SUMMARY:

This activity is aimed at backstopping the overall development of the HIS for HIV/AIDS supported by

PEPFAR on various areas. It encompasses: (i) Support the USG team for the preparation of the PEPFAR

annual and semi-annual reports and for overall planning effort (ii) technical assistance to the Ministry of

Health for elaboration of the M&E framework, M&E plan, and the M&E regional workshops on HIV/AIDS and

for the generation of reports on demand (iii) technical assistance to IHE for the improvement of data

collection and reporting processes as well as data quality control mechanisms (iv) technical assistance to

SOLUTIONS for the overall design and continuous enhancement of the web-based (MESI) and for the

improvement of data base management and data quality inputs (v) technical assistance to the Regional

Information Officers of the USG team (RIO) in the rolling out of the internetworking infrastructure, especially

in system design and implementation. The primary emphasis of this activity is: training and workshops,

HMIS, USG data base and reporting system, and IT. Specific target population include physicians, nurses

or health professionals involved in data collection, management and analysis, Statisticians and data clerks,

District Regional Officers, Regional Information Officers, NGOs, and local organization consultants involved

in M&E and data.

BACKGROUND:

Prior to the advent of PEPFAR, the USG team had received support from a specialized US-based

organization to help with the development of an M&E system for the national HIV/AIDS program with a

mandate to standardize indicators, organize M&E 101 training for the MOH staff and key USG partners, and

support the dissemination of HIV/AIDS data. This mandate expanded under PEPFAR to incorporate

progressively additional tasks such as: (i) support the USG team for preparation of PEPFAR reports (ii)

support to the reinforcement of IT infrastructure and the training of field staffs in basic computer skills, (iii)

technical support to local organizations such as IHE and SOLUTION for data collection validation, reporting

and analysis. The strategy adopted by this support organization to deliver this technical assistance has

been to detail a full time M&E officer in Haiti and commission specialized short term consultancies for

specific works. Through this assistance: more than 600 individuals received M&E training in various areas;

an architecture for the rational deployment of IT infrastructure has been developed and implemented with a

perspective of establishing a countrywide network; 42 sites have been outfitted with basic computer

equipment and internet connection; field personnel have received hands-on training at different sites for the

use of computer and internet; the USG team has received regular support to prepare its annual and semi

annual reports; processes and mechanisms at the two local institutions, IHE and SOLUTION has made

significant improvements. As the contractor for these activities came under the UTAP mechanism, the USG

team has put into place a competitive process to find a follow on contractor.

ACTIVITES AND EXPECTED RESULTS:

ACTIVITY 1:

With the expansion of the program with the help of International Funds like PEPFAR and Global Funds,

Haiti is facing a human resources crisis. In order to enhance the capacity of health care staff at the local,

regional and national level providing health care services, Tulane will assist the Haitian Ministry of Health

and the Haiti State University (UEH), in the elaboration and the development of a Public Health Masters

Program and Short-term certificate program. The purpose of this Masters Program and Short-term

Certificate Program is to: (1) establish a new health professional network focus on program and program

improvement, to take advantage of the great strides made in M&E demand for donors for accountability and

efficiency, but also as a retention tool for the Ministry of Health, (2) produce qualified health professionals in

Health Monitoring and Evaluation to work with the private and public sectors, (3) be country owned and

operated.

Tulane will provide technical assistance to the Ministry of Health and CDC-Haiti in-country partners in the

development of a short course certificate program on Monitoring and Evaluation to improve program

implementation, accountability and transparency in Health and to provide a platform for experience

exchange in the area of Health M&E between practitioners and theories. These short courses will

emphasize the logical models of Health Programs, communication, networking, Information Technology,

data management, analysis and reporting. Tulane will provide technical assistance to the MOH to provide

long distance learning training on M&E primarily through online classes using video-conferencing facilities

and follow-up discussion calls with Professors.

ACTIVITY 2:

With more than 85% of patients in care and available on the Electronic Medical Records used by Ministry of

Health and Population (MSPP), by GHESKIO, and PIH, as well as the aggregated data on MESI, it is

important to access the current functionality and the sustainability of these systems to ensure that these

systems are adhering to the national and international standards in data elements, security, confidentiality,

storage and transfer and utilization of information. Tulane proposes to assist with an evaluation of key

aspects such as usefulness, security, simplicity, flexibility, quality of data of Haiti's Patient Monitoring

Systems for best practices and recommending improvements.

ACTIVITY 3:

Tulane with provide TA to the MSPP in data collection, analysis and interpretation to address key questions

related to the epidemic. Tulane proposes to provide technical assistance for the following activities: (1)

gaining basic understanding on the utilization of data medical record forms and various Health Information

systems (EMR, MESI, TRAINSMART, LIS, HIV/QUAL), (2) managing and understanding these databases;

(3) gaining a basic understanding of analytic methods; (4) learning and utilizing Geographic Information

Systems software, STATA and SPSS software. Tulane also proposes to conduct training workshops on

data cleaning, use, analysis, writing, and triangulation with the goal of identifying drivers of the epidemic.

