This is a continuing mechansim that was establisehd in August reprogramming.

Implementing Mechanism: The Development Center for Public Health (DCPH) is a Vietnamese nongovernmental organization (NGO). In FY 2007 and FY 2008, DCPH was sub-partner to an international NGO that was implementing HIV prevention and HIV care programs. DCPH has also worked with the Vietnam Ministry of Health in the development of national guidelines on prevention of mother-to-child transmission (PMTCT) and national strategies on TB control in close settings. In FY 2008, DCPH became a local prime partner with U.S. Department of Defense (DoD) PEPFAR to provide technical assistance and support on a wide range of prevention, care and treatment activities that include PMTCT, TB/HIV and antiretroviral treatment (ART).

By the end of FY 2010, the DoD PEPFAR in Vietnam will support four regional military hospitals to: 1) establish HIV prevention activities in tuberculosis, including HIV counseling and testing using the provider-initiated counseling and testing (PICT) model; 2) establish HIV prevention activities in the OB/GYN departments, including HIV counseling and testing using the PICT model; 3) establish referral systems in the TB and OB/GYN departments to link patients to additional HIV/AIDS care and treatment services; 4) provide training in HIV/AIDS prevention, screening and care for TB and OB/GYN healthcare professionals; and 5) strengthen four out-patient clinics to meet national care and treatment standards.

The comprehensive goals and objectives under this award reflect DCPH's breadth across three technical areas: Prevention of Mother-to-Child Transmission (MTCT), TB/HIV (HVTB) and Adult Treatment (HTXS).

Linkage to Partnership Framework: In partnering with DCPH, the U.S. DoD is directly supporting the PEPFAR Partnership Framework's central strategy of building local capacity to ensure that programs are sustainable. In FY 2007 and FY 2008, DCPH progressively gained technical skills and greater management experience and proved to be a capable implementing partner for HIV prevention and HIV/AIDS treatment programs in various civilian communities.

DCPH demonstrated that they can also work with the Vietnamese military in implementing HIV prevention and treatment programs in military settings. Forging a strong collaborative effort between the Vietnamese military and a capable local prime partner to carry out future HIV prevention and treatment programming is a central goal for DoD in order to promote sustainability.

Target Population and Geographical Coverage: The target population includes civilian and military TB and/or suspected TB patients; young women seeking gynecological and pre-natal services; and adult HIV patients using medical services at the four regional military hospitals. Although military health care facilities are mandated to care for military personnel and their families, more than 80% of the clients/patients are civilians. With FY 2010 funding, the coverage of these programs will be maintained at four military hospitals: Hospital 103 in Hanoi, Hospital 175 in Ho Chi Minh City, Hospital 121 in Can Tho City and Hospital 17 in Da Nang City.

Health System Strengthening: DCPH's key contributions to health system strengthening include partnering with local organizations and utilizing local experts, who subsequently will help build the capacity of technical staff for the host government and its partners. DCPH is committed to providing qualified and dedicated human resources in the implementation of these technical areas through: 1) regular in-service training for on-site and off-site implementing staff; 2) upgrading staff training by using national training standards; 3) regular on-site management coaching for implementing staff; 4) producing a cadre of trainers who can offer the same training to others in the future; 5) providing professional staff development through workshop and conferences, when needed, to encourage professional advancement; 6) on-going assessments to promote retention of qualified staff; and 7) periodic assessments for quality improvement of the implementation process.

Cross-cutting Programs and Key Issues: DCPH covers two cross-cutting programs: Human Resources for Health by conducting on-going professional development training; and minor renovation of PICT sites to meet national standards. Key issues addressed by DCPH include family planning, TB, military populations and mobile populations.

Program Efficiency: DCPH's strategy to become more cost efficient over time is to: 1) make HIV counseling and testing services more available to TB and suspected TB patients; 2) increase the HIV counseling and testing services to all women who seek OB/GYN care at the four military hospitals; 3) use existing military-relevant education, information and communication (EIC) materials; 4) refer clients and patients to other PEPFAR-supported and Vietnam government-supported sites for services; 5) use available, approved educational materials from other PEPFAR partners in PMTCT, TB/HIV and HIV care and treatment, and 6) collaborate with other PEPFAR partners and experts in MTCT, HVTB and HTXS to enhance training, networking and resource sharing to ensure sustainability.

