Joint Circular No. 05/2003/TTLT-BYT-BQP guiding the cooperation between military and civilian health services in malaria prevention and control work.

CIRCULAR

JOINT CIRCULAR OF THE MINISTRY OF HEALTH AND THE MINISTRY OF NATIONAL DEFENSE

GUIDELINES ON THE COORDINATION BETWEEN MILITARY AND CIVILIAN MEDICAL SERVICES IN MALARIA PREVENTION AND CONTROL

IMPLEMENTATION OF DIRECTIVE NO. 09/CT ISSUED BY THE CHAIRMAN OF THE STATE COUNCIL OF MINISTERS (NOW PRIME MINISTER) REGARDING MILITARY MEDICAL SERVICES;

TO FULLY EXPLOIT THE STRENGTH OF CIVILIAN AND MILITARY MEDICAL SERVICES FOR THE CARE OF THE PUBLIC AND MILITARY PERSONNEL IN MALARIA PREVENTION AND CONTROL, THE JOINT MINISTRY OF HEALTH AND MINISTRY OF NATIONAL DEFENSE ISSUES THE FOLLOWING GUIDELINES ON THE COORDINATION BETWEEN MILITARY AND CIVILIAN MEDICAL SERVICES IN MALARIA PREVENTION AND CONTROL: 19/4/1988 1. SCOPE OF GUIDANCE:

THIS JOINT CIRCULAR GUIDES THE COORDINATION IN MALARIA PREVENTION AND CONTROL WORK AMONG MILITARY AND CIVILIAN MEDICAL UNITS ACROSS THE COUNTRY.

I. GENERAL ISSUES

THE COORDINATION OF MILITARY AND CIVILIAN MEDICAL SERVICES IN THE PREVENTION AND CONTROL OF OTHER DISEASES AND THE ADMISSION OF INJURED OR ILL PERSONS SHALL BE CONDUCTED IN ACCORDANCE WITH JOINT CIRCULAR NO. 09/TT-LB ISSUED ON JULY 21, 1992 BY THE MINISTRY OF HEALTH AND THE MINISTRY OF NATIONAL DEFENSE.

2. IN THIS JOINT CIRCULAR, CERTAIN TERMS ARE UNDERSTOOD AS FOLLOWS:

MILITARY MEDICAL SERVICES: MILITARY HEALTH SERVICES.

CIVILIAN MEDICAL SERVICES: STATE HEALTH SERVICES EXCLUDING MILITARY HEALTH SERVICES.

PRIMARY HEALTH CARE: HEALTH SERVICES AT THE COMMUNE, VILLAGE LEVEL, OR EQUIVALENT MILITARY HEALTH SERVICES.

MEDICAL SUPPLIES: INCLUDE DRUGS, CHEMICALS, MEDICAL EQUIPMENT, ETC., USED FOR DIAGNOSIS AND TREATMENT OF MALARIA PATIENTS, AND FOR PREVENTION AND CONTROL OF MALARIA EPIDEMICS.

II. STRENGTHENING ORGANIZATIONAL STRUCTURES

1. AT THE CENTRAL LEVEL:

ENHANCE CLOSE COOPERATION BETWEEN THE DEPARTMENT OF PREVENTIVE MEDICINE, RELATED DEPARTMENTS (MINISTRY OF HEALTH), THE NATIONAL MALARIA CONTROL PROJECT (CENTRAL INSTITUTE OF PARASITOLOGY AND TROPICAL DISEASES, INSTITUTE OF PARASITOLOGY AND TROPICAL DISEASES IN QUI NHON, HO CHI MINH CITY BRANCH OF THE INSTITUTE OF PARASITOLOGY AND TROPICAL DISEASES) AND THE MILITARY HEALTH DEPARTMENT AND THE MILITARY PREVENTIVE HEALTH SYSTEM IN GUIDING AND UTILIZING CIVILIAN AND MILITARY HEALTH FORCES TO ACHIEVE THE OBJECTIVES OF THE NATIONAL MALARIA CONTROL PROJECT.

ESTABLISH A CENTRAL MILITARY-CIVILIAN HEALTH COMMITTEE COMPRISING REPRESENTATIVES FROM THE MINISTRY OF HEALTH, THE MILITARY HEALTH DEPARTMENT, AND THE NATIONAL MALARIA CONTROL PROJECT. MEET ONCE EVERY SIX MONTHS TO REVIEW WORK AND SET THE PLAN FOR THE NEXT SIX MONTHS. MEET URGENTLY WHEN NECESSARY.

