An sinh xa hoi doi voi dong bao dan toe thieu s6 eae tinh mien niii phia Bac Viet Nam Nguyen Van Tu^n' ' Vien Khoa hoc to chiic, can bp - Ban T6 chiic Trung ucmg Email: nguyentuan.xhnv@gmail.com Nhan 22 thang 12 nam 2019 Chip nhan dang 17 thang n5m 2020 Tom tat: Trong nhung nam qua, Dang va Nha nude da co nhieu chinh sach va ngudn lire uu tien phat trien toan dien kinh t e - x a hdi, ca sd ting, giam ngheo, phat trien ngudn nhan lire va dam bao an sinh xa hdi (ASXH) cho ddng bao dan tdc thiiu so (DTTS) d Viet Nam noi ehung va ddng bao DTTS cac tinh mien nui phia Bac ndi rieng Ben canh nhiJng tuu dat dupc, chinh sach ASXH ddi vdi ddng bao DTTS cac tinh mien mii phia Bac nhieu h ^ che, bat cap Dieu doi hdi phai due nit nhiJng kmh nghiem, tir thiic diy kinh ti phat trien, di ddng bao DTTS noi day se dupc eham lo, bao ve va trp giiip ASXH mdt each tdt nhit va day du nhat Tur khoa: Bao dam an sinh xa hpi, dan tdc thiiu sd, mien niii phia Bfic Phan loai nganh: Sii hpc Abstract: Over the past years, the Party and the State have devised many policies and earmarked many resources to prioritise comprehensive socio-economic and infrastmctural development, poverty reduction, human resource development and social protection for ethnic mmorities in the country in general and those living in the northern mountainous provinces in particular Besides the achievements, the social protection policy for ethnic minority people in the provinces is still faced with many limitations and discrepancies That requires experiences to be gained, thus motivating economic development, so that the local ethnic mmorities will be cared for, protected and supported in terms of social protection in the best and most complete way Keywords: Ensuring social protection, ethnic minorities, northern mountainous areas Subject classification: History M& dau Khu vuc m i i n mii phia B i c gdra 14 tinh vdi hon 30 dan tdc cimg sinh sdng Day la dia ban vira cd vi tri chien luge ve an ninh, qudc phdng, vira cd nhieu tiem nang, loi the v i phat triin ndng, lam nghiep, thuy dien, cdng nghiep che biin lam san, khai thac Khoa hoc xa hpi Viet Nam, so - 2Q2Q mo, du lich Day cung la ncri c6 loi the ve giao thucmg voi Trung Quoc va Lao vi co duong bien gioi trai dai tii Dong sang Tay Trong nhung nam qua Dang va Nha nuoc luon quan tam dau tu nhieu cho viing nui, vung dong bao dan tpc thieu so, cac huyen ngheo, xa, thon, ban dac biet kho khan; thuc hien toan dien cac chinh sach ho trgf, giiip doi vcri dong bao DTTS, CO d6ng bao DTTS cac tinh mien mii phia Bac He thdng cUnh sach ASXH d5i voi d6ng bao DTTS da duoc ban hanh kha day dii va toan dien, bao gom ho tra tao viec lam, bao hilm xa hpi, tro giup xa hpi va dam bao tilp can miic toi thieu cac dich vu xa hpi (giao due, y tj, nha cr, nuoc sach, thong tin) da gop phin nang cao doi s6ng vat chat va tinh thin cho d6ng bao cac dan tpc Ben canh nhimg thuan lpi vln t6n tai nhiJng kho khan thuc hien ASXH d5i vol ddng bao DTTS cac tinh miln nui phia Bic Bai vilt phan tich thuc trang va giai phap tang cuong ASXH dii vcri ding bao DTTS cac tinh miln mii phia Bac Thifc trang an sinh xa hpifloivol dong bao dan tpc thilu so cac tinh mien mil phia BSc 2.1 Thdnh tuu dift iuac Thir nhdt, bao ddm thu nhap tdt cho nguai lidn Qua 15 nam thuc hien Nghi quyit so 37NQ/TW 01 thang nam 2004 cua Bp Chinh tti vl phucmg huong phat triln kinh tl - xa hpi va dam bao qu6c phong - an ninh vung trung du va mien niii pliia Bac, bp mat kinh tl - xa hpi cua ca vimg da co nhimg buac phat