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An sinh xa hoi cho Iao dong di cu- & Viet Nam: Thu-c trang va nhCmg vin dg dat BoSm Kim Thing* Tom tat: Lao dong di cu thudc nhdm d6 tdn thuong, ngudi Iao ddng kho tijp can cac chinh sach, phap luat cua Nha nude noi chung va an sinh xi hgi (ASXH) ndi rieng Nhdm ddi hjgng cung gap nhi6u bit Igi sdng lai cac phd Idn vdi miic phi sinh hoat cao, cugc sdng thiSu cac diSu kien thiet yeu Ban than Iao dgng di cu cOng nhiiu han chd v6 nhan thiic, thieu hut ve chinh sach va khung phap ly, ddng thoi cac rao can ve ti6p can cac dich vu xa hgi khiSn cho ngudi di cu dS roi vao nhiing nii ro nhit dinh Ben canh dd, Iao ddng di cu cung chua dugc dua vao pham vi quan ly, vSn dgng va hd Up cua chinh quygn dia phuong di giiip hg va gia dinh vugt qua cac khd khan cua cudc sdng Bai viit dua tren co sd kSt qua "Diju Ua di cu ndi dia qudc gia nam 2015" Tdng cue Thing ke tiin hanh; Di6u tra vi thuc trang viec lam, ddi sing ciia ngudi Iao dgng di cu tii ndng thdn dd thi va khu cdng nghiep nSm 2013 va mgt sd cugc khao sat gin day di iam can cir chiing mmh cho van di neu tren Tir khoa: An sinh xa hgi; Cham sdc sire khde y ti; Lao ddng di cu Ngiy nhSn bii: 13/5/2020; chinh sua; 22/5/2020; duy6t dang: 29/5/2020 Sau han 30 nam ddi mdi, ciing vdi su phat trien ciia nen kinh t i va qua trinh dd thi hda vdi tdc dp nhanh, di cu Iao ddng d Viet Nam dang diln manh me, dgc biet la d cac phd Idn Luc lupng lap ddng tham gia vao tit ca cac nganh nghd, ITnh vuc san xuat kinh doanh va cd vai trd quan trpng phat trien kinh te, xa hdi dat nude Ddng thdi, su dich chuyen cua thi trudng Iao ddng cung dat khdng it thach thirc cho viec thuc hien cac chinh sach an sinh xa hdi va bao dam quyen fpi cho Iao ddng di cu va gia dinh hp Viec tiep can toan dien cac dich vu an sinh xa hpi dd cd duac cudc sdng ben vimg tai noi di cu den ddi ' TS., Vi?n xa hpi hoc, Vi^n Han ISm Khoa hpc xa hpi Viet Nam 44 Nghien ct>u Gia dinh va Girn Quyin 30, so 2, tr 43-57 vdi Iao ddng di cu vin nhiing ban chd nhit dinh, ka ca vdi nhung dich vu xa hpi CO ban Tidp can vdi cac djch vu ASXH dd cd cac thidt chd vd giao due va cham sdc siic khde y td la diu tu, cham sdc cho ngudn luc ngudi, la mgt nhiing ydu td quan trpng ddi vdi su phat trian kinh td - xa hdi ciia mdi quoc gia, dac biet la qudc gia dang phat tridn nhu Viet Nam Tuy nhidn, hien rat nhidu Iao ddng di cu phai ddi mat vdi nhiing thach thirc da chieu viec tidp can cac dich vii xa hdi DSic diem nhan khiu hoc - xa hoi cua Iao dong di cir tir ndng thfin thi "Didu tra di at ndi dia qudc gia nam 2015" Tong cue Thdng kd tidn hanh nam 2015 vdi nhdm ngudi di cu va khdng di cu tudi tu 15-59 Mlu didu tra gdm cd 18.131 hg gia dinh da dugc diau tra theo phiau hg, 4.969 ngudi di cu va 3.000 ngudi khdng di cu dugc phdng van theo phidu ca nhan Ngoai ra, vdi ciu phin dinh tinh, 85 ngudi di cu va 30 ngudi khdng di cu duoc chgn sd nhiing ngudi dugc phdng vin ghi phidu tidp tuc duoc phdng van sau tai sd 20 tinh didu tra Kdt qua didu tra cho thiy, 13,6% dan sd ca nude la ngudi di cu Ty Id ngudi di cu nhdm mdi 15-59 la 17,3%, dd ngudi di cu ddn chidm tdi 16,0% Cd ddn 19,7% dan sd ciia khu vuc thi la ngudi di cu, d ndng thdn eon sd chi la 13,4% Trong tdng sd ngudi di cu d dp tudi 15-59 thi hien nii chidm 52,4% va nam chidm 47,6% Cu thd, sd lugng ngudi di cu la nu chidm ty !e 17,7% so vdi tdng dan sd nir, sd nam di cu chidm ty Id 16,8% so vdi tdng dan sd nam nhom tudi Lao ddng di cu cd dp tudi kha tre, chu ydu cd dp tudi tu 15-34 tudi (72,9%) Ty trpng Iao ddng di cu d dp tudi tir 15-34 ciia nii cao hon nam (76,8% so vdi 69,1 %) Cd 32,0% ngudi di cu dd tudi 15-59 dang lam vide chua tung ket hdn sd ciia ngudi khdng di cu la 15,9%) Ty Id Iao ddng di cu nam chua tung kdt hdn cao hon Iao ddng di cu nii (34,4% so vdi 29,6%) (Bao cao di cu ndi dia, 2015) Kdt qua mgt lan niia khang dinh nhan dinh vd xu hudng "nii hda" di cu da dupe nhac ddn drong cugc Dieu tra di cu Vidt Nam nam 2004 va cac cudc didu tra khac trudc dd Ty Id qua dao tao chuydn