1 Background Medical equipment is one of the major contributors to the rapid progress of healthcare and the improvement of public health services. The constant increase in the variety and complexity of available health technologies require good management capacity to allocate the resources efficiently. The review of the World Bank's global $1.5 billion investment in medical devices showed that there are cases where 30% of the more sophisticated equipment stock was unused and the rest had 25-35% downtime. A root cause turned out to be ineffective management including planning, acquisition and subsequent operations . In the context of limited public health care funding, ensuring resources for medical equipment and infrastructure is challenging for Vietnam. There is no official data by Vietnam Ministry of Health (MOH) on total budget for medical equipment investment, maintenance and effectiveness throughout the health system. There are international guidelines and recommendations by WHO, especially for developing countries, on how to organize the management according to the equipment life-cycle . How well Vietnam equipment management practice follow the recommended guidelines and how WHO guidelines and recommendations can apply in Vietnam are basic questions to be investigated. The research will thus address one important, but often neglected, building block of the Vietnamese health system; Technologies, with particular focus on finding determinants of medical equipment performance to improve management effectiveness via education and training intervention. 2 Rationale In Viet Nam, as in many other countries of a similar income level, health technology management is not well-developed. There is no sound evidence on the effectiveness of the health technologies. According to a recent report, the percentage of medical equipment in good use condition ranges from 20% to 50% of total medical equipment in use in hospitals at all levels. In addition, the percentage of equipment being maintained drops to 30% in central and provincial level hospitals, and even to 10% in district level hospitals . The education of e.g. public health experts and/or clinical engineers in Health Technology Management is not systematically taking place in Vietnam. However, Department of Medical Equipment Management at the Hanoi School of Public Health (HSPH), the only of its kind among all health related universities in Vietnam, is responding to the importance of this area and is eager to identify priority areas to be addressed in the curriculum of master of hospital management and continuous training for health professional training program. Access to functioning and safe medical equipment at the point-of-care is key for providing health care services to the population. Typically technology "intensive" services profit more from an improved technology infrastructure. In this sense, everybody using health care services will eventually benefit from the system change. 3. Importance There is no current data or studies of similar systematics or scope. In the area of health systems and policies, there is thus a great interest in obtaining such reference data. The research is proposed specifically in Vietnam because of its development level - the health care expenditure on health technology in relation to the presence of appropriate management practices and education is particularly poor, i.e. there is great potential for improvement. 4. Research Impact At all stages of the research, relevant stakeholders and policy-makers will be involved closely. The results of the research will on one hand inform the MOH in the development of policies and actions on the other hand allow the HSPH in curriculum development and on design further research.

The 3SIP2C project is focused on quantifying the types and amount of plastic waste entering the coastal margin of Vietnam, and understanding the pathways and destination of that plastic into the wider environment and marine life, and how this plastic impacts upon business activities such as aquaculture, fisheries, tourism and coastal communities. Vietnam's 3260 km coastline stretches across 28 coastal provinces and supports rural livelihoods that are engaged in coastal tourism, fisheries and aquaculture industries that are between them worth more than US$17 billion per year. These industries are themselves contributors to the plastic waste problem, but are also impacted by that waste, such that it represents a risk to civil society and business performance, health and safety. Our project will focus on plastic waste comprised of large (>50 mm), macro- (5 - 50 mm) and micro-plastics (<5 mm). The project is organised into five work packages, with Capacity Building and Engagement acting as the unifying theme throughout our proposed science, policy and governance programme. Our work packages flow from a fundamental understanding of the physical processes that transport plastics into coastal areas using 3 dimensional particle tracking models that account for seasonal changes in transport processes, and that account for the effects of tides, waves and freshwater inundation on these processes. We will couple this with a broadscale sampling strategy designed to gain insight into the characteristics and quantities of those plastics and the contaminants that are transported into the coastal system. This will be linked to a work package focused primarily on understanding the impacts and causes of large plastics on businesses and civil society associated with coastal communities, which will involve engaging citizens in collection of data on the distribution of large plastic through 'fishing for plastic' and the use of App technology. We take a deeper dive into the pathways by which macro and micro-plastics interact with the environment and interact with organisms, particularly those relevant to businesses such as fisheries and aquaculture. We will use experiments to understand how those plastics and their associated contaminants relate to health and disease threats in e.g. coastal aquaculture systems. We will interrogate the existing national and international legislations and policies that address the issue of plastics in supply chains and investigate where shortcomings in the integration of policies leads to shortfalls in their successful implementation. Finally, using a broad suite of techniques such as discourse analysis, focus groups, round-table discussions, gamification and citizen science, we will greatly increase awareness of the issues associated with plastic pollution and the effective solutions that could reduce its occurrence or its impacts on society. This engagement will interface with citizens at local, regional and national levels, and with managers and Government officials in relevant ministries. This proposal is ambitious with a multidisciplinary team from 8 research institutions and 7 partners in Vietnam covering all regions of the coastline, and HWU in the UK. Our engagement, impact and delivery are further strengthened by strategic partnerships with the wider non-academic collaborations through retailers (The Cooperative, UK; Sainsbury's), major seafood importers and processors (Labeyrie Fine Foods - Lyons Seafood) and a Vietnamese business consortium (IDH-Vietnam) and Vietnamese NGOs Centre for Marine Life, Conservation & Community Development (MCD), and global NGOs the Global Ghost Gear Initiative (GGGI) and Global Aquaculture Alliance (GAA). These partners provide the necessary access, expertise and impact translation to realise potential solutions that deliver demonstrable reductions in the causes and consequences of plastic waste in the environment.