To establish a functional Maternal Death Surveillance & Response (MDSR) system in 2 departments: 1) Conduct MDSR orientation and advocacy meetings with departmental and facility leadership; adapt/print MDSR data collection and reporting tools; train health facility staff on MDSR protocols and ethical reporting in priority facilities; establish and train two departmental MDSR review committees; and set up a simple data flow and reporting system from facilities to the departmental level. (2026) 2) Provide supportive supervision and data quality audits in priority facilities; convene initial departmental MDSR review meetings to analyze aggregated/anonymized cases; develop targeted response actions based on findings; replicate the 2026 MDSR establishment package in two new departments; link with the national technical working group to harmonize reporting; and develop/disseminate bi-annual MDSR bulletins for stakeholders. (2027) 3) Facilitate a lessons learned workshop with all four departments; develop a costed MDSR sustainability and scale-up plan for the Ministry of Health and potential donors; organize a national advocacy forum presenting analyzed MDSR data; and initiate community-based surveillance pilots involving community health workers (ASCPs) and traditional birth attendants. (2028)

To strengthen quality of care and integration pathways for NCDs and maternal health at the health networks: 1) Map existing referral pathways and identify gaps for NCDs in the Port-au-Prince department; adapt/disseminate standardized clinical protocols for priority areas; train CHWs from displacement sites on maternal health and NCD screening and health promotion; establish screening points in secure displacement sites; and initiate monthly coordination meetings between CHWs and the nearest PHC clinics for referral and support. (2026) 2) Develop integrated “NCD-in-Maternal-Care” clinical pathways for conditions such as hypertension and diabetes during ANC/PNC; scale the CHW model by training additional CHWs and expanding screening points in two additional departments; and launch a simple mHealth tool or reinforced referral/recording mechanism to track outcomes and improve coordination with clinics and data visibility. (2027) 3) Finalize and officially disseminate national-approved integrated protocols for NCD and maternal health care at the PHC level based on pilot results; and develop and initiate a sustainability and handover plan with national counterparts to ensure continuity of screening points, CHW-team functions, and protocol adherence monitoring post-project. (2028)

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)