Sustained capacity building of Local Health Workers in detecting and responding to Avian Influenza and Emerging Infectious Diseases : Achievements and challenges

USAID's Avian and Pandemic Influenza Initiative in Vietnam aims to improve public and private sector capacity to prevent, detect and control highly pathogenic avian influenza (HPAI) and enhance surveillance of HPAI and emerging infectious diseases (EIDs) at community level. The project has trained trainers and supported diffusion courses for village level animal and human health workers and communicators (e.g. commune cultural officers, Women's Union staff) across five provinces in Vietnam to enhance local competency and performance in recognizing and addressing EIDs. In 2011, the project conducted a post-training assessment to evaluate the effectiveness of the capacity building effort through self-administered questionnaires on health worker knowledge, attitudes and practices combined with focus group discussions and in-depth interviews for 1316 trainees, 220 trainers, and 59 local Animal and Human Health officers. While the assessment identified a high level of knowledge and positive attitudes in all groups six months to a year after the training courses, important challenges remain in sustaining changes and improvements. Key barriers at institutional and individual levels include: a lack of regular incentives (e.g. salary or allowances) for public animal health workers; shortage of resources, standardized tools and frameworks for follow-up, coaching and continued on-site training and learning; and high turnover rates of animal health workers. To address these shortcomings the project continues to work with local counterparts and partners on localized follow-up/coaching mechanisms while advocating with government counterparts for the formal establishment, recognition and funding of local animal health workers and networks.