The goal of the Pathways for Participation (Pathways) project is to develop an empowered and effective civil society that provides a sustainable and significant impact, is accountable to its constituency, and contributes to the national HIV response. The project aims to achieve this goal by 1) establishing and strengthening select, local NGOs to serve as future capacity-builders; 2) strengthen organizational, technical and leadership capacity of CSOs; 3) implement effective community-based interventions; and 4) strengthen the advocacy capacity for CSOs to influence HIV policies and programming. Target populations are MARPs, including IDUs and their sexual partners, sex workers and their clients, MSM and PLHIV in 9 provinces (An Giang, Can Tho, Dien Bien, Hai Phong, Hanoi, HCMC, Lao Cai, Nghe An and Quang Ninh). Cost-efficiency has been a priority of this project from the design. There has been a strong focus on hiring Vietnamese nationals, and the international chief of party will be transitioned to Vietnamese leadership by year 4 of the project. Efforts are in place to reduce the reliance on international consultants. The project will focus on strengthening the capacity of select local CSOs so that in the future they can assume the role of the international NGO to develop replicable and effective community-based services. The project M&E team will collect, analyze and disseminate strategic information about civil society to strengthen informed decision-making for resource allocation, advocacy and policy. Baseline, midterm and end-of-project assessments to ensure accountability and to inform decision-making at programmatic and higher levels will be conducted. No vehicles will be purchased for this project.

In COP 11, the Pathways for Participation program (Pathways) sub-grantees focused on addressing comprehensive HIV-prevention and care, and provided psychological and social support services for PLHIV and MARPs groups. In COP 12, Pathways will strengthen the capacity of local NGOs, MARPs and PLHIV community-based groups (registered and nonregistered) to provide community-based support and services; advocate for the increasing role of the MARP/PLHIV sector in the national HIV response; and develop and promote replicable, evidence-based models of HIV service provision in Vietnam. To accomplish its objectives, the project will focus on the following activities: -Strengthen case management practices; -Strengthen coordination between community services and outpatient clinics; -Promote local level multisectorial coordination to improve service availability and access; -Develop systems and capacities to monitor changing needs of PLHIV and adjust support accordingly; and -Develop innovative service-delivery models for ethnic minorities and rural settings.

In COP 11, the Pathways for Participation program (Pathways) sub-grantees focused on addressing psychological needs of orphans and vulnerable children (OVC) to improve the quality of psychology support, life skills for older children and child protection, such as foster care. In addition, the program implemented nutritional support in collaboration with FANTA to improve the quality of nutrition assessments, counseling and screening. In COP 12, Pathways will continue working closely with the Ministry of Labor, Invalids and Social Affairs (MOLISA), the Ministry of Health (MOH) and Ministry of Education and Training (MOET) to integrate the OVC program into the national childcare and protection system led by MOLISA, and to identify key data gaps to assist the government, donors and NGOs in program planning and implementation of the national plan of action on children infected with HIV/AIDS (NPA). To accomplish these objectives in COP 12, Pathways will focus on the following activities: -Strengthen the quality of HIV care and support; food and nutrition, and psychosocial support; -Provide other social welfare services through existing government regulations and services; -Maximize the resources mobilized from faith-based organizations, private sector and civil society to ensure the sustainability of the program; -Support MOLISAs role in coordinating the multiple key players involved in NPA, including tracking the implementation and evaluation of different models of OVC care and service; -Standardize the reporting system and procedure for OVC program data collection to avoid duplication and to produce systematic output data for program management and planning; -Develop an M&E framework that will be placed under MOLISA but will interface with the frameworks and indicators of MOET and MOH systems.

The use of routine data for decision-making and program planning within the CSO sector is weak because of the lack of technical capacity. This results in poor-quality evaluations, data collection and analysis. COP 12 funding will be used to strengthen M&E capacity of CSOs, promote the use of data to monitor program quality and progress, and use evidence and data for advocacy purposes. To achieve this, Pathways will: -Design and refine routine M&E system, including measures for data QA; -Provide onsite supportive supervision/coaching for sub-partners to implement M&E and data QA;

-Develop, implement and monitor data QA; -Coordinate with provincial partners to leverage M&E efforts at the provincial level; and -Support program staff in data use, communicating and presenting M&E data for program improvement.

