Decision No. 370/2002/QD-BYT on issuing the "National Standard for Commune Health during 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 indicators for rural health stations to implement.

Article 3. This Decision shall take 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, Director 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 POPULATION HEALTH PROTECTION AND HEALTH EDUCATION COMMUNICATION WORK

A. SOCIALIZATION OF HEALTH CARE AND POPULATION HEALTH PROTECTION

1. Health care and population health protection work in the commune are 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 are implemented to fulfill these resolutions.

2. There is a Health Care Board operating regularly in the commune, 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 are held every six months to evaluate health care and population health protection work in the commune, with community representatives participating.

3. The community and political-social organizations at the local level are 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 have been trained in basic knowledge and skills for health education and communication.

2. Counseling and health education communication are integrated into health stations, communities, and households.

3. Health education through the commune's public address system should be conducted at least:

Plainlands and midlands: four times per month or more

Mountainous areas: two times per month or more

4. Organize and participate in community meetings in villages and hamlets to promote health education 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 grasp 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) should 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 should be taken and cooperation should be sought to promptly control it.

2. Measures should be in place to prevent large-scale epidemics from occurring in the area.

B. NATIONAL TARGET PROGRAM ON HEALTH

Achieve and exceed annual targets and indicators assigned for national target programs on the prevention 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 excreta reaching 70% or more

4. Percentage of households managing animal waste hygienically should 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 checks are reported to families, and over ninety percent of cases identified in the school health program are 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 should reach at least 0.6 visits per person per year.

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

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

Plainlands and midlands: ninety percent or more

Mountainous areas: seventy percent or more

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

Plainlands and midlands: twenty percent or more

Mountainous areas: fifteen percent or more

5. Pay attention to elderly health care; one hundred percent of individuals aged eighty years and older should be managed for health.

6. No serious adverse events leading to death during treatment should occur.

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

STANDARD IV

TRADITIONAL MEDICINE

1. The health station should have a garden or potted plants of traditional medicinal herbs, including at least forty types listed in the Ministry of Health's regulations.

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

3. Implement non-pharmacological treatments using traditional medicine methods, especially in places where there are dedicated traditional medicine practitioners.

STANDARD V

CHILD HEALTH CARE

1. Full immunization coverage for infants under one year old according to regulations should reach:

Plainlands and midlands: ninety-five percent or more

Mountainous areas: ninety percent or more

1. Full immunization coverage for infants under one year old according to regulations should reach:

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

Plainlands and midlands: ninety percent or more

Mountainous areas: eighty percent or more

Plains and midlands: 90% or more

Plainlands and midlands: ninety percent or more

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:

Plains and midlands: 75% or more

Mountainous areas: fifty percent or more

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

Plains and midlands: 95% or more

Mountainous areas: 85% or more

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

Plains and midlands: 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 should reach:

Mountainous areas: 75% or more

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

Plains and midlands: 65% or more

Mountainous areas: 35% or more

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

Plains and midlands: 70% or more

Mountainous areas: 55% or more

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

Plains and midlands: 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 main 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: 8-9 rooms or more, including:

4.1. Health education and counseling room

4.2. Reception and pharmacy counter

4.3. Outpatient consultation and emergency treatment room

4.4. Family planning service room

4.5. Delivery room

4.6. Postnatal care 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 Class III health stations.

- One direct telephone line.

- Clean and stable potable water supply.

7. Maintenance: infrastructure is maintained and serviced annually once every 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 basic emergency equipment.

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

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

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

5. Equipment for processing and storing traditional medicine: herbal roasting pan, scales, 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 initiatives.

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 villages, remote areas.

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:

- A general practitioner or multi-skilled physician (plains must have a doctor).

- A midwife or pediatric nurse (plains must have a high school midwife or pediatric nurse).

- A nurse (plains must have a high school nurse or higher).

2. For health stations with four or more staff members, there must be one dedicated traditional medicine practitioner. When there are fewer than four staff members, the health station must have staff trained in traditional medicine.

3. A health station must have a pharmaceutical assistant (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 establishing a trade union group at the health station.

2. There must be a professional library and monthly professional meetings.

3. There must be 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 MANAGEMENT OF HEALTH INFORMATION

1. The head of the health station must be a doctor or multi-skilled physician and must have undergone training or instruction in management skills.

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 regulations of the Ministry of Health.

4. Participate in managing private 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 Class III communes as prescribed by the government.

4. Manage funds from target programs well. Preserve and develop the 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.