TA PLAN FORM (v 4.8.14.

0)
USAID/SMART TA
ASSESSMENT PERIOD

1/10/2013

To

30/6/2014

DATE OF ASSESSMENT

20/8/2014

SITE INFORMATION

Van Ban OPC, Van Ban district, Lao Cai province

SERVICES PROVIDED

ARV for adults

ARV for children

HTC

MMT

PMTCT

C&S

Out-reach

TB

STI

AREA

City

Rural

Mountainous

OTHERS

Clients in prison

% total clients)

Ethnic group clients

% total clients)

Total clients under management:

HUMAN RESOURCES
Full-time: 8
Part-time: 1
Total: 9

Name

Position

Sau

OPC chief,
doctor
Doctor
Assistants
OPC nurse
OPC
pharmacist
Lab
Technician

Thom,
Thuy
Dao
Hoang
Cuong

Name of USAID/SMART
TA provincial site
monitor
Dr. Nguyen Thanh Ha

108 (14 Pre-ART/ 94 ART)

Contracted
Part-time
Full time

Gov
Part-time Full-time
X
X
X
X
X

Name of OPC chief

Name of PAC
representative

Dr. Nguyen Thi Sau

Dr. Dinh Thi Hoan

File assessment data

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TA PLAN FORM (v 4.8.14.0)

USAID/SMART TA

TA Assessment
Summary Results

Result

HUMAN RESOURCES

58%

STRUCTURE AND
ACCESS

74%

DRUG SUPPLY

52%

LABORATORY
CAPACITY

30%

DATA MANAGEMENT

30%

CASE MANAGEMENT

0%

ART/Pre-ART
DELIVERY

52%

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TA PLAN FORM (v 4.8.14.0)

USAID/SMART TA
SUMMARY RESULT OF HIVQUAL AND SMART TA INDICATORS
SMART TA
Standard

No Indicator

1
2

4
5
6

8
9
10

Proportion of medical record is more than 80%

of score used the patient chart review tool
Proportion of patients who newly registered at
the OPC in last 6 months are tested for CD4
within 15 days of enrolment
Proportion of pre-ARV patients who visit the
OPC regularly (according the national guideline
every 3 months and per appointment with
doctor)
Proportion of patients who were newly
registered at OPC was prescribed INH
Proportion of ARV patients visiting the OPC for
medication pick-up according to scheduled
appointment in the last visit
Proportion of ARV patients who are assessed
for medication adherence in the last visit
Proportion of patients were initiated ART within
15 days after qualification in last 6 months
Proportion of qualified HIV patients are
prescribed for Cotrimoxazole or DAPSONE for
the last visit
Proportion of patients are screened for TB in
the last medical visit
Proportion of patients are tested CD 4 at least 1
in last 6 months

Proportion of patients who still alive and on

treatment after 12 months on ART (NGI ID)
Proportion of patients retained in care after 12
12 months of registration (SMART TA
recommended ID)
11

Present result

Difference

Score

Pass or fail

0%

0%

Fail

75%

0%

Fail

75%

0%

Fail

80%

0%

Fail

85%

0%

Fail

90%

0%

Fail

65%

0%

Fail

90%

0%

Fail

80%

0%

Fail

85%

0%

Fail

85%

0%

Fail

80%

0%

Fail

80%

Last round result

SMART monitoring score

SMART TA classification

Improving

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TA PLAN FORM (v 4.8.14.0)

USAID/SMART TA

No

Issue

HUMAN RESOURCES
Dr. Sau is quite busy with Hospital
Treatment Activities. In reality,
Ms. Thom and Thuy (doctor
assistants) receive and provide
treatment services to OPC
patients.
STRUCTURE AND ACCESS
TB Infection Control:

1.

Solution

Hand on training at site is necessary

to these two doctor assistants

2.

Medical mask available but not

enough to deliver to all coughing
patients

IEC materials on Universal

Precaution: not available

Drs. Ha, Dr.

Hoan - Lao Cai
PAC

Supporter

Other
sources

Deadline

Actual
date of
completio
n

Note

Bi-monthly

Dr. Bich Thuy FHI 360

The air flow and environment is

good in term of IC
1.

