Enhancing the local health care system is a key priority of the Government of Viet Nam. In this regard, the Ministry of Health (MOH) will spearhead the implementation of the government's Master Plan for Strengthening the Local Health Care Program (SLHCP). SLHCP will consolidate and build on efforts to improve the quality of and access to primary health care services, especially for the poor and ethnic minorities in remote, border, and disadvantaged areas. It seeks to improve the network of local health facilities (consisting of commune health stations (CHS), district health centers, and district hospitals) to meet the changing health requirements of the population. More specifically, SLHCP will (i) upgrade the local health facilities to meet national standards, (ii) strengthen health human resources, (iii) improve operating and financing mechanisms, and (iv) enhance local health system management.
|Project Name||Support to Strengthening Local Health Care Program|
|Project Type / Modality of Assistance||Technical Assistance
|Source of Funding / Amount||
|Strategic Agendas||Inclusive economic growth
|Drivers of Change||Gender Equity and Mainstreaming
Governance and capacity development
Private sector development
|Sector / Subsector||
Health / Health sector development and reform
|Gender Equity and Mainstreaming||Gender equity|
|Description||Enhancing the local health care system is a key priority of the Government of Viet Nam. In this regard, the Ministry of Health (MOH) will spearhead the implementation of the government's Master Plan for Strengthening the Local Health Care Program (SLHCP). SLHCP will consolidate and build on efforts to improve the quality of and access to primary health care services, especially for the poor and ethnic minorities in remote, border, and disadvantaged areas. It seeks to improve the network of local health facilities (consisting of commune health stations (CHS), district health centers, and district hospitals) to meet the changing health requirements of the population. More specifically, SLHCP will (i) upgrade the local health facilities to meet national standards, (ii) strengthen health human resources, (iii) improve operating and financing mechanisms, and (iv) enhance local health system management. SLHCP will contribute to overall government efforts to achieve universal health coverage (UHC) and promote inclusive growth. MOH has requested a small-scale capacity development technical assistance (S-CDTA) from the Asian Development Bank (ADB) to enhance the institutional capacity for SLHCP implementation. A reconnaissance mission conducted on 16 26 September 2016 reached an understanding with MOH on the impact, outcome, outputs, implementation arrangements, cost and financing, and consulting services for the S-CDTA.|
|Project Rationale and Linkage to Country/Regional Strategy||Despite the significant gains in poverty reduction and improvement in the health status of the Vietnamese population, evidence points to growing inequity in health between the rapidly developing urban cities and disadvantaged remote areas. In the latter, morbidity and mortality attributable to communicable, maternal, perinatal and nutritional conditions remains high, with the disparity most pronounced in mountainous areas. Ethnic minorities, members of poor households, and people with low education levels bear a disproportionate share of the disease burden. In border areas, the risk of communicable disease spread poses an ongoing threat to regional health security. In tandem with the threat from communicable diseases, the country faces a significant and growing burden from non-communicable diseases (NCD). In 2012, the World Health Organization estimated that NCD accounted for the highest share of overall disease burden in Viet Nam and 72.9% of deaths. As Viet Nam transitions to an aging population, the share of disease burden attributable to NCD as well as the associated financial burden on households, particularly the poor, is likely to rise. The dual burden of communicable and NCD presents challenges for the institutional and managerial capacities of Viet Nam's health system, particularly at the local level.|
|Impact||Quality of and access to local health systems strengthened toward better health outcomes, particularly in disadvantaged, remote, and mountainous areas|
|Description of Outcome||SLHCP implementation readiness strengthened|
|Progress Toward Outcome|
|Description of Project Outputs||
Technical assessments completed
Institutional and capacity development framework developed
Development assistance options for supporting SLHCP identified
|Status of Implementation Progress (Outputs, Activities, and Issues)||ADB fielded a mission to discuss with the government program processing milestones and agree on the program description of the Local Health Care Sector Development Program, (ii) implementation arrangements; (iii) financial management; (iv) procurement and consulting services requirements; and (v) ADB requirements on safeguards and gender. A discussion on outstanding issues and information gaps also took place to ensure implementation readiness.|
|Summary of Environmental and Social Aspects|
|Stakeholder Communication, Participation, and Consultation|
|During Project Design|
|During Project Implementation||
Implementation achievements of the TA project are described by output below. A summary of progress against the design and monitoring framework indicators for each output and outcome is in Appendix One.
