Circular 32/2024/TT-BYT guides the functions, tasks, authorities, and organizational structure of District Health Centers under provincial cities and centrally governed cities issued by the Minister of Health.

CIRCULAR

Guidelines on the functions, tasks, powers, and organizational structure of District Health Centers, urban district health centers, town health centers, and provincial city health centers under centrally governed cities

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Pursuant to Resolution No. 99/2023/QH15 dated June 24, 2023 of the National Assembly's 15th term regarding special supervision on the mobilization, management, and utilization of resources for COVID-19 prevention and control work; implementation of policies and laws on primary healthcare and preventive healthcare;

Pursuant to Decree No. 24/2014/NĐ-CP dated April 4, 2014 of the Government stipulating the organization of specialized agencies under provincial People's Committees and centrally governed city People's Committees; Decree No. 107/2020/NĐ-CP dated September 14, 2020 of the Government amending and supplementing certain articles of Decree No. 24/2014/NĐ-CP;

Pursuant to Decree No. 95/2022/NĐ-CP dated November 15, 2022 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health;

At the proposal of the Director of the Cadre and Civil Servant Department, Ministry of Health;

The Minister of Health issues this Circular guiding the functions, tasks, powers, and organizational structure of District Health Centers, urban district health centers, town health centers, and provincial city health centers under centrally governed cities (hereinafter referred to collectively as District Health Centers).

PART I

GENERAL PROVISIONS

Article 1. Scope of Regulation

This Circular guides the functions, tasks, powers, and organizational structure of District Health Centers, including District Health Centers located in administrative units at the district level that have general hospitals with Class II or higher ratings operating within their territory.

Article 2. Legal Status

Article 1. District Health Centers are public health service organizations directly under the People's Committee of the district, urban district, town, or provincial city under a centrally governed city (collectively referred to as the People's Committee at the district level). District Health Centers have legal personality, separate offices, seals, and bank accounts opened at the State Treasury and banks in accordance with the law.

Article 2. District Health Centers are subject to comprehensive management by the People's Committee at the district level; they are directed, guided, inspected, and supervised in terms of professional expertise, technology, and business operations by the Department of Health and other specialized agencies under the provincial People's Committee in accordance with the law.

Chapter II

FUNCTIONS, TASKS, POWERS

Article 3. Functions

District Health Centers have the function of providing professional and technical services related to preventive healthcare, medical examination and treatment, rehabilitation, reproductive health, food safety, population, and other healthcare services as prescribed by law; they directly manage commune health stations, ward health stations, town health stations (collectively referred to as commune health stations) and other organizations under the District Health Center (if any) within their territory.

Article 4. Tasks and Powers

Clause 1. Implement activities providing professional and technical services related to preventive healthcare:

Point a. Implement activities to prevent and control infectious diseases, HIV/AIDS: surveillance, early screening and detection, vaccination, preventive treatment, implementation of measures to prevent and control infectious diseases and mitigate their consequences; prevention and control of factors causing the emergence and spread of infectious diseases;

Point b. Implement activities to prevent and control non-communicable diseases: monitoring and preventing risk factors, surveillance, early screening and detection, management of high-risk individuals and patients with non-communicable diseases in the community, and implementation of measures to prevent and control non-communicable diseases;

Point c. Implement community nutrition activities; school health; environmental health, hygiene during burial and cremation for cases of death due to dangerous infectious diseases; occupational health; prevention and control of occupational diseases, accidents, and injuries; monitoring the quality of water used for daily purposes; environmental protection for healthcare facilities and prevention and control of harmful factors for health according to the law;

Point d. Organize and implement health examinations, classification of health status, regular health check-ups for workers, and health check-ups for military service obligations as prescribed by law.

Clause 2. Implement activities providing professional and technical services related to medical examination and treatment, rehabilitation:

Point a. Provide first aid and emergency care;

Point b. Conduct medical examinations, treatments, and rehabilitation according to the medical examination and treatment license and the scope of professional activities approved by the competent authority;

Point c. Perform techniques, procedures, surgeries, and transfer patients to other medical examination and treatment facilities as prescribed by law;

Point d. Organize and manage drug substitution therapy for opiate addiction, treatment for other types of addiction, and HIV/AIDS treatment as prescribed by law;

Point đ. Coordinate in conducting medical forensic examinations as prescribed by law; participate in forensic medical examinations when requested.

