Tre OVC thudng d l bj suy dinh dudng, dd bi t i n thuang tam ly, thiiu hut tinh cam, bj phdn biet d i i xu, sy chdm sbc t u gia dlnh, bj dua vdo cdc trung tdm nhu bj Igm dyng tinh dye, I
Trang 1nghTa thing kd gida hal nhbm vdi P <0.05 (bdng 1)
Nhu vdy kem Daivobet cb tdc dyng tdi s y thay dfli
eOa cytokine ndy trong mdu
Nhw viy, bang kp thu$t flow cytometiy-asatsted
immunoassay chdng tdi OB xit nghiim ding thdl 9
cytokine trong huyet thanh b$nh nhin b^ch biin thi
lan tia tru&c vi sau dliu tri kem Dalvobe cho thiy, cb
Si/glim ning dd dc cytokine IL-5 IL-12 GM-CSF,
IFN-Y vi TNF-a, cdc cytokine cbn Igi khbng cb s y thay
d i i , Trong dd cic cytokine IL-12, GM-CSF vi IFN-y li
nhOng cytokine CEiu hda dip dng miin dich ti bio
theo kiiu Thl Kit qui nghiin cdt; niy phO hqp v&i ca
chi miin dich cua binh b$ch biin, dc ti bio TCD4
cytokin (IL-2 IL-3 IFN-y TNF-a GM-CSF) kich thich
cic M bio TCDB boat hoi (con dwdng Thl)
2 S v t h a y d i l cytokine d bdnh nhdn bgch b i i n
tru-dc vd sau d l i u trj b4ng kem Vltlskin
Bflng ky thuflt flow cytometry-assisted
immunoassay chCing tfli dd xdt nghidm d i n g thdi 9
cytokine: IL-2 IL-4, IL-5, IL-10, IL-12, IL_13,
GM-CSF, tFN-y vd TNF - a trong huyit thanh bdnh nhfln
bgch b i i n t h i lan tba trude vd sau d i i u tq kem
Vitiskin K i t qud cho thfly, khflng cb s y thay d i i n i n g
d i tflt cd 9 cytokine Nhu vfly thuic kem Vitiskin
khbng cb tdc d i n g Idn cdc cytokine trong mdu, hay
nbi cdch khde thuic ndy khbng tdc dflng tdi phdn dng
miin dich ciia ca t h i
K t T LUAN
Vdi 65 bdnh nhdn bgch biin Ian tba dup-c xdt
nghidm 9 cytokin tidng ky thuflt flow cytometry-assisted
immunoassay chiing tbi dd thu dupe k i t qufl sau:
1 D l i u tn b i n g Daivobet giim ning di cic
cytokine IL-5, IL-12 GM-CSF, IFN-y vi TNF-a sau
diiu tn Cde cytkin IL-2, IL-4, IL-10, IL-13 khbng eb
su thay d i i
2 D i i u tri bflng Vitiskin tflt ca 9 cytokine 2,
IL-4 IL-5, IL-10, IL-12, IL-13, GM-CSF, IFN-Y vfl TNF-o
tarde vd sau d i i u tri khdng cd sw thay dii
1 0 5 Khflc Dgl, Ld Vdn Dbng vd CS (2007), Kit qud xdt nghidm d i n g thdl 9 cytokine trong dj(^ mdng phii bdnh nhdn ung thu vd lao phii bflng cbng ngh$ flowcytometry-asslsted Immunoasay, Tgp ehl y du'pc hoc qufln sy 5, 32, tr.17-23
2, Caixa T Hongwen F., Xlran L (1999), "Levels of soluble Interieukin-2 receptor in the sera and skin tissue
fluids of patients with vitiligo', J Dermatol Sd 2^, pp
59-62,
3 Dennis W Metzger (2010), lnterieukin-12 as an adjuvant for induclton of protective antibody responses
Cytokine, Volume 52 pp.102-107,
4 Huang-Pin Wu, Sheng-Fong Kuo, Shao-Yun Wu, Duen-Yau Chuang (2010), High interieukin-12 production from stimulated peripheral blood
mononuclear cells of type 2 diabetes patients Cytokine Volume 51 pp 298-304
5 Katie ST, Sara J et al (2009), Analytical validation of a highly sensitive micropartide-based immunoassay for the quantitation of IL-13 in hunwi
serum using the Erenna® Immunoassay system Journal
