Aligning Development Partner/ Non-Governmental Organization (DP/INGO) support in the health sector International Cooperation Department, Ministry of Health Ha Noi, 28/06/2016

Contents Background 1 Overview of DP/ INGO support 2 DP/ INGO support - Harmonized and Aligned? 3 What could be the way forwards? 4

1. BACKGROUND

The new context of the health sector for the period 2016 – 2020 Changes that have impact on the health sector: Accession of Viet Nam to middle income country status and Viet Nam’s vision of high income country by 2035 Demographic and epidemiologic change Development issues: inequities, urbanization, globalization, industrialization that can impact on the capacity of health systems to adopt Climate change that could increase vulnerability of communities and populations New and emerging global and regional agendas, such as SDG’s, TPP, ASEAN post 2015 health development agenda

Legal basis for health sector development: 2016 – 2020 Strategy for socio economic development Master plan for the Health Sector 2030 The 5-year health sector plan SDG Action Plan for Viet Nam (coordinated by MPI)

Guiding documents on ODA/ INGO management Direction of the government on attracting, managing and using ODA and favorable loan in Request of DPM Vu Duc Dam (Announcement 288/TB- VPCP 24/8/2015) Decree 16/2016 NĐ- CP issued on 16/03/2016 on management and use of official development assistance (ODA) and concessional loans provided by foreign donors Decree 12/2012/NĐ-CP issued on 01/3/2012 on on the Registration and Administration of Foreign Non- Governmental Organizations in Vietnam Decree 93/2009/NĐ-CP issued on 22/10/2009 On the issuance of the regulation on management and utilization of aid from international non-governmental organizations …….

09 priorities in the 5 year health plan (1) Hospital overloading reduction; (2) Local health system focusing on preventive medicines; (3) Mother and child care, population and planning promotion; (4) Human resource, science technology improvement; (5) Following code of conduct, ethics standard improved; (6) Financing mechanism reform, UHC; (7) To re-organize management model of food safety, pharmaceuticals, vaccines, biological, medical equipment; (8) To consolidate health system form central to local level, to improve state management and international cooperation; (9) To develop informatics system and health communication/education

2. OVERVIEW OF DP/ INGO SUPPORT IN THE HEALTH SECTOR

DP support to Viet Nam health sector Info Number of DPs:~ 28 (including UN agencies) ODA amountUSD 1.52 bil, in which grant 28.4%; loan 71.6% Number of projects,32 Major areas of supportInfrastructure investment, Equipment, Human resource development, Policy development, Technical support- technology transfer and research… ODA support in 2015 ( Source: data.icdmoh.gov.vn and DPF presentation 08/01/2016 )

INGO support to the health sector INGO support to MOH agencies in 2015 InfoMOH agencies Number of INGOs:~ 150 Support value:N/A Number of projects, in which:306 Project/programmatic support86.6% Investment project0.6% Non-project support12.7% Major areas of supportTechnical support: HIV/AIDS; TB, Vaccine, Tobacco, Mental health, Mother and child care… System support: research, capacity building, training, infrastructure … Source: MOH - INGO report 2015

Overview of DP/INGO support to the health sector (by regions) North East provinces: Average:15 projects/ province Red River Delta: 11 pro/prov Ha Noi: 156 projects North Central provinces: 21 pro/prov South Central provinces: 15 pro/prov South East provinces: 10 pro/prov HCM: 50 projects North West provinces: 16 projects/prov South West provinces: 8 pro/prov Can Tho : 15 projects Central Highland provinces: pro/prov Sources: Online database of DP/INGO support to the health sector

