-Ezas •!iB'''sifm!m XXong tac dan so, ke hoach hoa gia dinh, l^cai thien tinh trang mit can bang ^:gidi tmh sinh or Viet Nam hien ik: PHfHAl NAM* 7i ^ ^^dang gjWpj ^ ^ e n ^ "f ^^^ ^^^^ ^ ^ ^^™ bungpbat xu hudngloa ebon gidi tmh sinh trd v ^ di dang hao ddng d cac niidc chau A hien nay, trongddcd Nam Xu hixdngnay da va dang d^t nhiSu thach thUc d6i vdi sti phat ben vUng kinh t^- xa hoi cua nudc ta va dilai nhiiu he luy tUOng '^^^^•VifcthUchiendSngbdcacgiaiphaph^hieudSciithiSntinhtrangma't ^^ cSn b&nggidi tmh sinh d ViSt Nam dang trd nen ci'p bach Thiic trang mft c&i bing chinh Ifi sy bfi't binh dfing ^ g m tinh kMsinhdVMt Nam gidi, Ifi tam ly ua thich Ty so gidi tfnh sinh trai vfi coi thudng gifi tri cua • dugc tfnh bfing so tre em trai ngudi phu nfl, vdn dfi bfit re " sinh trfin 100 tre em gai sfiu cfic gia ^ n h truyin ^ nfim Thdng thUdng cfl thd'ng A Ddng Tu tUdng gia ff 100 bfi gai dUde sinh se d trudng, "trgng nam kinh nfl" II tUdng flng khoang 103 den dugc lUu truyen qua nhilu li 106 h6 trai sinh Mat cfin t b l hd va trd thfinh dinh ki&i I bing gidi tfnh sinh xay xfi hdi Dieu dfi dly ,; ty s£f gidi tfnh sinh Idn phy nfl xuong vi tri phu j hdn 106 hofic nhd hdn 103 thufic, d gifi tri vfi dia vi thfi'p , Hifin tugng mfi't can bfing gia dinh, d n g dong vfi J gidi tinh sinh la hfiu qua xfi hfii, ft d ed hdi hgc tfip, eua nhdm nguyen nhfin viec Ifim, chfim sdc y te nhu chfnh Ifi su bfi't binh dfing gidi dan dng (tam I;^ Ua thich eon trai); su Hfiu h i t d c gia (finh Viet l^m dyng nhflng tien hd khoa Nam quan niem d tiai hoc - cfing nghfi, d mdi dUde xem Ifi da ed ky thufit lya chgn gidi tfnh "nhfit nam viet hflu, thfip nfl thai nhi trudc sinh vfi viee vilt v6", d eon trai mdi "ndi thu h^p quy md gia (finh ddi tdng dudng", khdng d Cd t h i thfiy, nguydn nhfin trai la tuyet tu Chfnh vi the, gdc r l ciia viec lua chgn gidi ngucri phu nfl phai chiu rfit tfnh thai nhi trudc sinh nhieu sflc fip phai sinh duoc eon trai tfl phia nhfi chdng Neu khong, hg ludn cd nguy cd bi xuc pham, bao hfinh vfi ngugc (!fii Ben canh dd, hfi thd'ng an sinh xa hgi eho ngUdi cao tuli chUa phat triln, nhfi't Ifi d khu vuc ndng thdn, ndi cd tdi 70% dan so dang sinh song Ngudi cao tuoi h l u hit khfing d lUdng hUu hay trd cfi'p xfi hfii, y t^ Do dd, ngUdi cao tuli thudng phu thudc vfio kha nfing phung dUdng cua cai, mfi theo quan ni^ra eua gia dinh truyin thing, trach nhifim dd chu ylu thudc vl eon trai Dfiy cung Ifi mdt nhiing ly hinh thfinh tam Iy muln sinh trai Song song vdi sU yfiu thfch eon trai, vigc lam dung nhflng * ThS Vi^n Nghidn cflu Gia ^nfa vfi Gidi s6n9 (n-2oi6)| 27 m yi Tiiu O I | M ^ A M S C I A O V | , NANG CAO sac KHdE NHAN DAN ••^'mMvtUlUtrmum'Umdieil^MUnlkL,! t h i n h tilu ttt sti phSt trien cua khoa hoc - cong ngh§, d6 c6 cong ngh6 y hpc hi§n djii, ky thuSt si6u am d^ can thigp via qua trinh s i n g loc gidi tlnh trudc ainh ciing nhu h i n h dang njo pha thai nh4m loai bo thai nhi gai chfnh I i nguyen nhan trilc tiep giy mtft cin biing gidi tinh sinh Dang luu y l i hi6n nay, song song vdi cdc dich vu y te hiSn d^i thi cac cd sd n?o p h i thai khdng an toin v i ty 1$ n?o p h i thai co xu hudng t i n g cao, giy anh hudng dJc bi$t nghiem din sflc khoe, chfft lupng d i n so, tao nhiing rui ro Idn den tinh mang cua phu nii I Sdl19 (11-2016) Ngoii ra, quy m6 gia dinh nho cung gdp phSn ttio i p lijc cho viec lua chon gidi tlnh thai nhi trudc sinh Mong muSn c6 trai nhung vSn phai chiu i p luc giam sinh v i thflc hidn chinh sich din scfkg hoach hda gia dinh (mSi cip vp chdng chi sinh 1-2 con), da khifo cic cip vp chdng tim k i f o v i sfl dung cac dich vu Ivia chon gidi tlnh truoc smb Nhifa gia dinh chip thuin vide cd gii, nhung chi trudng hpp da smh dupe trai Mdt scf nghien cflu da chi rJng cic cip vp chSng da c6 mdt gii thi nhifa kha ning ISn smh sau se Ifla chpn gidi tinh M c6 dupe trai, kit qua l i lin sinh sau thudng m i t cin Uinta bSng gidi tinh sinh cao hdn IStn sinh dSu tiSn Nhiin| t i & bO y hpc da trJ t h i n h cdng cu ii thyc hijll mong rnuSh co trai nhij mdt "cflu cinh" doi vdi m^t sS cip vql chSng di d i p flng ca hai muc tidu Theo t i i h^u cua T^ng eye Din sd' - Kg hoach hda gia dinh, hien nay, toin chiu A dang thifo hvt tdi 117 tri«u phu nO su chenh l^ch ty sK gidi tfnh smb Vi0t Nam l i mdt nhiing nudc cD su chdnh l#ch gidi tinh sinh cao d chiu A, nhtt U nim trd l^u diy Nim 2015, ty sff gidi tlnh sinh t a i n u d c t a l i 112 8/100-trong thing nim 2016 t* la niy dat mflc 113,4/100 t u d ^ -lEX^EQBiSBim Bang l:T^aggidi tlnh cua tre em mdi sinh phan theo viing chia theo viing va nim CANirdc Dong bing sdng Hing Trung du v i mien niii phia B4c Bic Trung Bd v i duyen hai mi^nTnmg M y Nguydn Ddng Nam Bd Ddng bSng sdng Ciu Long 2005 10S,6 109,3 101,8 2010 111.2 116,2 109,9 Sa bd 2015 112.8 120,7 114,3 Thay doi so vdi 2005 10,7% 11,0% 11,2% 104,7 114,3 112,2 10,7% 108,5 106,8 103,8 108,2 105,9 108,3 104,2 114,2 103,7 9,6% 10,7% 10,0% NguSn: Tmigew: Thong k§ ^ i cfl 100 bd gai dugc smh hda gia dinh, sdm nhfin thflc dinh xfl phait vi pham hanh rathi d hdn 113 bd trai cung tfim quan trgng vfi nd lue ehinh vl dan sova tre em da ddi Nlu ty sd'gidi tinh tilp kilm soat tinh tr^ng mfi't chi ro, nghidm efi'm cfic hfinh tyc gia tfing vfi i^fiy cfing lan cfin h ^ g gidi tfnh sinh vi lua chgn gidi tfnh