of Immunological f^thods Volume 350, pp.161-170
6 Kiyoto Hohnoki, Atsushi Inoue , Chang-Sung Koh (1998), Elevated serum levels of IFN-y, IL-4 and TNF-a/unelevated senjm levels of IL-10 in patients with demyelinating diseases dunng the acute stage, Jouma/
of Neurammunology Volume 87 pp 27-32
7 Patricia Mdndez-Samperio (2010), Role of interieukin-12 family cytokines in the cellular response to
Diseases Volume 14 pp e366-e371
8 Rehan Khan., Somesh Gupta , Alpana Shamia (2012), Circulatory levels of T-cell cytokines Onterleuldn [IL]-2, IL-4, IL-17, and transforming growtfi ^ctor-P) in
patients with vitiligo Journal of the Amencan Academy
of Dermatology, Volume 66 pp,510-511
9 Rui Chen, You Yin, Zhongxin Zhao., et at (2012), Elevation of seaim TNF-a levels in mild and moderate Alzheimer patients v^th daytime sleepiness,
Joumal of Neuroimmunology, Volume 244, pp.97-102
NHU C&U VA S U O A P llTNG NHU c £ u C H A M SdC SQt KHOE CHO TRE NHIEM HIV
VA THE Bj ANH HUIDTNG BOD HIV/AIDS (TRE OVC) TAI HUYEN SdC SON H A N O I N A M 2011
T 6 M T A T :
Tri em IB dii twpng di bi tin thuong d$c biit li tri
(OVC) rit di bi inh hudng vi sOc khoi vi tim ly bdi
HIV Tmng bdi cinh HIV dang ngiy dng gia ting hiin
nay, cin cd nhOng can thiip thich h</p di h$n chi dc
tie ding cua HIV lin tri Mpc tiiu nghiin cuv Xic dinh
cBc nhu ciu vB s y dip ung cic nhu du CSSK cua tri
OVC ddng th&i tim hiiu nhOng rBo dn inh hw&ng din
SU' dip ung nhu ciu dd V&i phuung phip nghiin cOv
md ti est ngang kit hpp dinh tinh vB dinh lux/ng 52 tri
OVC tw 8-17 tuii vi 90 ngw&i chSm sdc chlnh cho tri
PHAN V A N TUdNG, PHAM THj H 6 N G NGUYEN NGUYEN NGQC
OVC duvc phdng vin, kit hpp v&i PVS vB TLN K^t qui nghiin cuv 70% tri dang d dd tuii tir 5 din 11, ty
li nam nO" li nhw nhau (nam 58% nir 42%); 49%tiim6 cdi bd hoic me, 9% dcemmdcdidbi lin me 60% ngu&i chSm sdc tri OVC dang sdng chung vdi HIV/AIDS; 71% nwgi&i, tmng dd 54% di gdachingvi 49%bimpcdHIVdwangtlnh Tri OVC d 2 nhdm nha ciu CSSK chlnh' (1) Nhu ciu chim sdc sOc khde ttie chit, (2) Nhu ciu chim sdc sdc khde tinh thin vB xS hdi Bin rio cin chlnh tmng viic dBp img nhu c^u CSSK cOa tri OVC, gim cic rBo dn vi kinh ti, nt}$n
Trang 2phin biit dii x d v&i tri OVC vi gia dlnh tri khi ning
tiip c$n dich vp y ti tai dia phwang
TiF khoA: HIV tri OVC, nhu du rdo cin
SUMMARY:
Children am vulnerat^e subjects, especially r^Sdren
(OVC) are susceptible to health and psychofogy by HIV
In the context of HIV are increasing today, them should
be appropnate inten/entbns to reduce the impact of HIV
on children Study objectives: Identify the needs and meet
the health cam needs of OVC, and exptore the barriers
affecting the demand V\7ith the method of cross-sec^kjnal
descripBve study combined qualitative and quantitative
52 OVC aged 8-17 years and ^ primary cam for OVC
interviewed, combined with the deep inten/iew and focus
5 to 11 the pmportion of giri and boy are equal (male