ProvincesProvinces (number of projects) North East, (15 projects/province on average) Phu Tho (13), Ha Giang (15), Tuyen Quang (11), Cao Bang (20), Bac Can (9), Thai Nguyen (15), Lang Son (12). Bac Giang (15) North West (Avg.16)Dien Bien (21), Lai Chau (14), Lao Cai (15), Yen Bai (15), Son La (12), Hoa Binh (18) Red River Delta (Avg.11 except Ha Noi) Ha Noi (156), Ninh Binh (7), Ha Nam (12), Thai Binh (15), Hung Yen (12), Hai Phong (12), Hai Duong (10), Bac Ninh (8), Vinh Phuc (7) North Central (Avg.21) Hue (24), Quang Tri (22), Quang Binh (14), Ha Tinh (11), Nghe An (27), Thanh Hoa (28) Central High Land (Avg.12) Gia Lai (14), Kon Tum (12), Dak Lak (14), Dak Nong (11), Lam Dong (12) South Central (Avg.15) Bnh Thuan (12), Ninh Thuan (12), Phu Yen (10), Binh Dinh (14), Quang Ngai (14), Quang Nam(13), Da Nang (29) South East (Avg.10 except HCM) HCM (50), Ba Ria (7), Binh Phuoc (14), Dong Nai (10), Tay Ninh (8), Binh Duong (13) South West (Avg.8) Ca Mau (4), Bac Lieu (4), Soc Trang (6), Hau Giang (5), Can Tho (15), Kien Giang (7), An Giang (19), Dong Thap (18), Vinh Long (6), Tra Vinh (6), Tien Giang (9), Ben Tre (7) Overview of DP/INGO support to the health sector by provinces Sources: Online database of DP/INGO support to the health sector

3. DP/ INGO SUPPORT - HARMONIZED & ALIGNED?

Alignment of DP/INGO support with priorities of the health sector for Priorities of the health sector Some examples of DP/INGO support Reduce hospital overloading Some ongoing projects/program: -Health system development for central north provinces -Health system development for North East and Red River Delta provinces - Provincial hospital development …… Some proposed projects: -Health support for central north provinces - additional -…… Local health system focusing on preventive medicines Some ongoing projects/program: - HIV/AIDS prevention in sub Mekong region -Prevention of communication diseases in sub Mekong region, phase 2 -…… INGO projects on IV/AIDS, TB, Malaria ; Vaccine …… Some proposed projects - Health security for sub Mekong region -Improvement of primary health care -…….

Alignment of DP/INGO support with priorities of the health sector for Priorities of the health sector Some examples of DP/INGO support Human resource, science technology improvement Some on- going projects - Health professional education and training for health system reform (HPET) - Human resource development - INGOs projects on capacity building, training …. Some proposed projects - Human resource development (phase II) …. Financing mechanism reform Proposed projects: - Support to implement the roadmap towards universal health coverage …..

Alignment of DP/INGO support with priorities of the health sector for Priorities of the health sector Some examples of DP/INGO support Re-organize management model of food safety, pharmaceuticals, vaccines, biological, medical equipment Some on going projects : - Capacity building for food safety administration in Mekong sub region …. Some proposed projects: - Consolidate national food safety system - Production of Measles-rubella vaccine …. To develop informatics system and health communication/education Many INGO projects focuses on this areas

Major contribution of DP/INGO support for Vietnam health sector At central level: Upgrade the infrastructure for the central hospitals and institutes Strengthen the capacity of the health management agencies Provide valuable technical and financial support for making policies (Health Insurance, Pharmaceutical laws, Tobacco control…) Provide the evidence for the policy making process At local level: Capacity building for local health system (infrastructure, HR) Provide additional resources to implement health priorities, in remote and disadvantage areas Improve the infrastructure for health services Increase access to health service for people Strengthen the grass root health systems for Viet Nam Improve health indicators

Difficulties in aligning DP/INGO support Lack of a common framework for prioritization and planning among the DPs/INGOs Lack of framework for information and monitoring contribution to key government priorities Foresight on sustainability and inclusion of transition mechanisms for DP support are not included in planning processes Budgetary frameworks of DPs/INGOs are not very well- designed and aligned to national health sector plans

4. WHAT COULD BE THE WAY FORWARD?

Why to align and harmonize? Improve development cooperation effectiveness, in coherence with health sector priorities, health system and government directions Enhance effectiveness of coordination among agencies through common arrangement, procedures and information sharing Avoid overlap/duplication in support, and reduce transaction cost Ensure rationale and consistency in policy making, decision giving and coordination

What to align and harmonize? Harmonize priorities and development agenda Harmonize funding/investment support Harmonize technical support

Thank you!