Decision No. 3370/2002/QD-BYT on issuing the "National Standard for Rural Health Stations for the 2001-2010 period"

Pursuant to …;

Regarding the issuance of the "National Standard for Rural Health Services for the 2001-2010 Period"

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THE MINISTER OF HEALTH

Pursuant to the Government Decree No. 68/CP dated October 11, 1993, stipulating the functions, tasks, authorities, and organizational structure of the Ministry of Health.

At the proposal of the Director of the Planning Department and the Director of the Cadres and Civil Servants Organization Department of the Ministry of Health

Pursuant to …;

Article 1. Now hereby promulgates with this Decision the "National Standard for Rural Health Services for the 2001-2010 Period".

Article 2. The National Standard for Rural Health Services for the 2001-2010 Period serves as the standard and criteria for rural health stations to implement.

Article 3. This Decision takes effect fifteen days from the date of issuance. All provisions contrary to those set forth in this Decision are abolished.

Article 4. The Heads of the Office, Inspectorate, Directors of Departments under the Ministry of Health, Directors of the Vietnam Drug Administration, Directors of the Food Safety and Control Bureau, and Directors of Provincial Health Departments are responsible for implementing this Decision./.

NATIONAL STANDARD FOR RURAL HEALTH SERVICES FOR THE 2001-2010 PERIOD

(Issued together with Decision No. 370/2002/QĐ-BYT dated February 7, 2002 of the Minister of Health)

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 STANDARD I

SOCIALIZATION OF HEALTH CARE AND PROTECTION AND HEALTH EDUCATION COMMUNICATION WORK

A. SOCIALIZATION OF HEALTH CARE AND PROTECTION

1. Health care and protection work for the people in the commune shall be included in the resolutions of the Party Committee and People's Council of the commune. Specific action plans approved by the People's Committee of the commune shall be developed to implement these resolutions.

2. There shall be a Health Care Board operating regularly at the commune level, headed by the Chairman or Vice-Chairman of the People's Committee of the commune, with the Head of the Health Station serving as the Deputy Chairman and heads of relevant departments at the local level as members. Meetings shall be held every six months to evaluate health care and protection work in the commune, with community representatives participating.

3. The community and political-social organizations at the local level shall be actively involved in implementing health programs in the area.

B. HEALTH EDUCATION COMMUNICATION WORK

1. One hundred percent of health station staff and village health workers shall be trained in basic knowledge and skills related to health education and communication.

2. Counseling and health education and communication activities shall be integrated into health stations, communities, and households.

3. Health education through the commune public address system shall be conducted at least:

Plainlands and midlands: four times per month or more

Mountainous areas: two times per month or more

4. Community meetings organized and participated in by the commune shall be held at least:

Plainlands and midlands: six times per year or more

Mountainous areas: four times per year or more

5. The percentage of households that have acquired basic knowledge about essential health practices for mothers and children at home and in the community, accident prevention, and knowledge about preventing certain dangerous diseases in the locality (as determined by the provincial health department and local authorities) shall reach:

Plainlands and midlands: sixty percent or more

Mountainous areas: fifty percent or more

STANDARD II

ENVIRONMENTAL SANITATION AND DISEASE PREVENTION

A. DISEASE PREVENTION

1. Early detection and timely reporting of infectious diseases causing epidemics (including food poisoning, pesticide poisoning, accidents, and injuries) according to the regulations of the Ministry of Health. If an epidemic occurs, initial measures shall be taken and cooperation shall be sought to promptly control it.

2. Measures shall be implemented to prevent large-scale epidemics from occurring in the area.

B. NATIONAL TARGET PROGRAM ON HEALTH

Achieve and exceed the annual targets and indicators assigned for the national target program on the prevention and control of certain social diseases, dangerous epidemics, and HIV/AIDS.

C. ENVIRONMENTAL HEALTH: CLEAN WATER, HYGIENIC LATRINES, WASTE MANAGEMENT, ANIMAL WASTE MANAGEMENT, OCCUPATIONAL HEALTH

1. Percentage of households using clean water:

Rural areas: seventy percent or more

Urban areas: ninety percent or more

2. Percentage of households using hygienic latrines:

Rural areas: seventy percent or more

Urban areas: ninety percent or more

3. Percentage of households managing waste properly:

Rural areas: seventy percent or more

Urban areas: ninety percent or more

4. The ratio of households properly disposing of feces meeting hygiene standards reaches 70% or more

4. Percentage of households managing animal waste hygienically shall reach seventy percent or more

5. Participate in joint inspections of occupational health in the area

D. SCHOOL HEALTH

1. Annual health check-up rate for students:

Kindergarten: eighty percent or more

Primary and secondary schools: sixty percent or more in plainland communes and forty percent or more in mountainous communes.

