Correctional environments present unique challenges and opportunities for leadership, particularly in the public health department. In Haiti, where the burden of infectious diseases such as HIV and tuberculosis (TB) is high among incarcerated populations, innovative approaches to health care in prisons are critical. "Health through Walls" (HtW) is a pioneering initiative led predominantly by women, which strives to enhance health service delivery within the Haitian correctional system. This abstract outlines the roles and impacts of women leaders within HtW, emphasizing their instrumental role in managing and implementing health programs, and details transferable learning that could be applied in other work locations and countries.

Under the leadership of women, HtW has established a comprehensive framework to address HIV and TB within prisons. The Chief of Party, Madame Karine Duverger, exemplifies the impact of female leadership in orchestrating complex health interventions across multiple facilities and demonstrates success in a male-dominated environment for over a decade.  HtW's programs include the continuation of robust HIV/AIDS services, which encompass HIV prevention, testing, immediate treatment initiation, and continuous care. These efforts are aligned with the World Health Organization’s 5 Cs (consent, confidentiality, counseling, correct results, and connection to care), ensuring that services are ethical and practical. Under the leadership of Madame Duverger, WASH services have been redeveloped to reduce the opportunities for gender-based violence.

Infectious diseases continue to attract stigma, and HtW has established gender-sensitive services designed by women for women. TB management is integrated within HIV services, following national and international guidelines to ensure a dual approach to these intersecting health issues. 
HtW also champions innovative community-based strategies to extend care beyond prison walls. This includes employing community health workers to increase access to testing and treatment and ensure continuity of care for released prisoners. This approach not only addresses the immediate health needs of incarcerated individuals but also aids in their reintegration into society by connecting them with ongoing care.

The success of these programs under female leadership within HtW highlights the critical role that women must play in leading change within challenging environments. It underscores the necessity of empowering women in leadership roles, particularly in sectors where they can significantly impact public health and welfare.

By providing a platform for women to lead and innovate, HtW improves health outcomes for incarcerated populations and sets a precedent for gender empowerment in correctional system leadership. This model serves as a beacon for global efforts to integrate women into leadership roles. It demonstrates that when women lead, they bring unique perspectives and solutions that can transform institutions and enhance societal well-being.