T H D C TIEN - K I N H NGHIEM Mot SO van de ve xay dung mo hinh Trung tam Dan so ke lioach hda gia dinh true thuoc Uy ban nhan dan huyen • ThS MAI XUAN PHinmG (*) - HA KE BJNH (") au han nim thuc hiin Thdng tUsd cua cac Trung tSm DS-KHHGD la 4.513 ngudl, OS, ngiy 14/5/2008 dia B6 Y te hudng binh quan la 6,4 ngUdi/Trung tam - D l l vdl cdp xa: md hlnh quin ly can bg dan chi tidt ehdc nang, nhiim vu, to chde bo miy cda Chi cue Din sd - DS-KHHGD xa cung cd sg khac bidt giQa c^c ke hoaeh hoa gia dinh (DS-KHHGD) thudc Sd Y tinh: + fl 36 tinh, p h i cdn bd DS-KHHGB ted eip linh, Trung tim DS-KHHGD huyen thudc Chi cue DS-KHHGD tinh, cin bq DS-KHHGD xa xa la vidn chde thudc Trgm Y t l xa + (3 14 tinh, p h i logi can bd DSii vien chde thuoc Tram Y td xi vi cdng tic vien DS-KHHGD thon, ban cho thi'y: td ehdc bd KHHGD xa la vien chde thudc Trung tdm DSmay cOa Chi cue DS-KHHGD ttnh va edng tic KHHGO huyen, lam viee tgi UBND xa vien DS-KHHGD d thdn, ban co ban dn dinh, + 13 tinh, p h i logi cdn Igi vin giO nhung tuyen huyen vi tuydn xi vin cd nhdng nguyen la can bd khdng chuy§n trdch v l cdng vudng mac nhat dinh Ket qui cic nghiin cUu, tac DS-KHHGD va UBND xa quin ly (nhj khio sat da cho thay nhdng khd khan, thuin Iqi giai doan Dy ban Dan sd, Gia dinh va Trd em thdo hlin mo hlnh tdchdc DS-KHHGD tuydn trudc day) (Ridng tinh Qudng Blnh, Thanh huyin vi xi theo Thdng tusdOS vi cic md hinh Hda, Hd Chi Minh mdi dupc giao khic nhu sau: bien ehl, dang ehuin bj xet tuyin) + Cd 53 tinh, thdnh p h i loai da giao 8.928 Thpc trang mo hinh to chde cdng tac DSKHHGD hipn chi tieu bien c h i sU nghiep ldm edng tdc DS- D l l vdi d p tinh: cd 63/63 tinh, KHHGD xa phudng, dd s l da dupc tuyen trgc thupc Trung uong lap Chi cue DS- dgng la 7.504 ngUdi (ehllm 84% so vdl bidn c h i dupc giao) KHHGD thupc Sd Y t l - Doi vdl d p huyen: ed 62/63 tinh, Hien nay, edn 10 tinh, p h i chua phdn phi trgc thudc Trung gpng lap Trung tam bo chi tieu bidn e h l lam cdng tac DS-KHHGB DS-KHHGD d p huyen Rieng tinh Blnh DUPng d p xa Thanh Ho Chi Minh giao can bd da sap nhdp Trung tam DS-KHHGD vao Trung chuydn trach thgc hidn theo Nghj djnh s l 92/ tam Y t l tu culi nam 2012 2009/ND-CP 22/10/2009 cda Chinh phCi, Cd 48 tinh, p h i lap Trung tdm nhung hudng phg d p theo trinh dd dao tgo, DS-KHHGD huyen true thupc Chi cue DS-KHHGD dupc hudng blo hilm xa hdi, blo hiim y te vd tinh theo Thdng tu s l 05; 13 tinh, logi tang phg cap theo thdm nidn cdng tdc lap Trung tam DS-KHHGD trgc thupc K i t q u i nghien cdu ddnh gia hogt ddng UBND d p huydn Tgi p h i Ho Chi Minh, md hinh t l chde DS-KHHGD Thudng trgc Thanh iiy da thd'ng nhit cho 2.1 Md hinh Trung tim DS-KHHGD huy^n lap Trung tam DS-KHHGD trgc thupc UBND Trgng tam nhgn dgpc sg chi dgo va bao cdo huyen