Monitoring and Evaluation Plans: In FY 2010, U.S. DoD PEPFAR will further strengthen collaboration with other PEPFAR agencies and partners, i.e., CDC, USAID, Family Health International (FHI), Harvard Medical School AIDS Initiative (HAIVN), CDC Laboratory, etc. to promote common monitoring and evaluation (M&E) activities, and inter-agency quality assurance (QA) plans. In addition, DoD PEPFAR, in partnership with DCPH, will also provide routine observation, supervision and oversight through site visits and on-site coaching/mentoring.

This is a continuing activity from FY 2009. In FY 2009, the U.S. Department of Defense (DoD) used FY 2008 carry-over funds and $59,250 from FY 2009 funds to implement HTXS. Therefore, in FY 2010, this budget code reflects a 20% increase in budget, and thus a budget code narrative is required.

09-HTXS Budget Code Description: To support the Vietnam National Action Plan No. 3 on Care and Support for HIV/AIDS-infected People Program, U.S. DoD PEPFAR is collaborating with the Development Center for Public Health (DCPH), a Vietnamese NGO, to strengthen existing HIV/AIDS care and treatment programs at four military hospitals: Hospital 103 in Hanoi, Hospital 175 in HCMC, Hospital 17 in Da Nang and Hospital 121 in Can Tho. In FY 2008, DCPH became a DoD local prime partner, providing: technical assistance to the Vietnamese military on: provision of antiretroviral treatment (ART) clinical follow-up testing; clinical consumables and supplies; travel expenses for trainees to attend didactic trainings and experience sharing conferences; and operational support to four sites.

09-HTXS ACTIVITY #1 ART Clinical Support, $198,000 DCPH will: 1) maintain care and treatment service provisions in four infectious disease departments and in four outpatient clinics within the four military hospitals; 2) support patient follow-up testing and ART care; 3) provide support for transport of samples and specimens; 4) provide operational support to four sites; 5) conduct routine TA visits, on-site coaching and mentoring, and offer operational support to four sites to ensure the service delivery protocols are in line with the national guidelines; and 6) conduct routine quality assurance (QA) visits for quality improvement.

09-HTXS ACTIVITY # 2 Travel for Trainees for Capacity Building Activities, $ 30,000 - DCPH will organize and provide support to select individuals to attend workshop-based training, clinical mentoring at "Center of Excellence" civilian sites, experience-sharing conferences and other related events within the region.

09-HTXS Quality Assurance An important goal for U.S. DoD in FY 2010, is to conduct relevant program evaluation as part of building a high-quality and sustainable program. In collaboration with U.S. DoD PEPFAR, and in close coordination with the DoD Care and Treatment Program Officer, DCPH will: 1) conduct routine site visits to ensure that the service delivery protocols are in line with the national guidelines, 2) conduct routine site visits to ensure implementation as planned; and 3) coordinate with other PEPFAR partners to ensure linkages among all sectors are effective and that national standards are met.

09-HTXS Targets:

Number of adults with advanced HIV infections who are newly enrolled in ART: 160

Male: 100

Female: 60

Number of adults with advanced HIV infection receiving ART: 560

Male: 350

Female: 210

Percentage of adults known to be alive and on treatment 12 months after initiation of ART: 85%

Number of healthcare workers who successfully completed an in-service training program: 30

This is a continuing activity from FY 2009. In FY 2009, working with a CDC partner, the U.S. Department of Defense (DoD) began to implement prevention of mother-to-child treatment (PMTCT) in two sites. Therefore, this budget code reflects a new area, and thus a budget code narrative is required.

01-MTCT Budget Code Description: To encourage the use of local staff and expertise, and promote sustainability, U.S. DoD PEPFAR will be partnering with the Development Center for Public Health (DCPH) to strengthen the MTCT program at four miltiary hospitals: Hospital 103 in Hanoi, Hospital 175 in HCMC, Hospital 17 in Da Nang and Hospital 121 in Can Tho. In FY 2009, this activity was under the CDC-administered cooperative agreement with the Harvard Medical School AIDS Inititive in Vietnam (HAIVN) for basic training only. DCPH received a grant from U.S. DoD FY 2008 funds to provide on-site technical assistance and clinical support to the two sites.

In FY 2010, all activities related to MTCT will be realigned under one partner for ease of administration, consistency in implementation, uniform training and monitoring, and cost efficiency. In FY 2009, MTCT activities were performed by two different partners. In FY 2010, the same activities will be conducted by a single new partner. Additionally, previously developed technical materials will also be used. Thus, in FY 2010, DCPH will be the prime partner with U.S. DoD PEPFAR for implementing MTCT activities at four sites.