2. AT THE PROVINCE LEVEL:

IN PROVINCES WHERE MALARIA IS PRESENT, ESTABLISH A PROVINCIAL MILITARY-CIVILIAN HEALTH COMMITTEE COMPRISING THE FOLLOWING MEMBERS:

+ DIRECTOR OF THE PROVINCIAL MALARIA PREVENTION CENTER OR DIRECTOR OF THE PROVINCIAL PREVENTIVE HEALTH CENTER.

+ HEAD OF THE PROVINCIAL BORDER GUARD HEALTH DEPARTMENT.

+ COMMANDER OF THE SANITATION AND DISEASE PREVENTION UNIT OF THE MILITARY REGION OR MILITARY CORPS (IF PRESENT IN THE PROVINCE).

3. AT THE DISTRICT AND COMMUNE LEVELS:

ALL DISTRICTS IN MALARIA ENDEMIC AREAS, BORDER REGIONS, REMOTE AND REMOTE AREAS MUST ESTABLISH A DISTRICT MILITARY-CIVILIAN HEALTH COMMITTEE COMPRISING THE DISTRICT PREVENTIVE HEALTH CENTER, THE HEAD OF THE MILITARY HEALTH DEPARTMENT OF MILITARY UNITS, AND THE MILITARY HEALTH DEPARTMENT OF BORDER GUARDS STATIONED IN THE AREA.

SEPARATELY, COMMUNES IN THESE AREAS MAY ALSO ESTABLISH A COMMUNE MILITARY-CIVILIAN HEALTH COMMITTEE WITH SIMILAR MILITARY AND CIVILIAN HEALTH COMPONENTS IF NECESSARY.

III. IMPLEMENTATION OF MALARIA PREVENTION AND CONTROL MEASURES

IN MALARIA ENDEMIC AREAS, UNIFY MALARIA PREVENTION AND CONTROL MEASURES FOR BOTH MILITARY PERSONNEL AND THE POPULATION AS FOLLOWS:

1. VECTOR CONTROL EFFORTS:

USE BED NETS.

TREAT BED NETS WITH CHEMICALS TO REPEL AND KILL MOSQUITOES. SPRAY RESIDUAL CHEMICALS ON WALLS OF HOUSES AND CAMPS.

THE PROVINCIAL MALARIA PREVENTION CENTER OR THE PROVINCIAL PREVENTIVE HEALTH CENTER, AND THE DISTRICT PREVENTIVE HEALTH TEAM ARE RESPONSIBLE FOR TECHNICAL GUIDANCE SUCH AS THE CHEMICALS USED, DOSAGES, AND APPLICATION TIMES AS PER THE NATIONAL MALARIA CONTROL PROJECT.

ADJUST THE APPLICATION OF RESIDUAL SPRAYING, TREATED BED NETS, OR BOTH, ACCORDING TO THE MALARIA SITUATION IN EACH AREA AND AT APPROPRIATE TIMES.

IT IS PREFERABLE TO ORGANIZE THE SPRAYING AND TREATMENT OF BED NETS FOR BOTH MILITARY UNITS AND LOCAL POPULATIONS AT THE SAME TIME AND WITH THE SAME CHEMICAL TO FACILITATE MONITORING AND GUIDANCE.

WHEN CARRYING OUT SPRAYING AND TREATMENT CAMPAIGNS FOR MILITARY PERSONNEL AND THE POPULATION, THERE MUST BE MILITARY AND CIVILIAN HEALTH COORDINATION THROUGH THE PROVINCIAL, DISTRICT, AND COMMUNE MILITARY-CIVILIAN HEALTH COMMITTEES.