triln rit In tuong Trong giai doan 2005-2018, cac chi tieu vl thi truong 22 lao dpng, giai quyet viec lam co ban hoan tit theo kl hoach dat ra, da giai quyit viec lam cho 2,174 trieu lao dpng, thang dlu nam 2019, giai quyit cho 710.000 lao dpng [1] Hoat dpng vay von tao viec lam tu Quy quIc gia vl viec lam tilp tuc gop phin quan trpng h5 trp tao va tu tao viec lam cho nguoi lao dpng Mac dii kinh tl - xa hpi cua ding bao DTTS cac tmh miln mii phia Blc dien mao da CO su thay dii, nhtmg nhm ehung thu nhap bmh quan dlu nguoi ttong nhom DTTS v&i each rit xa so vol thu nhap bmh quan dlu nguoi tten ca nuac Hien nay, thu nhap bmh quan dlu nguoi cua dong bao DTTS dat khoang 1,1 trieu/nguoi/thang, chua bing '/z so vol miic binh quan chimg ca nuoc [9] Thu nhap binh quan dlu nguoi ciing thi hien su phan hoa sau ttong nhom 53 DTTS, dac biet la dii vai nhom thu nhap thip nhit trung binh duoi 632 nghin ding/thang/nguoi, gom cac dan tpc nhu Lo Lo, La Hii, Mong Trai lai, nhom thu nhap cao nhit tnmg binh dat tren 1.200 nghin ding/nguai/thang, mirc chenh lech gin nhu gap doi giiia nhom thu nhap cao nhit va nhom thu nhap thap nhat Dieu cho thiy, thu nhap dau nguoi thap se dan den each tiep can cac nguon luc va nguon ASXH se bi han che Thit hai, y tk vd chdm soc siic khde ngdy cdng duffc ddm bdo - Bao hilm y tl Ty le nguai DTTS cac tinh miln nui phia Bac su dung the bao hilm y tl (BHYT) dl kham chiia benh khong cao Theo quy dinh, ngucri co the BHYT noi chtmg va ding bao DTTS noi rieng se duac hucmg cac chinh sach ttong kham chiia benh Tuy nhien, ty le su dung the BHYT cua nguai DTTS trung binh chi dat 44,8%, dac biet mpt sl dan tpc nhu (La Ha, Muong), ty le sir dung chi dat chua din 1/3 [10], o mpt phuong dien nao cung Nguyen Van Tuan the hien ty le ngudi DTTS din cac co sd y te de kham chira benh la rit thip Nhieu nghien cim cho ring, sd dt cd thuc trang tren la ngudi dan cd nhimg each ung xir, lua chpn khac chiia benh thay cho viec di den cac co sd y ti tu chiia theo cac phuong phap cd truyin (thude dan gian, thu thuat me tin ), ngudi dan chi din tram y te xa, hoac den huyen benh da trd nen qua nang, nang lire, diiu kien de dieu tri cua tuyen xa, huyen yeu; sir hiiu bidt ve lgi ich ciing nhu each sir dung the BHYT mot bd phan ngudi DTTS chua day du; dieu kien kinh te khd khan; tam ly ngai di xa, khoang each den cac co sd y te rat xa, di lai gap nhieu khd khan, han che ve phuong tien - Ve eham sdc siic khde Cdng tac eham sdc sue khde cho ddng bao DTTS cd chuyen bidn tich cue, tien bd Tiep tuc dau tu xay dung cac tram y td xa viing DTTS cac tinh mien mii phia Bac Tir nam 2016 din nam 2019, Nha nude da cap kinh phi the bao hidm xa hgi (BHXH) cho 20,705 trieu lugt ddng bao DTTS Tuy nhien, ty le kham, chiia benh cua ba cdn thap (phdng kham da khoa khu vuc cua cac tinh miin mii khdng dugc dieu tri ndi tni, chua dugc toan BHYT, ch^m duoc giai quyit) [4]; tang cudng y ti du phdng va bd tri bac sy vi lam viec tai tram y te xa dat 87,5% Cac dia phuong ciing da trien khai Di an giam tinh trang tao hdn, hdn nhan can huyit d 22 tinh vimg DTTS cac tinh miin mii phia Bic; cd 70,9% phu nil mang thai dugc kham thai it nhit mpt lin tai cac CO sd y ti va tap trung phd biin d mdt sd dan tdc nhu Mudng, Tay (khoang 80-85%) Trong dd, d mdt sd viing dan tpc mien mii phia Bic, ty Id phu nu dugc di kham thai rit thip (5 dan tdc cd ty le dudi 50%), thip nhit la La Hu (9,1%), Ha Nhi (25,4%), Si La (25,5%), Mdng (36,5%) Diiu cho thay, tai cac dan tdc thupc nhdm cd ty suat tu vong d tre dudi tudi