Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013

Details for Mechanism ID: 11963
Country/Region: Dominican Republic
Year: 2013
Main Partner: U.S. Centers for Disease Control and Prevention
Main Partner Program: NA
Organizational Type: Implementing Agency
Funding Agency: HHS/CDC
Total Funding: $50,000

Goals: Strengthen the capacity for Early Infant Diagnosis (EID) at the National Reference Laboratory (NRL) of the MOH, increasing the availability of quality assured PCR DNA testing, CD4 and viral loads for children born to HIV+ mothers in the DR.

Objectives:

Strengthen the GODR MOHs capacity to establish Quality Assurance Systems both at PMTCT and EID large volume hospitals to make a greater impact on the Quality of EID services in the DR.

TA to improve the current transport/delivery system for EID and any other referred tests to the NRL, so that samples get tested and results reported, in a timely manner and under confidential conditions.

Support to have updated and complete EID data available, for analysis and decision making, through a strengthened centrally-located EID data base at the NRL.

TA for improvement of data collection and reporting of EID results at NRL as MOHs centralized site.

Geographic Coverage & Target Population: USG/CDC will work at main MoH maternities and pediatric hospitals, and other high volume regional, mainly in Region 0 (Santo Domingo) and II (Santiago), along the PMTCT working group.

Transition Strategy: USG will work closely with the MoHs Services Division, REDES, to improve the current transport lab network referral, linked to the NRL. This will establish a permanent system owned by the MOH.

Cost Effectiveness: Technical assistance will help assure that quality HIV serology and Syphilis rapid testing is reported the same day. Laboratory procedures will enable pregnant women get their results during the same visit, and HIV positive cases to get immediate follow-up.

Funding for Treatment: Pediatric Treatment (PDTX): $50,000

The USG/CDC will provide technical assistance (TA) to the GoDR to strengthen EID services by working primarily with the National Reference Laboratory (NRL), two large Maternities, and the main pediatric Hospital in Region 0. TA will expand to the largest volume regional hospitals and pediatrics centers in time.

TA will seek to support to the NRL to maintain their external quality assurance (EQA) Proficiency Program with CDC, CAP and WHO for HIV, EID PCR, HIV Viral Loads, CD4, Syphilis, and Hepatitis B and C serology and maintaining their Quality Assurance System. USG will work closely with the MoH to improve the collection and packaging of sample referrals and improve the lab network transportation referral, linked to the NRL to ensure that samples get to the NRL in adequate conditions. To ensure that results are reported in a timely manner, we will assist in improving the centrally-located EID data base at the NRL, using the data for planning and decision making and strengthening forecasting and procurement in order to reduce reagent stock-outs. Quarterly meetings will be held with the clinical and laboratory personnel from the maternity and pediatric hospitals and the NRL to share information, lessons-learned, to identify barriers, and to highlight good practices on the efficient use of laboratory support for effective PMTCT and EID service provision.

To improve data usage, the USG will work with the MoH to develop or improve the following: a standardized EID sample requisition form, a centrally-located EID data base at the NRL to improve PMTCT program data collection, and a plan for the routine reporting of data relevant to various programs of the MoH. A standardized monthly reporting form will be developed summarizing EID updated data to be used for decision making.

The MoH Laboratory Directorate will lead the process to develop Quality Assurance programs. This will include Standard Operating Procedures for Rapid HIV and RPR tests and supportive laboratory procedures and supervision including the correct usage of guidelines on HIV and EID algorithms.

Subpartners Total: $0
Ministry of Health - Dominican Republic: NA
Key Issues Identified in Mechanism
Child Survival Activities
Military Populations
Mobile Populations
Safe Motherhood