Clause 3. Implement activities providing professional and technical services related to reproductive health care:

Point a. Implement activities to provide maternal and child health care, neonatal and child health care, adolescent and youth reproductive health care, male reproductive health care, and elderly reproductive health care;

Point b. Perform gynecological techniques and procedures and implement contraceptive methods as prescribed;

Point c. Prevent and control sexually transmitted infections, reproductive tract cancers, and congenital diseases.

Clause 4. Implement activities providing professional and technical services related to food safety:

Point a. Implement activities to prevent and control food poisoning; investigate, monitor, and handle food poisoning incidents and foodborne illnesses; monitor food contamination risks within the territory;

Point b. Guide and supervise food production and trading establishments, food service businesses, and street food vendors within the territory in ensuring food safety according to the law;

Point c. Participate in assessing food production and trading establishments within the territory for compliance with conditions; participate in inspections and checks on food safety and perform other tasks related to food safety as prescribed by law and as assigned.

Clause 5. Implement activities providing professional and technical services related to population:

a) Implement pre-marriage counseling and health check-ups; prenatal screening and newborn screening; family planning services; community-based infertility prevention measures; population and family planning counseling and services for minors and young adults; healthcare and nutrition services for the elderly.

b) Organize and coordinate inter-departmental activities to implement population work aimed at managing population fluctuations, adjusting birth rates, controlling population size, and regulating gender imbalance at birth; reducing early marriage and consanguineous marriages; improving population quality and providing appropriate healthcare for the elderly in accordance with legal provisions.

6. Conduct diagnostic tests, imaging examinations, and functional investigations to support specialized technical activities according to the Center's functions and tasks and the needs of the people; organize and ensure biological safety measures in laboratories and radiation safety in accordance with legal provisions.

7. Provide medical services for disaster response and recovery, and emergency medical situations.

8. Promote and provide information on Party policies and State laws; organize counseling, education, communication, and mobilization activities to encourage public participation in health protection, improvement, food safety, population, and development activities within the jurisdiction.

9. Manage, guide, supervise, and support specialized technical activities:

a) Establish health management records for residents within the jurisdiction.

b) Directly manage and oversee specialized technical activities at commune health stations and other organizations under the County Health Center (if applicable).

c) Guide, inspect, and supervise the provision of basic health service packages by commune health stations.

d) Guide, inspect, and supervise specialized technical activities at healthcare facilities under administrative agencies, schools, forestry farms, enterprises, industrial zones, high-tech zones, export processing zones, and village health workers, midwives, and population cooperation officers.

10. Train and develop healthcare personnel:

a) Conduct training and capacity building for staff under its management authority in accordance with legal provisions.

b) Participate in training, workshops, and capacity building for village health workers, midwives, population cooperation officers, and other groups as specified by competent authorities.

c) Serve as a practical training base in accordance with legal provisions.

11. Purchase, receive, supply, store, distribute, and use medicines, contraceptives, vaccines, medical supplies, chemicals, and medical equipment for professional activities in accordance with authorized regulations and legal provisions.

12. Implement projects and programs in the fields of health and population in accordance with authorized regulations; coordinate military and civilian healthcare activities based on actual conditions and legal provisions.

13. Enter into contracts with social insurance agencies to organize health insurance examination and treatment services at the County Health Center, commune health stations, and other organizations under the County Health Center (if applicable) in accordance with legal provisions.

14. Conduct and participate in scientific research and technological development; apply scientific and technological advancements in professional activities.

15. Perform social work tasks, quality management, information technology, digital transformation, and international cooperation in accordance with actual conditions and legal provisions.

16. Maintain statistical records and reporting systems; build, compile, and provide health and population data bases in accordance with legal provisions.

17. Manage human resources, finance, and assets in accordance with delegated authority and legal provisions.

18. Perform other tasks and powers assigned by competent authorities.

Chapter III

ORGANIZATIONAL STRUCTURE, PERSONNEL, AND FINANCIAL RESOURCES

Article 5. Organizational Structure

1. The leadership of the County Health Center includes the Director and Deputy Directors.

Appointments, reappointments, transfers, rotations, dismissals, and resignations of the positions of Director and Deputy Director of the County Health Center shall be carried out in accordance with legal provisions and the delegation of the Provincial People's Committee Chairman.

2. Functional Departments of the County Health Center:

通函生效及其他规定（第19-22条）

b) Planning and Operations Department;

c) Communication and Health Education Department;

d) Nursing Department;

đ) Finance and Accounting Department.

