Các chính sách cho trẻ bị ảnh hưởng bởi HIV AIDS tại việt nam một số thách thức trong thực tiễn

CAc CHiNH SACH CHO TRE ®I ^ ^ H i r d N G B I H I V / A T O S T A I VIET NAM: MOT SO THACH THlJfC TRONG THlfC T E I N VOHOANGSON" NiHZ ^^^7"" '^'^ -"^od todn cdu hda, hi OAig,hdp ludt chlnh sdch :ia h Jl^T.Z t ' " ^ " ^ " ^ ' ^ ' ^ ^ • ^ ' ^ ^ han di quyin cda '2^^^^-'^mv.nudidudngdua^gUidMi.eSngd^,duocbdoo,dmmoiht,Uidil>^ Tv^lT T '^'^- ^ ' ' ^ ^ • ' ^ ^ ' ^ cdechinhsdchddlnhanehfbMsUl^dU '^•'•^'•^P'^-"*cdechinHsdd.:cah^cuat,ibidnhhitingbdimV/AWS ^^h6a:Chlnhsdeh:mV/AJDS:anhhuing:sU^thi;l,iem l^ZZfTLf^ ^ '^'^ " """"^^ "-""^ ô^ ô.ằ.P^ằ.ằ so tha ã^'^^ã^'^'^i^l'yaVremalnsasguaranteedasaUatherchildrenlnhealthcaielinclud^ being treatment ""^ mv a/jhltson children, nurturing communis based on Family community, J l ^ T °" ' ^ ' '"'^ " ^ ""^aing, Houiever in practice the policies have been "'•••'train^i'^dmHmination on access to the social uiafireifchildnma/fi^ ^""•rds: policy: mv/AmS: influence; discrimination: children Ngiy nhdn bdi: IS/5/2015; Ngdy duyit dang bdi: lB/7/2015 B#t vSii d l ^ • ^ j j ^ j ^ y^ mv/AIDS CMnh sich Lfo diu tifo Dpi hdi dfog Lidn Hop khdng ^ thi phto bi^ ddi xA dfi vditaeM tjude dff ed pMdn hpp d|ic bidt vl vfo dl foh huSng bdi HIV/AIDSn> HIV/AIDS (gpi tfft Iff UNGASS) vio thfog Tuy nMdn,ta*W inh hufog bffi HIV/ 6/2001 tpi New York gifla cic nguydn thu AIDS vfa chua thit sU dUOe quan tffm cho qu&gmtedn thd gidi nhfoikdu gpi ting dfo thing 3«006 kM Hdi ngM Tu vfo khu oAig Sfl c«n kfft cua cie qudi gia taong vflc Ddng A - Thai Knh Duongvltaeem vi Bnh Vflc mV/AIDS vi dff dua rataiydnbd HIV/AIDS dupc t l ehUe tai Hi Ndi, cie dai cam kdt am cie quoc gia vt efo mue tifo bifo taong vi ngoai nude da xic dmh rfog B n T m f r " t ° "*" "'''"'*• "^^ vfo dltaeem bi anh hufog bffi HIV/AIDS T ^ f t ' ^ ' ^ , < ^ «a "14a eto tMfo vfog taong cie chuongtainhvi ^ A m ^ ^ T " " ^ " " ^ * * •=*" " ^ "*" -htoh =4ch cua eac q-adb gia Vi HTOAIDS efo dupe h8tapdffe bidt, cic viy, Hdi nghi dua Ldi kdu goi hinh^dng qudc gia phai ed cac ehinh sffeh vff cMfo ' lupc iffu dii nhfo, cung cffp mdt mdi " NCS Khoa Xi h,c H«rii.Khoato.1 hsi trudng tdt itt hd trp cho tre ml cdi vi tre l'!S!fT^''^°°^™'=^'^ Hd th£fng phap l u ^ vfi efic chuih^sfidb lien quan d i h tre b|>'aiih vhudng; bdi HIV/AIDS khfi nhilu, n e n trong^ bfii vilt nfiy chung tdi chi rfi soat lu|it, nhiJng chinh sfich hi$n hfinh C&C'idiiiih sfich nfiy ^ da ductc phfin nhdm vfi chia nho thfinh cfie tidu chi di phfin tich ^61 dung lidn qjian Nhanxdt „,„,, PHAP L|;NH - Lu^T ^ Phip l$nh phdng, • Difo eua phip Ifoh quy Phip l ^ h dff thi hidn rfft Ch&gHIV/AIDS, 1995, djnh: Nhiing ngUdi bi nMlm ro vide bfo v§ quyln cua kdm theo Ngh; dinh HIV/AIDS dupc bfo vp chfog Ipi ngudi cd HIV khfog k# thj 8134/CP (1996) hudng sfl phfo hi$t a& xcl (PBDX) phto bi|t dm x£l dfo trifo khai eac boat CM cd Dieu ndi den gifo Dilu 