cao nhat [10] Ben canh dd, ty le ngudi DTTS nhiem HIV chu yeu tap trung d cac tinh vimg mii phia Bac kha cao Cac tinh nhu Scm La, Dien Bien, Lai Chau va Thai Nguyen la nhirng tinh cd ty le ngirdi DTTS nhidm HIV cao nhit (tir 63%-81%) Ba tinh cd sd ngudi DTTS nhidm HIV cao hon sd trung binh cua ca nude la Dien Bien (0,67%), Lai Chau (0,36%), Son La (0,36%) Da sd ngudi nhidm HIV la ISy nhiem qua dudng tinh due va dudng kim tidm ma chu yeu la tiem chich ma tiiy Thdng qua xem xet cac dan tdc ddng nhSt tai cac tinh, cd the suy luan rang ngudi Thai, Tay, Nimg, Dao la cac dan tdc cd nguy CO nhiem HIV cao nhat tai cac tinh tren [10] Do ba DTTS chu yeu sdng d nai cd dia ban di lai khd khan, nen khoang each tir nha den cac co sd y te nhin ehung tuong ddi xa, dac biet xa vdi mdt sd dan tdc nhu Ld Ld (tdi tram y te: 10 km, benh vien: 39,2 km); Si La ( tdi tram y ti: 7,2 km, tdi benh vien: 24,6 km) Tinh trung binh tram y ti d each nha 3,8 km va benh vi?n each 16,7 km [10] Cac DTTS thudng phan bd d khu vuc mien niii, tang co sd thieu va yeu, giao thdng di lai gap nhieu khd khan Do dd, de thiic day kinh te - xa hdi cac tinh mien nui phia Bic phat triin, hon het can phai cd co chi hd trp di thiic d^y kinh te phat trien, gdp phan nang cao chat lugng cudc sdng va dam bao ASXH cho ddng bao DTTSd nai day Thii ba, chinh sdch trg giiip xd hpi vd ho trg gidm ngheo luon duge chu trgng qua cdc ndm - Chinh sach trg giiip xa hdi Nham bao dam thu nhap va cac dieu kien sdng tdi thieu cho ddng bao DTTS gap rui ro, bat 23 Khoa hpc xa hdi Viet Nam, sd - 2020 hanh, ddi ngheo, thiet thdi cudc sdng khdng cd dii kha nang tu lo dugc cupc sdng cua ban than va gia dinh Trong nhimg nam qua, cac dia phuong mien niii phia Bac noi cd ddng ba DTTS sinh sdng da tap tnmg trien khai thuc hien tdt Phap lenh Uu dai ngudi cd cdng vdi each mang, chu trpng giai quyet che dp chinh sach cho ngudi c6 cdng va ca nhirng trudng hpp cdn tdn dpng chua giai quyet Ddng thdi, ciing day manh nang cao hieu qua cdng tac trg giiip xa hdi, tiep tuc md rdng ddi tugng thu hudng vdi hinh thlie hd trg thich hgp; nang dan miic trg cap xa hdi thudng xuyen phii hop vdi kha nang ngan sach dia phuong De thuc hien tdt chinh sach hd trg dot xuat, dam bao ASXH, khdng de ngudi nao bi thieu ddi khdng dugc trg giup, tir nam 2016 den nam 2018, Thu tudng Chirih phii da cap (khdng thu tien) 117 nghin tan gao hd trg cac dia phucmg cd ddng ddng bao DTTS sinh sdng; cap tir ngudn ngan sach Trung ucmg 1.000 ty ddng hd trg lam nha cho nhiing hd bi thien tai mat nha d, phin Idn la ddng bao DTTS; da quan tam hem viec bd tri ngan sach Trung uong hd trg phat trien kinh te - xa hdi vimg DTTS miin mii va thuc hien chinh sach ddi vdi ddng bao DTTS Kinh phi de thuc hien tdt chinh sach chi hd trg cho cac tinh ve y ti, giao due, theo phuong eham nam sau cao hon nam trudc co ban dugc dap img du - Chinh sach ho tro giam ngheo Trong thdi gian qua, viec thuc hien cac chinh sach phat trien kinh te - xa hpi cdng cudc giam ngheo ca nude ndi ehung va vimg DTTS cac tinh mien mii phia Bac ndi rieng da dat nhiing ket qua quan trpng Ty le ngheo DTTS giam nhanh tir 38,72% (2005) xudng cdn 31,38% (2010); 25,77% (2015) va 15,82% (2018) Ty le ngheo d cac huyen ngheo giam binh quan 5,5%/nam, cac xa 24 ngheo giam binh quan tir 3-4%/nam Din nam 2017, cd huyen tdng sd 64 huyen ngheo theo Nghi quyit 30a thoat ngheo, gdm: Ba Bi (Bic Kan), Tan Son (Phii Thp), Tan Uyen, Than Uyen (Lai Chau), Quynh Nhai, Phii Yen (Son La) Cd huyen hudng co chi theo Nghi quyit 30a thoat khdi tinh trang khd khan: Bat Xat, Van Ban (Lao Cai); Kim Bdi (Hda Binh); Vo Nhai (Thai Nguyen) Dac biet, mdt sd tinh cd ty le giam ngheo tren 5% trd len nhu: Lao Cai, Yen Bai, Lai Chau Den het nam 2018, toan vimg cd huyen thoat ngheo va dugc Thu tudng Chinh phu tang Bang khen, 72 xa dac biet khd khan vimg DTTS va mien nui khu vuc dat chuan ndng thdn mdi [1] Tuy nhiSn, nhin ehung sd hp ngheo tai day van cdn kha cao: vimg mien mii Ddng Bac tren 304 nghin hd (chiim ""77%); viing mien niii Tay Bac tren 192 nghin hd (chiim 96,9%) Ca biet, mpt sd tinh cd ty trpng hd ngheo DTTS/tdng sd hd ngheo cao tren 80% nhu: Cao Bing (99,5%), Ha Giang (99,3%), Lai Chau (98,7%), Dien Bien (98,6%), Bic Kan (95,3%), Lang San (94,1%), Lao Cai (92,2%%) [1] Ket qua giam ngheo vdi ddng bao DTTS ghi nhan su chuyen bien ro ret d mdt sd khu vuc 12 tinh da giam han 4.000 hd ngheo DTTS mpt nam, diin hinh nhu Ha Giang, Tuyen Quang, Cao Bang, Lang San, Lao Cai, Yen Bai va Hda Binh Nhimg hp thoat ngheo tieu bieu da dupc Bd Lao ddng - Thucmg binh va Xa hdi cimg Uy ban Dan tdc biiu duong qua trinh vuon len cupc sdng Dac biet, mat bang dan tri dugc nang cao Viing dan tpc va miin mii da hoan phd cap giao due tiiu hpc va xda mu chii Hd thdng trudng phd thdng dan tdc ndi tni dugc hinh va phat triin tir Trung uong din cac huyen vimg Nguyen Van Tuan dan tdc va midn mii, tao ngudn dao tao dpi ngii can bp DTTS Tuy vay, vdi cac dia phuang nay, ket qua giam ngheo vdi ddng bao DTTS chuyen bien rd nhit vdn tap trung d khu vuc, dia ban cd nhimg thuan Igi qua trinh phat trien kinh te - xa hdi, cdng tac xda ddi, giam ngheo dat dugc ket qua kha quan, ddi sdng cua ddng bao cac dan tpc dugc cai thien dang ke Thu tu, ddm bdo muc toi thiiu mpt so dich vu xd hpi ca bdn cho ngucri ddn, dgc biet la nguai ngheo, DTTS vd nguai cd hodn cdnh khd khdn - Dam bao giao due tdi thieu Ty le tre em DTTS cac tinh mien niii phia Bac di hpc diing cap rat thap, trung binh d muc dudi 60%, chu yeu la ngudi Ld Ld, Ma; hpc sinh di hpc dling dp tudi d cap trung hgc phd thdng chua den 10% [3].Tuy nhien, van cd mdt sd dan tdc tre em di hpc diing cap rat cao nhu Si La (88,3%), Tay (79,4%), dd ty le tre em di hgc diing cap trung binh ehi dat 32,3% [9] Ty le ngudi DTTS biit dpc, biet viet tieng phd thdng chua cao, cd nhieu dan tpc hom mpt nira dan sd mil chu" Theo sd lieu thdng ke, hien cac tinh mien mii phia Bac cd tinh cd ddng ddng bao DTTS sinh sdng, mdt sd tinh cd ty le ngudi dp tudi lao ddng khdng biet chii rat cao, nhu; Lai Chau, Ha Giang, Dien Bien, Son La, Bac K ^ , Lao Cai, Yen Bai, Cao Bang Dieu cho thay viec xda mii chii d ngudi trudng la thach thirc rat Idn vdi cac tinh cd ddng bao DTTS sinh sdng - Dam bao nha d tdi thieu Hien nay, cac DTTS viing niii phia Bac dia ban sinh sdng thiiu dat san xuat va dat d cao han han so vdi cac tinh cdn lai cua ca nude Vin di quy hoach dat d cdn nhidu bat cap, chinh sach di ddi dan di cu den noi d mdi dd phuc vu cho cac du an nhu xay hd thuy lgi bi eham tre, khien cho ngudi dan thiiu dit d va dat san xuat, nhieu hd DTTS gap khd khan vide thich img vdi cupc sdng mdi Mac du DTTS d cac tinh la tuong ddi it, chu yeu la ngudi Mudng, Thai, Mdng chinh sach vi quy hoach dit dai, cai tao dat va tai djnh cu cho DTTS tai cac tinh mien mii phIa Bac van can phai dugc chii trgng nham dam bao cudc sdng va sinh ke dn dinh cho ngudi dan Ben canh dd, tinh trang sdi mdn, thoai hda dit van dang la van de ndi com can dugc khac phuc nham tao them quy dat d va san xuat cho DTTS d khu vuc Hien tinh Lang Son, Cao Bing, Bic Giang cd ty le hd DTTS thidu dat va dat san xuat thap nhat Dieu cho thay, cac hp dan tdc Tay, Nimg, Dao sinh sdng chu yeu tai day it gap khd khan ve van de dat dai - Dam bao nude sach Trong dieu kien nha ve sinh dat chudn cua hd DTTS cdn kha thap, dieu kidn tiep can nude hgp ve sinh sinh boat hang cua nhdm hd DTTS tuong ddi cao Men cd 73,3% sd hd DTTS da duoc tiep can ngudn nude hgp vd sinh sinh boat, cd tir 30 din 50% sd hp dugc sur dung nude hop ve sinh hang gdm cac DTTS nhu La Ha, La Chi, Pu Pec, Ha Nhi, Ld Ld Cd thi ndi, mac dii trung binh ty le hd DTTS cd tiep can den nude hgp vp sinh la cao, nhung vln tdn tai nhieu DTTS cd ty le hd tiep can rit thip Diiu cho thay, can rat nhieu nd luc de cd the nang cao ty le cac hp DTTS sir dung nude hop ve sinh sinh hoat hang Tiip can thdng tin Theo danh gia ehung, ITnh vuc thdng tin, truyen thdng vung DTTS cac tinh mien mii phia Bic cd buoc phat triin nlianh, co ban dap iing nhu ciu thdng tin, lien lac'ciia ngudi dan Tir nam 2016 din nay, da chuyin phat 18 Ioai in phim bao, tap chi vdi sd luong 51,2 trieu 25 Khoa hpc xa hdi Viet Nam, sd - 2020 td; kenh VTV5 Bai Truyen Mnh Viet Nam nhu Chuong trinh 135; Chuang trinh 3a cua san xuat va phat sdng hau het cac CMnh phu Trong dd, ngan sach Trung tuan, gdm 22 thii tieng DTTS; nam uang lai chua bd tri dugc ngudn vdn rieng 2017, da xuat ban gan 100 dau sach vdi di thuc hien mdt sd ehinh sach, vay khoang 250.000 ban, phuc vu ddng bao khdng dat dugc muc tieu cac di an, chinh DTTS Mang dien thoai di ddng da phu sach da dugc phe duyet; mdt sd van de biic sdng khap dia ban mien niii; cd hon 16.000 xiic ddng bao DTTS, nhu: di cu tu diem giao dich buu cMnh vien thdng, dam phat, thieu dit d, dit san xuit, nude sinh bao thdng tin lien lac thdng sudt mpi hoat giai quyit chua Meu qua, ddi sdng cua mdt bd phan ddng bao DTTS cdn tinh hudng Mdt dieu dang chii y la, viec dam bao nhieu khd khan Thu nhap binh quan cua thdng tin, truydn thdng d cae tinh mien mii hd ddng bao DTTS nhiiu noi chi bing 40phia Bac chu yeu thdng qua he thdng loa 50% binh quan thu nhap khu vuc; ty truyen Ddi vdi cac tinh khu vue mien le dan sd DTTS chiim 14,6% nhung ty le mii nhu Cao Bang, Lang Son, Ha Giang, hd ngheo chidm 52,7% sd hp ngheo cua ca Dien Bien, viec tuyen truyen thdng tin nude [4], c6 tinh ban 90% hd ngheo rai thdng qua loa phat la kha quan trpng vao hp DTTS nhu Ha Giang, Cao Bang, ddi vdi cac hd DTTS khdng cd dieu kien de Lai Chau Ty Id tai ngheo va phat sinh trang bi cac phuong tien thu phat sdng ngheo tuong ddi cao [1] truyen thdng Hien nay, loa phat van Chat lugng giao due, y te, van hda d la phuang tien thdng tin va tuyen truyen vimg DTTS cac tinh mien niii pMa Bac tuong ddi quan trpng tai cac xa Thdng tin da dugc nang len nhung so vdi mat bang dupc phat qua loa thudng day dii va cu the ehung vin cdn thap, muc dp tiep can cac hon cho timg dia ban so vdi cac thdng tin dich vu cdn nhidu khd khan Van cdn dupc cung cap tren ti vi va dai bao khoang 21% ngudi DTTS tren 15 tudi chua dpc thdng, viet thao tieng Viet Ty le dupc cap the BHYT cao nhung ty le kham, chua 2.2 Hgn chi vd nguyen nhdn benh cdn thdp (phdng kham da khoa khu vuc ciia cac tinh mien mil khdng dugc dieu Nhiing han che, bat cap thuc hien tri npi trii, chua dugc toan BHYT, dudng ldi, cMnh sach cua Bang va Nha eham dugc giai quyet) Ty le ngudi khdng nude ddi vdi vimg DTTS d mien niii phia cdn mac trang phuc dan tdc, khdng biet ndi Bac din den kinh te - xa hdi cd nhiing bude tieng dan tpc cua minh cang tang; dan eham