ACTIVITY 4:

Distance learning-online training: Tulane will continue to support the deployment of IT infrastructure by

providing equipment at specific facilities to facilitate online training, technical assistance for needs

assessments and architecture design and implementation. Tulane will provide technical assistance to the

MSPP to offer online video training in the fundamental concepts and tools for M&E of HIV/AIDS programs in

French and Haitian Creole, linked to the use of data collection tools and the use of reporting of data for the

Activity Narrative: facility-based level. This will limit the displacement of health workers from different health facilities around

Haiti to the training center in Port-au-Prince in order to receive training and permit information of new

versions of the Electronic Information database to be shared. The video-conference system will allow the

Health Professional at the MOH at the central level to communicate on a regular basis with other health

professionals at the regional and communal levels.

ACTIVITY 5:

Tulane will provide technical assistance to implement the "digital fingerprints" identification system of

patients attending and receiving ART at health facilities. This system is meant to reduce duplication of

patients receiving HIV care within or from different regional health facilities. Tulane will assist the MOH by

conducting a small pilot study with the intention of identifying best practices and recommending

improvements.

ACTIVITY 6:

Tulane will support the U.S. Government team in Haiti in the preparation of the semi-annual and annual

reports for the President Emergency Plan for AIDS Relief. Tulane will develop templates to tally data and

provide support to the U.S. Government in-country team for the tabulation and validation of data during the

preparation of reports.

ACTIVITY 7: Tulane University will support the MOH by providing specialized consultancy to lead and

organize the task force and workshops for developing the National M&E Plan for the National AIDS Control

Program. Tulane University will lead the task force by: 1) organizing task force and working group

meetings; 2) ensuring efficient control of information; 3) working with all partners; 4) obtaining technical

assistance from Tulane as needed; 5) leading the drafting of the document.

ACTIVITY 8:

Tulane University will provide technical assistance and backstopping to METH to ensure completeness,

accuracy and quality of data that are being reported from the sites. Indeed METH S.A. needs substantial

assistance to face with difficulties with late reporting, facility capacity to process and report this data, lack of

clearly defined indicators. Tulane University's assistance will include: (i) continuous assessment of the

relevance of the data collection and reporting tools and their adjustments to the need of the programs (ii)

regular data audit that focuses on the existing data quality, instruments, reporting templates and the data

base currently being used (iii) joint site visits with IHE to review facility protocols and procedures and assess

data quality by comparing central database with log books (iv) comparison between data posted on the

electronic systems (MESI, EMR, and LIS) and data entered into paper systems (iv) support for the

preparation of a curriculum adapted to different categories of personnel (v) support to IHE for the

development of a manual to better define the indicators (vi) training of IHE statisticians and data base

managers in use of statistical package software such as SPSS to increase their capacity for analysis (iv)

Regular meetings with umbrella organization implementing the PEPFAR program such as PIH, GHESKIO,

MSH which are collecting data both to feed the national system and to serve their own needs to ensure

harmonization of their system with the national system. Tulane University will help create a tool for the audit

of their data. This overall assistance will be provided through both the Tulane University local M&E officer

and through specialized short term consultancy. The expected result is to ensure that the processes,

mechanisms, and tools existing for data collection, validation and reporting are adequate and are set to

provide good quality data.

ACTIVITY 9: Tulane University will provide technical assistance for the continuous development of MESI.

Tulane will: (i) provide its technical support in order to continually assess the status of the MESI data base

system for its completeness, its relevance and accuracy. Mechanisms will be developed to verify the MESI

database and confirm that data have been updated (ii) provide technical oversight/guidance for the

development of key technical support documents to facilitate the uniform and consistent operation of the

system. These documents may include: data management plan and data quality plans and procedures. (iii)

Collaborate with SOLUTION for the formulation of new queries for generation of reports from the database

and for the design of data reporting templates to be incorporated into the MESI (iv) work with SOLUTION to

incorporate into MESI a set of relevant and dynamic graphics for the display of information. (v) Develop built

-in formula for data validation (v) Develop and implement with SOLUTION data dissemination and use plan

that includes promotion for the MESI database itself among implementing partners.

ACTIVITY 10: Tulane will provide financial and technical support to TBD for data triangulation of ANC,

DHS, BSS and other designated/available data sources. The prevalence of HIV in the general population

will be estimated from ANC surveillance and will be compared with the results of the 2005 HDHS+ to arrive

at the best possible estimate of HIV prevalence in Haiti.

New/Continuing Activity: Continuing Activity

Continuing Activity: 18848

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

18848 18848.08 HHS/Centers for Tulane University 9393 9393.08 Tulane $700,000

Disease Control &

Prevention

Emphasis Areas

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $150,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.17: