Measuring results - Experiences from Vietnam November 2016

Vietnam: At a glance Total Population: 93.4 million Ethnic minority: 15% Land size: ¾ are mountains Poverty: - National: 15% - In mountainous areas: 30-55% Literacy: National: 95-98% Ethnic minority: 80% Health care system: state owned

Limitations and challenges of the National M&E system for MNCH

Examples A 5 year National maternal and newborn care programme had a list of indicators but had no specific M&E plan or no tool/method for data collection (e.g. % of mothers know at least 3 danger signs) Tools and system are available (Maternal death surveillance) but there was limited training, poor monitoring and supervision Technology: a software was developed for data management but out of date (not a web based design) and only 35 provinces could use this software among 63 provinces

Examples Quality of data: the figures reported from the regular health information system were still in favour of “high achievement” (far lower or higher than the figures from surveys). Example: Neonatal mortality: MOH: 3.29‰; MICS5: 11.95‰; % of birth attended by trained health staff: regular report: >60%; Survey in the same communes: 14% Challenges: motivation of the staff and payment method; a syndrome of “proud achievement”

How do we measure?

Model 1 Method: Community score card to measure the quality of care from the user’s perspective Strategies: Using people’s voices and people’s representative (People’s council)

Health sector People District People’s Council Monitor Improve access Improve quality Reduce risks Provincial People’s Council Health sector District People’s Council Monitor District People’s Committee Voice/Accountability People Monitor Feedback

Model 2 Method: Client exit interview to measure the satisfaction of clients Strategies: Using technology (mobile devices) to get un-biased feedback from the users

Model 3 (GAC-funded project at design phase) Method: Measuring access and utilization of prenatal, delivery and postnatal care using a M&E system Strategies: Develop an app to be used on mobile phone which could support the village health workers to manage information related to the pregnant women in their villages.

Commune and district health centers Data management Home visit Village health worker Group education Commune and district health centers

How to influence policy? Develop model, testing and sharing with the network (Reproductive health affinity group) and with MOH Involve MOH at the start of the model development Empower and use voices of civil society to advocate for change