COP 12 funding will be used to support the Pathway for Participation project (Pathways) to strengthen the capacity of lead partners. Lead partners will provide organizational and technical capacity-building services to other Vietnamese CSOs. The lead partners will ensure that targeted CSOs have access to organizational capacity-building in governance, financial and organizational management, human resource management, strategic planning and reporting, resource mobilization, management information systems, and M&E. Illustrative activities include but are not limited to: -Developing and implementing capacity-building plans with lead partners and other CSOs involved in the program; -Mentoring partner(s) to build capacity as a capacity-building provider; -Conduct assessments to understand the need of the partner(s) to become capacity-building providers (both technical and organizational capacity because the organization(s) will not only need to be able to provide capacity-building support, but they also will need to be able to operate as a sustainable organization(s)); -Establishing demonstration sites where innovative models can be developed and assessed, and expertise pooled; and -Developing and implementing an M&E strategic plan that includes, but is not limited to, benchmarks and indicators to measure the partner(s) progress toward expected results.

In Vietnam, the HIV prevalence among sex workers (SWs) is high 3.2% according to sentinel surveillance or 9.1% according to the IBBS 2009 positivity rate. The prevalence among MSM has significantly increased in some provinces with high concentrations of MSM in Ho Chi Minh City and Hanoi. IBBS 2009 showed that MSM prevalence can be as high as 14.2% in some provinces. Increasing inconsistent condom use, multiple sexual partners, and drug use among SWs and MSM is a challenge for HIV response in Vietnam. The Pathways for Participation program (Pathways) focuses on strengthening community-based services provided by and for MARPs of HIV infection, particularly FSWs and their clients, and MSM in nine PEPFAR-focus provinces. COP 12 activities will include: 1) Strengthening outreach activities to FSWs and MSM to increase service coverage and uptake. This will be done through different modalities, which may include but are not be limited to: -Improving outreach approach to include case management of clients, and peer-driven and network-based outreach; -Expanding responsibility of outreach workers to ensure PLHIV and MARPs are connected to clinical services; -Exploring new methods of outreach, such as social networking and combining peer educators to provide services in a geographic catchment area; -Exploring strategies to increase effective reach and use of technology such as phone/SMS and Internet-based interventions to more effectively reach sub-populations and populations with overlapping risk behaviors; and -Increasing effective harm-reduction strategies. 2) Strengthening the advocacy capacity for FSWs and MSM networks and community-based organizations working on FSWs and MSM interventions. Along with UN and the USAID Health Policy Initiative, this activity will provide support to CSOs of MSM and FSWs to ensure their voice is heard, increase their ownership of programmatic interventions, and share information with other partners to learn from each other. Additionally, the capacity of FSW and MSM groups will be strengthened so that they can participate in national and provincial strategic planning meetings.

The Pathways for Participation program (Pathways) focuses on strengthening community-based services provided by and MARPs of HIV infection, particularly IDUs and their sexual partners within 9 PEPFAR-focus provinces. COP 12 activities will include: 1) Strengthening IDU outreach activities to increase service coverage and uptake. This will be done through different modalities, which may include but are not be limited to: -Improving the IDU outreach approach to include case management of clients, and peer-driven and network-based outreach; -Expanding responsibility of outreach workers to implement a full range of services to ensure IDU groups are effectively referred to clinical services; -Exploring new methods of outreach such as social networking and combining peer educators to work in a team for all MARPs in a geographic catchment area; -Using village or community health workers; -Exploring strategies to increase effective reach and use of technology such as phone/SMS and Internet-based interventions to more effectively reach sub-populations and populations with overlapping risk behaviors; and -Increasing effective harm-reduction strategies. 2) Implementing BCC messages including Break the Cycle, as well as other messages. This effort will be done in partnership with PSI. Technical assistance (TA) also will be provided to explore the most effective and efficient channels to distribute prevention commodities. 3) Providing support services to help patients on methadone find employment, regain their normal family life and reintegrate into community and society.