Family Health
International (Organization of Family Health International - FHI 360)
- Nationality: United
Sate of American
- Scope of work:
medical, clinical trials, prevention, care and treatment of HIV and drug
addiction.
- Areas Activities: Lao
Cai, Dien Bien, Thai Nguyen, Ha Noi, Hai Phong, Quang Ninh, Thanh Hoa, Nghe An,
Quang Binh, Quang Tri, Da Nang, Dac Lac, Dac Nong, Quang Nam, Quang Ngai Khanh
Hoa, Can Tho, An Giang, Ho Chi Minh City, Tien Giang, Vinh Long and Ca Mau
- Contact: 043 934 8560
FHI 360 has long term partnership with Hai Phong since 1998
in HIV area. First was a study on HIV prevalence, Integrated Biological and
Behavior Surveillance - IBBS, followed by establishment of an urgent harm
reduction response named as Hai Au People with Injecting Drug (PWID) club, and
now, a comprehensive continuum of prevention to care and treatment of HIV,
especially expanded from health sector to DOLISA sector since 2010 (MMT co-pay)
and 2011 – with Atlantic Philosophy supported case management and research
project.
Hai Phong (together with HCMC) is the 2 biggest provinces
received funding and TA (about 500,000 USD/year) from FHI 360 amongst 9 focus
PEPFAR provinces. Hai Phong is always a pioneer leader in HIV program and
implementation: First IDU club and outreach program in the country – harm
reduction; First MMT clinic; First MMT co-pay model; First MMT satellite model;
First transition MMT province with significant support from local government on
MMT; Highest coverage on MMT compared to other countries; High reaching IDUs
and FSWs; Highest local commitment to sustain the program (via MMT project and
followed by HIV commitment); and Enabling environment. Moreover, FHI 360 is
looking forward to work with Haiphong to: Maximizing the effective use of
resources given to the province and introducing more efficient service delivery
models; Encouraging and facilitating local ownership and increasing
contributions from health sector and other local service providers in the
province; and Preparing the province for the successful transition of the
program to the GVN.
In Hai Phong, FHI
360 has good cooperation with the partners to implementing effectively programs
/ projects funded by USAID as:
- SMART TA in Hai Phong province
The USAID Sustainable Management of the HIV/AIDS Response and
Transition to Technical Assistance Project – or “SMART TA” – is a five-year,
$45 million initiative managed by FHI 360 that strives to ensure the provision
of quality, comprehensive and sustainable HIV services through a strengthened national
response, including Hai Phong. At present, SMART TA is supporting the Continuum
of Prevention to Care (CoPC) services and interventions including two
out-patient clinics (OPC), four HTC service sites, one PWID and one FSW
outreach intervention covering series districts. Also SMART-TA is providing TA
for six out of nine MMT clinics in Hai Phong. Over the last year, SMART TA has
improved its model focusing on achieving the dual goals of improving quality of
care while gaining greater efficiencies. SMART TA has also pioneered
integration of services in some of its sites including integrating as many as
services at one site (HTC and ART, IDU and HTC) and promoted the transition of
services from donor to local government.
- Increasing government commitment and support for sustainable Methadone (MMT) in Hai Phong
The MMT program, initiated in 2008 with support from PEFPAR,
WB, GF, FHI, and HAARP, is now undergoing unprecedented national scale up. By
the end of September 2012, 49 medical clinics in 15 provinces and cities across
the country were providing government-approved MMT services, with over 10,000
clients. In recognition of the benefits MMT programs have already made toward
improving the socioeconomic situation in Vietnam, the GOV plans to expand MMT
nationwide to provide treatment services for 80,000 clients by 2015.
Despite these successes, challenges remain in ensuring the
GOV can provide sustainable services as PEPFAR support diminishes. US
Government funding is currently scheduled to decline by 30% in 2012, 70% in
2013, and will go to zero by the end of 2014. The GOV initially expressed
reluctance to use government finances to offset the decline in resources from
international donors.
FHI 360 has played a leading role in bringing relevant
players together to develop a transition plan amenable to the GOV and partners
that will require minimal out-of-pocket payments from clients. The People’s
Committee of Hai Phong has shown strong support for MMT by approving Decision No 1932/QĐ-UBND in November
2011, which outlines a sustainable plan for MMT service delivery for the period
2011-2014. With support from FHI 360 and the People’s Committee, the Hai Phong
Financial Department approved funding to cover half of the running costs for
MMT service delivery. Funding will go to all eligible MMT clinics in the city
under the coordination of the Hai Phong Center of HIV/AIDS Prevention and
Control. Financial support will cover operational costs, including personnel,
coordination meetings, referrals and clinic renovation/maintenance.
As funds have begun to decline, FHI 360 and Hai Phong
leadership have made considerable efforts to keep copayments and other
out-of-pocket expenses low. One approach is the 50/50 funding mechanism,
developed by FHI 360 and the People’s Committee of Hai Phong, which will ensure
that copayments are the same across clinics, and that MMT clients pay the same
fee regardless of the level of service and drugs they receive. Decision No 1932/QĐ-UBND also provides a
basis for increased funding support from the local government. Hai Phong has
agreed to cover 50% of the costs, which, based on cost models, translates to
1.01 billion VND in 2012, 2.57 billion VND in 2013, and 3.90 billion VND in
2014.
Hai Phong is also pioneering an initiative, with FHI 360
support, to improve MMT health worker quality and retention by shifting from
short-term contracts to long-term, government paid contracts. During the fiscal
year, 28 out of 85 project staff who were working at MMT clinics in Hai Phong
were converted to government paid staff. This move will establish Hai Phong as
a leading national example of sustainable MMT program delivery.