01-MTCT ACTIVITY #1 Training, Technical Assistance (TA) and Operational Support, $63,000 DCPH will: 1) organize and conduct refresher training on PMTCT for selected military healthcare professionals; 2) organize and conduct initial didactic training on PMTCT activities for select military healthcare professionals, including physicians, nurses and midwives working at OBGYN and/or related departments; 3) conduct routine technical assistance visits, on-site coaching/mentoring and operational support to four sites to ensure the service delivery protocols are in line with the national guidelines; and 4) conduct routine Quality Assurance (QA) visits for quality improvement.

01-MTCT ACTIVITY # 2 - Infrastructure Renovation/Upgrading, $ 30,000 - DCPH will: 1) provide support to the Vietnam Ministry of Defense (MOD) for assessment of facilities for minor renovation, as needed, of two testing and counseling sites; and 2) provide basic consumables and clinical supplies to sites.

01-MTCT Quality Assurance: An important goal for U.S. DoD in FY 2010 is to conduct a relevant program evaluation, as part of building a high quality and sustainable care and treatment program. In collaboration with U.S. DoD, and in close coordination with the DoD Care and Treatment Program Officer, DCPH will: 1) conduct routine site visits to ensure that the service delivery protocols are in line with the national guidelines, 2) conduct routine site visits to ensure implementation as planned; and 3) coordinate with other PEPFAR partners to ensure that linkages among all sectors are effective and that national standards are met.

01-MTCT Targets:

Number of pregnant women who were tested for HIV and received their results: 4,000

Percentage of pregnant women who were tested for HIV and know their results: 70%

Number of healthcare workers who successfully completed an in-service training program: 30

This is a continuing activity from FY 2009. In FY 2009, working with a CDC partner, the U.S. Department of Defense (DoD) began to implement TB/HIV programs at two sites. Therefore, this budget code represents a new area with a DoD partner, and thus a budget code narrative is required.

10-TB/HIV - Budget Code Description: To encourage the use of local staff and expertise, and promote sustainability, U.S. DoD PEPFAR will partner with the Development Center for Public Health (DCPH), a Vietnamese nongovernmental organization, to strengthen TB/HIV program at four miltiary hospitals: Hospital 103 in Hanoi, Hospital 175 in HCMC, Hospital 17 in Da Nang and Hospital 121 in Can Tho. In FY 2009, this activity was under a CDC-administered cooperative agreement with the Harvard Medical School AIDS Inititive in Vietnam (HAIVN) for basic training only. DCPH received a grant from U.S. DoD in FY 2008 to provide on-site technical assistance and clinical support to the two sites.

In FY 2010, all activities related to TB/HIV will be realigned under one partner for ease of administration, consistency in implementation, uniform training and monitorin, and cost efficiency. In FY 2009, TB/HIV activities were performed by two different partners. In FY 2010, the same activities will be conducted by a single new partner. Additionally, previously developed technical materials will also be used. Thus in FY 2010, DCPH will be DoD PEPFAR's prime partner to implement TB/HIV technical area.

10-TB/HIV ACTIVITY #1 Training, Technical Assistance (TA) and Operational Support, $63,000 DCPH will: 1) organize and conduct refresher training on TB/HIV for selected military healthcare professionals; 2) organize and conduct initial didactic training on TB/HIV care for selected military healthcare professionals including physicians, nurses and technical staff working in infectious disease departments, exam departments and/or related divisions; 3) conduct routine TA visits, on-site coaching/mentoring and operational support to four sites to ensure that the service delivery protocols are in line with the national guidelines; and 4) conduct routine quality assurance (QA) visits for quality improvement.

10-TB/HIV ACTIVITY # 2 - Infrastructure Renovation/Upgrading, $ 30,000 - DCPH will: 1) provide support to the Vietnam Ministry of Defense (MOD) for assessment of facilities for minor renovations, as needed, of two testing and counseling sites; and 2) provide basic consumables and clinical supplies to four sites.

10-TB/HIV Quality Assurance: An important goal for U.S. DoD in FY 2010 is to conduct relevant program evaluation, as part of building a high-quality and sustainable program. In collaboration with U.S. DoD PEPFAR, and in close coordination with the DoD Care and Treatment Program Officer, DCPH will: 1) conduct routine site visits to ensure that the service delivery protocols are in line with national guidelines, 2) conduct routine site visits to ensure implementation as planned; and 3) coordinate with other PEPFAR partners to ensure linkages among all sectors are effective and that national standards are met.

10-TB/HIV Targets:

Number of TB patients who have an HIV test result recorded in the TB register: 1,500 (100%)

Number of health care workers who successfully completed an in-service training program: 30