This is a continuing activity from FY07.

PEPFAR is partnering with the Hanoi School of Public Health (HSPH) in the development and

implementation of information systems to support external quality assessment (EQA) programs in Vietnam.

HSPH has experience in developing and deploying information systems to support clinical activities.

PEPFAR will provide guidance to HSPH on the development of tools to support the needs of the National

Reference Laboratory, which is conducting EQA for HIV diagnosis and clinical testing. HSPH will

collaborate with the Ministry of Health (MOH)/Vietnam Administration of HIV/AIDS Control (VAAC) and the

National Institute of Hygiene and Epidemiology (NIHE) to develop these systems.

The laboratory information system training officer contracted by HSPH in FY07 will continue to collaborate

with VAAC and PEPFAR to support laboratory activities in Vietnam and will also be responsible for the

deployment of EQA information systems. Partnership with HSPH for this activity will help build sustainability

for data management activities in other partners besides the MOH in order that they will have the capacity

to implement similar activities in other provinces in the future.

This is a continuing activity from FY07. The narrative below is unchanged from FY07. Major changes to this

activity since FY07 approval are:

• Hanoi School of Public Health (HSPH) will continue to develop its staff and facilities to become a Center of

Excellence for human capacity development in public health. The school will develop routine curricula for in-

service and pre-service trainings targeting the development of the Vietnam public health workforce by

partnering with the Ministry of Health, General Statistics Office (GSO), National Institute of Hygiene and

Epidemiology and other government agencies responsible for the planning, implementation, and

management of HIV/AIDS public health programs.

• HSPH will continue to develop and implement specific in-service training for patient monitoring systems.

The school will be a key partner in the expansion of CAREWare as a patient monitoring tool in out-patient

clinics supported by PEPFAR.

• HSPH will also continue to work with the national care and treatment technical working group (TWG) to

manage the development and localization of CAREWare for use in Vietnam.

• The school will play a critical role on the national monitoring and evaluation (M&E) TWG as both

implementers and trainers to ensure that the National M&E Framework is implemented in 2008. Building on

survey expertise and lessons learned from the development of survey methodologies to support a survey of

clients of commercial sex workers, HSPH will partner with UNC/Measure and GSO to conduct additional

surveys including another round of a general population-based AIDS Indicator Survey. This second round

will attempt to better elicit information on sexual and drug use risk behaviors.

• The general population survey with a focus on identifying clients of commercial sex workers was

reprogrammed in 2007 from Tulane to HSPH. This activitiy will be completed by the school without

additional funding.

• Finally, the school will work with other universities and training institutions in Vietnam to develop in-service

and pre-service trainings focused on M&E, data use, program management, surveillance and health

management information system (HMIS) activities.

FY07 Activity Narrative:

Hanoi School of Public Health (HSPH) is currently the government of Vietnam (GVN) partner with the

greatest capacity for training and support in M&E, HIV/AIDS information systems development and support,

and data analysis and use including data disaggregated by sex. HSPH has drafted a memorandum of

understanding (MOU) with the Ministry of Health/Vietnam Administration for HIV/AIDS Control (MOH/VAAC)

to provide these services to VAAC, NIHE, the four VAAC regional M&E centers, and at the provider level

throughout Vietnam. HSPH has a PEPFAR-supported training room with 48 networked computers and state

-of-the-art presentation equipment. HSPH has developed a curriculum in conjunction with VAAC to transfer

knowledge specific to HIV/AIDS public health activities to HSPH students. FY07 funding will support the

expansion of the HSPH curriculum to include HIV/AIDS SI-related trainings for 24 individuals to develop an

SI public health workforce. Ongoing activities include implementation of CAREWare, an HHS/Health

Resources and Services Administration (HHS/HRSA) electronic patient monitoring system for HIV/AIDS

care and treatment, laboratory external quality assurance (EQA) software, and Laboratory Information

Systems (LIS) for Vietnam and development of relevant training materials for implementation. HSPH will

also provide direct technical assistance (TA) to VAAC for counseling and testing (CT) and M&E information

systems. When a counterpart university is identified in Ho Chi Minh City (HCMC), HSPH will assist HCMC

Provincial AIDS Committee (HCMC PAC) in developing that university's capacity to provide similar support

for HCMC. Finally, PEPFAR will support HSPH to develop in-service and pre-service training curricula on

data use, M&E, systems development, and surveillance methodology for HIV/AIDS programs. These

trainings will be available to Masters of Public Health, Bachelors of Public Health, and HSPH In-Service

training program students. PEPFAR will support HSPH to train 200 individuals in SI and provide SI TA to 8

organizations.

