Decision No. 35/2001/QĐ-TTg on approving the National Health Care and Protection Strategy for the period 2001-2010

Pursuant to …;

Regarding the approval of the Strategy for Health Care and Protection of the People's Health for the Period 2001-2010On the Proposal of the Minister of Health at the Memorandum No. 3769/TTr-BYT dated June 1, 2000.

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PRIME MINISTER

Pursuant to the Government Organization Law dated September 30, 1992;

Pursuant to the Law on the Protection of the People's Health enacted on June 30, 1989,

Approves the Strategy for Health Care and Protection of the People's Health for the Period 2001-2010 with the following main contents:

DECISION:

Article 1. a) General Objective: Strive for all people to access primary health care services and have conditions to approach and utilize quality medical services. Everyone should live in a safe community, develop well both physically and mentally. Reduce the incidence of disease, improve physical fitness, increase life expectancy, and promote genetic development.

1- Objective:

- Health indicators to be achieved by 2010:

b) Specific objectives:

+ Average life expectancy of 71 years.

+ Maternal mortality rate reduced to 70/100,000 live births.

+ Infant mortality rate under one year old decreased to below 25% of live births.

+ Under-five child mortality rate decreased to below 32%.

+ Neonatal weight below 2,500g reduced to below 6%.

+ Prevalence of malnutrition among children under five years old reduced to below 20%.

+ Average height of young adults reaching 1.60 meters or more.

+ Having 4.5 doctors and 1 university-level pharmacist per 10,000 people.

- Reducing the incidence and mortality rates of infectious diseases causing epidemics. Preventing large-scale outbreaks. Controlling the incidence and death rates of cholera, typhoid fever, dengue fever, malaria, plague, hepatitis B, Japanese encephalitis B, sexually transmitted diseases... Maintaining the results of polio eradication and neonatal tetanus elimination. Limiting the rate of HIV/AIDS infection.

Preventing and managing non-infectious diseases such as cardiovascular diseases, cancer, accidents and injuries, diabetes, occupational diseases, mental illness, poisoning, suicide, and diseases caused by unhealthy lifestyles (drug addiction, alcoholism, obesity...).

- Enhancing equity in accessing and utilizing healthcare services, especially diagnostic and treatment services.

- Improving the quality of healthcare at all levels of the healthcare system in preventive medicine, diagnostic and treatment, rehabilitation, and health promotion. Applying scientific and technological advancements to enable the country's healthcare sector to keep pace with advanced countries in the region.

2- Main Solutions:

a. Investment: including state investment, community contributions, and international aid..., with state investment playing a leading role. Gradually increasing the regular budget allocation for healthcare within the total state budget. Prioritizing investment in poor areas, mountainous regions, remote areas, and ethnic minority areas for preventive health activities, traditional medicine, primary healthcare at grassroots level, diagnosis and treatment for the poor and policy beneficiaries, maternal and child health protection.

- Implementing pilot financial mechanisms and policies at some hospitals in major cities, aiming towards self-balancing of regular income and expenditure based on health insurance and hospital fees. Adjusting hospital fees to align with costs, technical investments, and professional levels at each level; suitable for the contribution capacity of the people in each region and the payment capacity of each type of beneficiary.

- Expanding voluntary health insurance; consolidating the compulsory health insurance fund, moving towards universal compulsory health insurance.

- Strengthening mobilization and coordination of aid sources, particularly non-reimbursable aid for technical support and preferential loans for development investment.

b. Organizational Improvement:

- Consolidating and perfecting the healthcare system, building and improving preventive healthcare networks, diagnostic and treatment networks, and pharmaceutical networks towards streamlining to achieve high efficiency. Perfecting management mechanisms from provincial to grassroots levels.

- Developing regional general hospitals (across counties) in remote areas far from provincial centers. Consolidating and enhancing the quality of operations of multi-disciplinary clinics in clusters of villages in mountainous, remote, and ethnic minority areas.

- Enhancing the capacity of the preventive healthcare system from central to grassroots levels, particularly provincial preventive healthcare centers and hygiene and epidemic prevention teams in districts and urban areas. Consolidating labor health departments and establishing occupational disease clinics in key industrial provinces and cities. Perfecting the network for quality and food safety management.

- Improving the specialized inspection system.

- Reorganizing and upgrading the infrastructure and technology of training institutions for healthcare personnel. Reforming and improving the quality of training, strengthening teaching staff at some secondary healthcare schools to develop them into college-level healthcare institutions.

c. Strengthening Management:

- Training healthcare organizational and management personnel at all levels. Clearly defining management responsibilities for each level of the healthcare system and localities.

