PROGRAM AREA: AB Prevention (HVAB)

SUMMARY: The Leadership, Management and Sustainability (LMS) Program will be providing capacity

building support across a number of PEPFAR program areas. Under AB prevention, a number of activities

will be implemented to build the capacity of the Ministry of Health and Population (MSPP) through support

to the National AIDS Program. First, with the end of the HCP Project in Haiti, the Leadership, Management

and Sustainability (LMS) Program will continue to be supported by USAID to lead the current program on

strengthening departmental-level capacity to plan, coordinate, and monitor interventions focusing on

promoting appropriate behaviors for HIV/AIDS prevention, addressing issues of stigma and discrimination

reduction, and community mobilization for increased demand for and use of HIV/AIDS services. JHU/CCP

will continue to provide some technical assistance to the program through a limited subcontract with LMS.

This program is funded through 50% AB and 50% OHPS funds.

In addition, LMS will provide support to FOSREF to increase its capacity to provide access to services for

sexually transmitted infections (STIs), HIV/AIDS, and sexual and reproductive health, at the institutional and

community levels, to the youth of Cité Soleil. The program plans to reduce by 50% the HIV prevalence in

the population of Cité Soleil and particularly among the youth in this area. In addition, the program will offer

other alternatives to the youth of Cité Soleil. This program is funded through 50% HVOP, 25% HVCT, 15%

HVAB, and 10% HBHC funding, and a description of this activity can also be found under those program

areas.

AED's SmartWork Project has ended and USAID is phasing out AED's involvement with the work itself in an

effort to consolidate its BCC prevention strategy and provide technical assistance through fewer partners.

Because the local organizations that are working in this area also need a certain amount of capacity

building at the same time as being able to quickly get on track for future sustainability, USAID is supporting

LMS to integrate this activity into its ongoing technical assistance and capacity building to the local

organizations that are well-placed to do AIDS in the workplace interventions and have been working with

SmartWork project personnel, training materials, and BCC materials. These activities are funded through

50% AB and 50% HVOP, and a description of these activities can be found under both program areas.

BACKGROUND: The President's Emergency Plan in Haiti supports a comprehensive HIV/AIDS prevention,

treatment, and care program. The Health Communication Partnership (HCP), led by the Johns Hopkins

Bloomberg School of Public Health, Center for Communication Programs (CCP) was involved with

innovative HIV prevention work for more than four years in Haiti. The HCP programs included coordination

of BCC activities under the leadership of the Ministry of Public Health and Population (MSPP); promotion of

VCT and PMTCT services; care and support for PLWA; and abstinence and faithfulness programs for

youth. The 2006 APS awarded to CCP added OVC and AB for most at-risk youth components to this

portfolio. Last year, CCP took the lead in coordinating BCC prevention activities in Haiti. More specifically,

CCP provided technical assistance to the MSPP to map prevention activities in each department, looking in

more detail at the local partners, funding agencies, activities, and identifying the gaps to suggest

appropriate solutions. In addition, to better provide guidance to the MSPP, CCP participated in a series of

meetings and organized training in community mobilization techniques for NGOs and departmental staff. In

January 2008, local CCP staff joined LMS to continue this work.

FOSREF has a mandate from the Ministry of Health and Population (MSPP) to deliver youth-focused sexual

and reproductive health and HIV/AIDS services to youth nationwide. Youth, who represent more than 50%

of the population, are the most vulnerable groups for HIV/AIDS and unwanted pregnancies, with a high

incidence of clandestine abortions. In this context, FOSREF has identified key cities in the country where

specific programs for youth must be implemented to meet the unmet needs of young people for sexual and

reproductive health and HIV/AIDS prevention. To date, FOSREF has created and implemented a network

of 15 youth centers in cities. During the last four years, FOSREF has identified areas in the marginalized

segments of the large cities, particularly in the Metropolitan areas of Port-au-Prince, where there are no

existing youth services. Cité Soleil is one of these areas, representing one of the largest challenges in

terms of unmet needs of youth for sexually transmitted infections, HIV/AIDS, sexual violence, and other

sexual and reproductive health matters. Young people have been victims of gang activities that have

reduced them to desperate circumstances.

