high
risk behavior that seek anonymity are offered at several CT sites around the country by partner Promoteurs Objectif Zerosida
(POZ). Sexually-active adolescents and youth have access to CT services in a network of youth centers run by the Foundation
for Reproductive Health and Family Education (FOSREF) around the country where specially-trained counselors provide age-
appropriate education and counseling and refer positive individuals to HIV/AIDS integrated care and treatment services and HIV+
pregnant youth to comprehensive PMTCT sites. The USG Team will also continue to focus promotion efforts on those specific
populations most likely to become HIV infected.
The USG will also support CT training, which will continue to be organized by the Haitian Institute for Community Health
(INHSAC), a local training organization, in partnership with International Training and Education Center on HIV (I-TECH). They
will conduct refresher courses for current counselors in the CT sites and train new counselors from clinic and community-based
VCT settings. The two-week training on in-depth psychosocial support to PLWHA and their families provided to psychologists,
social workers and other key personnel will be extended to three-weeks with a one-week practicum at one teaching hospital, in
order to better equip them to deal with issues such as stigma end discrimination, partner referrals, bereavement counseling and
so on. A training program for PLWHA as lay counselors will also be initiated this year to enable them to address ART adherence
issues and post-test counseling; once trained, these lay counselors will be eligible to work as paid staff within Haiti's various ART
programs
In order to enroll 8,000 new patients this year and reach the USG Team's September 2009 antiretroviral (ARV) treatment target of
25,000, assuming at 8% the proportion of positive among people tested in the targeted sites, at 30% the attrition rate among them
and at 25% the proportion needing ARV among those who tests positive (based on previous years data) , approximately 600,000
individuals will need to be tested
Table 3.3.14:
Reinforcement of counseling and testing services at the three community- based programs.
Replace one C&T community- based services (Campeche) by a new one in the Southeast.
FHI will conduct the following activities in this program area.
Activity 1: Reactivation of Counseling and Testing services at the Haitian National Police: FHI will conduct a
quick assessment to evaluate previous efforts and identify areas where reinforcement is needed. FHI will
enter into a sub-agreement with the PNH to support testing for active duty officers and for candidates since
each year the organization screens thousands of new candidates. This agreement should allow the PNH to:
refurbish spaces at its fixed testing posts, accommodate ad-hoc counseling and testing services during the
enrollment process, and hire additional contractual counselors during the enrollment process, train new
counselors or provide refresher training to old ones, recruit social workers and psychologists, deliver
organization-wide promotional activities for counseling and testing, and create post test- clubs. FHI expects
to reactivate at least two former fixed posts in the metropolitan area, while creating a new post in the North.
It is expected that 3000 current active duty officers and new enrollees will be counseled and tested at the
PNH.
Activity 2: Reinforcement of Counseling and testing services at the three community-based programs.
In addition to elements already in place that provide pre and post test counseling, emphasis will be put this
year on (i) reinforcing mechanisms to retain patients once they test positive, and reduce attrition occurring
through the referral process, and (ii) setting up better partner referral services to limit the transmission of the
disease within families and communities. To accomplish this, resources will be devoted to: (i) hiring social
workers and community health workers to beef up psychosocial support provided at the testing facility as
well as at home to patients and to reach out to their families and partners, (ii) providing escort services and
supporting transportation costs when patients are referred to care facilities, (iii) expanding post test clubs
and PLWA groups to a 90% participation goal, (iii) reinforcing community mobilization activities to promote
services and mitigate stigmatization within the communities. FHI expects to test 2000 people in each
community.
SUMMARY:
Activities in this program seek to further expand counseling and testing (C&T) services at three existing
community-based programs and resume those services at the Haitian National Police (PNH). Although
implementing sites will receive varying amounts of support depending on needs and prior performance,
overall activities will include: refurbishing work space, hiring and training counselors and social workers,
procuring basic office equipment, setting up escort services for referrals, organizing people living with
HIV/AIDS (PLWHA) support groups, mobilizing the community, and working to achieve service QA/QC. The
major emphasis areas for these activities are community mobilization; training, strengthening human
resources and infrastructure. Specific targets include general population and men in uniform (military).
For the past two years FHI has provided field support to three grass root community-based programs by
enabling them to add a C&T component to other ongoing educational and development activities. This pilot
experience has shown how communities with high stigma practices can widely accept HIV testing when
testing activities are supported by strong community mobilization and awareness campaign.
FHI has worked with the Haitian National Police (PNH) to support prevention activities during the past two
years, while the counseling and testing services component was developed through another mechanism. In
Fiscal Year 2008 the United States Government team will take steps to create more synergy in activities
developed in partnership with the police by streamlining the supporting mechanisms.
Activity 1: Reactivation of Counseling and Testing services at the Haitian National Police: TBD will conduct
a quick assessment to evaluate previous efforts and identify areas where reinforcement is needed. TBD will
organization-wide promotional activities for counseling and testing, and create post test- clubs. TBD expects
services and mitigate stigmatization within the communities. TBD expects to test 2000 people in each
Continuing Activity: 18954
18954 18954.08 HHS/Centers for Family Health 9391 9391.08 FHI $250,000
Construction/Renovation
Military Populations
