What we do

Civil Society Development

Background

Civil Society embraces the general public at large, representing the social domain that is not part of the State or the market. Civil Society is a sphere where people combine their collective interests to engage in activities with public consequence. The increasingly accepted understanding of the term Civil Society Organisations (CSOs) is that of non-state, not for-profit, voluntary organizations formed by people within the social sphere of civil society. These organisations draw from community, neighbourhood, work, social and other connections.

The Disabled People’s Organisation (DPO) encouraged disabled people to share their dreams, to develop personal plans, and to help them to make those dreams and plans come true. As an organisation we grew our capabilities to support the holistic development of individuals, families and groups of people with disabilities (written by a disabled person from a village in Quang Tri Province during a reflection session in 2015).

MCNV’s response

MCNV has increasingly strengthened and cooperated with CSOs over the years. CSOs have become an increasingly common channel through which we assist elderly, women with HIV/AIDS, ethnic minorities, youth and People with a Disability (PWD) to exercise citizenship and contribute to social and economic change. The involvement of Community Based Organisations that are organised by the marginalised people themselves, ensures their full participation in our programs.

Besides working with a myriad of Community Based Organisations in Lao PDR and Vietnam, MCNV also collaborates with civil society organisations at provincial and national level. For example, MCNV has established and cooperates with provincial ‘Village Health Workers Associations’(VWHAs).

In the health system we are so close to villagers that people call us the “long arm” of the health sector. Our Village Health Workers Association was founded in 2006, and now has 1,115 members based in 138 communes in nine districts and towns of the province. On basis of our experiences in Quang Tri, two other Village Health Workers’ Associations have been established in Cao Bang and Phu Yen provinces, in 2010 and 2011. We for example support the Disabled People’s Organisations (DPO) and Old People’s Organisations (OPA) in fundraising activities. We also assist the Community Based Organisations to prepare dramas or to make video clips to lobby and advocate for better health practices and policies (Interview with Board Member of Village health Workers Association, 2015).

Achievements

To date, MCNV has strengthened and collaborated with over a hundred CSOs and CS movements in Lao PDR and Vietnam. In addition to that, MCNV has provided Technical Advice to Civil Society Partners in Sri Lanka, Tajikistan and Georgia, on the strengthening of Civil Society Organisations in their country.

Through CBOs and their clubs, peer-to peer support is channelled and improvements in policy implementation and policy development are lobbied for. For example, Old People’s Organisations in Quang Tri successfully lobbied for an increase of the district budget for health of the elderly.

Due to the flexible characteristics of CSO organisations and due to their profound local knowledge on the culture and values of communities in remote areas of Lao PDR and Vietnam, they are in an excellent position to collaborate with other societal groups in experimenting new approaches in health and sustainable livelihood. For example in Lao PDR, the CBOs at village level named ‘Village Development Committees’ (VDC) have been partners of the district department of agriculture in experimenting new rice varieties, cattle raising and fish ponds.

Trust relationships between villagers and district partners has improved. The VDCs are able to articulate the needs of the ethnic minority groups in the villages and this has led to more communication and achievements of program interventions in the villages. (Interview with consultant evaluating the program in Lao PDR, 2014).

Support women living with and affected by HIV

People with disability and Elderly

Background

HIV/AIDS epidemic has become the most emerging public health problems in Vietnam since 1990s. By the end of year 2015 there was a total of 227,000 people living with HIV while more than 75,000 people have died from AIDS. In estimation about 14,000 new cases of HIV are founded every year.

During 12 years working in HIV/AIDS area, MCNV had a considerable contribution to Vietnam HIV/AIDS situation in establishing and providing support to a community – based organization of women who are living with HIV, called Sunflowers, in seven Northern provinces in Vietnam. The program has contributed to improving access to health care for women living with HIV because of the strengthened referral system.

MCNV’s responses and achievements

Beginning in 2004, a group of women living with HIV was established by MCNV’s support. The simple aims were to ensure that, if pregnant, women can access to information and medicine that would help to prevent the transmission of HIV from mother to child. This initial pilot was successful in achieving its goals, and with the generous support of the Royal Netherland Embassy, it was scaled-up to a further three provinces between 2006 – 2009. In its third phase these achievements were consolidated and the model adapted to suit the needs of people living in remote mountainous regions. Then the program covers seven provinces and the Sunflowers group supports over 1,500 women living with or affected by HIV/AIDS and their families.

The Sunflowers groups help to ensure that they can overcome the barriers and obstacles they face to live active and fulfilled lives. This support comes in many forms, it includes: counselling and care at home and in hospitals, support to secure stable livelihoods, assistance with children’s education, and engagement with the community to reduce stigma and discrimination. Over more than 12 years the program has demonstrated that when women living with HIV work together their confidence and self-esteem increases enabling them to become powerful advocates for change and developments.

From 2012, after handing over, the network of Sunflowers had worked more independence with its own steering board of national level, and leaders of each provincial group. The Sunflowers are maintaining supports in improving health care access, income generating, and social by monthly meeting, revolving fund, and many supportive events. From this period, overcoming difficulties, Sunflower maintains its groups and networks with many valuable activities. More than 1,100 women living with HIV frequent attend the monthly meeting. Living with poor health status, many leaders of Sunflowers cannot be able to have a longer contribute to their group. Sunflower have refreshed themselves by changing most of group leaders and Network leaders and its structure.

In addition, MCNV provides health care insurance to Sunflower members, therefore, 100% of women living with HIV are protected by health insurance. The program also organizes vivid trainings to cultivate skills and knowledge to Sunflowers and their family members. Specifically, parenting skills were provided to grandparents who are raising orphan children. The training, such as hepatitis C prevention, ARV therapy, pig raising skills have been delivered to members of the Sunflower groups.

Future plan

Currently and in a couple of year MCNV is providing technical and a little financial supports, which is enabling the Sunflowers to be strengthened, and capable to work more independently as a Community Based Organization of women living with HIV, to bring support to women living with HIV continuously.

Sexual and reproductive health and rights in Dien Bien province

Health and Nutrition

Background

Youth in Vietnam, especially ethnic minority youth in mountainous areas, increasingly face health and social problems as a result of lacking the knowledge and skills of sexual and reproductive health and rights (SRHR). Vietnam has the highest abortion rate in the world, 83.3 abortions/1,000 women. In 2012, Vietnam had the highest incidence of new HIV infections in mainland South East Asia, and more than one-third of people living with HIV are under the age of 30. The HIV epidemic is growing most rapidly where education is poor, particularly in ethnic minority areas. Many of these problems can be attributed to a lack of comprehensive SRHR/HIV education for young people, who are not provided with the knowledge and skills they need to confidently and effectively protect themselves and others from unwanted pregnancy and infection. Only half of adolescents surveyed were able to correctly identify ways of preventing the sexual transmission of HIV. Young people increasingly engage in pre-marital sex and early marriage and childbirth are common. Poverty and remoteness limit access to information about SRHR. The little SRHR/HIV education available does not incorporate life-skills approaches. The effectiveness of health education programs are compromised by not being linked to quality youth-friendly SRHR/HIV services.

MCNV’s responses

To improve SRH in Vietnam, MCNV has strategies to support ethnic minority adolescents in improving accessibility of SRH education and services. We are now implementing a pilot project in Dien Bien called: “Open Door: improving access to sexual and reproductive health services for ethnic minority youths in Dien Bien high schools”. This three year project is implemented in two target schools, providing high quality life-skills-based SRHR/HIV education for ethnic minority adolescents, enabling them to make responsible choices and decisions regarding SRH and equipping them with the knowledge and skills to engage in safer sexual behaviors. This education is focused on ethnic minority youth in boarding schools and delivered through school-based youth clubs.

Technical guidance is provided by skilled SRHR health workers, teachers and women living with HIV. These clubs also aim to engage young people within the wider community outside the boarding schools, through a variety of innovative communication activities, such as drama, music and sports events. They also utilize social media channels to engage and communicate with young people. By doing this, the knowledge and skills of teachers are strengthened for better communication with young people about the sensitive topics of SRHR.

Future plan

In the future, MCNV expects to expand the SRH project to other schools in Dien Bien provinces and other provinces in Vietnam. After finishing the pilot project, the technical guidance for teachers would be published and introduced to education networks, from the national level through to district level. The work will also be distributed regionally, in particular through the new Adolescent Health Platform launched in Laos in November 2016.

Network of village health workers

Health and Nutrition

Background

In the health system of Vietnam, village health workers (VHWs) are grassroot based that are closely connected with villagers and are often called the “extended arm of the health sector”.

VHWs are not employees of the government; they are local community volunteers who receive special training for their community health work. The network of VHW is an important component for providing health care at the village level. The VHWs link the commune health centres with the villagers. They live in the villages where they work and provide simple health care and counselling to people, most of whom they know. The services given by VHWs are very important not only for the villagers but also for the government health system, especially to reach the poor and those living in remote areas with limited access to quality medical care.

MCNV’s responses

For many years MCNV has been helping to develop capacity and improve the quality of work of the VHWs in the three provinces of Cao Bang, Phu Yen and Quang Tri. In these provinces, the VHWs have established their own organizations called the Village Health Workers’ Association (VHWA) which function as local NGOs. Currently, these VHWAs are forming a network of approximately 3,000 members. The establishment of the VHWAs came in response to the expressed needs of VHWs in the provinces to foster learning and sharing for professional capacity improvement. In addition, they make it easier to voice the concerns of VHWs and villagers at higher health levels.

One of the most important tasks of VHWs is to give health educational communication at the grassroots level, as pointed out in Circular 07/2013/TT-BYT of the Vietnam’s Ministry of Health. To improve the quality of this kind of work, MCNV has helped the VHWAs learn and successfully apply many creative methods for behavior change communication (BCC). Some methods often used for BCC activities in the community include drama, shadow drama, folk composing and singing, participatory video, photo-voice and puppet shows. Although different in terms of techniques, these two-way methods of communication improve the interactions between VHWs and villagers and are applicable to almost any community health problem. The VHWAs now have good experience and skills in these methods, contributing to making people change their knowledge, attitudes and practices for better health in a more effective way. In the period of 2011 – 2015 the three VHWAs have used these methods to provide 807 communication events for different target groups and the communities, attracting the attention of over 26,500 people.

Achievements

The VHWAs are highly appreciated by local authorities and other organisations. For the past years the three VHWAs have cooperated with different organisations in the health sector, such as food safety departments, centres for HIV/AIDS prevention and district health centres, in community BCC actions. In Quang Tri, for example, the VHWA has trained groups of people living with HIV so that they can organize social events to communicate with villagers about HIV topics. The VHWAs also have good experience in working with ethnic minority groups in the border areas. One of the VHWA’s remarkable interventions is about using creative methods of BCC to communicate with groups of ethnic minority teenagers in some communes along the Vietnam – Lao PDR border, aiming at tackle the problems of unsafe sex practices and unexpected pregnancy.

The VHWAs also often train and collaborate with community based organisations, especially disabled people’s organisations, in using creative methods as a tool for expressions and life-skills development. In Quang Tri, the VHWA has been invited by other INGOs, including World Vision International and Handicap International, to provide trainings on creative methods of BCC for their partner organisations. In 2013, the VHWA joined in a consultancy mission together with MCNV to provide similar trainings to the UNFPA’s partners in Ben Tre and Hai Duong provinces. Earlier, the VHWA used to give such trainings for health workers and volunteers in Noong district, Lao PDR. In short, the VHWAs are now capable of providing technical support in creative BCC for health development projects/actions.

healthnetwork3 — VHWs facilitated puppet making as a life-skills development activity for disabled youths

The working model of the VHWAs in Cao Bang, Phu Yen and Quang Tri has been reported to and appreciated by the Ministry of Health. These three VHWAs could play an important role in upscaling the model to other provinces in Vietnam in future.

Climate Change Adaptation for the Poor Coastal Community in Ben Tre

Climate Change Adaptation, Improve Livelihoods

Background

Serious drought in Ben Tre 2016

The serious drought and salinity in Ben Tre other Mekong river delta provinces of Vietnam in the beginning of 2016 was declared as a natural disaster by the government. The shortage of fresh water for human consumption and agricultural production is especially affecting poor people living near the coastal areas.