phat trien so vdi cac tinh tren dia ban ca, dan vii, nhac cu truyen thdng cua nhieu ca nude Tir dd keo theo cac van de ASXH DTTS chi dugc phuc d ^ g cd ll hdi, it cua ngudi dan vimg DTTS chua dugc dam dugc diin ddi sdng hang [4] bao nhu: ddng bao cae BTTS sinh sdng d Nguyen nhan ciia han che tren la do: (1) dia ban kinh te - xa hpi khd khan va dae Xuit phat diim cua vimg DTTS cac tinh biet kho khan; d nhimg dia phuong ngheo, miin mii pha Bic thap, dia hinh cMa cit, chii yeu nhan hd trg ngan sach tir Trung kM hau khic nghiet, chit lupng ngudn nhan uong, khd cd the long ghep cac chuang luc va mat bing dan tri thap; rit khd khan trinh, du an de thuc hien cMnh sach dan tpc viec thu hiit diu tu; thiiu viec lam 26 Nguyen Van Tuan ddi ngheo, tMen tai, benh tat, dang la thach thiic Idn; (2) Biin ddi hau, tMen tai, bao lii anh hudng Idn din vimg ddng bao DTTS sinh sdng Sat Id dit, lii dng, IG quet d cac tinh Tay Bac Iam cho ddi sdng cua ddng bao DTTS da khd khan lai cang khd khan them; (3) Nhan thuc cua mdt sd can bp, cdng chiic, vien chuc d dia phuong mien mii phia Bic cdn phien dien, chua that ldng quan tam den ASXH cho ddng bao vimg DTTS; (4) Su phdi hgp giiia cac Bp, nganh, dia phuong noi day chua thudng xuyen, chat che Phan dinh vimg DTTS mien nui pWa Bac theo trinh dp phat trien cdn bat cap, dinh miic dau tu cdn thap (mpt nam xa 135 dugc ty ddng, thdn dac biet khd khan dugc 200 trieu ddng) [4] Chua cd ddng ngan sachridngdd thuc Men chinh sach dan tdc, vay de an, cMnh sach nhieu nhung thiiu ngudn luc thuc hien, chua dat dugc muc tieu de ra; (5) Viec td chiic thue Men chinh sach ASXH d cac cap, nhat la cap co sd cdn yeu Ngudn lire cho thuc hien cMnh cdn han hep, miic hd trg tir ngan sach nha nude cdn thap, phan tan, chua diing ddi tupng; tMiu su phdi hgp, long ghep vide thuc hidn cac cMnh sach; chua huy dpng hit su tham gia tir cpng ddng, tMeu chinh sach khuyen khich ngudi ddn tu an sinh, ngudi ngheo tu vuon Idn thoat ngheo Mot so kinh nghiem due nit tur thyc hien an sinh xa hoi doi vdi dong bao dan tpc thieu so cac tinh mien niii phia Bac Tir qua trinh thuc Men chinh sach an sinh xa hpi cho ddng bao DTTS cac tinh miin niii phia Bac, cd the nit mdt sd kinh nghiem nhu sau: Tap trung xay dung mdt chuong trinh giam ngheo tdp trung cho nhiing vimg trpng diem khu vuc mien mii, vimg ddng bao DTTS (nhu Nghi Quyit 30a) di tranh tan man ngudn luc va tap trung giai quyit tinh trang ngheo ddi dang cd xu the co cum lai d mdt sd dia ban nhu Men nay, tap trung vao ho trg phat triin san xuit, phat tridn CO sd tang va nang cao nang lire di hp tu vuon len thoat ngheo Trong do, cMnh sach giam ngheo cho ddng bao DTTS tai cac tinh tren can tap trung vao viec ndng cao nhdn thiic va bat dau bang viec chuyen ddi san xudt ndng ngMep tir ban tu cung, tu cap sang san xuat thucmg mai, da dang hda sang cac co hdi viec iam phi ndng ngMep, dac biet nhimg ITnh vuc cd the tiep can vdi cac phd Idn hoac cac thi trudng qudc te, nhan rdng cac md hinh va phat trien cac chien luge giam ngheo cua ddng bao DTTS dugc thuc Men theo mdt loat cac buoc tir chuyen mdn hda tdi da dang hda ndng nghiep va tich My vdn tai cMnh, xa hpi va van hda, cu the mdt sd nhdm cMnh sach nhu sau: - Thuc hiin chinh sdch tin dung teu ddi cho ddng bdo DTTS Can xdy dimg mdt chinh sach tin dung thdng nhit, khdng nen tdn tai ddng thdi nhieu miic lai suat va ddn hudng din miic lai suat thi trudng de tgo diiu kien cho cac td chirc tin dung canh tranh binh ding, gdp phin nang cao Meu qua vdn vay Miic vay cho sdn xuat phai