Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013

Details for Mechanism ID: 11969
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: $241,500


To improve the quality of HIV testing in PMTCT Programs in the Dominican Republic, by assuring timely availability of HIV and Syphilis same day results at PMTCT clinics, in alignment with recently updated EID/PMTCT guidelines on both congenital HIV and Syphilis prevention.


To update the HIV testing guidelines, to incorporate the use of a standardized logbook for HIV tests processes and results.

To provide emergency wards at main maternities with basic laboratory infrastructure to be able to report HIV and Syphilis quality rapid tests, with quality and in a timely manner.

To improve sample referral transport and delivery for CD4, HIV viral loads and EID testing.

GC: The target population to be addressed includes pregnant women who visit the antenatal clinics and emergency wards at the two largest maternity hospitals, and at the high volume hospitals located in the poorest neighborhoods in Region 0, Region I, Region II , Region V , and Region VIII.

TS: The participating laboratories will enroll in the first group of the External Quality Assurance Program for HIV serology, from the NRL, to further become hubs for their regions, in trainings and as leaders, to make these changes sustainable and cost-efficient over time.

CE: By integrating a Quality Assurance System at these laboratories, lead by the Lab Directorate of MOH, the whole institution will benefit from waste management and biosafety measures implemented, as well as mentors, staff trainings, establishing standardized protocols at all levels, and improvements in plan designs.

M&E: Periodic review of standardized HIV tests logbook and direct feedback to lab supervisors and staff.

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $241,500

USG will continue to provide technical assistance (TA) and advocate for the provision of same-day HIV and syphilis test results through a series of activities, such as the validation of HIV reagents that are available in the country; development of an official HIV testing algorithm to be implemented within PMTCT, and TA to switch over to RPR instead of VDRL for syphilis diagnosis. The USG will provide TA to ensure quality testing. To accomplish this objective, an external quality assurance (EQA) program for HIV serology will be rolled out initially in the 10 PEPFAR PMTCT priority hospitals including the two largest maternities. This EQA program will also focus on strengthening the management system and personnel in the processing and reporting of HIV results. This initiative works in parallel and has synergies with the SLMTA initiative also taking place, which focuses on human resources strengthening at maternity and high-volume hospitals.

Through this implementing mechanism, the USG/CDC will focus on strengthening testing within the PMTCT in Region 0. This includes the assurance that HIV and syphilis testing is conducted at labor and delivery at the main maternity hospitals and the development of an ER laboratory. TA also will be provided to strengthening the CD4 and viral load sample transport system, as well forecasting and procurement to reduce stockouts in the country. In addition, the USG will advocate and provide TA for the MOH to switch from VDRL to RPR for syphilis testing/diagnosis within PMTCT hospitals, since it is a rapid test recommended by CDC.

As part of the overall USG effort, the CDC will provide TA in the implementation of the new HIV testing guidelines and standardized logbook released by the MOH (DIGECITSS). CDC will also provide TA on the updated National Quality Norms, revised last year with support from CDC, recently released by the MoH viceMinistry of Quality. The USG/CDC will also facilitate quarterly meetings with regional hospitals to share lessons learned, barriers and successes in their PMTCT programs, as well as sharing programmatic information. These meetings will be coordinated with DIGECITSS and the National Reference Laboratory.

Subpartners Total: $0
Ministry of Health - Dominican Republic: NA
Cross Cutting Budget Categories and Known Amounts Total: $50,000
Human Resources for Health $50,000
Key Issues Identified in Mechanism
Child Survival Activities
Mobile Populations
Safe Motherhood