8: Giio dpc phdng, chfog dfog phdng, chfog nMlm mV/AIDS phai dupc dua dflc truyfo thdng vl HIV cho AIDS/AIDS ' • Vt' , -, vio cac trudng hoc vdi ndi dung tre em phii-hop tfing lopi hinh trudng Phip Ifoh niy chua dl cffp hpe, trinh dd, lUa tuoi, gidi tinh dfo tre cd HIV vi tre bj foK vff phong tue, tip qufo eua eic hudng bdi HIV dto tde • - ' ^ ') Dilu 18, Khofo 3: NgMdm effm KM ngudi ta k^ thj, phfo vi|c dUa tm cdng khai vl ten, bidt a& x{l vdi nguffi nMlm turn, dia cM, Mnh anh cua ngudi HIV tM nhflng vi pham nffy bj nMlm HIV/AIDS, trii trufog se xit 1^ sao? ' ' *' '*^ (^ ,-pn f Ii hpp duoc sfl ding f cila ngudi dd • ?,.-*rt Eg will i i c n m HQC UHOI , • • •^MEWV i VO HOA N G SON Lu^t phdng, ch&ig ^^em vi n i t gfiy h0i chUng suy gjilm mien dich mic phai d ngudi (HIV/AIDS), Ngfiy 29 thang m&m 2006 CSiUdng I, Dilu 6: Chinh siich Lu|lt dli cd nhieu svia dli, c i ^ Nha nudc v l pfadi%, c h & ^ sung hdn so vdi phap Idnh HIV/AIDS, Khoan ''HS trtf phdng n h i m tfip trung tfing eUdng ch^Dg HIV tij( me ^oig con, nu& sfl iham gia cua cfic ban dudng tre em dudi t h a i ^ tuoi sinh ngfinh dofin t h i cac cfip, eac t a ngudi me nlnlm HIV bing Iflc vfi n£ sfla thay the va b^nh nhfin AIDS nfldc ciing nhfl sfl ph£S hdp CO hofin canh dgic biet khd khfin' da i^finh n h i m vfio v ^ d l Dieu 15: Phdng, chraig HIV/AIDS chfim sde ^ l u tri ngfldi cd cd sd giao due thudc h$ HTV; quyln eua ngfldi cd thdng giao due qudc dfin - cd sS HIV; cf&n moi hinh thfle k^ giao due cd trfich nhi$m t l chflc Ha; phfin biet d£a xfl vdi giaug d£iy eho hoe sinh, sinh vidn, i^fldi nhiSm HIV vfi mdi hoc vidn v l phdng, chfiTng HIV/ trfldng chinh sfich hS trd AIDS ling ghep vdi giao due gidi T h i hi^n rd sLt Uu tidn tinh, sfle khde sinh san Cd sd chfim sde dilu tri cho giao due khdng dUdc cd cfic hfinh tre em ed HIV vfi phu nfl visau: mang thai nhilm HIV T t t chdi tiep nh$n hoc sinh, sinh vidn, hoc vien vi ngUdi dd nhiSm HIV Ky l u p duoi hoc vi ngudi dd nhilm HIV Tach bi^t, han chi, cfi'm dofin hoc sinh tham gia cfu; hog* ddng, dich vu vi i ^ d i dd nhilm HIV Ydu du xdt nghidm 1KI§C xufii trtnh ket qua xdt n ^ d m ddi vdi hoc sinh, sinh vidn" Dilu 39: Phu nfl nhilm HIV thdi k;^ mang thai, tre em Yi^ dilu tri ART cho bdnh dudi t u l i nhilm HIV dUOc Nhfi nhan dUdc thUe hi^n theo thfl nudc cffp miln phi thudc khang tfl flu tien; Tre em, phy nfl ed HIV (ARV) iTu tidn dilu tri t i a i vfi nudi nhd dfldi HIV/AIDS eho tre em tfl du t u l i tuoi dudi 16 t u l i nhilm HIV Lufit da qui dinh bao hilm Dilu 40: Bao h i l m y t l dm vdi y tl^ se chi tra cho ngudi nhiem ngudi n h i l m HIV Ngudi dang HIV, nhUng thiic tl' chfla cd tham gia BHYT hi nhilm HIV thdng tfl hudng dfin eua bao duoc Quy bao hiem y t l chi tra |hilm Y t ^ d l thflc hi$n HlUNL|ICKH0AHQC)dH9l g] CAC CHINH SACH CHO THE BI ANH HLTflNG Bdi fflV/AIftg;,; Dilu 41: Tre nMlm HIV hi bd inHs^ i dd» vffn gia roi, ngudi nMlm HIV khdng ndi