2. Annual dental examination and care rate for primary and secondary school students:

Plainlands and midlands: fifty percent or more

Mountainous areas: thirty percent or more

3. Results of all health examinations shall be reported to parents and over ninety percent of cases identified in the school health program shall be managed and treated.

STANDARD III

OUTPATIENT CLINICAL CARE AND FUNCTION REHABILITATION

1. Average number of outpatient visits per person per year at the health station and in households shall reach 0.6 or more.

2. Percentage of patients diagnosed and treated appropriately at the health station shall reach eighty percent or more.

3. Percentage of disabled persons in the community being managed shall reach:

Plainlands and midlands: ninety percent or more

Mountainous areas: seventy percent or more

4. Percentage of disabled persons receiving guidance and rehabilitation services in the community shall reach:

Plainlands and midlands: twenty percent or more

Mountainous areas: fifteen percent or more

5. Elderly health care shall be prioritized; one hundred percent of individuals aged eighty years and above shall be managed.

6. Serious adverse events leading to death during treatment shall not occur.

7. All specialized staff shall possess basic knowledge and skills in emergency care, reproductive health care, and normal delivery.

STANDARD IV

TRADITIONAL MEDICINE

1. The health station shall have a garden or potted plants containing at least forty types of medicinal herbs specified by the Ministry of Health.

2. The percentage of patients treated with traditional medicine or combined with modern medicine at the health station shall reach twenty percent or more.

3. Treatment using traditional medicine without medication shall be carried out, especially in places where there are dedicated traditional medicine practitioners.

STANDARD V

CHILD HEALTH CARE

1. Immunization coverage for infants under one year old according to regulations:

Plainlands and midlands: ninety-five percent or more

Mountainous areas: ninety percent or more

1. Immunization coverage for infants under one year old according to regulations:

Plainlands and midlands: ninety-five percent or more

2. Twice-yearly Vitamin A supplementation for children aged six to thirty-six months:

Plain and midland areas: 90% or more

3. Monthly growth monitoring for children under two years old; twice-yearly growth monitoring for children aged two to under five years:

Plainlands and midlands: ninety percent or more

Plainland and midland areas: 90% or more

3. Monthly growth monitoring for children under two years old; twice-yearly growth monitoring for children aged two to under five years:

5. There is an organization to carry out deworming for children.

Standard VI

REPRODUCTIVE HEALTH CARE

1. All pregnant women are examined at least once during pregnancy, with the ratio of pregnant women being examined three or more times during three pregnancies reaching:

Plainland and midland areas: 75% or more

Mountainous areas: fifty percent or more

2. The ratio of pregnant women receiving full doses of tetanus toxoid vaccination before delivery:

Plainland and midland areas: 95% or more

Mountainous areas: 85% or more

3. The ratio of women giving birth attended by trained health personnel:

Plainland and midland areas: 95% or more

Mountainous areas: 90% or more

4. The ratio of women giving birth at healthcare facilities:

3. Percentage of disabled persons in the community being managed shall reach:

Mountainous areas: 75% or more

5. The ratio of mothers receiving care from health personnel at least once in the first week postpartum:

Plainland and midland areas: 65% or more

Mountainous areas: 35% or more

6. The ratio of couples using modern family planning methods:

Plainland and midland areas: 70% or more

Mountainous areas: 55% or more

7. The ratio of women aged 15-49 years old who have gynecological examinations annually:

Plainland and midland areas: 30% or more

Mountainous areas: 20% or more

Standard VII

INFRASTRUCTURE AND EQUIPMENT

A. INFRASTRUCTURE

Health stations must be constructed according to the "Industry Standards-Model Design" issued by the Ministry of Health, with the following basic criteria:

1. Location: near traffic routes, in the center of the commune.

2. Land area: on average, 500 m2 or more in rural areas and 150 m2 or more in urban areas.

3. Overall construction includes:

- Main building, auxiliary structures.

- Drying yard, model garden for medicinal plants.

- Trees providing shade cover over 30% of the land area.

- Protective fence, gate, and signboard.

4. Main building:

- Construction grade: minimum grade III

- Minimum area: on average, 90 m2 or more

- Number of functional rooms from 8 to 9 rooms, including:

4.1. Publicity and counseling room

4.2. Reception and pharmacy counter

4.3. Outpatient and emergency treatment room

4.4. Family planning services

4.5. Delivery room

4.6. Post-delivery room

4.7. Patient ward

4.8. Cleaning and sterilization room

4.9. Traditional medicine consultation room (for health stations with dedicated traditional medicine staff).

- Sanitary facilities may be located within the main building or auxiliary structure.

5. Auxiliary structures include: kitchen, warehouse, water tank, toilet, and parking garage (depending on commune needs and conditions).

