thi tran'^l NhOng n a m qua, Benh vien da khoa tinh Lai Chau va cac Trung tam y td' tuye'n huydn ludn n h a n duge sU quan tam, cM dao kip thdi eua Sd Y te trong vide bao ve va eham sdc
Trang 1Chfnh sach y te doi vdi dan tdc Cong va Sila d huyen MiTdng Te
va Nam Nhun, tinh Lai Chau
LE MINH ANH*
PHAM T H I THU HA*=
Tom tdt: Cdng vd Si La Id hai tpc ngucd cd ddn sd rdt it d nii&c to, tap trung chu yeu
& xd Nam Khao, Can Hd (huyin Mudng Te) vd xd Nam Chd (huyen Nam Nhiin), tinh Lai Chdu Theo sd lieu dieu tra ndm 2014, ngu&i Cdng d Lai Chdu cd 1.256 ngUdi (chiim 0,32%), ngU&i Si La cd 521 ngiiai (chiim 0,14%) Cupc sdng cda hg chu yiu gdn liin v&i sdn xudt nong nghiep vd khai thdc cdc sdn vdt tu nhiin Nhiing ndm qua, ngdnh y te tinh Lai Chdu dd triin khai nhiiu chUOng trinh, chinh sdch nhdm ndng cao nhu cdu chdm sdc sUc khde & cdc tpc ngu&i thiiu sd, trong do cd ngU&i Cdng vd Si La d hai huyin Mudng Te vd Nam Nhun NhUng chinh sdch ndy da giup cho dong bdo cd ca hpi diigc tiep can vd hUdng thu cdc dich vu y ti, hgn che chuyin tuyin dieu tri khi khong cdn thiit Tuy nhien, do dia bdn cu tru cda ngUdi Cdng vd Si La & vung sdu, vung xa nen cung gdy ra nhUng khd khdn khong nho trong viec triin khai mpt sd chiOmg trinh, chinh sdch y ti DUa trin kit qud nghiin cdu tgi hai xd Nam Khao vd Can HS (huyin Mu&ng Te) vd xd Nam Chd (huyin Nam Nhdn), bdi viet gop phdn cung cdp nhUng tU lieu mdi
vi mpt sd chinh sdch y ti ddi v&i ngU&i Cdng vd Si La trong bdi cdnh hiin nay
Tit khoa: Chinh sdch y ti, ddn tpc Cdng, ddn tpc Si La, Mu&ng Te, Nam Nhun,
Lai Chdu
l T h t f c t r a n g c l i i n h s a c h y t e h i ^ n n a y cham sdc sflc khde eho ngudi dan thdng
qua sfl phat t r i l n cua mang ludi y te Hien
1.1 Chinh sdch phdt trien mang i- i - D m
nay, toan tinh co 8 Irung tam y td
litdfi y te huygn/thanh phd, 1 benh vien da khoa, 2
Trong nhflng nam qua, nganh y t l tinh benh vidn chuydn khoa, 15 phdng kham da Lai Chau da ed nhieu nd Ifle trong vide khoa khu vflc va 108 t r a m y t l xa, phudng
Trang 2thi tran'^l NhOng n a m qua, Benh vien da
khoa tinh Lai Chau va cac Trung tam y td'
tuye'n huydn ludn n h a n duge sU quan tam,
cM dao kip thdi eua Sd Y te trong vide bao
ve va eham sdc sUc khoe cho ngUdi dan
trdn dia ban
Trung tara Y td' huyen Mudng Te Mgn
nay gora ed 14 Tram y te xa/thi tran, 1
benh vidn da khoa, 1 dpi y te dU phdng, 1
dpi eham sde sflc khde sinh san va 3 phdng
kham vdi tdng sd 90 giudng bdnh, 33 bac
si (trong do cd 6 bae sT chuyen khoa I), 72
y SI, 42 dilu dfldng, 22 dfldc si, 18 nfl hp
sinh, 6 ky thuat vien, 10 can bd dan sd va
30 can bd khac'^'
Tmng tam Y te huyen Nam Nhun dflgc
cMa t h a n h 3 khoi, gora: khd'i Hanh chinh,
khd'i Dfl phdng va khdi Dieu tri Khd'i Hanh
ehinh gom cd 3 phdng: Phdng To ehUc
-Hanh chinh quan tri, Phong Ke hoach
NgMep vu va Phong Tai vu; khd'i Dfl phdng
gbm cd 2 dpi: Dpi Cham sdc sflc khoe sinh
san va Dpi Y te dfl phdng; khdi Dieu tri
gbm 5 khoa: Khoa Kham benh, Khoa Ndi
NM Lay Hoi sflc ca'p cflu, Khoa Ngoai
-s a n - Chuyen khoa, Khoa Can lam -sang va
Khoa Dupe Trung tam co t a t ea 149 can bp,
vien chfle; trong dd cd 15 bac si da khoa, 72
