Local Health System Sustainability Project
The Government of the Dominican Republic has made good progress toward its goal of ending HIV by 2030. Advances to date have been due to strong national coordination and ownership of HIV programs, and the decentralization of HIV services through comprehensive care clinics and community-based and mobile services. Still, only half of all people living with HIV are on antiretroviral therapy. Continued progress depends on improving the efficiency and quality of HIV treatment and care – particularly for people of Haitian descent and others who may face stigma, discrimination, or economic, cultural, or linguistic barriers.
LHSS is supporting government efforts to further strengthen community-level and mobile HIV service delivery and quality. We are working to:
- Update national guidelines and develop standard operating procedures for mobile service delivery, including services delivered through mobile clinics, lay counselors, and community teams
- Strengthen the government’s supply chain management system for HIV products by building capacity for forecasting, quantification, procurement, and tracking
- Promote adherence to HIV clinical guidelines by implementing a supportive supervision system that encourages health workers to continually learn and improve
- Standardize in-service training for HIV health workers
Our work will particularly benefit people who are more affected by HIV than the general population, and who often have less access to health care because they fear stigma and discrimination. These groups include individuals of Haitian descent, sex workers, men who have sex with men, and transgender people. They will have better access to culturally sensitive, high-quality, patient-centered HIV care, including testing, treatment, and viral load suppression to improve their quality of life.