dugc can cii tren co sd ke hoach/du an san xuit; ngudi ngheo DTTS ludn cdn dugc giiip dd va dugc hudng dan lam an, qua viec cdp tin dung, td chirc dao tao khuyen ndng va cung cip thdng tin thi trudng cho cac nhdm ndng ddn chinh quy va pM chinh quy theo yeu ciu nhim dap ling nhiing nhu ciu hien cd d dia phuong 27 Khoa hpc xa hdi Viet Nam, sd - 2020 - Tdng cu&ng hogt dpng ho trg gido due vd ho trg dgy nghi cho hgc sinh thupc hp ngheo Vi muc tieu giam ngheo ben viing cho tucmg lai, can xem xet xdy dung chinh sach toan dien hd trg tre em ngheo DTTS; bao dam muc tieu tre em dugc den trudng, nang cao dan tri, gdp phan giam ngheo tuong lai; cai tMen he thdng cung cdp dich vu giao due ca vd co sd vat chat, dpi ngii giao vien, chuong trinh hpc Md rdng day hpc song ngii, lay tieng me de lam gdc bang cac thir tieng cua cac nhdm DTTS Idn hon dua tren boat ddng thi diem ciia Bd Giao due va Dao tao va Quy NM ddng Lien Hop Qudc (UNICEF) tai cac tinh Lao Cai, Yen Bai, Ha Giang Tap trung dao tao ve kinh doanh cho phu nii va nam gidi ngudi DTTS nhu: Chuang trinh dao tao ve ndi dung khdi nghiep va nang cao boat ddng kinh doanh cua ban; dao tao nghe md rdng cho nien, chii trpng vao cac ky nang ITnh vuc ndng nghiep va pM ndng nghiep tai mdt ncri cu the d dia phuang Cdn cd chinh sach khuyen kMch, hd trg cho hpc sirih DTTS tham gia hpc nghe dd dam bdo dieu kien sinh hoat cho ngudi di hpc Can phat huy hon niia De an day nghe lao ddng ndng thdn ddi vdi ngudi ngheo DTTS - Ddy mgnh hogt dpng khuyen nong, khuyin ldm, khuyin ngu Ke hoach tap huan phai dugc xay dung dua tren nhu cdu ciia ngudi dan va dugc tdng hgp len xa Tieh hgp hoat ddng khuyen ndng cho ngudi ngheo tir cac chuong trinh muc tieu qudc gia hien vao chuomg trinh khuyen ndng thudng xuyen cua nganh ndng ngMep va phat trien ndng thdn Trong tMet ke mdt muc rieng ve khuyen ndng cho ngudi ngheo DTTS; cin chii y d i n thdi gian phu hgp de 28 td chiic tap huin khuyin ndng, thdi lugng phu hpp vdi trinh dp va ndi dung, ngdn ngii truydn dat ddi vdi vimg ddng bao DTTS - Ho trg y ti vd nhd & cho ddng bdo Xdy dung nhiing chinh sach dac thii eham sdc siic khde ddi vdi timg nhdm ddi tugng, timg khu vue cu thi Thuc hien cd Meu qua cac nhdm giai phap chinh sach ve tai ehinh; d i u tu; dao tao can bp, phat trien ngudn nhan luc tai chd; chinh sach dac thii ddi vdi eham sdc siic khde, dan sd va ke hoach hda gia dinh vimg DTTS Thuc Men tdt chinh sach BHYT cho cac ddi tupng neu tren; tao dieu kien thuan lgi cho ngudi benh kham, ehiia benh BHYT giam ganh nang ehi phi y te cho ddng bao DTTS Tiep tuc ddu tu co sd vdt ehdt, trang thiet bi y te cho cac tuyen co sd, nhat la tram y td xa viing sdu, vimg xa noi co ngudi DTTS sinh sdng; phat tridn md hinh ddi y te luu ddng de trien khai cac hoat ddng kham, chiia benh tai vimg sau, vung xa Xay dung va ap dung che dp, chinh sach dao tao va phdt trien ngudn nhan luc y te cho vung mien mii DTTS Tang cudng kha nang cung iing dich vu y te co ban cho ddng bao dan tdc thieu sd Dieu chinh mirc ho trg tir ngan sach ve nha d cho hd ngheo DTTS theo Quyet dinh sd 167/2008/QD-TTg 12 thang nam 2008 ciia Thu tudng Chinh phu V i cMnh sach hd trg hd ngheo vd nha d Xem xet hd trg cho nhiing hd ngheo dang sdng dudi cac deo mii, canh cac sudi nhu d Ha Giang, Lao Cai Gan hd trg nha d vdi cdng tac di dan d i dua ngudi dan khdi nhiing dia ban cd nMeu nii ro, nhdt la rui ro v i tinh mang - Thuc hien hieu qud vi trcr giup xa hpi Cac cip cMnh quyin timg bude bao dam Nguyen Van Tuan cho mpi ngudi dan cd thu nhap dudi miic