thai nhi, rdng thi se anh hudng nghidm vfi coi vi0e dfiu tu cho cdng cu t h i Ifi: J- Nghiem cfim trgng din v i n di cfin bfing tfic dfin si, chfim sdc sflc tuydn truyin, p h i biln gidi cua Vi$t Nam 20 - khde sinh san la diu tU cho phUdng phap chgn Igc gidi 25 nfim tdi, gay nen nhilu h^ su phat triln bin vflng, tfnh thai nhi dudi cfic hinh J, Ivy tidu cue eho su phat triln mang 1^ hieu qua tnic tilp thflc: tiehfle ndi chuyen, vilt, bin vflng kinh t l - x a h § i cua vl kinh t l , xa hfii vfi mdi djch, phat hfinh cfic lo^i sfich, j quic gia trudng Vi tbl Dang va Nhfi hao, tai lieu, tranh, anh, ghi J T:y a l gidi tinh sinh nudc ta xac dinh d n tfing hinh, ghi am; tfing trfl, luu I khdng diu gifla cfic vflng, cudng su lanh dsio, chi dao truyin tfii lifiu, phUdng tidn miin d nUdc Khu viic eua cac cfi'p uy vfi chfnh vfi cac hinh thflc tuyfin I trung du vfi miin niii phia quyen; nfing cao hifu lUc truyin, biln khfic ve Bic, ding b4ng sfing Hing quan ly nhfi nUdc; huy ddng phUdng phfip chgn Igc gidi tfing manh nhfi't (tren 11%), sU tham gia cua tofin xa hdi; tfnh thai nhi; 2- Nghifim efi'm khu vi^c Tfiy Nguyen d ty Ig tiep tifc kifin tofin hfi thing chin doan gidi tfnh thai nhi tfing thfip nhfi't (9,6%) Theo t l chflc bd may d l thUc hien bAng bien phfip, nhu xac djnh cfic chuyfin gia linh v\fc cd hieu qua cdng tac dan si, gidi tfnh thai nhi qua trifiu dfin si, nlu khdng d d c bien chfim sdc sflc khde sinh san, chflng, bat m^eh; xfit nghiem phfip kilm chi tfic dd tfing ty nh4m cai thifin tinh trang mfiu, gen, nUdc li, t l bfio; a l gidi tfnh sinh mfit cfin bang gidi tfnh sieu am; 3- Nghiem cfiin loai nhflng nfim tdi thi muc tifiu sinh va coi dd Ifi mfit bo thai nhi vi ly lUa chgn 115 tre sd smh trai/lOO tre sd nhfliig chiln Iflgc quoc gia gidi tfnh b ^ g cac bi0n phap: sinh gfii vfio nfim 2020 khd d quan trgng n h ^ cai thien pha thai, cung cfi'p, sfl dung t h i d^t dugc (Xssm bang 1) chfi't l u ^ g dfin so d c loai hofi chfi't, thudc vfi Thdi gian qua Dang vfi Nghi dinh s i 114/2006/ bifin phap khfic Nhfi nudc ta rfi't quan tfim ND-CP, cua Chinh phii ban Quylt dinh so' 2013/QDtdi cdng tac dfin so, ke ho^eh hfinh ngfiy 03-10-2006, quy TTg, ngfiy 14-11-2011, cua S6n9 '(1V2016)| 29 ^m i«58 'TliUBIEM: CHAM S6C BAO V M A N G CAO SOfC KHdE N H A N D A N ^ Thu tudng Chinh phu xac dinh rd, C^en ludc Dan si'va Sflc khoe sinh san 'Wdt Nam giai doan 2011 - 2020 Ifi mgt ngi dung quan trgng cua Chien lUdc phfit trien kinh te - xa hdi cua da't nudc, gdp phfin nang cao chfi't lUdng nguon nhan lUc, nang cao chfit lUdng cudc song cua tflng ngUdi, tflng gia (finh va tofin xa hdi; giai quyet dong bg cac vfiii d l dan