lTl'iGnui!,NGmUi;«ii Danh gia siic khoe va sii tham gia cua ngiidi cao tudi phat tridn cong ddng tai xa cua huyen Tiln Hai, tinh Thai Binh nam 2010 Lfi Vu Anh", Dang Huy Hoang^, Tran VC', Nguyin Ngpc Bich", Nguyin Tidn Thingf Ket qud cua nghiin cdu tdng quan chinh sdch cua Hdi Y te Cong cdng Viet Nam vd bdo cao thuc hiin Chuang trinh hdnh ddng qudc live ngUdi cao tudi (NCT) ndm cua Uy ban Quoc gia NCT cho thdy NCT ngdy cdng tham gia vdo qud trinh phdt triin cgng dong Bdi bdo ndy trinh bdy ddnh gid ban ddu nhdm tim hieu tinh hlnh sdc khoe vd stf tham gia cua NCT cdc hogt ddng gia dinh, xd hgi vd phdt trien cdng dong tgi xd cda huyen Tien Hdi, linh Thdi Binh Ddnh gid dugc thiit kicdt ngang kit hgp phuang phap dinh lugng vd dinh tinh Cd mdu phdng vd'n dinh lugng Id 958 NCT; thdng tin dinh tinh thu thdp qua thdo lugn nhdm vdi NCT vd 12 phong vdn sdu ldnh dao cua xd Kit qud chira rang ty If NCT ttf ddnh gid siic khde binh ihudng cao (47,5%) nhung sd ngudi NCT mdc mgt hay nhieu benh ly sdc khoe cung rdt cao (97,4%) NCT tham gia cdc cdng vifc gia dinh (CVGD), xd hgi (VHXH) vd lao ddng sdn xud't (LDSX) chiim ly le khd cao ldn lugt Id 88% 79,7% vd 29,5%; ngodi nhieu NCT bie't vd tham gia cdng tdc phong chdng ldc hgi (PCTH) thudc Id vd phdng chdng Igm dung rugu bia tgi dia phuang Ddc biet NCT td 60-74 tuoi da sdcdn sdc khoe vd dang tham gia vdo cdc cdng viec gia dinh vd xd hdi theo hinh thdc tU nguyen vd cd nhu cdu duac ddo tao kiin thdc ky ndng Tuy nhiin chinh quyin dia phuang vdn thiiu cdng tdc truyin thdng vd cdc vdn bdn hudng dan cho su tham gia cua NCT Do dd, de khuyin khich su tham gia cua NCT cdc chuang trinh can thiep cdn phd'i hgp vdi chinh quyin dia phuang xdy dung mgt ca chi phd hgp NCT tham gia vdo cdc hogt dgng giup phdt triin cgng ddng nin d tuoi td 60 -74 nhiit tinh, cd kinh nghiem chuyin mdn Td khod: ngudi cao tudi, su tham gia Assessment on health status and participation in community development of the elderly in communes of Tien Hai district, Thai Binh province in 2010 Le Vu Anh", Dang Huy Hoang^, Tran Vu', Nguyen Ngoc Bich", Nguyen Tien Thang' 20 Tap chi Y td Cdng cdng, 1.2015, Sd 34 • Ngdy nhjn bii: 1.12.1014 • Ngdy phin bi$n: 11.12.2014 • Ngiy chinh sOa: 18.12.2014 • Ngdy difOc chap nblD ding: 20.12.2014 I TdNG QUAN & NGHIEN ctiu I Findings from a policy review conducted by Vietnam Public Health Association (VPHA) and a Report on years implementing the Intematioruxl action program on Ageing by Vietnam National Committee on Ageing (VNCA) showed that there has been more and more involvement of the elderly in the community development process This article will present our baseline survey with ihe aim of assessing the health status and participation ofthe elderly in family, social activities arui community development in communes