Decision No. 58/TTg stipulates certain issues regarding the organization and system of policies for primary healthcare.

Pursuant to …;

Provisions on the organization and policy regime for primary healthcare

PRIME MINISTER

To implement Resolution No. 4 of the Fourth Plenary Session of the Central Committee of the Communist Party of Vietnam, Seventh Term, on urgent issues concerning the care and protection of people's health;

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

At the proposal of the Minister of Health, the Director of the Civil Service and Personnel Department under the Government, the Minister of Finance, and the Minister of Labor, Invalids and Social Affairs;

Pursuant to …;

Article 1: Primary healthcare organizations within communes, wards, towns (referred to collectively as primary healthcare):

1. Primary healthcare is the first technical medical unit that comes into contact with the people, situated within the state's healthcare system, tasked with providing initial technical health services, early detection of epidemics, treating common illnesses, and normal childbirths, promoting the population to implement family planning measures, preventive hygiene, and enhancing health.

2. Primary healthcare is organized based on the residential area and the community's health care needs. Medical staff in primary healthcare must have appropriate professional qualifications, and those responsible for primary healthcare must possess management capabilities to uniformly direct all aspects of medical activities, ensuring quality and effectiveness.

Article 2:- Medical staff in primary healthcare

Medical staff in communes, wards, towns, villages, hamlets, etc., referred to collectively as medical staff in primary healthcare, are determined according to their operational areas, population size, and specific regional needs, and are arranged as follows:

1. Commune, ward, town healthcare:

a. Plain, midland, urban areas;

Depending on the population and operational area, from 3 to 6 medical staff are allocated for each health station.

b. Mountainous, Central Highlands areas:

Depending on the operational area and population, from 4 to 6 medical staff are allocated for each health station.

AT In remote highland and deep rural areas, commune healthcare stations may only have 1 to 2 medical staff permanently present at the facility to oversee and compile the situation of healthcare work in the commune and provide medical services to nearby villages, while other medical staff are assigned to work in villages, inter-village areas, and hamlets.

c. In addition to the medical staff specified above: if there is a need, communes and wards can employ contractual medical staff, paid by the commune or ward based on the work performed.

2. Village, hamlet, ấp, bản, buôn, liên bản buôn healthcare:

Depending on the geographical features and population of each region, the medical workforce is organized appropriately, with at least one medical staff or community health worker operating in each village, hamlet, ấp, bản, buôn (inter-village buôn), paid by the commune or ward outside the number of medical staff mentioned in part a, b of point 1 of Article 2 above.

Article 3:- Policy and benefits for medical staff in primary healthcare:

1. Medical staff in primary healthcare previously belonging to the state's staffing plan retain their status and enjoy all rights and benefits under current regulations as civil servants.

2. Medical staff in primary healthcare specified in part a, b of point 1 of Article 2 of this Decision, not included in the state's staffing plan, still enjoy all benefits like teachers working in communes and according to the salary scale of medical staff with the same level of education as stipulated in Resolution No. 25/CP dated May 25, 1993 of the Government.

3. AT For villages, hamlets, buôn in highlands, border areas, islands, and remote areas without dedicated medical staff, temporarily, personnel from other sectors currently working in these areas can be trained in necessary medical knowledge and skills to meet the initial health care needs of the local population. The State assigns the Department of Health to pay a supplementary allowance based on the effectiveness and content of the agreed-upon work. This supplementary allowance does not exceed 50% of the salary of medical staff with the same level of education.

4. Medical staff outside the scope defined in part a, b of point 1 of Article 2 of this Decision are managed by the People's Committee of the commune or ward, and supplementary allowances are paid based on the completion of assigned tasks and community acceptance.

5. Social insurance regime:

a. Medical staff in primary healthcare specified in part a, b of point 1 of Article 2 of this Decision, who fulfill all social insurance obligations, are entitled to all social insurance rights and benefits as prescribed by the state.

b. Current commune and ward medical staff receiving living expenses according to previous regulations but not meeting the conditions to enjoy the social insurance regime shall be entitled to retirement benefits as stipulated in Resolution No. 46/CP dated June 23, 1993 of the Government.

Article 4:- The funding for salary and benefits for grassroots health workers at commune and ward levels shall primarily be covered by the provincial budget. If the provincial budget is insufficient, the central government will provide support. The Chairman of the Provincial People's Committee shall assign the Director of the Department of Finance and the Director of the Department of Health to manage the disbursement in accordance with the prescribed regulations.

Article 5:- The Ministry of Health shall develop a plan to train grassroots health workers locally to ensure stable requirements in terms of quantity and quality, particularly in highland, mountainous, remote, and isolated areas.

For health workers in plain and midland urban areas who voluntarily serve in highland, remote, and isolated areas, border regions, they shall receive a salary and allowance equal to 1.5 to 2 times that of health workers with the same qualifications within the state civil service.

Article 6:- The Ministry of Finance shall coordinate with relevant sectors to balance the budget and work with the Ministry of Health to immediately implement a project to strengthen and build commune health stations at the beginning of 1994 to eliminate white communes (communes without health workers) and those without health stations. The budget includes funds for constructing facilities, equipping specialized technical equipment for commune health stations, and training and supplementing staff, especially in highland, remote, and isolated areas, and ethnic minority regions.

Article 7:- To promptly support the primary healthcare system in providing health care for people in counties with mountainous highlands, deep interior, remote, and isolated areas, border regions, islands, and counties with highland and deep interior communes, mobile medical teams shall be established. These mobile medical teams shall be equipped with tools and transportation means to perform preventive health measures, epidemic control, malaria prevention, goiter prevention, planned childbirth, common disease treatment, and professional skill enhancement for grassroots health workers. The number of personnel in the team belongs to the staffing of the county health center and operates under the direction, management, and supervision of the Director of the County Health Center.

Article 8:- This Decision takes effect from the date of signature. All previous provisions contrary to this Decision are hereby abolished.

Article 9:- The Ministers of the Ministries of Health, Finance, Labor - Invalids and Social Affairs, and the Head of the Civil Service Organization Board - Government shall guide the implementation of this Decision.

Article 10:- The Ministers of the Ministries, Heads of agencies equivalent to ministries, agencies under the Government, and Chairmen of the People's Committees of provinces and centrally governed cities shall be responsible for implementing this Decision./.