T A I L I $ U THAM K H A O Khflc Dgl, Ld Vdn Dbng vd CS (2007), Kit qud xdt nghidm ding thdl cytokine dj(^ mdng phii bdnh nhdn ung thu vd lao phii bflng cbng ngh$ flowcytometry-asslsted Immunoasay, Tgp ehl y du'pc hoc qufln sy 5, 32, tr.17-23 2, Caixa T Hongwen F., Xlran L (1999), "Levels of soluble Interieukin-2 receptor in the sera and skin tissue fluids of patients with vitiligo', J Dermatol Sd 2^, pp 59-62, Dennis W Metzger (2010), lnterieukin-12 as an adjuvant for induclton of protective antibody responses Cytokine, Volume 52 pp.102-107, Huang-Pin Wu, Sheng-Fong Kuo, Shao-Yun Wu, Duen-Yau Chuang (2010), High interieukin-12 production from stimulated peripheral blood mononuclear cells of type diabetes patients Cytokine Volume 51 pp 298-304 S v t h a y d i l cytokine d bdnh nhdn bgch b i i n Katie ST, Sara J et al (2009), Analytical tru-dc vd sau d l i u trj b4ng kem Vltlskin validation of a highly sensitive micropartide-based Bflng ky thuflt flow cytometry-assisted immunoassay for the quantitation of IL-13 in hunwi serum using the Erenna® Immunoassay system Journal immunoassay chCing tfli dd xdt nghidm d i n g thdi of Immunological f^thods Volume 350, pp.161-170 cytokine: IL-2 IL-4, IL-5, IL-10, IL-12, IL_13, GMCSF, tFN-y vd TNF - a huyit bdnh nhfln Kiyoto Hohnoki, Atsushi Inoue , Chang-Sung Koh bgch biin t h i lan tba trude vd sau d i i u tq kem (1998), Elevated serum levels of IFN-y, IL-4 and TNFa/unelevated senjm levels of IL-10 in patients with Vitiskin K i t qud cho thfly, khflng cb s y thay d i i n i n g demyelinating diseases dunng the acute stage, Jouma/ d i tflt cd cytokine Nhu vfly thuic kem Vitiskin khbng cb tdc d i n g Idn cdc cytokine mdu, hay of Neurammunology Volume 87 pp 27-32 nbi cdch khde thuic ndy khbng tdc dflng tdi phdn dng Patricia Mdndez-Samperio (2010), Role of interieukin-12 family cytokines in the cellular response to miin dich ciia ca t h i mycobactenal disease, IntemationalJoumal of Ir^edious K t T LUAN Diseases Volume 14 pp e366-e371 Vdi 65 bdnh nhdn bgch biin Ian tba dup-c xdt Rehan Khan., Somesh Gupta , Alpana Shamia nghidm cytokin tidng ky thuflt flow cytometry-assisted (2012), Circulatory levels of T-cell cytokines Onterleuldn immunoassay chiing tbi dd thu dupe k i t qufl sau: [IL]-2, IL-4, IL-17, and transforming growtfi ^ctor-P) in D l i u tn bing Daivobet giim ning di cic patients with vitiligo Journal of the Amencan Academy cytokine IL-5, IL-12 GM-CSF, IFN-y vi TNF-a sau of Dermatology, Volume 66 pp,510-511 diiu tn Cde cytkin IL-2, IL-4, IL-10, IL-13 khbng eb Rui Chen, You Yin, Zhongxin Zhao., et at su thay d i i (2012), Elevation of seaim TNF-a levels in mild and D i i u tri bflng Vitiskin tflt ca cytokine IL-2, IL- moderate Alzheimer patients v^th daytime