sdng tdi tMdu ddu nhan dugc trg giiip xa hpi; hoan chinh he thdng chinh saeh trp giiip xa hpi theo hudng tiip tuc md rpng ddi tugng thu hudng, nang din muc trg cap xa hpi thudng xuyen phii hop vdi khd nang ngdn sach nha nude Trong dd can, quan tam han den vin di ngudi ngheo DTTS, dac biet la cdng tac chi tra ciing nhu tinh kip thdi trg giiip xa hdi ddt xuit Kit luan Trong nhiing nam qua, Nha nude ludn quan tdm, ddu tu nhieu cho vimg mii, viing ddng bao DTTS, cac huyen ngheo, xa, thdn, ban dac Met khd khan; thuc Men toan dien cac chinh sach hd trg, gixip dd ddi vdi ddng bao cac DTTS He thdng chinh sach ASXH ddi vdi ddng bao DTTS da dugc ban hanh kha ddy du va toan didn, bao quat cac ITnh vuc ASXH gdm hd trg tao viec lam, bao hiim xa hpi, trg giiip xa hpi va dam bao tiep can d miic tdi thieu cac dich vu xa hdi (giao due, y te, nha d, nude sach, thdng tin va dam bao cho mpi ngudi dan dugc kham chiia benh mien pM d cae ca sd y td ), qua dd gdp phan ndng cao ddi sdng vat chit va tinh thin cho ddng bao DTTS yen tdm phat trien kinh te, xdy dung va bao ve Td qudc bdi canh Viet Nam dang hdi nhap qudc te sdu rdng Men Khu vuc cac tinh mien mii phia Bac la dia ban sinh sdng ciia cpng ddng nhieu ddn tpc vdi nhimg diiu kien khd khan ve co sd ting, phat triin san xuit va tiep can cac dich vu cdng Do dd, dam bao ASXH cho ddng bao DTTS noi day la gidi phap ca ban de giam ngheo ben viing, nang cao ddi sdng va gdp phin dn dinh chinh tri xa hdi Tai lif u tham Idiao [1] Bp Lao dong - Thuang binh v^ xa h^i (2015), Bdo cdo da chiiu a Viet Nam: Gidm ngheo d tdt cd cdc chieu cgnh de dam bdo cupc sdng ehdt luong cho moi nguai ndm 2015, Wk Noi [2] Chinh phu (2012), Bdo cdo Kit qud thuc hien Nghi quyit so 70/NQ-CP vi Chuang trinh hdnh dpng ciia Chinh phii thicc hien Nghi quyit so 15/NQ-TW ngdy 01 thdng ndm 2012 cua Ban chdp hdnh Trung uong Ddng khoa XI mpt s6 vdn de ve chinh sdch xd hpi giai dogn 20122020, Ha Npi [3] Chinh phii (2019), Di dn ldng thi ddu tuphdt trien kinh ti - xa hoi viing ddn tpc thieu so mien nui vd vung kinh te - xa hpi dgc biet kho khdn giai dogn 2021-2025, dinh huong 2030 Hk Ngi [4] Cong thong tin di$n tii tiy Ban Dan tgc cua Quoc h6i (2018), Bdo cdo ddnh gid ndm thuc hiin chinh sdch ho trg phdt trin KT-XH vung DTTS mien nui (giai dogn 2016-2018) Ha N6i [5] Vien Chien lupc phat trien - Bg Ke hoach va Dau tu (2018), Bdo cdo nghien ciru phdn viing phuc vu quy hogch 2021-2030, Ha Ngi [6] Vi?n Khoa hgc Lao dgng va Xa hgi (2011), Ddnh gid chinh sdch gidm ngheo giai dogn 2006-2010 vd de xudt^chinh sdch cho giai dogn 2011-2015 [7] World Bank (2012), Khoi ddu tdt, nhung chua phdi dd hodn thdnh: Thdnh tieu dn lu^g cua Viet Nam gidm ngheo vd nhirng thdch thuc mai [8] World Bank Vift Nam (2011), Tdng cudng hi thong trp giup xa hpi nhdm khdc phuc nhieng thdch thuc vi tinh trgng ngheo doi vd di bi ton thuong diiu kien mdi [9] http://www.gso,gov.vn [10] http://www.cema.gov.vn 29 ... mien mii phIa Bac van can phai dugc chii trgng nham dam bao cudc sdng va sinh ke dn dinh cho ngudi dan Ben canh dd, tinh trang sdi mdn, thoai hda dit van dang la van de ndi com can dugc khac phuc... 135; Chuang trinh 3a cua san xuat va phat sdng hau het cac CMnh phu Trong dd, ngan sach Trung tuan, gdm 22 thii tieng DTTS; nam uang lai chua bd tri dugc ngudn vdn rieng 2017, da xuat ban gan 100... ngudn nhan uong, khd cd the long ghep cac chuang luc va mat bing dan tri thap; rit khd khan trinh, du an de thuc hien cMnh sach dan tpc viec thu hiit diu tu; thiiu viec lam 26 Nguyen Van Tuan ddi