Directive No. 03/1999/CT-BYT on intensifying the implementation of the health plan for 1999 to achieve the targets set forth in the Resolution of the Eighth National Party Congress regarding people's health care work.

Implementing the Resolution of the Eighth National Party Congress and Resolution 37/CP of the Government on strategic orientation for health care and protection of people's health during the period 1996-2000 and the National Policy on Medicines of Vietnam, the health sector has achieved many significant accomplishments. Basic health indicators of our people are much higher than those of countries with similar economic income levels. However, alongside these achievements, we still face many difficulties and shortcomings in disease prevention, treatment, staff training, and scientific research.To build upon the achievements made, address deficiencies, and overcome budgetary constraints, effectively implement the 1999 plan and the main targets for 2000, the Minister of Health issues directives to the provincial and municipal health departments directly under the central government, units directly under the Ministry, health sectors of other ministries and industries, and heads of national health program objectives (referred to as units) to direct and implement the following key tasks:

1. Strengthen preventive health work, proactively prevent and control infectious diseases such as Dengue Fever, Malaria, Typhoid, Japanese Encephalitis, Cholera, Plague... with the following basic measures:a) Actively launch environmental sanitation activities from the beginning of the year, properly handle waste water and garbage disposal, and implement measures to control disease vectors. b) Enhance the epidemic surveillance system at all levels to proactively prevent infectious diseases that cause epidemics. For areas with high risk of epidemics, attention should be given to epidemic monitoring, early detection, and timely reporting to higher levels for prompt action.

c) Urgently implement the goal of preventing Dengue Fever, continue to intensify efforts to prevent HIV/AIDS, and maintain results in preventing other infectious diseases; do not allow large-scale outbreaks to occur, and when they do, take immediate measures to contain them. Strive to reduce the number of cases and deaths from infectious diseases by 30% and 10%, respectively, compared to 1998.

d) For provinces currently experiencing cholera outbreaks, concentrate all efforts to contain the outbreak, minimize the number of cases and deaths caused by cholera. For provinces at risk of cholera spread, strictly apply quarantine measures to prevent outbreaks, and if they occur, take prompt containment and eradication measures.

The Standing Office of the Council for International Cooperation on Non-Governmental Organizations (Vietnam Friendship Association) is the agency responsible for receiving registration dossiers, leading, and coordinating with member agencies of the Council to examine dossiers and return results of reviews of registration dossiers of foreign non-governmental organizations in Vietnam.Improve the quality of medical examination and treatment a) Vigorously promote the education of the twelve ethical principles among healthcare staff, implement hospital regulations to enhance the quality of medical examination and treatment (MET) and reduce inconvenience for patients. Continue to effectively implement Directive 661-TTg dated October 17, 1995 of the Prime Minister on immediate medical treatment for emergency and trauma patients; Directive No. 11 CT-BYT dated December 11, 1995 of the Minister of Health on improving patient services in hospitals, and Directive No. 08/1998/CT-BYT dated November 6, 1998 on preventing and treating obstetric emergencies to minimize possible complications during treatment.

b) Gradually adjust the MET network to align with the planning of the sector and localities. Depending on the circumstances of each facility and locality, invest in developing three areas: infrastructure, staff qualifications (paying attention to addressing the staff structure to meet community disease patterns), and equipment.

c) Pay attention to providing good MET services to the poor, those who have contributed to the country, families with policy benefits, and ethnic minorities. For those who are extremely poor, effectively implement Circular 05/1999/TT-LT of the Ministry of Health, Ministry of Finance, Ministry of Labor, Invalids, and Social Affairs.d) Rectify hospital pharmacy work, strengthen the Hospital Drug and Treatment Council to effectively implement Directive No. 04/1998/CT-BYT of the Minister of Health on safe, rational, and economical drug management and use..

2e) Organize well the provision of health insurance medical examination and treatment (HIET), avoiding discrimination between patients paying hospital fees and those with HIET cards. Resolve any issues arising from implementing Decree No. 58/1998/NĐ-CP of the Government on issuing the HIET Charter.

f) Hospitals must implement regular hygiene practices, regularly whitewash and paint doors to ensure hospitals remain clean and beautiful.3. Improve the quality of maternal and child health care work.In 1999, focus on the maternal and child health care program with the following main contents:a) Provide health care for mothers before, during, and after childbirth, ensuring clean delivery and safe motherhood. Each pregnant woman receives at least three antenatal check-ups and one postnatal check-up within 42 days after delivery, striving for over 80% of deliveries to be attended by healthcare personnel. b) Strengthen information, education, communication, and counseling on reproductive health, safe motherhood, and clean delivery for women of reproductive age.

c) Reduce the number of induced abortions by 25% compared to 1998 through close cooperation with population and family planning committees at all levels in providing contraceptive services and population communication.

d) Coordinate and integrate child health programs such as expanded immunization, ARI, CDD, Vitamin A supplementation, etc., aiming to reduce infant mortality rates under one year and five years old to 35‰ and 42‰, respectively, eliminate polio, and eradicate neonatal tetanus by 2000.