A family lacks fresh water

Global Climate change is increasingly making direct impacts on the living situation of huge numbers of people in developing countries whose livelihoods depend strongly on natural conditions. People who earn their living from agriculture, fisheries and aquaculture are the most vulnerable. Natural events such as typhoons, floods, droughts and saline intrusion are happening more often and more intensely in recent years, eroding people’s assets and investments and pushing many back into poverty. The salinity in the main rivers (4‰ isohaline) had intruded about 45-65km from river mounths and the whole of Ben Tre province was covered by water with a salinity of 1‰. More than 20,000ha of rice in Spring-Summer crop had been lost. About 8,500 ha of fruit trees were partly damaged by the drought and salinity. More than 98,000 households (about 400,000 people) lack fresh water because they do not have enough containers to store rain water.

MCNV’s responses

MCNV quickly responded to the climate change issues in Ben Tre for the poorest people who are suffering most from the drought and salinity. The aim of MCNV is to create a sustainable mechanism which could help the poor maintain and step by step adapt their livelihoods to the more difficult natural conditions.

From May 2016, MCNV provided loans to help families to build big water containers to retain more rain water for human consumption during dry season. Loans from MCNV microfinance project in Binh Dai district allow poor family to build high capacity water container of about 3m3 each. Loans should be paid back monthly over 12 to 24 months so that it is convenient also for the poor. Up to August 2016, 150 households have borrowed from the MCNV project to build 286 big water containers with total capacity of 858m3. The loans for water containers will be available throughout this year and in coming years to create access for the poor to store more fresh water. Many more people can be supported by loans than with one time grant support.

A mushroom production workshop

With financial support from Jumpstart Foundation, MCNV collaborates with the Ben Tre provincial Women’s Union to establish women cooperatives, which provide stable jobs and income for poor women. These jobs help poor families to adapt to climate change by reducing their dependency on farming. Five women cooperatives will be established in Binh Dai and Ba Tri district for the production of mushrooms and dried fish, that will create jobs for at least 100 poor women. These cooperations will be the first test for more productive models for poor women in the future.

Future plan

MCNV would like to establish a livelihood adaptation knowledge website to share our field experience to help poor communities to improve their livelihoods by adapting to climate change. We believe this could be very helpful for other places and people who are facing the same problems.

At the same time, MCNV also looks for Corporate Social Responsibility programs to supply water containers to kindergartens, commune health centers and friendship houses for extreme poor people in Ben Tre. Creative trainings on adapted livelihoods should be provided widely to raise awareness for everyone to better prepare them for unavoidable climate change.

First members of dried fish women cooperative

Climate change impacts on livelihoods are very complex and many more poor communities will need comprehensive support to adapt to new situations. MCNV expects to find additional development partners to do practical field research and bring innovative methods that could help poor communities to stablise their lives and overcome the additional challenges from climate change.

This intervention records the first foot print of MCNV into the Climate Change sector. MCNV commits to support poor communities to adapt their livelihoods with best effective and innovative approaches to make this effort sustainable and helpful to poor people.

Support to people with disability

Health and Nutrition, People with disability and Elderly

Background

Approximately 7.8% of Vietnamese people are living with a disability (PWD) and about 75% of them are living in rural areas. Vietnam has ratified the UN Convention on the Right of People with Disabilities (CRPD). Accordingly, the Government commits to protect the rights of PWD based on the principles of equal opportunity and inclusive development in a barrier – free society. To realize these rights, the Vietnam National Assembly has approved the Law on Disability. Based on this, the Government has in the last 10 years developed and brought into operation many policies to support the PWD, focusing on health care, education, social security and vocational training.

Problem

However, many PWD are still excluded from different aspects of complete life. About 35 % of disabled children at primary schooling age have never gone to school while this applies to only 3 % among those without disability. Still about 42% of the PWD who can and want to work could not find a job; in comparison to 4% among those without disability. PWD are faced with many challenges in socio-economic development and in their daily life when they could not access transportation vehicles or public buildings; could not participate fully in social activities due to limited access to information and communication; could not benefit from developments as they were not heard and not counted sometime and somewhere. This situation is caused by the limited capacity of public service providers in policy implementation and the weak capacity of PWD in demanding and raising their voices while stigma and discrimination against disability still exists.

