Luận văn chiến lược phát triển tại bệnh viện nhiệt đới trung ương tới năm 2020

LuẬN văn Chiến lược phát triển tại bệnh viện nhiệt đới trung ương tới năm2020 THESIS TITLE DEVELOPMENT STRATEGY FOR THE NATIONAL INSTITUTE OF INFECTIOUS AND TROPICAL DISEASES TO 2020..

LuẬN văn Chiến lược phát triển tại bệnh viện nhiệt đới trung ương tới năm

2020 THESIS TITLE

DEVELOPMENT STRATEGY

FOR THE NATIONAL INSTITUTE OF INFECTIOUS AND TROPICAL DISEASES

TO 2020

STATEMENT OF AUTHORSHIP

Except where reference is made in the text of the thesis (Capstone Project), thisthesis contains no material published elsewhere or extracted in whole or in part from

a thesis by which we have qualified for or been awarded another degree or diploma

No other person’s work has been used without due acknowledgement in the maintext of the thesis This thesis has not been submitted for the award of any degree ordiploma in any other tertiary institution

INTRODUCTION……….…… 8

Chapter 1: Theory ……….……11

1.1 Concepts……….… 11

1.2 Stages in strategy establishment……… 12

1.3 Analysis of the operational environment of the business organization…15 1.3.1 Analysis of external environment……… 16

1.3.2 Analysis of internal environment……… 20

1.4 Proper strategies for the organization………21

1.4.1 SWOT Matrix……….…… 21

1.4.2 IE Matrix……… 23

Chapter 2: Analysis and evaluation of the operation of the National Institute of Infectious and Tropical Diseases……… 29

2.1 General introduction to the institute ……….……….… 29

2.1.1 History……….…29

2.1.2 The organization of the hospital……… 30

2.1.3 Number of wards……….………… 32

2.2 Analysis of External Environment ……….….32

2.2.1 General environment……….… 32

2.2.2 Industry environment (Medical environment)………37

2.2.3 Competitors’ environment……… 38

2.3 Analysis of internal environment……….…….42

2.3.1 Finance………42

2.3.2 Organization and HR……… 45

2.3.3 Infrastructure, facilities and technology……….….48

2.3.4 Image of the hospital and its brand……….49

2.3.5 Training and research……….….50

2.3.6 Leadership in the fight against infectious diseases……….51

2.3.7 International cooperation………51

Chapter 3: Establishment of the development strategy of the hospital to 2020… 52

3.1 Vision……… 52

3.2 Missions NIITD……….…… 52

3.3 Bases on which NIITD sets up goals and objectives……….… 52

3.3.1 Development estimates……….…… 52

3.3.2 SWOT Matrix ……… 55

3.3.3 Internal-External Matrix ……… 56

3.4 Establishment of development strategy……… … 58

3.4.1 Strategy on working skills……….….58

3.4.2 Strategy on scope……… 62

3.4.3 Strategy on structure and organization……… 62

3.4.4 Strategy on HR development……… 66

3.4.5 Strategy on infrastructure and other facilities……….66

3.4.6 Financial strategy……… 67

3.4.7 Strategy on professionalzing the services provision of the hospital… 69 3.4.8 Implementation roadmap……….69

3.5 Recommendations……….71

CONCLUSION……….73

REFERENCES……… 74

LIST OF TABLES

Table 2-1: Description of wards………32

Table 2-2: Comparativeness and market share in 2008……….38

Table 2-3: Number of patients when NIITD was a department of Bach Mai hospital……….41

Table 2-4: Number of patients after separation……….41

Table 2-5 : Financial figures over the past three years……… 43

Table 2- 6: Spendings over the years……….44

Table 2-7 : Differences in revenue and spending……… 44

Table 3-1: Estimates of patients to 2020……… 53

Table 3-2: Score table of internal factors……… 56

Table 3-3: Score table of external factors……… 57

Table 3-4: Human resources development plan………66

Table 3-5: Estimation of main financial sources up to 2020……….68

LIST OF FIGURES

Figure 1 – 1: Comprehensive model of strategy management……….11

Figure 1 – 2: Model of the relations between business organization, external and internal factors……… ……….15

Figure 1 – 3: Model of five competing forces according to M Porter……….18

Figure 1 – 4: SWOT Matrix……….….23

Figure 1 – 5: IE Matrix ……….27

Figure 2-1: Structure of NIITD……… 31

Figure 3 - 1: Model SWOT Matrix……….… 55

Figure 3 – 2: Model of IFE Matrix………58

Figure 3-3 : Gantt model of activities and their time frame……… 69

LIST OF CHARTS

Chart 2-1: Number of patients over the years……… 41

Chart 2-2: Comparison of revenue and spending over the years……… 43

Chart 2- 3: Distribution of human resources……….47

Chart 2- 4: Distribution according to education and qualifications……… 47

Chart 2- 5: Distribution according to ages……….48

Chart 3 – 1: Estimates of patients to 2020……….53

The system of state-run hospitals in Vietnam is considered vital part of healthcare system in the country State-run hospitals receive a big part of total medicalspendings of the state budget, accounting for 35.8% Increases in the financialresources and in the quality of services are those which should be paid attention to

To do this, the goverment of Vietnam issued two important decrees No.10/2002/ND-CP and 43/2006/ND-CP which gives state-run hospitals autonomy intheir financial policies These two decrees are hoped to ease the operation of state-run hospitals by giving them a chance to increase their financial budget In addition,these are also hoped to give momentum for the whole medical system to increasetheir service quality and increase the public health

In recent years, tropical and infectious diseases such as HIV/AIDS, SARS,different types of flu (H1N1) strike Vietnam heavily The National Institute ofInfectious and Tropical Diseases (NIITD) is the leading medical organization inVietnam which is fighting those diseases However, so far there is not a verycomprehensive development strategy for the hospital In order for the hospital tooperate more effectively, it is necessary to establish a comprehensive developmentstrategy This study is conducted with the hope to provide a development strategyfor NIITD to 2020

Aims of this project:

- Provide a brief review of literature on the planning of development strategy

- Provide some analysis, assessment and evaluation of the operations of NIITDover the past three years and different kinds of factors (internal and external)based on which the development strategy for NIITD will be built

- Establish a developmental strategy for NIITD from 2010 to 2020

- Work out measures and make some recommendations and suggestions forNIITD to achieve its strategic goals

Subjects and scope of the study:

Analysing business environment of the hospital from 2007 to 2009 in order to orientthe business strategy for the period of 2010-2020

Methodologies:

Data collecting methods:

Primary sources: personal meetings with those in charge and those who can provideinformation (Board of Directors and staff)

Secondary sources: hospital’s reports, newspapers, medical magazines, Internet, etc

Comparison, analysis and synthesis:

Make comparisons between different variables, between specific objectives, goalsand real business achievements, etc Then the authors will analyse the differencesbetween variables, objectives and goals set up and those real achieved After that,they will synthesize and summarize the results

Use of tables, figures and charts:

The authors will use the tables and charts to find out the common things ordifferences or trends of those variables analyzed and reflection on them

Connection with experts:

The authors of the papers consult with experts in the subject matter for furtherunderstanding of the data and conclusions of the matters concerned

SWOT method:

Idenitifying and analyzing strengths, weaknesses of the hospital, opportunities it hasand threats it encounters

IE method:

Giving points and score to work out the direction for development of the hospital

The authors of the papers will also try to use the data collected to reflect on theory

in the area of developmental strategy and use the ideas in the theory to evaluate theoperation of NIITD

Organization: Three chapters

Chapter 1: Theory

Chapter 2: Analysis and evaluation of NIITD operations

Chapter 3: Establish the developmental strategy for NIITD to 2020

CHAPTER 1:

THEORY 1.1 Concept

There are many different definitions of business strategy Many of them claim that business strategy is to do with art of implementation and monitor of business activities in order to achieve long-term goals of a business organization Here are some:

According to Alfred Chandler (1962), strategy is the “determination of the basic longterm goals and objectives, and the adoption of courses of action and the allocation ofresources necessary for carrying out goals…”

“Corporate strategy is the pattern of decisions in a company that determines andreveals its objectives, purposes, or goals, produces the principal policies and plansfor achieving those goals, and defines the range of business the company is topursue, the kind of economic and human organization it is or intends to be, and thenature of the economic and non-economic contribution it intends to make to itsshareholders, employees, customers, and communities.” (Andrews, 1980)

“Strategy is the direction and scope of an organisation over the long-term: which achieves advantage for the organisation through its configuration of resources within a challenging environment, to meet the needs of markets and to fulfil stakeholder expectations” (Johnson and Scholes, 1992)

Bateman and Zeithaml pay attention to the psychological context of strategicdecision making, to its incremental nature, the role of historical antecedents andindividual biography, and the extent of convergence between personal andorganizational goals (1989)

In general, the definitions of strategy include the following features:

1 Clearly developmental goals measures in each periods

2 Strategic directions which guide the activities of the business organizationand ensure the success of the organization in the constantly changing

environment

3 Mobilization of all the resources of the business organization and utilization

in the most effective way both in the medium and long term and grasp ofopportunities in order to become more competitive and successful

4 Business strategy should be built with the philosophy that enables bold stepswhich enhance success in the business environment

5 Business strategy should be built for a long period rather than short term(e.g often 3-10 years at least)

Business strategy helps the business organization to:

1 realize clearly the goals and objectives in doing business

2 seize the business opportunities and make the best use of those opportunities

to actively overcome threats and difficulties in the business environment

3 increase the effectiveness of the use of the business’s resources with a view

to ensuring sustainable long-term development of the business organization

4 create solid bases on which business policies and decisions are made so thatthe business organization can survive and develop in the competitive andconstantly changing environment

1.2 Stages in strategy establishment

According to Fred R David, strategy management includes the following threestages:

- Strategy formulation

- Strategy implementation

- Evaluation of the implementation of the strategy

Stage 1: Strategy formulation

In this stage, the business organization has to establish the business goals andobjectives, to examine the strengths and weaknesses, opportunities and threats that

the organization has to encounter Based on the analysis of the strengths,weaknesses, opportunities and threats, the business organization can set up its long-term goals and measures to achieve those goals, select its strategy and work outalternative strategies More specifically, the business organization has to considerthe following issues: what to penetrate, what to skip, how to allocate resources,expand operations or diversify, enter international markets, merge or form jointventure, avoidance of hostile takeover, etc.

Stage 2: Implementation of strategy

This second stage can also be referred to as action stage of strategicmanagement Four activities often carried out in this stage is: (1) set up annualgoals, (2) make policies, (3) motivate employees and (4) allocate resources Thisstage is most difficult It is to do with the mobilization of human resources(managers and other staff) and other resources to carry out measures to achieve thegoals In this regard, interpersonal skills and consensus on pursuing goals arecritical

Stage 3: Evaluation

This last stage in the process often includes the following activities: (1)review the bases for the present strategy which includes internal review andexternal review, (2) measure the achievement of the goals and objectives orperformance measurement and (3) make adjustments to pave the way forsustainable future development or corrective action

This process is of great importance because present success does not meansthe business organization will continue success in the future So it is important forthe business organization to evaluate the present success comprehensively and tolearn lessons from the current success and failure so that it can succeed in thefuture It is also important for the organization to know that success creates newand different problems and thus complacency will lead to demise

Process of strategy development

Feedback

Formulate Carry out Evaluate strategy strategy strategy

Figure 1 – 1: Comprehensive model of strategy management

External audit Set up

long-term goals

Set upannual goals

Internal audit

Finalize thebusinessgoals

Set uppolicies

Allocation

of resources

Measureandevaluateperformance

Because the focus of this paper is placed on the establishment of the

strategy, the authors will concentrate on the period of planning the strategy

1.3 Analysis of the working environment of the business organization

In order to establish the strategy for the business organization, it is necessaryfor the organization to consider all the factors that can exert influences on theoperation of the organization In this regard, it is important to focus on externalfactors (e.g general circumstances, the field in which the organization is operating,competitors) and internal factors (e.g the organization history, staff, etc.)