sleepiness, IL-5, IL-10, IL-12, IL-13, GM-CSF, IFN-Y vfl TNF-o Joumal of Neuroimmunology, Volume 244, pp.97-102 tarde vd sau diiu tri khdng cd sw thay dii vd sau d l i u tri kem Daivobet c6 s y khdc bIdt c6 y nghTa thing kd gida hal nhbm vdi P U _ health care and society f^ourmain barriers in meeting the DPI tup'ng nghidn edu, c d mdu vd chpn mdu health cam needs of OVC, including economic bamers, - Phbng vfln bflng bdng hfli cflu tnjc d i i vdi 52 trd awareness of OVC and caregivers on HIV/AIDS, stigma OVC td 8-17 tuii vd 90 ngudi chdm sbc chlnh cho trd and dscrimination OVC and their families, access to OVC he^h sen/ices locally - PVS 14 dgl didn hp gia dlnh dang chdm sbc tre nhidm HIV tgi nhd Keywords: HIV, OVC, need, barrier - TLN 08 cdn bb cdc ban ngdnh dodn t h i hdn DAT V A N D £ quan d i n cflng tdc chdm sbc bdo vd t r i em, 05 Nhdn Bao vd, chdm sbc tre em Id m i i quan tdm hdng vidn y t i lidn quan d i n chdm sbc sue khbe cho tre dflu cua tflt cd cdc quie gia trdn t h i gidi, Vidt Nam Id OVC vd cde Bde sy ciia Trung tdm y t i dy phflng nude dflu tidn tgi Chdu A vd Id nude thd hai trdn t h i huydn Sbc San, ciia huyen va.12 Cdn bb chdm sbc gidi dd phd chufln cbng udc BVTE ngdy 20 thdng 02 tgi nhd chp trd OVC nhbm Hoa Sim Tim (nhbm nam 1990 [1] cua nhung ngudi sing chung vdi HIV/AIDS) Dai dich HIV/AIDS Id mbt vfln nan cua todn t h i M i u nghidn edu Nghien cuu chpn todn bb tre em gibi, anh hudng d i n nhiiu d i i tupng, 66 tre em bj nhlim hoflc cb b i mp bi nhilm HIV/AIDS tai huyen la dii tuang phai gdnh chju nhiiu hdu qua ndng n i Sbc San va nhung ngudi chdm sbc chlnh cdc em Nam 2008, todn t h i gidi da cb tdi 430 000 tre em sinh Dia d i i m vd thdi gian: NC dupe tiin hdnh tai bj nhidm HIV Tai Vlpt Nam, theo bdo cdo ciia Bfl Y Thdi Nguyen td thdng 11/2010 - 4/2011 t i tinh den ndm 2009, t i n g s i tre em phdt hidn eP HIV T h i i t kd nghidn edu' Mb ta cflt ngang k i t hap (+), 121 em, 66 eb 1.876 em dang dupe diiu dmh tinh vd dinh lupng trj ARV, ty Id Idy tnjyin td mg sang eon la 0,25%_yd sd Phuang phdp thu thdp sb lidu tdng Idn 35% n i u khbng dupe can thidp Tre nhilm vd - Bang hbi cflu triic cb s i n cho 02 d i i tupng la bi anh hudng bdi HIV/AIDS (Orphan and Vulnerable Ngudi Cham sbc chinh cho tre OVC gia dinh Children - OVC) bao g i m cdc d i i tupn_g: Tre em va Trd OVC (dfl t u i i Id 8-17 tuii); nhilm HIV va Tre em eb nguy ca cao nhidm HIV tre - Hudng ddn phbng vfln sdu danh cho 14 dai dien em m i cbi b i va me hode b i hoflc mp chit vi gia dinh dang cham sbc tre nhilm HIV/AIDS (db tuii nhiWigiy lien quan d i n HIV/AIDS, 0-17 tuii), - Thao lufln nhbm trpng tdm (ddnh cho nhung cdn Sbc San la huypn phia bde Ha Nbi, vdi didn tich bb vd nhdn vidn dang iam vide tai cdc ca quan cung 313 km2 dia ban