Where We Work / USAID/Central America Regional Program (G-CAP)

The Capacity Project provided assistance to USAID's Central America Regional Program (G-CAP) to improve the capacity of the region’s health workforce to deliver comprehensive HIV/AIDS treatment and care, including tuberculosis coinfection. This work took place in Belize, Costa Rica, El Salvador, Guatemala, Nicaragua and Panama.

Activities were organized around three objectives:

1. Improve pre-service education on HIV comprehensive treatment and care, with special attention to reducing stigma and discrimination against people living with HIV in health establishments
2. Improve the capacity of human resources for health to deliver quality HIV comprehensive treatment and care through performance improvement and supportive supervision
3. Improve the capacity of human resources in nongovernmental and faith-based organizations for managing income generation projects for people living with HIV.

Examples of the Project's work in these countries include the following:

1. Through the Project’s performance improvement approach, multidisciplinary care teams at selected health facilities assessed the quality of HIV/AIDS service provision based on performance standards, and developed and implemented action plans to address identified gaps. As a result, hospitals showed marked improvement in performance, many averaging a 30% increase from baseline, with stellar cases showing increments of almost 60%.
2. University of Belize faculty worked with the Project to build capacity to offer training and refresher courses on HIV counseling and testing and to strengthen the integration of HIV into the curriculum.
3. Selected medical students and faculty at the Evangelical University of El Salvador successfully completed the Capacity Project’s training course in voluntary counseling and testing for HIV. The course content included HIV/AIDS counseling skills, clarification of misconceptions about populations vulnerable to HIV, practices for discussing risk reduction with clients and counseling and testing protocols.
4. The Project supported the National Alliance of People Living with HIV in Guatemala in the creation and operation of an Internet café in the Zacapa hospital, an income-generating pilot project for the Alliance’s self-support groups. Revenue from the café helps improve members' adherence to treatment.
5. The Nicaragua Ministry of Health announced its plan to incorporate the Project's performance assessment tool and methodology for HIV services into the national norms for prevention of mother-to-child transmission. The Ministry also planned to implement the tool for HIV treatment.
6. Based on the success of the Project’s performance improvement approach, the Guatemala Ministry of Health announced that the follow-up to the gaps defined using the approach would be included in the country’s health plan covering the first 100 days of 2009. The Project implemented the strategy to strengthen HIV and TB coinfection services. This process identified performance gaps and motivated multidisciplinary care teams to improve services, particularly client/provider interaction and compliance with clinical and technical protocols.

Related resources:

• "Better Service for the Client and the Community": Strengthening HIV Training in Belize
• Bridging the Gaps: Improving Decentralized HIV Services in Panama
• Implementation of Performance Support Approaches in Central America and Uganda
• Supporting Health Worker Performance with Effective Supervision
• “Yielding Very Positive Results”: Improving Decentralized HIV Services in Costa Rica
• USAID/Central America Regional Program (G-CAP) News Stories