The relationships between the factors are presented in the following figure:

Figure 1 – 2: Model of the relations between business organization and

external and internal factors

Industry Competitors Rivalry among existing firms

Bargainin

g power

of suppliers

Threats of substitute products

or services

Bargaining power

of buyers

Threats of Potential Entrants

Technological

Global

Demographic Economic

Socialcultural

Political

/

Legal

The above model shows us the influence of the external and internal factors exert

on the operation of the business organization

1.3.1 Analysis of external environment

General environment:

The influence of the demographic environment:

Demography in the macroscopic environment has a connection with: Population;Structure of age; Distribution of geography; Ethnic Community; Distribution ofincome

The influence of the economic environment:

The condition of macroscopic economic environment determines thewholesome and prosperousness of the economy It also has an effect on businessesand industries Economic environment defines the essence as well as orientation ofeconomy in which buisiness operates The influences of economy on a company canmake a change in making value and its income

Here are four important factors of macro-economic environment:

• Rate of growth of economy,

• Interest,

• Exchange rate,

• Rate of inflation

The influences of polical and legal environment:

The political and legal factors also have a considerable effect on opportunities andthreats from the environment such as: The related and new policies of thegovernment, Law, Industries the organization chooses to operate in, the fields inwhich the managing policies of the State can influence on the orgnainzation’s

activities and profits

On global scale, companies have to face a series of noticeable matters about politicsand law as: Trade policies, Traditional barriers of protection set up by differentcountries

The influences of cultural and social environment:

Social attitude and cultural Value create Social foundation, Changes,Technical conditions, Political–Law, Economy and Demography The social changealso creates opportunities and threats

The influence of technnonogical environment:

Technology is a very active factor It is changeable For this reason,technology brings businesses many oppotunies as well as threats It is the fact thatfew industry and business do not use or do not depend on Technology It is sure that

a lot of advanced technology will be invented and come out into society Thiscreates chances or threats for businesses and industries The development of thenew technology can make a new market and as multiply many kinds of newproducts as a result Also, new technology can create a change in competitiverelationships in industries and make the existing products become backward andtheir quality does not meet requirement of society Changing in technologyinfluences on many parts of society

Technology includes the activities which are related to creatation of new knowledge,application that new knowledge in creating: new products, processes and newmaterials In short, Changing technology includes creativeness and extermination,opportunities and theats Changing technology can have an effect on the height ofthe barrier and reorient the structure of industries at the root

The global environment:

Global markets, existing markets which are changing, important international –

political events, the institutional particularities and culture of global market,globalization of market creates both opportunities and threats, therefore should beaware of the different particularities in culture, society and institution of globalmarkets

Analysis of industry environment and competitive environment

The analysis of industry environment is very important to external environmentanalysis Here we will present Porter’s five forces model to analyse:

Figure 1- 3 : Porter’s Five Forces Model

Industry Competitors Rivalry among competing firms in the

industry

Threats of substitute products

or services

Threats of Potential Entrants

Bargaining power

Rivalry among existing competitors in the industry

Industry consists of a group of companies which supply same or alternativeproducts or services

Pressure from competitors should be taken into consideration and analyzed carefullybecause it can directly threatens the existing and development of all businessesoperating in the same industry The following factors affect the level ofcompetitiveness of companies: number of competitors, degree of competitiveness,the growth rate of the industry, differences in products and services provided,diversity

Threats of potential entrants:

According to M-Porter, the potential competitors are businesses which have notappeared yet but will influence on industry in the future Whether there are more orless competitors and how much the competitors influence, the industry depends onthe following factors: industry attractiveness and the barriers when joining theindustry The more competitors, the more competitive and the less profits thecompanies in the industry gain

The entry of new competitors depends on the industry attractiveness Theattractiveness itself depends on economic environment and the “future” of theindustry, whether it can be profitable in the future and how profitable it is