y si, 21 dilu dfldng, 13 dflgc si, 7 nfl hd sinh,
2 ky thuat vidn xet ngMem'^'
Trong he thd'ng ehara sdc sflc khde cdng
lap, T r a m y te xa la ncfi d^u tien ngU&i dan
c6 t h e t i l p can kM o'm dau, dich benh va
eac v^n d l lidn quan dd'n sflc khoe NMem
vu cua Tram y td' xa la thfle Mdn vide eham
cac dich vu kham, ehfla benh, eae chfldng trinh y td' qud'e gia, phat Men sdm va trien khai nhuftig bidn phap phdng, ching dich benh xay ra tren dia ban Vdi ngfldi Cdng
va Si La - noi dau tien hp cd the de dang tid'p can va kham, ehfla benh la Tram y te'
xa Nam Khao, Tram y t l xa Can H i
(huy-en Mfldng Te) va Tram y te xa Nam Cha (huyen N a m Nhun)
Ben canh ed sd y te tuyen tinh, huydn,
xa tM Y t l thon ban dflpc coi la "ehan r i t " cua y te' tuye'n xa, lam viec dfldi sU eM dSn, giam sat cua Tram trudng y te xa hay ngu&i dugc Tram trUdng y te uy quyin Trong tuyg'n y t l tai thbn ban edn eb thdm mdt sd' ehflc danh nhfl cgng tae vidn dan
so, egng tae vign dinh dUBng, cb dd thdn ban Khao sat tai dia ban cho thay, eM ed ban Nam Khao (xa Nara Khao) vSn duy tri chfle danh cpng tac vidn dan sd, cbn lai da
sd y te' thon ban Mem ludn cdng tac dan sd'
va dinh dudng^*'
Chinh saeh phat t r i l n mang lUdi y t l tai tinh Lai Chau da giup cho ngUdi Cd'ng
va Si La ed nMeu eu hdi Ifla chpn cae cd sd
y t l Theo bao cao eua Tram y te xa Nam Khao nam 2017, cd 3.239 Iflgt ngfl&i den khara ehfla bgnh, dat 87,5% cM tieu de ra; trong dd ed 2.344 Iflgt kham ehfla benh cho ngfldi ngheo, 102 Iflgt dieu tri ndi tru, 3.137 Iflgt dieu tri ngoai trii Tai xa Can
Ho, n a m 2016 cb 4.726 Iflgt kham ehfla bgnh; trong dd cd 2.903 Iflgt kham ehfla bgnh eho ngfldi ngheo, dat 88,3% cM tidu dflge giao NgMen cflu tai xa Nam Cha
Trang 3Nghien cdu Dong Nam A, sd_6/2^jZ
2017, so Iflgt ngfldi kham chUa benh tang
tfl 3.124 Iflgt len 4.188 Mgt Khao sat tai
dia ban cho thay, mac du mang lUdi y te d
tinh Lai Chau duge Mnh thanh va phat
t r i l n kha sdm, nhuhg ngU&i Cong va Si La
cM thfle sfl quan tam va tiep can vdi cac eU
sd y te khoang 10 nam trd lai day, dac biet
la sau tai dinh cfl thuy dign Lai Chau n a m
2014 So vdi nen y hpc el truyin da phat
trien lau ddi tM he thbng Tay y da the
hien nhung uu dilm vupt trdi trong vide
phat Mdn sdm va giai quye't nhanh nMeu
can benh khd ehfla Sfl phat trien eua
mang Ifldi y te va Meu qua ehfla benh
trong thdi gian qua da gbp phan nang eao
nhan thfle, mem tin eua ngfldi Cong va Si
La trong viec eham soc sflc khoe theo
phflong phap khoa hpc Men dai
1.2 Chinh sdch ve nhdn lite y te
Dd'i vdi mgi linh vflc tM eon ngfldi ludn
dbng vai trd trung tam, quye't dinh sfl
thdnh cdng, phat t r i l n eiia linh vflc dd Vdi
linh vflc y te tM vai trb eua con ngu&i edn
quan trgng ga'p bdi kM k i t qua dieu tri phu
thupc ehii ye'u vao dpi ngu bae si Chinh vi
vay, eac ehinh saeh lien quan d i n dao tao,
phan bo nguon n h a n lUc y te se ed a n h
hudng ra't ldn d i n vigc dat cae mue tieu
cdng bang, Meu qua va phuc lgi xa hgi eua
nganh Y^^'
Cdng tac phat trien nhan lUc y te trong
thdi gian qua tai tinh Lai Chau da dat dupe
nhOftig t h a n h tflu dang ke, dae biet UBND
tinh luon ban h a n h nMeu cMnh sach d l
thu hut ngudn nhan Iflc cho tinh, trong dd
toan nganh y t l cua tinh cd hun 3.076 can
bb, nhan vien; trong db, tuyen tinh la 1.118 ngfldi; tuye'n huyen 1.297 ngUdi; tuyln xa 661 ngUdi va 1.077 ban cd n h a n vign y t l thbn ban, 174 ed dd thdn ban;ed
387 bae si, 43 dUpe sy dai hpe, 98 dieu dudng, 26 CUf n h a n y te ebng ebng, Hien nay, cb 108/108 Tram y t l xa/phUdng/thi tra'n cd nhd tram, 66,7% Tram y te xa co bac si lam viec (trong db cd 13,8% Tram y
te cd bae si bien c h i tai tram), 84,6% Tram
y te eb nfl hb sinh hoae y sy san nhi, 95,5% thdn, ban cb nhan vidn y te boat dpng'^'
De nang eao ehat Iflpng nguon nhan Iflc hign ed, nganh Y te tinh Lai Chau da tham muu vdi UBND tinh v l edng tac dao tao nang cao nang lue eho nguon n h a n luc nganh Y Theo dd, nMeu van ban da duge ban hanh nhU: Quye't dinh sd
42/2004/QD-UB ngay 30/7/2004 cua 42/2004/QD-UBND tinh Lai Chau ve cMnh saeh hd trg dao tao, boi dudng va thu hut ddi vdi can bb, ebng chfle, vien chfle di hgc va d i n cong tae tai tinh Lai Chau; Quye't dinh so 29/2011/QD-UBND ngay 06/10/2011 eua 29/2011/QD-UBND tinh quy dinh ve chinh sach hb trg dao tao dd'i vdi can bp, ebng ehflc, vibn chfle di hpe va thu hut nhflng ngfl&i tinh nguyen d i n Lai Chau edng tae; Quye't dinh sd 46/2014/QD-UBND ngay 29-12-2014cua 46/2014/QD-UBND tinh v l viee ban hanh quy dinh thfle hign eMnh sach thu hut nguon nhan lUe va hb trg dao tao, bbi dudng dd'i vdi cdn bd, cdng ehflc, vien ehUe trdn dia ban tinh Lai Chau Trong 6 thang diu n a m 2017, Sd Y te tinh Lai Chau da cfl 03 vidn ehflc di hge Idp dai hoc; 05 vien chfle di hpc Idp cao dang; 17
Trang 4vien chUe di hpc Idp Trung ca'p Ly Man
CMnh tri; 18 vien chfle di hgc l&p Quan ly
n h a nude chuong trinh Chuygn vidn; 17
ngfl&i di hpc Idp Chuygn vidn chinh; 115
edng chfle, vien ehflc di hgc Idp tieng dan
tdc Hmdng; 90 cdng ehflc, vien ehflc di dn,
dfl tM dai hgc va sau dai hpc Ben canh dd,
Sd Y t l tinh edn mcf 01 l&p bbi dfldng Me'n
thfle Y hpe co truyin cho 29 vien chfle lam
viec tai Trara y te xa/phu&ng/thi tra'n, md
02 Idp dao tao n h a n vien y t l thdn ban eho
60 hpc vien trong thdi gian 3 thang, mcf 01
16p y sy da khoa eho 30 hpc vien cua nflde
CHDCND Lao, duy trt dao tao 02 Idp dai
hpc dieu dfldng tai trfldng Trung cap y te,
dong thdi cdn dao tao h e n tuc ve ehuyen
mdn cho 311 vien chfle nganh y te'"''
Tai Trung tam Y te huyen Mfldng Te va
Nam Nhun, lanh dao Trung tam thfldng
xuyen ra soat nhu e^u dao tao hang n a m
eho can bd y te, dae biet la can bb y t l
tuyen xa Trong n a m 2018, cd 04 can bp di
hgc bae si da khoa va 05 can bb di hgc dai
hge dieu dudng Hien nay Tram y t l xa
Nam Khao (huyen Mudng Te) ed 6 can bp
(3 bien ehe va 3 htfp dong), trong db eb 4
y si da khoa, 1 dflgc si va 1 y ta; Tram y te'
xa Can H i (huyen Mu&ng Te) cd 5 can bd
(4 bien che va 1 hgp dong), trong dd ed 1
bac si, 2 y si, 1 nfl hd sinh, 1 dugc si; Tram
y te xa N a m Cha (huyen Nam Nhun) c6 5
ean bb, trong do cM cb 4 y si da khoa, ehfla
cd bac si, dugc si, dilu dUBng, nfl hd sinh
Nhflng can bd lam viee tai cac Tram y te
ludn khdng ngdng eung eo, nang eao tinh
t h a n traeh nhiem, thai dd phue vu cham
