END-OF-PROJECT WORKSHOP ACCOUNTABILITY IN HEALTH SERVICE PROVISION IN DISADVANTAGED AREAS

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1 PRESS RELEASE Issued on 17 June 2016 END-OF-PROJECT WORKSHOP ACCOUNTABILITY IN HEALTH SERVICE PROVISION IN DISADVANTAGED AREAS Venue: Da Nang city, Vietnam Date: 17 June 2016 Da Nang city, June 17th 2016, Marie Stopes Vietnam (MSV) collaborated with the Vietnam Center for Community Reproductive Health (VNCRH), Lam Dong and Quang Binh Department of Health to organize the Project Review Workshop: Strengthened Participatory Monitoring of Service Performance Accountability in providing reproductive health and family planning services at community health stations for people living disadvantaged areas of Lam Dong and Quang Binh provinces. Funded by the European Union (EU), the project was implemented in 10 communes in Dam Rong district (Lam Dong province) and Minh Hoa district (Quang Binh province) during period 4/2013-6/2016. The workshop brought together representatives from government bodies at central level, local project partners, and especially local communities the main beneficiaries of the project, Marie Stopes Vietnam, the Vietnam Center for Community Reproductive Health (VNCRH), representatives of international and local non-government organizations, and news agencies in Da Nang city. Under the framework of this project, the concept of accountability focuses on the relationship between service providers at communal level and their clients. Service providers are responsible for delivering health services safely in accordance with Vietnam Ministry of Health s guidelines and standards, and respect the rights of service users. Furthermore, service providers have the responsibility for providing accurate information to and consulting their clients in a clear way regarding their health status and treatment options. Service providers are also expected to give their clients advice which is culturally-sensitive, respecting the services choices and treatment decisions made by the clients after they are given sufficient information. Other areas which require transparency include service fees (where applicable), and continuation of care including referring the client to health facilities at higher levels when necessary. Service users and local people in the community have the rights to participate in

2 direct dialogues with and give feedback to heath staff at the community health station and its related agencies with regards to the shortcomings of existing services, and how to improve service provision and the interaction between the service provider and the client, as well as to monitor the implementation of agreed solutions and improvements overtime. The project aims at building an initial foundation for a model of increasing service performance accountability in providing reproductive health and family planning services, addressing the key challenges in ensuring the availability of and adequate access to essential services at grassroots level. The project strives to create an impact on agencies which are interested in and responsible for supporting, improving service quality and access to reproductive health and family planning services at community health stations in 10 targeted communes under the project. The two agencies which take the central roles in the model of community-based monitoring of service performance accountability are community health stations and local people in need of reproductive health and family planning services. On the side of service providers, project interventions include: the formulation of a set of standards regarding to client care, counseling and provision of essential reproductive health and family planning services; offering training and service provision certificates; provision of essential medical equipment and devices; refurbishment of community health stations; regular on-site monitoring of service provision to improve services quality and client s satisfaction. The interventions on the side of service users include: communication activities and campaigns to raise awareness of the availability of services at community health stations and the benefits of reproductive health and family planning services; promoting local people s greater involvement in direct dialogues with health staff at community health stations to give feedback on quality of provided services; most noticeably the establishment and piloting of a mechanism of accountability monitoring which involves individuals and agencies which have an important influence on improving quality of services at community health stations, naming Commune People s Committee, District Health Center, representatives from Women s Union and other civil society groups in the community, members of civil society organizations, and local people. Through the operation and management of this model, the capacity of local authorities is improved. They have better knowledge of health priorities at the grassroots level, which enables them to make right decisions timely to effectively support the health care and treatment activities of their communities. Considering the above objectives, the project has succeeded in: 2

3 Successfully established a feasible and effective mechanism of accountability monitoring between the public service providers and local communities in the most disadvantaged areas in Vietnam. Under the model, the rights and involvement of local people and civil society organizations were ensured through direct dialogues with and monitoring of service performance accountability of service providers. Local people in disadvantaged areas, especially the poor and people of ethnic minorities, enjoyed improved status and served as a key actor in improving the service quality at community health stations. This was achieved through their involvement in assessing level of client s satisfaction, giving feedback and ranking the quality, effectiveness, and acceptability of the services they received. The capacity of participating community health stations in providing essential reproductive health and family planning services was improved; there was radical and positive changes in the attitude and behavior of service providers towards their clients as a result of frequent supportive monitoring tours and constructive feedback from service users. Thanks to technical and financial support from the project, 10/10 community health stations had standardized reproductive health and family planning services in accordance with MOH s national guidelines. Midwives at 10 community health stations were trained about service provision skills. They were tested and certified to provide IUD services at their community health stations. Strengthened management and service provision capacity of local partners, contributing to their effective implementation of the Government of Vietnam s policies in order to improve the quality of reproductive health and family planning services in disadvantaged areas. As of 30/5/2016, people were raised awareness on the client s rights to quality reproductive health and family planning services; 9 rounds of accountability monitoring were carried out with 90 meetings and the participation of approximately 3,000 local people; 25 training courses were organized among 500 participants; 10/10 community health stations were able to provide a full range of health services according to MOH s guidelines; 23,700 clients received reproductive health and family planning services of high quality (out of these, 1,177 clients received intrauterine devices (IUDs) at their community health stations); level of client s satisfaction was 87-88%, a significant improvement compared to baseline figure of 50% - baseline study report). Mr Cao The Canh Member of the Accountability Monitoring Board at Hoa Tien commune, Quang Binh province shared: If in other projects, the general public were 3

