USAID Disability Rights Enforcement, Coordination and Therapies (DIRECT)

MAJOR RESULT TO DATE (AS OF MARCH 2017)

Disability Rights Enforcement, Coordination and Therapies (DIRECT) The project is funded by USAID and implemented by VNAH in collaboration with Vietnamese partners including the Ministry of Labor, Invalids and Social Affairs (MOLISA), Ministry of Health (MOH) and governments of Tay Ninh and Binh Phuoc provinces.

The project has a goal to expand opportunities for persons with disabilities through higher quality and sustainable services, awareness, and advocacy strengthening. Specifically, the project aims at, 1): Enhanced resources for disability programs and services; and 2): Enhanced access to quality rehabilitation services. These are being achieved through supports to Government of Vietnam National Committee on Disabilities (NCD) to improve coordination and enforcement of disability policies; and expansion of health insurance coverage for rehabilitation services. Secondly, DIRECT supports the development of rehabilitation services – include improving human resources and treatment facilities - and delivery of direct assistance for persons with disabilities, especially those with severe and developmental disabilities in Binh Phuoc and Tay Ninh provinces.

The project started in November 2015 and will end in September 2020. By end of March 2017, after 16 months of implementation, the project has achieved several major results, as following:

To date, 1,300 persons with disabilities have received direct assistance, including rehabilitation therapy services, assistive devices and home improvement etc., About 20% of our beneficiaries are victims of, or those exposed to Agent Orange. Persons with disabilities having exposed to Agent Orange is one of the project priority beneficiary groups. The project also prioritized women and girls with severe disabilities. So far, 37% of the project beneficiaries are female. Prior to therapy/support, the project engaged Vietnamese and international rehabilitation specialists to conduct clinical assessment to identify the beneficiary’s needs in rehabilitation, assistive devices and other supports. After the assessment, a plan for intervention/treatment was developed and services/supports are followed up for each individual person.

1,350 Service Providers has been trained by the project to date. Capacity building training for local service provider is one of the key objectives of the project. Training so far focused on rehabilitation therapies, disability assessment skills and disability information system (DIS). Of these,

Participants are social and health workers from local systems. Of these, over 35 doctors and 65 health professionals are being trained in short course programs (10 months) to become rehabilitation practitioners. These trainings are delivered by the HCMC University of Medicine and Pharmacy and the Curtin University (Australia). VNAH also collaborated with the Butterfly Basket Foundation (Netherland), CESO (Canada) and other volunteer health professional in training and services in rehabilitation to people with disabilities in Tay NInh and Binh Phuoc provinces.

22 rehabilitation units have been set up and equipped. The project assisted in the set up and provision of rehabilitation equipment for 22 rehabilitation units at hospitals in Binh Phuoc and Tay Ninh. These rehabilitation units and the rehabilitation practitioners trained by DIRECT will help improve availability and access to quality services for people with disabilities.

7 new disability-related policy developed, with support from DIRECT. These included national and provincial disability policy and action plans. The highlights among these are the CRPD plan of action approved by the Prime Minister, and Ministry of Health Circular 18, which helps increase insurance coverage for rehabilitation from 33 to 248 new techniques/services or 7,5 times.

VNAH’s DIRECT Project Summary of Results to Date (June 2020)

Expected results (annual targets)	Progress during reporting quarter
✔ 2,100 persons with disabilities will have received direct assistance (this includes new and existing beneficiaries that need follow ups in three target provinces).	✔ Total 1,213 persons with disabilities received direct services, of which 251 are new beneficiaries, exceeded the target by 25%.
✔ At least 75% of beneficiaries demonstrated improvement in ADL	✔ This indicator will be reported in Q4, as planned.
✔ Increases in OT services at new rehab units in Tay Ninh and Binh Phuoc.	✔ This indicator will be reported in Q4, as planned.
✔ At least 10% increase in number of clients served at rehab units in Tay Ninh and Binh Phuoc	✔ This indicator will be reported in Q4, as planned.
✔ 1,431 service providers and caregivers (including rehab workers) trained to support persons with disabilities	✔ 958 SP were trained including: - 33 rehab practitioners in Dong Nai trained in usage of wheel chair, coaching/mentoring on rehab techniques (PT and OT services); - 191 service providers in Dong Nai trained in DIS. - 490 service providers in Binh Phuoc trained in Circular 01. - 244 service providers and caregivers in Dong Nai and Tay Ninh trained in GE/GBV (22 TOT trainees, 91 service providers and 131 caregivers).
✔ 10 new policies, procedures developed and/or drafted, including: 1) the revised LET with provisions on rehabilitation, 2) the national rehab strategy, 3) the standard/MOH recommended rehab medical record, 4) package of standard rehab services as part of primary health care package, 5) a set of technical procedures and costs for rehab services (costs for 50-60 techniques, and procedures for 40 services), 6) the MOLISA action plan for sectorial rehabilitation, 7) the decree on social work services, and 8,9,10) three provincial action plans for rehabilitation.	✔ 12 policies were supported, including: - Four policies completed/approved (Circular for Medical Doctor to prescribe rehab; Binh Phuoc, Tay Ninh and Dong Nai provincial rehab plan) - Six policies drafted and pending approval (revised LET, Social work Decree, national rehab medical record, Circular on rehab service within primary healthcare package, a list of 55 additional OT/ST services/techniques; MOLISA sector rehab plan). - Two policies are in process (revised Circular 46, national rehab strategy)
✔ 38 local organizations supported in capacity building (of which, all 26 rehab units and 3 VAVA/disabled centers show improvements in rehab and disability services capacity; while 8 organizations: MOH, MOLISA, DOHs (3), DOLISA/PCD (2) and VAVA (1) show improvements in new policy/plans/systems serving the disabled	✔ 38/38 organizations are being supported, including: - 27 rehab units in Binh Phuoc, Tay Ninh and Dong Nai provinces - 3 VAVA and Disabled Children centers - 3 DOHs - 2 DOLISAs - MOH and MOLISA and Central VAVA(3)