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Thufc trang va khuynh htfdng su" dung ngudn nifdc an udng/sinh hoat va nha tidu hd gia dinh tai CHILILAB, huyen Chi Linh,
Hai Duftfng, 2004-2010
Le Thi Thanh Hiftmg (•), Tran Khanh Long (*), Tran Thi Tuyet Hanh (*)
H4 thdng gidm sdt Ddn sd- Dich te hoc tqi huyen thi xd Chi Linh, goi tat Id CHILILAB, duoc Trudng Dqi hoc ¥ te Cong cgng xdy dung tU ndm 2003 vd dd tie'n hdnh dieu tra qua 4 vong cO bdn vdo cdc ndm 2004, 2006, 2008 vd 2010. Bai bdo ndy phdn tich cdc so lieu vi sii dung cdc nguon nudc vd cdc loqi nhd tieu hq gia dinh (HGD) tqi he thong CHILILAB detim hiiu thuc trang vd khuynh hudng sut dung cdc nguon nUdc vd nhd tieu cda cdc HGD tqi dia bdn. Ket qud nghiin ciht cho thdy cdc nguon nudc chinh md ngUdi ddn tqi CHILILAB sU dung cho dn udng vd sinh hoqt la nudc mdy, nUdc gieng khoan, nudc gieng khoi vd nudc mUa. Cdc loqi nhd tieu phd bie'n duoc sd dung d CHILILAB Id nhd tieu tu hoqi/ bdn tU hoqi/ tfidm doi nUdc, nhd tieu hai ngdn vd nhd tiiu mqt ngdn. Mot sd rdt it h^
gia dinh sH dung hdxi cdu hoac khong co nhd tieu. Ti le cdc HGD sd dung nUdc mdy tdng gdn gdp 3 ldn (tU 12.9% lin 36,2%) trong giai doqn tit 2004 di'n 2010; trong khi tl le cdc HGD s^dung nhd tieu tu hoqi/ bdn tU hoqi/ thdm d^i nUdc cung tdng gan gap 2 ldn d giai doqn 2010 (60,2%) so vdi giai doqn ndm 2004 (33,1%). Cdc HGD gidu vd khd d CHILILAB co khuynh hudng chiem ttu the trong nhiing HGD sti dung cdc nguon nudc duqc coi Id ddm bdo han cUng nhu sd hSu vd sd dung cdc loqi nhd tieu duqc coi Id hop ve sinh han. Nhiing HGD d thdnh thi cung co ti li tii'p can vdi nguSn nudc mdy vd nUdc gieng khoan, nhd tiiu tu hoqi/ bdn tyt hoqi/ tfidm dqi nUdc cao han. Tuy nhiin, bg so liiu CHILILAB khong thu thdp sdlieu ve thUc trqng xdy ditng, sddung, bdo qudn nguSn nudc cUng nhu nhd tieu nin bdi bdo khdng phdn tich dugc thuc trqng ve sinh ve nguon nUdc cdng nhu nha tiiu ma cdc HGD dang sddung.
Tvl khoa: nudc dn udng. nudc sinh hoqt, nhd tieu, CHILILAB.
Status and trend on household use of drinking water and latrines in CHILILAB, Chi Linh
District, Hai Duong province, 2004-2010
Le Thi Thanh Huong (*), Tran Khanh Long (*), Tran Thi Tuyet Hanh (») The Demographic - Epidemiology Surveillance System in Chi Linh District (CHILILAB) was established in 2003 by the Hanoi School of Public Health. CHILILAB conducted its first baseline survey in 2004 and a similar survey was repeated every two years (2006. 2008, and 2010). This article analyses data on water sources and types of latrines used by households in Chi Linh District to understand the situation and the trend on household use of water sources and types of latrines. The results show that there are four types of main drinking water sources used by the households there.
Tap chi Y t&' Cdng cong, 4.2012, Sd 24 (24) 19
I TfiNG QUftNK NGHIEN ctiu I
namely tap water, drilled well-water, deep well-water and rain-water. The main types of latrines commonly used by households in CHILILAB are septic tank/semi-septic tank/pour flush. tH-o- compartment, and single-vault. There is a small number of households using bucket latrine or without latrine. The proportion of households having access to tap water increased by approximately 3 times between 2004 and 2010 (12.9% to 36.2%, respectively). Similarly, the proportion of households having septic tank/semi-septic tank/pour flush latrines also increased statistically from 33.1% in 2004 to 60.2% in 2010. There is a statistical correlation between the social-economic status of households and the residence of households (urban, rural) with the drinking water sources used and access to improved latrines. Households with better economic status and living in urban areas have belter drinking water sources (tap water) and latrines (septic lank/semi-septic lank/pour flush).
However, data on the use, storage of water and the toilet was not collected and therefore analysis of the hygienic situation of households' water source and latrines is not available in this article.