mdn ky thuat ciia nhihig ngudi di cu dang lam vide (37,4%), cao hon so vdi ngudi Iao ddng khdng di cu (28,3%) Khdng cd sir khac biet va ty le da qua dao tao cua Iao ddng di cu giiia hai gidi nam va nii (37,6% so vdi 37,3%) (Bao cao di cu ngi dia, 2015) Doan Kim Tli3ng 45 d Viet Nain, qua trinh cdng nghiep hda - hien dai hda bit diu thi su chuyen dich ca cau kinh te cung didn manh me hon, di cu ndng thdn din thi ciing cang chidm tm thi ban Kit qua cudc Diiu tra Dan sd giiia ky 2014 cho thiy, ban 5,6 trieu ngudi tit tadi ttd len di cu, thi cd 29,0% di cu tir ndng thdn din thi, 28,8% di cu tir ndng thdn din ndng thdn, 30,1% la di cu ttt thi din thi, 12,1% la di cu tir thi din ndng thdn (TCTK va UNFPA, 2016) Biiu cho thiy di cu gdp phin quan trpng vide dap ung nhu ciu Iao ddng cang tang cua luc lupng Iao ddng thi ddng thdi lam giam lire lupng Iao dpng d ndng thdn Ngudi Iao ddng di cu la mot nhdm yeu thi, di hi tdn thuong tai khu vuc dd thi, dupe tiip can rit it vdi cac chinh sach an sinh xa hdi Hp ciing la nhdm dan sd phai ddi mat vdi nhieu thach thurc, khd khan qua trinh lam vide va sinh sdng tai noi den; la nhdm dan sd chiu nhieu thiet thdi va di bi tdn thuong xa hdi; nhimg mang ludi an sinh xa hdi tir trudc din chua bao phii nhieu den hp, dac biet la nhdm dang lam d khu vuc kinh te phi chinh thiic Hien nay, cudc Cach mang cdng nghiep 4.0 da tao dieu kien thuan Ipi che su dich chuyen lap ddng giiia cac viing va tren pham vi ngoai qudc gia Tin hieu tich cue ciia thi trudng Iao ^dng ciing dat khdng it thach thiic cho vide thuc hien cac chinh sach an sinh xa hdi va bao dam quyen loi cho ngudi Iao dpng Chinh sach an sinh xa hdi vdi hd khau, day la mpt nhiing rap can Idn nhit ddi vdi vide tiep can an sinh xa hdi ciia ngudi Iao ddng di cu An sinh xa hoi tiep c?n giao due vJ y tl ciia Iao dong di cir: thyc tr^ng vii nhirng yen t6 anh hutimg 2.1 Tmh trang iU hgc va tiSp cgn he thdng gido dgc cong cua em Itto dong di cir Theo Jon Sward va Nitya Rao (2009), giao due va di cu dupe xem la hai nhan td tac ddng ddn su phat bidn Giao due duoc xem la cd anh hudng tich cue din phat triin, va nd ddng vai trd quan trpng frong viec cai thien ddi sdng cua ngudi dan ngheo thdng qua viec cung cip cho hp ky nang, kha nang phan tich, su tu va tu tin Ben canh dd, di cu ddng vai trd nhu mdt nhan td tiem tang tao su phat triin nhung ddng thdi cung tao nhiing chi phi va su nii ro nhat dinh cho xa hpi (Sward va Rao, 2009) Di cu tac ddng din giao due theo ca ehiiu hudngtichcue va tieu cue (GSO, 2011) Ddi vdi mpt sd hp gia dinh, di cu la nhim dat dupe trinh dp hpc van cao hon va diiu kien giao due tdt hon Tuy nhien, ddi vdi nhieu gia dinh khac, di cu 46 Nghien ci>u Gia dinh va Gioi Quyen 30, so 2, tr 43-57 CO thd tao su gian doan hgc hanh va cac tac ddng tieu cue den ngudi di cu va cac vien hd gia dmh Tit nam 1986, Viet Nam bit diu thue hien cdng cudc Ddi Mdi, lay ddi mdi kinh td lam trpng tam, tung budc chuydn ddi co ciu kinh td tir mdt nucfc ndng nghidp mpt nude cdng nghiep theo hudng hien dai Qua do, cac md hinh khu cdng nghiep (KCN) da dugc hinh thanh, phat tridn da dang nham thu hut cac ngudn luc diu tu Tuy nhidn, mdt sd vin dd cung ddng thdi sinh nhu: dan sd co hgc tang nhanh, cac vin dd vd an sinh xa hgi cho nhdm dan sd nay, dd ngudn luc vd vat chit tai cac cip co sd lai khdng the dap ling Kdt qua vd didu tra di cu ndi dia nam 2015 (Tdng cue Thdng kd va Quy Dan sd Lien hgp qudc, 2016), cho thiy nhdm di cu tit ndng thdn thi chidm ty Id cao nhit 04 nhdm di cu (ndng thdn - thi; dd thi - ndng thdn; thi - dd thi va ndng thdn - ndng thdn), phin Idn hp la nhung Iao ddng tre, thudng kdt hdn mudn hoac chua cd gia dinh va di cu vi muc dich kinh td Theo sd lieu thdng kd, tinh dan thang 12/2016 ca nude cd 325 khu cdng nghiep (KCN) dugc lap vdi 2.989.613 Iao ddng, dd 1.188.291 Iao ddng nu (63%), mdt sd nganh nhu da giay, ddt may, chd bidn thiiy san cd doanh nghiep ti le nu chiam tdi 80% ddn 90% Q cac KCN tap trung nhidu cong nhan (dac biet la nii cdng nhan tre) nhu cau gui la rat Idn Theo khao sat nam 2017, ed khoang 52,6% Iao ddng nii tai cac KCN cd nhd dudi tudi va cd nhu ciu gui tre Chi cd khoang 19% gia dinh cong nhan tai cac KCN va lan can giii vao cac co sd mam non cdng lap cdn lai phai giri d cac nha tre tu nhan hoac nhdm tre, co sd mam non tu thuc Cdng tac quan ly nha tre, nha mlu giao danh cho cdng nhan cdn nhidu bat cap (Bao cao kdt qua tdng kdt 10 nam td chirc CDVN thuc hien Nghi quydt 20/NQ-TW 28/01/2008 vd tidp tuc xay dung giai cap cdng nhan Viet Nam thdi ky day manh CNH, HDH dat nude) Hau het cac KCN hien chua cd quy hoach va xay dung nha d, nha tre mlu giao, co sd tang va cac thiat cha van hda, xa hdi phuc vu ngudi Iao ddng (Trinh Thanh Hang, 2018) Cimg vdi la trd em di cu chju nhiau thidt thdi thu hudng quyen cham sdc va vui choi Ngudi Iao dgng di cu ciing it cd thdi gian danh cho ban than va phai lam viec ea kip, lam thdm gid anh hudng den viec cham sdc va nudi day cai Do^n Kim Thing 47 Bieu Tinh trang di hgc cua em Iao dgng di cu (%) 0Lao dgng di cir dang CO vg/chong • Hgco tij 5-18 tu6i dang song chung DHo CO tit 15-18 tu6i dang di hpc Ngudn: Bd Lao dgng - Thuong binh va Xa hdi, 2013 Sd lieu cung cho thiy cd 11,9% tre em cac gia dinh Iao ddng di cu khdng di hgc, (Iao ddng di cu thi chidm 12,8%; nhdm Iao ddng tai cac khu cdng nghiep chidm 5,0%o) Theo Bao cao qudc gia vd Lao ddng tre em nam 2014 cua Bd Lao dgng - Thuong binh va Xa hdi thi ca nude cd 9,6% tre em tudi tii 5-17 tudi khdng di hpc Nhu vay, ty le tre em cac hd di cu dd thi khdng di hgc cao hon ty le chung ciia ca nude, nhung nhdm tre ciia cac gia dinh di cu dan cac khu cdng nghiep lai thap ban Didu cd the la nhdm Iao ddng di cu Iam viec tai cac khu cdng nghidp phan Idn la Iao ddng tre lam viec cac nha may, xi nghiep ndn cai hg cdn d tudi nhd, ty Id nghi hgc thudng gap d cac bac hpc cao han Didu tra di cu ndi dia qudc gia nam 2015 cho biet ca nude cd 13,4% ngudi di cu va 5,5% ngudi khdng di cu cd tudi dang di hgc sdng ciing, nhung khdng di hgc Cudc didu tra cua Ngan hang thd gidi va Vien Han lam Khoa hpc xa hdi Viet Nam (2016) cho thiy cai cua nhung ngudi di cu cd hd khau tam tni if den trudng hon so vdi cai ciia nhirng ngudi cd hg khau thudng tni (Ngan hang Tha gidi va Vien Han lam KHXH Viet Nam, 2016) 48 Nghien CIPU Gia dinh va Girn Quyen 30, s o 2, tr 43-57 Bieu Ty 1? tre c^c giafflnhc6 hd khau va di cu di hoc trudng tu (%) HTre CO hg khau tai quan^uy|n noi cir tni • Tre c6 ho khSu tai quan/huy?n khac ciing tinh cir tni (L Tre CO hp kh4u tai tinh khac ncri cu tni B Tit ca tre em tuoi di hpc Nha tre mau giao Tieu hpc THCS THPT Ngudn: Ngan hang The gidi (WB), 2014 He thdng giao due phd thdng ciia nude ta gdm cac loai trudng Idp cdng lap va ngoai cdng lap He thdng giao due cdng lap dugc nha nude hd trg ndn chi phi cho giao due cdng lap thudng thap hon so vdi giao due ngoai cdng lap Ddi vdi nhiing gia dinh di cu cd cai citng di va dp tudi di hpc thi van de khd khan Idn nhat cua hp gap phai la lua chgn dugc trudng hpc phu hgp cho bdi ndu mudn cho hgc trudng cdng phai cd hp khau, nhung dieu la rat khd khan Cdn nau mudn hgc trudng tu thi khdng phai gia dinh nao ciing cd kha nang kinh td dam bao cho theo hpc dupe Nhu vay, qua trinh di cu tre em la mpt nhiing nhdm ddi tugng g^p nhidu khd khan va rit dd hi tdn thuong bdi cha me cac em hoac nhung ngudi bao trg cho cac em bi han chd bdi cac co hdi tidp can cac dich vu xa hpi, bao trg xa hdi Tre em ciia nhiing gia dinh di cu se chiu nhidu thi?t thdi de va an sinh xa hdi nhu: cham sdc siic khde, ca hdi hpc tap, ciing nhu tham gia vao cac hoat dpng vui choi giai tri noi nhap cu TMhu vay cd su khac biet kha Idn tidp can vdi he thdng giao due cdng cua tre em cac gia dinh cd hp khau d tinh khac so vdi noi hg dang cu tru Theo sd lieu eiia NgSn hang Tha gidi (WB, 2014) trd em cd hd khiu tai quan, huyen noi cu tni cd ty le hpc trudng tu thuc thap ban nhidu so vdi tre em cd hg khau tai tinh khac noi cu tni, dac biet la d bac tidu hpc va trung hgc co sd Ddi vdi bac tidu hgc, ty le hgc sinh cd hd khau tai quan, huyen noi cu tni theo hpc la 1,4% dd ty le tre cd hp khau tai tinh khac ncri cu tni la 6,8% cao Doan Kim Thang 49 gip 4,8 lan Tuomg tu nhdm trung hpc co sd la 0,7% va 8,8% (gSp 12,5 ik) Tir bac mam non den trang hpc co sd, tre em cac gia dinh di cu thudng chi duoc nhan vao trudng cdng tre em cac hd thudng tni cdn du chd Do vay, ty le tre em di cu hpc tai cac truang Ur thuc la kha cao Nhtmg d bac hpc trung hpc phd thdng, ndu nhu khdng cd hd khiu thudng tni thi tre cac gia dinh di cu khdng dupe nhan hd so thi tuyen, eon cac em hd khdng di cu cung phai thi taydn Trong trudng hop thi khdng dat se phai hpc tai cac trudng dan lap hoac hr thuc Cd thd day la la nguyen nhan khidn ty le tre em hpc trudng Ox cac hd thudng tru va tam tni d bac nroig hpc phd thdng khdng cd chenh lech nhidu nhu d cac bac hpc thap han Khi xem xet ve kha nang di hpc cua tre em cac gia dinh Iao ddng di cu thay cd it nhat hai yen td chi phdi tdi kha nang nay, dd la: trudng lap cd dii de cac em dupe hpc tap khdng; gia dinh ciing nhu ban than cac em cd dii didu kien, nang luc de tiep tuc di hpc khdng? Phan phan tich tren da neu nhimg khd khan, rap can ciia ngudi Iao ddng di cu la khdng cd hd khau, nen em hp khdng the vao hpc tai cac trudng cdng, hoac chi dupe vao cac trudng cdng ndu cac em co hd khau thudng trii da dd chd hpc Cdn ddi vdi trudng tu thi chi phi kha cao khdng phai gia dinh nao ciing cd the dap ung dupe, trpng cac chinh sach mien, giam chi danh cho nhftng gia dinh cd hd khau Ben canh dd, cac trudng mam non cdng lap qua tai, it nhan tre nhd (dudi 36 thang tudi), vi thieu co sd vat chat, dpi ngii giao vien Cac trudng mam non tu thuc cd chit lupng thi mire thu hpc phi cap, luong cdng nhan thap, khdng dii chi tra hpc phi chp Cac trudng ciing rat ban che nhan tre dudi 36 thang tudi, dac biet la tre dudi 18 thang tudi vi Ipi nhuan thdp, yeu cdu cao vd ky nang cham sdc, nudi dudng tre, kha nang nii ro cao Cac trudng lap mam non cd thdi gian ddn, tra tre khdng phu hpp vdi thdi gian lam viec theo ca kip cua cdng nhan d KCN (Trinh Thanh H5ng, 2018) Mdt sd nghien ciiu dinh tinh trudc day ciing da neu len mdi quan ngai ve nhung khd khan ma ngudi di cu phai ddi mat ttong vide xin hpc cho mmh Viec thidu cac trudng tidu hpc d cac phd, chang ban nhu d phd Hd Chi Minh va Ha Ndi cho tre em dp mdi tir - 10 tudi da dan tdi su khd khan tai cac vimg ven dd cd nhidu ngudi di cu di chuyen ddn va van de dupe ndu nhu mpt vfa dk cip thidt nhit lam giam co hdi chp cai cua ngudi di cu di hpc Tre em cd hp khiu dang ky thuong tni (KTl va KT2) dugc dam bao mdt cho hpc tai mot trudng tidu hpc cdng lap, nhung cac h^dng khdng cd nghia vu phai cung cip noi hpc cho tre em ddn nl cac hp gia dinh cd hd khau KT3 va KT4 ndu cac trudng hpc da du hpc sinh Kdt qua ciia mdt sd nghien 50 Nghien CLFU Gia dinh va Giai Quyen 30, so 2, tr 43-57 ciiu dinh tinh cho thay dudng nhu mdt sd ngudi di cu gap khd khan xin hpc cho va chi tra tien hgc phi (Locke, Catherine va cdng su, 2008) Ciing can cd nhidu nghien ciiu ban niia dd danh gia vin dd nham dua nhirng khuyen nghi dam bao ring cai cua ngudi di cu va khdng di cu cd co hdi tidp nhan chuong trinh giao due chit lugng nhu nhau, phii hgp vdi quyen ciia hp ghi Hidn phap Khi dugc hdi va kha nang di hpc ciia tre em mdt nghien ciiu gan day Ngan hang Thd gidi (WB) thuc hien nam 2014, Iao ddng di cu Iam viec tai Ha Ndi dugc hdi cho bidt: "Con cua em hoc tren nay, nhung hoc trdi tuyen nen phdi chi phi tdn kem Idm Dixin hgc ddu vdo cung phdi mdt mdy trieu roi Neu minh cd cdi hg khdu (hi nd dihon, xin hgc cho hay xin di Idm gi ciing han " (Nu didn KT3, phudng VTnh Tuy, Ha Ndi); hoac: "Minh phdi nhd ngudi quen, ndi that mdy chi co quan em ciing phdi nhd ngudi quen mdi xin dugc, khdng phdi dua thdng md xin duac ddu du co hd khdu Hoi minh chi cd qua cdm on ndi chung cUng nhe nhdng thdi chu khdng vdn de gi ddu Bay gid cdc chdu hgc hanh khd khan Idm chic khong nhu xua Neu khong phai Id ddn d day Igi khdng quen biii gi thi chi cd hgc trudng tu thdi" (Nii KT2, NghTa Tan, Ha Ndi) (Ngan hang