MCNV’s response to the problem

MCNV has invested a lot of resources over a long time to implement activities that support the inclusion of PWD in Vietnam. The Disablity program started with Community Based Rehabilitation (CBR) as a part of Community Managed Health Development (CMHD) program in Quang Tri in the 1990s. Then it was expanded to Dak Lak (1998), Cao Bang (2001), Phu Yen (2002), Khanh Hoa (2005), and Dien Bien (2014). Today MCNV’s Disability Program consists of 4 main components:

Medical Rehabilitation
Inclusive Education
Income Generating Activities
Empowerment for PWD and Disabled People Organizations

In the implementation of the Disability Program MCNV collaborates with Governmental partners from the national to the commune level based on the existing structure of the public service system. MCNV also always involves the PWD and their families in the process. The program focuses on creating new services that are suitable to the local context of culture and resources to ensure sustainable changes in the quality of life of PWD. Much attention is given to the building of capacity for all stakeholders, including the PWD themselves, from the individual to institutional level. All support for PWD are based on their real needs and distributed with their full participation.

Achievements so far

More than 20,000 adults and children with disabilities and their families have benefited from different types of medical, educational and economical rehabilitation and social support. About 60% of PWD improved their independent functioning in daily life as a result of home based rehabilitation and referral services. 70% of poor PWD have escaped from poverty thanks to MCNV’s financial and technical support to their Income Generating Activities. 88% of CWD at school age now have access to appropriate education in the project areas. In total 47 Disabled People’s Organizations (DPO) were supported to amplify the voices of PWD in communication and dialogue on policies and services in their communities. These DPO play a fundamental role to facilitate the participation of 55% members of DPO in social and sport activities on the local and national level. The CBR model initiated by MCNV was successfully documented and integrated into the rehabilitation policy by the Ministry of Health and replicated in other provinces.

Future plan

MCNV will apply the lessons learned in supporting PWD in new areas including the Northeast and the Mekong Delta. The program will focus on facilitating cooperation among stakeholders to ensure disability issues are integrated in the mainstream of society’s development. Specific projects will be designed for PWD and their organisations to improve their capacity in lobby and advocacy for the rights of PWD. MCNV also will strengthen its cooperation with Ministries and Institutions in development of disability – related human resources as well as in seeking evidence of cost – effectiveness that can be used for policies and decision making.

Mental Health

Health and Nutrition

Mental Health (MH) disorders significantly contribute to the worldwide burden of diseases. The health services and policies in Vietnam pay only limited attention to MH.

Development of occupational therapy in Vietnam

Health and Nutrition

Background

Rehabilitation has been developed in Vietnam for more than 40 years; it is still a big gap of Occupational Therapy (OT) development. The main rehabilitation practice in Vietnam is Physical Therapy (PT), yet there are currently no qualified occupational therapists in Vietnam. OT services are provided by physiotherapists with minimal clinical training in OT, or by occupational therapists from other countries who come for short periods. It is only available in a few large hospitals. Specific OT services were unavailable for mental rehabilitation, elder care, home-based care, school-based services for children with special needs, etc. The faculty (PT and Rehabilitation doctors) may not be well-equipped to teach OT in depth, due to lack of experience, equipment, and resources, limited information from books, especially those written in English. In addition to the lack of qualified OT doctors, those qualified with Masters to teach OT are not available in Vietnam. The participants of OT training survey were of the unanimous opinion that OT education needs to be commenced in Vietnam.

Being aware of the fact that OT is essential to provide comprehensive rehabilitation services, the Ministry of Health (MOH)’s orientation of rehabilitation development up to year 2020 stated that OT is one of specialized fields in rehabilitation. It is obligatory to establish Occupational Therapy Departments in Rehabilitation Hospitals as well as Provincial General Hospitals.

MCNV’s responses

In October 2015, MCNV received a fund from USAID to run a 5 – year project of OT training development in Vietnam. The project’s goal is to create the foundation and necessary conditions in order to develop the training system of professional OT in Vietnam, including the provision of OT trainers, competency-based training curriculum and OT-related policies. Specific objective of this project as follows:

To develop a group of capable OT trainers in HMTU and UMP HCMC.
To develop a 4-year competency-based OT curriculum at a regional level.
To pilot an OT Bachelor training course in HMTU and UMP HCMC
To set up two OT units for practicing during training procedure.

To implement this project in the context of having no OT experts and trainers, MCNV already approached School of Allied Health Sciences, Manipal University (SOAHS – MU), India to ask for technical support during the project implementation. Two universities in Vietnam were involved in this project including Hai Duong Medical Technical University (HMTU) and University of Medicine and Pharmacy, Ho Chi Minh City (UMP HCMC). The project has also received strong supports from Administration of Medical Service and Administration of Science Technology and Training, MoH.

Achievements so far

After almost one year conducting the project, the following results have been achieved:

Sending a group of 4 or more trainers from HMTU and UMP HCMC to one-month orientation course on OT in SOAHS – MU.
Sending a group of 5 Physical Therapists to an English course and Bachelor of OT course (BOT) in SOAHS – MU.
Sending a group of 6 key persons from MoH, HMTU, UMP HCMC and MCNV to the study tour on OT in SOAHS – MU.
Develop the BOT program outlines for full-time and part-time training courses
Develop the Syllabus of part-time BOT program which will be piloting at HMTU and UMP HCMC in year 2017.

In the coming years, MCNV will continue to run the program as planned to reach all objectives.

Microcredit and income insurance

Improve Livelihoods

Microfinance – A sustainable engine for development

Background

Impacts of microfinance to the poor

At the heart of the Sustainable Development Goals (SDGs) is a commitment “to eradicate poverty everywhere, in all its forms and dimensions by 2030”. Inspired from this goal, all MCNV programs in Vietnam are committed to contribute to poverty alleviation efforts by integrating microfinance tools to support marginalized groups who are normally the poorest in their community. Over the past 10 years, MCNV has disbursed micro finance services including loans for production and water retention, savings, and health insurance, to more than 7000 households with the total value of more than 650,000Euro in programs in Vietnam.

Microfinance has proved to be one of the most powerful engines in the global effort to end the crushing poverty that deprives hundreds of millions of the world’s people of sustenance and hope. Microfinance gives poor people the opportunity to establish an existence and to create a future with prospects.

MCNV loan allow her to build water containers to save rain water to prepare for draught and salinity

Micro loans, saving and other financial services in combination with financial literacy trainings could greatly help the poor start-up their micro-businesses to generate income . This would provide the clients and their families with greater qua
ntities and more nutritious foods, education for their children and to the opportunity to improve their houses. Consequently, microfinance has an impact on the future generations.

Microfinance has a positive impact far beyond the individual household. Jobs are created, knowledge is shared, civic participation increases, and women are recognized as valuable members of their families and communities. Microfinance could also improve the community solidarity and connection between people.

An equally important part of microfinance is the revolving mechanism in using funds from donors so if microfinance is managed well, it could allow a certain amount of funding to serve more and more poor families. These funds would be more beneficial longer term so the impacts will be multiplied in comparison with other kind of development grants.

An extreme poor old lady received a friendship house built from MCNV microfinance projects in Ben Tre 2015

Micro-entrepreneurship is the key for the poor’s self-empowerment. It turns the poor from a passive and weak role in the development process to active agents of change. The personal talents and community support are fully mobilized for business development and this process is the best capacity building for those who are poor. Microfinance directly impacts and benefits women’s empowerment since microfinance particularly focus on women and gradually consolidates the role and capacity of women in family and in the community.

Future plan

In recent decades, the microfinance crises have showed that microfinance could harm the development if being used in an extreme way. So MCNV is making its effort to balance the social and financial performance of microfinance projects by using Social Performance Management (SPM) system. Applying the SPM permits microfinance assist the poor to escape poverty while ensuring the whole microfinance system runs as healthy as a double bottom-line financial institute.

MCNV also wants to share and expand the best practice in microfinance and social performance management to other organizations and communities. We look forward to like-minded partners and donors to promote the real microfinance with focus on social performance and sustainability.

What we do

Sexual and reproductive health and rights in Dien Bien province

Background

MCNV’s responses

Future plan

Network of village health workers

Background

MCNV’s responses

Achievements

Climate Change Adaptation for the Poor Coastal Community in Ben Tre

Background

MCNV’s responses

Future plan

Mental Health

Development of occupational therapy in Vietnam

Background

MCNV’s responses

Achievements so far

Microcredit and income insurance

Microfinance – A sustainable engine for development

Background

Future plan

History & General Introduction

Our Main Partners

Our Supervisory Board

Our Teams

Vision & Mission

about mcnv

recent posts

Microcredit and income insurance