so, sflc khde sinh san, tfip tnmg nfing cao chfit lUdng dfin sd', cai thien sflc khde hfi me vfi tre em, phat huy Igi the ciia cd clu "dfin s i vfing", chu ddng dieu chinh tdc tfing dfin so vfi kilm sofit ty sd' gidi tfnh sinh CiJipMp hudng tdi ci&i thiSn tinh trang m^t cfin biing gidi tfnh sinh Chiln luge Dan so' va Sflc khde sinh san Vifit Nam giai doan 2011 - 2020 xac dinh muc tifiu giam manh tdc dd tfing ty s i gidi tfnh sinh", dfic biet tfip trung vfio cfic tinh, thfinh p h i true thudc Trung uong d tinh trang mfit cfin bfing nghifim trgng ty sd' gidi ti'nh sinh, tiln tdi dua ty s i nfiy trd lai mflc 105 106 tre sd sinh trai/lOQ tre sd sinh gai vfio khoang nfim 2025 (vdi chi tieu ty so gidi tinh sinh dudi mflc 113 tre sd sinh trai/lOO tre sd sinh gfii vfio nfim 2015 vfi dudi mflc 115/100 vfio nfim 2020) Dl thUc hien dugc muc tifiu tren, hudng tdi sU phat triln bin vflng kinh t l - xa hdi dfit I S l (11-2016) nUdc, thdi gian tdi, d c clTp uy trudc sinh, cac cd sd naio pha vfi chfnh quyen ciing toan thai Dfic biet rfi soat vfi xii ly dan d n chung tay, n l lUc nhflng cd sd y t l kh6i^,^u thUc hien ddng bd cac giai dieu kien cd sd vfit c ^ phap sau day: trang thid't hi vfi trinh dd, Mgt la, giai phap tfl cdng chuyfin mdn linh v ^ tac td chflc, quan ly lidn quan den chfim sdc sfc Cfic td chflc, doan t h i cin khoe sinh san vfi kd' ho^di xac dinh d i ^ tac dfin so'vfi k l hda gia (finh Nghifim efi'm hoach hda gia dinh Ifi ndi cac hfinh vi vi phtim quy djnh dung quan trgng, phai thudng ciia Phfip lenh Dfin so vi xuyen giam sat, kilm tra tinh nghidm efi'm cac hfinh vi \\^ hinh thUc hien cdng tfic nfiy chon gidi tfnh thai nhi dudi theo m\ie tieu ds di Nfing mgi hinh thflc (dugc quy ( ^ eao chfi't lUdng t l chflc vfi can dilu 10 Nghi dinh si bd Ifim cdng tfic dfin sd', gia 104/2003/ND-CP, ngfiy 16-9(Jinh vfi tre em tfl Trung Udng 2003, cua Chfnh phu vl vi?c den cd sd du manh d l quan Iy quy dinh chi tilt vfi hudng va to chflc thuc hidn td't cdng din thi hfinh mdt s i dilu cua tac tuydn truyin, giao due, Phap Idnh Dfin s6) vfin ddng vfi dua dich vu k l Hai Ik, giai phap v l chfnh hoach hda gia dinh den tfin sach vfi diu tu -m ngUdi dfin Dflc bifit quan Mfi't can b^ng gidi tinh tam, bli dUdng, khuyin khfch sinh khdng chi thudc p h g u ^ cho ddi ngu cfin bd chuyen cua cdng tfic dfin sd', klho^cK trach cdng tac dfin s6', gia hda gia (finh ma cdn Ifi kit dinh vfi tre em d cfic xa, qua cua chfnh sach phfit trien phudng, thi trfi'n vfi ddi ngu kinh t l - xa hdi, lu^t binh cdng tac vien dfin si, gia ifinh dfing gidi, chfnh sach xda ddi, vfi tre em b cfic thdn, xdm, giam nghdo vfi cac chfnh sach ban, Ifing