Key words: drinking water, latrine. CHILILAB
(•) - Ths. Le Thi Thanh Hirdng. Ph(5 tnrdng BO mSn SiJc kh6e mdi tnlflng, Trrfflng Dai hpc Y tf C6ng cgng, 138 Gi^ng Vo, Hi N$i. Email: [email protected]
- Ths. TrSn Thi Tuye't H^nh, Bp m6u Site kh6e moi trtfclng, Tnrdng Dgi bpc Y le C6ng cpng, 138 Giing Vo, Hi N$i. Email: [email protected]
- CN. Trio Khinh Long. BO mfin Sd'c kh6e moi tnTdng, Tnrang D^i hpc Y te Cflng cOng.
138 Giing Vfl, m N$i. Email: [email protected],vn
1. D$t v&n dl
H§ thdng Gi5m s5t Dan s d - Dich te hoc tai thi xa Chi Linh (CHILILAB) do Trtfdng Dai hoc Y td Cdng cdng xay diTng t£rdau nam 2003 vk b i t dau Ibtfc hien vdng thu Ihgip sd lieu cd ban dau tifin tai 7 xa/thi tran vao thing 7 nam 2004 (CHILILAB la thanh vien cda Mang Itfdi cfic cd sd thtfc dia qudc td INDEPTH).
Dan sddtf(?c bao phu trong h? thd'ng gdm hdn 61.000 dan Ctf trd irong 16.923 HGD (nam 2004) va tdi nam 2010. s d d i n ctf trd va s d H G D da tSng len khi dang kd, lln Itfdt la hdn 69,000 ngtfdi va 19.371 HGD.
Sau mdi 2 nam, he ihdng iai tien hanh tiiu thap cdc s d U ^ u cd ban gdm: dieu tra thdng tin ve nhan khau hpc, thtfc trang nha d, lai san lau ben cua hd gia dinh, s^ dung ngudn ntfdc Sn udng vk nha tifiu v.v. Bai Mo nky sd dung sd li?u nen ctia 4 vdng dieu tra ci3a CHILILAB trong khoang thdi gian lit nam 2004 den nam 2010 vdi c i c muc d e u :
- Md ta thtfc trang va khuynh htfdng svt dung ngudn ntfdc Sn udng va sinh boat cua c i c HGD tai cdng ddng dSn ctf Chi Linh giai doan 2004 - 2010;
- Md ta thtfc irang va khuynh htfdng sij-dung nha tieu cua c i c HGD tai cpng ddng dan ctf Chi Linh giai doan 2004 - 2010;
- M d t i mpt s d ydu t d lifin quan tdi thtfc trang su" dung ngudn ntfdc an ud'ng, sinh boat va nha tieu ciia c i c H G D tai cdng d d n g dan ctf Chi Linh giai doan 2 0 0 4 - 2 0 1 0 .
2. PhUcfng p h a p nghi@n citu
sa dung sd lieu thtf cS'p dtfdc trich xual tCf ket qua cua 4 vdng d i e u tra cd b a n cOa CHILILAB trong c i c n a m 2004, 2006, 2008 va 2010 dd phSn tich kfi't q u i nghifin ctfu. D a y l i hfi thdng ihu th^p s d li^u doc t h e o thdi gian, thu t h i p sd hfiu 2 n a m / l l n . C i c sd lieu dtfdc sd dung dd phSn tich trong b i i b i o n i y g d m :
- C i c thdng tin chung v e HGD: tinh trang kinh t d h p gia dinh, dia b a n ctf tni (ndng thdn, thanh thi);
- C i c thdng tin vd thtfc trang stf dung c i c ngudn ntfdc k h i c nhau cua c a c H G D ;
- C i c thdng tin vd thtfc tr^ng stf dung c i c Ioai nha tifiu cua c i c H G D .
Tinh trang kinh te cua cac HGD tai CHILILAB dtfdc tinh l o i o dgfa iren c i c v^t dung lau bdn, didu kipn n h i d, dieu kien sinh boat ciia c i c HGD. Cac ydu i d n a y dtfdc tfdc Itfdng dtfa trfin phtfdng phip p h a n tich n h a n td (Factor Analysis) trong 66 c i c
Tap chf Y te Cong cdng, 4.2012, So 24 (24)
I TfiNG QIIAN & NGHIEN Dtillj
nhan tdquyel dinh ddphan loai mtfc sdng HGD dtfdc xac dinh thdng qua ky thuai PCA (Principle Component Analysis). Sau khi linh toin va tfdc Itfdng dtfdc cac nhan td, chi sd mtfc sdng ciia HGD dtfdc tinh toan va chu£n hda theo cic sd' lieu dtfdc Ihu ibgp. Chi sd mtfc sdng dtfdc phin theo quintile (5 nhdm cln bing, 20% trong mdt nhdm) nham muc tieu phan chia mtfc sd'ng thanh 5 mtfc do: nghfio, can ngheo, trung binh, kha vi giau. Bai bao stf dung cac phSn tfch thdng ke md ta va phSn tich gdm kidm dinh khi binh phtfdng (Chi square), kiem dinh Post-hoc.
