The Improving Health Facility Infrastructure (IHFI) program focuses on providing health facilities with clean, reliable electricity, allowing safe use of sensitive laboratory equipment, IT equipment, increasing on-site safety, and contributing in other ways to improved delivery of health services. For the COP12, Tetratech will work on four key areas: 1) additional installations of no-contact battery backup power systems, ensuring stable, high quality electricity supply for laboratory and IT areas; 2) additional training of health facility technicians to operate and maintain the backup power systems, such as batteries, inverters and diesel generators; and including daily and monthly technical data logging and centralized data collection; 3) rollout of short training sessions for health facility Medical Directors and/or Administrators, to develop familiarity with the backup power systems, and understand their uses and limitations; in addition, supporting and holding accountable the technicians assigned to maintain them; and 4) energy assessments of additional facilities to identify needed energy infrastructure investments for continued safe and reliable operations. All IHFI activities are coordinated with the Project Management Unit (UGP), and support and training is provided to the technical department at UGP. Technical data from the different health facilities will be centrally stored at UGP. IHFI will continue to prioritize installations based on need and in coordination with UGP priorities. Over the next few years, we expect UGP to consolidate its capabilities in order to take on the energy backup systems and other energy infrastructure investments.

Although the laboratories are a subset of the key parts of health facilities needing improvement in electricity reliability, IHFI has found that the laboratories are often the first area or issue identified. Many of IHFI's interventions are catalyzed by laboratory needs, but invariably end up being broader installations, covering more than just laboratories. The budget indicated here is estimated to apply to laboratories only.

Clean and reliable energy is a fundamental requirement for laboratory certification or accreditation, and as more laboratories in Haiti move in this direction, the energy backup power systems will have to be upgraded.

Overall strengthening of health systems through IHFI focuses on two common barriers to optimum operation of health facilities: 1) poor and insufficient energy infrastructure; and 2) lack of knowledge on what to do about it. The IHFI approach is to work through UGP with individual health facilities where these needs have been identified, analyze and design appropriate systems, train/teach facility directors and administrators about their operation and benefits, and train facility technicians to maintain these systems and report system data regularly to facility administration, which in turn, reports data regularly to UGP. This required information flow helps ensure attention to and familiarity with the new systems, while allowing UGP to develop data across the country on improvements.

One other IHFI activity helps feed into UGP's understanding and prioritization of energy infrastructure needs: energy and water assessments at health facilities. These assessments look at the electrical installations in each facility studied, provide analysis and review of gaps or problems, and identify and prioritize a series of investments required to bring the electricity and water systems to best practice levels.

Working with UGP allows IHFI to identify both laboratory and IT electricity needs, making the investments more efficient. However, IHFI could also help other Partners use any of their energy infrastructure investments in a more effective way, sharing best practices from IHFI installations, combined with the Partner's particular needs. Aside from some co-funding from APHL in 2011, this effort has not been pursued.