4. Accelerate the target program to prevent malnutrition in children to reduce the rate of malnutrition in children under five years old (weight-for-age) by 3% annually with the following proactive measures:

a) Continue to implement the target program to prevent malnutrition in children, focusing on poor areas with high rates of child malnutrition; strictly follow the guidelines

f) Hospitals must implement regular hygiene practices, periodically whitewash and repaint doors, ensuring that hospitals remain clean and tidy at all times.

3. Improve the quality of health care services for mothers and children.

In 1999, focus on the program to provide healthcare for mothers and children with the following main contents:

a) Provide health care for mothers before, during, and after childbirth, ensuring clean delivery and safe motherhood. Each mother should have three prenatal check-ups during pregnancy and at least one postnatal check-up within 42 days after childbirth, striving for over 80% of mothers to receive medical care during childbirth. during pregnancy and to be examined at least once within 42 days postpartum, striving for more than 80% of mothers to receive healthcare services from medical staff.

b) Strengthen information dissemination, education, communication, and counseling on reproductive health, safe motherhood, and clean delivery for individuals of childbearing age. safe childbirth and clean delivery for individuals of reproductive age.

c) Reduce the number of induced abortions by 25% compared to 1998 through close cooperation with population and family planning committees at all levels in providing contraceptive services and population communication.reduce the rate of induced abortion compared to 1998 through close cooperation with Population and Family Planning Committees at all levels in providing contraceptive services and population communication.

d) Coordinate and integrate programs for child health care such as expanded immunization, ARI, CDD, Vitamin A, etc., aiming to reduce the mortality rate of children under one year old and under five years old to 35‰ and 42‰ respectively, eradicate polio, and eliminate neonatal tetanus by the year 2000.

4. Vigorously promote the target program to prevent and combat malnutrition in children to reduce the malnutrition rate of children under five years old (weight-for-age) by 3% annually through the following proactive measures:

a) Continue to implement the target program to prevent and combat malnutrition, focusing on poor areas with high rates of child malnutrition; strictly adhere to relevant regulations. The objectives have been stipulated in Decision No. 244/1998/QĐ-TTg dated November 17, 1998 of the Prime Minister on supplementing the objectives of preventing and combating malnutrition among children into the National Target Program.Eradicating certain social diseases and dangerous epidemics. b) Strengthening health education and nutrition communication for pregnant women and lactating mothers to help them acquire knowledge to effectively care for their children's health and prevent malnutrition.

c) Building pediatric-friendly hospitals and clinics, establishing nutritional departments in hospitals to quickly restore nutrition for sick children who need hospitalization.

5. Consolidate and strengthen the primary healthcare network.

a) Continue implementing Decree No. 01/1998/NĐ-CP of the Government on the local healthcare organization system and Circular No. 02/TT-LT jointly issued by the Ministry of Health and the Civil Service Committee under the Government guiding the implementation of the above decree. In 1999, priority will be given to solving investment issues for 1,000 particularly difficult communes out of 1,715 poor communes nationwide with four contents: having a health station; having adequate medical equipment; having healthcare staff working at the commune level, village health workers, and revolving funds for medicines (based on ODA and domestic budget sources).

b) To ensure that by the year 2000, 100% of commune health stations have midwives (NHS) or pediatricians, 40% of communes have doctors serving, and 100% of villages have community health workers. Provincial Health Departments shall plan and implement the following measures: Organizing specialized obstetric and pediatric refresher courses for general practitioners and midwife knowledge training for nurses; organizing primary midwife training at secondary health schools and practical training at district health centers (TTYT); allocating positions to recruit midwives for communes; implementing policies to encourage midwives from lowland areas to work in highland areas. Implementing the selection and training system for doctors specializing in commune-level services. After completing their studies, these doctors must be assigned to work in communes; reorganizing human resources at provincial and district healthcare facilities reasonably to allow doctors to rotate and work in communes. At the same time, regularly arranging for commune doctors to work in treatment departments at district health centers to improve their professional skills; Implementing a system to utilize retired military and civilian doctors in the locality to serve in communes; coordinating with the Ministry of Defense in training military doctors to work in border guard posts and units stationed in remote, border, island, and difficult areas to provide both military and public health services.

Quickly perfecting the village health system with five key requirements: Unifying the organizational structure, leadership, and functions of village health according to the regulations of the Ministry of Health. Having appropriate activities based on the level of cadres in each region. Having regular meetings with commune health stations. Having monthly allowances from the state budget and contributions from the community. Having medical kits and medicines suitable for the professional level of village health workers (according to the list specified by the Ministry of Health).Provincial Health Departments need to effectively implement the assignment of targets and plans, especially the activities of district health centers and commune health stations; decentralizing management of health indicators to promote the initiative and creativity of primary healthcare levels; strengthening guidance and supervision to help facilities promptly resolve difficulties and obstacles.6. Financial expenditure management and budget control.

Given the situation where the state budget investment in healthcare does not increase and still implements savings of 10% according to the overall policy, leaders of units need to implement the following:

a) Closely monitor and manage the approved 1999 budget spending plan. b) Find all possible measures to mobilize other funding sources to support healthcare. c) Vigorously promote administrative reform, anti-corruption efforts, strengthen budget management and direction, supervise expenditures, implement thriftiness, and properly execute the provisions in Decision No. 248/1998/QĐ-TTg dated December 24, 1998 of the Prime Minister on several policies and measures for economic management and the 1999 state budget estimate, and Circular No. 190/1998/TT-BTC dated December 31, 1998 of the Ministry of Finance guiding the implementation of some points on policies and management of the 1999 state budget estimate.d) Fully understand and creatively implement economic solutions in healthcare, coordinate and rationally utilize existing resources to overcome financial difficulties.

7. Ensuring essential medicines for the people:

a) Vigorously promoting the production and distribution of domestically produced medicines, ensuring sufficient supply of essential medicines for primary healthcare, especially in remote and far-flung areas. Paying particular attention to improving the quality of domestically produced medicines. Minimizing imports of medicines that can be produced domestically to meet needs.

b) Strengthening inspections and quality checks of medicines on the market, at pharmacies, and in healthcare facilities.

8. Promoting competitive spirit:

Gradually building exemplary models and outstanding individuals in the sector, selecting units for targeted healthcare guidance, finding suitable operational models for localities, practically enhancing the quality of operations across the sector. In the short term, units need to organize well the launch of a campaign to learn from Dr. Pham Ngoc Thach, former Minister of Health, and other outstanding examples of commune-level doctors, good deeds of units and within the sector.Besides the key tasks mentioned above, in 1999, units need to direct and implement comprehensively all assigned tasks such as training, scientific research, basic construction, medical equipment, traditional medicine, blood safety, food hygiene and safety, disaster prevention, military-civilian integration, inspection and supervision, administrative reform, and democratic institutions... to fully exploit available resources to successfully complete the 1999 tasks, creating favorable conditions for the entire sector to achieve and exceed health targets set for 2000.

b) Seek all means to mobilize other sources of funding to support healthcare.

c) Vigorously advance administrative reform, anti-corruption efforts, strengthen management and directive control of the budget, monitor expenditures, and achieve frugality, effectively implementing the provisions in Decision No. 248/1998/QĐ-TTg dated December 24, 1998 of the Prime Minister regarding certain policies and measures for economic and social development plans and state budget estimates for 1999, and Circular No. 190/1998/TT-BTC dated December 31, 1998 of the Ministry of Finance guiding the implementation of certain points on policies and state budget estimates for 1999. strengthen administrative reform, anti-corruption efforts, enhance management and directive control over the budget, monitor expenditures, and ensure implementation.d) Fully understand and creatively implement economic solutions in the health sector, coordinating and rationally utilizing existing resources to overcome financial difficulties. 1999.

d) Fully understand and creatively implement economic solutions in healthcare, coordinate and utilizeg resources effectively to address financial difficulties.

7. Ensure essential medicines for the people:

a) Vigorously promote the production and sale of domestic medicines, ensuring adequate supply of essential medicines for primary healthcare facilities, especially remote areas. Emphasize improving the quality of domestically produced medicines. Minimize imports of types of medicines that can be produced domestically to meet needs. types of medicines that domestic production can meet the demand for.

b) Strengthen inspection and quality control of medicines on the market, at pharmacies, and in healthcare facilities. on the market, at pharmacy counters, and in healthcare facilities.

8. Promote competitive activities:

Gradually build exemplary models and outstanding soldiers in the industry, select units for targeted guidance on healthcare, find suitable operational models for localities, and practically enhance the overall quality of operations in the industry. Initially, units need to organize well the launch of competitive activities to learn from the example of Dr. Pham Ngoc Thach, former Minister of Health, and other exemplary models of doctors working at commune level, as well as good deeds of units and individuals within the industry. campaign to promote learning from the example of Doctor Pham Ngoc Thach, former Minister of Health, and outstanding role models among individuals,including doctors working at commune level, exemplary individuals and good deeds within units and the sector.

In addition to the key tasks mentioned above,in 1999, units need to direct and implement comprehensively all assigned tasks such as training, scientific research, basic construction, medical equipment, traditional medicine, blood safety, food hygiene, disaster prevention, military-civilian medical cooperation, inspection and supervision of administrative reform and democratic institutions, making full use of resources to successfully complete the 1999 tasks, facilitating the entire industry to achieve and exceed the health targets set for 2000.

Upon receipt of this Directive, units must immediately organize its implementation and report on the results quarterly to the Ministry of Health. The Departments and Bureaus need to inspect, urge, and work with units and localities to promptly resolve difficulties in order to effectively implement the 1999 plan of the Sector.1999 of the Sector./.