Person in
charge

Monitor regularly to ensure 3Is

including IC and medical masks are
applied effectively

SMART TA, PAC to send UP IEC

materials to OPC including hand
washing procedure, safe coughing
guidelines

Drs. Ha, Hoan Lao Cai PAC

Regularly
OPC doctors
and nurses

Thanh Ha, Mai

Phuong FHI
360
Dr. Hoan
PAC

September
2014

OPC doctors
C

DRUG SUPPLY

There is interruption of OI drugs in

the last 6 months

There is an open discussion between

CDC-US-VAAC representatives and
leaders of PAC Lao Cai, Van Ban
Hospital on the mechanism of
purchasing OIs drugs.
PAC Lao Cai should follow up with
Van Ban to ensure the mechanism
will be applied at the soonest

Dr. Ha, PAC

Director
Dr. Hoan - PAC
Van Ban
Hospital
Director

September
2014

OPC Chief

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TA PLAN FORM (v 4.8.14.0)

USAID/SMART TA

LABORATORY CAPACITY

Basic tests have not been

prescribed for OPC patients since
the beginning

PAC Lao Cai is responsible for

discussing clearly with Van Ban
Hospital on how to find the simple
and most effective way to apply
basic tests for all OPC patients.

5 out of 10 cases in randomly

selection have not been tested
CD4 in the last 6 months

OPC staff should develop a plan of

CD4 test 1 month in advance and
inform PAC for better collaboration

GeneXpert and Viral Load have

not been implemented in Van Ban

DATA MANAGEMENT

Documentation: paper work,

lacking of e-logbook. Contact
information of patients have not
been updated regularly

Documentation: Three logbooks:

ART, pre-ART, daily medical checkup are updated, but not regularly.
There is no logbook to follow up
with transfer out patients.

Hand on training for OPC doctors on

GeneXpert and Viral Load

E-logbook will be issued very soon.

In the meantime, the triage nurse is
encouraged to use the Excel file of
HIVQUAL to manage and update all
OPC patients
Triage nurse, counsellor, C&S team
to talk to patients and their
supporters to update their contact
information regularly
All the key logbooks of OPCs should
be updated at least on weekly basis
for better management and reducing
the workload in the last minute.

Dr. Ha, Lao Cai

PAC Director
Dr Hoan, PAC
Dr Loan, Van
Ban Hospital
Director
Dr. Sau
Ms. Thuy &
Thom

Dr Thanh Ha,
Dr. Son, FHI
360

September
2014

September
2014

Dr. Hoan, PAC

Drs. Ha, Hoan PAC
December
2014

Dr. Thuy, FHI

360

Triage nurse,
counselor,
C&S

PAC

Monthly

Triage nurse

PAC

Sept, 2014

The transfer out logbook should be

developed and used regularly

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TA PLAN FORM (v 4.8.14.0)

USAID/SMART TA
F

1.

CASE MANAGEMENT

Patient Follow-up: Follow-up of

referral cases, patients late reexamination, poor treatment
adherence must be improved.

Triage nurse,
counselor

OPC doctors should refer to MoH

guideline (3003, 4159) and consult
with clinical experts from PAC or FHI
360 to ensure the treatment
activities are following regulations
and on track.

Dr. Ha, Hoan

PAC

PAC to
monitor

December
2014

ARV and PreARV Service

Clinical Stage classification is still
not appropriated

Plan: Increase the rate of retention

in care of the all the patients
including Pre-ART and ART
Do: Triage nurse records late reexamination, referral cases, phone
to them to remind for reexamination, confirm the successful
referral. Counselor provide
counseling session to the patients on
benefits of early treatment,
significance of treatment adherence,
etc; implementation of LTFU SOP
See: Check with the number of
patients who show late reexamination and poor treatment
adherence and see the records at
the record books.
Act: Continue with the action above
or change as appropriate.

Cotrimoxazole criteria has not

been noticed seriously
INH prescription is not
appropriated

Bi-monthly
Dr. Thuy, FHI
360

Clinical TA and on-site training would

be encouraged

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