I. Palliative care training and capacity building:

Physician palliative care training/capacity building: In COP9 full transition of the physician palliative care training and capacity building was made to local clinical leaders. A new group of local clinicians was nurtured through a fellowship training in COP10 that has further strengthened local ownership and capacity of providers. To date, the majority of HIV and cancer clinicians have been trained in the 5-day training. In-service (including distance learning). Pre- and in-service palliative care training was been integrated into Hai Phong Medical University on COP09 and in COP10 into to Hanoi Medical University, further increasing local ownership and sustainability of physician palliative care training and health work force strengthening. COP 11 will focus on training physicians that have not yet been trained. MoH VAMS will lead a total of 2 palliative care trainings. No international TA will be required for physician palliative care training. Pathfinder will provide smaller scale support to Hai Phong MU in running pre and in-service training, planning for complete handover by the end of the project.

Nurse palliative care training/capacity building: In COP9/10 the nurse palliative care training curricula was developed and piloted. This is the first curricula of its kind in Viet Nam. In COP10 the training will be adapted and submitted to the MoH for approval. In COP11, MoH VAMS will lead 2 nurse trainings with TA support from BSPCC who will support a growing leadership role of local nurses (this will include a ToT). Given the limited development of nurse palliative care provision, TA from BSPCC will be required in ensuring there are local trainers who are able to fully lead training and mentoring by COP12. In COP12, it is expected that international TA will no longer be required for this component. However, as with the physician training, additional training and capacity building of local nurse trainers in palliative care will be sought.

Pharmacist training: In COP11, 2 trainings will be held. VAMS will provide TA for this training. BSPCC support will no longer be needed

Other support: Clinical mentoring, clinical networks and an assessment of local capacity building and sustainability will also be conducted in COP11. Pathfinder will provide smaller scale support in developing the mentoring and supportive supervision capacities of new master trainers/mentors and precept site providers.

II. CHBC training and capacity building:

CHBC training/capacity building: In COP11, FHI will run 2 ToTs to assist CDC life-gap in leading future CHBC trainings and mentoring efforts. TA for this training will be provided locally by local and expat experts. This will include finalizing the curriculum, SOPs and QA materials.

III. Mental health training and capacity building:

Mental health training/capacity building: In COP11, FHI will increase the number of mental health care trainings to 4 given the number of HIV clinicians who require training. This will include finalizing the curriculum, SOPs and QA materials. In COP12, a ToT will be held to fully transition this training to local clinical trainers/leaders.

IV. Strategy for becoming more cost efficient over time: From the start of the program, the aim has been to provide targeted capacity building of lead clinicians and then transfer capacity to local providers. Through this process, the MoH takes greater responsibility for leading the work translating into greater cost efficiencies. In addition, support from international TA is only used during the first few years of introduction of new training/clinical capacity development areas and then phased back. This has already taken place for the physicians palliative care training.

V. Contribution to HSS: The focus of this CoAg is to build the capacity of the MoH and medical universities to lead and manage HIV, palliative care and addictions medicine training (pre-service, in-service and continuing education). The Co-Ag has already made a substantial contribution to the capacity of the MoH and universities to lead more evidenced-based adult clinical learning programs and innovations in learning (eg distance learning) while building the local health workforce clinical, mentoring, teaching and supportive supervision skills.

/ CME- distant learning: implemented by Pathfinder with TA from FHI to deliver distance e-learning training course in HIV care and treatment for target group

- Target: 25 HCWs

/ Medical education at HN MU: support HN MU by FHI to institutionalize, deliver training curricula in HIV care and treatment.

- Target: 200 undergraduate students trained; approved integrated training curricula framework by MOH; and dissemination workshop

Physician pediatric palliative care training/capacity building: A similar process will be followed with the physician palliative care training as with the nurse training. In COP11, there will be 2 trainings. Given pediatric palliative care is even more nascent than nurse palliative care, TA from BSPCC in COP11 will be critical to ensuring there is adequate capacity for this training to be fully localized.

Two training courses plus practicum will be delivered to pediatricians who work on HIV and cancer settings.

Activity 1: Technical Assistance to Vietnam to establish high quality research systems

Institutional and human capacity to conduct and manage research in Vietnam is relatively new. To address this COP11 funds will be used to continue activities around supporting the establishment and expansion of sites to adequately implement, manage, and oversee high quality research that will be used to inform better program practices and interventions. Building upon COP10 activities and achievement, FHI will provide technical assistance to the Ministry of Health to expand the capacity for ethical research oversight through institutional review boards (IRBs) and standard operating procedures at up to four institutions that will be identified as 'Clinical Research Units' through an objective review process.

Formal training will also be provided in the areas of: protocol development, study design, adverse-events reporting, and research ethics. Curricula for these will be standardized in collaboration with MoH for future application.

These are continuing activities since COP10 (Total funding: $1,385,000)

/ Build national capacity for the implementation of methadone maintenance treatment (MMT) through 1) developing national accreditation training curricula for MMT staff; 2) training a cadre of national MMT master trainers; 3) strengthening institutional capacity for in-service and pre-service MMT training delivery within medical universities in Hai Phong and Hanoi; and 3) strengthening national capacity and systems for providing clinical supervision/mentoring to MMT clinics.

/Build institutional capacity across Vietnam to better address the addiction-associated needs of drug users through 1) training on the basic principles of addiction and evidence-based addiction treatment approaches for service providers (incl. government and non-government partners of PEPFAR) who work with drug users; 2) strengthening mentoring and supervision systems for case managers and counselors who provide services to drug users in community-based settings; and 3) institutionalizing addictions training into the universities of Ministry of Labor, Invalids and Social Affairs.

The key contribution to Health Systems Strengthening is the development of both curricula and a cadre of expert MMT-providers that contribute to policy changes, development and dissemination of MMT guidelines, creation of institutional networks and alliances, and intensive long-term trainings (human resources for health) that will eventually be sustained by the host country.

None

/ Continuing Lab Program Activity

/ Support for international accreditation (ISO 15189) of 2 selected laboratories (possible examples include military , large regional hospital).

/ Package includes training, direct TA to laboratory staff, twice monthly monitoring visits