Initiated in 2002, Strategically Managing AIDS Responses Together in the Workplace (SMARTWork) fosters

social dialogue around workplace HIV/AIDS prevention at national and enterprise levels, as well as stigma

and discrimination reduction. Taking a bipartite (business-labor) approach at the enterprise level and a

tripartite (business-labor-government) approach at the national level, SMARTWork has aimed at reducing

HIV transmission through effective prevention programs, and has encouraged policies that provide for

workplace protection and human rights of individuals affected and infected by HIV. The workplace is a

critical channel to provide HIV/AIDS prevention interventions. SMARTWork intervenes through workshops,

outreach, and special events using a core group of trainers and outreach workers to deliver messages that

foster fidelity, partner reduction, and condom use. Complementing and reinforcing these messages are

workplace policies, IEC materials, and referrals to CT, STI, and care and treatment services.

PROGRAM AREA: Condoms & Other Prevention (HVOP)

SUMMARY: The Leadership, Management and Sustainability (LMS) Program, through support from

USAID, will provide assistance in capacity building to a number of NGO partners involved in HVOP activities

as well as support to capacity building in establishing a national procurement and logistics system. LMS will

continue to provide assistance to FOSREF to provide access to services for sexually transmitted infections

(STIs), HIV/AIDS, and sexual and reproductive health, at the institutional and community levels, to the youth

of Cité Soleil. The program plans to reduce by 50% the HIV prevalence in the population of Cité Soleil and

particularly among the youth in this area. In addition, the program will offer other alternatives to the youth of

Cité Soleil. This program is funded through 50% HVOP, 25% HVCT, 15% HVAB, and 10% HBHC funding,

and a description of this activity can also be found under those program areas.

AED's SmartWork Project has ended and USAID is phasing out AED's involvement with the work itself in an

effort to consolidate its BCC prevention strategy and provide technical assistance through fewer partners.

Because the local organizations that are working in this area also need a certain amount of capacity

building at the same time as being able to quickly get on track for future sustainability, USAID is supporting

LMS to integrate this activity into its ongoing technical assistance and capacity building to the local

organizations that are well-placed to do AIDS in the workplace interventions and have been working with

SmartWork project personnel, training materials, and BCC materials. These activities are funded through

50% AB and 50% HVOP, and a description of these activities can be found under both program areas.

BACKGROUND: In Haiti, youth, who represent more than 50% of the population, are the most vulnerable

groups for HIV/AIDS and unwanted pregnancies, with a high incidence of clandestine abortions. FOSREF

has a mandate from the Ministry of Health and Population (MSPP) to deliver youth-focused sexual and

reproductive health and HIV/AIDS services to youth nationwide. In this context, FOSREF has identified key

cities in the country where specific programs for youth must be implemented to meet the unmet needs of

young people for sexual and reproductive health and HIV/AIDS prevention. To date, FOSREF has created

and implemented a network of 15 youth centers in many cities. During the last four years, FOSREF has

identified areas in the marginalized segments of the large cities, particularly in the Metropolitan areas of

Port-au-Prince, where there are no existing youth services. Cité Soleil is one of these areas, representing

one of the largest challenges in terms of unmet needs of youth for sexually transmitted infections,

HIV/AIDS, sexual violence, and other sexual and reproductive health matters. Young people have been

victims of gang activities that have reduced them to an almost hostage-like situation. Based on recent

official information from the Ministry of the Interior, the Director of the National Police, and from the UN

Peace Keeping Forces (MINUSTAH), the security situation in Cité Soleil has improved enough to begin to

target services to the population in this area.