58% female 42%); 49% lossed ntother or father 9% of
the orphans father and mother 60% of people who take
care of OVC living with HIV / AIDS; 71% of women, of
vAiich 54% were wktowed and 49% of HIViJOSitive
mothers OVC have 2 groups pnmary health cam needs
(1) physical health care needs (2) the demand for mental
health cam needs of OVC, including economic bamers,
awareness of OVC and caregivers on HIV/AIDS, stigma
and dscrimination OVC and their families, access to
he^h sen/ices locally
Keywords: HIV, OVC, need, barrier
DAT V A N D £
Bao vd, chdm sbc tre em Id m i i quan tdm hdng
dflu cua tflt cd cdc quie gia trdn t h i gidi, Vidt Nam Id
gidi dd phd chufln cbng udc BVTE ngdy 20 thdng 02
nam 1990 [1]
Dai dich HIV/AIDS Id mbt vfln nan cua todn t h i
gibi, anh hudng d i n nhiiu d i i tupng, trong 66 tre em
Nam 2008, todn t h i gidi da cb tdi 430 000 tre em sinh
ra bj nhidm HIV Tai Vlpt Nam, theo bdo cdo ciia Bfl Y
t i tinh den ndm 2009, t i n g s i tre em phdt hidn eP HIV
trj ARV, ty Id Idy tnjyin t d mg sang eon la 0,25%_yd sd
bi anh hudng bdi HIV/AIDS (Orphan and Vulnerable
Children - OVC) bao g i m cdc d i i tupn_g: Tre em
em m i cbi do b i va me hode b i hoflc mp chit vi
nhiWigiy do lien quan d i n HIV/AIDS,
Sbc San la 1 huypn phia bde Ha Nbi, vdi didn tich
313 km2 dia ban rflng gom 25 xd vd 1 thj trfln, ddn s i
taing binh ndm 2009 Id 290.000 ngudi; Ca cflu kinh t i
chuyin djch theo hudng ty trpng nganh dich vy tdng,
ngdnh nbng nghidp giam Sbc San la huyen cbn nhiiu
khb khdn nhung cb t i c db phflt trien khd nhanh, i n
tnnh [5]
Tre OVC thudng d l bj suy dinh dudng, dd bi t i n
thuang tam ly, thiiu hut tinh cam, bj phdn biet d i i xu,
sy chdm sbc t u gia dlnh, bj dua vdo cdc trung tdm
nhu bj Igm dyng tinh dye, Igm dyng sdc lao dflng vd
sd dyng ma tuy VI vfly vlflc eb nhdng can thidp nhdm gidm thiiu nhdng nguy ca cho trd OVC Id rdt cfln thiit, D i cung cflp cdc bflng chdng cho bdn d i xuflt k i hogeh can thiflp hidu qufl cho trd OVC vd h i trp gia dinh ciia trd, chiing tfli t i i n hdnh nghidn edu
"Nhu ciu vi Sir dip Ong nhu ciu chdm sdc sdc khde cho tri nhlim vd bf inh hurimg b&l HIV/AIDS (tri OVC) t^l huyin Sdc San, Hi N^l nim 2011
"Vdi 2 muc tidu
Myc tidu nghidn edu
1 Xdc i^nh ede nhu c i u vd ddnh gid sy ddp yng nhu c i u chdm sbc syc khbe ciia t r i nhiim vd bj flnh hudng bdi HIV/AIDS (trd OVC) vd gia dlnh dang chdm sbc trd OVC tgi huydn Sbc San, Hd Npi ndm 2011
2 Tim h i i u nhdng rdo cdn dnh hudng d i n sy ddp yng nhu cflu chdm sbc sdc khbe cho trd nhiim vd bj
nam 2011 PHLraNG P H A P NGHIEN Cl>U _
1 DPI tup'ng nghidn edu, c d mdu vd chpn mdu
- Phbng vfln bflng bdng hfli cflu tnjc d i i vdi 52 trd OVC td 8-17 tuii vd 90 ngudi chdm sbc chlnh cho trd OVC
- PVS 14 dgl didn hp gia dlnh dang chdm sbc tre nhidm HIV tgi nhd
- TLN 08 cdn bb cdc ban ngdnh dodn t h i hdn quan d i n cflng tdc chdm sbc bdo vd t r i em, 05 Nhdn