Hqn che cua so Uiu:
Bp so'lieu khi dd so vdi cd mau ldn, icha phong phtf vd cic thdng tin khac nhau va lien luc iheo 4 vdng dieu tra ttf nim 2004 den 2010, tuy nhifin CHILILAB khdng thu tbSp thdng tin vd thtfc trang ve sinh trong xay dtfng, stf dung va bao quan cic loai ngudn ntfdc va nhi tifiu. Do vay chtfa danh gii dtfdc tinh trang vfi sinh ciia cac loai hinh ngudn ntfdc in ud'ng, sinh hoat va nha lieu cua cic HGD tai CHILILAB.
3. Kdt qua
S.l.Thdng tin chung ve cQng dong ddn cti tqi CHILILAB
Trong giai doan ttf nam 2004 ddn 2010, sd din ctf trd trong didn nghien ctfu ciia CHILILAB dao ddng ter xS'p xi 61.000 ngtfdi ddn 69.000 ngtfdi, nhin chung sddin ctf trd tang din theo nam. Sfi'HGD tai CHILILAB cung tang dan, ttf 16.923 hd nam 2004 tdi 19.371 hd nim 2010, Phan bdgidi tinh cua ngtfdi dan trong cpng ddng khi ddu, ti lfi nam - ntf xS'p xi 1:1. Din tdc chifi'm da sd la dan tdc Kinh (99.6%), cdn Iai la cic dSn tpc khic nhtf San Dm, Tay. Hoa...
99,8% ngtfdi din khdng theo tdn giio nao, sd con lai theo dao Thien chua giio.
Ngbe nghipp cua ngtfdi dan tai CHILILAB dtfdc linh toin dtfa tren nhdm ngtfdi cd dp tudi ttf 15 de'n 60, trong dd khoang hdn 1/5 dkn sd'lam nghd ndng, tuy nhifin ddng chu ^ la ti lp lam nong giam dan ddu theo nam, vdi t! Id lam rupng giam ttf 26,2% nam 2004 xud'ng 22,7% nim 2010. Ti Ifi ngtfdi din trong nhdm tudi nay la can bd, vifin chtfc nha ntfdc cung ting nhe trong khoang tbdi gian 2004 - 2010, vdi 7,2% nim 2004 vk 9,8% nim 2010. Ty lfi cdng nhan cung ling khi ddu dan trong khoang 2004 - 2010, vdi ti Ip 8.5% nim 2004 va 13,5% nim 2010. Ti lfi ngtfdi dan tham gia cic cdng vipc budn ban hdi tSng
nhe theo ttfng nim, vdi 13,4% nam 2004 va 17,7%
nam 2010. Sd' HGD sd'ng tai kbu vtfc thanh thi vi ndng thfin khdng chfinh Ifich nhau nhieu. Ti le HGD sdng tai thanh thi chiem khoang gan 54% trong ca 4 ddt dieu tra.
3.2. Thtfc trg.ng vd khuynh hiidng stC d^ng ngudn nildc dn uShg vd sinh hoqt cua cdc HOB Cic ngudn ntfdc chinb ma cic HGD 6 CHILILAB stf dung cho muc dich an udng vk sinh hoat gdm ntfdc miy, ntfdc gifi'ng khoan, ntfdc gifi'ng khdi, ntfdc mtfa. Ngoai ra, cdn mpt ti lp rat nbd cic HGD van phai stf dung ntfdc hd ao, ntfdc sdng sufi'i cho muc dich an udng va sinh boat.
Bieu do 1. Thtic trqng vd khuynh hudng sddung nguon niidc dn uo'ng va sinh hoqt cua cdc HGD tqi CHILILAB, 2004 - 2010.
Bieu dd 1 the hien tinh trang va khuynh htfdng sii dung 4 ngudn ntfdc in ud'ng vi sinh boat cua cic HGD tai dia ban CHILILAB irong 4 ddi didu tia cd ban ttf 2004 de'n 2010. Ke't qua d Bidu dd 1 cho tbay trong nam 2004, cd tdi gan mpt ntfa sd HGD d CHILILAB (48,5%) stf dung ntfdc gieng khdi li ngudn ntfdc chmh cho muc dich in ud'ng va sinh hoat cua gia dinh. Ti lfi stf dung ntfdc gieng khoan va ntfdc may la ngudn ntfdc chinh cho muc dich nay tiiap hdn, lln Itfdt la 34,1% va 12,9%. Tuy nhifin, sau 4 ddt didu tra, d le cac HGD stf dung ntfdc miy lim ngudn ntfdc chinb cbo muc dich an udng va sinh hoat da tang mot each ding kd, gin ga^p 3 lan (12,9% nam 2004, tang Ifin 36,2% nam 2010) (x'=3578,81; p<0,0001). Song song vdi vipc iang sd HGD stf dung ntfdc may, d le HGD su" dung ngudn ntfdc gifi'ng khdi la ngudn ntfdc chinh cho an udng va sinh hoat cung giam di mdt cich ding kd va cd ^ nghTa thdng kfi, ttf 48,5% nam 2004 xudng 21,7% nim 2010 (x'=3519,06;p<a,0001).