Initiated in 2002, Strategically Managing AIDS Responses Together in the Workplace (SMARTWork) fosters

social dialogue around workplace HIV/AIDS prevention at national and enterprise levels, as well as stigma

and discrimination reduction. Taking a bipartite (business-labor) approach at the enterprise level and a

tripartite (business-labor-government) approach at the national level, SMARTWork has aimed at reducing

HIV transmission through effective prevention programs, and has encouraged policies that provide for

workplace protection and human rights of individuals affected and infected by HIV. The workplace is a

critical channel to provide HIV/AIDS prevention interventions. SMARTWork intervenes through workshops,

outreach, and special events using a core group of trainers and outreach workers to deliver messages that

foster fidelity, partner reduction, and condom use. Complementing and reinforcing these messages are

workplace policies, IEC materials, and referrals to CT, STI, and care and treatment services.

PROGRAM AREA: Palliative Care: BHC&S (HBHC)

SUMMARY: The Leadership, Management and Sustainability (LMS) Program will receive support from

USAID to work with partners to develop their capacity to serve People Living with HIV/AIDS (PLHWA). LMS

will continue to work with the Maison l'Arc-en-Ciel (MAEC) to expand the number of OVCs and PLWHA

families impacted by MAEC's outreach program to metropolitan Port-au-Prince's children infected/affected

by HIV/AIDS and to build on a model MAEC has begun to develop for community mobilization using a large

group of community-based organizations (CBOs) in the Frères and Croix des Bouquets areas. Through this

support, MAEC will continue to increase its caseload from its present 286 families and 572 children/youth to

367 families and 873 children/youth through identification and referral by MAEC partners such as Cornell-

GHESKIO. MAEC will create support groups of PLWHA and non-infected CBO volunteers for its families in

these two zones. The families will receive tangible services such as health care, training, nutritional

support, and school fees as well as participate in MAEC's peer home visiting program that has had an

important effect on bolstering self-esteem and reviving hope among its families. This support offers MAEC

the opportunity to extend its model into Cité Soleil, probably the neediest area in the exceptionally resource-

poor country. In summary, the MAEC activities consist of two main activities: care and support of OVCs

and their families; and a community-level partnership with international, local, and CBOs to support PLWHA

families while working to prevent HIV infection and reduce stigmatization. LMS will help strengthen the

leadership and management skills of the MAEC support groups and increase the involvement and capacity

of the staff towards a common sustainable goal and lasting impact of the program. This program is funded

through 75% HKID and 25% HBHC funding, and a description of these activities can be found under both

program areas.

In addition, LMS will continue support to FOSREF to provide access to services for sexually transmitted

infections (STIs), HIV/AIDS, and sexual and reproductive health, at the institutional and community levels,

to the youth of Cité Soleil. The program plans to reduce by 50% the HIV prevalence in the population of

Cité Soleil and particularly among the youth in this area. In addition, the program will offer other alternatives

to the youth of Cité Soleil. This program is funded through 50% HVOP, 25% HVCT, 15% HVAB, and 10%

HBHC funding, and a description of this activity can also be found under those program areas.

BACKGROUND: MAEC is a Haitian non-profit NGO that began work in the Port-au-Prince area in July

1996 with the opening of the first residential care and treatment facility in Haiti for children orphaned or

affected by AIDS. MAEC began a non-residential program in 1998 and provided monthly medical visits and

other activities for children as well as a dry food ration for the family and regular home visits by social

workers and auxiliary nurses. The participating families live in some of the most HIV-affected areas of the

country, the metropolitan Port-au-Prince communes of Carrefour, Croix des Bouquets, Cite Soleil, Delmas,

Pétionville (including Frères), Port-au-Prince, and Tabarre. Families living in an impoverished area with at

least one HIV+ child or a child who had lost at least one of his or her parents to the disease were eligible to

receive care. As the program has expanded since 2002, through partnerships with Plan Haiti, FHI, and

UNICEF, MAEC was able to add an outreach center that houses classrooms for children and heads of

families, provides medical and psychological consultations as well as cultural activities, etc. Food is

provided by partners CRS and WFP. Community mobilization activities were added through the use of

elected mothers who were trained and able to provide home visits even during times of instability in the

country.

