Health strategy and policy institude

Vũ Thị Minh Hạnh, Trần Hồng Cẩm, Phan Hồng Vân, Hoàng Thị Mỹ Hạnh,Vũ Thị Mai Anh, Trịnh Thị Sang, Trần Vũ Hiệp, Hoàng Ly Na, Tường Duy Trinh, Nguyễn Thị Minh Hiếu, Nguyễn Thị Thủy

• Progress and outcomes against the plan defined in the Project Document: The project as a whole has been keeping pace with the set timeline. The organizational network and staffing arrangements have been set in place, from the national level Project Management Unit to sub-project management teams, as well as service providers in a consistent manner right from the initial year. Technical guidelines have been released to help maintain consistency in implementation in the 28 project provinces. Project components have been increasingly expanded both in terms of lines of activities and coverage, especially in the first and second years according to plan.

• Fund management and spending: Financial management in the project has been handled strictly, to the standards and consistently across the board, with regular monitoring and control. Fund management and spending have complied with the existing laws and regulations, the donor’s policies and tailored to the project goal and objectives. The disbursement rate over the fiscal years in the project however remains low (< 70%).

• Involvement of local stakeholders: Surveys in specific locations indicate that, being aware of the usefulness and practicability of the project, all local stakeholders have been willing to welcome and implement the project. Local subproject management teams were quickly set up to work as the focal point to take over and coordinate implementation. Local project staffing has also been expressly taken care of as needed. Project facilities were provided and managed appropriately in ways that are both adapted to the local conditions and meeting the project requirements.

• Contributions of the project in capacity development for the national HIV/AIDS control network: support for capacity building in the administration and management of the National AIDS control program provided to the executive unit; playing a role implementing capacity building in various fields of activities of the National AIDS program; The project also contributes to enhancing diagnostic and therapeutic capacity for HIV/AIDS, as well as opportunistic infections through provision of equipment, upgrade of laboratories and so on. Support for capacity development of the information collection and management network.

• Usefulness and relevancy of the various components of the project with the National AIDS control Strategy: The project was designed in a relatively holistic way to respond to the present developments of the epidemic in Vietnam. The various project components are interconnected and mutually supportive. Outputs of one component can be the inputs for the next, whereby creating the synergy to drive the National strategy for AIDS control in the selected sites. Beneficiaries from the project are diverse and increasing to cover most HIV vulnerable groups. The project has proven to be practically beneficial to targeted clients. It has made significant contributions to translating the National strategy for AIDS control to real life in the selected sites. The project provides an important source of both technicality and finance for the local stakeholders to implement the National strategy for AIDS control.

• Sustainability: In this phase, the project is basically aligned with the government’s priorities for AIDS control by 2010 and vision by 2020. Project components are backed by a solid legal framework while practicability is guaranteed, for it to continue to be a strong source of assistance to the AIDS control program in Vietnam. Administrative and management capacity of the AIDS control program has been markedly improved. Technical guidelines developed by or with inputs from the project have made their way to become National guidelines for AIDS control. Facilities and equipment provided by the project will continue to prove their long-term future usefulness. The quality of services delivered by the project will build clients’ trust with medical practices and help improve the reputation of those benefiting from the project. Numerous socio-cultural preliminary works have helped sensitize vulnerability to HIV/AIDS of specific groups.

Lessons learnt: Coming to Phase III, the project has selectively draws from and builds on the implementing experience gained in Phase II. The substantial resources support (funding and technicality) from the project is sufficiently capable to make a difference with AIDS control activities in the treatment sites. The willingness of local stakeholders in welcoming the project has created the social consensus and enabling conditions needed to set the program in motion. The advent of AIDS centers in the selected sites forms the needed legal framework and status for successful coordination of the various project components. The streamlined and improved AIDS control network workforce provides added value to the implementation of the components. The close staffing link of Project Management Units of various levels with counterpart AIDS control agencies is vital for the effective operation of the various project components. The harmony in technical practice and interactive support of various other projects in the AIDS control program in the selected sites help create concerted efforts in the implementation of the project components.

Challenges and drawbacks: organizational models and staffing composition; specific provisions of implementing and planning guidelines; training; service link and referral; quality supervision and assurance, monitoring and evaluation; implementation of interventions (outreach, voluntary counseling and testing, care and treatment); financial management and spending; communication, advertisement and advocacy.

• Immediate actions: expedite optimization of the organizational structure and staffing composition for project management units from the national to implementing levels, to upgrade the managerial and implementing capacity; timely adjustments of regulatory enactment for project implementation, both in terms of management and technicality; renewal of how annual work plans are prepared; further maintenance and improvement of the quality of training in the project; quick remedies for specific implementing gaps to improve service quality; paying more attention to the link and transition between the project various components through the development and introduction of implementing guidelines, information sharing mechanisms and so on; further improvement of monitoring and evaluation quality and effectiveness; Correction and adjustment of specific financial management and spending deficiencies;

• Project development strategy for the next phases: expanding interventions to cover other high-risk groups, including men having sex with men, cross-border mobile groups, immigrants to urban areas etc.; increased linkage and transition between services, not only within the project but other external projects as well; Increasing empowerment of subproject management teams in implementation administration and coordination; Stepping up education on AIDS control and advertisement of project services; Attachment of individual accountability and duties in benefiting from the project services with a view to contribution by affordability, as full subsidy is only provided to the poor and qualified social welfare beneficiaries; Maintenance of the current project models and role, both as technical assistance providers and implementing support units, for the foreseeable future.