Ngoai 4 ngudn ntfdc chinh nfiu trfin, cac HGD tai CHILILAB cdn stf dung mpt so'ngudn ntfdc khac cho Tap chi Y tfi' Cdng cong, 4.2012, Sd 24 (24) 21
I TfiNG QUftN& NGHIEN DUN I
an ud'ng va sinh hoat nbtf ntfdc bd ao (vdi ti le rat nhd la 0,1% nam 2004 va 0,6% nam 2010), ntfdc sdng sudi (0,7% nam 2004,0,8% nam 2006 va 0,7% nam 2008 va den 2010 khdng cd HGD nao tai CM Linh sii dung ngudn ntfdc nay cho in udng va sinh boat).
3.3.Thtic trqng vd khuynh hit&ng svt dung nha tiiu cua cgng dong ddn cti CHILILAB Trong sd cic loai nhi tieu dtfdc stf diing, nha tieu ttf hoai/ban ttf hoai/iham dpi ntfdc va nha ueu hai ngan dtfdc coi la nha tifiu hdp ve sinh neu xay dtfng, stf dung va bao quan ddng cich. Tai cdng ddng dan ctf CHILILAB, cic loai hinh nha tifiu chinb dtfdc cac HGD stf dung gdm 3 loai la nha tifiu ttf boai/ban ttf hoai/ tha'm ddi ntfdc, nha tifiu hai ngan va nha nfiu mpt ngan.
Bieu dd 2 the hifin tbtfc trang va khuynh htfdng stf dung cac loai hinh nha tieu khic nhau cua cdng
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Biiu do 2. ThUc trqng vd khuynh hudng sddung cdc loqi nha tieu cua cdc HGD tqi CHIULAB, 2004-2010.
ddng dan ctf CHILILAB irong 4 giai doan dieu tra Cd bin ttf 2004 den 2010. Ngoii 3 loai hinh nha tieu chinh dtfdc cic HGD stfdung la nhi tieu ttf hoai/bin ttf hoai/tbi'm dpi ntfdc, nhi lieu hai ngin vi nha tieu m$t ngan, Bieu dd 2 cdn the hifin tinh trang khdng cd nha tifiu bang vipc phai di nhd hang xdm ciia cic HGD. Ngoai ra. cic HGD cdn stfdung cic Ioai nha tieu khdng hdp vfi sinh nhtf hdxi cau, hoac ip dung cic bifin phap di lifiu mat vfi sinh nhtf di chung vdi gia sdc, di ra sdng hoic di ra vtfdn, nhtfng vdi ti lp ri'l nho.
Kfi't qua d Bidu dd 2 cho tha'y ti Ie cac HGD su- dung Ioai hinh nha lieu hien dai la ttf hoai/ban ttf hoai/ tiiam dpi ntfdc tang rat nhanh qua 4 vdng dieu tra, vdi khoang 1/3 HGD cd loai hinh nha tieu nay nam 2004 nhtfng den 2010, con sdnay da la 60 2%
cic HGD (z==2946.16; p<0,0001). Song song'vdi
xu thd ting cua loai hlnh nha tieu nay, nha tieu hai ngan va mpt ngin dtfdc stfdung bdi cic HGD tai Chi Linh cung giam di ding ke. Ti le cic HGD stf dung nha tifiu hai ngin giam mdl each cd J nghia thdng kfi ttf 36,2% d giai doan thu thap sd' heu dau tifin xudng 17,8% d giai doan 2010 (x'=538,75;
p<0,0001). Ti Ip HGD stf dung nha tieu mdl ngin ciing giam cd y nghia thdng kfi ttf 25,6% d dau giai doan thu tb^p sd lieu (2004) xudng cdn 16,1 % vao ddt tbu thap sdlipu lan 4 (nam 2010) (x'=1712,66;
p<0,0001), Tuy nhien, ti le di nhd nha tifiu ciia cic HGD cd xu htfdng lang mdt each cd j! nghia thdng kfi trong giai doan 2004 - 2006 (ttf 3,3% den 5,9%) vdi x'=143,67; p<0,0001. Ttf nam 2008 dfi'n 2010, ti lp niy giam nhe xudng, lln Itfdt la 5,4% vi 5,3%
nhtfng Ichdng cd J? nghia Ihd'ng ke (p>0,05).
