1. INTRODUCTION. Background:

Transcription

1 IMPROVING THE HIV, SEXUAL & REPRODUCTIVE HEALTH SERVICES FOR SEX WORKERS IN VIETNAM: A DIALOGUE ON TRANSLATING GOOD POLICIES INTO GOOD PRACTICE Workshop Report, Vietnam November INTRODUCTION Background: UNFPA has been working with APMGlobal Health to develop a regional curriculum template on effective HIV and Sexual and Reproductive Health among Key Populations (KPs). The curriculum is intended for adaptation and use at country level. The UNFPA Vietnam Country Office agreed to include the workshop in its planned activities in 2014 in partnership with the Vietnam Ministry of Labour, Invalids and Social Affairs MoLISA and DSEP, its Department of Social Evil Prevention, which deals particularly with issues relating to sex work. Adaptation Process: Following several teleconferences involving UNFPA Country Office (CO), UNFPA Regional Office and APMG, Julia Cabassi (UNFPA Regional Adviser, HIV and MARPs and Lou McCallum, Director APMG, travelled to Hanoi in October 2014 and met with the CO, MoLISA and other stakeholders to begin the adaptation process form UNFPA and APMG s regional template curriculum. Given the recent closure of the 05 Rehabilitation Centres for sex workers in Vietnam and the shift on towards an engagement with sex workers in community it was DSEP s preference to have a workshop that focussed on building the capacity of MoLISA, DoLISA and DSEP staff to translate the new policy into action at provincial level. Structure of this report: As well as this brief introduction, this workshop report provides a summary of the workshop process in three categories. Panel Discussions describes three panels held during the workshop and what each guest speaker highlights as well as the following participant discussions. Presentations briefly describes the key issues raised in PowerPoint Presentations during the workshop. Interactive Group Processes describes the barriers and opportunities raised during small group and large group interactive processes held throughout the workshop. It presents conclusions presented by small groups during a mapping exercise, policy challenges identified and the Action Plans agreed to by participants in the Provincial Groups at the end of the workshop. Participants: Given the shift in focus away from a national dialogue towards a capacity development workshop for provincial and local staff, MoLISA decided to include teams from four provinces: Hai Phong, Quang Ninh, Nam Dinh and Can Tho. It was intended that each team would comprise DoLISA and DSEP staff, sex worker/peer educators and health service managers. Smaller teams (or individuals) from APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

2 Bà rịa, Thanh Hoa, Lào Cai, Thừa Thiên-Hue and Phu Tho also attended. In addition to provincial staff and volunteers, staff from DoLISA at national level and representatives from several national NGOs, INGOs and UN organizations also attended. Table 1. Participating Organizations National level Number of participants MoLISA/DSEP 8 INGO/UN 5 Health sector 0 Sex workers 2 Provincial level DoLISA/DSEP 22 Women s Union 6 Health sector 3 Sex workers 5 It was difficult to secure health sector participation in the workshop. Although this sharpened the focus on the coordinating role of MoLISA/DoLISA/DSEP and on models for engagement between sex workers and these agencies, the absence of health service planners and managers form the respective provinces made it difficult to effectively map current service access and plan strategies for greater access to key health services in provinces and districts. The absence of national Ministry of Health Officials also made it difficult to determine policy and procedure obstacles that might stand in the way of better access. Workshop Objectives: The objective of the workshop was to increase the capacity of policy-makers, planners and implementers to improve the HIV, sexual and reproductive health of sex workers in Vietnam, based on global and regional evidence for effectiveness and in support of recent changes in national and provincial policy. Workshop Programme: The workshop was held at the Kim Lien Hotel, Hanoi from Tuesday 25 th Friday 28 th November The full final workshop programme is attached. The programme included an opening ceremony with presentations from key national agencies and six modules: Module 1: Context of HIV and SRH and Impact Among Sex Workers Module 2: Evidence-based Programmes & Services for Sex Workers Module 3: Engaging Sex Workers with HIV & SRH Services Module 4: Critical Enablers in the sex work environment Module 5: Planning ahead - identifying key priorities for change APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