rflng gom 25 xd vd thj trfln, ddn s i cflp djCh vy vd chdm sbc sue khbe cho tre OVC, taing binh ndm 2009 Id 290.000 ngudi; Ca cflu kinh t i dang lam vide cho dy an cua t i chuc HRI tai huyen chuyin djch theo hudng ty trpng nganh dich vy tdng, Sbc San, ngdnh nbng nghidp giam Sbc San la huyen cbn nhiiu khb khdn nhung cb t i c db phflt trien khd nhanh, i n Phuang phdp phan tich sb lieu: S i heu tnnh [5] dupe ldm sgch vd nhdp bdng phin mem Epidata, phdn tich bdng phfln m i m SPSS d i i vdi so lieu dinh Tre OVC thudng d l bj suy dinh dudng, dd bi t i n luang, cdc cube PVS vd TLN duac ghi am lai vd gb thuang tam ly, thiiu hut tinh cam, bj phdn biet d i i xu, bdng d l lam cdc dan chung phan k i t qua bbe Ipt lao dbng, lam dung tinh dye, Nhung yeu to Y HQC THV"C HANH (840) - so 9/2012 K£T QUA NGHI£N cCru vA BAN LUAN Thdng tin chung v i d i l tuyng nghidn c6-u Thdng tin v i trd OVC: Phfln tdn trd dang d dO t u i i t d din 11 (70%), ty Id nam n d Id nhu (nam 58% n d 42%), da s i trd OVC tdi huydn Sbc San cb trinh dO hpe vfln t h i p , da s i cd trinh dO hpc vdn cflp (nam: 42,9%; n d 50%), vSn cbn trd nam khflng di hpc G i n mpt nua trd OVC (49%) Id trd m i cbi bfl hodc mg, db d i n 98% Id m i ebl b i , 9% cdc em m i cbi cfl bo Ifln mg, s i trd m i ebl thl phfln Idn sing vdi bng bd hodc vdi cd mp vd bng bd D i i u ndy cOng dCing vdi truyin thing cua ngudi Vidt Nam Id gba phy vfln sd chung s i n g ciing vdi b i mg anh chj em dflng nhd c h i n g neu ching qua ddi Thdng tin v i n g u ^ chdm sdc trd: 60% dang sing Chung vdi HIV/AIDS; % ngudi chdm sbc trd Id nd gidi, db 54% dd gba ching vd 49% bd mg eb HIV duang tinh Da s i ngubi chdm sbc trd trinh db hpc vdn cflp (nam: 57,9%; n d 50%) Ngudi chflm sbc chii y i u d db l u i l 25 -35 (nam 47,4%, n& 55,7%) V5n cbn 11 ngubi (nam 15,9%; n& 11,4%) trdn 66 tuii lao ding 56-77 theo quy d|nh cua phdp luflt, ddy Id mbt nh&ng y i u t i dan din sy hgn e h i d i l vdi vide chflm sbc trd OVC, N g h i nghidp cua ngudi chdm sbc trd OVC da dgng, nhung chu ydu td nbng ddn vdi ty Id 46%, Phdn Ifln nhdng ngudi cd thu nhflp gia dlnh dang chdm sbc trd OVC Id n d gidi Cdc nhu cflu vd si;- ddp dng nhu cflu chdm sbc sue khde eCia trd OVC vd gia dlnh dang chdm sdc trd 2.1 Nhu ciu vi Sir dip irng nhu ciu chim sdc dinh dudng cOa tri OVC: 3/3 tnjdng hpp cb HIV vd dd sinh eon cho biit hp dupe kit nil tdi chuang trinh PMTCT tgi Bdnh vidn Phy San Hd Nfli td thdng thu cua thai ki sau db dupe diiu trj dy phflng ARV vd dupe eur>g cflp sda thay t h i sda mg sau sinh cho d i n trd dupe 18 thdng Kit qufl khdo sdt cua cdc tnjdng hpp khdc cho thfly rflng tnjng binh, trd dn du bda mpt ngdy, 49% trd OVC trfl Idi luc ndo cOng cb dfly du luong thye, tnDng hflu hit nhdng ngudi chdm sbc ede em lai nbi rflng ede