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July 2008 1
MOVING WITHOUT LIMITS
Quarterly Report FY2016 Quarter I – Oct 1st – Dec 31st, 2015
Submission Date: Jan 29, 2016
Cooperative Agreement Number: AID-440-A15-00006
Activity Start Date and End Date: Oct 1, 2015 to Dec 31, 2015
AOR Name: Nguyen ThiHoa Le
Submitted by: Catalina Serna-Valencia, Executive Director
The International Center (IC)
1001 North Carolina Ave SE
Washington. DC, 20003-3907 Tel: +1 202-316-5823
Email: [email protected]
This document was produced for review by the United States Agency for International
Development Vietnam Mission for Asia (USAID/Vietnam).
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1. PROJECT OVERVIEW/ SUMMARY
Program Name: Moving without Limits
Activity Start Date And End Date: July 20, 2015 to July 19, 2017
Name of Prime Implementing Partner:
The International Center (IC)
[Contract/Agreement] Number: AID-440-A-15-00006
Name of Subcontractors/Subawardees:
Major Counterpart Organizations - ThuaThien Hue Provincial Department of Health and Department of Foreign Affairs
- Quang Nam Provincial Department of Health
Geographic Coverage
(cities and or countries)
ThuaThien Hue province: QuangDien and ALuoi districts
Quang Nam province: PhuNinh and Dai Loc districts
Reporting Period: Oct 1, 2015 to Dec 31, 2015
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ACRONYMS AND ABBREVIATIONS
AOR Agreement Officer’s Representative CBR Community-based Rehabilitation CWD Children with disability CHS Commune Health Station DHC District Health Center DOFA Department of Foreign Affairs DOH Department of Health DOLISA Department of Labor, Invalids and Social Affairs DORH Da Nang Orthopedic and Rehabilitation Hospital DPO Organization of people with disabilities GVN Government IC The International Center IEE Initial Environmental Examination IR Intermediate Result M&E Monitoring and Evaluation MOU Memorandum of Understanding NGO Non-governmental Organization OGCDC Office of Genetic Counseling and Disabled Children OT Occupational therapy PC People’s Committee P&O Prosthetic and Orthotic PWD People with disability PWMD People with mobility disability QNam Quang Nam QNGHNMA Provincial General Hospital of Quang Nam in the Northern Mountainous Areas TTHue ThuaThien Hue USAID United States Agency for International Development VietCOT Vietnamese Training Centre for Orthopaedic Technologists
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1.1 ProjectDescription/Introduction
Following Cooperative Agreement No. AID-440-A-15-00006, countersigned between the U.S.
Agency for International Development (USAID) and the International Center (IC), dated June 12,
2015, the award of $512,795, has been given to IC to implement the Moving Without Limits
Project for the period of two years starting from July 20, 2015, to July 19, 2017, in the two
provinces of ThuaThienHue (TTHue) and Quang Nam (QNam).
The goal of this project is to improve the accessibility of people with mobility impairments in
TTHue and QNam to quality assistive devices with three main targets areas as following:
- Improved availability of quality assistive devicesfor people with mobility
impairments:Through direct and continuous support of assistive devices for people with
mobility disability (PWMD) based on their individual needs, regardless of causality and
differences in gender and other characteristics, IC expects to improve the mobility
functions, the independent living, and better participation of about 400 PWMDs in the
community.
- Improved capacity of selected province based practitioners and technicians on provision of
quality assistive devices: Through on-the-job training followed by continuous and
supportive supervision visits of national and international specialists, the capacity of
selected province based practitioners and technicians on provision of quality assistive
devices would be improved so that they could provide better responses to local needs in
provision and management of assistive devices in order to ensure significantly impact on
health outcomes for PWMDs.
- Increased DPO’saccess to information on assistive device services:Understanding the role
and importance of Disabled People Organization (DPO) in ensuring equal opportunities and
social inclusion of PWD, DPO will be engaged in project activities through direct and regular
meetings for sharing information on service information, rights of people with disabilities
(PWDs) and assistive devices related information. This will expand opportunities for PWD to
access to the better services for better lives and health outcomes.
The program will be implemented in QuangDien and A Luoi districts ofTTHueprovince and
PhuNinh and Dai Loc districts of QNam province.
1.2 Summary of Results to Date
Project results are for the Quarter I, FY 2016 from Oct to Dec, 2015 (see Annex A)
Note: The Results Performance Column depicts level of achievement expressed as a percentage of Actual versus Planned.
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2. ACTIVITY IMPLEMENTATION PROGRESS
2.1 Progress Narrative
In this reporting period, the project really engaged local partners to accelerate project
implementation. Almost all of the activities set for this period have been carried out. Below is
summary of results by objectives:
Objective 1: Improved availability of quality assistive devices for people with mobility
impairments in ThuaThien Hue and Quang Nam
Act 1.1 Identify situation on barriers and facilitators on accessibility to assistive devices in terms
of users and providers’ perspective, referral pathways and cost (See Annex E for the assessment
outline)
- Information on rehabilitation and orthopedic services provided by selected commune
health stations and district health centers was collected.
- Information of situation on barriers and facilitators on accessibility to assistive devices
and quality of life of people with mobility impaired also collected through the outreach
in QuangDien(TTHue) and Dai Loc(QNam)communes.
Act 1.2 Provide direct screening through outreach activities (home visit, etc.) for selection of
providing mobility solutions
- Outreach protocol for screening including home visits was developed in consultation
with international and practitioners at provinces.
- Two outreach trips to QuangVinh commune, QuangDienDistrict (TTHue) and Dai
Dongcommune, Dai Locdistirct(QNam) to do screening and identify the needs of people
with mobility impairment were carried out. Targets of screening for this quarter were
higher than plan. Total of screened in 2 communes are 136 in compared with 50 as plan.
Act 1.3 Provide assistive devices (estimated at an intervention rate of 60% of direct
assessments) to PWDs
- Due to the break in December and an activity change in outreach, the assistive devices
are planned to be delivered in next quarter instead of this reporting period.
- No one got devices in compared with 36 as plan.
Objective 2: Improved capacity of selected province based practitioners, DPO core members
and technicians on provision of quality assistive devices
Act 2.1 Identify currentsituationson thecapacityofprovincial-
basedhumanresourcesonassistivedevices
- More information from the selected commune health station (CHS) and district health
center (DHC) in TTHue and QNamto identify current situation on capacity of provincial-
based human resources on assistive devices were collected.
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Objective 3:Increased DPO’s access to information on assistive device services
Act 3.1 Designinformation on assistive devices for users
- Information on the need of users when received assistive devices was collected.
- Information of DPO on handout for DPO memberswas collected.
- Initial design for flyers developed.
Besides achievements in terms of the project goal and objectives, the project has obtained key
accomplishments affecting the project progress. Firstly, procedures to officially implement the
project in the provinces have been completed. Thanks to the efforts and support of leaders of
Department of Health (DOH) in ThuaThien Hue and Quang Nam, Memorandum of
Understanding (MOU) between IC and DOH have been signed and got approval from People’s
Committees. This is an essential requirement for kick-off project activities in provinces.
Secondly, consultants supporting technical issues to ensure the quality of project have been
identified, they are P&O technician, OT specialist. P&O technician is a former lecturer of the
Vietnamese Training Centre for Orthopaedic Technologists and OT specialist is also a lecturer of
Da Nang University of Medical Technology and Pharmacy. In addition, to keep regular
monitoring for the project, a part time M&E cum Research Officer was also recruited to support
the team in monitoring activities and research. These Vietnamese consultants and International
P&O specialist formed a technical group supporting IC team in implementing and quality
control for project.
In general, the project is slower than plan of the year in term of number of activities.
