Background and Summary. Haiti is a country in the Caribbean with around 10 million inhabitants (World Bank 2009). It has a surface area of 27,000 square kilometres divided into ten (10) geographic and health departments. Haiti has the highest tuberculosis incidence and prevalence rates in the western hemisphere. According to WHO's most recent estimates for 2009 (WHO 2010 Global Tuberculosis Control Report), the incidence rate is 238 per 100,000 population for all forms of tuberculosis (24,000 cases) and 148 notified and relapse new cases per 100,000 population (14,833 cases) for all forms of tuberculosis. The prevalence rate is 331 per 100,000 population for all forms of tuberculosis (33,000 cases). Case detection rate is 62% (all forms) in 2009, while treatment success rate is 82% (2007 cohort). In order to substantially reduce TB transmission and TB-related morbidity and mortality, the National Tuberculosis Control Program (PNLT) is active at all levels of the health pyramid with a peripheral level (diagnosis and treatment centres, CDTs, and treatment centres, CTs), an intermediary level (departmental coordination) and a central level (the PNLT's Central Coordination). The DOTS strategy has been in application since 1997. The PNLT currently bases its actions on the 2006-2015 Strategic Plan, which was recently updated. All of the program's action plans and activities are in line with the main strategic focuses of this plan, which is entirely consistent with the components of the STOP TB strategy. The Round 3 Grant, which ended in July 2009, made it possible to increase the number of institutions applying the DOTS strategy. As a result, the percentage of tuberculosis cases under DOTS rose significantly. The number of notified cases of smear positive pulmonary tuberculosis also increased since 2005. The Round 9 Program intends to continue with the progress that was made in Round 3, by extending the DOTS network and improving the quality of DOTS services. Given the increase in the number of MDR-TB cases over the past few years, the fight against multi-drug resistance will also be a core component of the Round 9 Grant. The quality of DOTS will be improved by: (1) strengthening human resources at all PNLT levels (coordination, departments, laboratories, peripheral centres) responsible for management, monitoring, evaluation and patient services, and (2) supplying laboratories with technical equipment. Because of Haiti's geography and the state of its roads, access to DOTS services is ...
Background and Summary. MENTOR will target the northern provinces of Zaire and Uige and the Huambo province of Angola with school, community and health facility based programs for NTD control and prevention programs. While reliable surveillance data and mapping of diseases in Angola is minimal, passive surveillance at health facility level does demonstrate that the northern, significantly poorer provinces carry a disproportionately high burden of NTDs. With this in mind, MENTOR aims to work with and support both the Ministry of Education (MoE) and the Ministry of Health (MoH) to roll out a NTD prevention and treatment campaign in schools and communities in three targeted provinces. National scale mass drug administration campaigns to control NTDs are the main goal of the MoH NTD program. MENTOR proposes to support the MoH towards this national goal, commencing with an initial roll out of drugs targeting diseases that are known to be present and pervasive. Specifically, MENTOR will support MoH using existing MoH stocks and donations of Albendazole and Praziquantel to target specific NTDs, including schistosomiasis, lymphatic filariasis and those NTDs (helminthes) that are soil transmitted. MENTOR will work with the MoH and MoE to target women of childbearing age, pre-school aged children, school aged children under 15 years of age as well as at-risk adults in rural and urban communities, in Huambo, Uige and Zaire with a mass drug administration (MDA) programme. In addition, MENTOR will ensure health facilities throughout the provinces receive trainings on how to diagnose and treat the targeted neglected tropical diseases. A Water, Sanitation and Hygiene Education (WASHE) programme will also be implemented in schools, in order to contribute to the prevention of infection or re-infection with these diseases. MENTOR will closely support the provincial MoH teams to ensure the efficient execution of the NTD program and effective programme monitoring. Additionally, MENTOR will facilitate sustainable capacity building of MoH partners in the three provinces, as they take on increasing responsibility for overall implementation of these NTD activities.
