Non-governmental organizations (NGOs) provide quality HIV care to low-income key and priority populations in the Dominican Republic (DR) and helped stabilize the HIV epidemic at 2,400 new infections in 2017. However, most rely on declining international donor funding and risk having to discontinue HIV care for vulnerable populations if they are unable to find new revenue sources. SHOPS Plus is working with USAID and local partners to help maintain NGOs’ ability to deliver HIV services to support sustained epidemic control.
SHOPS Plus is collaborating with USAID/Dominican Republic, USAID/Washington, select NGOs, and other local stakeholders to strengthen the national HIV response by increasing the sustainability of key NGO service providers. The project is strengthening the efficiency of select NGOs as they transition to social enterprise business models and helping them to access new revenue sources so they can continue offering HIV services at no cost to key and priority populations.
The Dominican System of Social Health Insurance presents an important opportunity for these NGOs. NGOs can contract with Seguro Nacional de Salud (SENASA), the public health insurance company, and receive payment for providing HIV and primary care services to PLHIV enrolled in the insurance scheme. SHOPS Plus is advocating to SENASA to contract NGOs and is also helping its NGO partners to navigate SENASA’s contracting requirements and negotiate payment rates.
People living with HIV must be enrolled as SENASA members before contracted NGOs can receive payment for services. Many barriers ranging from legal obstacles to social exclusion prevent these people from enrolling. SHOPS Plus is facilitating enrollment by supporting the NGOs, SENASA, and the Dominican government to standardize procedures for collecting and processing insurance applications.
SHOPS Plus is also fostering an enabling environment for private sector service provision by addressing institutional barriers that could impact the long-term viability of these arrangements and supporting the development of sustainable markets for HIV products.
Photo credit: © 2009 Jessie Kalsmith and © 2007 Helen Hawkings, Courtesy of Photoshare