Thi^c hifin che dd y t l khac Do do, Nhfi nUdc bao hiim xa hdi vfi bao Mini d n tilp t\ic hofin thifn Phfip y t l ddi vdi cfin bd dfin si, gia If nh dfin sd' cho phfl hgp vk ^ h vfi tre em xa, phudng, dilu kifn phat triln kinh t l thiti&i xfi hfi hifn Hf thing Quan ly, dilu hfinh cdng tfic dfin 80 vfi k l hoach hda gia (finh d n dfi'y m ^ h cd c h i phfin cfi'p vfi phoi hgp lien ngfinh theo chUdng trinh myc tieu quic gia, tfing cudng kilm tra, giam sat vifc t l chflc thuc hidn Xil ly nghifim nhflng cd sd tiln hfinh sfing Igc gidi tfnh chfnh sach d n hudng tdi cic vflng ddng dfin, cd mflc sinh cao cung nhu mflc chfnh Ifch gidi tfnh sinh eao, mi&i nui, vflng sfiu, vflng xa, vflng khd khfin vfi cfic ddi tui^g Uk ngudi nghfio, vi thfinh nien, nifin Nhfi nudc d n phai d cac chfnh d c h khuyin khfch ddi isxs^aaEsmmm ^- vdi cac d n g ddng, gia dinh, d dan sd' va ke hosich hda gia Nam ifi, xa hgi hda vfi hdp ^' nhfin lam tot cdi^ tac dfin s i (finh vifc phm hdp vdi tac qudc te" d n g tac dan "f vfike hoach hda gia dinh; thuc d c d p , cfic nganh, doan t h i sd - ke hoach hda gia (finh '" dfi'y phong trao thUe hien nhan dan la then chot de tao Nha nudc thUc hifn phan ^ chinh sfich dfin si'va ke hoach dilu kifn vfi mdi trudng bd cdng khai vfi sb dung cd * hda gia dinh Viec dfing ky, thufin Idi cho mdi gia (finh, hifu qua cac ngudn kinh phi * thu thfip va xi( ly thdng tin, mdi ngucft dan tu nguyfn thflc ddi vdi cdng tac dan sl^vfi ke < dfl lieu ve dan so la hit sflc hien chfnh d c h dan so" vfi ke hoach hda gia dinh Day '• quan trgng giflp eho vifc quan hoach hda gia ifinh manh vifc xa hdi hda cdng !i ly dfin cUva hoach dinh chfnh Bon la, giai phfip vi chfi't tac dan sd* va ke hoach hda s sach, xay dUng chien ludc Ifldng cui^ cfip dich vu cham gia dinh thdng qua vifc huy ' phat triln kinh t f - x a hgi sdc sflc khde sinh san vfi ke ddng su ddng gop cua d c to " Ba la, giai phfip vl tuyen hoach hda gia finh chflc, ca nhan vfi tofin xfi hdi, i; truyin, vfin dfng, gifio due Hoan thifn he thong dich nhltm tfing cudng tiim lUc vfi ^ ^ D l v manh d n g tac tuyfn vy, chfim sdc sflc khoe sinh nang cao hifu qua cac boat ^ ^ ^ ^ F g i a o due ve chfnh d c h san vfi thUc hifn ke hoach ddng chfim sdc sflc khde cdng B ^ ^ H chfnh sach hinh dfing hda gia dinh, dap flng dfiy du dong ndi ehung, sflc khde g i d i , ^ y d^ nhfin thdc, tam ly nhu d u eiia ngudi sii dtmg ve sinh san ndi rieng vfi nang trgng nam khinh nii, tfip qufin cfic bif n phap tranh thai Chfl eao chit Ifldng dfin si sinh de tofin xa hdi Long trgng dfiu tu, nfing d p cd sd Huy dfng rdng rai cfic ghdp vfi sii dung da dang d c vfit chfi't, trang thiet hi vfi