The Mekong Regional Health Support Project (MRHSP) was implemented in all 13 provinces/city in Mekong Delta River from the early 2006 with the total budget of USD 85 millions. The project’s overall objective is to improve the access and utilization of high quality and financially reasonable health care service in this region, especially for the poor. After 5 years of the project, CCRD conducted the end-line survey from December, 2011 to May, 2012 to measure the change of project indicators as well as to provide independent evaluation on the outcomes, achievements and limitations of the project’s implementation. CCRD is also the independent organization that conducted both the baseline survey (2008) and the Midterm survey (2009) of this project.
Quantitative method was the main information collection method in the end-line survey to measure the change of project’s indicators. The sample size and randomized sampling method was applied similarly as the baseline survey to ensure consistency. In total, there were 3,550 households and 775 inpatients at 18 provincial hospitals and regional general hospitals in Mekong River Delta areas. Households were selected using randomized sampling method for population-based study. Hospital inpatients were also randomly selected using the list of in-patients who will be discharged from the provincial hospital the next day of the interview day.
In addition, qualitative method was used to provide more in-depth information for highlighted issues from the quantitative method. There are 16 focus group discussion and 31 in-depth interviews with the following target groups: (1) the poor/near-poor (2) the leaders of provincial hospitals (3) leaders of provincial preventive centers (4)Managers of the CPMU (5) Managers of the PPMU (6) representative of Provincial Social Insurance Department (7) health staff who received training supported by project.
To ensure consistency with the baseline and mid-term evaluation, most questions in the previous questionnaires related to the general population characteristics and project indicators were re-used for this end-line survey.
In overall, the project was successful in achieving all expected results for five project components after 6 years. By December, 2011, the project at central and local level has disbursed 98.5% of the total project budget, in which the project focused on the last two years of project life. The most striking success is to increase the health insurance coverage for the poor and the near-poor in the project provinces (95.9% and 42.1% respectively). The project outcomes increased nearly 6% compared to expected results or 3 folds increase as compared to the baseline. Similarly, the project also exceed its expected level in the respect of reducing mortality rates of two selected diseases which are: respiratory distress of newborns and trauma brain injuries, but the referral rate to the health facilities of Ho Chi Minh city did not decreased. Supply of medical equipment for the provincial hospital and provincial preventive centers was the main activities of project. Approximately 99% medical equipment supported by project were currently in use at health facilities and were fully met the actual demand of them. The number of health staffs received training supported by project exceeded the expected result at all type of training (long-term and short-term training) and type of specialty. These supports provided great opportunity to increase the qualification and technical capacity of health staff, which hardly materialized with the current Government budgets.
The Mekong Regional Health Support Project was perhaps the very first project of this type which was designed and implemented in Vietnam. On the other hand, it was one of very few project had design that allowed adequate rooms for flexibility and adjustment as well as strictly and effectively applies the result-based approach. After 5 years of implementation, thank to the great efforts of the staff of CPMU, LPMUs and to very high commitments from the local leaders, the project has harvested quite positive results, despite of difficulties and constraints it had to faced throughout its life. Besides, there had been some weakness and constrains that needed to be taken as lessons learnt for regional projects in the future focusing on management, communication activities, human resource and maintenance operation of medical equipments.