3. Specialized Departments of the County Health Center:

a) Disease Control and HIV/AIDS Department;

b) Public Health Department;

c) Food Safety Department;

d) Population and Development Department;

đ) Reproductive Health and Obstetrics Department;

e) Outpatient Clinic/Multi-specialty Clinic Department;

g) Emergency and Intensive Care Department;

h) Internal Medicine Department;

i) Surgery Department;

k) Anesthesia and Recovery Department;

l) Pediatrics Department;

m) Traditional Medicine and Rehabilitation Department;

n) Infectious Diseases Department;

o) Infection Control Department;

p) Laboratory Department;

q) Imaging Department;

r) Oral and Maxillofacial, Ophthalmology, and ENT Department;

s) Pharmacy and Medical Supplies Department;

t) Nutrition Department;

u) Counseling and Substance Abuse Treatment Department.

4. Organizations under the County Health Center:

a) Commune Health Stations;

b) Other organizations under the County Health Center (if applicable), their functions and responsibilities are defined by competent authorities based on local needs and actual conditions, in accordance with legal provisions.

5. Based on the nature, characteristics, and actual needs of each locality, competent authorities decide:

a) The establishment and restructuring of functional departments, specialized departments, commune health stations, and other organizations under the County Health Center to match job requirements and meet legal criteria and conditions.

b) Specific duties of functional departments, specialized departments, commune health stations, and other organizations under the County Health Center in accordance with legal provisions and local delegation and decentralization.

6. The arrangement of inpatient beds at the District Health Center to meet and be suitable for actual needs shall be advised by the District Health Center and submitted to the competent authority for consideration and decision, ensuring conditions as prescribed by law.

Article 6. Human Resources

1. The number of staff working at the District Health Center shall be determined based on job positions according to functions, tasks, and scope of activities of organizations under the Center as stipulated in Article 5 of this Circular, assigned or approved by the competent authority.

2. Based on functions, tasks, organizational structure, and job position list, the District Health Center shall develop a job position plan, determine the structure of civil servants by profession and submit it to the competent authority for approval; annually develop a staffing plan, report to the competent authority for consideration and decision in accordance with the provisions of the law.

Article 7. Financial Sources

1. State budget.

2. Revenue from public service activities.

3. Fees retained by public service units for expenditure as prescribed by laws on fees and charges.

4. Borrowed capital, aid, and sponsorship as prescribed by law.

5. Other revenues as prescribed by law (if any).

Chapter IV

IMPLEMENTING PROVISIONS

Article 8. Effective Date

1. This Circular takes effect from January 1, 2025.

2. Circular No. 07/2021/TT-BYT dated May 27, 2021, guiding the functions, tasks, powers, and organizational structure of the District Health Centers, urban districts, towns, and cities under provinces, cities directly under the central government, shall cease to be effective from the date this Circular takes effect.

Article 9. Cross-References

In case the referenced documents in this Circular are replaced or amended, they shall be applied according to the replaced or amended documents.

Article 10. Responsibility for Implementation

1. People's Committees of provinces and centrally-administered municipalities:

a) Decide on transferring district health centers under the provincial Department of Health to the management of the district-level People's Committee in accordance with the law; complete before July 1, 2025;

b) Direct the detailed definition of the functions, tasks, powers, and organizational structure of the District Health Center in accordance with the law;

c) Direct the issuance of regulations on coordination between the district-level People's Committee and relevant provincial specialized agencies in implementing tasks related to health care, protection, and improvement of people's health in the locality;

d) Direct relevant provincial specialized agencies to review and propose to the competent authority for consideration and amendment of regulations within their jurisdiction in managing the field at the district level in accordance with the law and the delegated management level.

2. Departments of Health of provinces and centrally-administered municipalities, relevant specialized agencies under the provincial People's Committee:

a) Direct, manage, guide, inspect, supervise the implementation of professional and business tasks related to providing services in the fields of health, food safety, population in the district in accordance with the law;

b) Coordinate with the district-level People's Committee to implement health and population programs in the locality according to the delegated management level.

3. District-level People's Committee:

a) Ensure material conditions, finance, human resources, and other necessary conditions for the District Health Center to effectively perform its tasks as prescribed;

b) Coordinate with provincial specialized agencies and direct relevant district-level specialized agencies in implementing and strengthening state management in the field in the locality;

c) Issue or submit to the Chairman of the district-level People's Committee for promulgation specific regulations on the functions, tasks, powers, and organizational structure of the District Health Center in accordance with this Circular, meeting actual needs and conditions in accordance with the law and local delegated management level.

In the course of implementation, if any issues arise, difficulties, or obstacles, the relevant agencies, organizations, and individuals are requested to promptly report them to the Ministry of Health (through the Cadre and Civil Servant Organization Department) for examination and resolution./.