em hflu hit ehl cb du no, chflt lupng luang thye khflng dflm tido, Trong s i nhdng ngudi chdm sbc trd, eb 19% nbi Id nhfln dupe mflt s i h i trp v i dmh dudng, dfl h i trp t d cdc nhpm ty lye la 56%, % dupe nhfln tu Nhd nude Hinh thdc h i trp dmh dudng p h i biin nhflt Id sua (82%) vd ggo (38%) Phfln Idn ngudi chdm sbc trd d i u biit nhu c i u cham sbc dinh dudng cua tre s i n g chung vdi HIV/AIDS Mbt ba mp 28 t u i i dang chdm sbc bj nhilm HIV cho biit "Nhiiu mi chBu im dau thl cBi chit dinh dw&ng nd cOng cin khBc hon so v&i binh thwdng hBng ngiy Vi dp nhw li mi chiu m$t mdi tri khdng muin in hay tri muin in mdt di gi diy thi minh si dip Cmg cii nhu ciu cua trd vi chi biin nhOng di mB tri muin Sn hon thi kich thich tri Sn nhiiu han IB chi ludn thay ddi mdn in cho tri hBng ngiy" Tuy nhidn diiu kidn kinh t i khfl khdn, b i mg phai di lam ca ngdy ndn viic ddp ung dung nhu cflu dlnh dudng cOa trd OVC vSn cbn hgn c h i MOt Ong b i 30 t u i i cho biit: 'BQ-a tnra thl thw&ng thw&ngphii in cam rAl, thi/c thl biy gl& nhi cOng khdng c6 dliu kiin vl bd m$ dl lim hit ci c d 6n & nhi v&i Ong bi cd dl gl thl Bn cii diy chO nhiiu lOc bdmpvicd thim tning hay li mua thdm cho chiu dc cii tht/c phim cd chit dlnh dw&ng nhw trOng, thU, ci thay dii cho chiu chir thi/c chiu chi cd bda gpi Id di chit dlnh dw&ng thdl chie cdn bOv trwa biy gid dng bi in gi chiu Sn niy" 2.2 Nhu ciu vi s ( / dip ting nhu ciu chim s6c y ti cOa tri OVC: 37% trd OVC cho biit minh cb sdc khod tit, 33% trd Idi "binh thudng" Trong dd % ngudi chflm sbc trd cho sdc khbe cua em mInh d dien 'binh thudng" Nhiiu ngudi chdm sbc lo nggi sdc khbe cua chinh hp cb t h i cOng Id mOt trd nggi vide chflm sbc em minh Cd 94,4% trd OVC biit v i HIV nhung biit diua dfly dii Mflt bd mg 28 tuii cho b t i t "Hidn tai thl chiu cOng dil biit qua qua c/)d cbn rtdi vi kiin thdc sdu thl chiu cOng c/ius hiiu lim Chiu cN biit ^y'UiOc cOa chiu bi di tjiiA diy chiu tri udng thudc vl udng thuic si triCkipc syaJngctia (^u chw cdn chiu (^ y thuc dupe di wy gpi li nd hiiu ndng ctiir khdng hiiu sSu' Trong vbng thdng trude phdng vfln, cb 39,1% trd O V C b j i m Khi d i n e a s d khdm ehda bdnh, thdi (JO aia bde sy khdm bdnh Id thfln thidn gdn gOi, binh thudng vdi ty Id l i n lupt Id 22,7 % vd 77,3%, khbng cd trubng hpp ndo b| coi thudng ghdt bd Chi phi y t i md ede gia dlnh phdi ch|u chu yiu ta ehl phi dl Igi vd ehi phi thuic men, trung binh thflng ede gia dinh ehi 276.000 d i n g d i mua thuie, 67% so t i i n ndy Id ddnh cho thuie khdng sinh - logi thuic khbng dupe bdo h i i m h i trp cho trd dudi tuii Rflt nhliu ngudi chdm sbc trd OVC dd phfli vay np lai d l cP t i i n ehl tidu thuie men cho trd OVC 2.3 Nhu ciu vi Sir dip img nhu ciu chim sdc giio dye Mflc dCi nhdng ngudi trd Idi phbng