4 those who waited to be benefited, then this project placed the general public in the central position and the Accountability Monitoring Board were those who supported and encouraged them to express their own opinions and propose solutions to bring benefits to their own. We highly value the innovative approach of this project. To date, local people are able to access reproductive health and family planning services in a convenient way, and enjoy the enthusiastic attitude of community health station staff. Final project assessment showed that 94.2% of respondents of reproductive age used family planning services at their community health stations (an increase of 15.1% compared to baseline figure). Most respondents chose to have pregnancy examinations and give birth at community health stations. 82.6% of women had gynecological checks at their community health stations (an increase of 22.6% as opposed to baseline figure). The increase in the number of clients who used reproductive health and family planning services at the community health station helped to alleviate the overloading at district hospitals and patient s bypassing, as well as to increase the convenience and reduce transportation and health care costs for the general public. Ms Nguyen Thi Bich Hang, Country Representative of Marie Stopes Vietnam stated: The project adopted a new approach, and was piloted in the field of reproductive health and family planning services for the first time in Vietnam. The project s achievements and lessons learnt have confirmed the effectiveness of accountability monitoring in improving quality of primary health care services in general and reproductive health services in particular at grassroots level, especially in disadvantaged areas. The model is in line with directions and determination of the Ministry of Health regarding enhancing quality of services at health facilities, towards the patient s satisfaction (Circular No. 19/2013/TT-BYT dated 12/7/2013) and need to be replicated in other disadvantaged areas. Accountability should also be clarified and applied at higher level with main subjects of Department of Health, Provincial People s Committee and the main object of the community health station, in order to overcome existing obstacles, encouraging and promoting the inclusion of essential reproductive health and family planning services as an important component of primary health care at grassroots level, bring the services as close as possible to the people. The workshop is expected to be a precious opportunity for MSV and its project partners to share achievements and lessons learnt in the process of implementing the project, to discuss solutions to ensure the sustainability of the model and the potential of replicating the model in other disadvantaged areas across Vietnam. 4

5 Information about Marie Stopes International (MSI) Formatted: French (Belgium) Marie Stopes International is a leading international non-governmental organization that provides family planning services. MSI s headquarters are located in London, UK. So far, MSI has been operating in 37 countries and on 6 continents, mainly in developing countries. In 2015, MSI global served more than 20 million women, creating more than 29 million (CYPs) couples year of protection. Formatted: English (U.K.) MSI first came to Vietnam in 1989 and has cooperated closely with non-governmental organizations and government agencies to implement the reproductive health and family planning programs in many provinces/cities in Vietnam. With its vision to ensure the basic rights of individuals to have children by choice, not chance, MSI has made great efforts to bring about quality reproductive health and family planning services to communities and also to cooperate effectively with partners, to enhance access to healthcare service in Vietnam. MSV has currently been supporting a network of 11 Obstetric-Gynecological and Family Planning (FP) clinics named Marie Stopes, 2 networks of social franchised clinics named BlueStar (250 private clinics), Sisterhood tinh chi em (250 commune health stations), and a program promoting the provision of long-term and permanent family planning services in 31 provinces nation-wide. In 2015, those networks served 2.7 million client visits creating more than 3.6 million CYPs. MSI is committed to collaborating with Vietnam to assist in sustaining and meeting the reproductive health and family planning targets of the Vietnamese people. Formatted: English (U.K.) For more information, please visit our website at and Contact: Nguyen Minh Duc, Project Manager Marie Stopes Vietnam duc.nm@mariestopes.org.vn Ms. Bui Thi Mai Hoang, Communication Officer Marie Stopes Vietnam hoang.mbt@mariestopes.org.vn Mobi: Formatted: Italian (Italy) Formatted: French (Belgium) 5