of Tien Hai district Thai Binh province It was a cross-sectional study combining qualitative and quantitative methods The sample size of quantitative interview was 958 older persons Qualitative data was collected from focus group discussions and 12 in-depth interviews conducted in communes The findings showed that the proportion ofthe elderly who selfrated their health to be good was high (47.5%) but the proportion ofthe elderly having al least one or more diseases was also very high (97.4%) Surprisingly, the proportion of the elderly who participated in family, social and production activities was quite high (88%, 79.7% and 29.5%, respectively) Besides, there was also a quite high number ofthe elderly who knew and got involved in local tobacco and alcohol control activities Particularly, most ofthe elderly aged between 60 74 were healthy and participating in family and social work voluntarily and in need of knowledge and skill training However, local governments still tacked communication activities and guidelines for encouraging the participation ofthe elderly Therefore, we proposed to cooperate with the local government lo develop a network of Public Health Association at the grassroots level The core group of this nelM'ork consists of the enthusiastic elderly aged 60-74 having professional experience to involve in community development Keywords: elderly, the participation Tic gil: Tnrdng Dai hoc Y td Cdng Cflng Hfli Y td Cflng cOng Vidt Nam D$t vS'n dd G i l hda dan s d d a n g la mpt vl'n de cap b i c h cd anh htfdng Idn den cac khia canh v l n hda xa hdi tai Vifit Nam Theo b i o d o ke't qua suy rpng m l u ciia Tdng d i l u tra D i n sd va nha d 2009, ty le NCT d Vifit Nam hifin la 9% So vdi Dieu Ira nam 1999, ty Ifi NCT tang ty le tre e m dtfdi 15 ludi giam, "chi s d g i l hda" cua dan s d Vifit Nam Iang 1 % lOnam (tff , % len 35,9%) [1] Dan s d Vifit Nam se chuyen sang giai doan "din s d gia" didi gian ng^n khoang 17 - 20 n i m Cho ddn nam 2025, dtf d o i n se cd 15,45% dan s d i a NCT [6] Trong dd, Iheo Bao d o p h i t trien ngtfdi n i m 2009, tudi thp trung binh cua ngtfdi Viet Nam II 73,3 tudi tho khde manh chi dtfdc 66 moi Nghia la sd'nam dm dau trung binh cua ngtfdi dan Vifit Nam la 7,3 n a m [ 11] Td chtfc Y le thd gidi (TCYTTG) da dtfa khli n i e m "gia hda chu dpng" cd nghia 11 " Q u i trlnh tan dung d c ccf hpi v l y te, stf tham gia v l an sinh nhiim nang cao chat Itfdng cudc sd'ng ciia N C T " [13] Va "chij ddng" nghia 11 stf i h a m gia h e n tuc vao c i c boat ddng xa hdi, kinh le, v l n hda, tinh than, chtf khdng ddn t h u l n II kha nang boat ddng thd chl'l h o l e tham gia v a o Itfc ltfdng Iao ddng" R l s o l i tli hfiu cho tha'y cd mdi lien quan giCfa stf tich ctfc hoat ddng va tri trang t h i i k h d e m