3.4. Mo td mgt sdyeu tdlien quan t&i yi$c si dqng ngudn niidc dn uo'ng, sinh hoqt vd nhd tieu hg gia dinh
Mdt sdyeu tdcd ban ve HGD dtfdc stf dung de phan tich mdi lien quan gifla vific stf dung ngudn ntfdc an uo'ng, sinh hoai vi stf dung nhi tifiu cua ngtfdi dan d Chi Linh nbtf tinh trang kinh td HGD (ngheo, c|n ngheo, trung binh, khi, giiu) vi dia ban ctf trd cua gia dinh (ndng tiidn, thanh thi). Mpt sdyfi'u td'ci nhan nhtf mdi, gidi, dSn tpc, tinh trsing hdn nh3n... khdng dtfdc stf dung de phan tich vi ngudn ntfdc vi nha vp sinh li ngudn stf dung chung cda ca gia dinh.
3.4.1. Mgt sdyeu td lien quan tdi viic sH dung ngudn nudc dn udng. sinh hoqt cua cdc HGD tqi dia bdn CHILILAB
3.4.1.1. Mdi liin quan giQa viec sd dying ngudn nudc Sn udng, sinh hoqt cua cdc HGD tqi dia bdn CHILILAB vd tinh trang kinh ti'cua cdc HGD
Bieu dd 3 thd hipn stf phin bd' vific stf dung cic ngudn ntfdc khic nhau ciia cac HGD tai CHILILAB theo 5 mtfc phan loai vd tinh trang kinh tdHGD. Ket qua Bieu dd 3 cho tha'y irong ca 4 ddt dieu tra, cd stf khac bipt ro rang ve ngudn ntfdc stf dung vdi tinh trang kinh tdHGD. Ngudn ntfdc may dtfdc cic HGD cd mtfc kinh te khi va giau stf dung nhieu nhat; trong khi dd, cic HGD cSn ngheo vi ngheo lai stf dung nguon ntfdc gieng khdi vi ntfdc mtfa cao hdn ca (p<0,0001). Cu the, trong nam 2004, trong sdcic HGD stf dyng ngudn ntfdc miy, cd tdi 41,9% Ik cic hp giau va 24,7% Ii cac hd khi. Trong khi dd, cd tdi 29,4% cic hd ngheo va 25.9% cic hd can ngheo siy 22 Tap chi Y te Cong cdng, 4,2012, S6' 24 (24)
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Bieu do 3. Phdn bdsvt dtfng cdc ngudn niidc cua cdc HGD tqi CHILILAB theo tinh trqng kinh t^, 2004-2010.
dung ngudn ntfdc gieng khdi (x^=350I,79; p<0,0001).
Cac md hinh ttfdng ttf ciing dtfdc ghi nhan irong cac nam 2006, 2008 va 2010. Trong nam 2010, trong tdng sdcic HGD stf dung ntfdc may, cd tdi 44,7% l i cic hd giiu va 20,1% la cic hd khi; trong kbi do, ngudn ntfdc gifi'ng khdi cd 46,4% hd ngheo vi 31,8%
bp c|n ngheo stfdung (x'=6984,81; p<0,0001).
3.4.1.2. Mdi lien quan giUa viec sU dung nguon nudc dn udng vd sinh hoqt vd dia bdn cu trii cda cdc HGD iai CHILILAB
Bidu dd 4 Ihd hifin stf phin bd stf dung cic ngudn ntfdc cua HGD tai CHILILAB tbeo dia bin ctf trd d thinh thi va ndng thdn Irong 4 ddt dieu tra cd bdn, tiif nim 2004 de'n 2010. Ket qua til Bieu do 4 cho thi'y trong ca 4 ddt didu tra ttf nim 2004 den 2010. cac HGD d tbinh lhi cd khuynh htfdng stf dung ntfdc miy va ntfdc gifi'ng khoan cao hdn han so vdi cic HGD d ndng thon, trong khi do, cic HGD d ndng thdn lai cd xu htfdng stf dung ntfdc gidng khdi va ntfdc mtfa cao bdn so vdi cic hp sd'ng d khu vtfc thinh thi. Stf khic biet nay cp •$ nghia thdng kfi vdi p<0,001. Cu the, trong nam 2004, trong sdcic HGD dung ntfdc miy, cd tdi 82,9% la cic hd sd'ng d tbinh thi. Cung trong nam nay, sdho ddng ntfdc gieng khoan cd dia chi d khu vtfc thinh lhi chifi'm ldi 63,5% trong long sd cic hp cd stf dung ntfdc
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Bieu do 4. Phdn bo'sd dung cdc nguon niidc cua HGD tqi CHILILAB theo dja ban cti tru, 2004 - 2010
gieng khoan. Ngtfdc lai, so' HGD d nong thdn chie'm 58,7% tong sdbp stf dung ntfdc gieng khdi va chie'm 79,1% long so' hd stf dung ntfdc mtfa (x'=1860,26; p<0,0001).
Trong nam 2010, md hinh ttfdng Itf cung xay ra, cd 76,3% sd'HGD stf dung ntfdc miy sfi'ng d thinh lhi, 72,2% sd'hd dung ntfdc gidng khdi va 87,7% sd hp dung ntfdc mtfa sd'ng d ndng thon (x^=2957, p<0.0001).
3.4.2. Mot so'yi'u to lien quan tdi viec sd dung cdc loqi nhd tieu cda cdc HGD
3.4.2.1. Mdi lien quan gida viec sddung cdc loqi nim tiiu vd tinh trqng kinh te'cua cdc HGD
Bieu dd 5 md ta phan bd stf dung loai nha tifiu ciia cic HGD tai CHILILAB pban theo 5 nbdm tinh trang kinh le cua HGD. Cung itfdng ttf nhtf vdi ngudn ntfdc, ke't qua Bidu dd 5 cho tbay trong ca 4 giai doan didu tra, nhdm HGD giiu cd ti lfi sd htfli cac loai nhi tifiu ttf hoai/bin ttf hoai/thain ddi ntfdc cao nha't vi stf dung cic loai hinh nhi tifiu khic nhtf hai ngan, mdt ngin, hd' xi clu tha'p nha't. Trong khi do, d le nhdm ngheo va can ngheo stf dung cac loai nha tieu khac nhtfhai ngan, mot ngan, hdxi cau cao hdn ca. Stf khac biel nay cd "j nghia tiidng ke vdi p<0,0001. Cu the. trong nam 2004, cd ldi 54,6% sd ho stf dung nha tieu ttf hoai/ ban ttf hoai/ iham dpi ntfdc la nhdm hfi giiu, 30,4% la nhffng h$ cd kinh te'kha. Ngtfdc lai, trong sd'nh^g gia dinh stfdung nhi tifiu hai ngin, d Ifi nhdm hd ngheo va cin ngheo lln Itfdt la 23,0% va 26,6%. Ddi vdi nhffng gia dinh stf dung nha tifiu mpl ngin (la loai nha tieu khdng hdp vfi sinh), li le nhdm hp ngheo va cin ngheo ttfdng dtfdng nhau (lan Itfdt la 29,0% vi 29,8%).
Dac biel, trong nim 2004, vin cdn mdt sdHGD stf dung hdxi cau - loai nha tieu khdng dam bao vfi sinh. Trong sdcic HGD stfdung hd'xi cau, chu ydu li cic gia dinh ngheo (32,6%), cin ngheo (32.6%), tning binh (18,2%). Stf khic bifit ve loai hinh stf dung nhi tieu vi tinh trang kinh tdcua HGD d Chi Linh trong nam 2004 cd ^ nghia thdng ke, vdi x'=9533,84; p<0,0001.
Trong ddt dieu tra cudi (2010), cac HGD d mtfc kinh td thap hdn (khi, trung binh) cd khuynh htfdng stf
Tap chi Y tfi' Cdng cdng, 4.2012, So 24 (24) 23
I TfNG IBAN& NGHIEN eiru I
Biiu dS 5. Phdn bdsvt dtfng loqi nhd tieu cua cdc HGD tqi CHILILAB theo tinh trqng kinh te, 2004-2010.
dung nhi tifiu ttf hoai/ bin ttf hoai/ tham dpi ntfdc nhieu hdn. Cii thd, trong long sd cic HGD stf dung nba tieu ttf hoai/bin ttf hoai/thi^m dfii ntfdc, sd hd giau chiem 34,9%, sd hd khi chidm 29,8%, tiep do ia cic hd trung binh (24,4%). hp can ngheo (10,0%) vi ngheo (1,0%). Stf khic biet nay cd ^ nghia thdng ke vdi x'=13557.39; p<0,0001. Tuy nhien, d nhffng HGD stf dung c^c Ioai hinh nhi tifiu khic nhtf hai ngan, mpt ngan, hd'xi clu.... d lfi cic HGD ngheo va cin nghfio chidm tfu the'.
3.4.2.2. Mdi quan hi gida viic sti dung cdc loqi nhd tiiu vd dia bdn cU tni cda cdc HGD tqi CHILILAB, 2004-2010
Bieu dd 6 md ta thtfc trang phan bd vific stf dung cic loai nha tieu khic nhau theo dia ban ctf tru ciia HGD (thinh thi. ndng thon). Ke't qua ttf Bidu dd 6 cbo thi'y trong sd'cic HGD stfdung cic loai hinh nhi lifiu ttf hoati/ bin ttf hoai/ thS'm dpi ntfdc, li le cic HGD d tbanh thi chiem tfu Ihe. Trong khi do, vdi cic Ioai hlnh nhi tifiu mdt ngin, hai ngin, cic HGD d ndng thdn Iai cdti lfi stfdung cao hdn hin so vdi cac HGD d thanh thi. Stf khic bifit nay cd y nghia thdng kfi (p<0,0001). Dieu ding ngac nhifin la ddi vdi loai hinh hd xi cau, cic HGD d thanh thi lai cd d le stf
Biiu do 6. Phdn bdsH dqng loqi nhd tieu cua cdc HGD tqi Chililab theo dia bdn cUtru, 2004 - 2010
dung cao hdn ban so vdi cac HGD d nong tiidn (x'=4937,52; p<0,0001).