The gidi, 2014) Trd em di cu thidt thdi hon tre em thudng tni viec tiep can giao due Ty le tre em di cu chua tung di hgc cd sir cai thien theo thdi gian, nhung van cao han ty le tuong ung cua tre em khdng di cu Tre em cac gia dinh di cu thudng nghi hgc sdm hon so vdi tre em cac hp Iao dpng cd hd khau thudng tni Tinh trang tuong tu ciing dugc quan sat voi ty Id tre em ngoai nha trudng gdm tre em chua tiing di hgc va tre da timg di hgc nhung hien da thdi hgc O ca bac tidu hgc va tnmg hgc co sd, sd tre em di cu ngoai nha trudng bao gdm ca nhirng em chua timg den hudng va da bd hpc, deu cao han nhdm tre thudc cac gia dmh khdng di cu Ty Id fre em nii ngoai nha trudng cao han so vdi tre em nam Cu thd, d bac tidu hgc sd tre em di cu ngoai nha trudng chidm 7,23% tdng sd tre em thudc nhdm tudi nay, tre em cac gia dinh khdng di cu chi chidm 3,89% Tuang tu, d bac tmng hpc co sd, sd tre em ngoai nha trudng khdng di cu chiem 10,84%, so tre em di cu ngoai nha trudng cao gip 2,4 lin so vdi tre cac gia dinh di cu (25,7%) Cac trudng hgp cd the la: (i) tre em thdi hgc di cu tim vide lam; (ii) em ngudi Iao dpng di cu, dac biet la cdng nhan cac khu cdng nghidp, ngudi Iao ddng khu vuc phi chinh thiic khdng du didu kidn ddn trudng khdng cd hd khiu thudng tni, hoac khdng dii giay td can thidt, cac trudng hgc d noi nhap cu khdng du dap ling nhu cau cang tang ciia ngudi nhap cu (Ngan hang Thd gidi, 2014) Doan Kim Thing 51 Bieu Tre em ngoai nha trudng dp tudi tilu hoc va trung hpc cff so {%) 15 QNam 10 - • Nu QChung Di cu ] Khong di cu Tieu hpc Khong di cu Trung hpc CO so Ngudn: UNICEF, 2013 Ty Id tre em di cu ngoai nha trudng dp tudi THCS cao hem tre em tudi hgc tidu hgc Ndu tinh chung cho dp mdi 5-17 thi ty le Idn hon nhiau cho thiy tham chi tre em di cu dp tudi THPT ngoai nha trudng cdn cao han dp tudi THCS Hien tugng cd tha lian quan ddn tinh trang tre emfrongdo tudi 11 -17 di cu dd tim vide lam (Td chirc giao due Thanh thidu nidn Nhi ddng Lidn Hgp Qudc - UNICEF, 2013) 2.2 Tiep can he thong y te - cham sdc sire khde cua Iao dgng di cw Nham dam bao quydn tidp can cdng bang ddi vdi cac dich vu xa hpi co ban ciia toan dan Dang va Nha nude Viet Nam da ban hanh cac chinh sach hd trg ngudi dan tidp can cac dich vu xa hgi co ban co giao due, y td - cham sdc Stic khde Chinh sach giao due da tao dieu kidn cho tre nhap cu cd sd tam tni dugc dam bao ddn trudng tai noi dan Quydn tidp can dich vu y td, cham sdc siic khoe ciia ngudi Iao ddng di cu (NLDDC) ciing dugc md rdng thdng qua sd tam tni; tre em dugc lam giiy khai sinh tai noi ngudi me dang ky tam tru va dugc cip the BHYT mien phi cho tre dudi tudi cung liic vdi Giiy khai sinh; NLDDC dugc tham gia BHYT tai noi dang ky tam tni Nha nude da ban hanh nhieu co cha, chinh sach hd trg nha d cho cdng nhan Iao dgng tai cac KCN tap trung NLDDC cang cd co hdi dugc tidp can vdi cac dich vu xa hdi ca ban tdt hon Tuy nhien, miic tidp can cung cdn kha han chd so vdi viec dap ling nhu ciu cua NLDDC 52 Nghien CLPU Gia dinh va Gio'i Quyen 30, so 2, tr 43-57 Cd nhidu nhan td da tac dpng ddn viec tidp can he thdng y td - cham soc siic khde cua ngudi di cu Ban canh nhimg yiu td tac ddng true tiep ddn sire khoe ciia ngudi di cu, cac nhan td khac nhu didu kidn kinh td - xa hdi (didu kidn song va lam vide) va cac "ca hpi sdng" nhu noi sinh, giao due; co hpi viec lam; su phan biet ddi xu va bit binh ding gidi (lOM, 2005) Dia vi phap ly cua ngudi di cu tai noi ddn cUng quydt dinh kha nang tidp can cac djch vu y ta va xa hdi Kha nang hda nhap vdi van hda, Idi sdng tai khu vuc nhap cu ciing la mdt nhan to anh hudng ddn sire khde cua ngudi di cu va gia dinh hg Mdt nhan td quan trgng niia khdng thd thiau dugc chinh la su phat trian cua cac chinh sach va ca sd tang he thdng y td tai viing nhap cu Kdt qua nghien ciru gin day cua Td chirc Oxfam (2015) cho thay: 76,5% NLDDC khu vuc phi chinh thirc chua tham gia BHYT Trong 100% NLDDC khu vuc chinh thirc cd BHYT bit budc; thi chi cd 23,5%) NLDDC khu vuc phi chinh thirc cd BHYT, 12,3% cd BHYT tu nguyen, 6,7% cd