○ Orient health staff and health managers in existing potential for acceleration of primary health care (PHC) implementation through community mobilization, and in critical issues and methodologies for increasing community mobilization

○ Orient People's Committees and managers of non-health sector programs in need to strengthen PHC with focus on preventive health care and community mobilization; solicit their participation in community-based preventive care

○ Upgrade existing capacity of community-based mass organizations for delivery of education and information on appropriate family health care (including timely care, referrals to the public health system, rational drug use)

○ Develop capacity of mass organizations to mobilize families for community-based preventive health care activities and for increasing use of preventive MCH services

○ Orient Bamako communities in primary health care, in the proposed re-orientation of management and the delivery system in commune health services, and in the terms of referrals to Commune PHC Management Committees

○ Strengthen or develop community organizations for mobilization; identify on behalf of communities individual roles and responsibilities

○ Increase ability of grassroots workers to diagnose common ailments and provide adequate treatment, including correct drug dosage, so that community confidence in PHC services can be built

○ Conduct training courses on essential drugs and treatment of common diseases at community level in newly selected provinces supported by The Nippon Foundation in 1996

○ Develop supervision materials based on local needs; conduct training courses in provinces receiving essential drugs in 1995

○ Finalize social mobilization materials for district and commune levels; conduct training courses

○ Receive and distribute second year of bilaterally donated essential drugs to eight newly selected provinces

○ Completed baseline surveys of new 1996 project areas

○ Conducted workshop on social mobilization for health, which was co-chaired by the Minister of Health and the Vice-Chairman for the Central Committee for Science and Education

○ In collaboration with the Hanoi School of Public Health, initiated operational research on financial management of primary health care at district level

○ Conducted training courses for 2,100 Health Care Committee members at commune level on social mobilization activities

○ Trained trainers to instruct teachers from Provincial Secondary Medical Schools in essential drug administration and treatment of common diseases. Teachers in turn trained 2,060 commune health workers in initial eight project provinces

○ Printed and distributed to training courses in initial eight project provinces various training materials, including 9,600 copies of book, Essential Drug Administration and Treatment of Common Diseases at Community Level, and 1,000 copies of guidelines on how to conduct training courses on essential drug administration and common disease treatment at community level

○ Developed supervision materials

- Set up working groups at central and district levels

- Field-tested the materials in three different regions

○ Set up Integrated Health Care Committees at provincial and district levels in all sixteen provinces. Expanded to other provinces after review meeting in February 1996

○ With Health Education Center, developing health education messages for general population on rational drug usage and health education skills for health workers

○ Increased availability of drug at community level

○ Increased accessibility to all people

○ Increased general affordability of drugs

○ Raised morale of health workers by allowing feedback for improvement of working conditions and incomes in RDF system

○ Increased utilization of health services at community level

○ Improved sustainability at community level

○ See tables and graph

○ Since the government of Vietnam initiated the open policy in 1986, the number of health workers moving into private practice is increasing in urban and rural areas

○ Negative effects of private sector on community

- benefit-oriented

- increasing prescriptions of new generations of antibiotics

- lower affordability of more expensive drugs

- inaccurate dosages

○ Skills necessary for supervision unfamiliar to many health workers

○ Local health workers have limited skills for managing revolving drug funds

○ Training of health workers in some newly selected provinces too far in advance of drugs delivery

○ Strengthen supervision activities

- Establish/strengthen supervision teams at provincial and district levels

- Conduct training courses on supervision skills for members of supervision teams

○ Strengthen health education in communities

- Conduct needs assessment

- Develop health education materials with special emphasis on rational drug use

- Train health workers on communication skills

- Disseminate health education messages through mass media and at household level

○ Train health workers on rational drug prescription in the eight new project provinces

○ Conduct Workshops on Rational Drug Use for private physicians and drug sellers, with emphasis on rational use of antibiotics

○ Improve accounting and financing process at community level

- Complete operational research on financial management of primary health care at district level

- Develop financial management guidelines and forms

- Field test and finalize guidelines (emphasizing the revolving fund mechanism) for district and commune health authorities

- Revise materials

- Train health workers on accounting and financing process

○ Continue activities on social mobilization for PHC committee members

○ Plan workshops for provincial and district health authorities in project areas