3 2. SESSION SUMMARIES: 2.1 Opening Session: The Opening Ceremony was made up of presentations from MoLISA, the Vietnam Administration of HIV/AIDS Control (VAAC), the National Institute of Hygiene and Epidemiology, the Hanoi School of Public Health UNFPA and UNAIDS. Key points from each of the opening ceremony presentations: (Full copies of.ppt presentation are available in English and Vietnamese at Nguyen Xuan Lap, Director, Department for Social Evil Prevention There have been significant changes in national policy in relation to sex workers, encouraging engagement at community level There is still some mismatch between national policy and practice at provincial and local level There are also some policy gaps in relation to working with NGOs and CBOs in Vietnam that need to be addressed Professionalism and skills among the MoLISA/DoLISA DSEP team in improving, but we still don t have provincial guidelines to support these new roles We need to increase legal aid budgets to ensure greater access to legal services We want to support the full integration of sex workers into community Ritsu Nacken, Deputy Country Representative, UNFPA There has been real progress in the prevention and management of HIV and STIs in Vietnam UNFPA is keen to be working with MoLISA and DSEP to address the violence experienced by sex workers, from clients, intimate partners and authorities Violence and HIV risk and impact are intrinsically connected Female sex workers have the right to determine the number and timing of their pregnancies and to safely achieve their reproductive intentions Effective responses require a real partnership between sex worker communities and health service providers to tackle barriers to service access The legal and policy environment in which the response takes place can either promote or hinder that access. An enabling environment is therefore fundamental to an effective response Pham Ngoc Dung, Deputy Director, Policy - DSEP - MoLISA Population size estimates vary (DSEP 33,000, but might higher by some other agencies) Business providing sensitive services increasing each year: o 73,000 establishments in 2010 employing 48,000 attendants o 76,000 establishments in 2011 employing 52,000 attendants o 115,000 establishments in 2012 employing 68,000 attendants o 130,000 establishments in 2013 employing 108,000 attendants APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

4 DSEP is responsible for supporting the setting up clubs for sex worker prevention 250 set up by October 2014 Strengthen of the self-help model sex workers are very successful at reaching other sex workers and assisting them to reach services Problems exist in securing sustainable funding for these groups they are not properly recognised under law and most have been set up as pilot projects No cost-effectiveness evaluations have been done Significant barriers exist to loan uptake by sex workers self-stigma, identity/location issues this reduces the quality and effectiveness of interventions Nguyen Thanh Ha, Hanoi School of Public Health The 2003 Ordinance on Sex Work is out of date: o No effective mechanism is available for implementing economic, social, communication and education measures o Policy conflicts between Elimination of Sex Work, Drug policy and HIV Law: Resolution 108/2007/ND-CP on supporting harm reduction interventions o Sex workers with HIV particularly disadvantaged Drop in number of free condoms distributed (donor programmes wound down) Recommendations of the Ordinance review: o Review, amend and upgrade the Ordinance to a law with human rights, national and international contexts taken into account o o o Provide proper harm reduction services in community Support SWs to re-socialize: Developing re-socialization program Supporting SWs to change their jobs Enhance the effectiveness of sex work prevention UNAIDS report on the recently released HIV Investment Framework for Vietnam: 80% of funding for HIV programmes in Vietnam is from international support o 100% of methadone programming o 95% of ART International funding expected to decline sharply Health insurance not contributing so far Coverage: o FSW by programmes 51% o PWID with NSP 29% o PWID by Methadone 6% o MSM by programmes 42% o PLHIV on ART (of those eligible) 60% National Institute of Hygiene and Epidemiology: STI rates among sex workers falling steadily HIV prevalence rates among sex workers steadily dropping (4.7% 2010; 2.6% 2013) Injecting drug use estimate among FSW 1.6% (National average) - Much higher in some provinces (22% among venue-based - 32% among street -based SW in Hai Phong) APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

5 Regional data: National trend data on HIV prevalence among sex workers often masks high prevalence in some settings e.g. National average HIV prevalence among SW in Vietnam 3%, but range is 0% in some provinces to 22.5% in Hanoi Data on male and transgender sex workers is sparse Need to broaden strategies to reach sex workers e.g. Young SW using new technologies to find clients Need to integrate HIV and SRH for sex workers to: o Reduce unintended pregnancies o Improve access to antenatal, delivery and post natal care, including access to the antiretroviral drugs both for the mothers own health and to prevent infection to their child during pregnancy, delivery and breastfeeding Need to broaden focus of programmes beyond condoms: o Screening for unmet contraceptive need o Counselling on choice of contraceptive methods and understanding of the implications of different methods for preventing HIV/STI and unintended pregnancy o Acknowledge that sex workers experience high levels of coercion and violence and this affects their ability to maintain condom use, so they need additional contraception options 2.2 Panel Discussions: Sex Worker panel: The sex worker panel was made up of two representatives of the Vietnam National Sex Worker Network and five representatives from the provinces. Key themes: Sex worker groups are fragile need sustainable funding and legitimacy Identity cards is a big issue both identity cards to access services and ID cards for outreach Self-stigma is a big issue it is difficult to encourage sex workers to attend services when they know about stigma and discrimination from others Some of us get an allowance of 2m Dong (US$90) per months but we face many problems and drains on our finances Some of us don t receive an allowance and are expected to volunteer Need to connect drug users to self help groups and broaden methadone access drug use among SW and their partners is a big issue People struggle to see sex work as a legitimate job we are just like ordinary people and want to play a legitimate role in society Discussion: Some participants questioned whether sex workers should expect to draw resources from MoLISA and whether they should just offer their services to the community fee of charge. Others argued that peer educators were providing a good service in linking sex workers to services and that this should be considered a legitimate part of the makeup of HIV prevention and care services. APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