a n h d NCT [8] [9] Trong bdi c a n h q u i trinh g i l hda d i n s d d Vifit N a m , b i n canh npi dung c h a m sdc N C T , can cd nhiTng chinh sach huy dpng stf i h a m gia cua NCT vdi muc dich N C S K cho N C T cung nhtf tan dung ngudn Itfc ciia nbdm N C T Luail N C T 2009 da danh Tap chi Y te Cong cdng, 1.2015, Sd 34 21 I TfiNG aUftN& NGHIIN cdu I chtfdng n i - Phil huy vai Ird NCT nhtflig Lull NCT chi la Lull khung Vific phat tridn cic chinh sich cu the de phat huy vai trd, ting ctfdng stf Iham gia ciia NCT can cd nhffng bang chtfng cu the Ke't qua bao d o Ihtfc hifin Chtfdng trinh hlnh ddng qudc tfi' vl NCT nam ciia Uy ban vl NCT Vifit Nam cho th^y NCT cang Iham gia vio qui Irinh phat tridn cpng ddng Tuy nhien, kdt qua dat dtfdc d nhffng hoat dpng cic Iinh vtfc cdn rat han che va khdng cd stf htfdng din thtfc thi cu the Nghifin ctftf dtfdc tien hanh vdi muc Hfiu: md ta tinh hinh stfc khoe va stf tham gia ciia NCT Irong d c boat dpng gia dinh, xa hpi va Irong phit trien cdng ddng tai huyfin Tien Hai, tinh Thii Bmh nam 2010 Kfi't qua nghifin ctfu se dtfdc siJ dung lam d n ctf xay dtfng chtfdng uinh can thiep nham phli huy vai trd tham gia ciia NCT cho phat tridn cdng dong vl gdp phan cho vific thtfc thi Lull vl NCT Phiicfng phdp nghiin cihi 2.1 Bdi tugng nghien cdu: 11 ngtfdi cao tudi tff 60 tudi trd len vl d c lanh dao cdng ddng tai thj trin Tiln Hai, xa Phtfdng Cdng va xa Tay Giang ciia huyfin Tien Hai tinh Thii Binh 2.2 Thdi gian nghien cdu: Thing - thang 10 nam 2010 2.3 Thiet ke nghien cdu: md ta cat ngang kfi't hdp dinh Itfdng va dinh tinh - Phucmg phdp dinh lugng: Su" dung phtfdng phip phdng van phieu hdi ca'u true - Phuang phdp dinh linh: Su" dung phtfdng pbap "tiep cln cd stf tham gia lip ke hoach (Participant Action Planning Approach) vie't lat II PaPa vdi cic hoat ddng thao luan nhdm t|p Irung vl phdng vl'n sau 2.4 Chgn mdu va phuongphdp chgn mdu Chgn dia bdn nghiin cdu: Huyln Tiln Hai la dia ban cd sd'ltfdng NCT ddng, chifi'm 12% din sd' Irong huyfin vl chi hdi YTCC hoat ddng rat hifiu qua tich ctfc Irong mang Itfdi YTCC ciia tinh Thii Binh Hdi YTCC Vidt Nam da thd'ng nhat vdi Ianh dao huyen va chi hpi YTCC huyfin Tien Hai chpn xl cho dieu Ira dtfa trfin d c tifiu chi sau: - Lanh dao xa nhipt tinh, tam buyfi't vl ung hd viec phit huy vai trd tham gia ciia NCT - Cd td chtfc chi hdi YTCC boat ddng - Cd td chtfc Hdi NCT huyfin vl cd sd hoat dpng tdt 22 Tap chi Y te Cdng cdng, 1.2015, Sd' 34 Cd mdu cho nghiin cdu dinh lugng: sA dung cdng Ihtfc tinh cd mlu sau cho mot phtfdng/xl Trong dor n: ca mSu diiu tra (NCT) p: Ty l( mong muffn (Nghien ciiu ndy chgn tf If tham gia ciia - a/2P(l-p) NCT cho phdl c^ng dong vtH p = 30% d^a tren ket gud bdo edo ihi^c kifn Chuang trlnh hdnh d$ng quoc t^ve NCT S ndm cia [)> ban vi NCH' Vi?t Nam {?