BHYT hd ngheo/can ngheo, va 4,5% cd BHYT danh cho ddi tugng chinh sach Ddi vdi cac vidn cdn lai hd gia dinh NLDDC, ty !e cd BHYT la 60,7%, vin thip hon so vdi miic bao phu BHYT trung binh trdn ca nude (67% vao cudi 2014) Ngay ca BHYT tre em dudi tudi dugc cip midn phi thi van cdn ddn 13,2% tre mau khao sat khdng cd BHYT 71% NLDDC khdng tidp can dugc tdi dich vu y te cdng va chi cd 44% NLDDC cd BHYT sir dung thudng xuydn the BHYT Cach thuc diiu tri phd bien nhat dau dm cua NLDDC la mua thudc d hieu thudc vd udng, ty le cao nhat d nhdm cdng nhan may phi chinh thuc, cdng nhan xay dung, va ngudi ban hang rong (gin 80%) Ngay nhdm cd BHYT thi ciing cd tdi 71,2% chgn each (Oxfam, 2015) Trong thuc td, viec quyet dinh lua chpn md hinh cham sdc hay loai hinh dich vu cham sdc sire khoe chiu tac ddng cua rat nhiau ydu td nhu: kidn thiic; quan niem ve benh tat va kham chiia bdnh; kha nang tiep can dich vu y td; chit lugng dich vu; gia ca (Mogensen va cpng su, 2004) Do cac dieu kien da nhap hd khau han chd, Iao dpng di cu phai ddi mat vdi nhidu khd khan tham gia cac dich vu y td cdng tai noi tam tni Sire khde ciia ngudi di cu ciing cdn bj anh hudng tidu cue bdi didu kidn sdng va lam vide, vi vay hg cd nhu cau tidp can nhiing dich vu cdng, nhung nhieu ngudi di cu lai khdng thd tiep can dugc vdi BHYT cdng va each dieu tri tich hgp Didu cang lam gia tang nhiing khd khan phai chi tra dich vu y td tu nhan vdi muc chi phi cao BHYT ddng mpt vai trd rat quan trgng cham sdc sire khde cua ngudi dan, bdn canh dd BHYT cdn c6 y nghTa dac biet hon ddi vdi ngudi di cu phai ddi mat vdi nhiing thidt Doin Kim Thing 53 thdi viec tidp can vdi cac dich vu cham sdc siic khoe bi ban chd bdi cac mdi quan hd xa hpi tai noi d mdi Thea Didu tra di cu ndi dia nam 2015 toan qudc cd 67,6% ngudi di cu cd the BHYT, ddy la mdt sir cai thien Idn trpng cdng tac bao hidm so vdi mudi nam midc day Tuy nhien, vin cdn gin 30% ngudi di cu, khdng di cu chua cd the BHYT, nguydn nhSn chii ydu la ban than hp thiy khdng cin thidt chidm 50,0%, nguydn nhan thii hai dupe dd cap ddn la chi phi mua qua cao (25,0%) Khi dm dau, da sd (trdn 70%) ngudi di cu va khdng di cu tim ddn cac co sd y td cdng, chi cd giin 20% tdi dieu tri tai cac bdnh vien hoac phdng kham tu uhkn Da sd ngudi di cu (63,0%i) tu chi tra chinh cho Idn mic benh gin nhit cua mitih Bao hidm xa hdi (BHXH) Viet Nam chp bidt, tinh den hdt thing 5/2019, tdng sd ngudi tham gia BHXH, BHYT, BHTN la 84,352 trieu ngudi, dat 98,5% Trong dd, BHXH bit budc la 14,68 trieu ngudi, dat 95,9%i; BHXH tu nguyen la 347 nghin ngudi, dat 70,7%>; bao hidm that nghiep (BHTN) 12,88 trieu ngudi, dat 96,5% Rieng BHYT la 84,005 trieu ngudi, dat 98,6%; dat ty Id bao phu BHYT toan qudc la 89% (Ha My, 2019) Kdt qua khap sat cua Td chitc Oxfam 2015, cho thiy hiu nhu tit ca nhimg ngudi iao ddng di cu (NLDDC) khu vuc chinh thiic cd bao hiem xa hpi (BHXH) va bao hidm thit nghiep (BHTN) chidm 97,8%, thi nguac lai hiu nhu khdng cd khu vuc phi chinh thuc cd cac loai bao hidm (99%) Didu cho thiy BHXH ddi vdi ngudi Iao ddng khu vuc phi chinh thiic vin chua dupe thuc hien va mac du ed nhiing thay ddi vd chinh sach nham thu hiit su tham gia BHXH tu nguyen cua ngudi Iao ddng nhung chinh sach vin chua di vap cudc sdng Cd nhihig rao can tac dpng ddn tidp can cac dich vu an sinh xa hpi ciia Iao ddng di cu va gia dinh Iao ddng di cu Trudc hdt, dd la didu kien sdng tam bp cua nhiing hd gia dinh di cu, cha me thidu thdi gian quan tam den cai, va mdi trudng xa hdi xung quanh rd rang cd nhimg tac ddng bat loi den vide hpc ciia tre di cu Ben canh do, nhitng rao can vk thti tuc chuyen truong, nhap hpc ciia cac chau ciing la mdt trpng nhiing ydu td quan trpng duac nhac tdi Cd nhidu ly dp din ddn tinh trang nhidu tre di cu khdng di hpc, nhung nhimg ly dp chu ydu dupe cha me neu len la: "khdng cd giiy td diy dti nen khdng xin vao hudng dupe", tre "hpc kem ndn khdng mudn hoc, tu y nghi hpc", tre "theo ban be di lam kidm tidn" Tre em di cu khdng tidp can dupe tdi nha tre va mau giao cdng lap bdi mdt