Multilevel Integration Strategies to Enhance Service Provider Networks in Vietnam

Abstract: Globally, organizational and system interventions are needed to provide integrated services to address the needs of people living with HIV who use drugs (PLHWUD), including other comorbid conditions. Community health and service workforce can be mobilized to promote service integration, which is particularly critical in low- and middle-income countries. We develop and pilot test multilevel integration strategies in Vietnam, including structural changes for better treatment coordination, strengthening treatment provider networks for improved service collaboration, and involving community health workers to support those in need throughout the treatment cascade. The study is conducted in six provinces in Vietnam. In Phase 1, we conduct formative studies with 20 PLHWUD, 24 clinic providers from HIV and drug use treatment facilities, and six directors of Provincial AIDS Centers. Based on the findings, we establish a provincial coordination team at each participating province. In Phase 2, we implement and pilot test an agency-level intervention by training 72 service providers working at various HIV and drug treatment centers to enhance the coordination and networking among the providers and to improve interactions with their patients. Agency-level aggregated data are collected and compared at the baseline and at 12-months after the intervention. In Phase 3, we implement and pilot test our intervention strategies that focus on community health workers working at commune health centers to enhance their networking and collaboration with clinic providers at the treatment facilities. The intervention focuses on improving their communication skills to outreach and motivates PLHWUD living in the community to link them to and support them to stay in care. To assess intervention outcomes, we will recruit 80 commune health workers (CHW) and 240 PLHWUD from 40 commune health centers (CHC). Intervention outcomes on PLHWUD and CHW will be compared at baseline and every three months for one year.

Project Number: R01DA041008(2017)

https://reporter.nih.gov/search/1nF2mB6R7E6QQoc1W9IG1A/project-details/9276658

Contact PI/ Project Leader

LI, LI, (lililili@ucla.edu)

Organization

PUBLIC HEALTH RELEVANCE: There is an urgent need to provide integrated services for People Living with HIV who use drugs (PLHWUD). This study addresses the need by developing and implementing multilevel strategies focusing on strengthening provider networks and partnerships between HIV and drug treatment clinics, as well as between treatment agencies and community health centers. Study findings are expected to inform global efforts in service integration, as enhancing community capacity and partnerships are likely to be a relevant and sustainable strategy in other low- and middle-income countries.