The entry of new competitors also depends on barriers to entry The morebarriers, the less competitors and vice versa

Joe Bain (1956) claims that three factors that can influence a company’s entry to

a industry: initial capital requirements, threat of price cutting by established firms,and product differentiation

Bargaining power of buyers

Buyer groups are likely to powerful if: Buyers are concentrated or purchases arelarge relative to seller’s sales; Purchase accounts for a significant fraction of

supplier’s sales; Products are undifferentiated; Buyers face few switching costs;Buyer’s industry earns low profits; Buyer presents a credible threat of backwardintegration; Product unimportant to quality; Buyer has full information And buyersoften compete with the supplying industry by: bargaining down prices, forcinghigher quality and playing firms off of each other.

Bargaining power of suppliers

Suppliers are likely to be powerful if: Supplier industry is dominated by a fewfirms; Suppliers’ products have few substitutes; Buyer is not an important customer

to supplier; Supplier’s product is an important input to buyers’ product; Suppliers’products are differentiated; Suppliers’ products have high switching cost; Supplierposes credible threat of forward integration And suppliers exert power in theindustry by: threatening to raise or to reduce quality Powerful suppliers cansqueeze industry profitability if firms are unable to recover cost increases

Threat of substitute products or services

This is to do with products with similar function that buyers can choose.Clearly, more substitute products can limit the prices that firms can charge.Competiveness is high when the relative price of substitute products declines,consumers’ switching costs decline and competitors plan to increase marketpenetration or production capacity

1.3.2 Analysis of internal environment

Studying the internal environment helps businesses to define what they can do.Businesses can create good value for themselves and expoilt resources effectively

by exploiting key capacity or competitive advantage

Human resources:

Human resource plays an important role in success of business Forexample, a company has an excellent strategy but its staff do not work effectively,they can not carry out the strategy successfully and thus the company can notbecome profitable and successful So businesses should prepare a good humanresource in order to achieve the targets set up

Financial resource:

Financil condition is often considered to be the best method of evaluatingvalue of competitive position It is also the best condition to attract investors Analyzing financial index is the most popular method to define the strengthand the weakness of organization about business finance

Facilities and Equipment:

Equipment and technology help business to raise the ability of competition .However, investing on equipment requires a careful calculation when deciding toinvest

Some other resources of business:

It depends on each business industry Each business can consider some factors ininternal business which affect the business result

1.4 Selection of strategy for business

1.4.1 SWOT Matrix

SWOT Analysis is to analyze the outside factors which businesses have toface (Opportunities and Threats) as well as the internal factors of business(Strengths and weaknesses) This is a hard job which requires plenty of time, labour,

expenditure, ability to collect information, analyze and deal with it in the mosteffective way

A business organization has to identify opportunities and theats by analyzing data inthe following areas: Economy, Finance, Politics, Law, Society and competition atthe markets where businesses operate or intend to join in Opportunities may includepotentiality of developing market, lack of markets, being located near to materialresource or cheap and skilled labour resource Threats may include the limit ofmarket, more and more merciless competition, changes in strategy, politicunstablility in key markets or the development of new technique which makesexisting equipment and facilities backward

It is necessary for the business organization to analyse the internal factors includingstrengths and weaknesses, for example skills, resources, technology, trademarks,excellent managers and other advantages the organization has over its competitors

so that it can build a good image in the public and important or potential markets.The weakness of business is shown by means of defects, weakness or skill, resource

or the factors which limit ability of competition of business They are uneffectivedistribution system, un-well labour relationship, shortage of experiencedinternational managers or backward products in comparision with the competitor

SWOT is the abbreviation of:

Strengths - SWeaknesses - WOpportunities -OThreats - T

SWOT Matrix helps us to develop 4 types of strategy:

• SO – strength– opportunities strategies: Use inner strength to make fulluse of the outside opportunities

• WO- weakness– opportunities strategies: Improving the inner weakness

in order to make full use of the outside opportunities

• ST- strength– threatens strategies: Use strengths to avoid or reduce theeffects of outside threatens