FOSREF has a mandate from the Ministry of Health and Population (MSPP) to deliver youth-focused sexual

and reproductive health and HIV/AIDS services to youth nationwide. In Haiti, youth, who represent more

than 50% of the population, are the most vulnerable groups for HIV/AIDS and unwanted pregnancies, with a

high incidence of clandestine abortions. In this context, FOSREF has identified key cities in the country

where specific programs for youth must be implemented to meet the unmet needs of young people for

sexual and reproductive health and HIV/AIDS prevention. To date, FOSREF has created and implemented

a network of 15 youth centers in many cities. During the last four years, FOSREF has identified areas in the

marginalized segments of the large cities, particularly in the Metropolitan areas of Port-au-Prince, where

there are no existing youth services. Cité Soleil is one of these areas, representing one of the largest

challenges in terms of unmet needs of youth for sexually transmitted infections, HIV/AIDS, sexual violence,

and other sexual and reproductive health matters. Young people have been victims of gang activities that

have reduced them to an almost hostage-like situation. Based on recent official information from the

Ministry of the Interior, the Director of the National Police, and from the UN Peace Keeping Forces

(MINUSTAH), the security situation in Cité Soleil has improved enough to begin to target services to the

population in this area.

PROGRAM AREA: Orphans & Vulnerable Children: (HKID) - LMS: US 550,000

SUMMARY: The Leadership, Management and Sustainability (LMS) Program will receive support from

USAID to work with partners to build their capacity to provide services to Orphans and Vulnerable Children.

Specifically, LMS will continue to work with the Maison l'Arc-en-Ciel (MAEC) to expand the number of OVCs

and PLWHA families impacted by MAEC's outreach program to metropolitan Port-au-Prince's children

infected/affected by HIV/AIDS and to build on a model MAEC has begun to develop for community

mobilization using a large group of community-based organizations (CBOs) in the Frères and Croix des

Bouquets areas. Through this support, MAEC will continue to increase its caseload from its present 286

families and 572 children/youth to 367 families and 873 children/youth through identification and referral by

MAEC partners such as Cornell-GHESKIO. MAEC will create support groups of PLWHA and non-infected

CBO volunteers for its families in these two zones. The families will receive tangible services such as

health care, training, nutritional support, and school fees as well as participate in MAEC's peer home visiting

program that has had an important effect on bolstering self-esteem and reviving hope among its families.

This support offers MAEC the opportunity to extend its model into Cite Soleil, probably the neediest area in

the exceptionally resource-poor country. In summary, the MAEC activities consist of two main activities:

care and support of OVCs and their families; and a community-level partnership with international, local,

and CBOs to support PLWHA families while working to prevent HIV infection and reduce stigmatization.

LMS will help strengthen the leadership and management skills of the MAEC support groups and increase

the involvement and capacity of the staff towards a common sustainable goal and lasting impact of the

program. This program is funded through 75% HKID and 25% HBHC funding, and a description of these

activities is included in both program areas.

BACKGROUND: MAEC is a Haitian non-profit NGO that began work in the Port-au-Prince area in July

1996 with the opening of the first residential care and treatment facility in Haiti for children orphaned or

affected by AIDS. MAEC began a non-residential program in 1998 and provided monthly medical visits and

other activities for children as well as a dry food ration for the family and regular home visits by social

workers and auxiliary nurses. The participating families live in some of the most HIV-affected areas of the

country, the metropolitan Port-au-Prince communes of Carrefour, Croix des Bouquets, Cite Soleil, Delmas,

Pétionville (including Frères), Port-au-Prince, and Tabarre. Families living in an impoverished area with at

least one HIV+ child or a child who had lost at least one of his or her parents to the disease were eligible to

receive care. As the program has expanded since 2002, through partnerships with Plan Haiti, FHI, and

UNICEF, MAEC was able to add an outreach center that houses classrooms for children and heads of

families, provides medical and psychological consultations as well as cultural activities, etc. Food is

provided by partners CRS and WFP. Community mobilization activities were added through the use of

elected mothers who were trained and able to provide home visits even during times of instability in the

country.