sd trudng khdng nhan trd dudi thang mdi, thdi gian giir trd thudng theo gid h^nh chinh va khdng nhan giil ngoai gid hay khdng cd trudng cdng lap gin noi d, khdng cd hp khiu nen khdng xin hpc dupe hoac cha me 54 Nghien CLPU Gia dinh va Gio'i Quyen 30, so 2, tr 43-57 khdng bidt thu tuc xin hpc Trong dd, dac didm cdng viec eiia NLDDC la "di sdm, ve mudn"; dac biet la ddi vdi khu vuc chinh thiic, cac cdng ty thudng quy dinh thdi gian lam viec rit kbit khe Do vay, vin bidt gtti d trudng cdng lap se tidt kiem chi phi va tre duac cham sdc tdt hon nhung ddi vdi NLD, nhimg ea sd d gin nha trp, thuan tien cho viec dua ddn tre va giir tre ngoai gia moi la nhiing tidu chi uu tien hang diu ciia hp Tidp ddn, dd la nhitng rao can viec tidp can BHYT ciia NLDDC va gia dinh hp mdt phan nhan thiic nhu ban than Iao ddng di cu va gia dinh khdng cd nhu cau, khdng quan tam den BHYT, mdt phin thidu kha nang tai chinh, mdt phin thidu thdng tin khdng biet mua d dau, va mdt phin mudn mua nhung lai vudng mac ve van de hd khau nen khdng mua duoc Bieu Ly khong tham gia BHYT ciia LDDC khu vuc phi chinh thirc (%) Khong CO tien mua Khong co nhu cau mua BHYT BHYT tir nguydn Khong biel mua BHYT dau Ly khac Ngudn: Oxfam, 2015 Ket luan Theo quy dinh cua Hian phap Viet Nam thi cdng dan Viet Nam cd quydn tu cu tni, dd ngudi dan cd quydn di chuydn noi d cua minh theo mong mudn O ndng thdn viec phat trian cac nganh nghd kinh td cdn han chd, dd nhung dd thi Idn hay cac khu cdng nghidp lai cd sire hap dan ngudi Iao dpng rat nhieu vd viec lam, thu nhap, thu hudng ddi sdng van hda, tinh thin Chinh vi vay, ngudi Iao ddng ndng thdn, dac bidt la Idp Iao ddng tre thudng lua chon Doan Kim Thang 55 cac phd Idn, cac khu cdng nghidp dd cd viec lam, thu nhap tdt ban nhim thay ddi cudc sdng Lao dgng di cu tir ndng thdn dd thi hien chua dugc bao dam cupc sdng an toan; mire dp dd bj tdn thuong va nii ro cua hg rit cao Nhu cau vd an sinh xa hdi la rat Idn va cap thidt trdn tit ca mgi mat ciia cudc sdng Lao dpng di cu chua tiep can dugc he thdng an sinh xa hdi chinh thirc, dac bidt la cac hinh thitc bao hidm xa hgi va trg cap xa hdi chinh thirc tir phia Nha nude va cac td chiic chinh tri - xa hgi Di cu ludn di cimg vdi su phat tridn kinh td - xa hdi va ddng gdp vao tang CO hpi cai thien cudc sdng ca vd vat chat va xa hdi ciia ngudi di cu va gia dinh hp Mat khac, ngudi di cu cung gap mdt sd khd khan d noi ddn nhu: vay vdn dd phat tridn san xuit, tidp can nha d, hgc tap ciia cai va cham sdc siic khde y ta Chinh vi vay can cd chinh sach hd trg ngudi di cu dd dam bao hp cd thd tidp can dich vu xa hdi, binh dang nhu ngudi khdng di cu Ben canh dd, vdi mdt luc lugng Iao dgng di cu tre tir ndng thdn tdi, va trinh dp chuyen mdn ky thuat cdn thap, chinh vi vay cin cd cac chinh sach vd giao due dao tao nang cao trinh dp chuyen mdn ky thuat cua ngudi di cu dd cd the dap ling vdi nhu cau ciia thi trudng Iao ddng noi den, tang nang suat Iao ddng; can tang cudng cung cap thdng tin va dich vu cham sdc sire khde sinh san siic khde tinh due cho nhdm di cu tre tudi Ngudi di cu dua vao su giiip dd chu ydu tu mang ludi xa hgi phi chinh thiic Vai trd cua khu vuc chinh thiic vide gilip dd ngudi di cu vin cdn md nhat Can tang cudng vai trd ciia cac co quan, td chuc sir dung Iao ddng di cu, cac trung tam gidi thieu viec lam de cd thd hd trg ngudi di cu mdt each cd hieu qua qua trinh di cu va giiip hg vugt qua nhirng khd khan ban dau d noi ddn Dang luu y vd tidp can cac djch vu xa hgi co ban, ngudi Iao ddng di cu gap kha nhidu rao can, bao gdm cac quy dinh vd phan bd ngan sach dua trdn dan sd thudng tni; mdt sd qui dinh vh tidp can dich vu ASXH cdn gin vdi hd khau Trong dd cac thu tuc hanh chinh lidn quan den hd khau, BHYT, trudng hpc cdng Cling cin dugc cai thien theo hudng dan gian, nhanh ggn va hieu qua; chinh quyan cac cip cin tang cudng cdng tac kiam tra, giam sat cac td chiic, doanh nghiep nhim bao dam quydn Igi cho ngudi Iao ddng tran tat ca mgi ITnh vuc theo luat quy dinh Mgt vai h^m y chinh sach Trudc hat, nha nude cin