Tong s l ehl tidu bien c h i dupc phan b l cdng tac true tilp tQ Chi cgc DS-KHHGD nen trien khai nhanh va thuan tien hon Theo dd, Chi C)Phd Vtf trudng Vij Truyen thong - Giao di/ccue DS-KHHGD cd quyln ban Idn hdn d l l vdi Trung tam DS-KHHGD viae lgp, triln khai Tong CI/C Dan sd, kehogch hda va gia dinh vg theo ddi thpc hien kd hogch DS-KHHGD (") T^p chi T6 Chile nha nudc S e To chiic nhd nuwc s6' 11/3014 Tuy nhidn, dp dgng md hinh viec xa ma phdi thdng qua Trgm trfldng Tram Y t l Idnh dgo, chf dgo cua d p uy ddng va ehfnh xd nen cdng vide thfldng chdm vd kem hidu quyln dja phfldng v l edng tdc DS-KHHGD gan qud; mdt khac, ho phdi kiem them cdc nhiem vdl phdt trien kinh te - xa hdi khdng nhanh vg khdc cDa Tram Y t l xa Trdn thgc t l , can bd nhgy, kip thdi, bdi Trung tam khdng phdi ed chuydn trach cdng tde DS-KHHGD xa Idm viec quan thudc huydn UBND huydn khdng ddnh tgi Tram Y te vdn sD dyng trinh dp chuyen mdn gid vidn chfle cDa Trung tdm ndn khd gan ket eDa minh phye vu edng vide eDa nganh y te nhfl qud hogt ddng v l cdng tac DS-KHHGD cDa dja khdm ehfla bdnh, tilp ddn bdnh nhdn, qudn ly phfldng vdi vide hodn nhiem vu cDa vidn dflpc, cac ehflpng trinh phdng ehd'ng djeh, vd chfle Cd c h i qudn ly, bao cdo trfle tilp cDa sinh mdi trfldng, vd sinh an todn thfle pham Trung tam vdi Phdng Y t l huydn, UBND huydn Do dd, thdi gian ddnh eho nhidm vg chfnh Id g|p khd khan khdng phdi Id ddn vj ehD qudn edng tde DS-KHHGD bj hgn chi, ft cd thdi gian tryc tid'p, dan den viec lap, triln khai vd theo xuong tim hilu dja ban (thdn, I p , bdn, lang) ddi thgc hidn k l hoach DS-KHHGD eDa dja Mdt so ndi khdng ed kinh phf hd trp cho can bd phfldng vdi hogt ddng cDa Trung tdm kem hi#u DS-KHHGD xa di hpp giao ban tgi Trung tdm qud; khdng nhdn dflpe sg hd trp kinh phf cDa DS-KHHGD huydn hdng thdng, ddy Id dja phflPng cho hogt ddng DS-KHHGD, vi Trung mdt nhiem vy bat budc de bao cao tinh hlnh tdm khdng phdi Id ddn vj dg todn d p dfldi nen trien khai nhidm vy tgi xa vdi Trung tam vd nhan sg chi dgo v l chuydn mdn, nghiep vg tfl khdng dflde dau tfl kinh phi Trung tdm DS-KHHGD 2.2 Mo hinh Trung tam DS-KHHGD trt/c thugc 2.4 Viin chOc cua Trung tim DS-KHHGD lim UBND huyen Md hinh ndy nhdn dflde sfl Idnh dgo, chi viic tai UBND xa Vidn chflc eDa Trung tam DS-KHHGD lam dgo trgc tilp cDa ehfnh quyen d p huydn; sfl phli hpp hoat dpng cua Trung tam vdi cdc ban, vide tai UBND xa se nhdn dflpc sfl lanh dgo, ehl ngdnh, dodn t h i tren dja bdn vide Ilng dao trfle tid'p eDa d p uy dang va chinh quyln ghep cac hogt ddng DS-KHHGD vdo k l hoaeh xa day du, thie't thfle hdn vd thfle hidn tot nhidm phdt triln kinh t l - xd hdi ehung cDa huydn vu dfldi sfl qudn ly, ch? dao hfldng dan v l thudn Ipi hdn Trung tam Id cd quan thudc chuydn mdn