4. Ban lufin
4.I.Thtfc trqng vd khuynh ktidng sH difng cdc nguon nii&c cua cdc HGD
Trong sd' cic ngudn ntfdc ma ngtfdi dan stf dung cho an udng va sinh hoat, ngudn ntfdc miy dtfdc cho li dam bao vfi sinh hdn ca. Cic ngudn ntfdc gidng khdi, ntfdc gidng khoan va ntfdc mtfa ve mat ban cha't ciing cd thd coi la ntfdc sach. Tuy nhien, finh trang vfi sinh cua cic ngudn ntfdc cdn phu Ihupc ra't ldn vio cich ihtfc xtf 1^, bao quan/ chtfa dtfbg va stf dung ngudn ntfdc ciia ttfng HGD cung nhtf linh trang dtfdng d'ng din ntfdc vi bdm ntfdc (dd'i vdi ntfdc may).
Kdt qua nghien ctfu ttf Bidu dd 1 cho thay d le cac HGD d CHILILAB dtfdc tidp can va stfdung cic ngudn ntfdc dtfdc coi li vfi sinh khi cao trong ca 4 ddt dieu tra, Ti lfi tidp can va stf dung ntfdc may tang khi rd rpt mdt cich cd ^ nghia thdng kfi theo ttfng ddt dieu tra, lan Itfdt trong cic nim 2004,2006,2008 va 2010 la 12,9%, 17,0%, 30,7% va 36,2%, chtfng td ti lp ngtfdi din d CHILILAB dtfdc liep can vdi ngudn ntfdc sach ngay mpt ting. So sinb vdi kfi't qua stf dung ntfdc miy trong loan qud'c, trong nam 2004, d Ifi HGD 6 CHILILAB stf dung ntfdc miy tiia'p hdn so vdi d le loan qudc nim 2004 (15,3%) vi nam 2006 (20,6%), my nhifin, ttf nam 2008, ti 16 HGD CHILILAB stf dung ntfdc miy cao hdn ban (d lfi loan qudc irong nim 2008 li 23,3%). Neu so sanh vdi d le chung cua vung ddng bang sdng Hong, ti le HGD d CHILILAB stf dung ntfdc may trong nam 2004 va nim 2006 cQng tha'p hdn ti le chung cua ca viing (17,5% va 22,1%), nhiOig lai cao hdn nhidu so vdi d le chung ciia vdng d tiidi diem nam 2008 (23,4%). Dieu nay cd the ly giai mpt phan li trong nim 2008 tai huyfin Chi Linh cd mdt sd' nhi miy ca'p ntfdc quy md nhd dtfdc dtfa vao stf dung lai dia ban cic thi u-a'n Sao Dd va Pha Lai, cic xa Vin An va Tan Din. Ti lp cic HGD d CHILILAB stf dung ngudn ntfdc gieng khoan cijng cao hdn so vdi kdt qua chung cua 24 Tap chi Y t^ Cdng cpng, 4.2012, Sd 24 (24)
j TfiNG eilM ft CUDI
loan q u d c trong b a o c a o v e Ket qua k b a o s i l mtfc sdng HGD n a m 2008 ciia Tong cue T h d n g k e [3].
Ndu so s i n h v d i d le c a c HGD d ndng ihon Viel N a m v e thtfc trang stfdung c i c Ioai hinh ngudn ntfdc k h i c nhau trong b i o c i o cua Cue Y i d Dtf phdng va Mdi trtfdng (2007), d le H G D d CHILILAB stfdung ntfdc m i y , ntfdc gifi'ng khoan va gifi'ng khdi c a o hdn so vdi li le chung cua c i c HGD d ndng thdn Viet N a m 6 cdng ihdi d i e m n i m 2006 [2].
Tuy nhifin, do bd so'Ueu khdng cd nhiTng thdng tin vd tinh trang b a o q u a n / chtfa dtfng, xtf ly va stf d u n g ttfng ngudn ntfdc cua c i c H G D nen k h d n g the dtfa ra kfi't luan v e ngudn ntfdc ma c i c H G D stfdung cd dtfdc coi la h d p v e sinh hay khdng.
4.2.Thiic trqng vd khuynh hiidng s&dung cdc loqi nhd tieu cua cdc HGD T r o n g sd cac loai hinh n h i tifiu dtfdc c a c H G D stf d u n g , n h i tifiu tif h o a i / b i n ttf hoai/lham dpi ntfdc va nha tifiu hai ngan dtfdc coi la nha tieu bdp v e sinh ndu dtfdc x a y dtfng, stf dung va bao q u a n d d n g c i c h . T a i C H I L I L A B , c i c s d Upu dtfdc thu t h a p mdi chi dtfng d mtfc do md ta c i c loai hinh n h i tifiu ma c i c HGD stf dung n e n khong cd nhtfng p h a n lich ve tinh trang stf dung, b a o quan cac loai n b i tifiu cua cac H G D , d o v$y cung khdng danb g i i dtfdc tinh trang vp sinh c u a c i c loai nha tieu.