OVC vd cde Bde sy ciia Trung tdm y t i d y phflng huydn Sbc San, ciia huyen va.12 Cdn bb chdm sbc tgi nhd chp trd OVC trong nhbm Hoa Sim Tim (nhbm cua nhung ngudi s i n g chung vdi HIV/AIDS)
M i u nghidn edu Nghien cuu chpn todn bb tre em
bj nhlim hoflc cb b i mp bi nhilm HIV/AIDS tai huyen Sbc San va nhung ngudi chdm sbc chlnh cdc em
2 Dia d i i m vd t h d i gian: NC dupe t i i n hdnh tai Thdi Nguyen td thdng 11/2010 - 4/2011
3 T h i i t kd nghidn e d u ' Mb ta cflt ngang k i t hap dmh tinh vd dinh lupng
4 Phuang phdp thu thdp sb lidu
- Bang hbi cflu triic cb s i n cho 02 d i i tupng la Ngudi Cham sbc chinh cho tre OVC trong gia dinh
va Trd OVC (dfl t u i i I d 8-17 tuii);
- Hudng ddn phbng vfln sdu danh cho 14 dai dien gia dinh dang cham sbc tre nhilm HIV/AIDS (db tuii 0-17 tuii),
- Thao lufln nhbm trpng tdm (ddnh cho nhung cdn
bb vd nhdn vidn dang iam vide tai cdc ca quan cung cflp djCh vy vd chdm sbc sue khbe cho tre OVC,
Sbc San,
5 Phuang phdp phan tich sb lieu: S i heu dupe ldm sgch vd nhdp bdng p h i n mem Epidata, phdn tich bdng phfln m i m SPSS d i i vdi so lieu dinh
bdng d l lam cdc dan chung trong phan k i t qua
Y HQC THV"C HANH (840) - so 9/2012
Trang 31 Thdng tin chung v i d i l t u y n g nghidn c6-u
Thdng tin v i trd OVC: Phfln tdn trd dang d dO
t u i i t d 5 din 11 (70%), ty Id nam n d Id nhu nhau
(nam 58% n d 42%), da s i trd OVC tdi huydn Sbc
San cb trinh dO hpe vfln t h i p , da s i cd trinh dO hpc
vdn cflp 1 (nam: 42,9%; n d 50%), vSn cbn 3 trd nam
khflng di hpc G i n mpt nua trd OVC (49%) Id trd m i
cdc em m i cbi cfl bo Ifln mg, trong s i trd m i ebl thl
phfln Idn s i n g vdi bng bd hodc vdi cd mp vd bng bd
D i i u ndy cOng dCing vdi truyin thing cua ngudi Vidt
Nam Id gba phy vfln sd chung s i n g ciing vdi b i mg
anh chj em dflng nhd c h i n g neu c h i n g qua ddi
Thdng tin v i n g u ^ chdm sdc trd: 60% dang
sing Chung vdi HIV/AIDS; 7 1 % ngudi chdm sbc trd
Id nd gidi, trong db 54% dd gba ching vd 49% bd mg
hpc vdn cflp 2 (nam: 57,9%; n d 50%) Ngudi chflm
sbc chii y i u d db l u i l 25 -35 (nam 47,4%, n& 55,7%)
V5n cbn 11 ngubi (nam 15,9%; n& 11,4%) trdn 66
tuii lao d i n g 56-77 theo quy d|nh cua phdp luflt, ddy Id
mbt trong nh&ng y i u t i dan din sy hgn e h i d i l vdi
vide chflm sbc trd OVC, N g h i nghidp cua ngudi chdm
sbc trd OVC da dgng, nhung chu ydu td nbng ddn vdi
ty Id 46%, Phdn Ifln nhdng ngudi cd thu nhflp trong
gia dlnh dang chdm sbc trd OVC Id n d gidi
2 Cdc nhu cflu vd si;- ddp dng nhu cflu chdm
sbc sue khde eCia trd OVC vd gia dlnh dang chdm
sdc trd
2.1 Nhu ciu vi Sir dip irng nhu ciu chim sdc
dinh dudng cOa tri OVC:
3/3 tnjdng hpp cb HIV vd dd sinh eon cho biit hp
dupe kit nil tdi chuang trinh PMTCT tgi Bdnh vidn Phy
trj dy phflng ARV vd dupe eur>g cflp sda thay t h i sda
khdo sdt cua cdc tnjdng hpp khdc cho thfly rflng tnjng
ndo cOng cb dfly du luong thye, tnDng khi hflu hit nhdng
cb du no, chflt lupng luang thye khflng dflm tido,
Trong s i nhdng ngudi chdm sbc trd, eb 19% nbi
Id nhfln dupe mflt s i h i trp v i dmh dudng, trong dfl