6 Economic empowerment panel: PLAN International put together a panel to report on an economic empowerment project established by MoLISA. Key themes: Rationale for economic empowerment: Stigma, discrimination and violence against sex workers are directly related to the economic vulnerability Majority of women enter sex work for financial reasons due to lack of alternative employment opportunities Stigma reduces sex workers access to formal financial services, many incur large debts, including to pimps and brothel-owners and fines to police/justice system Recommendations: Microfinance support should be implemented with a strong gender focus, empowering women by giving them direct control over financial matters Recognize and promote the involvement of CSOs in programs/projects that support sex workers Establish referral mechanisms between functional agencies and DoLISA at different levels in supporting sex workers and collecting/consolidating data annually Set up mechanism/regulation/policy for budget transference to CSOs for providing services that directly support sex workers economic choices 2.3 Presentations: Full presentation slide sets are located at Session Elements of the comprehensive package WHO Consolidated Guidelines Models of supply creation Key points PeP currently only available for police and health staff need to expand to availability for sexual assault and ensure that sex workers can legitimately access it Need to increase sex worker access to dual contraception methods (condom plus another method) to reduce unintended pregnancy and abortion rates Need to increase access to safe abortion Sex workers as a resource for connecting demand for services and supply Hiring sex workers as part-time peer educators is more efficient than relying on voluntary labour o Increases productivity - greatly increases reach (they have more regular contact with peers) o Dramatically reduces time spent by staff on training and orientation increases retention times Need to find ways to guarantee the basic budget for peer groups so that they can survive then gradually build their organisational capacity The space between supply and demand is the most interesting: o Peers bringing sex workers in for clinic appointments o Peers working in clinics to reduce fear; increase friendliness o Doctors and nurses going to venues to teach about SRH o Community HCT APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

7 Appeal to broader needs, not just HIV o Drug and alcohol management o SRH o Child health Treatments cascade Take an interest in eliminating barriers down the treatments cascade Explore community HCT Connect HCT to treatment, care and support use peers as connectors See treatment as prevention as well as care reducing viral load o requires taking a long-term interest in sex workers with HIV, o requires peer educators to be supported to take on new roles in treatments support 2.3 Interactive Group Sessions: Group work session 2: Identifying priorities for improving sex worker access to services HAI PHONG: Partners Roles and suggested priorities: Health Organize partnership meeting to reach agreements Implementing communication and harm reduction activities Coordinating provision of supporting services in the city Providing health services: VCT, STIs, ARV Providing technical support for and monitoring the implementation of activities Document and report feedbacks to other partners Women s Union DSEP Support women to access loans Provide vocational training Counselling and referral for HCT Linking different organizations, branches, local government to garner their endorsement and support for intervention activities Collaborate with Health Centre to maintain activities Develop plan for sustain activities NGOs Provide technical assistance Provide funding support Develop intervention activities Police Ensure the safety and security in the community Support peer educators to carry out outreach harm reduction activities APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

8 Supporting services Expanding mobile services: VCT, STIs Expanding the beneficiaries of PEP Simplify administrative procedures for sex workers and drug users accessing services CAN THO: Partners Care International: Maintain the project that supports FSWS DSEP: mobilize resources to support peer groups Centre for legal aid, HIV/AIDS Centre Social organizations (CSO) International organizations through MoLISA and relevant ministries, peer groups Group work session 3: Provincial plans HAI PHONG: 6 month work plan 1. Enhance linkages between relevant stakeholders to maintain existing mobile services Activity Time Location Partners Expected outcomes 1. Meeting to build partnership and agreements between partners 2. Implementing the plan 3. Evaluating the implementation of activities Week 4/Jan 2015 Health Centre DSEP Police Health Peer group Owners of entertainment establishments Plan and specific tasks for each partner April 2015 Community As above Organise STIs check ups and VCT 90% of women have access to services June 2015 Health Centre As above Evaluating effectiveness and develop next 6 month plan APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