dilu y dflc va quy tac flng xfl cua ngfldi lam edng tae y te'.Dbi ngu can bd cua Tram ebn
la nhuiig ngfldi tre tuoi, nMet tinh, ed trach nMem vdi cdng viec va eb vai trd quan trgng trong cham sdc sflc khoe cho ngfldi Cd'ng va Si La trdn dia ban
1.3 Chinh sdch tdi chinh cho y te
CMnh sach tai ehinh y te la mgt trong nhiJng cMnh saeh quan trgng nhat quylt dinh den cong tac bao ve va eham sde sflc khde eho ngfl&i dan.Sau hcfn 2 n a m thfle Men D l an "Nang cao ehat lugng boat ddng he thdng y td' eo sd giai doan 2016-2020", Ban Chap h a n h Dang bd tinh Lai Chau da huy dbng nMeu nguin lUe de dau
tu, nang ea'p trEuig tMet bi y te eho cae tuye'n Nhd do da giup cho vide kham, ehfla
benh ban dau eua ngU&i Cd'ng va Si La b
hai huyen Mudng Te va Nam Nhun dupe thuan tien va Meu qua hOn
D i n nay, benh vien da khoa tuyen tinh
va Trung tam Y te huyen MU&ng Te, Nam Nhun deu eb he thdng may mbc y te' Men dai phue vu edng tac ehan doan, dilu tri ehuyen sau nhu may chup CT-Scanner, phau thuat sp nao, phau thuat npi soi, chay than nhan tao, tru sd lam vide tUcfng ddi khang trang Tuye'n xa cung dflpc tang cudng ve eu sd vat cha't, trang tMet bi, trong dd Tram y te xa Nam Khao, Can Ho (huydn Mudng Te) v l cu ban duge trang bi tren 80% danh rauc trang thiet hi thiet ye'u theo quy dinh Tram y te' xa Can Hb da dat tigu cM qud'e gia ve y te xa'^'
Ve eo ban, eae Tram y te xa da dam bao
Trang 5so Nghien cdu Dong Nam A, i6/20jt
kham, ehfla benhva thUc Men cae chUcfng
trinh mue tieu y te qud'e gia theo phan
tuyen quy dinh Tram y te' xa Nam Khao
(huyen Mu&ng Te) Men nay ed 10 phbng:
phdng h a n h cMnh, phdng true, phdng
tiem, phbng eham sde sflc khde sinh san,
phbng thu thuat, phbng Methadone, phdng
bdnh nhan, phdng kho, phdng dflgc, phbng
truyin thbng; 03 phdng tap t h i danh eho
can bd y te; 01 nha bep/nhd an danh cho
benh nhan; 01 vU&n thud'c Nam dign tich
300m2; 02 dan may vi tinh va may in; 02
tu lanh; 01 may hap, s^y; 01 may phat
dien'^' Tram y te" xa Can Ho cflng g6m 10
phbng, dd Id phbng hanh ehinh, phdng
Ddng y, phbng kham benh, phdng tidm,
phbng trfle, phbng san, phdng thu thuat,
phdng benh, phdng kho/dflgc Thude men
cua Trara eu ban day du, dflge nhan ve
hang thang'^"' Trara y td' xa Nam Cha
(huyen Nam Nhiin) do dia ban ebn nMlu
khb khan nen eac cu sd vat chat eua Tram
cdn nMeu tMeu thbn
Bao Mem y te (BHYT) la mbt trong
nhiing eMnh sach tru cot trong hd thd'ng
an sinh xa hgi ciia Dang va Nha nUde ta,
mang y nghia nhan dao va eb tinh cMa se
edng dbng sau sac Theo Luat BHYT, ngUdi
ngheo, d i n g bdo dan tpc thieu sd sinh sd'ng
d viing Mnh te khb khan duge h§ trg 100%
the BHYT, trong dd cd ngUdi Cb'ng va Si
La BHYT cua ngfldi Cd'ng va Si La thudc
the K2 danh eho vung flU tien (K2 la ma
ncfi ngfl&i dan tde thilu sd va ngU&i thupc
hp gia dinh ngheo tham gia BHYT, dang
sinh song tai vung eb dilu Men kinh te
-the BHYT K2, n l u ngU&i bdnh di kham, ehfla khdng dung tuyen van dUpc I^Y BHYT thanh toan cM pM kham, ehfla bgnh nhfl di dung tuye'n ddi vdi bdnh vien tuyen huyen, dilu tri ndi trii db'i v&i bdnh vien tuyln tinh, tuye'n trung uung (khdng c^n giay chuyen tuye'n kham ehfla bgnh) Neu kham benh tai cac benh vidn tuyen trung uung, ddi vdi dilu tri npi trfl (cd eM dinh nhap vien) tM dugc BHYT cM tra 100%, cdn db'i vdi trUdng hgp chi dieu tri ngoai tru (kham benh, nhan thud'c va dieu tri tai nha) tM can dupe xin giay ehuyin tuyg'n eija benh vien huyen de dUpc hfl&ng 80% cM pM kham, ehfla bdnh