vfln diu phdn flnh cdc tnjdng hpp trd bj xa Idnh vd bj phfln biflt dii xu tgi Idp hpc, song hflu h i t s i trd (94%) dupe di hpc nflm 2011 Chf eb 28% ngudi chdm sbc trd nhfln dupe sy h i trp v i gido dye Hp cho biit nguin hfl trp tdi chlnh cho cdc em di hpc cua Chlnh phu ehl dupe ddnh cho cdc hfl gia dlnh nghdo (thbng qua kdnh cua Hpi Chd thflp dd) khbng ddnh cho trd dang phfli sing Chung hodc chju dnh hudng t>6i HIV/AIDS - mdc dii db Id nhdng h i trp hpp phdp Nhiiu trd OVC chuyin sang tuii 18 mong m u i n dw&c di hpc nghi vd eb viic ldm tgt dia phuang huydn Sflc San 2.4 Nhu ciu vi s{r dip img nhu ciu chdm s6c timly 60% ngudi chdm sbc tre OVC cho biit hp cfln SLP giiip dd vd tdm ly tu nhdng nai cung cflp djc^ vy tif vfln tdm ly K i t qud nghidn edu cho thfly 75% ngudi chdm sbc thudng dupe chia se nbi b i gia dlnh, 29% chia sd vdi cdc nhbm t y lyc cua ngudi sing Chung vdi HIV Chi cb 6% ngudi chdm sbc tim kiim sy giiip d d tu cdc ca s d cflng epng nhu bdnh vien, trudng hpc, cb le nhung ca s d ndy khflng h i trff Y HQC THVC HANH (840)-si 9/2012 tu vfln tflm ly nhiiu hodc vl hp sp mpi ngudi s6 ky thj, phdn biflt d i i x d biit minh bj nhlim HIV Da s i ngudi chdm sbc trd OVC ddnh qud nhiiu thdi gian ldm vide d i h i tn? thu nhflp kinh t i cho gia dlnh ndn kh&ig cb thdi gian ehoi eCing trd, dpc sdeh cho trd nghe vd gidi dap cdc thfle mflc cho trd 96% trd OVC cho biit vfln kit bgn vdi hdng xbm vd ehoi vdi cdc bgn d tnj-dng VdottTfligian rdnh, cde em bd tuii nhb hon choi d i choi, 29% tre Idn tuii han (12-17 tuii) ldm nhdng cbng vide nOi trp (nflu nuflng, dpn dpp vd giflt giO) 44% tre OVC cho biit dfli cde em lo sp vd 51 % trd OVC cho biit Id thbng thubng cdc em eb thdi dpi vui v i Khi eb chuydn buin, cdc em it chia sd vdi bgn bfl vd thfly cb vi nggi mpi ngudi biit hodn cdnh cOa minh, cde em thudng chia sd vdi mpi ngudi gia dlnh, dflc bi$t Id ngudi chdm sbc 66% trd cho biit mg minh Id ngudi "hiiu cdc em nhflt nhd" Hflu hit cdc em mong m u i n sau ndy ldm bde si (26%), 23% muin ldm gido vidn, diiu ndy cb t h i ly gidi trd OVC thudng Idn Idn hodn cdnh dau i m vd chit ehbc bdn thdn trd eOng b| mdc cdm va cb ty ky thj minh, ndn eb t h i cde em muin trd bac si vl cac em tin sau ndy minh cb t h i cuu chua cho mpi ngupl nhd Bflng 1: Thdi dp ciia hdng xpm, bgn bd xung quang vd thfly cb vdi trd OVC Hdng xbm Bgn bd xung Thdycb Thdi db quanh n n n 11)80 thidn 12 14 10 14 11 167 gkn gOi Binh 74 71 85 88 70 83 Itiu'd'nq COI thuang Khflng c6 tofpng hp'p ndo coi thiffl'ng, gh6t citi6t bo bo Nhdn xdt Bdng trdn cho thiy da s i hdng xflm, ban bd vd thfly eb d i u c6 thdi dfl binh thudng d i i vdi trd OVC, khflng cfl d i i tuang ndo cb thdi db coi thudng ghdt bb d i i vdi tre, Nhung rdo cdn vide ddp dng nhu cflu CSSK cua trd OVC 