Edward Frongillo: https://orcid.org/0000-0002-8265-9815
Capacity Building (organization & administration); Delivery of Health Care (organization & administration); Government; Health Planning (methods); Humans; Nutrition Policy (trends); Planning Techniques; Politics; Quality Improvement; Vietnam
Vietnam has been decentralizing nutrition planning to provinces, which could help with local relevance and accountability. Assessment in 2009 found a continuing top-down approach, limited human capacity, and difficulty in integrating multiple sectors. Alive and Thrive (A&T) provided targeted assistance and capacity-building for 15 provincial plans for nutrition (PPNs). We aimed to (i) assess PPN content and quality improvements 2009-2014, and (ii) explain processes through which change occurred. Data consisted of interview-based assessments of provincial planning processes, annual PPN assessments, and tracking of A&T involvement. At endline, some provinces produced higher quality plans. Local planning skills improved, but capacity remained insufficient. Awareness of and support for nutrition improved, but some policy and legal environments were contradictory. Objectives were clearer, but use of data for planning remained inconsistent. Provinces became more proactive and creative, but remained constrained by slow approval processes and insufficient funding. Targeted assistance and local advocacy can improve decentralized planning, with success dependent on policy and programming contexts and ability to overcome constraints around capacity, investment, data use and remnants of centralized planning. We recommend strong engagement with planners at the national level to understand how to unblock major constraints; solutions must take into consideration the particular political, financial and administrative context.
Digital Object Identifier (DOI)
Published in Health Policy and Planning, Volume 31, Issue 10, 2016, pages 1333-1341.
© The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Harris, J., Nguyen, P., To, Q., Frongillo, E., & Menon, P. (2016). Progress in improving provincial plans for nutrition through targeted technical assistance and local advocacy in Vietnam. Health Policy And Planning, 31(10), 1333-1341. https://doi.org/10.1093/heapol/czw067