FINAL PROGRAM REPORT – Doctors of the World Support to the Haitian health system in the context of COVID-19

The virus was confirmed to have reached Haiti on March 19th, 2020, when the first COVID-19 cases in the country were confirmed. Doctors of the World (DoTW) designed the project "Support to the Haitian health system in the context of COVID-19" in 2020 to assist in the response against COVID-19 with the assistance of the United States Agency for International Development (USAID). The project targeted the communes of Martissant and Cité Soleil in Port-au-Prince (West department); the Goavienne region (West department) and the Nippes department, at the health facilities (HF) and community level. The project supported 10 HF's with trainings, set-up of triage stations and temporary isolation rooms, and increased respect of COVID-19 specific protocols. In total, 188,855 beneficiaries were reached in the 7 months of the project, with the support of health care and department directorate staffs, community-based organizations (CBO), Multi-skilled Community Health Workers (MSCHW), and matrons. The project was successfully executed in coordination with the health authorities (MSPP, West and Nippes Sanitary Departments and HF), the stakeholders of the COVID-19 response (PAHO/WHO, World Bank, ECHO, etc.), the humanitarian architecture in Haiti (OCHA, health cluster, international and national NGOs), the communities and their representatives, and the CBO of Cité Soleil and Nippes, Martissant, and the Goavien Region. In August 2020, DoTW Canada carried out a diagnosis of compliance with COVID-19 specific IPC measures in the 6 HF of Cité Soleil (Nippes) and Nippes. The diagnosis showed that very few IPC measures were followed due to a lack of equipment, training, protocols, and resources. However, at the end of the project, 98.94% of 66 IPC measures assessed in the diagnostic were followed in the HFs, and 89.34% in Cité Soleil. The project also faced challenges due to the security situation in Haiti, which made access to Cité Soleil and Martissant difficult and activities were suspended or implemented remotely several times. The economic crisis worsened an already worrying economic situation, and the local currency appreciated greatly, impacting the project budget. The project's performance was monitored through data collection on a weekly basis from HF registers with MSPP tools. The data showed that the project was able to prevent the further spread of COVID-19 in Haiti and support access continuity to basic healthcare services of the most vulnerable population in the West and Nippes departments. The total number of beneficiaries reached was 188,855, surpassing the target of 118,648. The project also supported the MSPP infection prevention and control (IPC) activities for COVID-19 in the West and the Nippes departments. The number of beneficiaries for outcome 1 was 12,227, which is the total of the number of people screened in the supported HFs and the number of health care staff trained. The project was able to train 90 health care staff, surpassing the target of 42 health care staff. The project also improved the knowledge of the population on protective measures, with 97% of the target population able to recall 2 or more protective measures. The supported HFs reported 0 suspected cases once the triage was functional, and the referral system set up by the MSPP sometimes allows the community to directly call the DDS in the event of a COVID-19 suspicion. The project also supported the continuity of essential health services such as primary health care (PHC), sexual and reproductive health (SRH), Gender-Based Violence (GBV), and mental health and psychosocial support (MHPSS). The project was able to reach a total of 188,855 beneficiaries, surpassing the target of 118,648.