2. EPIDEMIOLOGICAL SURVEILLANCE, CASE DETECTION, AND MANAGEMENT:

EPIDEMIOLOGICAL SURVEILLANCE OF MALARIA, SOURCE SURVEILLANCE, CASE DETECTION, AND MANAGEMENT ARE THE RESPONSIBILITIES OF MILITARY AND CIVILIAN HEALTH FACILITIES, BUT THEY MUST SUPPORT EACH OTHER DURING IMPLEMENTATION. ESPECIALLY, MILITARY HEALTH SERVICES OF BORDER GUARDS AND MILITARY UNITS IN REMOTE AREAS NEED TO ASSIST CIVILIAN HEALTH SERVICES IN SURVEILLANCE AND MANAGEMENT OF MALARIA CASES IN THEIR TERRITORIES AND AMONG CROSS-BORDER TRAFFICKERS. DEVELOP MICROSCOPY POINTS IN BORDER GUARDS POSTS (WITH LOCAL CIVILIAN HEALTH SUPPORT) AND IN REMOTE COMMUNES. MICROSCOPY POINTS OF THE CIVILIAN HEALTH SYSTEM CAN TEST OR PROVIDE TESTING MATERIALS TO MILITARY HEALTH SERVICES AND VICE VERSA. DIAGNOSTIC METHODS MUST BE UNIFIED BETWEEN CIVILIAN AND MILITARY HEALTH FACILITIES AS PER THE MINISTRY OF HEALTH'S GUIDELINES.

3. MALARIA TREATMENT: ORDINARY MALARIA DIAGNOSIS AND TREATMENT ARE CONDUCTED THROUGH MILITARY OR CIVILIAN HEALTH LINES AND ACCORDING TO THE MINISTRY OF HEALTH'S GUIDELINES.

IN CASES OF SEVERE MALARIA OR FALCIPARUM MALARIA, THE NEAREST HEALTH FACILITY (WHETHER MILITARY OR CIVILIAN) MUST TAKE RESPONSIBILITY FOR EMERGENCY TREATMENT.

TRANSFER TO UPPER LEVELS MUST FOLLOW THE INDICATIONS AND CONTRAINDICATIONS IN THE MINISTRY OF HEALTH'S MALARIA DIAGNOSIS AND TREATMENT GUIDELINES.

IN BORDER, REMOTE, AND REMOTE AREAS WHERE LOCAL HEALTH SERVICES ARE WEAK OR UPON REQUEST FROM LOCAL HEALTH AUTHORITIES, MILITARY HEALTH UNITS MUST PARTICIPATE IN CLINICAL CARE AND TREATMENT AS A REGIONAL HEALTH FACILITY. IN THIS CASE, THE COST OF CLINICAL CARE FOR THE POPULATION IS COVERED BY LOCAL HEALTH SERVICES.

WHERE NECESSARY AND POSSIBLE, MIXED MILITARY-CIVILIAN HEALTH CLINICS CAN BE ESTABLISHED TO SERVE BOTH MILITARY PERSONNEL AND THE POPULATION.

4. MALARIA EPIDEMIC PREVENTION AND CONTROL: MALARIA EPIDEMIC PREVENTION AND CONTROL IS THE RESPONSIBILITY OF BOTH MILITARY AND CIVILIAN HEALTH SERVICES. MILITARY AND CIVILIAN HEALTH SERVICES MUST MAINTAIN CLOSE RELATIONSHIPS AND INFORM EACH OTHER ABOUT MALARIA SITUATIONS IN THEIR RESPECTIVE TERRITORIES.

WHEN THERE IS A THREAT OF A MALARIA EPIDEMIC, LOCAL HEALTH SERVICES AND MILITARY HEALTH UNITS MUST IMMEDIATELY REPORT TO SUPERIOR HEALTH AUTHORITIES AND THE MILITARY-CIVILIAN HEALTH COMMITTEE AND ORGANIZE MEETINGS TO DEVELOP AN EPIDEMIC PREVENTION PLAN.

4. Work on preventing and controlling malaria: Preventing and controlling malaria is a health task for both military and civilian medical services. The military and civilian medical services must maintain close relations and inform each other about the malaria epidemic situation at agencies and units under their respective management areas.

When there is a threat of a malaria outbreak, local health authorities and military medical services of units stationed in the area must immediately report to the higher-level health authorities of both sides and the Military-Civilian Health Board using the fastest means possible, while organizing meetings to develop plans for preventing and controlling the disease.

When a malaria outbreak occurs, strict emergency reporting procedures must be implemented, and a Command Board to combat the epidemic must be quickly established to implement prevention and control plans, preventing the outbreak from becoming large-scale, prolonged, and widespread. The results of the epidemic prevention and control efforts shall be reported according to regulations to higher-level health authorities, the Preventive Medicine Department (Ministry of Health), the Central Institute for Malariology, Parasitology and Entomology, the Quy Nhon Institute for Malariology, Parasitology and Entomology, the Ho Chi Minh City Branch of the Institute for Malariology, Parasitology and Entomology, and the Military Health Service.

