October 2019 – present
With support from TB REACH Wave 5, FIT has been successfully piloting both public-public and public-private engagement activities in two districts of Ho Chi Minh City.
In Wave 7, we propose to collaborate closely with the National TB Program (NTP) and the local CHAI office to pilot additional private-sector engagement strategies, as we strengthen and scale up this public-private mix (PPM) approach to 14 districts of three cities (Ho Chi Minh City, Hai Phong and Ha Noi).
The project aims to:
- Expand access to diagnostic referrals among PPM providers
- Facilitate TB treatment notifications from the private sector
- Build evidence to inform PPM policy dialogue and review
Strategy 1: Diagnostic referrals
We will strengthen and scale up the Wave 5 diagnostic referral network by expanding activities to additional cities, engaging new types of healthcare providers (private pharmacists, PPM hospitals, and occupational health screening services) and adapting and using CHAI’s ACIS mHealth platform for data collection.
The project will engage pharmacists using the SwipeRx social network and integrate ACIS forms into the SwipeRx app so its users can screen and refer clients who are showing TB-related symptoms. We will also engage private companies who own mobile X-ray trucks that are routinely used to provide occupational health screening services. While factory workers, police officers and military staff are generally healthy, providing follow-on Xpert testing for those with X-ray abnormalities after already ongoing CXR screening requires limited effort and could identify people with TB who might have otherwise been incorrectly diagnosed or gone unreported. We plan to continue facility-based screening and referral at five hospitals in Ho Chi Minh City and two hospitals in Hai Phong and aim to expand these services to other public and private hospitals across the 14 evaluation districts.
Strategy 2: Notification
The treatment notification strategy will be expanded to the same intervention areas, and the will pilot universal Xpert testing among those who are notified. We will provide training to improve the capacity of private-sector providers, work with the NTP’s PPM team to develop a private-sector reporting tool and implement a M&E framework to verify the private-sector notifications. Privately-treated TB patients will be uploaded to VITIMES and included in the official notification data for our evaluation area.
Strategy 3: Policy review
FIT has drafted a policy brief summarizing the Wave 5 project activities and results. In dissemination talks, the NTP indicated that more large-scale data over a longer period of time were policy review or revision. Any national policy update must be combined with a review of the existing policy and its successes and failures in Viet Nam. Thus, throughout the Wave 7 grant we will work with the NTP to review and synthesize project data. We will organize a policy dialogue with key national, provincial and international stakeholders about our PPM activities in the hopes that the NTP will endorse a new PPM model that accepts private-sector notifications (collected and reported via this project) into their official TB statistics. This policy dialogue will occur during the planning stages for the next Global Fund grant cycle and may provide an opportunity for TB REACH-supported work to inform national investment plans.