9 QUANG NINH Activity Timeline Responsible organization 1. Establish counselling services points in the commune Jan 2015 DSEP Advocate local government Develop a work plan Jan 2015 Issue decree to establish services point and formalize implementing procedures Jan 2015 Jan 2015 Training on counselling skills Feb 2015 Organise implementation Supportive monitoring Report periodically 2. Support self help and peer support groups Organize an induction meeting to introduce groups and their activities in provision of SRH/HIV services with concerned parties Training and capacity building for women s groups Assess the needs of women s groups and find resources to support women s groups and sustain their activities Provide volunteer working cards Provide IEC materials and condoms Monitoring to support women s group activities Report quarterly March 2015 March 2015 March 2015 Jan 2015 Mar - Jun 2015 Feb 2015 Jan 2015 Jan 2015 Jan 2015 DSEP DSEP Commune People s Committee DSEP, Women s Union, Health Centre DSEP, People s Committee DSEP, Health Centre, Women s Union, and Services points DSEP DSEP, Health Centre, International organizations, Vocational training centre DSEP, Health Centre, Women s Union, Culture and Tourism Department DSEP, Health Centre Self-help group APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

10 NAM DINH: 6 month work plan Activity Timeline Location Implementer Collaborator /Partner Objective 1. Establish peer groups DSEP find funding sources Field survey and advocate local government Find key persons to provide information for establishing peer groups Support to produce operational guidelines for the peer group, assign responsibilities for each member Decision to establish the group and launch the group Regular meetings and activities, training to improve knowledge and build skills Jan 2015 Sex work points DSEP Police, Women s Union, Health, Culture and Tourism Feb 2015 As above DSEP Police, Women s Union, Health, Culture and Tourism Feb 2015 As above National SW network DSEP and relevant agencies Mar 2015 As above DSEP Police, Women s Union Mar 2015 As above Local government Police, DSEP Apr Jun 2015 Local government, women s group Relevant agencies Objective 2: Establish a comprehensive services package Meeting to establish a Jan 2015 Location where DSEP technical working group to develop the package the intervention model being implemented Relevant agencies Develop work plan Jan-Mar 2015 Location where DSEP the intervention Relevant agencies model being implemented Draft the plan of a workshop on services provision Apr 2015 As above DSEP Relevant agencies APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

11 CAN THO: 6 month work plan Activity Timeline Responsible agency and partners 1. Workshop on enhancing provision of supporting services for PLWH and SRH/HIV services for sex workers Quarter I, 2015 DoLISA in collaboration with Department of Health and Women s Union 2. Training for social workers, peer educators, and collaborators in approaching and referring sex workers to SRH/HIV services Can Tho Plan: Quarter II, 2015 DoLISA in collaboration with Department of Health and Women s Union Group work session 4: National Planning Key issues raised in national level groups discussion and during individual discussions with national level participants: Identity cards: Valid Identity cards are a requirement for a wide range of services and for health insurance. APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

12 Sex workers are often mobile and don t have the correct identity card. This blocks access. Identity Cards are provided to peer educators in some provinces to assist them to effectively carry out outreach without police interference (and there is a national circular to support this). Sex workers without a legitimate Identity Card cannot obtain a peer educator card. Mobile sex workers often don t have this card as it is tied to their registered location. The issue of a lack of a permanent address as barrier to ID cards and access to health insurance Need to recognize that the mobility of sex workers strongly linked to the lack of an enabling environment. Laws that continue to criminalize sex work, and law enforcement practices that harass sex workers and reduce economic independence undermine access to HIV/SRH services. Environments of forced labour: In some places, establishment owners and managers act as barriers to sex workers accessing services in a way which may indicate that sex workers are not free to access services without establishment owners or managers consent. It appeared that these sex workers do not have freedom of movement and this may indicate that this is not sex work (i.e. adult consenting engagement in selling sex) but forced labor. Report on ILO activities and opportunities for collaboration: ILO is a key partner on: o gaining a better understanding what constitutes sex work and what constitutes forced labor UN cannot support engaging with establishment owners/ managers where there is forced labor o developing occupational health and safety guidelines for establishments where sex work takes place including entertainment venues massages parlors, karaoke bars etc Key areas for collaboration with ILO include: o ILO has a partnership with the Vietnam Chamber of Commerce and Industry (Representative of employers) involved in sensitization to issue of sex workers/ entertainment workers; engaging employers of entertainment businesses; tentative first steps to addressing informal workers in entertainment industry o ILO is working with the Confederation of Labour on a small project on improving working conditions of sex workers o ILO has conducted qualitative study on labour conditions of informal workers in the entertainment / sex industry (draft report available mid Dec 2104) o ILO is scoping a quantitative study with MoLISA on labour conditions of informal workers in the entertainment /sex industry o ILO has a new position focusing on forced labor Legitimizing the role of CSOs and NGOs: There is a set of complex laws/bylaws that directly regulate the rights, establishment and operation of CSOs. A good legal framework is needed to create a supportive and transparent environment for CSOs to effectively develop and best contribute, much larger issue than in relation to CBOs and sex worker networks. APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