Nhin chung, trong tiidi gian ttf 2004 - 2010, ti lfi c i c H G D stf dung c i c loai nha tieu ttf h o a i / b i n ttf hoai/lham dpi ntfdc d CHILILAB t i n g d i n g k e va cd
•§ nghia Ihd'ng kfi (Bidu dd 2). So s i n h vdi ti le chung ctfa loan qudc, ti lfi c i c HGD d CHILILAB stf dung c i c loai hinh n h i tifiu ttf hoai, b i n ttf h o a i va tha'm dpi ntfdc c a o hdn liong cac n i m 2004, 2006, 2008.
Tuy nhien, lai cupc didu tra cua Tong cue T h d n g k e , cac loai n h i tieu ttf hoai va b i n ttf hoai dtfdc xe'p vao mpt nhdm, n b i tifiu t h i m dpi ntfdc Iai dtfdc xe'p vao mpt n h d m khac [3]. D i n g tiec la do khdng p h a n tich dtfdc sd' lipu ve tinh trang vp sinh cua c a c ioai n b i tifiu nfin khdng the so s i n h vdi ket qua dieu ira cua Cue Y te Dtf phdng Vifit Nam (2007), vdi d 16 18%
HGD 6 ndng thon Viet N a m cd n h i tifiu hdp v e sinh [2] va ldi n i m 2010, ti le H G D d ndng thdn Vifit N a m cd n h i lieu hdp vfi sinh l i 5 5 % [1].
4.3. Mgt sdyeu tdlien quan tdi svl dtfng nguon niidc vd nhd tieu cua cdc HGD Kfi't qua p h a n ticb bd so' lipu d C H I L I L A B cho thay cd md'i lien quan cd y nghta thdng kfi gitfa tinh t r a n g k i n h t e v a d i a b i n c t f trd ciia H G D vdi v i e c stf dung ngudn ntfdc va nha tifiu, Nhffng HGD cd mtfc kinh tfi' k h i hdn cd kha n i n g tifi'p can c a o hdn vdi c i c ngudn ntfdc dtfdc coi l i sach hdn c u n g nbtf nhtfng kieu nha lieu sach hdn. Ttfdng Itf, nhiTng HGD sdng d khu vtfc t h i n h thi cung cd ti lfi sd biTu nhffng ngudn ntfdc sach hdn v i nhtfng kidu nha tieu sach hdn so vdi nhffng HGD sd'ng d vung nong thdn.
5 . K h u y d ' n n g h j
M i c du b p sd h e u dieu tra ciia CHILILAB k h i dd sp v i chtfa nhieu thong tin phong phu, song c i c thdng tin v e dieu kifin ntfdc sach va finh trang nha v% sinb cbi mdi chd trpng tdi tfin c i c Ioai ngudn ntfdc cung nhtf tfin c i c loai n h i tieu ma ngtfdi d a n su^ dung, chtfa cd c i c s d lieu quan sat ve thtfc 16' stf dung, bao q u a n cac loai ngudn ntfdc va n h a tifiu n i y . De cd the cd nhtfng p h i n tich sau hdn v i dtfa ra dtfdc nhiJng kfi't l u i n cu thd hdn vd tinh trang ve sinh ciia ngudn ntfdc va n h i lieu cua cac H G D d CHILILAB, n h d m lac gia d e xua't C H I L I L A B c l n cd mpt nghien ctfu cu the, chuyfin sau v e linh vtfc ntfdc sach v i nha tifiu HGD va nhffng a n h htfdng tdi stfc khde ngtfdi dan d e cd nhffng dinh htfdng n g h i e n ctfu va can thiep kip thdi.
Lefi c a m d n
Chung toi xin chan thanh c a m dn Chinh quydn va nhan dan tbi xa Chi Linh, Van phong tbtfc dia CHILILAB ciing dpi ngu dieu ira vien, g i a m s i l vifin, n h i p lifiu vien da tham gia. thu thap. cung c a p sd'lifiu va hd trd chiing tdi thtfc hifin nghifin ctftf n a y .
T i i li$u tham khao
1. Cyc Quae IJ Moi tnlflDg Y te (2010). Bio cao tfatfc hi?n
"Chtfdng trinh Muc tieu QuSc gia v^ Ntfdc sach - Ve sinh moi tnrdng nflng thfln giai do^o 2006-2010.
2. Cue Y te Dtf phong Viet Nam (2007). T6m tat dilu tra thUc traog v^ sinh moi tntclDg v^ v^ siuh ci nhan & nflng thon Vi§t Nam.
3. T^ug cue Tho'ng kfl (2009). K^t qua khio sii mtfc sdng hp gia dinh nam 2008, Nha xuat bau Th^ng k£, 2009.
T a p chl Y t§' C d n g cdng, 4.2012, Sd 24 (24) 25