This activity is linked to HVSI MOH/VAAC (9376) and HVSI NIHE (9244). PEPFAR will support Tulane

University in FY2007 to partner with the University of Social Science and Humanity-Ho Chi Minh City

(USSH HCMC) to conduct a survey on general population HIV/AIDS risk behaviors, attitudes and beliefs

with a component focused on additional data collected on people identifying as clients of CSW. With FY05

funds, PEPFAR supported an AIDS indicator survey to collect information on knowledge, sexual behavior,

and attitudes about HIV/AIDS among the general population. The SI 5-Year Strategic Plan included a

repeat of the survey to detect changes in trends over time. However, the AIDS indicator survey results

recently obtained indicated almost no risky sexual behaviors among men and women aged 15-49, while

other data exists in Vietnam that indicate otherwise. Rather than continue with household-based general

population surveys, PEPFAR in FY2007 will collect more pertinent information on linkages between the

general population and MARPs. To obtain relevant information for program planning and policy

development, a survey will be conducted in FY2007 to identify risky behaviors in a general population

sample with a focus on identified clients of CSW. The proposed survey will apply methodologies proven

effective for collecting sensitive sexual behavioral information in the cultural context of Vietnam and will be

carried out in PEPFAR focus provinces, where an integrated biologic and behavioral surveillance (IBBS)

among MARPs will also be conducted. Tulane will partner with either an international or local NGO or

research institute to conduct the survey. A general questionnaire will be designed to collect individual

characteristics, knowledge of respondents, and their behaviors related to HIV. An extended questionnaire

will be used to focus on specific risk behaviors for those who engaged in premarital sex, extramarital sex, or

sex with CSW. Data from IBBS and the general population surveys will be analyzed to obtain a more

comprehensive and complete picture of the knowledge and behaviors among the general population and

MARPs in the 7 focus provinces. Tulane will provide SI TA to 2 organizations and training in SI for 10

implementing staff.

This is a continuing activity from FY07.

The U.S. government has collaborated with the Hanoi School of Public Health (HSPH) since 1998 to

support establishing the School as a leading academic center in public health capacity development, with

an overall goal of developing and institutionalizing a public health workforce for Vietnam.

In FY07, PEPFAR supported HSPH to organize and implement three training courses in three regions

(North, Central, and South) to instruct 70 provincial-level HIV/AIDS health staff (doctors, nurses, laboratory

technicians, counselors, and project managers) in Total Quality Management (TQM). Through the

application of Total Quality Management staff are able to administer flexible management concepts and

tools that allow them to adopt continuous improvement practices in their organizations to address such

processes as pre-test counseling at voluntary counseling and testing (VCT) centers, referrals from VCT to

out-patient care, and encouraging adherence to opportunistic-infection preventive treatment among persons

living with HIV/AIDS. As an important component of this training, HSPH faculty collaborated with regional

trainers to conduct supervisory visits to the students in order to provide mentorship, feedback and technical

assistance and support. A related element of this program involved the organization of TQM networks of

HIV/AIDS provincial staff. Through these networks, provincial staff, in conjunction with those who have

already attended regional workshops, met to share their experiences in the application of TQM.

HSPH also coordinated and implemented a Training of Trainers (TOT) course on project management for

regional trainers, the Ministry of Health's Vietnam Administration for HIV/AIDS Control (VAAC) staff, and

NGOs. This training was originally developed for PEPFAR Vietnam staff in FYO6 by the HHS/CDC Atlanta-

based Sustainable Management for Development Project. This course included an introductory module on

HIV/AIDS strategic planning at the provincial level and discussed linkages between provincial and national

strategies through VAAC.

In FY08, HSPH will continue to carry out the established TQM program with the implementation of another

three rounds of TQM training (three courses in three regions) and provision of supervisory technical

assistance visits to the students. The Sustainable Management for Development Project will again provide

technical assistance to the HSPH to coordinate and manage the development of TQM activities adapted for

provincial HIV/AIDS health workers. In addition, the HSPH will conduct a first round of the training on

"Project Management for Provincial HIV/AIDS Managers". PEPFAR will maintain their partnership with the

HSPH to focus on building the capacity of provincial HIV/AIDS program managers to plan, design,

implement, and evaluate HIV/AIDS prevention and care programs, through an agreement that was

developed in FY07 between VAAC and HSPH.

In FY08 HSPH will engage in two new activities. The first is designed to strengthen Vietnam's capacity for

sustainability in behavioral and social research. PEPFAR will support HSPH to develop a five-year project

intended to strengthen their collaboration with the Johns Hopkins Bloomberg School of Public Health. The

goal is to establish a behavioral and social sciences research infrastructure for Vietnamese researchers

working on HIV/AIDS-related issues. Through this program essential data on the underlying individual and

community-based behavioral patterns related to HIV acquisition and transmission in Vietnam will be

gathered and analyzed. This will help researchers better understand the unique local characteristics of the

emerging HIV epidemic and will provide information needed to effectively design, implement, and evaluate

appropriate HIV prevention programs. To further support this activity PEPFAR funding will be used to

convene national workshops, establish monthly behavioral science research round tables, set up a quarterly

newsletter, support visiting professorships, and research projects. PEPFAR will also support a master's

degree scholarship for leadership in public health and help develop a Johns Hopkins Bloomberg School of

Public Health certificate program that is tailor-made for HSPH staff.

A second new activity involves the development of HSPH as a center of excellence in HIV/AIDS in Vietnam.

The HSPH is in a unique position to play a key role in providing public health training and conducting

HIV/AIDS research. The Hanoi School of Public Health has made a commitment to build its training and

research capacity in HIV/AIDS over the next 10 years, as part of the "Hanoi School of Public Health

Development Strategy for 2005 - 2010." As a center for excellence, the HSPH will be better able to provide

technical assistance to strengthen national public health and HIV/AIDS systems in Vietnam. To further this

goal, PEPFAR will support the HSPH to conduct an internal study that will review and identify staffing

requirements and assess current and planned curricula. Following completion of this internal review, a

team of four senior HSPH staff will undertake a study visit to selected schools of public health in the United

States to learn how successful centers of excellence are created and sustained.