Table 2 Key stakeholders and their perceived benefits and challenges

TB patients

Patients noted that CHWs were the main benefit due to their ability to provide both tangible support (TB knowledge and counseling) as well as feelings of being supported and having a caring community. Encouragement from CHWs increased feelings of self-efficacy and motivated patients to prevent spread and complete treatment.

Isolation and stigma were the main challenges, in terms of the patients themselves, and in their perception of others. However, this value driver was indicated as a difficulty of the disease, not necessarily of the program.

Site coordinators & CHWs

The largest benefit project staff experienced for themselves was a sense of personal satisfaction when patients experienced positive health outcomes. Patients were viewed as friends or peers, creating a stronger sense of community.

A challenge faced by patients, which also translated to a challenge for project staff, was a lack of trust in the health care system. Staff encountered difficulties in contacting patients or convincing patients to obtain treatment at the district-level TB treatment facility.

TB Program

Direct support for ACF activities was mentioned as the greatest benefit. District-level TB healthcare providers noticed strengthened collaboration between the National TB Control Program, implementing partners, and the local government. CHWs were an essential bridge between stakeholders and provided consultation and advocacy for patients. The program provided direct support though GeneXpert tests, and this program support produced an increased number of TB patients detected and linked to treatment.

District-level TB healthcare providers felt burdened with an increased workload when being required to perform setup activities and manage community activities. The number of meetings, training, and reports were increased and many providers requested additional staff to assist with the workload.

Provincial and District Government

For government members, direct support for ACF activities was most beneficial, with an emphasis on the increase in concrete numbers such as households approached and individuals screened. They acknowledged the comprehensiveness of the program: approaching vulnerable groups, thorough data analysis, and tangible improvements.

A challenge was a fear and lack of trust of the government from TB patients, which made it difficult to reach patients and effectively communicate the aims of the program.

Viet Nam TB Ecosystem

Sponsors saw an improvement in their image, reputation, and partnerships. The project facilitated collaboration between all relevant groups which was mutually rewarding, and strengthened the credibility of the project.

During the project’s inception, the challenge was convincing funders that the project fit with the overall goals of the corporations. Through observing activities at the grassroots level and collaborating with local organizations, sponsors were able to change their mindsets surrounding the project.