The intention for this funding was to continue supporting the local Johns Hopkins University Center for

Communication (JHUCCP) Program team and their activities in AIDS prevention communication, education

and community mobilization. The mechanism that was expected to be available for this support (a follow-on

project to the JHUCCP centrally funded agreeement with USAID that ended in mid 2007) is not available as

the current implementing institution for that project decided not to pick up the local Haiti project. The

program and activities remain the same but the mechanism being used to channel the funds to the local

team and thus ensure continuity of programming is the Leadership, Management and Sustainability (LMS)

Project, managed by Management Sciences for Health mechanism.

PROGRAM AREA: Policy Analysis & System Strengthening (OHPS)

SUMMARY: In COP 08 the Leadership, Management and Sustainability (LMS) Program will continue to

provide institutional capacity building support to selected Government of Haiti units, such as the CNLS, to

increase their abilities to provide nationwide coordination, thereby increasing synergies and effectiveness of

the PEPFAR programs. LMS will develop leadership and management skills at national and departmental

levels. Support will also include strengthening organizational and program management capacity to

efficiently and effectively affect the national response, with particular emphasis on coordination issues.

LMS will provide support in areas of organizational development such as: development and maintenance of

constructive, informed working relationships with all stakeholders, including the USG, their IPs, and other

donor organizations; project management; clarifying roles and responsibilities; monitoring and evaluation;

strategic planning; sound governance; and leadership development. The goal of this technical assistance

and capacity building is an improved organizational structure with a clear mission, more efficient

governance, effective internal and external communication, monitoring and evaluation systems, and

improved management.

With the end of the HCP Project in Haiti, the Leadership, Management and Sustainability (LMS) Program

will continue to be supported by USAID to lead the current program on strengthening departmental-level

capacity to plan, coordinate, and monitor interventions focusing on promoting appropriate behaviors for

HIVAIDS prevention, addressing issues of stigma and discrimination reduction, and community mobilization

for increased demand for and use of HIV/AIDS services. JHU/CCP will continue to provide some technical

assistance to the program through a subcontract with LMS. This program is funded through 50% AB and

50% OHPS funds, and a description of these activities is included under both program areas.

BACKGROUND: As part of the development assistance under the USAID Investing in People Objective,

3.1 Health Area, 3.1.1 HIV Program Element, USAID provides technical assistance to the Government of

Haiti to reinforce the national health care delivery system and strengthen the leadership capacity and

systems of the Ministry of Health and Population (MSPP) to better manage the National AIDS Program.

The MSPP Departmental Health Directorates are increasingly taking on responsibilities for planning,

monitoring, and coordinating health care services in their regions.

The President's Emergency Plan in Haiti supports a comprehensive HIV/AIDS prevention, treatment, and

care program. The Health Communication Partnership (HCP), led by the Johns Hopkins Bloomberg School

of Public Health, Center for Communication Programs (CCP) was involved with innovative HIV prevention

work for more than four years in Haiti. The HCP programs included coordination of BCC activities under the

leadership of the Ministry of Public Health and Population (MSPP); promotion of VCT and PMTCT services;

care and support for PLWA; and abstinence and faithfulness programs for youth. The 2006 APS awarded

to CCP added OVC and AB for most at-risk youth components to this portfolio. Last year, CCP took the

lead in coordinating BCC prevention activities in Haiti. More specifically, CCP provided technical assistance

to the MSPP to map prevention activities in each department, looking in more detail at the local partners,

funding agencies, activities, and identifying the gaps to suggest appropriate solutions. In addition, to better

provide guidance to the MSPP, CCP participated in a series of meetings and organized training in

community mobilization techniques for NGOs and departmental staff.