Strengthening multisectoral leadership and engagement on HIV/AIDS in Vietnam: evidence from an evaluation of AIDS policy training in six provinces
L. Messersmith1, H.B. Tran2, Q.T. Truong2, D. Montagu3, H. La4, K. Eifler5, A.L. Smith6, J. Tuchman7, V.A. Le2
1Boston University School of Public Health, International Health, Boston, United States, 2Hanoi School of Public Health, Epidemiology, Hanoi, Viet Nam, 3University of California San Francisco (UCSF), Epidemiology and Biostatistics, San Francisco, United States, 4USAID, Washington, United States, 5John Snow, Inc, Boston, United States, 6Women's International Network for Guatemalan Solutions, Antigua, Guatemala, 7Management Sciences for Health, Boston, United States
Background: Vietnamese and US-based faculty trained over 400 Vietnamese provincial leaders in the determinants and impacts of HIV/AIDS; integration of human rights, gender and GIPA; best practices in prevention, treatment and impact mitigation; and multi-sectoral leadership. While previous evaluations of AIDS policy training have demonstrated improved knowledge among trainees, little data exist on the impact of training on the development and implementation of actual policies and programs. Boston University and Hanoi School of Public Health addressed this gap through a qualitative cross-over comparison study to evaluate the impact of AIDS policy training in six provinces.
Methods: Study provinces were divided into two groups: three provinces trained in July 2006 and three trained in January 2007. Data were collected at baseline in June 2006, in December 2006, and in July 2007. Methods included in-depth interviews with 229 trained cadres, 159 of their staff, 111 peer educators, and 14 NGO program managers and 17 focus groups with PLWHA.
Results: Data were coded and analyzed using domain analysis methods. After training, policy makers demonstrated increased integration of gender and human rights into policies and programs; decreased association of AIDS with “social evils”; and greater coordination and collaboration between sectors. Peer educators and PLWHA reported greater access to needles, syringes and condoms, improved program conditions, and increased PLWHA involvement as peer educators. The study also found continued tension between police and public health regarding harm reduction programs; improved scores among the police six months after training, but decreased scores one year after training; insufficient funds for HIV/AIDS programming among non-health sectors; and lack of involvement of PLWHA in policy and program decision-making.
Conclusions: AIDS policy training improves capacity of policy makers to design and implement effective multi-sectoral AIDS responses. Additional investment is needed to operationalize human rights, gender and GIPA and to improve meaningful engagement of non-health sectors.
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