3.1 Rdo can ve diiu kiin kinh te 70% ngudi cb thu nhflp hp Id nu, 14% s i ngudi chdm sbc tre OVC cho biit hp eb thu nhdp dudi 400 000 VND/thdng, dudi mdc chuin nghdo mdi dupe de xuit gfln day d i i vdi khu vuc thi Phfln Idn cdc hb (66%) chi co nhat mpt ngudi cb thu nhdp Hp cho biet thu nhdp khong du trang trai cdc chi phi cin thiit cho nhu c i u dinh dudng, hpc hdnh va y t i , ddc biet la gia dinh cb mpt hoac hai ngudi dau 6m Thuc te tre OVC phai di lam thdm Ifly tien chi tra hoc phi (50%) vfl qufln ao (17%) Khi dupe hoi cac em chia se nhfrng lo ngai ve viec kinh t i khP khdn se ddn den mdu thuan, cdng thing gia dinh, ddc biet phai chi tieu cho an uong, thuoc men, hpc hanh; Kinh te khb khdn cung khiin cdc em phai chung kien canh b i me cdi nhau, hodc bo me mai kiem tien md khbng quan tam, trb chuyen vdi cac em Ve su hb tra kinh t i , 36 % ngudi cham sbc cho biit cb nhdn dupe mot s6 hinh thuc h i tra kinh te 90% tu tra cflp/din bu xa hbi, 74% tu nha nude, 23% % % Y HQC THV'C HANH (840) - so 9/2012 % td cdc t i chdc cflng ding 3.2 Rio cdn vi nh$n thirc cOa tri OVC vi nguM chdm sdc trd Kit qud NC cho thfly gida ngudi chdm sflc vd trd OVC cb s y khde bidt v i nhfln thdc t h i ndo Id "dO thye phim dinh dudng" Sy khdc bidt ndy cb Id lidn quan d i n chflt lupng bda dn han Id s i lupng; phfln Idn cde em (81%) cho biit cdc em dn bda mpt ngdy, 12% cdc em tuii td 5-11 fln nhliu han bda mOt ngdy, Theo k i t qud NC, hidn chua eb nhdng hudng d i n cy t h i v i c h i dO dinh dudng cho trd em nhiSm HIV/AIDS; Kiin thdc v i dinh dudng vd qud trinh phdt triin cOa trd OVC cOa ngudi chdm sbc cfln hgn c h i 3.3 Rdo cin vi k^ thj vd phdn blU dii xu- v&i tri OVC vd gia dlnh tri Ky thl vd phdn bidt d i i xd vfln Id trd nggi Idn khiin cho ngudi chdm sbc vd trd OVC gflp khb khan Mflt s i ngudi chflm sbc trdnh khbng ydu edu h i trp- gido dye ho$c h i trp tdi chlnh cho eon em minh d i trdnh bj cflng ding ky th|, bdi muin dupe h i ^ ttii sd phdi ebng khai tinh trgng HIV, Tgi mflt sdn chai ddnh ndng cho trd Chung song vd bj flnh hudng bdi HIV, mflt cdn bp vfln dflng gido dye truyin thflng cua Hpi Phy Nd tinh cd nghe dupe mpt bfl mg chung sing vdi HIV nbi 'Dung cddicon choi & diy niu khdng muin nd bi liy nhiim" Mbt s i ngudi chdm sbc giflu khflng cho em minh biit tinh trang HIV va eb ngudi khflng chju cho di xdt nghidm, chlnh vi t h i nhiiu em khflng dupe Cham sbc vd/hoac h i trp tdm ly dfly dO Khodng 60% ngudi cham sbc cho biit hp b| ky thi va phan bidt d i i xu va 14% giiu khfl^ng tiit 1$ tinh trgng bdnh ciia minh 3.4 Rdo dn ve kha ndng tiep cSn dich vu y ti t^i dia phwcmg Chi phi di lai t i n kdm cbng vdi vide thudng xuyen phai d i n ca sd KCB 6h thdm khdm cung gdy khb khdn cho tre OVC vd pia dinh tre vide vide theo dfli sue