PROPOSAL ITEMS TO CALL FOR SUPPORT IN THE PREVENTIVE MEDICINE AREA ADMINISTRATION OF PREVENTIVE MEDICINE

1.SITUATION OF COMMUNICABLE DISEASES 2.SITUATION OF HUMAN RESOURCE FOR THE PREVENTIVE MEDICINE AREA 3.INFRASTRUCTURE AND MEDICAL DEVICES 4.ORGANIZATION AND STRUCTURE 5.PROPOSAL NỘI DUNG TRÌNH BÀY

SITUATION OF COMMUNICABLE DISEASES

Nguồn: Niêm giám thống kê bệnh truyền nhiễm SITUATION OF SOME COMMUNICABLE DISEASES,

Influenza A H5N1( /2012) Year /201 2 Tota l Cases Death s

HEMORRHAGE

Malaria

Meningitis

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TETANUS

CHALLLENGES IN THE COMMUNICABLE DISEASES AND EMERGING DISEASES  Impacts of climate change, immigration, urbanizations, changes of micro bacteria types, have made favorable condition for new epidemics and re-occurrence of the restricted diseases (SARS, HI A H5N1..)  Some diseases do not have vaccines and specific remedy, rate of healthy people bringing germs are high  NCD has the symptoms of increasing (diabetes, hypertension….), in 2012 there is occurrence of symptom “Hội chứng viêm da dầy sừng’” (which has not been defined the causes of this disease)

CHALLLENGES IN THE COMMUNICABLE DISEASES AND EMERGING DISEASES 1.Reporting system is not adequate due to shortage of infrastructure, equipments, human resource and budget. 2.Human resource: lack of both quantity and quality 3.Budget: shortage or delay 4.Community:  Lack of knowledge and perception  Not active in monitoring and prevention

HUMAN RESOURCE FOR PREVENTIVE MEDICINE AREA

HUMAN RESOURCE FOR PREVENTIVE MEDICINE AREA (2011) NoHealth staff categoryCentral Provincia l DistrictTotal 1 Doctor (of all categories) University – trained Pharmacist KBC63KBC63 3 Bachelor of Public health College medical staff Secondary medical staff Other categories Total KCB: Ko có báo cáo

DISTRIBUTION OF HUMAN RESOURCE BY EDUCATION LEVEL

TTCategory Preventive medicine AIDS Food safety Labor health and environme ntal health Malari a Border quarant ine Total Rate % 63 * 8*8* 27 * 13 * I Medical staff Doctors University trained pharmacist Bachelor of Public health College medical staff Secondary medical staff Other categories II Other specialities Other universities Other colleges Other secondaties school Other staffs Total SITUATION OF HUMAN RESOURCE AT PROVINCIAL LEVEL IN 2011

SITUATION OF HUMAN RESOURCE AT DISTRICT LEVEL IN 2011

HUMAN RESOURCE NEEDS OF UNIVERSITY TRAINED STAFF BY 2020 Specialities Rate / pop Preventive medicine 1,25 10,96711,09911,23211,36711,50311,64111,78111,92212,065 Bachelor of Public Health 0,32 2,8432,8772,9112,9462,9823,0173,0543,0903,127 Total1,57 13,81013,97514,14314,31314,48514,65814,83415,01215,193

COMPARISON BETWEEN THE NEEDS AND CAPACITY OF TRAINING

INFRASTRUCTURE AND EQUIPMENT

INFRASTRUCTURE AND EQUIPMENTS AT PROVINCIAL LEVEL Infrastructure: Survey in 44 provinces: Almost exist 1-3 building blocks, 10 provinces have the buildings which were constructed more than 10 years, 16 provinces have the degraded 75% houses. Number of buildings need to be repaired is 59%. Average square is 1065,3 m2, less than standard. The provinces meet only 52,1 % standards. The used rooms of provinces are lower than average. The average number of labs for each unit is 11, reach the national standard. The provinces have only met 75%. Used square of labs in provinces have large discrepancy. The provinces have only reach 62,6% Source: Evaluation of preventive medicine

INFRASTRUCTURE AND EQUIPMENT AT PROVINCIAL LEVEL Transportation: Statistic from 44 provinces, 100% provinces have cars, 56.8% have motobikes. Average of 2,6 cars/provinces not met the standar (4 cars/province). However there are many broken cars, only 4 provinces in good condition, 29 units under 50%. Computer connecting with Internet: Average number of computers is 17/provinces. The provinces have from ones. In comparison with, no province met standard, 17 provinces have these computers in good condition, the others have 50% which were broken. 100% provinces have internet connection, 26 units have more than 51% computers connected with internet. 8 units have less than 25% those conneted with internet. Nguồn: Đánh giá hệ thống YTDP

INFRASTRUCTURE AND EQUIPMENT AT PROVINCIAL LEVEL. Lab equipment No provinces met the standard of equipments. Quang tri have 76% of new equipment. 31% provinces have less than 35% equipments, 12 have 36-70%; The existing equipments are almost ruined, only 26/100 of equipments in good condition in all preventive medicine centers in survey. Nguồn: Đánh giá hệ thống YTDP

INFRASTRUCTURE AND EQUIPMENT AT DISTRICT LEVEL The Prime Minister has issued the Decision 1402/QĐ-TTg to approve the Projects of Development of Preventive medicine at district level for the period Evaluation of the VAHIP project 2011  As the statistic in 30 provinces, there are 123/249 districts do not have separate preventive medicine center ( 49%)  In survey of 20 provinces/Cities: almost district health centers have 20% equipment less than standards (Decision of 2367/QĐ-BYT)