nghiep vg cDa Trung tam DSUBND huyen nen cd dilu kidn de dflpc diu tfl KHHGD huyen gan vdi sfl phoi hpp qudn ly d l h i trp kinh phi hogt ddng; ed dD dilu kien tuyen ChD dpng trien khai cdng vide cDa UBND xa; cd dgng edn bd ndn vide danh gid can bp, vien sfl dau tfl hd trp kinh phf cDa UBND xa chflc gin vdi kit qud hogt dpng v l DS-KHHGD eae hogt dpng vl Id trach nhidm cDa chfnh cDa dja phflPng eg the vd sdt thgc; vide hfldng quyen dja phfldng Cdng tae tham mflu khdng ddn, chi dao cdng tde DS-KHHGD dd'i vdi qua trung gian se huy dpng dflpc cdc cap, cde UBND phfldng, xa thugn ldi, nhanh ehdng hdn ngdnh xa phd'i hdp dong bp, thfldng Vdi md hinh ndy, vai trd, quyln han cDa Chi xuydn, lidn tue, kjp thdi; tao dieu kien cho edn egc DS-KHHGD se bj gidm di khdng lanh bd chuydn trdch tdm huylt di xuing thdn bdn dgo toan didn md chi qudn \y chuydn mdn dd'i nam tinh hinh, vdn ddng ngfldi ddn thfle hidn chinh sdch DS-KHHGD vdiTrung tam 2.5 Kit qui liy y kiin cda cic dia phuang 2.3 Ddi ngu cin bd DS-KHHGD xa Ndm 2011, qua khdo sdt Ting cgc DSDdi ngu la vien chflc cDa Trgm Y t l xa nhflng khdng nhdn dfldc nhilu sfl quan tdm chi KHHGD thu dflde 8.843 y kiln phdn hoi cua 63 dao cDa d p Dy ddng va chfnh quyln d p xa Phd ehu tjeh UBND t?nh phg trdeh van xa, 63 Tlieo dd, can bd DS-KHHGD xd ft dflde hd trp Chi cgc trfldng Chi cgc DS-KHHGD t?nh, 695 kinh phi hogt ddng tfl UBND xd vd gap nhflng Phd ehD tjeh UBND huydn phy trach van xa, khd khan nhd't dinh vide phd'i hpp vdi cdc 695 Gidm dd'c Trung tam DS-KHHGD huydn, ban, nganh xa, cdng tac DS- 2.558 Trfldng ban DS-KHHGD xa, 2.488 Trgm KHHGD cd tfnh chat ddc thD rit d n sfl tham trfldng Tram Y t l xa vd 2.497 cdn bd DSgia cDa cac to chflc, dodn the eung nhfl cua KHHGD xa v l md hinh t l chfle Idm cdng tac todn xa hdi Cdn bd DS-KHHGD xa khdng DS-KHHGD d tuyin huyen vd tuyin xd Kit qud dflpc tham mflu trfle tilp eho lanh dao UBND nhfl sau: Td chuc nhd nuoc sd 11/3014 O Cd 59,2% y kiln dupc hdi mong mud'n Trung tam DS-KHHGD true thudc UBND huydn, dd s l Phd ChO tjch UBND huyen chilm ty le cao nhit Tilp den la y kiln de nghj Trung tdm trpc thupc Chi cue nhu Thdng tu sd 05 hudng din, chie'm 29,1 %; cd 11,6% y kiln d l nghj sap nhgp vdo ddn vj y t l tren dia ban huydn Dd'i vdi can bd xa, da so y kiln dupc hdl (78,6%) d l nghj can bp DS-KHHGD xa thupc Trung tdm iam viec tai UBND xa; 70,1% Trgm trudng Tram Y t l xa mud'n chuyin can bp DSKHHGD xa ve Trung tam DS-KHHGD qudn ly Mpt s l kien nghi ve mo hinh to chde DS-KHHGD cap huy$n, cap xa Thpc hien ChUPng trinh edi each hanh chfnh, nhdng ndm gan day Chfnh phu da tiln hanh phdn d p mgnh me cho UBND ede d p chju trach nhiem todn dien ve cdc mat hogt ddng d dja phuong, dd, viec tri he thing ldm cdng tac DS-KHHGD theo ngdnh dpc