Output 1: Technical assessments completed.
The TA project has supported MOH to identify the activities, implementation arrangements and required investment to deliver the local health care (LHC) system reforms envisioned under the Master Plan. This includes support to complete required due diligence for the proposed LHCSDP. The completed analyses cover: (i) assessment of the health sector; (ii) analysis of LHC policy; (iii) assessment of the financial management and procurement capacity of LHCSDP implementers; (iv) assessment of MOH implementation readiness for LHCSDP; (iv) assessment of program impact; (v) analysis of the economic and financial viability of LHCSDP; (iv) assessment of environmental and social safeguards systems.
Output 2: Institutional and capacity development framework developed.
Drawing on the analyses and technical assessment completed under output 1, the TA has supported MOH to identify and prepare the necessary frameworks to strengthen systems for LHCSDP delivery. Specifically, the TA has supported MOH to:
i. Develop a policy matrix that identifies the priority reforms to be delivered under LHCSDP in order to support Master Plan implementation;
ii. Identify risk mitigation measures and prepare capacity development frameworks governing (a) safeguards; (b) financial, procurement, and fiduciary systems; and (c) poverty, social, and gender issues;
iii. Prepare the Investment Policy for LHCSDP for submission to government.
The TA is currently preparing a capacity development program to strengthen implementation readiness for LHCSDP. This includes readiness for the application of new models of LHC service delivery, including the innovative use of information technology. These activities are proposed for implementation from September 2018 - June 2019 under an extension of the TA project.
Output 3: Development assistance options for supporting SLHCP identified.
A sector development program modality has been identified and agreed as the financing modality for the LHCSDP. The TA project has supported MOH to prepare an agreed-upon design for a $88 million policy based loan. The loan addresses key reforms in areas governing public investment, health service delivery, and health workforce quality in the LHC system, through the accomplishment of 14 policy actions.
The TA project has further supported MOH to prepare an agreed-upon design for the accompanying $12 million project grant for LHCSDP. The project grant will enhance responsiveness of LHC service delivery through piloting new service delivery model(s) in 12 districts. It will equip commune health stations and district health facilities with information systems to meet service delivery requirements of the family medicine model, introduce electronic health records linked to the communicable diseases information system, and conduct trainings on the implementation of electronic health records.
The TA project has prepared the required ADB documentation for LHCSDP processing, including the Reports and Recommendations of the President and linked documents. The TA has further supported MOH to prepare the Investment Proposal and Pre-Feasibility Study for LHCSDP for government review. A Feasibility Study report for LHCSDP will be prepared following approval of the Pre-Feasibility Study report by the Prime Minister.
|Consulting Services||The S-CDTA will finance international (7 person-months) and national (5 person-months) consulting services. The S-CDTA will be implemented from 1 March 2017 to 30 September 2018. All consultants will report to the ADB project officer. ADB will recruit individual consultants in accordance with ADB's Guidelines on the Use of Consultants (2013 as amended from time to time). To facilitate TA activities and ensure that MOH gains technical expertise and knowledge, the consultants will work closely with MOH counterparts, who will assist with the necessary stakeholder consultations and preparatory and analytical work. Consultative workshops will be conducted to disseminate TA outputs across relevant departments of MOH and to evaluate TA outcomes.|
|Responsible ADB Officer||Servais, Gerard|
|Responsible ADB Department||Southeast Asia Department|
|Responsible ADB Division||Human and Social Development Division, SERD|
|Concept Clearance||28 Nov 2016|
|Fact Finding||28 Nov 2016 to 28 Nov 2016|
|Approval||09 Dec 2016|
|Last Review Mission||-|
|Last PDS Update||27 Sep 2019|
|Approval||Signing Date||Effectivity Date||Closing|
|09 Dec 2016||-||09 Dec 2016||30 Sep 2018||30 Jun 2019||-|
|Financing Plan/TA Utilization||Cumulative Disbursements|
|225,000.00||500,000.00||0.00||0.00||0.00||0.00||725,000.00||09 Dec 2016||695,994.66|
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.
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|Title||Document Type||Document Date|
|Support to Strengthening Local Health Care Program: Technical Assistance Completion Report||TA Completion Reports||Jun 2020|
|Hỗ trợ Tăng cường Chương trình chăm sóc sức khỏe địa phương : Bảng Dữ liệu Dự án||Translated PDS||Mar 2018|
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
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