Health Through Walls Inc

What it reported doing in 2025

HIV/AIDS Assistance for Prisons in Haiti objective is the control and prevention of the spread of contagious diseases in Haiti's 17 prisons. Haiti's prisons do not have a sustainable system of care and HtW through funders help to fill in many gaps that exists to prevent neglect of care of the upwards of ten thousand inmates incarcerated there and eventual death of those who are sick or who contract a deadly disease while incarcerated. HtW has over 130 full time staff including doctors, nurses, laboratory technicians, counselors, radiographers and psychiatrists who work at all locations throughout the country, in the East, North, West and South. HtW is charged with setting up a sustainable system of care providing sanitation for all the prisons and creating a clean working environment for the officers and health care workers and a healthy living environment for the prisoners. HtW implemented a WASH program to ensure clean water for drinking, cooking and showering. Success of the HAP Program: Universal HIV Screening & Early Detection: The HAP program has been one of Haiti's most successful prison based health initiatives because it achieved something rare in correctional settings: consistent, system wide HIV screening. * Routine entry screening, mass campaigns, and provider initiated testing dramatically increased case detection. * In several facilities, screening coverage reached 80-100% of the incarcerated population. * Early detection reduced late stage presentations and improved treatment outcomes. This level of coverage is exceptional in low resource prison systems. 2. Reliable Access to ART & Continuity of Care Before HAP, incarcerated people often went months or years without access to antiretroviral therapy. The program changed that. * ART became consistently available in all 17 prisons. * Treatment interruptions dropped sharply. * Viral suppression rates improved because patients were initiated quickly and monitored regularly. * HAP established discharge planning, ensuring people leaving prison were linked to community clinics. Continuity of care is one of the strongest indicators of program success. 3. Integration of TB/HIV Services Haiti's prisons have some of the highest TB rates in the region. HAP's integration of HIV and TB services has been a major achievement. * Co infection screening became routine. * TB treatment and DOTS were strengthened. * Staff were trained to identify TB symptoms early and refer appropriately. This integration reduced mortality and improved case management for the most vulnerable patients. 4. Strong Peer Educator Network One of HAP's most innovative and successful components is its peer educator model. * Incarcerated individuals were trained to deliver HIV education, support adherence, and reduce stigma. * Peer educators became trusted messengers, increasing program reach. * This model improved health literacy and created a culture of support inside facilities. Peer led programming is widely recognized as a best practice in prison health. 5. Reduction in Stigma & Increased Health-Seeking Behavior HAP's education campaigns - posters, group sessions, peer outreach - significantly reduced stigma around HIV. * More people voluntarily sought testing. * Patients were more willing to start and continue ART. * Staff attitudes toward HIV care improved. This cultural shift is one of the program's most important long term successes. 6. Strengthened Health Workforce & Training HAP invested heavily in training prison nurses, physicians, and administrative staff. * Staff became proficient in HIV testing, counseling, ART management, and confidentiality protocols. * Facilities developed stronger internal capacity rather than relying solely on external partners. This workforce development is a major sustainability win. 7. Data Systems & Monitoring Improvements Even before EHRs, HAP improved record keeping and reporting. * Standardized registers and monitoring tools were introduced. * Facilities began track

Financial Efficiency

• Mission deployment rate: 100%; rating input score 100
• Program expense ratio: 100%; rating input score 100
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 63rd percentile among comparable filings
• Pay-setting controls: Limited
• Foreign activity oversight: Scored; rating input score 0
• Grant itemization coverage: Scored; rating input score 0
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Limited

Accountability

• Independent voting board: 100%; rating input score 100; 63rd percentile among comparable filings
• Governance controls: 9 of 9 controls in place; rating input score 100
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Pass
  • Other executive compensation review process: Pass
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: -11.1%; rating input score 9; 9th percentile among comparable filings
• Total-asset coverage ratio: 0.93; rating input score 31; 31st percentile among comparable filings
• Liabilities to assets ratio: 1.07; rating input score 2; 2nd percentile among comparable filings
• Officer compensation ratio: 2.2%; rating input score 74; 74th percentile among comparable filings

Growth

• Program expense growth: -8% per year; rating input score 0; 4th percentile among comparable filings
• Revenue growth: -13.1% per year; rating input score 0; 1st percentile among comparable filings
• Asset growth: -13.7% per year; rating input score 0; 1st percentile among comparable filings