Outline of the Project

Project Name

Project for Implementing Maternal and Child Health Handbook for Scaling Up Nationwide

Country

Vietnam

Date of R/D Signed

27 December, 2010

Project site

Dien Bien Province, Hoa Binh Province, Thanh Hoa Province, and An Giang Province

Term of Cooperation

14 February 2011 to 13 December 2014 (10 months extended)

Implementing Organization

Maternal and Child Health Department - Ministry of Health (MOH)

Project Background

In Socialist Republic of Viet Nam (Viet Nam), basic health indicators such as infant mortality rate (IMR), maternal mortality ratio (MMR), and life expectancy at birth have recently improved due to the Government's health reform , external support from international development partners, and the country's rapid economic growth. However, there is a significant discrepancy in those basic health indicators between socio-economically and geographically different areas. Especially those indicators among the poor or ethnic minority group residing in rural and remote areas are much worse than the national average. The Government of Viet Nam has been promoting the improvement of mother and child health to achieve the Millennium Development Goals (MDGs), which are aimed at reducing IMR from 36.7/1,000 in 2000 to 25/1,000 in 2010, under 5 mortality rate (U5MR) from42/1,000 in 2000 to 32/1,000 in 2010, and malnutrition prevalence among children under 5 years of age from 33.8% in 2000 to under 20 % in 2010.

To address the maternal and child health challenges, the Government and development partners developed and introduced program/project-specific home-based record, aimed at continuously monitoring and recording maternal and child health (MCH) status. However, having been supported by different development partners, each health program operates different MCH home-based records. Some home-based records are not in line with the MOH's policy and guidelines. Others covered not the continuum of maternal, newborn and child care period but rather fragmented part of it. Moreover, parallel operationalization of multiple MCH home-based records is not only increasing health workers' workload but also creating significant confusion at households. MOH assumed that co-existence and co-operationalization of different MCH home-based records would not contribute much to the improvement of MCH care services.

In this context, MOH intended to focus on the development of an effective the MCH handbook, whose prototype had been implemented by a Japanese Non-Government Organization in Ben Tre province since 1998 and Ha Giang province since 2009. What MOH intended to do was a MCH handbook which can be applicable nationwide and terminate the use of many other different MCH home-based records. By implementing a comprehensive MCH home-based record which enables health workers, pregnant women and their family members to continuously monitor the status from pregnancy, delivery/childbirth, postpartum, newborn, child health. It can contribute to reducing MMR, IMR and malnutrition prevalence among children under 5 years of age, through strengthening self-monitoring of MCH status particularly in the areas where access to health care services is a challenge.

In order to finalize the MCH handbook applicable nationwide, MOH planned to pilot the MCH handbook after revising the existing MCH Handbook in Ha Giang province in selected provinces that are representative of diversified social and regional groups in Viet Nam. Based on the evaluation of its piloting, the MCH handbook would be finalized for dissemination nationwide. In view of this scenario, the Government of Viet Nam requested the Government for a technical cooperation "Project for Implementing the Maternal and Child Health Handbook for Scaling up Nationwide".

In the project, the MCH handbook will be implemented in the four provinces of Dien Bien, Hoa Binh, Thanh Hoa and An Giang. These four provinces were representative for diversified social and regional groups in Viet Nam. In the process of implementing MCH handbook, Department of Health of the four provinces are expected to play a leading role in management of health administrative system in implementing activities, conducting supportive supervision and monitoring to lower levels. Based on the evaluation of the process and achievements of the Project's interventions, the MCH handbook and guidelines will be finalized and submitted to MOH for its consideration of the nationwide scaling-up.

Super goal

Health status of mothers and children in the country improves.

Overall Goal

Maternal and child health care improves by using Maternal and Child Health handbook (MCH handbook) nationwide.

Project Purpose

A standardized MCHHB for nationwide scaling-up is developed.

Outputs

• 1. Management and monitoring capacity of the MCHHB implementation is strengthened at all levels.
• 2. The MCHHB is operationalized by respecting the health system and plan in four provinces.
• 3. Experience and knowledge of the MCHHB implementation are summarized.

Activities

1. Management and monitoring capacity of the MCHHB implementation is strengthened at all levels.

1.1

Set up PMUs and management and implementing mechanism.

1.2

Improve capacity on management, monitoring, and evaluation for PMUs. 1.2.1 Conduct training courses for provincial PMUs on project management, monitoring, and evaluation. 1.2.2 Conduct training courses/study tour for sharing experiences on implementing/expanding the MCH handbook. 1.2.3 Develop M&E indicator, reporting form and training manual. 1.2.4 Conduct training course on M&E for staff of four provinces 1.2.5 Conduct periodical monitoring & supervision from central to commune level by PMUs. 1.2.6 Conduct PMU meetings quarterly, annually at central and provincial levels.

2. The MCHHB is operationalized by respecting the health system and plan in four provinces.

2.1	Implement the MCHHB and its users' guide. 2.1.1. Edit, print, and distribute the MCHHB and its users' guide to P-PMUs. 2.1.2. Provide MCHHB for pregnant women, mothers, HWs, VHWs/HVs and private sector at all levels of four provinces. 2.1.3. Utilize the MCHHB at CHCs and other health facilities at ANC, delivery, post partum, neonatal and child health care.
2.2	Improve knowledge, attitude, and practice (KAP) for HWs and VHWs/HVs. 2.2.1. Conduct training courses of the MCHHB for C-PMUs and P-PMUs. 2.2.2. Conduct orientation on Plan of Operation and training courses of the MCHHB for staff of provincial health service, provincial RHCC, provincial department of population and family planning, secondary medical school, women's union and other related organizations 2.2.3. Develop training materials and training methods for the trainers at all levels of four provinces, then distribute training materials in TOT. 2.2.4 Conduct TOT of the MCHHB and training method. 2.2.5 Conduct training for HWs, VHWs/HVs and private sector who are involved in maternal and child health on the MCHHB and its users' guide.
2.3	Implement IEC activities on the MCHHB. 2.3.1. Introduce the contents and how to use the MCHHB for pregnant women and mothers. 2.3.2. Propagandize through mass-media such as TV, radio, newspapers on the MCHHB in four provinces.

3. Experience and knowledge of the MCHHB implementation are summarized.

3.1	Prepare the final report based on the results of baseline and end-line survey, lessons-learnt, recommendations.
3.2	Finalize the MCHHB and its users' guide based on end-line survey results.
3.3	Estimate financial requirements for printing and distribution of the MCHHB.
3.4	Propose several optimal scenarios of training on the MCHHB use.
3.5	Submit finalized MCHHB, its users' guide and the final report to MOH upon approval by JCC.
3.6	Present the MCHHB and its users' guide approved by JCC to national and provincial stakeholders.

Inputs

Japanese side

• 1) Japanese Experts:
  • Long term: Chief Advisor and Project Coordinator
  • Short term: Other experts mutually agreed upon as necessary
• 2) Training:
  • Training in Japan (Management and utilization of the MCH handbook)
• 3) Equipment:
  • Equipment for training activities and others mutually agreed upon as necessary
• 4) Local cost:
  • Part of printing MCH handbooks and guidelines
  • Part of allowance and accommodation for participants of training courses, study tours, and workshops in 4 provinces
  • General expenses of the project office

Vietnamese side

• 1) Assignment of counterparts and project staff
• 2) Running expenses necessary for the implementation for the project
• 3) Local cost:
  • Part of printing MCH handbooks and guidelines
  • Part of allowance and accommodation for participants and lecturers of training courses, study tours, and workshops in 4 provinces