2.2 Implementation Status
In this reported period, the project started key activities toward objectives. As mentioned
above about the achievement on administration, the team has worked intensively with local
partners to kick off the project.
At the beginning, IC contacted with Department of Foreign Affairs (DOFA) as main partners at
both provinces following the experience from past projects. The USAID funded project is
designed to support people with disabilities who are the target of health and social sectors. It
requires a coordination body like DOFA to take the main role for the project. However, after
several times of discussion with DOFA, IC is consulted to partner with DOH as project mobilizes
network of health sector and need to be governed by department of healthrather than social
sector. This change made the process of getting MOU signed and approval from provincial
People’s Committees (PC) longer than planned. It was almost 6 months from the project
approval by USAID to be officially received by provinces.
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Understanding that without approval of provincial People’s Committee, project could not be
implemented in provinces. IC worked intensively with DOH of two provinces to draft MOU. By
end of October 2015, the final version was completed and signed by ThuaThien Hue DOH and
DOFA. Thus, the project has two partners in TTHue. While in Quang Nam, DOH takes
responsibility for managing project, the main partner with IC. In just a few weeks since the
MOU was signed, the approval decision from PC was issued. During that time, the two partners
provided great support to IC in preparing documents for getting approval from PC. Those
agencies understood procedures and approaches to work within province. In fact, if there were
no commitments from local partners, it would not have been completed in a short of time.
Based on the nature of the project, TTHue Provincial Rehabilitation Hospital was assigned to
work side by side with IC to realize project. This is an advantage for project as the hospital is
focal point managing rehabilitation network from commune level. Data on rehabilitation
program at communes and number of people with disabilities is in the system.
Due to the lack of such focal point agency in Quang Nam, DOH takes lead in direction and
coordination for project. In addition, theProvincial General Hospital of Quang Nam in the
Northern Mountainous Areas(QNGHNMA) located in Dai Loc district was assigned to support
technical issues. The Physical Therapy and Rehabilitation Unit manages rehabilitation program
and network of districts in the northern areas of Quang Nam province.
At the national level, IC joined common activities with other grantees to organize the launching
ceremony of new USAID grantees in October 2015. The shared activity created an environment
for grantees to talk and linkwith each other.
Kick off meetings in 2 provinces
Although it was not planned to have a meeting with all stakeholders in provinces before
implementing activities at commune level, IC organized a kick-off meeting to gather
stakeholders for introducing project’s objectives and timeline for 2016. In this meeting, project
and stakeholders got understand about each other, role and expectation of each party.
Participating in the meeting were representatives of agencies directly involving in the project
such as Vice Chairman of People’s Committee and Head of Commune Health Station of selected
communes, rehabilitation in charge of District Health Center and provincial hospital like
Rehabilitation Hospital in Hue and General Hospital of Quang Nam in the Northern
Mountainous Areas. Moreover, representatives of DOH, DOLISA, DOFA, Police and Agent
Orange Association joined the meeting. Doctors from Hue Central Hospital and Hue University
of Medicine and Pharmacy which project has developed linkages with for consulting technical
issuesalso attended.
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Other organization working in ThuaThien Hue under the fund of USAID also invited to the
meeting. It aimed to cooperate in common activities andshare information with each other. Ms.
KhaTu, ACDC representative in Hue attended the meeting and suggested collaboration in some
advocacy events.
Presented in the meeting was not only information about IC project but also information on
programs supporting for people with disabilities run by DOH and DOLISA. Participants could
image the overview of provincial support for PWD and IC program added as a part of whole
efforts for ThuaThien Hue and Quang Nam. Some representatives at thecommune level shared
their current work for PWD and felt encouraged when they are selected to work with project.
Attendants really participated in the meeting, they raised questions, discussed and provided
useful information for project, for example, database of PWD is available at Tam Thai CHS, a
selected commune in PhuNinh district, QNam.
During the meeting, the project emphasized the scope of support focusing on providing
assistive devices for people with mobility impairment therefore other expectation on orthotic
operations, livelihood for PWDs or long-term training for health workers will not be covered.
However, connection to other projects for those actual needs will be considered. In the
meeting, DOH also showed their commitment to project, Quang Nam DOH even agreed to
mobilize fund from province to organize short trainings on rehabilitation for village health
workers at project communes as a matching fund.
These are really useful meetings for project and it should be planned at the beginning of every
project.
Technical preparing for the outreach
Parallel with the completing procedures with provinces, IC preparing for the first outreach to
province. Since the date of outreach was decided by end of October 2015, technical things have
been outlined and prepared. IC contacted with practitioners who experienced with screening in
community to work on protocol and tools for screening. The team in ThuaThien Hue including
Dr. Xuan from Rehabilitation Hospital, Dr. Nhan from Hue University of Medical and Pharmacy
contributed for the general and rehabilitation part of the document. Ms. Suong, project OT
specialist prepared for the occupational therapy assessment and home assessment as well. Ms.
Duyen, P&O technician and Ms. Kerry Fisher worked on the short P&O form for community.
The idea of screening is not only to identify the needs of assistive devices but also to assess the
situation of mobility disability, the cause, and influent factors (both negative and positive) to
the independent living capacity and participation into social activities of people with disabilities.
Therefore, the screening is organized with a multidisciplinary team of specialists on different
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areas including international expert, national specialists, provincial and district practitioners,
commune health staff, village health workers and representative of organization of people with
disabilities directly involve and indirectly support to the screening at communities (see Annex F
for more detail).
Before going to screening at commune, group of international, national consultants and local
partners had a meeting to review the steps and requirements when work as a team. This was
very necessary as the first time all worked together. The multi disciplinary team was divided
into 4 tables: 1) receiving table for administration and baseline interview; 2) Rehab and general
health table: PWMD will be assessed on general health and rehabilitation; 3) OT assessment
table: PWMD will be assessed on self-care ability, sphincter control, transfers, locomotion,
communication, and social cognition. 4) Orthopedic assessment table: PWMD will be assessed
on orthopedic needs and prescribe devices followed the assessment forms.
The different of this screening is that debriefing after examination will be organized. Each group
reports its assessment for a case and other group could debate on the description and all will
get consensus for each PWD. In case of concerning, home visit will be decided. CHS is
encouraged to visit to have moreunderstoodabout the case after the screening trip.
Outreach to do screening
Screening at the commune is one of the crucial activities of project. It reaches to beneficiaries
and contributes to the successful of the project therefore the first outreach played a very
important role. This is to 1) test the organization mechanism with multi-partners collaboration
from commune to province, with social and health sector involvement; 2) to see how
effectiveness of a multi disciplinary team work for a screening at community; and 3) to know
about beneficiaries and the real needs.
As plan the first screening will assess for 25 PWD percommune in 3 days with one day for home
visits. However, after consulting with partners in both provinces project increase the number of
PWD per commune to 60 people.
Organizing the outreach was the process of getting involvement of different agencies: district
social division provided list of PWD, CHS checked the situation of people in the list and consult
to provincial contact point to select the commune. Decision making to select commune,
number for screening comes from partners in province.
In Hue, Rehabilitation hospital was very active in coordinating local agencies to the screening
from district health center to commune health station. It prepared invitation for PWD and
invited DHC and CHS to receive PWD and support the IC team in manage the process of
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screening. While in Quang Nam, this role was DPO. Mr. Truong Tan Buu, Vice Chair of the
provincial DPO Quang Nam connected the CHS, People’s Committee of Dai Dong commune and
the General Hospital of Northern Mountainous Areas to organize the screening. CHS and DPO
worked on the list of PWD in the commune and PC sent invitation to PWD and provided venue
for the event.
It could be seen that, in Hue with the leading organization by Rehab hospital, role of social
sector at commune level was little even none but the health system was fully engaged from
village health workers to commune to district and province though rehabilitation activities at
district level is limited. In a contrast, because of no provincial rehab hospital, the involvement
of different level of health sector was not full. There is no rehab service at district health center,
though invited, DHC staff just visited for the opening.
In the field, following the outreach protocols, 4 tables for different group of register and
assessment were set up. PWD go through all 4 tables on administration, rehabilitation,
occupational therapy and P&O assessment. After each session, the team had a debriefing
meeting to discuss about each case and decide which device will be the best for him/her. Most
of the cases, all three groups identified the same needs of people, however some cases caused
debate and discussion which leaded to home visits decision.
By end of the trip, 61 PWDs in Hue were screened and 51 PWDswere prescribed with assistive
devices, that number in Quang Nam was 75:53 respectively. There are different types of devices
such as brace, prosthesis, crutches, walking frame and stick, devices for hygiene, wheelchair
and tricycle in need as shown in Table 1
Table 1: Types and number of devices in need
No. Types of devices Number in need
No. Types of devices Number in need
1. Lower limb prostheses 35 11. Commode chairs 1
2. Upper limb prostheses 6 12. Bath/shower seats 4
3. Knee ankle foot orthoses 4 13. Grab bars and handgrips 6
4. Ankle foot orthoses 6 14. Walking frames 8
5. Upper limb orthoses 5 15. Tripod sticks 2
6. Wheelchairs 18 16. Quadripod sticks 16
7. Tricycles (three-wheeled cycles) 6 17. Walking sticks 1
8. Rehabilitation bicycle 1 18. White canes 1
9. Shoe raise 1 19. Axillary crutches 18
10. Fowler bed 1 20. Elbow crutches 3
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The team visited 8 people in Hue and 13 people in Quang Nam to access the living environment
and confirm the most suitable devices. The table below shows the prevalence of people
screened and number of people proposed to have assistive devices.
Table 2: Number of people with disabilities got assessed by sex, age, and disability severity
Province Number of PWD
Sex Age Level of severity
Male Female <6 6-16 16-60 >60 Profound Severe Mild Other
Total screened in 2 provinces 136 95 41 4 7 48 77 17 82 4 33
Total proposed for assistive devices 104 71 33 1 2 32 69 8 66 3 27
ThuaThien Hue
Screening in ThuaThien Hue 61 41 20 1 4 12 44 5 34 1 21
Proposed for assistive devices 51 34 17 1 1 9 40 3 29 1 18
Quang Nam
Screening in Quang Nam 75 54 21 3 3 36 33 12 48 3 12
Proposed for assistive device 53 37 16 0 1 23 29 5 37 2 9
In the FY year work plan, it is intended to provide P&O devices for PWD right after the
screening however, the plan is shifted to next quarter. It was changed because the casting was
not organized during the screening. There were 3 main reasons for this as follows: 1) casting for
person with disability in community requires a tightly procedure which will take longer time for
approval; 2) if the casting was carried out in commune, no special vehicle to move the cast to
hospital which may affect the quality of the devices; and 3) PWD need to follow regular process
of making devices which usually happened in the hospital with at least 3 times of visit. IC has
planned to work with workshops in Hue and Da Nang to arrange a suitable time for inviting
people to come for casting and fitting.
2.3 Implementation Challenges
Cooperation and support from partners in provinces are essential for the success of project.
During the time from Oct to Dec, almost of health units focus on completing government tasks
for example, professional documents and annual checking by Department of Health and
Ministry of Health. Therefore, to kick off activities in the field by end of the year was quite
pressure for both IC team and provincial partners. In Quang Nam, there is no provincial
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Rehabilitation hospital to be the focal point,IC worked directly with the Vice Director of DOH.
He spent a lot of time to deal with procedure at provincial level to get approval for project.
It is more advantage in Hue when Rehab hospital was assigned to be the project implementer.
The hospital took responsibility to process all documents with Department of Planning and
Investment and Department of Foreign Affairs.
Experienced from this is that the team has to contact intensively with provincial partners nearly
day by day so that people will make time for project.
2.4 PMP Update
In this reporting period, the M&E plan has been finalized with the support of AOR and USAID
officers. Project updated list of 10 indicators which includes USAID indicators and project ones:
PM6: Number of persons with disabilities received direct assistance provided by the
USAID-funded Moving Without Limits project
PM2: Number of service providers (individuals) trained who serve vulnerable persons
PM3: Level of satisfaction among male and female persons with disabilities receiving
service for P/O, OT in targeted areas
GMP-G1: Percentage of households reporting an increased involvement from part of
male family member(s) in supporting care to persons with disabilities
DMP1:Percentage of beneficiaries who report increased independence
DMP11:Number of devices produced locally by USAID’s innovation
DMP12:Percentage of people with disabilities and care givers are aware about
availability of service
DMP 15:Number of person-hour of training of service providers completed in the
reporting period
DMP16: Number of person-time that received direct assistance
Project indicator: The number of screened persons with disabilities
The M&E officer also worked with USAID office and other grantees to develop guidelines for
doing performance indicators reference sheets for disability projects.
The team coordinated with other grantees to give comments for the outline and methodology
of baseline survey for USAID/Vietnam disability program led by MSI. It is hoped that data of
baseline would serve for the project.
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3. INTEGRATION OF CROSSCUTTING ISSUES AND
USAID FORWARD PRIORITIES
3.1 Gender Equality and Female Empowerment
As mentioned in the performance indicators reporting plan, the project indicated the
beneficiaries of female accounting for 50% of target on number of persons with disabilities
received direct assistance provided by the project. Although this indicator could not be
reported in this quarter due to the casting in the field was not organized, it seemed that this
prevalence didn’t reach the target. Only 30% of female got screening in the field. The project
will think about the strategy to include women into the screening to increase the number of
female to be supported.
3.2 Sustainability Mechanisms
Following strategies of the project to involve local partners into project activities, in this reporting period, in order to organize outreach to commune, IC consulted with local-based hospital from the preparation. Outreach protocol was developed by discussing with people from the field. In fact, organizing an outreach to do screening for PWDs in commune is not new for local people. Usually, final decision on devices for PWDs is made by practitioners. Technician and physiotherapist played as supporting role.
In the IC outreach, practitioners, technician and physiotherapist worked as a team. Each one had certain time to work independently and gave his/her own decision. Individual decision contributedto the final proposal after discussing in the group. This way of operating required the role of leader. The leader should facilitate the conversation among the team and recognize expertise of other members. IC continued to work with hospitals for next quarters to enhance such working mechanism. It is expected that, once the discussion and working as a team practiced frequently, it will become a habit not only applied for outreach but also for in-patients.
At the same time, experience and guidelines will be documented for further development and contribution to the hospital.
3.3 Environmental Compliance
N/A
3.4 Global Climate Change
N/A
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3.5 Policy and Governance Support
N/A
3.6 Local Capacity Development
During this period, outreach was one of significant events. To organize an outreach, local
agencies from commune to provincial were mobilized. Agencies from both social and health
sectors have been consulted on the data of people with disabilities and organizational
methodology in order to build a mutual benefit. Project could reach the set objectives and the
partners could learn about organizing an outreach with a multi-discipline team and also add to
their report a meaningful work for community, for people with disabilities.
Following the outreach protocol, both Rehab hospital in Hue and General Hospital of the
Northern Mountainous in Quang Nam sent their staff to work with international and national
consultant on P&O and OT. At the 2 hospitals, no service on orthopedic is provided therefore
they want to be at least aware of different types of P&O devices. This will facilitate right referral
for patients coming to hospital. Head of Physical Therapy and Rehabilitation Unit even thought
of sending his staff to VietCOT to learn the technical on orthopedic preparing for the workshop
establishment in hospital in the next few years.
Regarding occupational therapy, this outreach was a specific opportunity for nurses of hospitals
to strengthen their knowledge and skill on accessing people with disability. Worked in pair with
Ms. Tran ThiHuyenSuong, a lecturer on physical therapy and experienced on occupational
therapy was such a good practice.Dr. Tran ThiQuynhTrang from Hue University of Medicine and
Pharmacy also supported for the OT group in Hue.
The debriefing session after screening in the morning and afternoon of each day was the most
interesting time for all practitioners, nurses, and technician. This session was led by a doctor
from the provincial hospital. Three assessing group on rehabilitation, OT and P&O had time to
report each case, findings, prescription, and concerns. Sometimes, participants discussed
exalted. People learnt from other through the discussion.
Participating in the outreach, P&O technicians from workshop of Hue Central hospital and Da
Nang Orthopedic and Rehabilitation hospital also had opportunity to booster knowledge and
skill with Ms. Dao ThiDuyen, former lecturer of VietCOT.
3.7 Public Private Partnership (PPP) and Global Development Alliance (GDA)
Impacts
N/A
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3.8 Science, Technology, and Innovation Impacts
N/A
4. STAKEHOLDER PARTICIPATION AND
INVOLVEMENT
Cooperation with 2 selected provinces enhanced:
As mentioned above IC received great support of DOH and its network, DOFA on submitting for
project approval. It is the essential for carrying out activities in the field. Besides, the
connection with technical partners of provincial hospitals becomes regular and cooperative.
In the next quarter, linkages with DPO and Association of Agent Orange will be reconnected for
target groups with severe disability.
Technical linkage with VietCOT, Da Nang Orthopedic and Rehabilitation hospital(DORH) and
Hue Central hospital:
For the outreach in December 2015, DORH sent a group of doctors and P&O technician to
Quang Nam. Doctors are experienced in rehabilitation as well as surgery. They provided useful
consultancy for patients and whole group. The meaningfulness of the DORH participation is that
they agreed to receive many cases who needed surgery before getting orthopedic devices
through the insurance referral from Quang Nam hospital.
Linkage with national and international non-governmental organization (NGOs):
The team participated in workshops on disability, Convention on the Rights of People with
Disabilities, etc. organized by both government and international NGO. Team took these
opportunities to link with organization work in the same areas.
Through a meeting with WHO, IC was introduced with an Australian OT currently living in Hanoi.
Several discussions made, it is hope that we could have her in the next outreach.
Other donors:
In the field trip coming back to Vietnam in October 2015, Dr. John Fisher, Core Vietnam
founder, paid a visit to PhuNinh Center for vulnerable children and rehabilitation for children
with disabilities in PhuNinh district, QNam province. He hoped that his contribution to PhuNinh
and USAID fund will help the children with disabilities and their family to improve their health.
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5. MANAGEMENT AND ADMINISTRATIVE ISSUES
Personnel
In this period, IC completed process of recruitment consultants for technical support. The group
now has 3 persons:
Ms. Dao ThiDuyen, P&O technician, consultant contract equivalent to 25% per month
Ms. Tran ThiHuyenSuong, OT specialist, consultant contract equivalent to 20% per
month
Mr. Pham Tran Thang Long, M&E cum Research Officer, consultant contract equivalent
to 40% per month
Ms. Duyenhas just retired from the VietCOT and experienced on lecturing as well as screening
at community. Other two young energetic persons are also lecturers of University. Ms.
Suongworks forDa Nang University of Medical Technology and Pharmacy – a government
agency, under contract mechanism. Mr. Long teaches at Thang Long University in Hanoi – a
private unit.
It took a long time and efforts to find relevant persons to work part time for project. For the
P&O and OT positions, it should be someone experienced with health system and at higher
level to give strong and clear direction to province. IC team intended to take responsibility for
monitoring and research at the beginning. However, to keep track with USAID M&E system by
quarterly is quite pressure. Therefore, the team looked for a person has experience on both
M&E system and research to support. Once again, part time job limited to find a good one.
After 3 months, through different networks we received a lot of applications for M&E position
but a few for P&O and OT, we could select the 3 persons as mentioned above.
These persons were requested to work for a probation time to see the competency and
commitment to the project. Theyall joined the outreach, working in a team with IC staff,
international and local partners to explore how they deal with project. By the end of field trip,
all approved that they could work well together, contributed value knowledge and skills to the
local partners. There is only problem that 2 out of 3 are engaging with lectures and sometimes
could not spend right time for project. It makes project to plan very carefully for each activity.
Upcoming procurement In next quarter after finalizing the list of devices identified from the first outreach, IC will work
with Da Nang O&R hospital and Hue Central hospital to discuss about procedure to provide
P&O devices for people with mobility impaired in Dai Dong and QuangVinhcommunes,
respectively.
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Other suppliers also contacted for the provision of assistive devices. It is expected that suppliers
in TTHue and QNam would have ability for this in order to reduce the transportation from big
city like Hanoi and Hochiminh city.
- Act 1.3: Provide assistive devices to people with mobility impaired from TTHue and
QNam.
6. LESSON LEARNED
At the beginning of the project, IC was consulted by the AOR on the focus for the project. Should it be one or two types of mobility problems, should it be limited the range of age, should it be focus on disability severity? After welldiscussed and agreed upon withheadsofSocialProtectionDivisionofDoLISA,prioritized beneficiaries will includes people (i)havemobilityimpairment;(ii)arepoor;(iii)donothaveanydeviceyetorhavingbutdamaged;and(iv)couldmakeuseoftheassistivedevicestoimprovetheirdailylifeandreduceburdenofcare.
Upon these criteria, IC worked with social unit at QuangDiendistrict in Hue to get the list of people with mobility impaired for the outreach. QuangVinh CHS support to check the list and people in need for assistive devices. CHS provided a list of 60 people among 288 people with mobility problems in the QuangVinh commune. It was quite surprised that 46% was from and over 60 years old.In fact, 72% came to the screening was over 60. Many of them are paralyzed after stroke. There was only one children with cerebral palsy (CP) came.
The situation in Quang Nam was not better, CHS provided a list of 85 people with mobility impaired ranging from 3 to 98 year old in which 56% was from and above 60 years old. And finally they invited 60 people come to the screening. Among 75 people were screened at the commune People’s Committee and at home, 44% was from 60. Many of them are amputee and one has CP.
We found out that, in the survey form led by TTHue DOLISA, cerebral palsy is categorized in intellectual disability with down, autism and intellectual retardation. Although in Quang Nam form, CP is put under mobility disability but there are not many listed.
Due to the unlimited on the age, it is very hard to see the impact of rehabilitation or assistive devices on independent living. And it will be an ethical problem when we provide examination but no intervention applied. Thus, project hasdeveloped clear guidelines on criteria of types of mobility impairment prioritized for severe cases, children and people at working age.
7. PLANNED ACTIVITIES FOR NEXT QUARTER
INCLUDING UPCOMING EVENTS
In next quarter from Jan 1 to Mar 31, 2016, the following activities are scheduled to take place:
16
Activity code
Activity/event Time (2016) Location
Adm Administration and network activities:
1 Meet with other grantees in the same province to share activities and plan to cooperation
Jan – Mar Hanoi
2 Join meeting and activities on disability and CRPD with other GVN and non-government organizations
Jan Hanoi
Obj 1 Improved availability of quality assistive devices for people with mobility impairments in ThuaThien Hue and Quang Nam
Act 1.1 Prepare for the data entry of users from 1st screening Jan – Mar Hanoi
Continue collect information of situation on barriers and facilitators on accessibility to assistive devices in terms of users and providers’ perspectives, costs and referral pathways from 2nd outreach
Week 2-3, Mar
TTHue, QNam
Act 1.2 Review and updatetools for screening at communes including home visits
Feb
Hanoi
Carry out 2nd outreach to PhuNinh (QNam) and A Luoi (TTHue) to access for PWMD with multi discipline team (international and national experts, local practitioners and DPO members).
Week 2-3, Mar
QNam,TTHue,
Act 1.3 Work with P&O workshops in TTHue and Da Nangto provide assistive devices for people with mobility impaired of 1st screening. Also contact with other suppliers on other kind of devices.
Feb-Mar TTHue, QNam, Da Nang
Obj 2 Improved capacity of selected province based practitioners, DPO core members and technicians on provision of quality assistive devices
Act 2.1 Get more information from the field to identify current situation on capacity of provincial-based human resources on assistive devices
Week 2-3, Mar
TTHue, QNam
Act 2.2 Prepare for training program and materials for health workers at commune level on basic knowledge on type of disability and follow up with users
Feb – Mar Hanoi
Obj 3 Increased DPO’s access to information on assistive device services
3.1 Develop flyers for DPO members and users on assistive devices Jan – Mar Hanoi
8. HOW IMPLEMENTING PARTNER HAS ADDRESSED
A/COR COMMENTS FROM THE LAST QUARTERLY
OR SEMI-ANNUAL REPORT N/A
9. FINANCIAL MANAGEMENT
There were some modifications within the budget made for technical events such as kick-off
meeting and technical meeting preparing for the outreach in both provinces. These were
important activities to get involvement of local partners. Through the direct meetings, concerns
17
were discussed and solved quickly. Technical meetings will become a key part of outreach on
the next plans.
Based on experience from the first outreach, a debriefing with the management agency, like
DOH, after the outreach is also included in the plan.
Other expenses were under management.
18
ANNEX A: PROGRESS SUMMARY
Table 1(a): PMP Indicator progress - USAID Standard Indicators and Project Custom Indicators
INDICATOR
CODE
NAME OF INDICATOR
DISAGGREGATION
BASELINE Unit of
Measure
QUARTER 1 QUARTER 2 QUARTER 3 QUARTER 4
FY 2016 Notes
OCT-DEC 2015 JAN-MAR
2016 APR-JUN
2016 JUL-SEP 2016
Targets Actuals Targets
Actuals
Targets
Actuals
Targets
Actuals
Targets
Actuals
QUARTERLY REPORTING
3-Z23
DMP15: Number of person-hour of training of service providers completed
Sex 0 hrs 0 0 1,440
0 800 2240
3-Z23a
Men 0 0 720
0 400 1120
3-Z23b
Women 0 0 720
0 400 1120
3-Z24
DMP16: Number of person-time that received direct assistance
Sex 0 times 36 0 54 54 56 200
3-Z24a
Men 18 0 27 27 28 100
3-Z24b
Women 18 0 27 27 28 100
3-Z32 Number of screened persons with disabilities
Sex, province
0 persons 50 136 80 80 80 290 136
3-Z32a
Men 25 70 40 40 40 145 70
3-Z32b
Women 25 30 40 40 40 145 30
ANNUAL REPORTING
3-Z29
DMP 1: Percentage of beneficiaries who report increased independence
Sex, level of disability, provinces
0 percentage 50%
19
3-Z29a
Numerator 100
3-Z29b
Denominator 200
3-Z30
DMP11: Number of devices produced locally by USAID’s innovation
Devices 0 Devices 5
3-Z31
DMP12: Percentage of persons with disabilities and care givers are aware about availability of service
Sex, provinces
0 percentage 80%
3-Z31a
Numerator 160
3-Z31b
Denominator 200
3-Z36
IR2.3 PM3: Level of satisfaction among male and female persons with disabilities receiving social or health service in targeted areas.
Sex. There are 5 scales: strongly dissatisfied, dissatisfied, moderate satisfied, satisfied, strongly satisfied
0 5-point measurement scale
4
3-Z36a
Men 4
3-Z36b
Women 4
3-Z39
DMP G1: Percentage household reporting an increased involvement from part of male
Provinces 0 percentage 20%
20
family member(s) in supporting cares to persons with disabilities
3-Z39a
Numerator 40
3-Z39b
Denominator 200
3.3.2-13
IR 2.3. PM2 (or PPR 3.3.2-‐ 13): Number of service providers (individuals) trained who serve vulnerable persons
Sex, provinces
0 persons 80
3.3.2-13a
Men 40
3.3.2-13b
Women 40
3.3.2-8
DO2.PM6: Number of persons with disabilities received direct assistance provided by USAID funded Programs (AT+ indicator 3.3.2-8. Number of vulnerable people benefiting from USG-supported social service)
Sex, level of disability, provinces
0 persons 200
3.3.2-8a
Men 100
3.3.2-8b
Women 100
21
ANNEX B: FINANCIAL MANAGEMENT
Cash Flow Report and Financial Projections (Pipeline Burn-Rate)
Chart 1:Obligations & Current and Projected Expenditures1
Quarter
Q3-2015
Actual
Q4-2015
Actual
Q1-2016
Projection
Q2-2016
Projection
Q3-2016
Projection
Obligation (USD)
-
75,994.20
75,994.20
101,325.60
64,870.30
Expenditure
Pipeline (USD)
20,607.90
53,452.97
79,690.54
98,052.41
98,052.41
0%
20%
40%
60%
80%
100%
Obligation Expenditure Pipeline
Q3-2016 Projection
Q2-2016 Projection
Q1-2016 Projection
Q4-2015 Actual
Q3-2015 Actual
22
ANNEX C: GPS INFORMATION
Places to do the screening to identify the needs of assistive devices
1. In ThuaThien Hue: Commune Health Station, QuangVinh commune, QuangDien District
2. In Quang Nam: People’s Committee, Dai Dong commune, Dai Loc District
23
ANNEX D: SUCCESS STORY TEMPLATE
Success Stories/Lessons Learned Template
One Story Per Template
Instructions: Provide the information requested below. Remember to complete the Operating
Unit Standardized Program Structure selections in order that your program element selections are
pre-populated in the FACTS drop-down menu. “ * ” indicates required fields.
* Program Element: Health
*Key Issues:Assistive devices
Title:Moving without Limits – The International Center’s Disability Program
Operating Unit:USAID/Vietnam
Please provide the following data:
* Headline (Maximum 300 characters): A good headline or title is simple, jargon free, and
has impact; it summarizes the story in a nutshell; include action verbs that bring the story to
life.
Multi-discipline Team for Commune Screening Ensures the Right Needs of People with
Disabilities
* Body Copy (maximum 5,000 characters): The first paragraphs should showcase the
challenge encountered and the context of the foreign assistance program. Presenting a conflict
or sharing a first person account are two good ways to grab the reader’s attention. Continue by
describing what actions were taken and finally describing the end result. What changed for the
person or community? What was learned? How did this make a difference in the community or
to the country overall? If this story is relating to a "best practice", what were the innovations in
planning, implementation or partnering that made it different? If this story is about an
evaluation, what program adjustments were made?
Many people with disabilities in Vietnam depend on mobility solutions to carry out daily
activities and participate actively and productively in community. Through humanitarian
organizations, many people with disabilities received assistive devices. However, the fact is
that many devices are not fit to PWD even it has good quality. Sometimes, devices could not
be used effectively due to the personal characteristic of disability or the living conditions.
24
IC’s project aims to improve the mobility functions of persons with disabilities by providing
assistive devices and insuring health practitioners and family member can properly maintain
devices.In order to do that, outreach to community was organized to assess the situation of
mobility disability and give right prescription on assistive devices for whom needed.
The outreach will be organized in 3 days at each commune. In the first 2 days, about 60 PWD
will be screened. Home visits will be organized in the third day to check home environments
and confirm right devices and to check very severe cases who could not go to the screening
place.
A multidisciplinary team of specialists on different areas, including international expert,
national specialists, provincial and district practitioners, commune health staff, village health
workers and representative of organization of people with disabilities directly involve and
indirectly support to the screening at communities. The team was divided into 4 groups in
charge of 2 main areas which are Administration (Group 1) and Professional (Group 2, 3, and
4). Group 1 includes commune/district health staff to do the administration and register for
PWD; Group 2 includes provincial rehabilitation doctors to check general health and
rehabilitation needs; Group 3 includes national and provincial occupational therapists to
assess self-care ability at home; Group 4: includes international/national technologists to
assess orthopedic needs and prescribe devices. Group 2, 3 could propose supportive devices
using for bathroom and toilet. PWDs will go through the 4 tables indicate 4 groups. After the
getting through Group 1, s/he could be flexible led to the other groups but it is to ensure that
s/he will be checked by all professional groups. Each session in the morning/afternoon, about
15 people will be screened.
After each session, all groups take 30-45 minutes to review and discuss all screened cases to
agree on the devices assignment. If the groups still having concerns about the effectiveness of
the devices, home visit is applied.
Debriefing session and home visit are assessed as the most success and significant of project.
It is reported that screening in the community to check for PWD have been organized many
times by either provincial team or project team but there was no debriefing to share ideas and
assessment of each one. In this session, practitioners,technicians and commune health staff
could see the comprehensive needs and current situation of one PWD through different
aspects of rehabilitation, occupational therapy, orthopedic and sometime surgery. Some ideas
caused debate, which facilitatedlearning from each other. Commune health staff contributed
to the assessments, as they know well about each person. The project coordinated and worked
with the group of international, national and provincial specialists to plan for these activities.
People attending outreach have been involved in the process of preparation and
implementation.
25
* Pullout Quote (1,000 characters): Please provide a quote that represents and summarizes
the story.
Dr. Doan Minh Xuan, Vice Director of ThuaThien Hue Rehabilitation hospital participated in
the process of organization said “Debriefing after each session among groups to get
consensus on the assistive devices for people with disabilities was appropriate and practical.
This allowstheevaluationtoprovideassistive devicesfor PWDsmostaccurately. Home visits
were very good to survey the living environmentin order to facilitate the effectiveandmost
appropriate use of the devices. At the same time,this is also anopportunitytosee
thelifeofPWDsand get the practitioners closer to people with disabilities”.
Participating in the outreach, a physical therapist of the hospital shared her views “I have
been attended in many training on occupational therapy for adults and children. Through this
outreach, I have opportunity to observe and understand more about people with disabilities
especially exploring home environment. After the trip, I discussed and gave more advices for
patients on home modification”, said Anh Hong.
* Background Information (3,000 characters): Please provide whether this story is about a
presidential initiative, Key Issue(s), where it occurred (city or region of country) and under
what item(s) (Objectives, Program Areas, Program Elements) in the foreign assistance
Standardized Program Structure. Include as many as appropriate. See Annex VIII of the
Performance Plan and Report Guidance for a listing of Key Issues. See the list and definitions
for the Standardized Program Structure. http://f.state.sbu/PPMDocs/SPSD_4.8.2010_full.pdf.
Outreach is under the Objective 1 of Moving without Limits project implementing from
July 2015 to July 2017. Project will organize 8 outreach trips for two provinces ofThua
Thien Hue and Quang Nam. It is estimated that 400 people with mobility impairments in
two project provinces will be provided with assistive devices for the whole project lifecycle
based on their actual needs.
Due to the timing, one commune per district will be targeted. Two districts of each
province will be selected to participate in the project. They are Quang Dien and A Luoi
districts in Thua Thien Hue province, Dai Loc and Phu Ninh districts in Quang Nam
province.
* Contact Information (300 characters): Please list the name of the person submitting along
with their contact information (email and phone number).
Dr. Nguyen Thi Mai Hien
IC Office
58 Tran Nhan Tong, Hanoi
Email: [email protected]
Tel: 04-3733 9444, ext. 206
26
MULTI-DISCIPLINE TEAM FOR COMMUNE SCREENING ENSURES THE RIGHT
NEEDS OF PEOPLE WITH DISABILITIES
Multi-disciplinary team
join a debriefing session to
review assessed cases in
QuangVinh commune,
QuangDien District,
ThuaThien Hue province.
Photo by IC
27
ANNEX E: ASSESSMENT ON ACCESSIBILITY TO
ASSISTIVE DEVICES AND REHABILITATION FOR
PEOPLE WITH MOBILITY IMPAIRMENT IN THUA
THIEN HUE AND QUANG NAM
(See attached file)
ANNEX F: OUTREACH PROTOCOL
(See attached file)
1
ANNEX E
Assessment on accessibility to assistive devices and
rehabilitation for people with mobility impairment
in Thua Thien Hue and Quang Nam (August 2015)
Table of Contents
1 Background information ................................................................................................................ 2
2 Purposes of the Assessment .......................................................................................................... 2
3 Focus areas of the Assessment ..................................................................................................... 2 3.1 Provincial services providing system ..................................................................................................... 2 3.2 Users ..................................................................................................................................................................... 3
4 Assessment Methods ....................................................................................................................... 3 4.1 Design ................................................................................................................................................................... 3 4.2 Timeline .............................................................................................................................................................. 4 4.3 Evaluation team .............................................................................................................................................. 4
5 Assessment output ........................................................................................................................... 4
Appendix 1. Schedule ................................................................................................................................ 5
2
1 Background information
USAID funded Disabilities Project has been implemented by The International Center
in two provinces of Thua Thien Hue and Quang Nam for 2 years from July 20, 2015 till
July 19, 2017. This is designed to improve the accessibility of the people with mobility
impairments in Thua Thien Hue and Quang Nam to quality and appropriate assistive
devices.
The project includes three components:
Component 1: Improve availability of quality and appropriate assistive
devices for people with mobility impairments in Thua Thien Hue and
Quang Nam
Component 2: Strengthen capacity of selected province based practitioners
and technicians on provision of quality assistive devices
Component 3: Increase awareness of DPO members and families on
assistive device related services.
In order to indentify the needs of people with disabilities and booster local capacity in
provision and management of assistive devices, a baseline survey on accessibility to
assistive devices and rehabilitation services for people with mobility impairment will
be carried out in Thua Thien Hue and Quang Nam provinces.
2 Purposes of the Assessment
The purposes of the assessment are to 1) identify situation on barriers and
facilitators on accessibility to assistive devices in terms of users and providers’
perspective; 2) identify referral pathways and cost for people with disabilities to
access services for continuum of care; 3) identify current situation on capacity of
provincial system including human resources and facilities on providing assistive
devices, rehabilitation services and training on related issues.
This assessment is not happened in one trip but prolong during project
implementation integrated with outreaches.
3 Focus areas of the Assessment
Two main objects of the assessment are 1) System to deliver assistive devices and
rehabilitation services, and 2) users of mentioned services.
3.1 Provincial services providing system
Brief assessment on services providing system on orthopedic and rehabilitation to
i. Identify orientation of service development in term of orthopedic, assistive
devices, physical and social psychology rehabilitation
3
ii. Identify situation on capacity of facilities and provincial-based human
resources on assistive devices (orthopedic and occupational)
iii. Assess the capacity and ability of facilities in term of infrastructure and
human resources on providing rehabilitation service
iv. Identify situation on barriers, facilitators and cost on accessibility to
assistive devices in terms of providers’ perspective
v. Identify and map referral pathways for PWD to access services for the
continuum of care required from identification of a disability to discharge
and follow up of interventions for that disability
vi. Identify training capacity and training need on comprehensive disability
services with focus on quality assistive devices
3.2 Users
Assessment on users to be carried to
i. Identify situation on barriers, facilitators and cost on accessibility to
assistive devices
ii. Identify and map referral pathways for PWD to access services for the
continuum of care required from identification of a disability to discharge
and follow up of interventions for that disability
iii. Identify information need on comprehensive disability services with focus
on quality assistive devices
4 Assessment Methods
4.1 Design
Qualitative method will be applied to get information needed. Semi-structured
interviews (SSIs) and focus group discussions (FGDs) will be conducted with
providers and users in Thua Thien Hue, Da Nang and Quang Nam to gain a better
understanding of the experience of service delivery and their ability for training.
In each province, FGDs will take approximately 1.5 hours and will be conducted with
the following providers at provincial and district levels:
- Doctors of rehabilitation
- Orthopedic technologists
- Technicians (Physiotherapists, occupational therapists)
- Doctor of traditional medicine
In addition to FGDs, a one-hour SSI will be conducted with head of orthopedic/
rehabilitation hospital/departments/unit to gain their perspectives on service
development. The proposal schedule is presented in Appendix 1.
4
Users will be interviewed to get their ideas on services and information they need
through the outreach activities to conduct direct assessment.
4.2 Timeline
The assessment will take place from August 2015 to April 2017.
First field trip to assess the providers will be from August 27-31, 2015 for Thua Thien
Hue and Quang Nam provinces.
Field trip to access users will be integrated into outreach activities during 2015 and
2016.
4.3 Evaluation team
Name Organisation Roles/Responsibilities
Nguyen Thi Mai Hien IC Lead design and coordination of
assessment
Kerry Fisher La Trobe Uni Co-design and facilitate SSIs and FGDs
Hoang Cam Linh IC Co-facilitate SSIs and FGDs and interpreter
Nguyen Hai Thanh VietCOT Co-facilitate SSIs and FGDs
5 Assessment output
The assessment outputs include the following:
Report 1: Current situation on provincial system of Thua Thien Hue and
Quang Nam to deliver assistive devices and rehabilitation services for
people with disability with focus on mobility disabilities.
Report 2: Report on perspectives of people with disabilities on barriers
and facilitators to access to assistive devices and rehabilitation services
and their needs on those services.
5
Appendix 1. Schedule
No. Activities Timeline
1. Assessment outline development August 2015
2. First field trip to get information on service provision August 2015
3. Draft of first key findings on service provision October 2015
4. Field trip to get information on users (part 1) and
additional information on the service provision
December 2015
5. Report on key findings on service utilization of the first
group of people with disability
February 2016
6. Field trip to get information on users (part 2)
additional information on the service provision
June 2016
7. Report on key findings on service utilization of the
second group of people with disability
August 2016
8. Field trip to get information on users (part 3)
additional information on the service provision
October 2016
9. Report on key findings on service utilization of the
third group of people with disability
December 2016
10. Field trip to get information on users (part 4)
additional information on the service provision
January 2017
11. Report on key findings on service utilization of the
fourth group of people with disability
February 2017
12. Report writing draft February 2017
13. Finalize report April 2017
Department of Health
Thua Thien Hue Province
Department of Health
Quang Nam Province
The International Center
Disability Project
OUTLINE
Screening people with mobility disabilities to identify the
need for assistive devices
Hanoi, November 2015
2
GENERAL INFORMATION
Disability Project
Goal Improved access to assistive devices for persons with
disabilities in selected districts of the two provinces of Thua
Thien Hue and Quang Nam thereby enabling them to better
integrate in life.
Executive Unit The International Center
Provincial Partners Department of Health in Thua Thien Hue and Quang Nam
province
Technical Units - Rehabilitation Hospital in Thua Thien Hue province
- Provincial General Hospital of Quang Nam in the
Northern Mountainous Areas
Cooperation Units - Vietnamese Training Center for Orthopaedic
Technologists, Da Nang Orthopedic and
Rehabilitation Hospital
- Department of Rehabilitation, Da Nang University of
Medical Technology and Pharmacy
- Department of Rehabilitation, Hue University of
Medicine and Pharmacy
- Department of Rehabilitation, Hue Central Hospital
- Provincial Department of Foreign Affairs
- Department of Labor, Invalids and Social Affairs
- Provincial Disability Association
- The District Health Center
- Department of Labor, Invalids and Social Affairs
selected districts implementing projects
- Commune People's Committee, the CHS project
Location - Thua Thien Hue province: Quang Dien and A Luoi
districts
- Quang Nam province: Dai Loc and Phu Ninh districts
Time frame From December 2015 until May 2017
Budget - Funding to support activities of screening and
consultants paid by the project.
- Location screening, local manpower contributed by
the marching fund
3
I. Introduction
Many people with disabilities in Vietnam depend on mobility solutions, e.g., assistive devices
such as wheelchairs, orthopedic/prosthetic devices to enable them to carry out daily activities
and participate actively and productively in community life. So far, there are many programs
to assist persons with disabilities that have been implemented including the provision of
supportive devices. However, the support has not met the high demand in terms of both
quantity and quality. There is a significant number of people with mobility impairments
having no devices. Many cases have been given assistive devices but they could not use
because it didn’t fit their disability condition and their needs.
The International Center (IC) received funding from the United States Agency for
International Development (USAID) to implement the project supports disabled athletes
called "Moving Without Limits" in the provinces of Thua Thien-Hue and Quang Nam from
January 20, 2015, to July 19 2017. The project aims to help disabled athletes in the two
provinces to improve functionality maneuvering through the provision of assistive devices
quality, ensure mobility impaired people can manage and use the correct tools with the
support of the medical staff and family thereby facilitate enable them to integrate better in
their lives.
To ensure the provision of assistive devices which are good quality and fit to the specific need
of each person with mobility disability, the project will organize outreach to do screening and
assessment for person with a disability based on the list provided by local partners. After
assessment, prescription for assistive devices of each person will be proposed.
II. Objectives
Organizing screening in the community in order to:
Assess the situation of mobility disability, the cause, and influent factors (both
negative and positive) to the independent living capacity and participation into social
activities of people with disabilities
Identify the needs of physical rehabilitation, orthopedic devices, and occupational
therapy
Give right prescription on assistive devices for whom needed
4
III. Output
Persons with mobility disabilities get assessments to identify the need of
rehabilitation, orthopedic devices, and occupation therapy
Persons with mobility disabilities get appropriate prescriptions on assistive devices
supporting mobility function
Influent factors (both positive and negative) for independent living capacity and
society integration of PWDs are collected
IV. Location and time
4.1. Location
- Thua Thien Hue province: Quang Phuong commune, Quang Dien district
- Quang Nam: Dai Dong commune, Dai Loc district
4.2. Time
- 3 days in Hue: December 14-16, 2015
- 3 days in Quang Nam: December 18-20, 2015
V. Participants
5.1. People will be screened
- People with disabilities regardless age, sex, severity or cause of disabilities
- Prioritized for whom
o Are poor
o Do not have any devices or have devices that have been damaged
o Could make use of the assistive devices to improve their daily life and reduce
their burden of care
5.2. People provide screening
- A multidisciplinary team of specialists on different areas, including international
experts, national specialists, provincial and district practitioners, commune health
staff, village health workers and representatives of organization of people with
disabilities, are directly involved and indirectly support the screening in the
communities.
- The multidisciplinary team includes:
Orthopedic group
o Orthopedic specialist, Ms. Kerry Fisher, La Trobe University, Australia:
Advise the project on the preparation to implement the screening; participate in
5
the field trip to assess the needs on assistive devices of people with mobility
disability (PWMD).
o VietCOT technologist, Ms. Dao Thi Duyen: Develop orthopedic tools, provide
instructions for the use of devices; directly support the field trip on the needs
assessment of devices; supervise the manufacturing at the orthopedic
workshop; and supervise the management of device usage.
o Rehabilitation doctors and the orthopedic workshop technicians, Da Nang
Orthopedic and Rehabilitation: Provide comments for the assessment tools;
provide direct technical support at the field trip on the needs assessment of
devices; manufacture orthopedic devices; supervise the management of device
usage.
o Rehabilitation doctors and technicians of orthopedic workshop, Rehabilitation
Dept., Hue Central Hospital: Provide comments for the assessment tools;
provide direct technical support for the field trip on the needs assessment of
devices; manufacture some of the orthopedic devices; supervise the
management of device usage.
Occupational therapy (OT) group
o Occupational therapist, Ms. Tran Huyen Suong, lecturer on rehabilitation at Da
Nang University of Medical Technology and Pharmacy: develop tools on OT
needs, living environment, provide direct support at the field trip on the needs
assessment on OT and living environment.
o Practitioners/technicians working in Hue Rehab hospital, Quang Nam General
hospital of Northern Mountainous Area: have knowledge on OT, support the
assessment process in the field.
Rehab, physical therapy and OT group
o Practitioner at Rehab Dept., Hue University of Medical and Pharmacy:
Develop assessment tools on rehabilitation, physical therapy, independent
living ability, quality of life; directly support the field.
o Practitioner at Rehab hospital: Develop the general health assessment,
comment for other tools; directly support the field in Thua Thien Hue.
o Practitioner at Quang Nam General Hospital of Northern Mountainous Area:
give comments for the assessment set of tools; directly support the field in
Quang Nam.
6
Supportive group
o Staff from Rehab and Traditional Dept., pilot District Health Center (DHC):
participate to support the needs assessment on rehab, OT, and organizing
screening in the community.
o Staff at pilot commune health station (CHS): collaborate with commune social
staff to select people with disabilities for the screening, support the organizing
activities, receive people coming to the screening, collect general information
of PWD.
o Village health workers (VHW): Identify PWDs, invite and provide guidelines
for PWDs for the screening.
o Representative of provincial social protection division, representative of
PWDs: support to the screening
VI. Steps
6.1. Preparation
- Identify PWDs for the screening
+ Social sector (provincial/district/commune) provides a list of PWMD within the
selected commune.
+ CHS, in collaboration with commune social staff and village health workers, to review
all PWMD in the list to ensure that persons meet the requirements of the screening and add
more people who are in need but not listed, especially ones that live far from the center and
don’t have access to information.
- Prepare logistics
+ CHS, in collaboration with VHW, sends invitations to each person on the list.
+ CHS is responsible to arrange the area for screening. It is noticed that the area will be
large enough to organize 4 different sections which are airy, clean to set tables for
practitioners and waiting benches for PWD.
+ IC staff cooperates with national and local consultants to prepare materials and tools.
- Disseminate information about the screening to commune loud speakers: objectives,
time frame, venue, and target group
6.2. Organizing the screening
PWMD will go through a procedure to be examined and assessed as follows:
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- Receiving table (1): PWMD return the invitation, review his name, DOB if they are
not correct; provide administration information and be interviewed on baseline
questionnaire -> Done by CHS staff and project staff.
- Rehab and general health table (2): PWMD will be assessed on general health and
rehabilitation -> Done by rehab doctor.
- OT assessment table (3): PWMD will be assessed on self-care ability, Sphincter
Control, Transfers, Locomotion, Communication, and Social Cognition.
- Orthopedic assessment table (4): PWMD will be assessed on orthopedic needs and
prescribe devices followed the assessment forms.
- Final table (5): PWMD comes back to Table 1 to be interviewed about his
experiences on living with disability, health care and other aspects of life and get
transportation support from project. CHS will inform who is visited to see the living
environment later on.
Person who is prescribed for assistive device will be informed and invited to Hue
Central Hospital/ Da Nang O&R hospital for casting and receiving P&O devices.
Other devices will be handed over in the commune.
6.3. Identify the needs and support plan
- By the end of each day, the multi-discipline team will meet to discuss =each case and get
a consensus on the intervention plan for PWDs.
- Persons from the main technical partner of each province (Hue Rehab hospital, QN
Northern Mountainous Area hospital) will chair and facilitate the meeting. S/he summarizes
conclusion of each case based on the discussion and exchanges among groups’ members.
6.4. Data summary and report writing
- By end of each screening, CHS will summarize data and report the results of screening
following the template and send to the main provincial technical agency, IC project office.
- All dossiers of assessment will be kept at CHS, copies will be sent to following agencies:
+ Orthopedic workshop in case orthopedic devices applied
+ IC Project office
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Annex 1: Screening Diagram
Mobility Disability The Person Responsible
Table 1
Welcome
- 2 CHS staff
- 1 IC staff
Table 2
General examination and
Rehabilitation
- 1 provincial rehabilitation specialist
- 1 district rehabilitation doctor
Table 3
Occupational Therapy
Assessment
- 1 bachelor experienced in
occupational therapy from central
level
- 1 bachelor experienced in
occupational therapy from provincial
level
Table 4
Orthopedic Assessment
- 1 international expert in orthopaedic
- 1 VIETCOT expert in orthopaedic
- 1 staff of Orthopaedic & Rehabilitation
Hospital in Da Nang/ Hue
- 1 provincial staff
Table 1
Interview for Project and
End
- 2 CHS staff
- 1 IC staff
1
ANNEX G
PHOTOS OF PROJECT ACTIVITIES
LAUNCH CEREMONY IN HANOI
USAID staff, IC team and partners from Thua Thien Hue province participated in the Launch Ceremony of
new project
KICK-OFF MEETING
IC organized kick-off meetings in two provinces to introduce project’s objectives and
timeline for 2016
Dr. Nguyen Van Van, Vice Director of Quang Nam Department of Health in Quang Nam chaired
the meeting
2
Ms. Thanh An (on the left side), Head of NGO Division, Quang Nam Department of Foreign
Affairs made a speech at the meeting in Quang Nam province
Dr. Hoang Huu Nam, Vice Director of Thua Thien Hue Department of Health opened the meeting
Dr. Nguyen Thi Mai Hien (IC) and Dr. Nguyen Quang Hien (Director of Rehabilitation Hospital)
introduced project activities
3
TECHNICAL MEETING
Technical meeting in provinces to discuss and get consensus on how to do the screening
and role of each person
SCREENING
CHS staff in Quang Vinh (picture on the right) and Dai Dong communes receiving people with
mobility impaired coming to the assessment
Dr. Do Van Thanh, Director of Da Nang Orthopaedic and Rehabilitation Hospital and the team
joined the outreach in Dai Dong commune, Dai Loc district, Quang Nam
4
Assessment on occupational therapy by Ms. Tran Huyen Suong (person in red) from Da Nang
University of Medical Technology and Pharmacy
Assessment on prosthetics and orthotics by Ms. Kerry Fisher (La Trobe University, Australia), Ms.
Dao Thi Duyen (VietCOT) and local team
The multi-discipline assessed special cases who could not go into the assessment room
5
Mr. Daniel Harter, USAID Contracting & Agreement Officer participated a debriefing session in
Quang Vinh, Quang Dien, Thua Thien Hue on Dec 15, 2015
Home visit to do new assessment and check living enviroment of
people with molibility impairments