Critical to the Dominican Republic's efforts to improve access to high-quality HIV services is a robust health workforce and strong systems to manage and support these valuable human resources. The Improving HIV Service Outcomes through Strengthening Human Resources Management project will refine key health workforce systems at the Ministry of Public Health, Ministry of Public Administration, hospitals, and other institutions.

Project Focus Areas

• Distribution of health workers. With support from IntraHealth, national stakeholders will improve the distribution of health workers so they are strategically deployed to provide HIV services where they are most needed. The project will use the Workload Indicators of Staffing Need (WISN) approach to build the evidence base that will inform these decisions. WISN calculates the number of each type of health worker (such as nurses and pharmacists) that are needed in a particular health facility, based on the facility’s workload.
• Performance management system. The project will finalize and support implementation of a national performance management system to improve HIV care and treatment.
• Maternal and child health. The third activity focuses on improving HIV services for maternal and child health at priority hospitals, strengthening the information system for perinatal care, and ensuring its use in clinical management

The project builds on the successes of IntraHealth's work in the country under the former global project, CapacityPlus. Through CapacityPlus, IntraHealth supported the Ministry of Public Health in a process of payroll reform, which revealed nearly 10,000 ghost workers (individuals receiving a salary but not working). The Ministry began a phased approach to clean its payroll by reclaiming the salaries of the ghost workers, resulting in savings of over $9 million annually. These savings are being used to improve HIV and other health services by hiring new health workers, increasing salaries by 10%, eliminating user fees, and investing in other health sector reforms, such as setting up a better procurement process for HIV testing kits and antiretroviral drugs.