13 3. Evaluation: Thirty-four participants returned completed evaluation forms. Here is a quick summary: 76% found the workshop either very useful or essential to their work 94% rated the overall presentation, delivery and content very good. Modules were rated as follows: Module Introduction Module 1: Context of HIV and SRH and Impact Among Sex Workers Module 2: Evidence-based Programmes & Services for Sex Workers Module 3: Engaging Sex Workers with HIV & SRH Services Module 4: Critical Enablers in the sex work environment Module 5: Planning ahead - identifying key priorities for change Rating 85% Very good 6% Excellent 85% Very good 12% excellent 70% very good 12% excellent 67% Very good 21% Excellent 39% Average 55% Very good 76% Very good 12% Excellent A range of qualitative comments were provided. The full report is attached in Appendices. APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

14 Appendix 1: Report on Training/Workshop evaluation 1- Information: Total of participants having workshop evaluation: 33 persons, including: 3 Health Staff 4 Women Union Staff 6 Peer Educators/Outreach Workers 20 Policy makers/program managers 2- Result of the evaluation Q1: Rate how relevant this workshop was to your position in your organisation 60% 40% 20% 0% 0% 3% Not useful A Little Bit Useful 21% Quite Useful 30% Very Useful 46% Essential Notes: About 2/3 participants think the workshop very useful and essential for their work Q2: Rate the overall presentation, delivery and content of the Effective HIV and Sexual & Reproductive Health(SRH) Responses among Key Populations 100% 94% 50% 0% 0% 0% 3% Poor Could Be Improved OK Very Good 3% Series1 Excellent Note: Most participants think presentation, delivery and content is very good APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

15 Q3: Rate each Module of the Workshop in overall delivery and content: 100% 80% 60% 40% 20% 0% 85% 85% 79% 70% 67% 55% 39% 21% 6% 6% 12% 12% 12% 3% 9% 12% 9% 3% 76% 12% 12% 1 (poor) (exellent) NA Notes: Most of participants have interested in introduction session and module 1,2,4 and 6 No. Question Responds from service providers (Health staff, Women Union) Q5 Three of the most important things you have learned during this workshop The role of peer, self help group Prioritized activities for SWs Cooperation and partnership of relevant sectors, agencies to support for SWs Comprehensive package for SRH/HIV intervention for SWs Empowerment for SWs and let they be equal partners Models of livelihood for SWs Planning Enable environment Responds from peer/outreach workers Connection between local authorities and PE groups Direction to support PEs The role of PEs PEs could be partners PEs will be able to join in planning process Enable environment Encourage the involvement of SWs to the program Models of livelihood for SWs Responds from policy makers and program managers SW play important role in harm reduction program ARV early treatment for SWs at potential risk of HIV transmission. livelihood for SWs Cooperation among relevant sectors to improve HR for SWs Concept of SW in the new context International experience Understand needs of SWs Role of PEs Participatory training methods, Priority based planning Evidence based planning Updated information on HIV situation in Vietnam Comprehensive Harm reduction package for SWs, SRH/HIV services and how to sustain it Lesson learned from other provinces APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