Background and Summary. Phase C of the Caldera Springs expansion includes two subdivisions. The first is a 16-lot subdivision for overnight lodging units (“OLU”) approved under land use file number 247-22-000182-TP. The second is a 72-lot residential subdivision approved under land use file number 247-22-000183-TP. The developer has elected to plat Phase C in phases. Phase C-1 was platted and recorded on January 11, 2023. Phase C-1 included 37 single-family residential lots and 16 OLUs (8 lots). The developer is now moving forward with platting of Phase C-2, which includes 35 single-family residential lots and 14 OLUs (7 lots). The developer requests an Improvement Agreement related to the infrastructure costs associated with the roads and utilities for the Phase C-2- OLU subdivision. Furthermore, the developer plans to incorporate required improvements associated with the Phase C-1 OLU subdivision into this Improvement Agreement. This requires an amendment to recorded County Document No. 2022- 954 in which the County Administrator is authorized to execute. The remaining improvements required will be accounted for in the new Phase C-2 Improvement Agreement. See Figure 1 below. 000 XX Xxxxxxxxx Xxxxxx, Xxxx, Xxxxxx 00000 | P.O. Box 6005, Bend, OR 97708-6005 (000) 000-0000 xxx@xxxxxxxxx.xxx xxx.xxxxxxxxx.xxx/xx Figure 1. Phase C-1 (blue outline) and Phase C-2 (red outline) (Source: Parametrix) Caldera Springs submitted the attached Improvement Agreement for road and utility infrastructure associated with Phase C-2 within the OLU subdivisions as well as the remaining improvements within Phase C-1 OLU subdivision. The cost estimate is included below and included in the attached agreement. The cost estimates were reviewed and approved by the Road Department. • 247-23-000818-IA: Phase C-2 (road and utility infrastructure for OLU subdivision) in addition to remaining improvements associated with Phase C-1 OLU subdivision - $1,328,430.29 Per Deschutes County Code 17.24.130(B), the security amount must be 120 percent of the cost estimate. For this reason, the bonds submitted by Caldera Springs for Phase C-2 and remaining improvements in Phase C-1 OLU infrastructure are in the amount of $1,594,116.35. Next Steps Staff anticipates the Improvement Agreements will return as a Consent Item on April 3, 2024 for Board signature of Document No. 2024-254. Following Board signature, the County Administrator is an authorized signatory on Document No. 2024-255, the amendment to recorded County Docume...
Background and Summary. What is the SCWA? The Student and Community Workforce Agreement (SCWA) is an agreement between Seattle Public Schools (SPS) and the building construction trade unions (meaning carpenters, laborers, masons, plumbers, electricians, etc.) but has no relationship to architects or engineers. The low responsive responsible prime contractor signs the SCWA and works under its provisions during the project. The prime contractor ensures all subcontractors agree and sign a letter of assent to the SCWA. The SCWA is similar to a Community Workforce Agreement or Project Labor Agreement, such as those held by the City of Seattle, King County, the Port of Seattle and Sound Transit. The agreement, in its simplest form, requires all contractors of every tier (including the prime and all subcontractors) to follow union protocols for hiring workers on the project. Under the SCWA, most workers will be dispatched and hired from the union hall. The union dispatcher will first seek and dispatch those workers with demographics that SPS and the SCWA have named as a priority (such as SPS students, SPS student providers, women and people of color).
Background and Summary. Haiti is a country in the Caribbean with around 10 million inhabitants (World Bank 2009). It has a surface area of 27,000 square kilometres divided into ten (10) geographic and health departments. Haiti is the country hardest hit by the HIV epidemic outside of the African continent. The HIV sero-prevalence was estimated at 3% in 2003 (National Sero-prevalence Survey) but recent data reflects a reduction to a range of 1.7% – 2.2%. Based on the latest available data from the UNAIDS report on the Global AIDS Epidemic 2010, the number of adults and children living with HIV is estimated at between 110,000 - 140,000 in 2009. The epidemic began primarily among men who have sex with men (MSM) and among blood transfusion recipients. Over the years, HIV has quickly spread to the male and female heterosexual population, with more females (15+) living with HIV, estimated at 67,000, compared to males (15+), estimated at 43,000. Only 43% of individuals in need of antiretroviral treatment (based on WHO 2010 guidelines) were receiving treatment in 2009, according to the 2010 WHO Towards Universal Access Progress Report. The Global Fund has funded HIV programs in Haiti since 2003 (through Round 1, Round 5 and Round 7). The Round 1 Grant covered mainly prevention activities with care and treatment interventions to provide support to those already infected and focused on pilot projects for combination antiretroviral (ARV) treatment. The Round 5 Grant was complementary to the Round 1 program. Its objectives included: i) increase in provision of treatment of people living with HIV/AIDS (PLWHA); ii) community care and support for vulnerable groups such as infants, children, orphans, youth and women in both rural and urban areas; and, iii) new types of advocacy activities. The Consolidated RCC Program includes the Round 1 RCC and Round 5 Phase 2 Programs and covers prevention, treatment as well as care and support activities with an integrated approach. The Consolidated RCC Program was implemented from 1 January 2009 until 31 December 2010 by Fondation Sogebank as Principal Recipient (PR). The United Nations Development Programme (UNDP) is taking over the PR mandate after Fondation Sogebank resigned from its functions in 2010. Prevention will continue to focus on behavior change communication campaigns (BCC) and activities to promote safer sexual behavior using mass media and face-to-face communication through peers, other advisors or health professionals. Condoms will be distri...
Background and Summary. The Human Resources Strategic Development Plan for the Health Sector 2009–2018, drawn up in 2008, points to the challenges of a lack of human resources, high workload among healthcare workers, compromised quality of services, low levels of motivation and the need to remedy them. In an effort to address these challenges and to help incentivize and reward the performance of healthcare workers, Benin submitted a Health System Strengthening (HSS) request through the HIV proposal during the Round 9 call for proposal. The HSS request, which was planned to be funded by several donors, was also submitted to the Health System Funding Platform initiative to support the implementation of a Result-Based Financing (RBF) project. The objective of the project is to improve the coverage and quality of health care services by awarding credits based on results achieved in the delivery of health services in all 34 health zones of Benin through the support of four donors: the World Bank (8 health zones), the Belgian Cooperation (5 health zones), GAVI (2 health zones) and the Global Fund (19 health zones). The RBF is based on a contract linking financing to results: health centers (referred to as Sub- Recipients) sign a contract with the Ministry of Health and receive credits based on the quantity BEN-HSS-PRSS Annex A Page 1 of 8 and quality of health services provided on a quarterly basis. The RBF indicators are mainly linked to maternal, neonatal and child health care, but also include HIV, TB and malaria services. To guarantee the integrity of the data, results achieved on all indicators are verified by an independent audit firm, and counter-verified by community-based organizations. A maximum of 50 percent of the RBF credit can be used for staff as performance incentives and at least 50 percent for running costs of the health centers including purchase of health equipment and drugs. RBF credits are allocated based on performance against agreed upon quantitative and qualitative indicators outlined in the Document de Cadrage. In addition, an amount of EUR 1,000,000 (one million Euros) has been budgeted for performance incentives to the central level of the Ministry of Health. Payment of these incentives will be linked to achievement of impact and outcome/coverage indicators measuring progress towards the Millenium Development Goals (MDGs).
Background and Summary. Sao Tomé e Prncipe is a small island state within the lower income bracket of African nations with a population of 148,968 inhabitants (66.6% under 25 years), 53.8% living in poverty. HIV prevalence among pregnant women increased to 1.5% in 2005. As of 2004, 157 cumulative AIDS cases have been reported. It is estimated that the number of people living with HIV/AIDS is 1020 (between the ages of 14 to 49 years) and around 200 patients are severely ill. Currently there are 37 HIV patients being monitored, 18 of which receive anti-retroviral (ARV) treatment. Dissemination of HIV related information is relatively low. Condom use among men is 40.7% and women 3.8%. Schooling attendance among 13-17 years old is about 25.3% with a high school drop out. In 2004 the HIV prevalence rate among TB patients was 10% while TB diagnosis is provided only in the hospital laboratory. The Central Hospital Blood Bank relies on blood donated by the family members of PLWHA or interned patients. Blood is not tested for hepatitis C or malaria. Health care workers have never been trained in safety precautions. The disposal of needles and sharp instruments is highly inadequate. Post exposure treatment with ARV drugs is not available. The only laboratory in the country running HIV diagnosis examinations lacks adequate infrastructure and is very poorly equipped. The Program will work towards developing services and activities that prevent and treat sexually transmitted infections (STIs) and HIV, provide prevention of mother to child transmission of HIV (PMTCT) services to HIV positive pregnant women, and second line ARV treatment to HIV positive individuals. Its activities will target vulnerable groups with information and behavioral change activities. The Program will assist in a development of capacities of the health services to reduce the transmission of blood-borne diseases, including HIV, hepatitis and syphilis by training health staff, developing the capacities of laboratories and raising awareness of blood donors. The Program will extend education and clothing support to orphans and caring families to remove some of the burden created by HIV. Finally, the Program will assist the National AIDS Program and non-governmental organizations to develop their institutional capacities to enable to carry out their functions.
Background and Summary. Sri Lanka is a low middle income (island) country with a population of twenty million people. It is currently experiencing a low level HIV epidemic with less than 0.1% of the adult population infected. The estimate number of people living with HIV as at the end of 2011 was around 4200. However, a gradual increase in new cases is being observed and the continuing presence of certain socio-demographic and behavioural factors associated with HIV infection may change the present HIV landscape. The main mode of transmission is unprotected sex between men and women (82.8%), with men who have sex with men having accounted for 12.3% of the transmission while mother to child transmission was 4.4%. Though injecting drug use is not a common phenomenon (0.5%), certain socioeconomic and behavioural factors noticed in the country may ignite an epidemic in the future. The presence of a large youth population, internal and external migration, clandestine but flourishing sex industry, low level of condom use and concurrent sexual relationships among key populations are some of such factors. Low level of sexually transmitted infections (STI), availability and accessibility to free of charge health services from the state sector, high literacy rate and low level of drug injectors are protective factors. The Grant focuses on increasing the scale and quality of comprehensive interventions for most-at-risk populations, i.e. female sex workers, men who have sex with men, drug users, SRL-913-G16-H Phase 2 Annex A and beach boys1 who are also identified as a high risk group based on the findings of the behavioural surveillance survey 2006-7. Voluntary counselling and testing will continue to be implemented in all STI clinics run by the National STD/AIDS Control Programme. Both governmental and non-governmental Principal Recipients will share the procurement and distribution of health products in some Service Delivery Areas (SDAs). All other activities will be contracted through the non- governmental Principal Recipient to local non-governmental organizations.
Background and Summary. Hub is a procurement vehicle supporting a long term programme of investment in community infrastructure for local authorities, NHS Boards and other public sector bodies across Scotland. It will provide a mechanism for delivering assets more effectively through a single partner, with continuous improvement leading to better value for money. Hub will deliver projects expressly identified in the Territory Delivery Plan as Qualifying Projects. Projects will focus on new build but could also include the refurbishment and asset management services of existing infrastructure. The hub structure will encompass both private project finance and traditional publicly funded developments, with delivery through Hubco, the joint venture company. The equity and working capital of Hubco will be split among the PSDP, the eighteen Participants and the Scottish Futures Trust (SFT) (60%, 30% and 10% respectively). A Shareholders Agreement among the PSDP, the eighteen Participants and the SFT will regulate the respective rights and responsibilities of each party and sets out the matters in relation to which Xxxxx must first obtain the consent of each category of shareholder. A hub Territory Partnering Agreement among the eighteen Participants and Hubco will set out the rights and obligations of the parties, including the provision of partnering services by Hubco to the Participants and the exclusivity provisions granted by some of the Participants to Hubco. The following are the key objectives of the hub initiative across Scotland:-
Background and Summary. Bhutan is a landlocked country, with a total population of 635,000 situated in the Himalayas bordering China, the northeast states of India, close to Nepal and Bangladesh. The borders are increasingly porous with greater commerce and trade. Some places, such as Nepal and the northeastern Indian states of Manipur, Nagaland, and Mizoram, are already experiencing “concentrated” HIV epidemics, while others, such as the Indian states of Sikkim and Meghalaya, maintain a relatively low prevalence. A high level of inter mobility across these borders indicates an urgent need for sharing information and collaborative programs on HIV/AIDS prevention efforts in the region. Based on the available data, UNAIDS estimates that the number of people living with HIV in Bhutan in 2007 is <500 and the prevalence of HIV infection among adults 15-49 is <0.1%. This classifies Bhutan as a low prevalence country. Since the first case was detected in 1993, the cumulative number of HIV cases as of the end of June 2006 has increased to 90 cases, half of them infected within the last
