42179-013: Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project | Asian Development Bank

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

Sovereign (Public) Project | 42179-013 Status: Active

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.

Project Details

Project Officer
Servais, Gerard Southeast Asia Department Request for information
Country
  • Regional
Modality
  • Grant
  • Loan
  • Technical Assistance
Sector
  • Health
 
Project Name Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project
Project Number 42179-013
Country Regional
Lao People's Democratic Republic
Viet Nam
Project Status Active
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)
concessional ordinary capital resources lending / Asian Development Fund US$ 5.00 million
Loan 2930-REG: Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project (LAO/VIE)
concessional ordinary capital resources lending / Asian Development Fund US$ 15.00 million
TA 8204-REG: Regional Capacity Development for Strengthened HIV Response
Cooperation Fund for Fighting HIV/AIDS in Asia and the Pacific under the Health Financing Partnership Facility US$ 1.00 million
Strategic Agendas Inclusive economic growth
Regional integration
Drivers of Change Gender Equity and Mainstreaming
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 Contributed to achieving and sustaining MDG 6a target on HIV/AIDS in the Lao PDR and Viet Nam
Project Outcome
Description of Outcome Increased coverage and quality of services for targeted populations
Progress Toward Outcome

LAO: The project has achieved one out of two outcome performance targets, which increased the service utilization among target groups. A monitoring survey, to measure achievements against the other outcome indicator will be conducted in December 2017.

VIE: A project midterm review mission was fielded in April 2017. Based on preliminary baseline survey, all but one indicator under outcome indicator 1 (related to the use of health services) reach the 50% increase target as of 2016. Most groups under outcome indicator 2 (IDU and MMP) reach the target with over 80% of the groups able to articulate correct information on HIV transmission and means of prevention.

The outcome indicator was then adjusted from 50% to 30% taking into account the national guidelines and the proportion of high risk pregnant women to be tested.

Based on agreements during the midterm review, a number of the DMF indicators as well as indicators under the gender action plan and ethnic minority development plan were adjusted.

A couple of packages for goods procurement and consultant recruitment are still underway.

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

LAO: Annual operation plans prepared by the provincial health offices follow MOH's standard planning template. HIV prevention and care interventions are systematically integrated into the plans.

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.

Sex-disaggregated data collection is integrated into the project's monitoring and evaluation system.

CHAS completed training on project management and planning for PCCAs and DCCAs. It also conducted trainings on mapping of target populations and rapid assessment of high risk behaviors. This data is used by DCCAs and PCCAs to prepare annual operational plans with activities directed to these high risk groups.

PMU and CHAS requested in June 2015 PCCAs to provide an update of the high risk populations targeted in each province. The update is provided in Appendix 8 of the quarterly report. High risk populations targeted in each province was updated during the first quarter of 2016. The update in provided in appendix 9 of QR 10. The target population mapped in 2016, subject to revision if necessary, will be the basis for preparation of AOP 2017.

VIE: In March 2017, VAAC issues guidelines for development of annual provincial HIV/ AIDS prevention and control plan which include gender-sensitive HIV strategy (i.e. prevention and care for pregnant women). All provinces are required to comply with the strategies stipulated in the guidelines.

The action plan will be reviewed by the gender specialist.

By Q1 2017, 261/261 (100%) district and province managers were trained, of which 100/261 (38%) were females and 37/261 (14%) were ethnic minorities.

All women managers and all managers from ethnic minority groups were trained.

Total HIV/AIDS managers in the 15 provinces in 2016 was 261, of which 100 (38%) women and 37 (14%) ethnic minority.

Manager performance was measured through the Pre/post-test results of the 3-month management training course. Results show that 46% of the managers had correct results in pre-test, and 76% of the managers had correct results in post-test (n = 76).

HSPH will assess in Q3 2017 the level of competency of the respondents based on the competency framework developed at the start of the Project. HSPH will also asses the output of the respondents (e.g. annual HIV plans) to evaluate the level of self-perceived knowledge and quality of actual output (skills).

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

LAO: Mobile clinic services on VCT and STIs for female sex workers, migrants, and truck drivers commenced in April 2015. To date, number of target population reached by mobile clinics increases from 1,978 in 2015 to 3,055 (2,002 or 65% are female) in 2016, and 3,659 (2,614 or 71% are female) in 2017 (as of June 2017).

Update of national guidelines and standard operation procedures for VCT trainers and counsellors, and STI treatment and management guidelines were completed. Related training are complete.

Development of and training on quality assurance tools were complete. The tools are being used for assessing service quality at health facility and mobile clinics.

VIE: All health facilities provide HIV services as per provincial plans. From 2015 to 2016, the number of health facilities offering methadone distribution services has increased. More district hospitals provide VCT services. More district health centers provide ART and PMTCT.

HIV services are provided according to provincial plan.

In 2016, 51% of all 6,189 staff trained by the project are female and 26% are ethnic minorities.

Monitoring survey preliminary results show that 60% of staff meets core competency standards at work.

Monitoring survey preliminary results show the 11 surveyed district health centers meet 50% of the quality criteria established by the project.

Due to late recruitment of the monitoring firm, the first assessment of the quality was conducted in February 2017. This indicator was revised after midterm review.

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

LAO: A total of 641 (274 or 42% are women, 396 or 61% from ethnic groups (151 women)) peer educators were recruited from 501 target villages and trained and provided with these BCC materials.

As of June 2017, a total of 130,648 persons (68,706 or 53% females, 94,106 or 72% from ethnic groups) were reached by peer education activities.

VIE: Monitoring survey preliminary results show that 49% of ethnic minority population received at least one BCC session during the past 12 months. For females, the proportion is 47%.

4 BCC sessions attendance is difficult to measure due to recall bias.

Indicator was revised after midterm review.

Compared to IBBS 2013, condom use among IDU has decreased in the project provinces. However, IBBS provinces benefit from several ODA supported HIV AIDS projects.

Current indicator does not reflect project output and activities: the project does not provide condoms and current government policies encourage condoms distribution via social marketing, which is not in the project scope.

Indicator was revised after midterm review. 76% (4,702/6,000) trained by December 2016.

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

4 MOU were signed:

- CHAS-VAAC Sep 2014

- Kontum-Attapeu Mar 2014

- Houaphanh-Thanh Hoa-Son La May 2014

- Phongsali-Dien Bien June 2014 (ratified agreement dated Nov 2013)

Regional cooperation focal points were appointed by 2013 and functional by 2014. PCCAs and DCCAs are the focal points.

Considering difficulties and amount of work required to organize bilateral meetings, it was agreed that CHAS and VAAC would join CDC2 regional steering committee meetings with bilateral Viet Nam-Lao PDR meetings as necessary.

The 5th CDC2 Regional Steering Committee Meeting was conducted on 10-12 December 2015 in Nha Trung, Vietnam. The director of CHAS and the project coordinator attended the meeting.

Joint strategy for regional cooperation 2015-2017 has been finalized on 1 October 2014 and ratified after the Hanoi meeting on 15 October 2014.

- CHAS-VAAC

- Kontum-Attapeu

- Houaphanh-Thanh Hoa-Son La

- Phongsali-Dien Bien

LAO: At the provincial level, three paired border provinces were selected for implementation of the MOUs: (i) Attapeu and Kon Tum; (ii) Houaphan and Thanh Hoa and Son La and (iii) Phongsaly and Dien Bien. These provinces have organized annual cross-border collaboration meetings regularly. HIV and AIDS are included in the topics discussed during the meetings.

VIE: The MOU signed at the bilateral meeting in Hanoi on 1 October 2014 and MOUs signed between provinces outline 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.

HIV-AIDS prevention activities are going on in the 3 provinces with Vietnamese speaking mobile populations such as infrastructure workers, truck drivers, service women. The number of persons reached are:

Phongsali: 760 persons including 350 females/46%

Houaphanh: 265 persons including 18 females/7%

Attapeu: 293 persons, including 121 females/41%

The implementation were extended to 7 provinces in Vietnam which include 4 current provinces and the 3 additional provinces are Quang Nam, Quang Tri and Ha Tinh.

By December 2016, following activities were implemented:

- Communication training for commune/village leaders: 2,230 people [women: 876 (39.3%) and minority: 1,446 (64.8%)].

- BCC sessions: 302 sessions; estimated 30,567 people attended with of about 24,546 minority people (80.3%); 1,910 mass media communication via loudspeakers.

- Harm reduction:

+ Received needles: 2,324 people [4 women (0.2%), 1,695 EM (72.9%)].

+ Received condoms: 2,884 people [34 women (1.18%), 1,952 EM (67.7%)]

- Number of people counselled and tested: 1,265 [women: 688 (54.4%) and 251 (19.8%)].

None of the 2016 provincial AOPs include cross border activities. VAAC guidelines for AOPs do not include cross border activities.

Indicator was revised after midterm review.

Geographical Location Lao People's Democratic Republic - Nation-wide, Attapu, Champasak, Houaphan, Khoueng Bokeo, Khoueng Oudomxai, Khoueng Phongsali, Louangnamtha, Salavan; Viet Nam - Nation-wide, Dak Nong, Gia Lai, Huyen Dien Bien, Kon Tum, Long An, Tinh Binh Phuoc, Tinh Ha Giang, Tinh Ha Tinh, Tinh Lai Chau, Tinh Lao Cai, Tinh Quang Binh, Tinh Quang Nam, Tinh Quang Tri, Tinh Son La, Tinh Thanh Hoa
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 were 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 were engaged in both countries. The executing agencies advertised consulting opportunities through the Consultant Management System at www.adb.org.

Procurement

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

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

In Lao PDR, the project procured medical goods consisting of test kits, drugs, condoms and laboratory consumables. In Viet Nam, the project procured medical equipment, basic laboratory equipment and supplies, reagents among others. The project also procured support equipment such as vehicles, computers and printers, audio-visual equipment, and office equipment.

As the project is closing by 30 June 2018, only a couple of packages are pending.

Responsible ADB Officer Servais, Gerard
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 18 Aug 2010
Fact Finding 09 Apr 2012 to 23 Apr 2012
MRM -
Approval 30 Oct 2012
Last Review Mission -
Last PDS Update 29 Sep 2017

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 4.56 0.00 91%
Counterpart 0.57 Cumulative Disbursements
Cofinancing 0.00 30 Oct 2012 5.62 0.00 112%
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 9.59 0.00 69%
Counterpart 1.33 Cumulative Disbursements
Cofinancing 0.00 30 Oct 2012 6.76 0.00 48%
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 - - - -

Project Data Sheets (PDS) contain summary information on the project or program. Because the PDS is a work in progress, some information may not be included in its initial version but will be added as it becomes available. Information about proposed projects is tentative and indicative.

The Public Communications Policy (PCP) recognizes that transparency and accountability are essential to development effectiveness. It establishes the disclosure requirements for documents and information ADB produces or requires to be produced.

The Accountability Mechanism provides a forum where people adversely affected by ADB-assisted projects can voice and seek solutions to their problems and report alleged noncompliance of ADB's operational policies and procedures.

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Title Document Type Document Date
Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project (Viet Nam Component): Procurement Plan Procurement Plans Apr 2017
GMS Capacity Building for HIV/AIDS Prevention Project (Viet Nam Component): Audited Project Financial Statements (January-December 2015) Audited Project Financial Statements Jul 2016
GMS Capacity Building for HIV/AIDS Prevention Project (Lao PDR Component): Audited Project Financial Statements (October 2014-September 2015) Audited Project Financial Statements Jun 2016
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 (Lao PDR Component): 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 Gender Action Plans 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 Project/Program Administration Manual Oct 2012
Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project Reports and Recommendations of the President 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.


The Public Communications Policy (PCP) establishes the disclosure requirements for documents and information ADB produces or requires to be produced in its operations to facilitate stakeholder participation in ADB's decision-making. For more information, refer to the Safeguard Policy Statement, Operations Manual F1, and Operations Manual L3.

Requests for information may also be directed to the InfoUnit.

Tenders

Tender Title Type Status Posting Date Deadline
Evaluating Model on HIV/AIDS Control across Border Individual - Consulting Active 28 Sep 2017 04 Oct 2017
Developing Guideline on Methadone Dispensing at Commune Level Individual - Consulting Active 28 Sep 2017 04 Oct 2017
L2930-VIE (SF): Greater Mekong Subregion Capacity Building for HIV/AIDS Prevention Project [Package 4: District laboratory equipment] Invitation for Bids Closed 27 Apr 2017 16 Jun 2017

Contracts Awarded

Contract Title Approval Number Contract Date Contractor Contractor Address Executing Agency Contract Description Total Contract Amount (US$) Contract Amount Financed by ADB (US$)
Various Expenses Loan 2930 13 Mar 2017 Various Various Viet Nam Ministry of Health Others 219433.53 219433.53
13C: Design and Production of BCC Materials Loan 2930 21 Feb 2017 Center for Community Health Research and 18H2 Yen Hoa New Urban Area, Cau Giay Hanoi, Viet Nam Ministry of Health Consultancy 42084.83