Neu nhfl trfldc day kM ddi sd'ng edn kho khan, ngfl&i dan thfl&ng tU ehfla tri bang eac bai thube dan gian moi kM dm dau nhUng tfl kM dUde ca'p the BHYT, rihieu ngU&i da big't dupe ldi ich cua kham, ehfla benh va nhan thay rang, dg'n benh vien de dugc cac bac si thara kham la mbt each dilu
tri tot nhat Day la ye'u td vi-t quan trpng
trong eong tae chara sdc sUe khde toan dien, gdp ph^n nang eao chat lu&ng eude sdng cho ngU&i Cd'ng va Si La tai dia ban Ngoai ra, cMnh sach BHYT cua Nha nU&c cdn giup cho ngU&i dan giam hdt nhflng khb khan v l Mnh te, day manh ebng cube xda ddi giam ngheo, gifl viMg on dinh cMnh tri
va cung cd long tin cua dong bao dan tgc tMlu sd ddi vdi Dang, Nha nfldc'^i*
Trong nhflng nam qua, cae Chuung trinh mue tieu qude gia v l y te ludn duge duy trt va thuc Men thU&ng xuyen tai vung
Trang 6phdng chdng lao, tigm ehung mcf rdng,
eham sde sflc khoe sinh san, phdng chong
suy dinh dUdng, dan so - k l hoach hba gia
(Bnh, NhiJng chuong trinh nay da gdp
phan quan trpng vao mue tieu cham sde
sflc khde va nang cao y thUc phdng ngfla
dich benh cho ngfldi dan
Ngoai nhiJng cMnh sach ve y t l ndi
tren, ngU&i Cong tai huyen Mu&ng Te va
Nam Nhun cdn dUgc thu hu&ng De dn phdt
triin kinh ti - xa hdi vdng cdc ddn tpc
Mdng, La Hd, Cdng, C& Lao dUpc Thii
tudng Chinh phu phd duyet tai Quyet dinh
so 1672/QD-TTg ngay 26/9/2011 va dugc
UBND tinh Lai Chau phe duydt eM tig't tai
Quyet dinh sd 1695/QD-UBND ngay
30/12/2011 D l an nay dflgc trien khai vdi
muc tieu hd trg va tao dieu Men eho dbng
bao phat trien san xuat, thoat ngheo, nang
cao d&i sd'ng vat chat, tinh than, gbp phan
vao viec bao ve mbi trfl&ng, rflng d^u
ngu-on va chu quyen bien gidi qud'e gia (UBND
tinh Lai Chau, 2011) Ndi dung eua D l an
tap trung den ehinh sach hd trg phat trien
y te, dd la: cap thuoe cho thon ban; hd trp
ngU&i n h a b e n h n h a n di dieu tri tai benh
vidn, phu nfl trong thdi ky mang thai, sinh
nd, h5 trg dinh dUdng eho trd so sinh, hd
trg lan dau eho n h a n vien y te ban
Tai xa N a m Khao (huydn Mu&ng Te),
trong giai doan 2014-2016, 149 ngU&i Cb'ng
dflpe hd trg mang thai va sinh de vdi t i n g
so t i l n 149 tridu dong, 18 ban dflge hd trp
cap thud'c vdi t i n g Mnh pM 18 trieu
dbng^^^^ Bdn canh dd, D l an ebn hd trg
benh n h a n dd'i vdi trfldng hgp bgnh nhan mac cae benh phai dieu tri ndi tru dai ngay (tu 5 ngay trd len) tai eac eo sd y te cua
N h a nflde tfl tuyen huydn trd len
Tai huyen Nam Nhun, Trung tam Y te huydn da chi dao Tram y t l xa thfle hien
r a soat dd'i tUpng duge thu hudng hang nam Trong dd, giai doan 2014 - 2017 da
hb trg 27,424 trigu d i n g eho y te thdn ban,
hd trg 210 phu nfl mang thai vdi t i n g Mnh
pM 210 trieu dong, ho trp 254 tre sd sinh vdi tong Mnh phi la 254 trieu dong*^^' NhiJng ehinh saeh nay da gbp phan quan trgng trong vieegiam ty le suy dinh dUdng, cai tMgn tinh trang sflc khoe eua phu nfl trong thdi ky sinh nd
Ngfldi Si La dang sinh s i n g tai ban Seo Hai va Si Thau Chai (xa Can Hb, huyen Mudng Te) cung dang duge thu hUdng De
an Hd trg, phdt triin ddn tgc rdt it ngU&i
trin dia bdn tinh Lai Chdu giai dogn 2017-2025, dupe Thu tUdng CMnh phu phe
duyet tai Quyet dinh 2086/QD-TTg ngay 31/10/2016 Ndi dung ciia D l a n tap trung vao mpt so eMnh sach v l kinh t l , van hda,
xa hpi, trong dd cd mang hd trp v l y te cho ngU&i dan Du Men trong thdi gian diln r a
du an, tong Mnh pM ho trg cho y t l ddi v&i dbng hao Si La la 1,048 ty dbng, gbm hb trg ba me mang thai la 524 trieu dong va
hd trg dinh dUdng eho tre em sU sinh 524 trieu dong^^*\ Du a n da va dang trien khai tai dia ban se gbp phan nang cao ddi sd'ng vat ehat va tinh than cho ngUdi Si La, nang cao cha't lUgng dan so, giam ty le suy
Trang 7tfldng tu ti dan tdc de hba nhap vao sU
phat t r i l n ehung cua huyen
2 N h f i n g k h o k h a n t r o n g vigc thu'e
h i ^ n c l i i n h s a c h y t e h i ^ n n a y
Thuc t i l n cho tha'y,cac ehinh saeh y tg'
thUe hign tai huyen Mudng Te va Nam
Nhun da dat duge nMlu thanh tflU dang
ghi nhan, song cung v i n cbn tbn tai nhflng
han ehe Mae du Sd Y te tinh da ed nhieu
cMnh saeh dai ngd dii vdi can bg nganh Y
nhUhg cae bac si miln xubi v i n ehfla thUe
sU man md vdi Lai Chau Tfl nam 2004 de'n
nay, nganh y t l Lai Chau ehfla thu hut
dflgc bae si dao tao cMnh quy b cae dia
phUcfng khae ldn day ebng tae Sd lugng
can bb cd trinh dd dai hpe tang len do cae
bac si la can bd y t l dia phUcfng duge eU di
hpc theo hinh thUe chuyen tu, cfl tuyln Xet
ve nhu eau, toan nganh y tg' Lai Chau can
tren 600 bae si nhflng Men nay mdi dap
flng dupe 60% nhu cau Tai Bgnh vien Da
khoa tinh Lai Chau, dfl duge xay mdi v&i eu
sd vat chat ky thuat hien dai, lUU lugng mbi
ngay dieu tri ndi tni vk kham benh trung
binh eho 500 lUUt ngu&i nhung ehuyen
khoa nao eung trong tinh trang thie'u bac
si,, Ddi vdi Mudng Te va Nara Nhun - hai
huyen khd khan nha't cua tinh Lai Chau
tM tinh trang thilu nhan lUc la dieu d l
Mlu'-^^' Bgn canh dd, trinh do nhan lUc ciia
can bb y t l d t a t ca cac tuyln khdng gib'ng
nhau Tuye'n tinh va tuye'n huyen thUdng
tap trung nMlu bac si cd tay nghe, trinh dp
chuyen mbn cao, trong kM dd tuye'n eO sd
nhu Tram y t l xa - ndi ngfldi Cd'ng va Si
tM lai ed it bae si ma chii ylu la y si, y ^ tdt ngMep trinh dp Trung ca'p Nd'u eoi trinh dp eua bac si nhfl thU&c do ve ehat lugng kham, ehfla benh thi cac tpc ngUdi nui day dang phai sU dung dich vu kham ehUa benh khong eao Nlu muon k h a m
ehfla bgnh b nhflng tuye'n eao hdn nhfl
tuye'n huyen, tuye'n tinh hay tuyln trung uung vdi may mdc, ky thuat Men dai tM hg phai ma't kha nhieu thdi gian, edng sflc va tai chinh eho viee di ehuyin va dieu tri
Da phan can bd tai Tram y te xa kha tre ngn trinh do chuyen mon cbn non ye'u,
do dd trong qua trinh t r i l n khai thUe Men nhidm vu cdn gap nMeu khd khan, bd ngd Tai Tram y te' xa Nam Khao (huydn Mudng Te) va Tram y te xa Nam Cha (huyen Nam Nhun) Mgn nay ehfla ed bac si
ma cM cd y si, day eung la ye'u t l gay khb khan cho ebng tac kham, ehfla benh De
giai quye't bai toan tMeu hut bac si b Tram