• WT- Weakness - Threats strategies: Improving the inside weakness toavoid or reduce the influence of outside threats

W + T

Overcome W to limit T

Figure 1 – 4: SWOT Model

The result of analysis process of SWOT should be ensured to be concrete,accurate, and satisfactory as business will use that result to develop the next actions:establish strategy, strategic target, strategy and concrete system to control strategy:Strategies are considered to be effective when they can make full use of outside Oand inside O and inside S as well as neutralize outside dangers, limit or overcomethe weaknesses of business itself

1.4.2 IE Matrix

IFE Matrix ( I F E – In te r n al fa c tors e n v i r o n me n t)

IFE Matrix summarizes and evaluates the important strengths andweaknesses of the functional marketing part

IFE Matrix is developed in 5 steps:

Step 1: Key internal factors

Conduct internal audit and identify both strengths and weaknesses in allbusiness areas It is suggested 10 to 20 internal factors be identified, but themore, the better The number of factors has no effect on the range of totalweighted scores because the weights always sum to 1.0, but it helps todiminish estimate errors resulting from subjective ratings First, list strengthsand then weaknesses

Step 3: Rating

Assign a 1 to X rating to each factor The rating scale can be per preference.Practitioners usually use rating on the scale from 1 to 4 Rating captureswhether the factor represents a major weakness (rating = 1), a minorweakness (rating = 2), a minor strength (rating = 3), or a major strength(rating = 4) If the rating scale 1 to 4 is used, then strengths must receive a 4

or 3 rating and weaknesses must receive a 1 or 2 rating

Step 4: Multiply

Now, multiply each factor's weight by its rating and we will have a weightedscore for each factor

EFE Matrix (EFE – External factors environment)

External factors evaluation helps us summarize and quantify the influences

of environmental factors on the business organization

Developing an EFE matrix is an intuitive process which resembles the way

of creating the IFE matrix The EFE matrix process uses the same five steps as theIFE matrix

Step 1: Key internal factors

Conduct internal audit and identify both strengths and weaknesses in allbusiness areas It is suggested 10 to 20 internal factors be identified, but themore, the better The number of factors has no effect on the range of totalweighted scores because the weights always sum to 1.0, but it helps todiminish estimate errors resulting from subjective ratings First, list strengthsand then weaknesses

Step 3: Rating

Assign a 1 to X rating to each factor The rating scale can be per preference.Practitioners usually use rating on the scale from 1 to 4 Rating captureswhether the factor represents a major weakness (rating = 1), a minorweakness (rating = 2), a minor strength (rating = 3), or a major strength(rating = 4) If the rating scale 1 to 4 is used, then strengths must receive a 4

or 3 rating and weaknesses must receive a 1 or 2 rating

Internal-External Matrix (IE Matrix) is built based on the 2 basic aspects:

• Total weighted score of IFE matrix

• Total weighted score of EFE matrix

The IE Matrix analyses a business organization as follows

Figure 1 – 5: Model of IFE Matrix

- Way of reading matrix:

• Total weighted score from 1,00 to 1,99: Shows the weakness

• Total weighted score from 2,00 to 2,99: Average

• Total weighted score from 3,00 to 400: Strong

- The IE matrix can be divided into three major regions that have different

strategy implications

• Growth and Build (The yellow cells – I, II, IV): Cells I, II, and IV suggest

the grow and build strategy This means intensive and aggressive tacticalstrategies Your strategies should focus on market penetration, marketdevelopment, and product development From the operational perspective,

a backward integration, forward integration, and horizontal integrationshould also be considered

• Hold and maintain (The green cells – III, V, VII): Cells III, V, and VII

suggest the hold and maintain strategy In this case, the tactical strategiesshould focus on market penetration and product development.