- Enhancing planning capacity (long-term and short-term) in various fields of healthcare activities. Regularly monitoring, supervising, and evaluating the implementation of plans.

- Effectively implementing the policy of temporarily increasing the number of specialized healthcare personnel in mountainous, remote, and ethnic minority areas. Combining military and civilian healthcare in serving the people's health, especially in areas with many difficulties in preventing and controlling epidemics and mitigating natural disasters.

- Continuing to perfect the legal framework for healthcare, drafting and promulgating the Drug Law, Food Regulations, and Amended Private Medical Practice Regulations... Issuing professional regulations, standards, and equipment lists for various healthcare specialties. Establishing systems and policies for healthcare personnel working in mountainous, remote, and ethnic minority areas.

- Enhancing knowledge of state administration and law for healthcare personnel. Building and improving the specialized inspection system to meet the functions and tasks stipulated in the State Inspection Regulation on Healthcare.

- Effectively implementing democratic regulations in all healthcare facilities. Building a movement of excellence, particularly in creating exemplary units and individuals in the healthcare sector.

d. Development of Healthcare Personnel.

d. Phát triển nguồn nhân lực y tế.

- Standardizing the training of health personnel for each level

- Training health personnel in various specialties to ensure the number of health workers per capita, balancing among different specialties. Promoting the training of master's degree holders, doctoral degree holders, specialists of the first and second levels for provincial and district levels, especially those responsible for departments and divisions. Deepening training abroad in fields or specialties that Vietnam does not have conditions to train domestically.

- Reorganizing human resources at provincial and district-level healthcare facilities to enable the rotation of doctors to reinforce primary healthcare. Enhancing professional expertise, strengthening labor discipline and medical ethics of health personnel.

- Gradually implementing a service obligation system for newly graduated doctors in mountainous, remote, and far-flung areas.

d. Consolidating and developing primary healthcare.

- Ensuring that all communes have health stations suitable for economic, geographic, ecological environmental conditions, and healthcare needs of each region.

- Striving to achieve by 2005: 100% of multi-disciplinary clinics in mountainous and remote regions being built solidly and having doctors; 65% of communes having doctors (of which 50% of mountainous communes have doctors); 100% of health stations having midwives, with 60% being high school-educated midwives.

- Striving to achieve by 2010: 80% of communes having doctors (of which 60% of mountainous communes have doctors); 80% of commune health stations having high school-educated midwives; all health stations having staff with pharmacy assistant qualifications responsible for pharmaceutical work and trained/certified in traditional medicine; ensuring 100% of villages have health workers with at least basic education. Developing volunteer healthcare teams in rural villages.

e. Strengthening preventive healthcare and improving health.

- Continuing to implement the goals of the National Program to eliminate certain social diseases and dangerous epidemics. Implementing programs to prevent non-infectious diseases such as cardiovascular disease, cancer, diabetes, genetic and congenital defects, drug addiction.

- Being proactive in disease prevention, avoiding large-scale outbreaks. Consolidating the reporting and epidemiological surveillance system, modernizing the health statistics management system.

- Developing plans to prevent and quickly mitigate the consequences of disasters, natural calamities, accidents, and injuries, particularly traffic accidents, workplace accidents, and occupational diseases.

- Implementing health and working environment issues in enterprises. Prioritizing monitoring and handling pollutants affecting health, such as hospital waste, plant protection chemicals, etc.

- Strengthening food quality control and safety. Researching and proactively monitoring food contamination to prevent poisoning and diseases caused by consumption. Developing inspection and supervision teams for food safety at all levels.

- Implementing reproductive health programs, safe motherhood, essential obstetric care, and family planning services. Striving to rapidly reduce maternal mortality rates, abortion rates, and women's gynecological disease rates.

- Implementing child health care programs such as preventing malnutrition, adolescent health, school dental health, preventing diarrhea, acute respiratory infections, rheumatic heart disease, and parasitic infections.

- Promoting mass physical exercise, health maintenance activities, enhancing the health and stature of Vietnamese people.

g. Diagnosis and treatment:

- Investing in upgrading the diagnosis and treatment system to meet regional needs and socio-economic capabilities. Specializing technical procedures and strictly regulating transfers between levels. Completing the planning of the diagnosis and treatment network, increasing the number of hospital beds in provinces with low bed-to-population ratios. Standardizing common equipment and techniques, effectively utilizing and fully exploiting medical equipment for diagnosis and treatment. Establishing a drug list suitable for hospitals, encouraging the use of domestically produced drugs. Preventing wastage and overuse of expensive drugs and advanced diagnostic and treatment techniques. Continuously promoting and strengthening rehabilitation activities to prevent complications from diseases.