y t l xa, thdi gian qua Sd Y te' tinh da cM dao cac bdnh vien, Trung tara chuygn khoa tuyen tinh, Trung tam y te huyen chu ddng
bd tri, sap xe'p cii bac si luan pMen tang efldng cho eae Tram y te xa Tuy nMgn, dieu bat cap la eac bae si lam viee tai Tram
cM dung gid hanh cMnh, khdng phai trfle nen cb nhiJng ea benh khd ngoai gid tM lai khbng ed bae si de thfle Men t h a m kham
Cong vide b Tram ra't nMeu trong kM
ngudn nhan Ifle mong, phai Mem nMgm nMeu viec (vfla phai kham benh, vflaphai thuc Men cae chUUng trinh y t l qud'e gia
nhu di truyin thdng b eae ban), tien hd trg
cdng tac phi hau nhu khdng ed hoae cd rat
it T i l n true cho can bg y te xa Men nay
Trang 8r a t tha'p (25.000 dong/ngay v&i ngay
thfldng; 32.500 dbng/ngdy v&i ngay thfl 7,
Chu n h a t va 45.000 dbng/ngay vdi ngay Id)
n e n ehfla thda man duge thdi gian, cdng
sflc cung nhfl thu n h a p ciia can bg y te
De "bao phii cham sde sflc khde" eho
toan dan, Sd Y te tinh da tang efldng uu
tien eho can bb y te' tuye'n thdn ban Tuy
nMen hien nay, nhflng ngfldi lara can bp y
t l thdn ban sau khi t h a m gia khda ddo tao
9 thang phai lam Mem nhiem ca can bd
dan sd, lai boat dbng trong dieu Men khd
k h a n ve dia hinh, giao thdng vdi mfle phu
ca'p chi hdn 650.000 dong/thang CMnh
thu nhap khdng dara bao nen nhieu can bd
y te thbn ban khbng "man ma" v&i nghe,
khdng du de cM pM eho cac sinh boat
trong gia dinh va eung ehfla tao dugc dgng
lUc cho can bd y t l nhiet huyg't vdi edng
viec Cac co dd thdn ban ehu ylu la nhiJng
can bd r a t tre (ngoai 20 tuoi), mdi hge bet
cap 2 va ehi dUge dao tao, tap hua'n 6
t h a n g v l Mnh nghiem dd de nen tay nghe
edn kem, ehUa duge ngUdi dan tin tU&ng,
lua chpn Mae du Men nay d cac ban diu
cb chfle danh ed dd thon ban nhung trong
n M l u n a m qua, cac ed dd hau nhU ehUa di
dd de duge ea nao hoae it nhat eung cM cd
1-2 ca Ban than hg eung mong raub'n dUpe
t h a m gia nhilu khoa tap huan, dao tao bun
nfla d l nang eao chuyen mbn eua rainh
Khao sat tai dia ban ngMen cflu cho
thay, eae ehinh saeh eham sdc sflc khde
cho ngfldi ngheo, dong bao dan tpc tMeu so
thong qua the BHYT eb "danh" nMeu ban
khdng sfl dung dich vu y te bang raflc trung binh cua ebng dbng va raflc cM tra BHYT cho hp eung ra't tha'p khie'n cho the BHYT cua ngfldi Cb'ng va Si La phat ra ehi lay so lupng hun la ehat lugng, khong giup dugc
hg nMlu trong viee tiep can va sii dung
dich vu y te
Trang thiet bi y te tai cac Tram mac du thu&ng xuydn dUpe ca'p phat nhungvan ebn tMg'u nMlu may mde cu ban nhu X quang, may sigu am, Tai Tram Y te xa Nam Cha (huyen Nam Nhim), co sd vat chat ciia Tram cdn chat hep, chi cd 3 gian nha gd ngn ehUa dam bao dupe ebng tae eham soc sflc khoe cho ngfldi dan, ehfla cd kho thud'c rieng nen ebn gap trd ngai trong khau bao quan va quan ly thude
K e t l u | i n
Trong nhflng nam qua, nganh y te tinh
Lm Chau da cd nhieu nd lUe trong vide cham sdc sflc khde eho ngfldi dan thdng qua sfl phat trien eua eac cM'nh sdch v l y
t l Mang Ifldi y te' ngay cang md rpng da giup cho viec kham, ehfla benh cua ngfl&i dan dupe eai thien, eae trang thie't hi y te ngay eang day du hcfn va tflng bUdc duge hidn dai hda, can bb y te' ngay cang dflge nang eao vl trinh dp chuygn radn Tuy