} d: Khodng sai l$ch cho phip giQa r^ 1$ mdu vd quin the (Nghiin citu chon d = 5%) a: Sai sgbac I = 5%: H? so tin cdy d sdc xud't 95% = 1.96 Cd mlu tai mdi phtfdng/xa dtfdc chpn II n = 320 (NCT)/1 xl Nhtf viy tdng sdNCTd xa dtfdc dinh gil d huyen Tien Hai 11 960 NCT Hd gia dinb dieu tra se dtfdc Itfa chpn nglu nhifin hfi thd'ng danh sach hp gia dinh cung cap bdi UBND xa vl tl't ca NCT hd gia dinh dtfdc chpn se dtfdc phong van Kdt qua nbdm dilu tra vifin dl phdng van 958 NCT tai hd gia dinh Cd mdu cho nghiin cdu dinh tinh: - Tii'n hanh thao lu§n nhdm d mdi xa gdm nhdm d c trtfdng thdn, nhdm NCT tich ctfc tham gia d c boat ddng cpng ddng Tdng cdng cd thao luin nhdm tap trung - Tifi'n hanh phdng vl'n siu ddi Itfdng gdm Bi thtf Dang Uy, Chu tich UBND, chu tich hdi NCT, Chii lich Hpi phu nCf xa d mdi xa Tdng cdng cd 12 phdng van sau Ke't qua 3.1 Thdng tin chung: Bang cho thay da cd 958 NCT dtfdc phdng vl'n dat 99,79% cd mau xac dinh cho nghifin crfu vl dtfdc phan bd'hpp IJ cho xa nghifin ciiti Ddi ttfdng nff gidi nhieu hdn so vdi nam gidi Sd NCT d nhdm radi tit 60 de'n dtfdi 75 d xa chie'm 64,3% Ve ca'u tnic gia dinh ciia NCT, kdt qua dilu tra cho thl'y hai phin ba sdNCT dang sdng vdi vd hole chdng, khoang 50% sd'ng gia dinh chi cd mdt thfi'hfi, ttfc II NCT sdng vdi Khoang mpt phin ba so'NCT dtfdc dao tao chuyen mdn ngliifip vu, cdn Iai 11 ttf hoc/gia truyen/kinh nghipm dan gian Trong so' NCT dtfdc dao tao, giao viin la nginh dtfdc dio tao nhieu nhat (22,9%), tidp Iheo la cd (14,7%) va yte (14,2%) I TfiNG HUM & NGHIEN ctiu I Bdng Dgc diem doi tiOfng nghien cdu "^ lc IV N N •i N U\ J3 134 421 M3 44.e JI8 43 ^ N™ Cb X XJl Tav GunB DAcfflfrndd •( 180 S6L 1B4 57 176 S5J 540 5S.4 iO-7i 230 71.9 191 60.1 IW 60.E 6IS 64.1 71* 90 :8 127 39 125 19 342 35 M.9 631 66 NS NbAmiuJi Tinb Inne Min shin dJi NCT 22^ 10.1 202 61.*i 207 aoa 9' 29.U 1(M i;.7 105 12.9 302 31.5 I to 00 0.9 0.0 OJ iifWn 00 13 0.9 0.7 Ki«ic 0.9 i 1.6 J U 12 1.2 CA va/chSng dinh NCT Nghin T&ii ctng u 14.1 71 :3.7 7: 13 189 202 Z69 BS.9 23S 76J Ul 77 74S 79 S 321 IOD 318 im 3!9 IM 998 IDD Nhdm nghiin ctfu da tim hidu vl cac khoan thu nhap vl chi phi cua NCT Ket qua cho thay t^ ifi sd hp gia dinh NCT ngheo 11 20,2% dtfa theo chuan ngh^o qudc gia Quyet dinh 170/2005/QD-TTg vl dtfa trfin tdng thu nhip nam qua ciia hd gia dinh 3.2 Mgt sdddc diem ve sdc khoe NCT Tj lp NCT cho rang minh khde va rat khde chiem tJ II khong cao (7,7% va 0,4%) Trong t^ lp NCT Itf dinh gil stfc khde binh thtfdng chie'm da sd 47,5% vl ty Ifi NCT ttf danh gil sffc khde kfim vl rl't kfim cung chiem f} 11 cao (34,8% va 9,5%) Khi so sinh giiia nhdm radi 60-74 va tff 75 tudi trd lln ta Ihl'y stf khic bifit Ket qui bieu dd cho thafy nhdm NCT Itfa tudi 60-74 njf danh gil ty Ie stfc I • RftttSoe iKhM •Binhthiion)i