dan gian hda thu tuc va cac quy dinh phirc tap hien va dang ky hg khiu, diau kien cu tru bao gdm giam bdt nhimg su each biet cung cip dich vu giiia dang ky thudng tru va tam tni va tao diau kien 56 Nghien cuu Gia dinti va Gio-i Quyen 30, so 2, tr 43-57 thuan loi da cd thd dang ky thudng tni dd dang hon Bd sung va thuc thi cd hieu qua he thdng chinh sach, phap luat dk giam thilu nhung yiu td tidu cue anh hudng ddn ngudi Iao ddng di cu tir ndng thdn dd thi (viec lam, thu nhap, doi sdng, giao due, y td, nha d ) Thii hai cin thidt phai xay dung va thuc thi he thdng an sinh xa hdi chinh thiic (bao hidm xa hdi, bao hidm y td, bao hidm thit nghidp va cac loai hinh trg gilip xa hdi ) dd ngudi Iao dgng di cu tir ndng thdn dd thi cd thd dd dang tiep can he thdng Cudi cimg, cin soat va loai bd cac quy dinh cho ddn van cdn gan cac chinh sach an sinh xa hdi vdi hd khiu, khdng gan chinh sach phan loai hd khau vdi vide tiap can cac dich vu cdng va cac loai hinh an sinh xa hdi chinh thirc, vi day la mgt nhung rao can Idn nhit ddi vdi vide tidp can an sinh xa hpi cua ngudi Iao ddng di cu; nha nude ddng chi tta bao hidm xa hdi tu nguydn cho Iao dpng phi chinh thirc va md rdng quydn loi BHXH tu nguyen; cd co chd phu hgp dd dam bao ngudi su dung Iao ddng phai cd h^ach nhiem ddng chi tra BHXH tu nguyen DSy ciing la mdt didu kidn quan trgng dd ngudi Iao ddng di cu va gia dinh hg thuan Igi hon viec tidp can vdi he thdng an sinh xa hgi, cd dich vu giao due va cham sdc siic khde y td Tai lieu trich dan Ha My 2019 Ty Id bao phii bao hiim y te da dat 89% dan sd Thdi bao tai chinh Viet Nam online 5/6/2019 http://thoibaotaichinhvietnam.vn/ pages/tiente-bao-hiem/2019-06-05/ty-le-bao-phu-bao-hiem-y-te-da-dat-89-dan-so72302.aspx Bd Lao dpng - Thuong binh va Xa hpi 2013 Thuc trgng viec lam, ddi sdng cua ngudi Iao dgng di cu tir ndng thdn dd thj vd khu cdng nghiep Locke, Catherine va cdng su 2008 Bdi cdnh the che dnh hudng tdi cdc lua chgn di cu tie ndng thdn thdnh thi vd cdc chien luge ddnh cho nam nit nien da ket hdn d Viet Nam Ngan hang Thd gidi & Vidn Han lam KHXH Viet Nam 2016 He thdng ddng ky hd khdu Nxb Hdng Diic, Ha Ndi Ngan hang The gidi 2014 Ddnh gid tdc dgng cua hd khdu tdi ddi sdng ngudi ddn Oxfam 2015 Rdo cdn phdp ludt vd thuc tien ddi vdi ngudi Iao ddng di cu tiep can an sinh xa hdi Nxb Hdng Diic Tdng cue Thdng ke - Quy Dan sd Lidn hgp qudc 2004 Nghien cuu Di ddn vd Sue khde (Nghien ciiu tidn hanh tai cac tinh/thanh phd: Ha Ndi, Hai Duong, Hai Phdng, Quang Nmh, Gia Lai, Dik Lik, Dac Ndng, Lam Ddng, Binh Duong, Ddng Nai va Hd Chi Minh) Oo&n Kim Th^ng 57 Tdng cue Thdng kd - Quy Dan sd Lidn hgp qudc 2016 Diiu tra Ddn sd vd Nhd d giita ky nam 2014: Di cu vd thi hda Tdng cue Thdng kd va Chuong trinh phat tridn Lidn Hgp Qudc 2001 Chuyen khdo di cu ndi dia vd dd thi hda a Viet Nam Nxb Thdng ke, Ha Ndi UNICEF 2013 Bdo cdo tinh hinh tre em ngodi nhd trudng: Nghien ciru cua Viet Nam World Migration (lOM) 2005 Cost and benefits of international migration Session: "Migration and Health"- Chapter 19: Investing in Migration Health International Organization for Migration Genever Trinh Thanh Hang 2018 Nhiing van de can quan tam den ddi sdng viec lam cua Iao ddng nu" cac khu cdng nghiep http://www.congdoan.vn/tin-mc/congtac-nu-cong-gioi-510/nhung-van-de-can-quan-tam-den-doi-song-viec-lam-cua -lao-dong-nu-trong-cac-khu-cong-nghiep-355716.tld ... hon ddi vdi ngudi di cu phai ddi mat vdi nhiing thidt Doin Kim Thing 53 thdi viec tidp can vdi cac dich vu cham sdc siic khoe bi ban chd bdi cac mdi quan hd xa hpi tai noi d mdi Thea Didu tra di. .. thiic cho vide thuc hien cac chinh sach an sinh xa hdi va bao dam quyen loi cho ngudi Iao dpng Chinh sach an sinh xa hdi vdi hd khau, day la mpt nhiing rap can Idn nhit ddi vdi vide tiep can an sinh. .. vdi 29,6%) (Bao cao di cu ndi dia, 2015) Kdt qua mgt lan niia khang dinh nhan dinh vd xu hudng "nii hda" di cu da dupe nhac ddn drong cugc Dieu tra di cu Vidt Nam nam 2004 va cac cudc didu tra
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