khoe/dieu tri cdc benh thudng gdp va benh HIV/AIDS V i mdc 66 tiip cfln cdc djch vu y t i hidn cb, 67% ngudi chdm sbc cho rdng muc dfl tiip cfln hp d muc "binh thudng," 27% d mire "tit." V i chi phi khdm chua bdnh vd mua thuoc, 82% nguai chdm sbc cho biit hp cb the bao hiem y te cho tre dudi tuii, nhien the bao hiem khbng chi tra cdc loai thuoc theo dan, thuoc dflt tiin ma tre thuang xuydn phai diing nhu thuoc khang sinh hoac phi tu van cho benh nhan ngoai tru Chlnh vi vay nhieu gia dinh phai d\ vay na Idi mfli cai bi om, thdm chi phai bdn tai san d i chi tra cac chi phi lien quan din y t i V i phuong tien di lai tbi cac ca sd y t i , 34% s6 ngudi dupe hoi cho biet ho di bflng xe may, 28% di xe bm, 20% su dung phuang tien giao thbng cbng cbng, va 13% di bdng xe dap Nhung ngudi chdm sbc tre OVC d gfln taing tam huyen Sbc San mat it thdi gian de den cdc ca sd y t i han so v d cac xa d xa Thi tran, tre OVC a cdc xd ndy thubng den bdnh vien A Thdi Nguyen, Mot s i rdo can va khb khan khdc md tre OVC va gia dinh phai d i i mdt, bao gom: Sue khbe cua ngubi chdm soc tre OVC vd nil sa mat mat, Rao can viec ddp ung nhu cflu giao due va hpc tap, Rao can ve su ddp ung nhu c i u tdm ly ciia tre OVC K£T LUAN 70% trd dang d 66 t u i l t d d i n 11 ,ty Id nam n d Id nhu (nam 58%, n d 42%)- 49% trd m i c i i b i hodc mg, 9% cdc em m i c i i cd bo Ifin mg 60% ngudi chflm sbc trd OVC dang s i n g chung vdi HIV/AIDS; % n d gidi, 66 54% dd gba ching vd 49% bd mg cb HIV duang tinh N g h i nghidp cilia ngudi chdm adc trd OVC da dgng, nhung chil ydu Id nflng ddn vdl ty Id 46% Trd OVC cb nhbm nhu cflu CSSK chlnh; (1) Nhu c&u chdm sflc sdc khde t h i c h i t vdi nhu c i u chlnh Id CS dinh dudng vd CS y t i , (2) Nhu cflu chdm sdc sdc khde tinh than vd xd hOi bao g i m cdc nhu cAu: Chdm sbc tdm ly gido dye, vd nhu c i u dupe bAo vd: phdp ly, khdi bj phdn bidt d i l x d , bj ky thj vd bj Igm dyng, ngu-pv ddi vd bdo ddm c6 nal d an todn Cb rdo cdn chlnh vide ddp dng nhu cflu CSSK cOa trd OVC, bao g i m : Rdo cdn v i kinh t i ; Rdo cdn v i nhdn thdc cua trd OVC vd ngubi chdm sbc trd; Rdo cdn vd ky thj vd phdn bidt d i l x d vdl trd OVC vd gia dlnh trd; Rdo cdn vd khd ndng tiip cdn djch vy y t i tgi dja phuong Tinh trgng bj xa Idnh vd phdn bidt d i l xu dupe d i cdp nhiiu nhflt d trudng hpc, nhidn hflu h i t ede em d i u dupe di hpe Vide lo sp bj xa Idnh vd ky thj tiit to tinh trgng HIV dd ngdn cdn viflc ngudi chdm sflc trd OVC dua cdc em di xdt nghidm HIV Chlnh phii Id nguin h i trp chlnh v i tdi chlnh vd gido dye cho trd OVC, ede nhbm ty lyc vd ede t i ehCrc cing ding h i trp ede em v i dmh dudng vd tflm ly/ tinh cdm K h u y i n nghj Tdng cudng ehudng trinh gido dye cho d i i tupng OVC vd ngudi chdm sdc chlnh v i k i i n thdc phbng ching