16 No. Question Responds from service providers (Health staff, Women Union) Responds from peer/outreach workers Responds from policy makers and program managers Enable environment Diversity opinions Right based approach Q6 Three actions that you will contribute to achieving the Priority Area Action Plans Support to establish and function PE groups Set up comprehensive package of services for SWs Enable environment Encourage the involvement of SWs to the program Training on harm reduction for social workers Support to distribute condom, syringe, IEC materials and referral to VCT, OPC, MMT BCC to SWs Referral to VCT, STI Communication Support PEs Connect to local authorities Strength capacity of PEs Referral to services Reach to new SWs Sharing communication experience Planning Develop policies to support HR for SWs Communication on HR Planning for HR and its implementation Advising support to services Setting up service referral Build up PEs network, support and connect with existing PEs Get feedback from PEs to advise policy makers Organize advocacy workshop to support HR models for SWs Empowerment to SWs Establishment of PEs and its functioning Coordination among local stakeholders HR Services for SWs Legislation support for SWs Vocational training for SWs Empowerment for SWs in income generation Q7 Strengths of the Workshop Group Discussion to solve critical issues Share lesson learned for various groups Good workshop content and delivery Evident based planning Group working Contents of presentations Participatory training Connection among participants Contents are appropriate and understandable. Facilitators are good presenters, Discussion on various HR models in provinces Planning process Group working Practical presentation Direct dialogs among PEs, Facilitators and other participants Sharing international experience on HR for SWs Using participatory training methods APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

17 No. Question Responds from service providers (Health staff, Women Union) Q8 Q9 Areas for improvement (weaknesses) for the Workshop programme or presentation: Thoughts or ideas on further training or capacity building required to assist your organization s capacity to work with Sex Workers in Vietnam: Questions for discussion should be clearer No too much theory Training document should be provided before each session More training games Heavy training sessions, languages barrier; need to take longer time Should have annual training to upgrade knowledge and skills of social staff Financial support to PE establishment in poor provinces Organise a field visit to learn about SRH/HIV services and SWs prevention and control in Hanoi Improve the coordination among sectors, agencies and PE groups Planning with existing resources Should provide training on HR for SWs for provincial stakeholders Responds from peer/outreach workers More training games Improve the coordination among sectors, agencies and PE groups. More training course to improve skills and knowledge of PEs SWs and PEs could raise their needs in the public Improve the knowledge about human right and SWs Responds from policy makers and program managers More examples inside and outside country Questions for discussion should be more clear Training document should be distributed in advance More pictures/documents relating contents of the workshop Languages barrier of interpreters Need more examples and lesson learned. Should have test right after module completion and Time and timeline to organize the workshop is not appropriate (end of year) Continuing training on HR in the locality. Need to have guideline to implement the policy. More information about the national policy on SW in Vietnam Organize more advocacy /orientation workshop for relevant authorities to get support for SWs Field visits to learn and share experience. More training courses for social workers Need to have more local stakeholders such as policemen, People Committees to participate in next training course More experience sharing Participation of PEs and APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

18 No. Question Responds from service providers (Health staff, Women Union) Responds from peer/outreach workers Responds from policy makers and program managers SWs in the workshop Note: Most of participants are happy with the contents and its deliver in the workshop, especially, SRH/HIV services Most of participants interested to hear and understand the need of SWs, they are willing to support Peer Educators establishment and functioning for HR There are 2 suggestions about it is a long training course (3 days is enough) and too much contents of training, it should be more concentrated. Noted by Dr Ngo Thi Khanh-UNFPA consultant APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

19 Appendix 2: Evaluation form 1. Please write your organisation and role: 2. Please rate how relevant this workshop was to your position in your organisation: Not useful A Little Bit Useful Quite Useful Very Useful Essential 3. Please rate the overall presentation, delivery and content of the Effective HIV and Sexual & Reproductive Health (SRH) Responses among Key Populations in Myanmar Workshop: Poor Could Be OK Very Good Excellent Improved 4. Please rate each Module of the Workshop in overall delivery and content: MODULE & SESSION Introduction & Overview of workshop programme and data Module 1: Context of HIV and SRH and Impact Among Sex Workers nh Module 2: Evidence-based Programmes & Services for Sex Workers Please rate each Module on a scale of 1 to 5 (1 = Poor to 5 = Excellent) Comment Module 3: Engaging Sex Workers with HIV & SRH Services Module 4: Critical Enablers in the sex work environment Module 5: Measuring progress and outcomes Module 6: Planning Ahead - Action Plans for Priority Areas APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

20 5. Please write down three of the most important things you have learned during this workshop 6. Please write down three actions that you will contribute to achieving the Priority Area Action Plans developed during this workshop 7. Please write down any strengths of the Workshop (such as presentation, content, activities, trainers): 8. Please write down any areas for improvement (weaknesses) for the Workshop programme or presentation: 9. Please write any thoughts or ideas on further training or capacity building required to assist your organisation s capacity to work with Sex Workers in Vietnam: THANK YOU APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