v i cdagMhg Utdhfnh nUOng tfla, khdng cdn kha n t o g txdSd^Ha^ ngti£b o&; lao ddng dupe ehffm sde, nudi khd^^ndi ^UOog tUa se dBet^ dudng tai eo sd bao trp xff hdi Nhi'iiudc nudi dudng tpi loa j sdibfotargxahdi Luit Bfo vd, Chim Lufft da dinh ca Chuong vdi D f a v i o edng udc qudbi sde v i Giio due tae 12 Dieu (tfl Dilu 11 dfo 22) cie v l quyfo tre em m i Vi$t em ngiy 15 thing quyfo CO bfo v i hon phin cua N a ^ (^ xffy dung lufft niy tae Trong ea chuOng IV vdi 18 nim 2004 nhami d i m bao cfo quyln cua dilu (ta difo 50-68) Bao vd, chim tre, nMdn luit ehUa thi sde tre em ed hofo canh d^c bidt Mffn quyfo bay td f kidn vff v i dd: Dilu 53: Trd em nMlm HIV/AIDS khdng bj p h i n dupc Ifog nghe ciia trd vi bipt d€S xfi; dupc N h i nudc vff xa ehUa thfft sfl quan tim dfo hdi tpo difo Mpn dl chfla bdnh, nhdm tre bj foh hudng bdi nudi dufog tai gia dhih hoffe tai HIV/AIDS dffc bipi: l i nMMg eo sd trp giiip tre em tre sd'ng gia (finh cd cha, mp, ngudi nudi dufog nMlm HIV hay m l cdi cha, mp chit vi AIDS C H I N H S A C H L I ^ N QUAN Y TE djnh sd Hutog dfo vide thflc M$n xdt Trude dffy d l xfo ffinh tri lOSai^BVT vd" huftig ngMdm phit Mfo nMlm HIV nMlm m V phai chd kM tri dfo xdt ngluffm phat cho tre dudi 18 thfog tuli bfog Idn hon 18 thtog tuli mffi xd) hi$n n h i ^ HIV dm tad ky thufft khuydch dpi gen - PCE nghidm khfog djnh vi tb^ dudi 18 thing tuS ban dl phit M#n ADN hoffe AEN gian nffy tae edn mang khffni^ cfo HIV hinh ngiy 02/4/2010 thi e^a mp; nhUng vffi khof^ B& tupng l i tee phoi nMlm hpc tifo bd ngiy nay, c h f o | HIV dudi 18 thing tuli (tre sinh tii ngUdi me nMlm HIV hoffe ta cd t h i phit M^n sdm hdlj ngudi mp cd xet ngMpm stog Ipc tee ed nhilm HIV hay khdng HIV duong tinh) nhUng chUa cd qua k j thufft khuydch dpi xdt ngMpm khfog dinh tinh gen Dilu nffy giiip nit ngfo trpng nMlm thffi gian dilu tri cho tec n ^ Tre duffi 18 thing tuli dupe tad i m tinh vff giim i p Iflc ehfo dofo ngM ngd nMlm HIV tffm 1^ lo Ifog ciia gia dinh hoffe dupe ehfo doto Iffm stog tre kM bilt ket qua i m tfnh bpnh HIV/AIDS nffng v i ed xdt ngMdm khtog thi khfog HIV duong tinh Bl NHlimtnMHgtMiKli fIfWtMt •iliA J'.H !i VOHQANGSON Quyft djnh BS T i i ilidu bao gdm cboJtlB%, Dfla v i o hudng dfo chung 872/QD-BYr cfo B? CSiuOng 1:, Tfog q u a n ' Bua To chfle Y Te Th* Giffi t M f o g B d Y t ^ v i p h d YIN/Mm v i My i p i y f e tfl mBO), Bd Y tff vff cac foydt t i i hdu chuydn sang coiu.Ghttftig : ( X i m adc, chuydn gia da bifo soan quy mto "hudng dan qudc dilu tri ^ dfl pUdl^tliy tarUyfo e h u f o hda Ipi quy trinh ^ gia cham sde, diiu tri tfl mp sang vff GhUtbig : dfoi bao Mfo qua hem vd hd tra phu nU cd Chffmsdc, diSu trivff hStapcho q u i tifoh ehffm sde, dilu trj thai nhiim HIV, tri tae phoi n h i l m v i n h i l m HIV vff ho trp cho phfl nfl m t o g phdi nhilm vd bi Trong mSi chuOng Iff tflng bii, thai, t r e phffi nMfoa v i bj iiiUm HIV" ngiy 19 tflng p h f o