- Effectively implementing hospital regulations, reforming administrative procedures in diagnosis and treatment. Ensuring patient service conditions at healthcare facilities, particularly essential issues such as organizing meals, clothing for patients, and hygiene in healthcare facilities.

- Diversifying diagnosis and treatment activities including state-owned healthcare facilities, industry-owned facilities, semi-public, private, and foreign-invested facilities.

h. Developing Traditional Medicine:

Continuing to effectively implement Directive No. 25/1999/CT-TTg dated August 30, 1999 of the Prime Minister on promoting Traditional Medicine activities.

i. Drugs and Medical Equipment:

- Continuing to implement the "National Drug Policy" with the main objectives of ensuring regular and sufficient supply of quality drugs to the population, safe, rational, and effective drug use. Consolidating and improving the national pharmaceutical management system from central to local levels.

- Planning and restructuring the Pharmaceutical Industry towards concentration, specialization, and focused investment, ensuring efficient investment. By 2010, all pharmaceutical production facilities must meet GMP standards. Modernizing the drug distribution network, focusing on rural, mountainous, and remote areas.

- Completing the legal framework for medical equipment, improving organizational structure, and establishing technical service centers for medical equipment. Investing in modern equipment according to the technical level of the disease prevention and diagnosis-treatment system. Developing the medical equipment industry in Vietnam.

k. Developing Science, Technology, and Health Information:

- Gradually modernize diagnostic imaging techniques, biochemical, physicochemical, immunological, genetic, and molecular biology diagnostics. Apply advanced technologies and techniques in cardiology, endoscopy, orthopedics, microsurgery, organ replacement, and transplantation. Establish several standard laboratories and three specialized centers in the North, Central, and South regions for quality testing and food safety.

- Develop biotechnology, particularly genetic technology, propagation, and tissue culture technology to serve pharmaceutical production, vaccine production, and biological preparations for diagnosis and treatment. Promote automation technology mainly in medical equipment manufacturing, hospital waste processing, and hospital management operations.

- Continue to improve and enhance the effectiveness of two specialized healthcare centers in Hanoi and Ho Chi Minh City, promptly implement specialized healthcare centers in Hue and Da Nang, and other regional healthcare centers.

Strengthen the statistical reporting system, management information provision, and timely supply of reliable information for management at all levels.

l. Socialization of healthcare activities:

- Continuously promote the implementation of Resolution No. 90/CP of the Government dated August 21, 1997 on "Directions and Policies for Socializing Educational, Healthcare, and Cultural Activities." Integrate health protection and enhancement requirements into macroeconomic policies, social policies, development programs, job creation projects, and poverty reduction initiatives.

- Diversify healthcare service models, seek and exploit various investment sources for healthcare such as voluntary health insurance, foreign aid, etc. Establish exemplary models for environmental sanitation and community safety.

- Continue to consolidate and develop health education communication centers in provinces and cities. Expand the network of communicators down to communes. Utilize appropriate communication methods and forms to encourage all strata of the population and mass organizations to voluntarily participate and contribute to protecting their own and communal health.

3- Implementation funds:

a. Annually, based on assigned tasks to implement the National Health Care and Protection Strategy for the period 2001-2010, the Ministry of Health will prepare a budget estimate to be submitted to the Ministry of Finance and the Ministry of Planning and Investment for review and inclusion in the annual state budget, which will then be presented to the Government for submission to the National Assembly for approval.

b. Provincial People's Committees directly allocate their local annual budgets to implement health care objectives and tasks within their jurisdictions.

4- Implementation Period of the Program: from 2001 to 2010.

Article 2. The Ministry of Health is the main agency responsible for implementing the Program, coordinating with relevant ministries and agencies (Science and Technology, Environment, Planning and Investment, Finance, Fisheries, Agriculture and Rural Development, Industry, Trade, Education and Training, Culture and Information, Public Security) in developing plans, providing guidance, monitoring, and summarizing the annual implementation situation of the Program to report to the Prime Minister; organize mid-term reviews of the Program in 2005 and final evaluations in 2010.

Article 3. This Decision shall take effect fifteen days from the date of signature.

Article 4. Ministers of Ministries, agencies at the ministerial level, heads of related agencies, Chairpersons of Provincial People's Committees under the central government are responsible for enforcing this Decision./.