h i trp t d cdc nhpm t y lye la 56%, 3 1 % dupe nhfln t u
Nhd nude Hinh thdc h i trp dmh dudng p h i b i i n
nhflt Id sua (82%) vd ggo (38%)
Phfln Idn ngudi chdm sbc trd d i u biit nhu c i u
cham sbc dinh dudng cua tre s i n g chung vdi
HIV/AIDS Mbt ba mp 28 t u i i dang chdm sbc con bj
nhilm HIV cho biit "Nhiiu khi mi chBu im dau thl
cBi chit dinh dw&ng nd cOng cin khBc hon so v&i
binh thwdng hBng ngiy Vi dp nhw li khi mi chiu
m$t mdi tri khdng muin in hay tri muin in mdt di
chi biin nhOng di mB tri muin Sn hon thi kich thich
hBng ngiy"
Tuy nhidn do d i i u kidn kinh t i khfl khdn, b i mg
phai di lam ca ngdy ndn v i i c ddp ung dung nhu cflu
b i 30 t u i i cho b i i t : 'BQ-a tnra thl thw&ng thw&ngphii
in cam rAl, thi/c ra thl biy gl& nhi cOng khdng c6 dliu kiin vl bd m$ dl lim hit ci c d 6n & nhi v&i Ong
bi cd dl gl thl Bn cii diy chO nhiiu lOc bdmpvicd thim tning hay li mua thdm cho chiu dc cii tht/c phim cd chit dlnh dw&ng nhw trOng, thU, ci thay dii cho chiu chir thi/c ra chiu chi cd 1 bda gpi Id di chit dlnh dw&ng thdl chie cdn bOv trwa biy gid dng bi in
gi chiu Sn niy"
2.2 Nhu ciu vi s ( / dip ting nhu ciu chim s6c
y ti cOa tri OVC:
37% trd OVC cho biit minh cb sdc khod tit, 33% trd Idi "binh thudng" Trong khi dd 5 1 % ngudi chflm sbc trd cho sdc khbe cua con em mInh d dien 'binh thudng" Nhiiu ngudi chdm sbc lo nggi sdc khbe cua
sbc con em minh
Cd 94,4% trd OVC biit v i HIV nhung biit diua dfly
dii Mflt bd mg 28 tuii cho b t i t "Hidn tai thl chiu cOng dil biit qua qua c/)d cbn rtdi vi kiin thdc sdu thl chiu cOng c/ius hiiu lim Chiu cN biit ^y'UiOc cOa chiu bi di tjiiA diy chiu duy tri udng thudc vl udng thuic si duy triCkipc syaJngctia (^u chw cdn chiu (^ y thuc dupe di wy gpi li nd hiiu ndng ctiir khdng hiiu sSu'
Trong vbng 1 thdng trude phdng vfln, cb 39,1% trd
O V C b j i m Khi d i n e a s d khdm ehda bdnh, thdi (JO aia bde sy khdm bdnh Id thfln thidn gdn gOi, binh thudng
hpp ndo b| coi thudng ghdt bd
Chi phi y t i md ede gia dlnh phdi ch|u chu yiu ta ehl phi dl Igi vd ehi phi t h u i c men, trung binh 1 thflng ede gia dinh ehi 276.000 d i n g d i mua thuie, 67% so
t i i n ndy Id ddnh cho t h u i e khdng sinh - logi thuic khbng dupe bdo h i i m h i trp cho trd dudi 6 tuii Rflt nhliu ngudi chdm sbc trd OVC dd phfli vay np lai d l
cP t i i n ehl tidu t h u i e men cho trd OVC
2.3 Nhu ciu vi Sir dip img nhu ciu chim sdc giio dye
Mflc dCi nhdng ngudi trd Idi phbng vfln diu phdn flnh cdc tnjdng hpp trd bj xa Idnh vd bj phfln biflt dii
trong nflm 2011 Chf eb 28% ngudi chdm sbc trd nhfln dupe sy h i trp v i gido dye Hp cho biit nguin hfl trp tdi chlnh cho cdc em di hpc cua Chlnh phu ehl dupe
Hpi Chd thflp dd) khbng ddnh cho trd dang phfli sing
db Id nhdng h i trp hpp phdp Nhiiu trd OVC khi
chuyin sang t u i i 18 mong m u i n dw&c di hpc nghi vd
eb v i i c ldm tgt dia phuang huydn Sflc San
2.4 Nhu ciu vi s{r dip img nhu ciu chdm s6c timly