HIV/AIDS Cfl gidi phdp thdo g d rdo cdn cbn Igi cho vide sd dyng dich vy y t i v i rdo cdn v i kinh t i ndn cd d i i db trp cap h i tn? vide ldm cho gia dinh trd OVC, Rdo cfln v i ky thl vd phdn bidt dii xu vdi trd OVC vd gia dlnh trd cfln gido dye cho cflng ding dflc bidt thiy cb, hpc sinh d tnMni'lteQIvi'Mtn'thdc HIV/AIDS vd luflt phbng ching HIV/AID8?R*iclnvd khd ndng Sip cfln djch v y y t i l g i d|l prumg oin OO cdn bO y t i t u v i n dfly dD cho ngubi chim tdo vt oio MU V* cte nOI dung chdm sbc sdc khde dlnh diPdng, dliu trf b«nh ev hOI TAI L I | U THAM KHAO f, BO Y t i (1996), Quy djnh chuyin mdn vi xd ly nhlim HIV/AIDS ban hdnh kim theo Quyit dlnh si 2557A3D-BYT ngdy 26/12/1996 cOa Bd Yti Franca-lert, Nguyin Thj Thiing, Luu TTii Blch Ngoc vd CS (2010), "Trd em nht«m HIV d Vidt Nam Cdc nhdn ti xd hfli dnh hudng d i n tiip cfln chdm sdc y l i ' , Tdf liiu HOi nghi khoa hoc qudc gia vi HIV/AIDS lin thir4 Ddm Thj Thanh Hoa, NguySn Thu Anh, Du, Saul Hetfenbeln vd CS (2010), "Khdo sdt nhu c i u vide ldm vd ndng lyc ciia ngudi sing chung vdi HIV vd ngudi sau cai tgi Hd Nfli, Tii liiu Hdi nghi khoa hoc qudc gia vi HIV/AIDS lin thw 4 Lisa Messersmilh Lore Sabin, Trfln Lan Anh vd CS (2010), "Khfl ndng l i i p cfln vd cdi thidn chflt lupng cdc djch vy y t i vd xd hbi cho phy nd sing chung vtn HIV/AIDS tgi Hfli Phbng vd TP H i Chi Minh" Tdi li^ Hdi nghi ^^°^ ^'^ ^"^ 9'^ ^^ HIV/AIDS lin thw Uy ban nhdn ddn huydn Sbc Son (2009), Bdo cdo sd 399/BC-UBND ngdy 15/12/2009 cua UBND huyin Sbc Son vi tinh hinh k^ qud »iwc tiin ri^im vu ph^ thin kinh tixd hdi an ninh qudc phdng ndm 2009, nhOng nhiim vptrpng^ nim 2010 Join forces against HIV - Shareyour head for the children (2009), A guide lo 'National plan o^ action for childmn affected by HIV and AIDS until 2010 with a vision to 2020' Ha Noi Unk»f (2010), An fijialysis of tiie situation of chiklren in Viet Nam 2010, Execubve Summary Usaid (2009), Social work for chiklren living m(h and affected by HIV/AIDS Ha Noi Usaid (2008), 'The cam and pmtection of children infected and affected by HIV in Viet Nam IN SEARCH OF PROMISING PRACTICES: Y HQC THt^JC H A N H (840) - so ^/2fll2 ... care of OVC living with HIV / AIDS; 71% of women, of yng nhu cflu chdm sbc sdc khbe cho trd nhiim vd bj vAiich 54% were wktowed and 49% of HIViJOSitive dnh hudng bdi HIV/ AIDS tai huydn Sbc San,... r^Sdren (OVC) are susceptible to health and psychofogy by HIV cfln thiit, D i cung cflp cdc bflng chdng cho bdn d i xuflt k i hogeh can thiflp hidu qufl cho trd OVC vd h i In the context of HIV are... 20 thdng 02 tgi nhd chp trd OVC nhbm Hoa Sim Tim (nhbm nam 1990 [1] cua nhung ngudi sing chung vdi HIV/ AIDS) Dai dich HIV/ AIDS Id mbt vfln nan cua todn t h i M i u nghidn edu Nghien cuu chpn todn