Assessment of Atlantic Philanthropies’ Support for the Health Sector in Viet Nam:1998– 2003 Especially Healthcare Facilities in Ho Chi Minh City, Da Nang, Hue, and Quang Tri/Dong Ha Town FINAL REPORT Thomas T. Kane, Ph.D. Consultant for Atlantic Philanthropies 10th May 2004 1 Table of Contents Title Page Table of Contents List of Acronyms Acknowledgements Executive Summary Chapter I : Introduction 1. Background to Atlantic work in Vietnam and Purpose of the Assessment 2. Assessment Methodology 3. Scope of Work Chapter II : Evaluation of Atlantic Support for Health Care Facilities Project Summaries, Quality and Appropriateness of Analysis; And Impacts to Date (Micro/Macro); Absorptive Capacity; and Platforms for future development, action, and additional resources A. Heart Institute in HCMC B. Da Nang General Hospital and East Meets West Foundation 1. Pediatric Department renovation 2. Intensive Care Unit renovation 3. OB-GYN Department renovation 4. Internal Medicine Department 5. Morgue and Funeral Home Building 6. Medical Waste (non-solid) Treatment Facility 7. Multi-purpose Building 8. Emergency Care and Diagnostic Center Building 9. EMWF Role in the AP Project 10. EMWF Healthy Heart Program 11. Capacity-Building to Da Nang City Health Providers 12. Other Atlantic-Supported EMWF Humanitarian Programs C. Hue Central Hospital 1. Pediatric Department Building 2. Cardiovascular Center D. EMWF/Quang Tri and Quang Tri General Hospital: Dong Ha Town 2 1. Renovations General Surgery and Pediatric Department Wing 2. Kids First Village 3. EMWF/Quang Tri Humanitarian Projects Supported by AP Chapter III: Program Level Assessment and Atlantic’s Role A. Overall Program Strategy and Impact B. Site and Project Selection C. Synergies/Multipliers D. Leverage Gained E. Atlantic’s Role: Staff Role and Interactions with Clients F. Future Platforms Chapter IV: Summary, Conclusions, Recommendations A. Summary B. Conclusions C. Recommendations End Notes References and Data Sources List of Persons Contacted/Interviewed. Table 1: Type of Projects, Budgets and Number of Beneficiaries of EMWF Humanitarian Projects Funded by Atlantic Philanthropies, By Year: 1999-February 2004. Figure 1: Total Number of Inpatients at Da Nang City, Hue Central and Quang Tri General Hospitals: 1998-2003. Figure 2: Number of Pediatric Inpatients at Da Nang City, Hue Central and Quang Tri General Hospitals: 1998-2003. Figure 3: Number of Cardiovascular Inpatients at Da Nang City and Hue Central Hospitals: 1998-2003. Figure 4: Number of Ob-Gyn Inpatients, Deliveries, and Burn Center Inpatients at Da Nang City Hospital: 1998-2003. Figure 5: Number of Surgeries at Da Nang & Quang Tri Hospitals 2000-3. Photos: Selected Photos of New Hospital Buildings, Renovations and Humanitarian Projects Funded by Atlantic Philanthropies. 3 LIST OF ACRONYMS AC Air Conditioner AIDS Acquired Immuno-Deficiency Syndrome APS Atlantic Philanthropic Services BCC Behavioral Chang Communication CMAA Construction Management Association of America CPFC Committee on Population, Family and Children CPI Clear Path International CVC Cardiovascular Center (Hue) DOLISA Department of Labor and Social Affairs DORC Da Nang Orthopedics and Rehabilitation Center EEG Electro-encephalograph EENT Eyes, Ears, Nose and Throat EKG Electro-cardiograph EMWF East meets West Foundation ER Emergency Room FAC Fondation Alain Carpentier FERF Family Emergency Relief Fund HCMC Ho Chi Minh City HCH Hue Central Hospital HHP Health Heart Program HIV Human Immuno-deficiency Virus ICU Intensive Care Unit IM Internal Medicine IMCI Integrate Management of Childhood Illnesses INGO International Non-Governmental Organization JICA Japan International Cooperation Agency MCNV Medisch Comite Nederland - Vietnam MIS Management Information System MOH Ministry of Health MPH Masters of Public Health NAV Nordic Assistance to Vietnam NGO Non-governmental Organization OB-GYN Obstetrician-Gynecologist ODA Overseas Development Assistance OT Operating Theatre PC People’s Committee PEP Physician Education Program PHC Primary Health Care STI Sexually Transmitted Infections UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund USD United States Dollars VAT Value Added Tax 4 VND Viet Nam Dong VVAF Viet Nam Veterans of America Foundation VVRP Vietnam Veteran Restoration Project WHO World Health Organization WVI World Vision International Acknowledgements The consultant wishes to thank the various organizations and individuals for their cooperation during this assessment of the Atlantic Philanthropies support for the Health Sector in Vietnam. Special thanks go to Dr. Le Nhan Phuong (Atlantic Philanthropies Vietnam Country Representative) and his staff at the Atlantic Philanthropies office in Hanoi and to Mr. Chris Oechsli (Atlantic Philanthropies/Bainbridge Island) for their support at various stages of the assessment, including the provision of various project documents and participation in discussions concerning Atlantic’s support of the Health Sector in Vietnam. I would also like to express my special appreciation to Mark Conroy (EMWF Country Director) and to John Ward (EMWF Quang Tri Office Director), and the rest of the staff at East Meets West Foundation in Da Nang and Dong Ha/Quang Tri, for all of their valuable assistance during the review of the EMWF projects supported by the Atlantic Philanthropies, for providing project documents, data, budget information, photos, and for their time during intreviews and project site visits. The consultant would also like to express appreciation to Dr. Pham Nguyen Vinh, Vice Director of the Heart Insititute in Ho Chi Minh City, Dr. Pham Hung Chien (Director of Da Nang City Hospital), Dr. Trinh Luong Tran Director of the Da Nang City Health Department, Professors Pham Nhu The (Director of Hue Central Hospital), Professor Bui Duc Phu, (Vice-Director Hue Central Hospital) and Dr. Tran Thi Minh Huong (Pediatrics Department Head, Hue Central Hospital), Dr. le Van Thanh (Director of the Quang Tri Hospital) , Mr. Roger Ferrell (President of Kids First Vietnam), Mr. John Troha (Delta Construction Company), Mr. Olivier Liacre (Consultant to the Heart Insititute in HCMC and to Hue Central Hospital Cardiovascular Center), Dr. Paul Wade (Project Director Operation Walk), and to all the staff, patients, patient’s family members, and other project beneficiaries who were interviewed during this assessment and who provided helpful input and feedback for the report. 5 Executive Summary Introduction: This assessment reviews the program of support of Atlantic Philanthropies to the Health Sector of Vietnam for the past five years, from 1998 through April 2004. The focus of this assessment is on the Atlantic-supported Da Nang, Hue and Quang Tri hospitals new building construction and renovation projects; the Atlantic supported humanitarian projects carried out by East Meets West Foundation (Da Nang and Quang Tri offices), the program of support to Heart Institute in HCMC, and selected other projects such as capacity-building and health professional training projects in Da Nang City, and the Kids First Village project in Dong Ha Village. The report describes the activities, achievements, budgets, project impact, challenges, funding leverage gained from Atlantic support and the recommendations for future financial and program support. However, it should be noted that there are a number of other Health Sector projects funded by Atlantic Philanthropies (e.g., in Hanoi and Ho Chi Minh City) that are not included in this report. The assessment reviews and evaluates over 17 health sector projects (and subprojects under EMWF) supported by Atlantic Philanthropies spanning a five-year period from 1998 – April 2004, with projects ranging in size from $34,000 (Operation Walk - Paul Wade's project) up to $3,800,000 new CVC project, which in aggregate total almost $19 million dollars in Atlantic funds. Except for the Heart Institute project in Ho Chi Minh City all the other health sector projects reviewed in this assessment were or are still being carried out in Central Vietnam provinces, and most of these are under the management, supervision and/or implementation by the East Meets West Foundation offices based in Da Nang and Quang Tri. Methodology: Fieldwork and site visits took place over 12 working days in Da Nang (5 days), Hue (3 days), Quang Tri (3 days), and Ho Chi Minh City (1 day), during the period from February 19 through March 5, 2003. Interviews were conducting with over 50 patients/clients/beneficiaries and over 50 senior, mid-level and junior hospital staff, project staff, EMWF staff and other NGOs (e.g., Kids First Vietanm; Clearpath International) and government employees and consultants, Each specific project assessment is structure in a consistent way the report structure based on the scope of work. The major components of each project assessment section consists of a brief description and documentation of (a) Project Activities; (b) Project Budget; (c) Project Achievements/ Impact (in terms of staff and patient satisfaction; increased client flow; increased number of inpatients and in the number of services provided; improved health services; staff receiving training; medical buildings built or renovated; etc); (d) Challenges/Needs identified; (e) Leverage/ Other Benefits (in terms of funding leverage gained and support from other sources); and (f) Recommendations (for future financial and/or program support for the activity). The assessment describes activities, budgets, achievements, challenges,