60% ngudi chdm sbc tre OVC cho biit hp cfln SLP giiip dd vd tdm ly t u nhdng nai cung cflp djc^ vy tif vfln tdm ly K i t qud nghidn edu cho thfly 75% ngudi
29% chia sd vdi cdc nhbm t y l y c cua ngudi sing Chung vdi HIV Chi cb 6% ngudi chdm sbc tim kiim
trudng hpc, cb le do nhung c a s d ndy khflng h i trff
Trang 4thj, phdn biflt d i i x d khi biit minh bj nhlim HIV
Da s i ngudi chdm sbc trd OVC ddnh qud nhiiu thdi
gian ldm vide d i h i tn? thu nhflp kinh t i cho gia dlnh ndn
vd gidi dap cdc thfle mflc cho trd 96% trd OVC cho biit
Vdo ttTfli gian rdnh, cde em bd tuii nhb hon choi d i choi,
trp (nflu nuflng, dpn dpp vd giflt giO)
44% tre OVC cho biit dfli khi cde em lo sp vd 51 %
trd OVC cho biit Id thbng thubng cdc em eb thdi dpi
bfl vd thfly cb vi nggi mpi ngudi biit hodn cdnh cOa
dlnh, dflc bi$t Id ngudi chdm sbc 66% trd cho biit mg
minh Id ngudi "hiiu cdc em nhflt trong nhd"
Hflu h i t cdc em mong m u i n sau ndy ldm bde si
(26%), 23% m u i n ldm gido vidn, d i i u ndy cb t h i ly
gidi do trd OVC thudng Idn Idn trong hodn cdnh dau
i m vd chit ehbc khi bdn thdn trd eOng b| mdc cdm va
cb khi t y ky thj minh, ndn eb t h i cde em m u i n trd
chua cho mpi ngupl trong nhd
Bflng 1: Thdi dp ciia hdng xpm, bgn bd xung
quang vd thfly cb vdi trd OVC
Thdi db
11)80 thidn
gkn gOi
Binh
Itiu'd'nq
COI thuang
citi6t bo
Hdng xbm
n
12
71
%
14 5
85 5
Bgn bd xung
quanh
n
10
74
%
11 9
88 1
Thdycb
n
14
70
%
167
83 3 Khflng c6 tofpng hp'p ndo coi thiffl'ng, gh6t
bo Nhdn xdt Bdng trdn cho thiy da s i hdng xflm,
ban bd vd thfly eb d i u c6 thdi dfl binh thudng d i i vdi
trd OVC, khflng cfl d i i tuang ndo cb thdi db coi
thudng ghdt bb d i i vdi tre,
3 Nhung rdo cdn trong vide ddp dng nhu cflu
CSSK cua trd OVC
3.1 Rdo can ve diiu kiin kinh te
70% ngudi cb thu nhflp trong hp Id nu, 14% s i
ngudi chdm sbc tre OVC cho biit hp eb thu nhdp dudi
400 000 VND/thdng, dudi mdc chuin nghdo mdi
dupe de xuit gfln day d i i vdi khu vuc do thi Phfln Idn
cdc hb (66%) chi co duy nhat mpt ngudi cb thu nhdp
Hp cho biet thu nhdp khong du trang trai cdc chi phi
cin thiit cho nhu c i u dinh dudng, hpc hdnh va y t i ,
ddc biet la khi gia dinh cb mpt hoac hai ngudi dau 6m
Thuc te tre OVC phai di lam thdm Ifly tien chi tra hoc
phi (50%) vfl qufln ao (17%) Khi dupe hoi cac em chia
se nhfrng lo ngai ve viec kinh t i khP khdn se ddn den
mdu thuan, cdng thing trong gia dinh, ddc biet khi phai
chi tieu cho an uong, thuoc men, hpc hanh; Kinh te khb
khdn cung khiin cdc em phai chung kien canh b i me
tam, trb chuyen vdi cac em
Ve su hb tra kinh t i , 36 % ngudi cham sbc cho
biit cb nhdn dupe mot s6 hinh thuc h i tra kinh te
90% tu tra cflp/din bu xa hbi, 74% t u nha nude, 23%
3.2 Rio cdn vi nh$n thirc cOa tri OVC vi nguM chdm sdc trd
K i t qud NC cho thfly gida ngudi chdm sflc vd trd OVC cb s y khde bidt v i nhfln thdc t h i ndo Id "dO
quan d i n chflt lupng bda dn han Id s i lupng; phfln Idn cde em (81%) cho biit cdc em dn 3 bda mpt ngdy, 12% cdc em t u i i t d 5-11 fln nhliu han 3 bda mOt ngdy,