loai hinh truyin thfing de nang cao trinh dfi cfin bd y te nganh, cfic to chflc chfnh tri xa hfii, cfng ddng tham gia tuyfn truyin, vfin ddng, giao tham gia eung cfi'p dich vu due den tflng gia tfinh, ngfldi chfim sdc sflc khde sinh san, cdng tfic truyin thdng, gifio due, eimg d p dich vu dfin si, dan Nang eao chfi't ludng ke hoach hda gia dinh, chUdng trinh gifio due sflc khde khuyin khich d c to chflc xa sflc khde sinh san Xay dung sinh san va k l ho^ch hda gia hdi va tu nhfin tham gia cung vfi thuc hifn Id trinh giam dfin mflc df bao cfi'p cua Nhfi (finh vfi ngofii nhfi trudng d p d c dich vu nfiy nudc Chuyin d i n phUdng cho vi thfinh nifin vfi Tfip trung triln khai d c thflc chi tra phf dich vu dan nifn V^n dgng d c gia (finh cd lo^ hinh cung d p dich vu sflc nhilu the he chfip hfinh khde sinh san k l hoach hda sf, sflc khde sinh san tfl vifc n^fim tflc quy djnh cua Nha gia (finh phfl hgp ddi vdi tiing e^p kinh phf cho cd sd cung nudc vl dfin s i vfi k l hoach hda vflng Tfing eUdng d c chien cfi'p dich vu sang vifc gia (finh, dd nfiu cao vai dich chfim sdc sflc khde sinh toan qua eac phUdng tifn trd ngudi cao tuoi d c san vfi k l hoach hda gia (finh trung gian Chu dfng tham gia cac to chflc, chudng trtnh ho^t ddng ddi vdi vung ndng thdn, viing qu& t l v e dan sfvfi sflc khde Huy dgng cac to chflc xa ddng dfin d mflc sinh cao, sinh san Tfing cudng hgp tfic hfi, thfinh phfin kinh te, cfi vflng d u , vung xa, vung khd qudc te' vfi tich ci^ tranh thu nhfin tofin xa hdi tham khfin Chu y dung mflc den su giup dd vl tai chfnh, ky gia tfch cue cdng tfic tuyen viee dap flng nhu d u dich vu thufit va hoc hdi kinh nghifm truyin, vfin dgng, gifio due ddi vdi vi nien, cua eac nude, cac to chflc qudc cdng tac dfin s i vfi k l hoach nien Ling ghfip boat dfing te cdng tfic kilm soat hda gia (finh; dd vai trd cung d p dich vu k i hoach mfi't cfin bfing gidi tinh, nfing vfi trfich nhiem cua eac cd hda gia (finh vdi phdng, chdng eao sflc khde sinh san vfi chit quan chuyen trfich cdng tfic HIV/AIDS lUdng dan so'! s6n9 (n-2oi6)| 3i ... hda gia dinh, chUdng trinh gifio due sflc khde khuyin khich d c to chflc xa sflc khde sinh san Xay dung sinh san va k l ho^ch hda gia hdi va tu nhfin tham gia cung vfi thuc hifn Id trinh giam... sd' gidi tfnh sinh CiJipMp hudng tdi ci&i thiSn tinh trang m^t cfin biing gidi tfnh sinh Chiln luge Dan so' va Sflc khde sinh san Vifit Nam giai doan 2011 - 2020 xac dinh muc tifiu giam manh tdc... chflc chfnh tri xa hfii, cfng ddng tham gia tuyfn truyin, vfin ddng, giao tham gia eung cfi'p dich vu due den tflng gia tfinh, ngfldi chfim sdc sflc khde sinh san, cdng tfic truyin thdng, gifio