• Harvest or divest: (The red cells – VI, VIII, IX): Cells VI, VIII, and IX are

characterized with the harvest or divest strategy If costs for rejuvenating the business are low, then it should be attempted to revitalize the business In other cases, aggressive cost management is a way to play the end game

CHAPTER 2 : ANALYSIS AND EVALUATION OF THE OPERATION OF THE

NATIONAL INSTITUTE OF INFECTIOUS AND TROPICAL DISEASES 2.1 General introduction to the institute

2.1.1 History

The National Hospital for Tropical and Infectious Diseases was formerly adepartment of Cong Vong Hospital (built in 1911 – now Bach Mai Hospital) Underthe domination of the French colonial, this hospital treated the popular infectious

diseases such as tuberculosis, dysentery, typhoid, fever…In the war, infectious

department of Bach Mai Hospital treated patients and also trained staffs and built anetwork of specialized doctors

On November 11th 1989, Ministry of Public Health issued the decision number705/BYT-QD which separated the infectious department of Bach Mai hospital, whichpaves the way for the later establishment of the National Institute of Infectious andTropical Diseases (NIITD) However, the institute then still operated under thecontrol of Bach Mai Hospital

NIITD is a good place for treatment of serious infectious diseases all over thecountry, expecially the dangerous infectious diseases such as: HIV/AIDS,SARS, Birdflu… It also instructs related departments of hospital in treating the infectiousdiseases and dealt with epidemic when they happens Annually, the Ministry of healthand hospital and other hospitals together successfully control dangerous epidemicsuch as fever, tuberculosis, dysentery, typhoid, SARS, A-type flu, H5N1 and otherdangerous diseases The hospital always completes its mission and gain bigachievement It is also awarded with competitive/emulate titles such as the title oflabour heros in the new periods

Given the constant development of the hospital and its contribution in treating aswell as infectious diseases containment, on the 3rd of May 2006, the Gorvernment

issued the decision number 487/QD-TTg on establishing the National Institute of

Infectious and Tropical Diseases.

On the 1st of July 2006, the National Institute of Infectious and TropicalDiseases starts to operate independently, out of the control of Bach Mai Hospital and

takes full responsibility of its operation and professional knowledge

Business name: Viện Các bệnh Truyền nhiễm và Nhiệt đới Quốc gia

International name: National Institute of Infectious and Tropical Diseases.Name in Abbreviation: NIITD

Address: 78 – Giai Phong road – Dong Da district – HN

Tel: +84.4.35763023 Fax: +84.4.5764358

2.1.2 The organization of the hospital

- Board of Directors: 3 people

DirectorVice Director (in charge of profession) Vice Director, (in charge of logistic and paraclinic aspects)

The hospital includes:

9 functional rooms , 5 clinical departments and Paraclinical

Here is the current chart of organization of NIITD:

Figure 2-1 Organization of NIITD

BOARD OF DIRECTORS

- The division of Hanoi Medical University

- Organizations of CommunistParty, Youth and TradeUnions

- Department of General Infections

- Department of Viral and Parasitic

Diseases

Paraclinical Departments

- Department of Imaging

- Department of Pharmacy

- Department of Clinical Laboratories

- Department of Infection Control

2.1.3 Number of wards

Table 2-1: Description of wards

Year Number of

wardsdesigned

Actualnumber ofwards in use

Source: 2007,2008,2009 Reports – NIITD

Comparing the number of wards according to the Ministry of Health’s quotawith the statistical of numbers of wards in Figures 2-1, we can see a big increase inthe frequency of wards usage; especcially in 2009, since NIITD still has been anaffiliate of BachMai Hospital, the wards were used twofold

2.2 Analysis of External Environment

2.2.1 General environment

Demographic

The population of Vietnam is now about 86 million and there is much morepeople living in cities People who live in cities now account for about 29,6% of thetotal population, increasing by 3,4%/year; and only 4%/year increase in thecountryside According to the last population census and population healthassessment in 2008, there is a big gap between the health indices of upper-incomeand lower-income people and those in different parts of the country ( Source : VnEconomy )

There is a big gap between people in cities and those in the countryside.

Economic

The program of hunger elimination and poverty alleviation by the government

of Vietnam has brought about positive changes in the country’s economy Manypeople have escaped the circle of hunger and poverty Some even become rich

Opportunities:

More rich people means that more people will be able to take care of theirhealth In other words, there is an increase in the demand for health services.Clearly, this is an opportunities for the hospital as a “supplier” of health services

Threats:

The current inflation increases the costs and expenses in the health care servicesand negatively affects the lives of the medical staff and at the same time mayindirectly reduce the investment in the health care services

Political-Legal

The government of Vietnam and the Ministry of Health have made clear that theypay much attention to the public health care by issuing a series of decrees anddecisions (46/NQ-TW, 43/ND-CP) which favor medical institutions and theiractivities More specifically, the decree No 43/ND-CP give the Institute a more freehand in its operation by giving it a “semi-autonomy” in its financial policy It is alsoworth noticing that the health care area of tropical and infectious diseases receivespecial attention from the government and the ministry The government annuallyincreases its investment in this area One more thing that should be noted here is thatthe government now allows different sectors of the society to invest and participate

in the health care services activities

Opportunities

The government has made clear policies on the general area of health care andthe specific area of infectious diseases And this is the time for the institute to makethe best use of those policies to develop The hospital is now partially regarded as abusiness organization operating in the market economny rather than a hospital of thecommand economy which “purely” devotes to the public benefits Now there is nolimitation in the scope of the operation of the hospital So it can take the chance toopen up new health care services New policies from the government now allow thehospital to source different funds from different parts of the society (e.g.: fromprivate organizations, etc.) in order to enlarge the hospital and and its operation

Threats:

Together with the opportunities, go many threats If the hospital can not takethose opportunities mentioned above They will surely become threats For example,now the government allows many sectors to invest in the area of health care Thismeans that the hospital now has more competitors If the hospital can not make thebest use of its strengths and opportunities to develop, many of its competitors willmove forward and push it behind This is very threatening

Working in the health care sector is generally respected in Vietnam Manypeople believe that medical jobs are to cure people and therefore doctors are “thesalt of the earth” Many people in Vietnam do not have a habbit of going tohospitals for regular check-ups or many do not participate in the service of healthinsurance Many people do not have a good attitude toward protecting theenvironment This may increase the pollution of the environment and thus causediseases Many do not pay attention to personal and social hygiene and thusaltogether leads to the fact that many people in Vietnam are infected with infectiousdiseases

The treatment of many poor patients without health insurance may be verycostly because some of them can not pay for the service they receive

Technological

Now Vietnam has enjoyed many achievements in the area of science andtechnology Undoubtedly, information science and Internet have greatly helped easethe work of the hospital In addition, a lot of modern equipment has helped doctorsdeal with many serious diseases effectively and helped cure many patients

Many pieces of equipment become out of date quickly and may cause a bigwaste if the hospital makes a wrong “calculation” in purchasing them.

Global

Now in the world, the outbreak and spread of infectious diseases have becomevery complicated Recently, many new dangerous infectious diseases outbreak andspread quickly, for example, HIV/AIDS, SARS, H1N1, H5N1, etc These diseasesspread very quickly and do not respect national boundary This situation requires aglobal effort Clearly, it is time for an international cooperation in the fight againstinfectious diseases

Climate change clearly affects Vietnam as coastal country According to thereports of the Ministry of Natural Resources and Environment, the degree hasincreased by about 0.7o C and the sea level has increased by about 20cm and floodmany coastal parts of Vietnam

Global warming causes ice melting and increases sea levels and floods many parts of the world.

Clearly the changes in the climate such as floods pollute the environment andincreases the chances of developing new diseases, particularly infectious diseases

2.2.2 Industry environment (Medical environment)

Vietnam is a tropical country, often wet and warm This provides favorableconditions for infectious diseases to occur and spread

In Vietnam now about 12-20% of the population is infected with hepatitis type

B and about 42,000 have been killed by the disease According to the report onHIV/AIDS in 2008, there were more than 135,171 people who had HIV, of which29,134 became sick and 41,418 have died (Source: 2008 Reports of HIV/AIDSDepartment-Ministry of Health)