Depending on the characteristics and scale of the epidemic or upon receiving requests for support from local military-civilian health boards, the Ministry of Health, the Central Institute for Malariology, Parasitology and Entomology, the Quy Nhon Institute for Malariology, Parasitology and Entomology, the Ho Chi Minh City Branch of the Institute for Malariology, Parasitology and Entomology, and the Military Health Service shall have the responsibility to organize the mobilization of mobile anti-epidemic teams from civilian and military health services at rear lines to reinforce and strengthen.

In cases where military health units require emergency medical equipment, treatment supplies, medicines, and chemicals for vector control that the military health service has not been able to prepare due to objective conditions, the civilian health authority shall have the responsibility to provide assistance and support, and vice versa.

For key state projects (construction of roads, hydropower projects, etc.), if the workforce includes both military and civilian forces, the health forces from both sides must have the responsibility to coordinate and unify the planning for malaria prevention and control, supporting each other with medical equipment and supplies when required.

IV. REGARDING TRAINING, EDUCATION AND COMMUNICATION FOR MALARIA PREVENTION AND CONTROL

Annually, representatives of military health are invited to attend summary meetings and regular malaria prevention and control coordination meetings organized by civilian health authorities at all levels. Conversely, under permissible conditions, civilian health authorities may be invited to participate in military health meetings.

Institutes, Branches, Provincial Malaria Prevention Centers, or County Health Prevention Centers have the responsibility to support the training and supplementary education of specialized staff for military health forces and Border Guard Forces. After discharge, these personnel may be prioritized for use as grassroots health workers participating in malaria prevention and control work.

Training courses on malaria prevention and control organized by civilian health specialty systems should invite military health participants based on the target audience and provide materials and resources to support the training of military health personnel in malaria prevention and control.

Military and civilian health authorities have the responsibility to develop and implement plans to disseminate information about malaria prevention and control to every soldier and local resident, providing them with knowledge about malaria and preventive measures. Civilian health facilities are responsible for providing educational and communication materials (posters, pamphlets, audiovisual materials, etc.) to military health units for malaria prevention and control education and communication activities.

V. REGARDING THE DEVELOPMENT OF PLANS AND THE ENSURING OF MEDICAL SUPPLIES AND FUNDS

Each military region, corps, branch, border guard unit annually develops detailed plans for their specific needs for professional activities, technical requirements, and supplies to ensure malaria prevention and control operations, which are then submitted to the Military Health Service. The Military Health Service has the duty to compile and report in writing to the Ministry of Health (Preventive Medicine Department, National Malaria Control Project).

Annually, the National Malaria Control Project (Ministry of Health) bases its supply and funding plan on the estimates provided by the Military Health Service, the Border Guard Health Office, and the nature of military activities to ensure appropriateness. The Ministry of Defense is responsible for ensuring part of the supplies and funds for the military's malaria prevention and control work. In case of urgent needs, additional support can be provided from the National Malaria Control Project.

When a malaria outbreak occurs, the party within whose jurisdiction it falls shall be responsible for the supplies and funding. Military and civilian health services shall assist each other according to their respective capabilities during the epidemic control process.

If the civilian health service requests military health to dispatch forces to help with civilian malaria prevention and control, the implementation of supplies and funding will be carried out through two methods:

+ For small-scale epidemics: Civilian and military health services in the same locality shall discuss and cooperate to support each other in resolving the issue.

+ For large-scale epidemics: The Ministry of Health (National Malaria Control Project) shall ensure the necessary supplies and funding.

VI. REGARDING REPORTING PROCEDURES

1. The Director of the Health Department shall report on the combined military-civilian health work to the People's Committee of the province and the Ministry of Health in regular reports.

2. The Head of the Military Health Service of the province shall report on the combined military-civilian health work to the Military Command of the province and the Military Region Health Office in regular reports.

3. The Provincial Military-Civilian Health Board shall report semi-annually and annually to the People's Committee of the province, the Ministry of Health, the Ministry of Defense (Military Health Service), and the Military Region Health Office.

4. The Military Health Service shall be responsible for directing the entire military health system to implement the objectives of the National Malaria Control Project according to the signed plan and to compile all military malaria prevention and control activities for semi-annual and annual reports to the Ministry of Health (National Malaria Control Project).

VII. EFFECTIVE DATE OF IMPLEMENTATION

1. This Circular takes effect fifteen days after its publication in the Official Gazette and replaces previous regulations and guidelines that conflict with the guidelines in this Circular.

2. During implementation, if there are difficulties or the need for supplementation to align with actual circumstances, units and localities should reflect these issues to the Ministry of Health and the Ministry of Defense for research and resolution.