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

Sovereign Project | 42179-013

Summary

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.

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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
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 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 --
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)

Most of the activities planned in 2014 were completed. The approved annual operational plan for FY 2014-2015 is being implemented. The plan will be reviewed by the international and national gender consultants and to provide recommendations and conduct training to include gender specific targets in the provincial AOPs for FY 2015-2016.

The Hanoi School of Public Health has recently conducted two courses related to planning and management capacity at national, provincial, and district level. Eighty-one trainees participated among those 32 women (40%). EA estimated that 60 persons received curriculum by the end of the year 2014.

In the absence of the M&E and gender consultants, CHAS has updated data on total population, ethnic groups and target population estimates: migrants and mobile population, and female sex worker in 35 target districts, which will be basis for development of AOPs and M&E system. CHAS completed training on project management and planning for PCCAs and DCCAs. Starting in FY 2014-2015, the districts will produce a yearly plan. CHAS will ensure that every district plan includes baseline and targets for (i) the number of HIV tests conducted; (ii) the number of new patients on ART; and (iii) the number of patients who discontinue the ART. and mobile population, and female sex workers. CHAS will ensure that every district plan includes baseline and target for (i) the number of HIV tests conducted; (ii) the number of new patients on ART; and (iii) the number of patients who discontinue the ART.

EA will conduct baseline survey in 2015.

EA proposed the performance indicated by 30 October 2014.

Results were presented yearly for the actual number of commune health station providing appropriate care treatment, harm reduction, methadone maintenance therapy.

CHAS confirmed that 3 mobile clinics are currently active in 14 target districts, as a one-year pilot. The Mission recommended to report quarterly the number of patients served by the mobile clinics, disaggregated by province, gender, migrants and ethnic groups.

As of December 2014, there are 3 ARV centers and 2 ARV sub-centers are providing ARV services in 8 target provinces.

As of December 2014, a total of 405 (220 female) people living with HIV/AIDS in 8 target provinces are receiving counselling and ARV treatment services.

Prepared design competency evaluation questionnarie and apply to targeted staff.

The number of STI diagnostics and treatments will be measured in the 35 targeted districts, using the routine information system. CHAS will report quarterly the data, disaggregated by sex and by province.

A total of 50 provincial staff (37 female, 10 from ethnic groups (8 female)) and 109 district staff (73 female, 36 from ethnic groups (25 female)) received training on STI management.

The customer satisfaction will be measured during the baseline survey.

EA to design quality evaluation questionnaire to district healtlh 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.

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

As of December 2014, 276 (124 or 45% are female, 112 or 41% from ethnic groups (54 female)) peer educators were recruited from the communities and trained and provided with IEC materials. These peer educators were selected by the communities based on selection criteria. About 320 peer educators will be recruited and trained in 2015.

CHAS confirmed to continue collecting at least the following data: (i) number of visits conducted, (ii) number of migrant and mobile individuals reached; (iii) number of ethnic minority individuals, and (iv) number of ethnic minority women reached.

Activities ongoing. As of December 2014, a total of 4,880 (2,823 or 58% are female, 1,687 or 35% from ethnic groups (1,036 female)) were reached by peer activities.

The baseline survey consulting firm 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.

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. Role and responsibilities of PPCCA and DCCA secretariat as focal points for HIV AIDS are defined. However, their role in cross border cooperation needs to be strengthened. A draft joint strategy for regional cooperation for 2 countries and joint provincial operational plan were the key outputs of the bilateral meeting for cross border HIV AIDS cooperation held in Hanoi 30 September to 1 October 2014.

For Viet Nam, a draft joint strategy for regional cooperation 2015-2017 was finalized on 1 October 2014 and ratified after the Hanoi meeting on 15 October 2014. Draft 2014-2017 joint operational plans for implementing 4 provinces in Viet Nam and 3 provinces in Lao PDR was ratified on 1 October 2014.

Activities ongoing.

The cross-border collaborative pilot activities for migrant and mobile populations conducted in 3 sites were implemented since Q3 2014. CHAS informed the Mission that cross-border activities were incorporated in provincial AOPs FY 2014-2015 of Houaphanh and Attapeu provinces.

Activities ongoing

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.

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.

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 The grant project for Lao PDR became effective on 8 February 2013. Some consultants were engaged and for some, recruitment is ongoing.
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 $500,000 for Lao PDR, and at more than $1,000,000 for Viet Nam. National competitive bidding procedures will be used for supply contracts valued at less than $500,000 for Lao PDR, and at less than $1,000,000 for 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 Nation's 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 ADB Officer Gerard Servais
Responsible ADB Department Southeast Asia Department
Responsible ADB Division Human and Social Development Division, SERD
Executing Agencies
Ministry of Health138A Giang Vo Str.
Ha Noi, 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 27 Mar 2015

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 2.13 0.00 43%
Counterpart 0.57 Cumulative Disbursements
Cofinancing 0.00 30 Oct 2012 2.06 0.00 41%
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 2.70 0.00 19%
Counterpart 1.33 Cumulative Disbursements
Cofinancing 0.00 30 Oct 2012 3.05 0.00 22%
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 0.00 0.00 0.00 0.00 0.00 0.00 30 Oct 2012 787,904.33
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - Satisfactory - - - -

Safeguard Documents

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No documents found.

Evaluation Documents

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