To strengthen resilient quality of care systems in Haiti's functioning referral hospitals amid humanitarian crisis, focusing on saving lives through evidence-based surgical safety improvements, capacity building, and scalable recovery models for the national health system. 2026: Establish the foundation for quality improvement at Hôpital Universitaire La Paix (HUP) through on-site technical support, creation of the Surgery Management Committee, assessments of infrastructure and clinical processes, development of priority surgical protocols, C-Arm integration, staff training, establishment of an M&E system, initial actions to reduce waiting times, and strengthened coordination with the Ministry of Health. 2027: Consolidate and expand the quality improvement model at HUP while beginning replication at Hôpital Universitaire Justinien and Hôpital Immaculée Conception des Cayes. Activities will include establishing quality improvement structures at the additional hospitals, introducing priority clinical and infection prevention interventions, strengthening monitoring and inter-hospital learning, expanding quality initiatives at HUP to other clinical areas, and supporting the Ministry of Health in developing national quality standards and a broader quality improvement framework. 2028: Consolidate implementation and sustainability across participating hospitals by closing remaining quality gaps, completing priority protocols and staff training, documenting improvement cycles, ensuring the functionality and maintenance of key equipment, finalizing national quality policy products, and completing the formal handover of quality improvement structures and responsibilities to national and hospital counterparts.

To develop and initiate the rollout of a health workforce training at PHC level adapted to the context of a protracted humanitarian emergency: 1) Finalize co-creation of the first six of twelve PHC training modules with the University of Sao Paulo and the VCPH; translate and contextualize modules for Haiti (French/Creole); and launch the first virtual training cohort on the VCPH platform for 50 nurses and PHC workers. (2026) 2) Finalize, translate and upload the remaining six modules to complete the full curriculum; launch two additional virtual cohorts targeting nurses and PHC workers from initial and new geographic areas; establish a Training of Trainers (ToT) program; implement a blended learning model with in-person practicum supported by ToT graduates; conduct a mid-term review and revision of the first eight modules based on cohort results; and formalize partnership with the Ministry of Health for adoption of the curriculum, including exploration of CPD credits. (2027) 3) Develop a national scale-up and sustainability plan for continued implementation and integration into pre-service and in-service pathways; launch a specialized advanced module or alumni network; and finalize agreements for official handover of the curriculum to national institutions (Ministry of Health, Haitian universities, VCPH) to ensure post-project continuity. (2028)

To strengthen health financing by producing National Health Accounts, developing health financing strategies, and advocating for equitable and increased health funding through a nexus approach. 2026: Support the Ministry of Health to compile, validate, analyze, and disseminate National Health Accounts for 2021–2024, in coordination with the Ministry of Finance, statistical authorities, donors, NGOs, social security institutions, and other key stakeholders. Use the findings to strengthen understanding of health expenditure trends, out-of-pocket spending, and donor dependency. 2027: Build on the National Health Accounts to conduct a broader health financing situation analysis and develop a national Health Financing Strategy aligned with UHC objectives. This will include policy options for domestic resource mobilization, pooling, strategic purchasing, contracting, and results-based financing, as well as engagement with donors and development partners to mobilize longer-term financing and explore the establishment of a Health Transition Fund. 2028: Finalize and support national adoption of the Health Financing Strategy, advance implementation of priority financing reforms, consolidate governance and financing arrangements for the proposed Health Transition Fund, and transition relevant tools, evidence, and coordination mechanisms to national counterparts to support sustainability.