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

2. 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

3. SITUATION OF COMMUNICABLE DISEASES

4. Nguồn: Niêm giám thống kê bệnh truyền nhiễm SITUATION OF SOME COMMUNICABLE DISEASES, 2006 - 2011

5. Influenza A H5N1(2003- 4/2012) Year200 3 200420052006200720082009201020114/201 2 Tota l Cases329610865702121 Death s 32019055520261

6. HEMORRHAGE

7. Malaria

8. Meningitis

9. TẢ

10. TETANUS

11. 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)

12. 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

13. HUMAN RESOURCE FOR PREVENTIVE MEDICINE AREA

14. HUMAN RESOURCE FOR PREVENTIVE MEDICINE AREA (2011) NoHealth staff categoryCentral Provincia l DistrictTotal 1 Doctor (of all categories) 88417158283427 2 University – trained Pharmacist KBC63KBC63 3 Bachelor of Public health 198391589 4 College medical staff 187148335 5 Secondary medical staff 109221555487872 6 Other categories 150740890 Total 1.1934.7177.26413.172 KCB: Ko có báo cáo

15. DISTRIBUTION OF HUMAN RESOURCE BY EDUCATION LEVEL

16. 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 4.71768.1 1 Doctors 86736019547178681.71524.8 2 University trained pharmacist 4769010630.9 3 Bachelor of Public health 110652131119453915.6 4 College medical staff 632061659231872.7 5 Secondary medical staff 1.22250611260225862.21131.9 6 Other categories 9642121502.2 II Other specialities 2.21231.9 1 Other universities 6081993923235301.29618.7 2 Other colleges 662963422121962.8 3 Other secondaties school 1608260823223555.1 4 Other staffs 21877563653655.3 Total 3.4551.3869252016682916.926100 SITUATION OF HUMAN RESOURCE AT PROVINCIAL LEVEL IN 2011

18. SITUATION OF HUMAN RESOURCE AT DISTRICT LEVEL IN 2011

19. HUMAN RESOURCE NEEDS OF UNIVERSITY TRAINED STAFF BY 2020 Specialities Rate /10.000 pop 201220132014201520162017201820192020 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

20. COMPARISON BETWEEN THE NEEDS AND CAPACITY OF TRAINING

21. INFRASTRUCTURE AND EQUIPMENT

22. 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 - 2009

23. 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 14-20 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 - 2009

24. 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 - 2009

25. 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 2007-2010 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)

26. ORGANIZATION SYSTEM

27. 63 TTYTDP tỉnh / thành phố 63 Chi cục ATVSTP 63 Trung tâm Phòng chống HIV/AIDS 712 TTYT quận/huyện 11.112 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

28. 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.

29. PRIORITIES TO PROPOSE 1.SRENGTHEN CAPACITY FOR PREVENTIVE MEDICINE IN EMERGING COMMUNICABLE DISEASE PREVENTION: 183.649.850 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: 7.810.800 USD TOTAL: 233.460.650 USD

30. 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…)

31. 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

32. BUDGET: 183.649.850 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 67,368,250 116,281,600 183,649,850

33. 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

34. 2.BUDGET: (TOTAL 853.368 MIL VND= 42 MIL USD) YearTraining categoryTargetKP 2012KP 2013KP 2014KP 2015 20126 year preventive medicine doctors 45422,700 4 year preventive medicine doctors 97048,500 Bachelor of Public Health 38619,320 20136 year preventive medicine doctors 49924,970 4 year preventive medicine doctors 80940,434 Bachelor of Public Health 38619,320 20146 year preventive medicine doctors 54927,467 4 year preventive medicine doctors 65132,546 Bachelor of Public Health 38619,320 20156 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

35. 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

36. BUDGET: 7.810.800 USD Activities/year Details Total 2012201320142015 Short term training 1,320,200 1,220,200 4,980,800 Long term training 654,500 2,618,000 Management 53,000 212,000 Total 2,027,700 1,927,700 7,810,800

37. THANK YOU VERY MUCH FOR YOUR ATTENTION