21 Appendix 3 Final program AGENDA TRAINING WORKSHOP ON IMPROVING THE HIV, SEXUAL & REPRODUCTIVE HEALTH SERVICES FOR SEX WORKERS IN VIETNAM : A DIALOGUE ON TRANSLATING POLICIES INTO PRACTICE Time: November th, 2014 Venue: Kim Lien Hotel, 7 Dao Duy Anh Street, Dong Da district, Hanoi. Time Items Responsible agencies/people Tuesday 25/11/ h00 09h10 Opening speech by Department of Social Evils Prevention Mr. Nguyen Xuan Lap, Director of Department of Social Evils Prevention 09h10 09h20 Speech by Department of Maternal and Child Health - MOH Ms. Luu Thi Hong, Director (MCH Department) 09h20 09h30 Speech by UNFPA Mr. Arthur Erken UNFPA Representative in Vietnam 09h30 9h45 Sex work in Vietnam - Harm Reduction Models being delivered by Ministry of Labour, Invalids and Social Affairs Department of Social Evils Prevention 9h45 10h00 Overview on Policies for Sex Work in Vietnam School of Public Health 10h00 10h15 10h15 10h30 10h30 10h45 Summary of Recently-released HIV Investment Framework for Vietnam Morning break Overview of the Program and Introduction of Modules UNAIDS in Vietnam Trainers APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

22 Time Items Responsible agencies/people 10h45 11h00 Summary of Needs Assessment and Expectations from Participants of the Workshop Trainers MODULE 1: Context of HIV and SRH Impact Among Sex Workers 11h00 11h15 11h15 11h30 Asia & the Pacific Data - HIV & SRH among sex workers STIs and HIV infection among female sex workers: epidemiological statistics Ms. Julia Cabassi Regional HIV Adviser, UNFPA Asia Pacific Regional Office Dr. Nguyen Anh Tuan National Institute of Hygiene and Epidemiology 11h30 12h00 12h00 13h30 Introduction of harm reduction approach into programs for female sex workers Lunch Break Trainers MODULE 2: Programmes and Services for Sex Workers 13h30 15h00 15h00 15h15 15h15 16h30 Overview of the Elements of the WHO Consolidated Guidelines and other Guidelines for Key Populations. Afternoon break Group Work: PROVINCIAL GROUPS Mapping against each element in the Consolidate Guidelines. Participants Trainers Wednesday 26/11/2014 MODULE 2: Programmes and Services for Sex Workers 08h00 09h30 Report back on Group Work Trainers 09h30 09h45 09h45 11h30 Morning break Technical Presentation Elements of a Comprehensive Package Trainers APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

23 Time Items Responsible agencies/people 11h30 13h30 Lunch break MODULE 3: Engaging Sex Workers with HIV & SRH Services 13h30 14h30 Panel Discussion: Needs of sex workers 14:30 15:00 Afternoon break 15:00 16:30 Innovative Models of Demand and Supply for Programmes and Services Trainers 08h00 09h30 Critical Enablers Thursday 27/11/2014 MODULE 4: Critical Enablers Presentation and group work How to strengthen the enabling environment for programmes among sex workers Trainers All Participants 09h30 09h45 09h45 11h30 11h30 13h30 Discussion Morning break Presentation and discussion on lessons learnt and partners involved in economic empowerment programme for sex workers. Lunch break Ms. Nguyen thanh Thuy DSEP All participants 13:30 14:30 HIV Treatment Cascade Trainers 14:30 14:45 Afternoon break MODULE 6: Planning Ahead 14:45 16h:30 Identifying the key priorities for improving linkages between services and access Trainers 08h00 09h30 Friday 28/11/2014 Planning against key priorities: practical steps, who to work with etc. Participants APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

24 Time Items Responsible agencies/people 09h30 09h45 Morning break 09h45 11h30 Presentation of the key points in Planning Participants 11h30 12h30 12h30 13h30 Presentation of summary of key points, priorities Closing remark Lunch Trainers DSEP Representative Representative from MCH Department APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

