Review Global Fund

APW to review the project of integration and decentralization of HCV treatment for people living with HIV (PLHIV) and people who inject drugs (PWID) at district outpatient clinics in Viet Nam with Global Fund supported DAA

1. Background

Viral hepatitis epidemic remains a major public health issue in Viet Nam. According to mathematical modelling results developed by MOH in collaboration with WHO, it is estimated that in 2017, almost 8 million Vietnamese people are chronically infected with HBV and 1 million people are chronically infected with HCV. HIV and HCV co-infection was reported at 35% of HIV patients according to IBBS 2015. Although national guidelines for hepatitis B and C treatment were issued by MOH, access to treatment to hepatitis B and C still very limited for many reasons.

In 2018, WHO advocated and provided technical advices to MOH to include DAA in the health insurance reimbursement list. As the result, DAAs were included in the Circular 30 which has been effective since 1st January 2019. Although DAAs has been reimbursed by health insurance, low reimbursement rate (50%) has precluded patients access to this live-saving treatment. Consequently, uptake of HCV treatment through health insurance scheme is low. With strong advocate from WHO and MOH, in 2020, GFATM agreed to support DAAs for treating HCV among PLHIV who have HCV/HIV coinfection.

In this global fund supported project, HCV treatment service has been integrated and decentralized at district HIV outpatient clinics. This is the first time, HCV/HIV patients can receive HCV treatment at district HIV OPC with free of charge DAAs while health insurance only reimburses HCV treatment services at provincial hospitals only. Thus, experiences from this project will be important evidence to advocate for decentralization of HCV treatment services to district health facilities and integration in HIV treatment clinics.

WHO is calling for a capable team to carry out a review of the HCV treatment project to document the results as well as lessons learnt from the integration and decentralization of HCV treatment for people living with HIV and people who inject drugs (PWID) in Viet Nam.

2. Planned timelines (subject to confirmation)

Start date: 15 May 2022
End date: 30 September 2022

3. Work to be performed

Specific objectives of the consultancy activity

To assess the clinical outcomes of integration and decentralization of HCV treatment services for PLHIV and PWID in the Global Fund supported provinces in Vietnam
To document the experience of hepatitis C treatment in access and delivery the services from patients and providers perspectives

Method(s) to carry out the activity

The consultant team will carry out the proposed activities under the overall guidance from the responsible officer of WHO Representative Office in Viet Nam.
Regular meeting with WHO team and VAAC to update the progression and to discuss and agree on the technical requirment during implementation.
Organize the technical working group to review the data analysis and report
Seek advices from WHO and VAAC if needed

Description of the tasks/process involved in carrying out the activity

Task 1: Develop data collection tool and IRB approval application

Activities: Develop data collections form (quantitative and qualitative survey) and submit application documents to the Institutional Review Board (IRB) for IRB approval
Output/s: IRB approval

Task 2: Analyze quantitative data Activities:

Review the database that extracted from HMED, clean the data and verify if needed.
Conduct data analysis

Output/s: Cleaned data set and outputs of the data analysis

Task 3: Conduct survey and qualitative research to document experiences as well as barriers and facilitators of integration and decentralization of HCV treatment service delivery at district HIV OPCs

Activities:

Conduct in-depth interview with patients who received HCV treatment services and health providers to document their experiences and perspectives in accessing and providing hepatitis C treatment services
Conduct focus group discussion to explore the barriers and facilitators to HCV treatment access for PLHIV in selected provinces in Vietnam.

Output/s: Transcription of qualitative data and outputs of data analysis

Task 4. Develop report on the clinical outcomes, experiences/lessons learned including barriers and facilitators of the project of integration and decentralization of HCV treatment services at provincial and district HIV outpatient clinics.

Activities:

Review and discuss the outputs of data analysis both quantitative and qualitative with WHO, VAAC and TWG for comment
Develop outline of the report and discussion with WHO and VAAC for agreement
Write draft report and share with WHO and VAAC for review and comment
Finalize the report and submit to WHO

Output/s: Final report which include the following sections: Background, Methodology, Results, Discussion, Conclusion and Recommendations.

4. Specific requirements The applicant must submit the following documents

Technical proposal including Background, Methods, Expected results and Timelines

Financial proposal

Documents to prove the technical capacity to undertake the proposed activities

+ Team leader requirement: Own university degree in medicine or public health. Having postgraduate degree or training in the area of public health or epidemiology. Having at least 10 years of work experiences in doing research in both qualitative and qualitative and/or project/ programme evaluation/review. Demonstrated good understanding/knowledge on hepatitis C diagnosis and treatment is desirable + Team members requirement: o Own university degree in the areas of medicine or public health or social science. Having postgraduate degree or post graduate training in the area of public health, epidemiology or infectious diseases. Experiences in conducting quantitative and qualitative survey o At least one member had proficient capacity in quantitative data analysis using statistical software such as STATA, SPSS, …. o At least one member has capacity in qualitative data analysis o At least two members have capacity and experience to conduct in-depth interview and group discussion o At least one member has experiences of clinical management of HIV and viral hepatitis

Language requirements: Demonstration of proficiency in both Vietnamese and English

Competencies: Not required

5. Place of assignment Hanoi, Vietnam

6. Medical clearance: NA

7. Travel: to Ho Chi Minh City, An Giang, Thai Nguyen and Lao Cai

8. Budget

Please take note of the following when submitting application:

The contractor will be responsible for paying taxes, if any.

Those who are interested can send letter of interest and resume to: