Leadership, Management & Governance Project End of Project Report

The project was funded by the United States Agency for International Development (USAID) under the United States President's Emergency Plan for AIDS Relief (PEPFAR). The project aimed to develop organizational capacity within the MOH to establish and carry out effective funding mechanisms, management, and stewardship of HIV prevention services provided by local NGOs. Additionally, the project aimed to develop organizational capacity within local NGOs to support the implementation of evidence-based, quality HIV prevention services for key and priority populations in compliance with the new MOH funding mechanisms. The project worked hand-in-hand with the MOH and NGOs, resulting in 25 total contracts being signed and monitored each year for education and prevention service delivery to key populations over the three years of the project. The project provided technical assistance during each annual contracting cycle, from the request for proposals to service delivery and final close-out of activities and contracts. The PEPFAR targets tracked by the project were consistently surpassed. The project also provided broader institutional support to the MOH, particularly to the Unit for the Administration of External Cooperation Funds (UAFCE), as they worked to strengthen their systems and processes to provide an enabling environment for the success of the contracts to the NGOs. The project facilitated the start of the UAFCE's certification in the International Organization for Standardization quality management ISO 9001, through hiring a consultant to begin the process with them, which will be completed in 2016. The project's key accomplishments include the issuance of 25 contracts to NGOs through four rounds of government bidding processes, making it possible for key populations, including female sex workers, men who have sex with men, Garifuna, and transgender populations, to have access to HIV and AIDS prevention services in four regions over three years. The NGOs met or surpassed most of their programmatic targets, reaching close to 40,000 people from key populations with quality HIV prevention and education services. The NGOs shared knowledge with one another and with regional health staff on successful education methods in reaching key populations. The MOH and NGOs are better equipped to recognize and respond to cases of gender-based violence (GBV), especially as it relates to HIV/AIDS. The project trained 85 people from local NGOs, MOH regional health staff, and health facility counselors, resulting in their development of 14 training plans for use by NGOs with their own beneficiaries on prevention of GBV, 14 referral plans for use by NGOs for cases of GBV, and 6 monitoring tools for regional health staff to monitor the NGOs' activities on prevention of GBV. Coordination at the local level between NGOs and Regional Health Offices was established and reported upon as a useful and positive experience for the improvement of service delivery to key populations and in organizational strengthening for the MOH and NGOs. The project's success has set a precedent for the United States Government (USG) funding a local government directly for HIV services to key populations, and it has provided a model for other countries in the region to follow.