Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 5128
Country/Region: Haiti
Year: 2007
Main Partner: Johns Hopkins University
Main Partner Program: JHPIEGO
Organizational Type: University
Funding Agency: USAID
Total Funding: $0

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $0

Linked to Activities 9308,9671,9683,9725. SUMMARY: Activities are focused on improving the availability and quality of PMTCT services at 53 USG-supported sites through frequent technical assistance visits; application of a quality assurance (QA) approach in supervision and monitoring of the sites, in coordination with IHNSAC; participation in the training of new PMTCT providers that are trained at the Haitian Institute of Community Health (INHSAC), a sub-partner to I-TECH; carrying out a coordinating role among the USG partners that work in PMTCT and linking their activities to USAID-funded maternal health activities in non-PEPFAR programs. The primary emphasis areas for this activity are local organization capacity development and QA, quality improvement and supportive supervision. The primary target populations are health workers and pregnant women.

BACKGROUND: Over the past two years (FY 2005 and FY 2006), the Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO) has supported the development of the PMTCT training package in collaboration with the Ministry of Health (MOH), has trained over 300 providers at over 40 sites, and has provided technical assistance to at least 18 sites in the form of needs assessments, supportive supervision, and equipment acquisition. In FY06, JHPIEGO will introduce the standards-based management and recognition (SBM-R) approach to service quality improvement and will provide support to a local training institution (INHSAC) to conduct on-going PMTCT training for new staff and ensure that they establish in-country training capacity. JHPIEGO has worked closely with all 10 regional departmental directorates of the MOH to plan and implement institutional strengthening activities, and will continue this effort by transferring supervision skills to departmental staff overseeing PMTCT activities.


There are three activities that will be carried out in FY 2007.

Activity 1: JHPIEGO will provide technical assistance to staff in 53 designated PMTCT sites to improve their capacity to offer counseling, testing, and treatment to women in antenatal care, labor and delivery, post-natal care and also increase referrals of both mothers and babies to HIV/AIDS care and treatment centers. Support will be provided to improve the organization of the clinical services (e.g. patient enrollment, patient flow, referral to other HIV/AIDS services.) A PMTCT adherence plan will be developed with each HIV positive pregnant women as part of her more comprehensive birth plan. This adherence plan will involve all three stages of pregnancy: antenatal, labor and delivery, post-natal periods, to make it very clear to the woman how important interventions at each stage are to the complete treatment. This effort should increase the number of women tested and the number of HIV-positive women following a full course of prophylactic treatment. Funds will be used for regular site visits during which providers are observed, using standardized tools and frameworks, performing their tasks so that gaps can be addressed and issues resolved. JHPIEGO will serve as a link with other USG support to these institutions by informing them of ongoing needs, such as those related to equipment, materials, ARV drugs, human resources, information management, infrastructure, community mobilization and behavior change communication. JHPIEGO will coordinate with the CRS and PIH networks to ensure that standardized quality PMTCT services are provided at all PEPFAR supported sites. JHPIEGO will also ensure that the PMTCT sites are linked with other, non-PEPFAR USAID initiatives to improve maternal health service delivery.

Activity 2: JHPIEGO will support INHSAC to implement supportive supervision and QA mechanisms. In FY06, JHPIEGO is charged with introducing SBM-R approach to performance and quality improvement in 12 obstetric care services in the country, specifically for PMTCT service delivery. In FY07, JHPIEGO will conduct a follow-up assessment at these 12 sites to assess the impact of this structured approach to QA and will hold a workshop to introduce nine additional sites for FY07 to the process. With the view to establishing the technical capacity in INHSAC to carry out this QA methodology, site visits will be made with INHSAC staff to continue this approach in all USG-supported PMTCT sites. Funds will also be used to run a workshop for INHSAC staff on how to implement the SBM-R approach. This activity is related to human resource retention because it emphasizes recognition for achieving standards, a key strategy for retaining staff.

Activity 3: JHPIEGO will serve as coordinating agency of institutions providing PMTCT support in coordination with the MOH. Funds will be used to hold quarterly meetings with all USG partners, as well as other donor-funded institutions and MOH facilities that are involved in PMTCT service delivery, in order to improve communication and coordination, to share lessons learned and to analyze reported service delivery data to be able to make programmatic adjustments and decision. While JHPIEGO is not charged with working at the community level, it will work with other USG partners to ensure that community interventions with pregnant women by trained birth attendants and community health agents are linked to the facility-level services.