theo mdt quy trinh rd n U i m H I V t h i n g nffm 2013 rtog ' ? ^ *ihl7e2013MX3' Dieu 17, Khofo 4: Phpt tifo Nghi djnh md ta v i cd mflc y l ijuy djnh x i phat vi tfl 15 trifo - 20 tridu dfog dm phpt rd r t o g nhiTng h i n h vi jfhpm h i n h chinh vffi mdt cac h i n h vi sau vi pham h i n h c h i n h tfl l i n h jmh vflc Y t l n g i y diy: edng khai tdn, dja cM ngudi vflc truyfo thdng, tU vfo, 14/11/2013 nMlm m i khdng cd sfl dfog f ehffm sde, difo trj, v i ^ l i m cfo hp S4 dung Mnh foh, thdng didp truyin thdng cd tinh ehfft k;^ thi, p h t o bidt dffi xfl vffi nguffi nMlm HIV, thffnh vito gia dinh nguffi nMlm HIV rffic- atm% eua nguffi nhilm HIV Vffi tre, cie trufog tuyIn sinh c t o cfl vffo ifoh tepng nMlm HIV, d u l i hoe sinh vl tinh trpng HIV cua hpc sinh dd hoffe cfo mdt thffnh' vito Dilu 21: Vi phpm quy itinh gia (finh hpc sinh ddi v l chfog k j tM, phfo bift dffi hoic ky lufft cffe hpc sinh vi xtl dffi vffi nguffi nMlm HIV hi ifoh trpng HIV ed t h i bj phpt phpt tiln tfl tridu - 10 t r i | u hoffe cd ngMa vu phai nhffn dfog dffi vffi hffnh vi: phfo bidt Ipi-hpc sinh dd Co quan t i % ddi xfi chim sde, dilu trj nhffn, xfi 1^ h i n h vi vi phpm nguffi nMlm HIV (Khofo e) iiinh c h i n h hdn quan d i n k;^ Tich bidt, effm doto, tfl chffi thi, p h t o bift dffi xfi vffi tre bj tifo nhffn hpe sinh, sinh vidn, anh hufog bffi fflV/AIDS sd hpe vifo vffo hpc taong eo sd giffo l i t h i c h thfle kM vide tfl chffi dflc thudc hd thdiig giffo due tre dfo t r u t o g thudng vffi qudc dto, CO sd bfo trp xff hdi vi nhflng ly khac nhu khdng U nMlm HIV hoffe t h i n h d t o g tuyfo, h i t chS, bj i p Iflc vito tiong gia flnh ed nguffi cua hdi che mp ndn mong phu huynh thdng cfoi nhilm m V ; wtmVBniMHgcxiii^i Q CAC CHINH SACH CHO TRE BI ANH H U N G B I HIV/AIDS Phat tidn tfl 10 trieu 20 trieu dong dm vdi mdt cac hfinh vi sau dfiy: Ky Iuat, budc thdi hoc hoc sinh, sinh vidn, hpe vidn vi ly nhiem HIV hofic vidn gia dinh cd ngUdi nhilm HIV CHINH SACH LIEN QUAN DEN GlAO DUG Bd Giao due & Dao CM thi da ydu cau cac cd sd tao da chi thi so': giao due tang cfldng hoat ddng 61/2008/CT-BGDDT t r u y i n thdng giao due v l HIV/ v l tfing cfldng cdng AIDS, giam k^ thi phfin biet ddi tae giao due phdng, xfl vdi ngfldi nhilm HIV bao gdm chdng HIV/AIDS tre n h i l m HIV Ydu eau tSft ca eac Cac cd sd giao due cam kit khdng ky thi vfi phfin bidt dfitt xfl vdi hoc sinh-sinh vidn, giao vien, cfin bd, nhfin vidn n h i l m HIV hofic hi anh hudng bdi HIV ed sd cam k i t thflc hidn Thdng tfl hen tich Ddi tfldi^ dfldc mien, giam hoe Thdng t u xac dinh nhdm 29/201D/TTLT- phi vfi hd trd chi phi hoe tfip tre thudc gia ^ n h chfnh saeh, BGaXTT-BICBLiXIBXH dd ed tre mo cdi cha, me vflng sfiu, xa, bidn gidi, trd vl hfldng dfin thfle khdng ndi nfldng tfla cd khd khfin em ho nghdo vfi tre md cdi hidn Nghi dinh v l kinh t l Tre em bi bo rdi, ma't khdng ndi nUdng tUa dfl^ 49/2010/ND-CP ve