da phln nao thoat ly khdi sg qudn ly, ehl dgo ciia UBND cung d p Vdl viec tang quyln hgn, tfnh dpc ldp tU chii ciia cong tdc DSKHHGD qua trinh triln khai cdng viec rit cln sg vao cupc cua d p dy ding, chfnh quyln va dodn t h i nhan dan cung d p Trong nhQng nam qua, Ddng ta da ban hdnh nhilu Nghi quylt ve cdng tac y te vd dan s l nhu: Nghj quylt Hdi nghj lln thd 4, Ban Chip hanh Trung Udng Ding khoa VII v l "Nhdng v i n d l d p bdch ciia su nghigp chdm sdc vd bdo vd sdc khde nhan dan" va Nghj quye't ve "Chfnh sach DS-KHHGD"; Bp Chfnh tri khda IX da ban hanh 02 nghj quyet: Nghi quylt s l 46/NQ-TW 23/02/2005 v l "Cong tdc blo vd, cham sdc va nang cao sdc khde nhan dan tinh hinh mdi" va Nghi quylt so 47/NQ-TW 22/3/2005 ve 'Tiep tgc day manh thgc hidn chfnh sach DS-KHHGD" D i n nhidm ky khda X, mgc du edng tdc dan s l dupc chuyin giao sang Bd Y t l , nhung B6 Chfnh trj da ban hanh 02 Kit luan: Kit ludn s l 43/KLTW 03/4/2009 v l thgc hidn Nghj quyet so 46/NQ-TVi/; K i t ludn s l 44/KL-TW 01/4/2009 v l thgc hien Nghj quylt s l 47/NQTW Nhu vdy Ding ta da khang djnh day la hai ITnh vgc ridng biet, cd each lam, gill phdp vdi vide thilt ke t l ehdc bd may thue hien khac Nghj quylt so 46/ NQ-TW ndu rd: "Cdc don vj chuyen mdn y te d dja phUdng dupe To chuc nha quan ly theo ngdnh" Nghj quylt s l 47/NQ-TW lai chi ro: "Cln phat huy sg phll hpp lien ngdnh va t l chde bd may ciia nganh Dan so phli dupc cung c l , kidn todn td Trung Udng d i n cd sd" Thgc t l triln khai va nhQng tuu dgt dupc nhilu nam qua cho thiy, edng tdc DS-KHHGD ddi hdi tinh xa hpi hoa, phll hpp Hen nganh rit eao dudi sU Idnh dao, chi dgo CLia d p dy ddng, chfnh quyln dja phUdng B§n cgnh gili phdp v l chuyen mdn y t l , cong tac DS-KHHGD cSn sg ehgng tay gdp sdc ciia cpng ding, cae ban, nganh, dodn thi Do d6, ddi hdi Trgng tam DS-KHHGD phll Id don vj si; nghidp dpc ldp trgc thudc UBND huygn d l c6 si; ehl dgo sdt ciia cap Ciy ding, chinh quyln dia phUPng Sau ddnh gia ndm thgc hi&n vide chuyin ChUe nang, nhidm vg quin ly nha nudc v l dan so tQ Dy ban Ddn so, Gia dinh vd Trd em sang B6 Y t l , 10/6/2011 Bp Y t l da kiln nghj Chlnh phd xem xet chuyin Trung tdm DSKHHGD trgc thudc UBND huydn, chuyin cdn bp DS-KHHGD xa hidn dang la vidn chUe cCia Tram Y t l xa sang la vien chde ciia Trung tdm DS-KHHGO, lam viee tgi UBND xa Qua thgc t l g i n 06 nam chi dao hoat ddng cua cd sd vd nguydn vpng ciia dia phuong, Tong cgc DS-KHHGD d l xudt md hlnh: "Trung tam DS-KHHGD trgc thudc UBND huyen, cin bd DS-KHHGD xa Id vidn ehdc ciia Trung tam DS-KHHGO lam viee tgi UBND xg" Viec chuyin doi md hinh d d p huyen, d p xa hoan toan thugn Ipi, khdng ggy xgo trdn ve to ehdc, khdng Igm tgng bien che, khdng tang kinh phi, chi thay doi ve cd quan chCi quin, ed ehl quin \