Regional: Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project

Sovereign Project | 42179-013 Status: Approved

Summary

ADB is helping the Lao People's Democratic Republic and Viet Nam prevent the spread of HIV/AIDS in 23 border provinces. The project will strengthen planning and management capacity at national, provincial, and district levels. It will enhance capacity to provide quality and accessible services, improve access to community outreach activities, and facilitate regional collaboration.

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Consulting Notices See also: CMS

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Procurement Documents


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Project Name Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project
Project Number 42179-013
Country Regional
Project Status Approved
Project Type / Modality of Assistance Grant
Loan
Technical Assistance
Source of Funding / Amount
Grant 0312-REG: Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention (LAO/VIE)
Asian Development Fund US$ 5.00 million
Loan 2930-REG: Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project (LAO/VIE)
Asian Development Fund US$ 15.00 million
TA 8204-REG: Regional Capacity Development for Strengthened HIV Response
CF for Fighting HIV/AIDS in Asia & Pac US$ 1.00 million
Strategic Agendas Inclusive economic growth
Regional integration
Drivers of Change Governance and capacity development
Sector / Subsector

Health - Disease control of communicable disease

Gender Equity and Mainstreaming Gender equity
Description

The project impact is to contribute to achieving and sustaining the Millennium Development Goal to have halted and begun to reverse the spread of HIV/AIDS in the Lao PDR and Viet Nam. The expected outcome of the project will be increased coverage and quality of services for targeted populations in 23 border provinces. The project has four outputs.

Output 1: Strengthened planning and management capacity at national, provincial, and district levels.

Output 2: Enhanced capacity to provide quality and accessible services to people vulnerable to HIV transmission.

Output 3: Improved access to HIV prevention outreach among target populations in communities and cross-border areas.

Output 4: Effective and sustainable regional collaboration to strengthen HIV response established.

Project Rationale and Linkage to Country/Regional Strategy

The GMS is one of the fast-growing subregions in economic development. GMS investments in transport corridors and trade agreements have improved regional connectivity and integration, thereby attracting more investment and facilitating the movement of people and goods across borders. ADB investment programs continue to give high priority to supporting enhanced connectivity as a driver of continuing the economic development in the GMS. Better regional connectivity and economic integration also increase mobility and migration which contribute to increased HIV risks and vulnerability, especially along newly developed economic corridors with high population mobility. The HIV epidemic in the region is fuelled by high-risk behaviors such as injecting drugs with unsterile equipment, having unprotected sex with multiple and concurrent partners, and through unprotected anal sex, primarily between men.

ADB's GMS and HIV Strategy recognizes that the GMS program and priorities with its focus on connectivity, competitiveness and community clearly intersects with some of the key risk factors and features of the HIV epidemic in the sub-region. Hence, the GMS HIV Strategy articulates that ADB has both an obligation to mitigate the HIV risks associated with transport and other infrastructure and an opportunity, to contribute strategically to the response to HIV and poverty in the sub-region. ADB's Country Strategies and Programs for Lao PDR and Viet Nam emphasize the need for continued support to communicable disease control including the containment and prevention of the spread of HIV in transport and economic corridors.

The proposed Project will address current gaps in HIV prevention and control in reaching high-risk and vulnerable populations, including migrants and mobile populations at higher risk settings along the economic corridors. The aim is to mitigate HIV risks due to increased mobility, migration and rapid economic development. The Project aims to strengthen HIV response systems through improved capacity for planning and management, accessibility and quality of services, awareness and knowledge of target populations along the economic corridors. Particular attention will be given to migrant, mobile and high risk populations along these corridors and border towns.

Impact

Project Outcome

Description of Outcome Increased coverage and quality of services for targeted populations
Progress Toward Outcome -
Implementation Progress
Description of Project Outputs

Strengthened planning and management capacity at national, provincial, and district levels

Enhanced capacity to provide quality and accessible services to people vulnerable to HIV transmission

Improved access to HIV prevention outreach among target populations in communities and cross-border areas

Effective and sustainable regional collaboration to strengthen HIV response established

Status of Implementation Progress (Outputs, Activities, and Issues)

Output 1:

Annual operation plans prepared by the provincial health offices are following the standard planning template and are organized in 8 programs and 98 sub-programs (called projects ). HIV plans are systematically integrated into overall AOPs of provincial health departments under program the CDC program.

With regard to gender sensitivity, AOPs for FY 2014/2015 have been reviewed by the international and national gender consultants recruited in May 2015.

During the workshop in April 2015 on review of progress of the project implementation and preparation of the project AOPs for the year 2015-2016, CHAS presented to PCCAs from the 8 target provinces the project gender and ethnic group action plan and provided recommendations on integration of project activities in the plan.

The national BCC and gender consultants recruited in May 2015 prepared specific integrated activities in the AOPs for FY 2015-2016. This includes mainstreaming gender and ethnic group sensitivity into plans, dissemination of GEGAP and DMF indicators to monitor, review of training and BCC materials, TOTs, conduct awareness activities on HIV/AIDS prevention using gender mainstreaming and ethnic sensitized materials with BCC in target villages.

122 manager of provincial, district received training, achieved 76.2% against project plan.

In which: - Women: 43 people

- Minorities: 19 people

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Output 2:

Pilot mobile teams providing VCT/STI services started in 3 provinces of Oudomxay, Salavan and Attapeu and are providing services for female sex workers, migrants, truck drivers, and youths residing in dormitories. The teams were equipped with STI drugs, HIV rapid test, IEC materials and condoms.

As of 31 December 2014, a total of 111 (103 female, 90 from ethnic groups) target population among female sex workers and migrants were reached by the mobile team in Oudomxay.

Presently, the CHAS M&E does not disaggregate VCT/STI services provided on sites and through mobile teams. Data has to be disaggregated by DCCAs and PCCAs to meet project requirements.

As of December 2014, a total of 50 provincial staff (37 (74%) are female, 10 from ethnic groups (8 female)) and 109 district staff (73 (67%) are female, 36 from ethnic groups (25 female)) received training on STI management.

Prepared the design competency evaluation questionnaire and apply to targeted staff. Provincial staff will apply the questionnaire to randomly selected staff.

CHAS developed a comprehensive quality assessment system and data collection forms. The tools have been field tested in three provinces and following field test, a workshop attended by PCCAs and provincial hospital staff was organized to conduct a detailed review of the data collection forms and discuss implementation methodology. Following revision of data collection forms, quality assessment will be conducted in all facilities and the results of the assessment establishing a score will provide a baseline. A Quality Assessment Consultant will be recruited to provide further technical inputs and advices on the quality assessment system.

EA to design quality evaluation questionnaire to district health center/commune health station based on quality assurance developed by VAAC. HSPH to apply the questionnaire in selected district health centers (DHC) and in selected commune health station (CHS). EA to apply questionnaire every year to all selected DHC and selected CHS.

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Output 3:

The baseline survey consulting firm which will be mobilized by end April 2016 in Laos will measure the access to HIV prevention outreach services among target populations in project districts. MMP, IDU and ethnic groups had attended at least one BCC session during the past 12 months. The baseline and endline survey will target the population of MMP, ethnic, and IDUs.

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Output 4:

Four MOUs outlining mechanism for regional collaboration, joint activities and sustainable financing were signed between Lao PDR and Viet Nam in 2014.

Regional cooperation focal points were appointed by 2013 and functional by 2014. PCCAs and DCCAs are the focal points, and their role and responsibilities for HIV AIDS are defined. However, their role in cross border cooperation needs to be strengthened. Joint strategy for regional cooperation and joint provincial operational plan were agreed at the cross border HIV-AIDS bilateral meeting in Hanoi on 1 October 2014 and MOUs signed between provinces outlining mechanism for regional collaboration and joint activities. Within this framework and with support from TA 8204, cross border collaborative pilot activities started in 3 sites. A meeting between the 3 provinces was conducted in July 2015 in Attapeu to review and discuss results of the pilot activities, plan further activities in 2015-2016, and discuss relevance of extension of pilot activities to other provinces.

Cross-border activities were incorporated in provincial AOPs FY 2014-2015 of Houaphanh and Attapeu provinces. Based on results and lessons learned of pilot cross-border activities in 3 pilot sites, cross-border activities will be extended to other provinces and incorporated into provincial AOPs.

Geographical Location

Safeguard Categories

Environment C
Involuntary Resettlement C
Indigenous Peoples B

Summary of Environmental and Social Aspects

Environmental Aspects The Project has no expected environmental impact, and does not involve any civil works.
Involuntary Resettlement The Project will not involve involuntary resettlement.
Indigenous Peoples

The project is classified as category B for indigenous peoples. The project includes a significant proportion of ethnic groups among its beneficiaries, who are among some of the poorest and most marginalized households in the Lao PDR and Viet Nam. The ethnic groups plan ensures ethnic peoples' needs will be analyzed and they will participate in and have access to project benefits.

In Laos, there is an ongoing mapping of risk behaviors and KAP of ethnic groups by gender and age. Thirty-five districts are covered by the mapping survey conducted by CHAS under grant funding in June 2014. The data for monitoring of the proportion of the ethnic people accessing services relative to the total population of the ethnic community and data reported by sex, age and ethnicity as well as type of services was completed in 2014 in 35 districts. The target of 100% participation of provincial, district, and village level ethnic health staff in various trainings is provided by the project. This has already been integrated in 2014 in peer educators' curriculum training.

The EA informed the recent Mission (September 2014) of the inclusion in the baseline assessment of the capacity of services providers for female sex workers and assessment of KAP of high risk groups and present findings disaggregated by sex, age and ethnicity with separate conclusions to be held with men and women. By 4th quarter of 2015, hotspot mapping will be conducted in constructions sites and along economic corridors with high concentration on female migrant workers, including FSWs. Mobile clinics will provide services in identified hotspot areas. The survey of project report on easy access to condoms and correct use of male condoms will be included in the baseline/endline survey. The identification and assessment of vulnerability of female drug users and design of appropriate interventions in Houaphanh and Phongsaly will be part of the block grant.

In Viet Nam, the project has prioritized the involvement of ethnic minority staff in relevant project activities. It is noted that additional effort is required for the activities in 2016 to ensure that the indigenous peoples (IP) related targets are achieved. Management training is one example in which the training output for IP staff will be substantially increased compared to the output in 2015. The capacity of the training institute and the possible implication on the health facilities (due to stay away on training) will be considered and clarified. In addition, the participation of the IP staff in long-term training (master degree program) will be encouraged.

Stakeholder Communication, Participation, and Consultation
During Project Design During project preparation, consultations with key stakeholders were undertaken including for preparing social and poverty analyses.
During Project Implementation

Business Opportunities

Consulting Services

All consultants will be recruited according to Guidelines on the Use of Consultants by ADB and its Borrowers (2010, as amended from time to time).

International individual consultants and national individual consultants will be engaged in both countries. The executing agencies will advertise consulting opportunities through the Consultant Management System at www.adb.org.

Procurement

All procurement of goods and works will be undertaken in accordance with ADB Procurement Guidelines (2010, as amended from time to time).

International competitive bidding procedures will be used for supply contracts valued more than $1,000,000 for Lao PDR and Viet Nam. National competitive bidding procedures will be used for supply contracts valued at less than $1,000,000 for Lao PDR and Viet Nam. Shopping method will be used for procurement of contracts of goods worth $100,000 and below. Vehicles will be procured from the United Nations Office for Project Services (UNOPS) for Lao PDR.

In Lao PDR, the project will procure medical goods consisting of test kits, drugs, condoms and laboratory consumables. In Viet Nam, the project will procure medical laboratory equipment consisting of viral load analyzers, CD4 machines, basic health laboratory equipment, reagents, and mobile laboratory. The project will also procure support equipment such as vehicles, computers and printers, audio-visual equipment, and office equipment.

Responsible Staff

Responsible ADB Officer Gerard Servais
Responsible ADB Department Southeast Asia Department
Responsible ADB Division Human and Social Development Division, SERD
Executing Agencies
Ministry of Health
138A Giang Vo Str.
Hanoi, Viet Nam

Timetable

Concept Clearance -
Fact Finding 09 Apr 2012 to 23 Apr 2012
MRM -
Approval 30 Oct 2012
Last Review Mission -
Last PDS Update 31 Mar 2016

Grant 0312-REG

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
30 Oct 2012 04 Dec 2012 08 Feb 2013 30 Jun 2018 - -
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 5.57 Cumulative Contract Awards
ADB 5.00 30 Oct 2012 3.05 0.00 61%
Counterpart 0.57 Cumulative Disbursements
Cofinancing 0.00 30 Oct 2012 3.45 0.00 69%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - Satisfactory - - - -

Loan 2930-REG

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
30 Oct 2012 17 Jan 2013 17 May 2013 30 Jun 2018 - -
Financing Plan Loan Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 16.33 Cumulative Contract Awards
ADB 15.00 30 Oct 2012 3.37 0.00 24%
Counterpart 1.33 Cumulative Disbursements
Cofinancing 0.00 30 Oct 2012 4.03 0.00 29%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - Satisfactory - - - -

TA 8204-REG

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
30 Oct 2012 - 30 Oct 2012 31 Dec 2014 - -
Financing Plan/TA Utilization Cumulative Disbursements
ADB Cofinancing Counterpart Total Date Amount
Gov Beneficiaries Project Sponsor Others
0.00 1,000,000.00 0.00 0.00 0.00 0.00 1,000,000.00 30 Oct 2012 787,904.33
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - Satisfactory - - - -
Title Document Type Document Date
GMS Capacity Building for HIV/AIDS Prevention Project (Viet Nam Component): Audited Project Financial Statements (17 January 2013-31 December 2014) Audited Project Financial Statements Jan 2016
GMS Capacity Building for HIV/AIDS Prevention Project: Audited Project Financial Statements (8 February 2013-30 September 2014) Audited Project Financial Statements Jul 2015
Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project: Consultant’s Report Consultants' Reports Feb 2015
Loan Agreement (Special Operations) for Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project (Viet Nam Component) Loan Agreement (Special Operations) Jan 2013
Grant Agreement (Special Operations) for Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project (Lao PDR Component) Grant Agreement Dec 2012
LAO/VIE REG: Xây dựng Năng lực Phòng chống HIV/AIDS cho tiểu vùng sông Mê-kông mở rộng : Bảng Dữ liệu Dự án Translated PDS Nov 2012
Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project Reports and Recommendations of the President Oct 2012
Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project Project/Program Administration Manual Oct 2012
Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project (Lao PDR, Viet Nam): Procurement Plan Procurement Plans Oct 2012
Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project Gender Action Plans Oct 2012

Safeguard Documents See also: Safeguards

Safeguard documents provided at the time of project/facility approval may also be found in the list of linked documents provided with the Report and Recommendation of the President.

None currently available.

Evaluation Documents See also: Independent Evaluation

None currently available.

Related Publications

None currently available.


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