1. USAID SHIFT YEAR1 Technical Strategies and Priority TA
Dr. Nguyen To Nhu, MD, PhD
Technical Director, USAID SHIFT

2. 5 KEY TA PRIORITIES Promoting local entities to the use TA Marketplace, TA demand creation
Priority 1: Support health system consolidation and social health insurance (SHI) implementation at site and provincial levels
Site level: all 46 HIV treatment facilities (HTFs) supported by USAID SHIFT
Intensive support to sites in maintenance provinces, focus on sites in HCMC, Hanoi and 9 sites to be transitioned in Y1
Intensive support to sites located at one function preventive medicine center
Provincial level: Nghe An, Dien Bien, Lao Cai, Bac Giang, other TA requests from provinces
Priority 2: Support interventions to retain people living with HIV (PLHIV) on antiretroviral therapy (ART)
Sites/provinces supported by USAID SHIFT
Support Ministry of Health (MOH) to achieve retention in different provinces/sites through TA/interventions
Attrition rate goal: <5%/year; <1.25%/quarter

3. 5 KEY TA PRIORITIES Promoting local entities to the use TA Marketplace, TA demand creation
Priority 3: Help increase # of PLHIV starting ART
Support 3 priority provinces (NA, DB, HCMC)
Support MOH review and provide TA to increase # of PLHIV starting ART
Mechanism: New case finding, old case finding using information system, Hospital provider-initiated HIV testing and counseling (PITC) and linkages to care and treatment (C&T), mobile reach-test-start (mRTS) approaches
Priority 4: Reduce stigma and discrimination (S&D), create enabling environment for key populations (KPs) to access HIV testing and counseling (HTC) and treatment, treatment retention, and increase HI card coverage amongst PLHIV
Strategic partners
Campaign
Priority 5: Advocacy
Financing for ARVs and methadone maintenance therapy (MMT) drugs
Technical guidelines, HIV Law revision

4. 90% of PLHIV know their status
Aligning 5 key TA priorities with Goals
Priority 1: Support health system consolidation and SHI implementation at site and provincial levels
Priority 3: Increase # of PLHIV in treatment
Priority 2: Retain PLHIV in treatment
90% of PLHIV know their status
90% of PLHIV who know their status are on ART
90% of those on ART have suppressed viral load
Priority 4: Reduce S&D, create enabling environment for KPs to access HTC and treatment, treatment retention, and increase HI card coverage amongst PLHIV
Priority 5: Advocacy

5. EXAMPLES OF PRIORITY TA Health system strengthening and transition
TA for HIV treatment facility (HTF) consolidation at provincial and site levels to gain eligibility for SHI reimbursement
TA to increase coverage of SHI cards amongst PLHIV
Advocacy and support to increase financial resources for ARV drug demand given donor funding reductions

6. EXAMPLES OF PRIORITY TA Monitoring, evaluation and strategic information
National HIV cascade and provincial HIV cascade tracking toward
Identify HIV program gaps to inform provincial program action via HIV cascade analysis, HIV Info and ARV treatment database
Help integrate facility electronic health information system (eHIS) to support SHI reimbursement, reporting and case management for HIV C&T services beyond 46 USAID SHIFT-supported HTFs
EPP and KP size estimation in selected provinces
Provincial and National guidelines on M&E system strengthening (C03 and C09)
NA and DB C03 strengthening

7. EXAMPLES OF PRIORITY TA Outreach, prevention, and HIV testing and counseling
Innovations and TA for active case finding
Old case finding
New case finding
Linking and engaging LTFU cases back to care and treatment
Reduce stigma and discrimination toward PLHIV and KPs to remove barriers to access and retain in HIV C&T
TA to assist local CSOs to develop capacity building action plans

8. EXAMPLES OF PRIORITY TA HIV care and treatment and MMT
HIV retention guidelines and TA support
Help revise Circular #32 detailing HIV treatment SOPs, protocols and tools, harmonizing with Law on Medical Examination and SHI reimbursement requirements
Case management and tracking to minimize patient loss during and after transition to SHI
TA support to train and certify HIV clinicians per SHI eligibility requirements
TA for mRTS in remote mountainous areas
Revise national MMT guidelines, MethQual package
TA to build cadre of national trainers and mentors for MMT and HIV care and treatment
TA support for TB-HIV integration and coordination

9. FINAL THOUGHTS
Not all TA requests will necessarily obtain USAID approval and funding
Chance for USAID approval increased if the TA request aligns with PEPFAR and USAID priorities
Priorities will evolve over time
Current hot topics:
Transitioning
SHI
eHIS
ART patient retention

10. Thank you for your attention!