Kem Bieu Phdn bdty If phan logi sdc khoe theo ddnh gid cua NCT theo nhdm tuoi khde d mffc binh thtfdng (50,4%) cao hdn ban NCT tff 75 tudi trd len (42,2%) vl ngtfdc lai sffc khoe rl't kim thi NCT tff 75 tudi trd len (15%) cao hdn ban nhdm NCT tff 60-74 tudi (6,5%) Stf khic cd $ nghia tbdng kl vdi p < 0,05 v l ly Ie m^c d c bpnh/nhdm benh d NCT dl dtfdc cln bp y te khim chan doin, kdt qua nghifin ctfu chi rang ty le cao nhl't 11 nhdm bfinh vl xtfdng khdp, tifi'p theo la d c bfinh vl rang, m^t, lang huyei Ip va thrf 11 benh da day/rupt Ngoli ra, sd NCT cho biet bi mac Iff bfinh trd lln chilm ty lp r^I cao, chidm 75,1% Sd NCT khdng m^c benh chiem tJ 11 thi'p (2,6%), cdn lai 22,3% NCT bi m^c tff 1-2 bfinh, va cic benh mac phli chii yeu 11 bfinh man Iinh phai dieu tri lau dai Ve mdt sd hanh vi sffc khde ciia NCT, 79,4% NCT nam da tffng hdt thudc Il/thudc lio, 34% hifin cdn hiit Trong dd, 12,4% hiit trfin 24 dieu/ngay Ty Ifi NCT nam vl niJ udng rtfdu hang ngiy chiem ty Ifi cao (72,5% NCT nam vl 30% NCT nff) VI ty Ifi nam lam dung rtfdu/bia 11 19,8% Ba phin ttf sd NCT cd tip thd due hang (74,4%) 3.3 Slf tham gia cua NCT vdo hogt d$ng CVGB, VHXH, LBSX: CVGD, VHXH vl LDSX la nhffng mang boat ddng chinh dtfdc nhdm nghifin crfu tim hieu Qua PVS cic Ianh dao xa, kei qui cho Ih^y NCT vln dtfdc dinh gil cao Irong cac boat ddng niy "NCT vdn Id mdt tiem ndng ldn cua xd hdi Vd ngUdi ta [NCT] cd thich Id sd'ng phdi cd noi dung Sd'ng vui, sd'ng khde, vd phai sd'ng cd ich cd phdi khdng g? Sd'ng cd ich Id minh phdi phdt huy cdc cu tham gia xd hdi vd tham gia cdc phong trdo cua dfa phuang, tham gia vdo cdi viic cila gia dinh gido due chdu cung Id mgt vdn di Rdi Id lao ddng sdn xudt Ndi thdt vdi anh Id bdy gid Id cd nhdng id'm gUang sdu bdy muai vdn ldm kinh tigidi" (PVS - Bi thtf Dang iiy xa) va "Nhdm cdn sdc khde thi cdi thi cung rd't Id hdng hdi, phdn cong thi citng deu nhdn cd cUng diu ldm cd " (PVS - Chii tich Hdi NCT xa) Theo kfi't qua dinh Itfdng, nhdm nghifin ctfu chia mrfc dp tham gia cua NCT thinh mrfc Iff ddn vdi mrfc II khdng tham gia bdt crf boat dpng nao, mrfc la tham gia ca nbdm hoat dpng Ket qui dinh Itfdng chi mffc dp tham gia khdng khic bifit giffa gidi, nhtfng cd khic biet giffa nhdm tuoi (6074 va 75 trd len) Tap chi Y te Cdng cpng, 1.2015, Sd 34 23 ITl'HGQUUItlieHltNCIilll • luioiig duuu jiia •rnitc1 Bieu Ph&n bS'ty /# cdc mdc dp tham gia cua NCT theo nhdm tuii Bieu dd trinh bay mrfc dp tham gia ciia NCT vio d c nhdm boat dpng giffa nhdm wdi 60-74 va Iff 75 trd Ifin vl kfi't qui cho thl'y cd stf khic bifit rd ret ty Ie khdng Iham gia nhdm trf 75 thi'p hdn mdt d e b cd '$ ngbia thdng ke so vdi nhdm dtfdi 75 tudi Ttfdng ttf, ty Ifi tbam gia ca nhdm cdng vific cung khic bi|t, cao hdn d nhdm tudi tha'p Gil tri xac suat thdng kfi rl't nhd (p