This final report discusses a project implemented by Agronomes & Vétérinaires sans frontières (AVSF) and the Academy for Educational Development (AED) to train field public and private veterinarians and veterinary paraprofessionals on avian influenza (AI also known as avian flu or bird flu) using and building on a manual that had been produced by AVSF entitled “Prevention and Control of Avian Influenza in small scale poultry: A guide for veterinary paraprofessionals in Vietnam”. Project objectives were to disseminate the manual to all vets and paravets in 10 provinces; strengthen capacities of 10 provincial Sub-Departments of Animal Heath (SDAH); create an opportunity for private paravets / vets and public veterinary services to meet and share on the AI topic; and to further disseminate the manual outside the project area through establishment of additional
partnerships.

The first step in the projects was to contact the SDAH in each province to secure commitment. The second step was to hold the training of trainers (TOT) workshop. One staff of each SDAH attended the TOT training sessions. These participants were selected by the SDAH of each province with the commitment that, after attending the TOT, they would then organise and facilitate the meetings in district towns and the manual dissemination. The objective was to provide a short update about the current situation of AI epidemic in Vietnam and in other countries, relevant information about the avian influenza disease and its diagnosis. Basic information was given to the trainees about participatory methods of training
organisation, and different techniques for passing messages to a large audience. The manual was presented - its contents, the topics to underline and the way to present it to the private vets and paravets. The participants also explored details of AI outbreaks.

The implementation of district meetings was delegated to the SDAH staff trained during the TOT. This included contacting the District Veterinary Station (DVS) to send via them the invitations for private vets and paravets working as
practitioners in communes and villages, and organising logistics. The main objective of the meetings was to present the manual and explain its contents. After the presentation, some time had to be spent in order to answer the questions of
private vets and paravets and receive their comments.

Following the district meetings, a debriefing session was held with the SDAHs to collect information about the implemented district meetings, the difficulties encountered by the SDAH staff and get their comments and recommendations for the implementation of a possible second phase. It also aimed to provide feedback to SDAHs with the results of the observations done during the monitoring visits and for AVSF to get feedback from the private vets and paravets on the manual.

The report identifies the strengths of this project as being the ability to widely disseminate a technical document over a short time period and provide brief training on a specific topic. As well, some training topics allowed AVSF to identify further training needs for public veterinarians. The main weakness of the project was related to the poor use of participatory methods during the District meetings. It was found that the lack of education of public vets on participatory approaches and cultural practices made it very difficult for a short term project to avoid the usual top down approach. However, a deeper emphasis during the initial TOT and a stronger monitoring of the first District meetings could avoid some of the mistakes

Recommendations

1. Replicate the approach to additional provinces - This 3-month project showed that it was possible to actively disseminate technical documents and pass messages on a large scale, with limited budget and time. Additional partnerships shall be sought in order to complete the objective of dissemination of the manual to the 50,000 private vets and paravets over the 64 provinces of Vietnam.
2. Upgrade training skills of SDAH staff - regarding the implementation of the project, the main improvement that can be done concerns the methods for passing along important information during the district meetings. Two main recommendations can be made to achieve this:
   
   
   • Upgrade the initial training in terms of meeting facilitation skills and participatory
     approaches. As AVSF is not an organisation specialised in such fields, hiring a
     specialised consultant for the TOT may be an option.

   • Increase the time dedicated to the district meetings monitoring, and rather spend 2 or
     3 days with the SDAH staff in order to provide them technical guidance and better
     advise them on their training methods. The corollary recommendation of that is to
     increase the implementation period for a possible second phase. A 2-month
     implementation period for district meetings is too short to allow more than one day
     monitoring.

3. Use the approach for the dissemination of other technical documents - the methodology could be applied to
   any other topics and technical documents. Veterinarians and veterinary paraprofessionals in Vietnam are dramatically lacking of concrete, appropriate and easy to use documents, related to their daily activity. Other manuals could be produced on
   specific topics according to targeted needs, and disseminated widely at provincial or even national levels. The preliminary testing of those documents and their review by different stakeholders is crucial for the ownership of documents disseminated by their targeted people.
4. Produce a manual on basic epidemiology and detailed investigation of outbreaks - the short training / discussion session organised on the investigation of AI outbreaks showed that despite the considerable efforts put on AI training for public vets in the two past years, this subject was very poorly documented and disseminated to them. The methodology of “tracking back - tracking forward” outbreaks was almost unknown to public vets, though internationally recognised as an essential
   component of any animal epidemic control policy.
5. Set up of District veterinary networks - several comments from SDAH trainers, as well as letters and comments received from the Directors of the SDAH of 2 Provinces show that the principle of district meetings was
   interesting to private vets / paravets, and district / provincial public veterinarians. Several
   participants of the debriefing have asked for further support in order to keep organising
   district meetings. This concept of “district veterinary networks” was
   appraised by the Department of Animal Health in 2003 who recommended that AVSF
   further expand these networks to reach more provinces. In 2006, AVSF will further strengthen this kind of network in at least 14 provinces and 51 districts throughout Vietnam. The methodology used for the set up of district veterinary
   networks (DVN) will be documented and disseminated. Set up of DVN in other provinces
   and districts should be considered, as being one efficient way to strengthen linkages
   between animal health stakeholders, and an excellent media for information collection
   and dissemination.