6. Technical infrastructure system:

- Connected to the power grid or equipped with its own generator for health stations in region III.

- One direct telephone line.

- Clean and stable potable water supply.

7. Maintenance: infrastructure is maintained and serviced annually once a year in the fourth quarter.

B. EQUIPMENT

1. Basic equipment for medical staff to perform primary patient examination and treatment: stethoscope, blood pressure monitor, thermometer, syringe pump, and initial emergency equipment.

2. Basic specialized examination tools: ophthalmology, otolaryngology, dentistry.

3. For health stations with doctors working there: nebulizer, microscope, simple laboratory testing machine.

4. Equipment for obstetric and gynecological examination, family planning, delivery, neonatal resuscitation, and child care.

5. Equipment for processing and storing traditional medicine: herbal stir-fry pan, scale, traditional medicine cabinet, mortar, pestle, acupuncture needles.

6. Equipment for implementing national health program goals, blindness prevention, oral health care, school dental programs, and other health care programs.

7. Equipment for community health education and communication activities.

8. Sterilization equipment: autoclave, drying cabinet, boiling pot.

9. Furniture: cabinets, tables, chairs, beds, bedside tables.

10. Common equipment: oil lamp, flashlight, water pump.

11. Village health kits: each village has 1-2 kits to provide basic services such as injections, first aid, and health education.

12. Clean birthing kits for mountainous, remote, and far-flung villages.

Standard VIII

STAFFING AND POLICY REGIME

A. STAFFING LEVELS

Ensure staffing levels according to current regulations.

B. STAFF STRUCTURE

1. A health station must have at least:

- General practitioner or multi-disciplinary physician (plainland areas must have a general practitioner).

- Midwife or pediatric nurse (plainland areas must have a midwife or pediatric nurse).

- Nurse (plainland areas must have a nurse with at least secondary education).

2. For health stations with four or more staff members, there must be one dedicated traditional medicine practitioner. If fewer than four staff members, the health station must have staff supplemented with traditional medicine training.

3. A health station must have a pharmacist (who can兼任) to manage medications in the commune.

C. SPECIALIZATION AND ORGANIZATIONS

1. There must be a party member participating in the commune's branch committee and establish a trade union group at the health station.

2. Maintain a professional library and hold monthly professional meetings.

3. No staff violating the twelve medical ethics principles.

D. Village health workers and volunteers

1. 100% of villages have trained health workers with at least three months of training according to materials issued by the Ministry of Health and regularly active.

2. Monthly professional meetings are organized by the health station involving village health workers.

3. Village health workers are integrated with volunteers from various health programs.

E. REGIME AND POLICIES

- Strictly implement all policies for grassroots health workers as stipulated by the state.

Standard IX

PLANNING AND FINANCE FOR HEALTH STATIONS

A. PLANNING AND HEALTH INFORMATION MANAGEMENT

1. The head of the health station must be a doctor or physician and must have undergone management skills training or orientation.

2. Develop quarterly, six-month, and annual activity plans. Annual plans must be approved by competent authorities. Conduct mid-year reviews and annual summaries of the health station's operations.

3. Maintain records and report according to the Ministry of Health's regulations.

4. Participate in managing non-public healthcare practices in the locality (if applicable).

B. FINANCE

1. State budget ensures financial support for the operation of commune health stations.

2. Poor people can receive medical treatment at the health station.

3. Effectively implement financial assistance for medication for communes in region III as prescribed by the government.

4. Properly manage funds from target programs. Safeguard and develop the health station's drug capital. There should be no financial management violations under any circumstances.

5. The People's Committee of the commune shall invest from the commune budget to ensure the maintenance and repair of infrastructure; annual repairs, upgrades, and additions of equipment for the health station.

Chuẩn X

ESSENTIAL MEDICINES AND RATIONAL USE OF MEDICATIONS

1. There shall be a counter for essential medicines at the health station. Medicines shall be stored according to the instructions on their labels; there shall be separate cabinets or compartments for storing toxic and addictive drugs in accordance with regulations.

2. There shall be a separate emergency medicine cabinet in the consultation room and it shall always contain a sufficient supply of common emergency medications in the locality and anti-shock medications.

3. There shall be various types of essential medicines as prescribed, with a minimum of sixty types. Depending on the disease structure of each locality, based on the list of essential medicines issued by the Ministry of Health, the Department of Health of the provinces and centrally governed cities will specify a list of certain types of medicines that health stations must have at a minimum.

4. Medicines shall be centrally managed under one authority and implemented in accordance with the drug management regulations; particularly for toxic drugs, psychotropic drugs, and addictive drugs; medicines shall be clearly managed according to their sources and used in accordance with regulations; they shall not exceed their expiration date, become damaged, or be lost.

5. Medicines shall be used safely and rationally in accordance with regulations.