25 Appendix 4: Participant List LIST OF PARTICIPANTS AT THE CENTRAL LEVEL No Full Name Organization 1 Cao Văn Thành MOLISA 2 Lưu Thị Hiền MOLISA 3 Phạm Ngọc Dũng MOLISA 4 Phạm Tiến Thành MOLISA 5 Vũ Thúy Hằng MOLISA 6 Vũ Thị Bích Vân MOLISA 7 Nguyễn Trường Giang MOLISA 8 Phạm Văn Đông MOLISA 9 Lưu Thị Hồng MCH- MOH 10 Nghiêm Xuân Hạnh MCH - MOH 11 Vũ Thị Tuyết Mai MCH - MOH 12 Nguyễn Anh Tuấn NIHE 13 Nguyễn Đức Mạnh Vice Director - VAAC 14 Nguyễn Thị Phương Mai UNAIDS 15 Huỳnh Lan Phương UNAIDS 16 Lương Thị Tình Care Organization 17 Nguyễn Ngọc Thắng Care Organization 18 Đỗ Việt Dũng Care Organization 19 Nguyễn Thị Kim Dung SCDI 20 Bà Nguyễn Thanh Thủy DSEP Hanoi - Plan project 21 Bà Lê Quỳnh Lan Plan International 22 Ông Đoàn Tuấn Dũng Plan International 23 Vũ Như Khánh Plan International 24 Lê Mai Thảo Plan International 25 Phạm Thị Thanh Huyền ILO 26 Lại Minh Hồng Mặt Trời Của Bé 27 Nguyễn Phương Lan Mặt Trời Của Bé 28 Nguyễn Thanh Thủy Nơi Bình Yên Hà nội (National SW APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

26 network ) 29 Trịnh Thị Hòa Nơi Bình Yên Hà nội (National SW network) LIST OF PROVINCIAL PARTICIPANTS (Attend 4 days) No Full Name Organization 1 Trần Quốc Vương Director Quang Ninh Sub-Department of Social Evils Prevention 2 Lê Thị Thanh Huệ Quang Ninh Sub-Department of Social Evils Prevention 3 Chị Thủy Quang Ninh Sub-Department of Social Evils Prevention 4 Chị Linh Peers suport Group in Quang Ninh province 5 Dương Thị Thu Huyền Deputy Director Sub-Department of Social Evils Prevention 6 Lê Lan Anh Officer - Sub-Department of Social Evils Prevention 7 Trần Nhật Linh Officer Centre for HIV/AIDS control in Nam Dinh province 8 Ngô Thị Hoa Officer Women Union in Nam dinh province 9 Nguyễn Thị Mai Tuyết Chairperson Women Union in Quat Lam town 10 Nguyễn Đức Phan Director Sub-Department of Social Evils Prevention 11 Đào Xuân Hùng Sub-Department of Social Evils Prevention 12 Nguyễn Xuân Hải Sub-Department of Social Evils Prevention 13 Vũ Văn Anh Sub-Department of Social Evils Prevention 14 Đinh Đắc Trường Head of Labour, Invalids and Social Affairs Unit Do Son district 15 Đinh Thị Thành Ba Đồ Sơn Health care centre 16 Phan Thị Hồng Quyên Women Union Do Son province 17 Đinh Thị Huyền Bông Hồng Đen Group 18 Nguyễn Thị Quỳnh Trang Bông Hồng Đen Group 19 Nguyễn Thị Thanh Hoa Trinh Nữ Group 20 Nguyễn Thị Thanh Hường Women Union Hai Phong city APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December

27 21 01 Đại biểu Centre for HIV/AIDS Control Hai Phong city 22 Nguyễn Thàng Huy Can Tho Sub-Department of Social Evils Prevention 23 Nguyễn Thị Thanh Thảo Officer Can Tho Sub-Department of Social Evils Prevention 24 Võ Thị Năm Doctor Centre for HIV/ AIDS Control in Can Tho province 25 Huỳnh Thanh Thảo Deputy chairperson Women Union in Can Tho province 26 Trần Kim Mười Hoi Gia club 27 Hoàng Thanh Thảo Sub-Department of Social Evils Prevention, Ho Chi Minh city 28 Nguyễn Thị Thanh Hương Sub-Department of Social Evils Prevention, Bà rịa VT province 29 Nguyễn Kiều Anh Deputy Director - Sub-Department of Social Evils Prevention, Thanh Hoa province 30 Thành Officer - Sub-Department of Social Evils Prevention, Thanh Hoa province 31 Trần Diệu Thúy Sub-Department of Social Evils Prevention, Lào Cai province 32 Nguyễn Tường Long Sub-Department of Social Evils Prevention, Lao cai province 33 Phạm Thị Hồng Hải Deputy director Sub-Department of Social Evils Prevention, Phu Tho province 34 Phan Nam Khánh Sub-Department of Social Evils Prevention, Hue city 35 Lương Hoàng Nam Sub-Department of Social Evils Prevention, hue city APMG UNFPA Workshop: HIV/SRH in VietnamWorkshop report December