nhien, viec trien khai vk thfle hidn eae
chinh saeh y te hien nay van ebn gap nhieu trd ngai dan d i n hieu qua ciia nhufng
chinh sach nay doi vdi ngu&i Cb'ng vk Si
La chUa cao Mang lUdi y t l duge bao phu rgng khap nhUng trang thiet hi y tg' va trinh dp nhan lUc d eae tuyg'n khbng dong
Trang 984 Nghien ciJu Dong Nam A, so^
h a n che', viee dau tfl tai chinh cua Nha
nfldc va ciia tinh cho cac Tram y t l tuyln
xa cbn kha khiem ton, sfl van hanh BHYT
ebn nhieu bat cap, quyin lpi cua ngfldi sfl
dung va ngfldi cung cap dich vu diu khong
dflpc dam bao kMin BHYT ehfla thfle sU
mang lai Meu qua cham sbc sflc khde cho
ngfl&i dan
De hoan thien cac cMnh sach y te Men
nay, cac cap iiy dang, chinh quyen, doan
t h i cac ca'p cin tang efldng dau tU nang ca'p
cae Trung tam va Benh vien tuyg'n tinh va
huyen theo hU&ng Men dai, ky thuat cao;
tap trung phat t r i l n tuyen y t l cd s&, nha't
la dau tu xay dung Tram y te' xa dat tieu
cM qub'c gia; nang cao y dflc va trach
nhigm cila can bg y te, cham lo xay dung
ddi ngu can bp y tg', nhat la bae si eho
tuyen xa; tang cUdng edng tac luan pMgn
can bb y t l tfl tuyg'n trgn ho trp cho tuyg'n
y te cd sd; tflng bfldc thfle Mdn ehii truong
xa hgi hda trong boat ddng y te, gdp p h i n
dat dugc muc tigu ebng bang va phuc lgi xa
hbi eho ngUdi dan./
CHU THICH
1 Db Nhung, Hoang Hgi (2016), Lai Chdu
tdng cUdng cung cd vd hodn thien mgng
ludi y ti ca sd, http://www.dangcongsan.vn/
khoagiao/taichautangcuongcungcovah o a n t khoagiao/taichautangcuongcungcovah i e n m a n g l u o i y t e c o s o
-406756,html, truy cap ngay 10/3/2019
2 Trung tam Y te huyin Mfldng Te, 2017
3 Trung tam Y te huyen Nam Nhijn (2017),
nhiim vu cdng tdc y te ndm 2017; P^^^^^ hudng nhiem vu vd gidi phdp ndm 201
4 Le Minh Anh, Pham Thi Thu Ha (2018),
"Mang ludi y te trong cham soc sdc khoe ciia ngudi Cdng va Si La & tinh Lai Chau ,
Tgp chi Ddn tpc hoc, Sd 3, tr 44-52
5 Dang Thi Le Xuan (2012), "Chinh sach y
te va cham soc bao ve sdc khoe nhan din:
ThUc trang va khuye'n nghi" Tap chi Kinh
ti vd Phdt trien So 181, tr 48-56
6 Sd Y te tinh Lai Chau (2017), Bdx) cdo sa
kit cdng tdc y ti 6 thdng ddu ndm, nhiim
vu vd gidi phdp 6 thdng cudi ndm 2017
7 Sd Y te tinh Lai Chau, 2017, tldd
8 Thong tin do chi Vu Thi Tam, Trfldng tram
Y t l xa Can Ho eung ca'p
9 Tram Y te xa Nam Khao, 2017
10 Tram Y te xa Can Ho, 2016
11 Bich Dilm (2017), Bdo ddm chdm soc y ti
cho dong bdo cdc ddn tpc thieu sd d Viit Nam, http://www.tapcMcongsan.orgvn
/Home/Van-hoa-xa-hoi/2017/48440/Bao- dam-cham-soc-y-te-cho-dong-bao-cac-dan-toc.aspx, truy cap ngay 9/4/2019
12 UBND tmh Lai Chau (2011), Bdo cao
viic thUc hien Nghi quyit so 16I2011INQ-HBNB ngdy 11712011 cda HBNB tinh ue cong tdc di ddn, tdi dinh cU thdy dien Lai Chdu
13 Trung tam Y te huyin Nam Nhiin (2017), tldd
14 UBND huyen Mubng Te (2017), Be dn hd
trg phdt triin dan tpc rdt it ngudi trin dia bdn tinh Lai Chdu giai dogn 2017-2025
15 Le Phii Hilu (2018), Lai Chdu khdc phuc
tinh trgng thiiu hut ngudn y te,
http ://wvAv tapcM congsan.org vn/Home/Va n-hoa-xa-hoi/2018/49094/Lai-Chau-Khac- phuc-tinh-trang-thieu-hut-nguon-nban-luc-y.aspx, truy cap ngay 5/4/2019