This is a continuing mechanism that was established in August reprogramming.

The implementing mechanism -the Vietnam Nurses Association (VNA) - is a Vietnamese nongovernmental organization (NGO). In FY 2007 and FY 2008, VNA was a sub-partner to an international NGO that was implementing HIV/AIDS care and treatment programs. In FY 2009, VNA became a local prime partner with the U.S. Department of Defense (DoD) PEPFAR Vietnam program to provide training and technical assistance (TA) on HIV/AIDS care and support activities in the military and in civilian settings. In FY 2010, in partnership with DoD PEPFAR, VNA aims to: 1) strengthen the military nursing system by using nurses as key players in HIV care and treatment; 2) introduce and/or enhance universal precaution protocols and practices throughout the military healthcare system using a workshop-based and on-site coaching approach; 3) establish and strengthen the client/patient-focused nursing practice at four military hospitals; and 4) advocate for broadening the scope of practice for nurses in Vietnam to enhance their job satisfaction, encouraging them to remain as positive contributors to the Vietnamese healthcare system.

The award reflects VNA's achievements in the key technical area of adult care and support (HBHC).

Linkage to the Partnership Framework: The Vietnam Nursing Association (VNA) supports the PEPFAR Partnership Framework by building local capacity that will help sustain programming. VNA is also a professional organization for Vietnamese nurses; its mission is to advocate for nurses and nurses' roles in Vietnam and its healthcare system. VNA, since its conception, has played an important role in promoting the development of the nursing profession in Vietnam by influencing the government's policies and developing standards for nurses.

In FY 2007 and FY 2008, VNA leadership progressively gained in-depth technical skills, advocacy skills and management experience. VNA has proved to be a reliable and capable implementing partner for HIV care and support in various civilian hospitals.

Beginning in late FY 2008, VNA became one of the first Vietnamese prime partners working with the U.S. DoD. VNA demonstrated that they can also work directly with the Vietnamese military in implementing care and support programs in military settings. Forging a strong collaborative effort between the Vietnamese military and a capable local prime partner to carry out future HIV care and support programming is a central goal for DoD in order to promote sustainability.

Target Population and Geographical Coverage: Target population includes civilian and military adult HIV patients using the medical services at the four regional 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. Although military healthcare facilities are mandated to care for military personnel and their families, more than 80 percent of the clients and patients are civilians from the surrounding communities.

With FY 2010 funding, the coverage of this care and support program will be maintained, with focus on the quality of care and patient accessibility, at four military hospitals.

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

Cross-cutting Programs and Key Issues: VNA covers the cross-cutting program of Human Resources for Health by adopting national training standards and offering periodic in-service training for staff development. Key issues addressed by this mechanism include pre-service education, military populations and mobile populations.

Program Efficiency: VNA's strategy to become more cost efficient over time is to: 1) expand coverage of quality HIV care and support for HIV patients based on the client/patient-focused nursing model in four military hospitals; 2) use available and approved educational materials; 3) collaborate with other PEPFAR partners, experts and universities to enhance training, networking and resource sharing for referrals and sustainability; and 4) strengthen collaboration between military and civilian care and support programs to improve patients' accessibility to care.

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, the Harvard Medical School AIDS Initiative in Vietnam and CDC Laboratory, in order to promote consistent training curricula, interagency quality assurance (QA) plans, and standardized monitoring and evaluation (M&E) activities. In addition, VNA, in partnership with DoD PEPFAR, will also provide routine observation, supervision and oversight through site visits and on-site coaching and mentoring.

This is a continuing activity from FY 2009. REDACTED. In FY 2010, the proposed prime partner for this activity is the Vietnam Nurses Association (VNA).

08-HBHC Budget Code Description: In line with PEPFAR's effort to develop human resources to provide healthcare, VNA is an important proponent of increasing nurses' contributions to the Vietnamese healthcare system. As such, the U.S. Department of Defense (DoD) PEPFAR will collaborate with VNA to build capacity among Vietnam's nurses. In FY 2010, VNA will conduct a comprehensive training program for PEPFAR and non-PEPFAR military and civillian nurses and others. The comprehensive training program will include clinical management, HIV care and support, patient-focused practices, patient monitoring, and universal precaution and infection control practices.

08-HBHC ACTIVITY #1 Training and Technical Assistance (TA), $170,000 VNA will: 1) organize and implement a comprehensive training program on universal precautions and infection control using the training-of-trainers (ToT) and teach-back approach; 2) provide on-site coaching to reinforce trainings; 3) conduct training on HIV care and support, emphasizing emotional and social support, nutrition support, follow-up care, pain management, self-care and treatment adherence; 4) train selected nurses in the management of outpatient clinics through practicum mentoring; 5) roll out the client/patient-focused nursing model and practice at two new outpatient clinics through coaching and frequent technical assistance; and 6) conduct routine TA visits to four sites to ensure protocols (i.e., service delivery, universal precautions and infection control) are practiced as taught and are in line with the national guidelines.

08-HBHC ACTIVITY # 2 Maintain Support at Clinical Sites, $ 40,000 - VNA will: 1) provide operational support to clinical sites; 2) procure necessary equipment, supplies and consumables for four sites; and 3) support travel expenses for trainees to attend training and workshops.

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

08-HBHC Targets:

Number of HIV-positive adults receiving a minimum of one clinical service: 1000

Male: 650

Female: 350

TB/HIV: Percent of HIV-positive patients who were screened for TB in HIV care or treatment setting: 100%

Number of health care workers who successfully completed an in-service training program: 150