Theo k i t qud NC, hidn nay chua eb nhdng hudng
d i n cy t h i v i c h i dO dinh dudng cho trd em nhiSm HIV/AIDS; Kiin thdc v i dinh dudng vd qud trinh phdt triin cOa trd OVC cOa ngudi chdm sbc cfln hgn c h i
3.3 Rdo cin vi k^ thj vd phdn blU dii xu- v&i tri OVC vd gia dlnh tri
Ky thl vd phdn bidt d i i xd vfln Id trd nggi Idn khiin cho ngudi chdm sbc vd trd OVC gflp khb khan Mflt s i ngudi chflm sbc trdnh khbng ydu edu h i trp- gido dye ding ky th|, bdi muin dupe h i ^ ttii sd phdi ebng khai tinh trgng HIV, Tgi mflt sdn chai ddnh ndng cho trd Chung song vd bj flnh hudng bdi HIV, mflt cdn bp vfln dflng gido dye truyin thflng cua Hpi Phy Nd tinh cd
cddicon choi & diy niu khdng muin nd bi liy nhiim"
Mbt s i ngudi chdm sbc giflu khflng cho con em minh biit tinh trang HIV va eb ngudi khflng chju cho con di xdt nghidm, chlnh vi t h i nhiiu em khflng dupe Cham sbc vd/hoac h i trp tdm ly dfly dO Khodng 60% ngudi cham sbc cho biit hp b| ky thi va phan bidt d i i
xu va 14% giiu khfl^ng tiit 1$ tinh trgng bdnh ciia minh
3.4 Rdo dn ve kha ndng tiep cSn dich vu y ti t^i dia phwcmg
Chi phi di lai t i n kdm cbng vdi vide thudng xuyen
phai d i n ca sd KCB 6h thdm khdm cung gdy khb
khdn cho tre OVC vd pia dinh tre trong vide trong vide theo dfli sue khoe/dieu tri cdc benh thudng gdp va benh HIV/AIDS
V i mdc 66 t i i p cfln cdc djch vu y t i hidn cb, 67%
ngudi chdm sbc cho rdng muc dfl tiip cfln hp d muc
"binh thudng," 27% d mire "tit."
V i chi phi khdm chua bdnh vd mua thuoc, 82% nguai chdm sbc cho biit hp cb the bao hiem y te cho tre dudi 6 tuii, tuy nhien the bao hiem khbng chi tra cdc phai diing nhu thuoc khang sinh hoac phi tu van cho
vay na Idi mfli khi con cai bi om, thdm chi phai bdn tai
san d i chi tra cac chi phi lien quan din y t i
V i phuong tien di lai tbi cac ca sd y t i , 34% s6 ngudi dupe hoi cho biet ho di bflng xe may, 28% di xe
bm, 20% su dung phuang tien giao thbng cbng cbng, va 13% di bdng xe dap Nhung ngudi chdm sbc tre OVC d gfln taing tam huyen Sbc San mat it thdi gian de den cdc
xd ndy thubng den bdnh vien A Thdi Nguyen, Mot s i rdo can va khb khan khdc md tre OVC va gia dinh phai d i i mdt, bao gom: Sue khbe cua ngubi chdm soc tre OVC vd nil sa mat mat, Rao can trong viec ddp ung nhu cflu giao due va hpc tap, Rao can ve su ddp ung nhu c i u tdm ly ciia tre OVC
Y HQC THV'C HANH (840) - so 9/2012
Trang 570% trd dang d 66 t u i l t d 5 d i n 11 ,ty Id nam n d
Id nhu nhau (nam 58%, n d 42%)- 49% trd m i c i i b i
hodc mg, 9% cdc em m i c i i cd bo Ifin mg
60% ngudi chflm sbc trd OVC dang s i n g chung
vdi HIV/AIDS; 7 1 % n d gidi, trong 66 54% dd gba
c h i n g vd 49% bd mg cb HIV duang tinh N g h i
nghidp cilia ngudi chdm adc trd OVC da dgng, nhung
chil ydu Id nflng ddn vdl ty Id 46%
Trd OVC cb 2 nhbm nhu cflu CSSK chlnh; (1) Nhu
c&u chdm sflc sdc khde t h i c h i t vdi 2 nhu c i u chlnh
Id CS dinh dudng vd CS y t i , (2) Nhu cflu chdm sdc