ORGANIZATION SYSTEM

63 TTYTDP tỉnh / thành phố 63 Chi cục ATVSTP 63 Trung tâm Phòng chống HIV/AIDS 712 TTYT quận/huyện Trạm Y tế xã 27 Trung tâm phòng chống sốt rét -Viện VSDT TƯ -Viện Pasteur TP. HCM -Viện VSDT Tây Nguyên -Viện Pasteur Nha Trang -Viện YHLĐ & VSMT -Viện Vệ Sinh YTCC -Viện Dinh dưỡng -Viện Kiểm nghiệm An Toàn Vệ sinh TP -Viện sốt rét- KST -côn trùng Trung ương -Viện sốt rét- KST -côn trùng TP. HCM - Viện sốt rét- KST -côn trùng Quy Nhơn - Viện kiểm định quốc gia vắc xin và sinh phẩm y tế -Viện vắc xin Nha Trang Bộ Y tế Cục Y tế dự phòng, Cục ATVSTP Cục PC HIV/AIDS, Cục QLMTYT 13 Trung tâm kiểm dịch và y tế biên giới 08 Trung tâm SKLĐ & VSMT23 Trung tâm PC BXH

DIFFICULTIES 1.Function and task are not unique and stable. 2.So many focal points in implementing the preventive medicine areas leading to the decrease of the resources and overlap in function and tasks.

PRIORITIES TO PROPOSE 1.SRENGTHEN CAPACITY FOR PREVENTIVE MEDICINE IN EMERGING COMMUNICABLE DISEASE PREVENTION: USD 2.SUPPORT FOR THE HUMAN RESOURCE FOR PREVENTIVE MEDICNINE: 42 MIL USD 3.SUPPORT FOR THE FIELD EPIDEMIOLOGY TRAINING PROGRAME FOR THE PREVENTIVE MEDICINE STAFF: USD TOTAL: USD

1.SRENGTHEN CAPACITY FOR PREVENTIVE MEDICINE IN EMERGING COMMUNICABLE DISEASE PREVENTION 1.Country level prevention 2.Strengthen capacity of monitoring and responding to the communicable epidemics 3.Improve the diagnostic capacity of laboratories 4.Consolidate the treatment and prevention capacity. 5.Improve the knowledge, behavior change communication and risk communication. 6.Strengthen the researchs (epidemiology, influenza virus, drug resistance, vaccine, intervention evaluation…)

1.SRENGTHEN CAPACITY FOR PREVENTIVE MEDICINE IN EMERGING COMMUNICABLE DISEASE PREVENTION COMPONENTS 1.Improve capacity of communicable diseases monitoring system 2.Strengthen the capacity of treatment and responding to the epidemics and out breaks 3.Improve the behavior change communication and risk communication about the emerging Communicable diseases 4.Improve the preventive medicine capacity through multiplying the district preventive medicine model 5.Coordination, monitoring, evaluation, research and project management

BUDGET: USD ActivityState budgetODATotal Improve capacity of communicable diseases monitoring system 14,283,250 74,146,600 88,429,850 Strengthen the capacity of treatment and responding to the epidemics and out breaks 13,850,000 7,600,000 21,450,000 Improve the behavior change communication and risk communication about the emerging Communicable diseases 2,985,000 5,970,000 Improve the preventive medicine capacity through multiplying the district preventive medicine model 24,000,000 48,000,000 Coordination, monitoring, evaluation, research and project management 12,250,000 7,550,000 19,800,000 Total 67,368, ,281, ,649,850

1.Increase the number of enrollment of doctors for the preventive medicine. 2.Improve the capacity for the training places. Build up the system of advanced, modern, diversifying training facilities and training programe for country and global level; 3.Strengthen the policy to attract staff and improve the professional capacity in the preventive medicine 2.SUPPORT FOR THE HUMAN RESOURCE FOR PREVENTIVE MEDICNINE

2.BUDGET: (TOTAL MIL VND= 42 MIL USD) YearTraining categoryTargetKP 2012KP 2013KP 2014KP year preventive medicine doctors 45422,700 4 year preventive medicine doctors 97048,500 Bachelor of Public Health 38619, year preventive medicine doctors 49924,970 4 year preventive medicine doctors 80940,434 Bachelor of Public Health 38619, year preventive medicine doctors 54927,467 4 year preventive medicine doctors 65132,546 Bachelor of Public Health 38619, year preventive medicine doctors 54927,467 4 year preventive medicine doctors 63331,663 Bachelor of Public Health 38619,320 Total 90,520175,244254,577333,027

3.SUPPORT FOR THE FIELD EPIDEMIOLOGY TRAINING PROGRAME FOR THE PREVENTIVE MEDICINE STAFF  Short terms: (3 weeks and 3 months) in order to meet the needs of urgent training needs on investigating and responding to the epidemics for the staff at district and provincial level.  Long terms: (2 years) International standards, Field epidemiology Master; First specialization on Field epidemiology.  By 2015, 2900 graduates from short term training, 50 from long terms

BUDGET: USD Activities/year Details Total Short term training 1,320,200 1,220,200 4,980,800 Long term training 654,500 2,618,000 Management 53, ,000 Total 2,027,700 1,927,700 7,810,800

THANK YOU VERY MUCH FOR YOUR ATTENTION