nguon nudi dfldng; tre em mo cdi hudng chinh sach nfiy Tre mien, giam hoc phi, cha hofic m? nhflng ngfldi edn lai nhilm HIV, tre bi anh hudng ho trd ehi phi hoe tfip la me hofic cha mfft tich theo quy bdi HIV khdng thudc nhdm vfi cd c h i thu, sfl dinh tai Dilu 78 cua Bd lufit Dan ddi tfldng dUde miln giam hoc dung hoc phi ddi vdi sfl hofic khdng du nfing Iflc, kha phi Nhflng ne'u tre b} anh cd sd giao due thuoc nfing de nudi dUdng theo quy hfldng bdi HIV thude di$n eac hd thd'ng gifio due dinh cua phfip lufit em bi m l cdi; tre thude h0 quoc dan tfl nfim hoc nghdo thi dUde hudng chinh 2010-2011 den nfim sach hoc 2014-2015 CHINH SACK LIEN QUAN DEN B A O TRQ X A H O I Nghi dinh 67/2007/ ND-CP cua Chinh phu 13/4/2007 ve chinh sach trd giup cac ddi tUdng bao trd xa hdi M Dilu 4; Ddi tfldng bao trd xa Chinh sfich xfi hdi dinh hfing hudng rd rfing chfim sde tre thang xa, phuctog thi tra'n diia vfio gia (finh - cong ding hoi dfldc hfldng trd cffp quan ly gom: tre em md cdi ea cha Dinh mflc trd cfip xa hdi da va me, tre em hi bd rdi, mfft tfing hdn trfldc vfi dU0c tinh XHANLVIfKHUHOCXAHOl stfMtn vO HOANG SON W N ^ a n h M f f l O K K ngufo nudi dudng; tre em m l cdi theo h i sd (1-3) nhU tre m l ND-CP ena CMnh d m hoffe me nliifng nguffi cfo Ipi cffi hd sd 1, tre nMlm HIV phu ngiy 27/02/2010 Iff me hope cha mfft tidi theo quy (1,5- 3) tfly Uieo dp tuffi, h o t o da dupe sfia doi, bS iBnh tpi Dilu 78 cfo Bd lufft D t o cfoh gia dinh efo trd sung mdt so dilu ttt sfl hope khdng dfi nffng luc, kha Tre bj foh hudng bffi Nghj djnh 67/2007/ n t o g de nudi dutog theo quy HIV/AIDS cM cd tre nMlm ND-CP djnh eua p h i p lufft; khdng edn HIV &udc hd nghdo va tre nguffi nudi dudng v i tre em nhilm mo cdi cha mp hoffe ehi m l cffi m v / A I D S thudc hd gia (Bnh mdt phia cha hay me pMffi nghdo vff thudc dipn dupc trp cffp cdn ]pi mfft tich (bd di) thudc h i n g t h i n g Difo 7, Khofo tre hd nghdo tM mffi dUpc hufog em m l cffi dupe 180.000 dfog/1 ciiinh sffeh trp cffp xff hdi niy thing Tre em bj nMlm HIV duffi 18 thing turn Aide 360.000d/lhang Tre em nMlm HIV trdn 18 thfog t u l i dupc 450.000d/thfog Nhffn nudi dudng tre em duffi 18 t h i n g t u S nUlm HIVdupc 54a000d/lhang Ngudn: Cdc cMnh sdch cho tre bi anh hudng bdi HIV/AIDS, di tdi: Kf thi dm vdi tri bi anh huing bdi HIV/AIDS (nghidn cOu Qudn S vd qudn Binh Thanh, TP Hd Cfei Minh) ndm 2014 cua tdc gid T h i c h thflc c u a c a c c h i n h s a c h tham gia BHYT efo k h i kMdm tdn Theo thVc t i e n khfo s i t cfia Cue Phtog, chfog mv/AIDS NMn qua cfo v t o b f o trdn dff eho thffy n i m 2012, sd nguffi nMlm HIV/AIDS ed h$ thfog p h i p lufft v i cac chinh sich h t o the BHYT khac theo tflng dja quan dfo tre bi foh hufog bffi HIV/AIDS phuong tfl 15% dfo 65% dd hOn 50% tpi Vipt Nam k h i tofo difo vff dffy du, l i hd nghdo, 35% l i hd can ngheo vff 15% n M t o vipc tiep cffn dupe cie ehinh sach la cffe dffi tupng khfo