Chdm sbc tdm ly gido dye, vd nhu c i u dupe bAo vd:
phdp ly, khdi bj phdn bidt d i l x d , bj ky thj vd bj Igm
dyng, ngu-pv ddi vd bdo ddm c6 nal d an todn
Cb 4 rdo cdn chlnh trong vide ddp dng nhu cflu
CSSK cOa trd OVC, bao g i m : Rdo cdn v i kinh t i ; Rdo
cdn v i nhdn thdc cua trd OVC vd ngubi chdm sbc trd;
Rdo cdn vd ky thj vd phdn bidt d i l x d vdl trd OVC vd
gia dlnh trd; Rdo cdn vd khd ndng t i i p cdn djch vy y t i
tgi dja phuong
Tinh trgng bj xa Idnh vd phdn bidt d i l xu dupe d i
cdp nhiiu nhflt d trudng hpc, tuy nhidn hflu h i t ede
em d i u dupe di hpe Vide lo sp bj xa Idnh vd ky thj
khi tiit to tinh trgng HIV dd ngdn cdn viflc ngudi
chdm sflc trd OVC dua cdc em di xdt nghidm HIV
Chlnh phii Id nguin h i trp chlnh v i tdi chlnh vd
gido dye cho trd OVC, ede nhbm t y lyc vd ede t i
ehCrc c i n g d i n g h i trp ede em v i dmh dudng vd tflm
ly/ tinh cdm
K h u y i n nghj
1 Tdng cudng ehudng trinh gido dye cho d i i
tupng OVC vd ngudi chdm sdc chlnh v i k i i n thdc
phbng ching HIV/AIDS
2 Cfl gidi phdp thdo g d 3 rdo cdn cbn Igi cho vide
sd dyng dich vy y t i v i rdo cdn v i kinh t i ndn cd d i i
v i ky thl vd phdn bidt dii xu vdi trd OVC vd gia dlnh trd
cfln gido dye cho cflng ding dflc bidt thiy cb, hpc sinh d
HIV/AID8?R*iclnvd khd ndng Sip cfln djch v y y t i l g i
d | l prumg oin OO cdn bO y t i t u v i n dfly dD cho ngubi
dlnh diPdng, dliu trf b«nh ev hOI
TAI L I | U T H A M KHAO
f, BO Y t i (1996), Quy djnh chuyin mdn vi xd ly nhlim HIV/AIDS ban hdnh kim theo Quyit dlnh si 2557A3D-BYT ngdy 26/12/1996 cOa Bd Yti
2 Franca-lert, Nguyin Thj Thiing, Luu TTii Blch Ngoc
vd CS (2010), "Trd em nht«m HIV d Vidt Nam Cdc nhdn t i
xd hfli dnh hudng d i n tiip cfln chdm sdc y l i ' , Tdf liiu HOi nghi khoa hoc qudc gia vi HIV/AIDS lin thir4
3 Ddm Thj Thanh Hoa, NguySn Thu Anh, Du, Saul
Hetfenbeln vd CS (2010), "Khdo sdt nhu c i u vide ldm vd
tgi Hd Nfli, Tii liiu Hdi nghi khoa hoc qudc gia vi HIV/AIDS lin thw 4
4 Lisa Messersmilh Lore Sabin, Trfln Lan Anh vd
CS (2010), "Khfl ndng l i i p cfln vd cdi thidn chflt lupng
cdc djch vy y t i vd xd hbi cho phy nd sing chung vtn HIV/AIDS tgi Hfli Phbng vd TP H i Chi Minh" Tdi li^ Hdi nghi ^^°^ ^'^ ^"^ 9'^ ^^ HIV/AIDS lin thw 4
5 Uy ban nhdn ddn huydn Sbc Son (2009), Bdo cdo sd 399/BC-UBND ngdy 15/12/2009 cua UBND huyin Sbc Son
vi tinh hinh k^ qud »iwc tiin ri^im vu ph^ thin kinh tixd hdi an ninh qudc phdng ndm 2009, nhOng nhiim vptrpng^ nim 2010
6 Join forces against HIV - Shareyour head for the children (2009), A guide lo 'National plan o^ action for childmn affected by HIV and AIDS until 2010 with a vision
to 2020' Ha Noi
7 Unk»f (2010), An fijialysis of tiie situation of chiklren in Viet Nam 2010, Execubve Summary
8 Usaid (2009), Social work for chiklren living m(h and affected by HIV/AIDS Ha Noi
9 Usaid (2008), 'The cam and pmtection of children infected and affected by HIV in Viet Nam IN SEARCH OF PROMISING PRACTICES: