Y HQC VIET NAM THANG 7 • SO 1/2013
TiNH HINH TRAO DOI THONG TIN VA CO CHE DIEU PHOI VIEN TRO NUOC NGOAI CHO UNH VOC Y TE TAI 3 TJNH BAC GIANG, BAC NINH VA HA NAM
TOM
TATThUc trang cong tac dieu phoi vi|n trd nUdc ngoai cho linh vUc y te d tuyen tinh hien nay con nhiiu bat cap. Viec thiet lap mot cd che dieu phw vien trd giij^ tuyen trung Udng va tuyen tinh la rat can thiet de sU dung hieu qua nguon von vien trd cho nganh y te.
Nghien cihj dui^c tien hanh nham muc tigu: (i) Mo ta thUc trang tinh hinh dieu phoi vien trd y te tai 3 tinh Bac Giang, B^c Ninh va Ha Nam va (ii) Xac djnh cd che dieu phoi vien trd phu hdp de thUc hien vien trd y te cd hieu qua hdn giCi^ tuyen tinh va tuyen trung Udng vdi thiet ke mo ta cat ngang ket hdp 2 phUdng phap dinh tinh va djnh lUdng va chgn mlu theo phUdng phap chuyen gia bang cong cu dieu tra la bp cau hoi phong van ban cSu true. S6 liSu nghien ciTu dinh lUdng dUdc lam sach bang chuttng trinh Microsoft Excel, phan tich tren phan mem STATA 10.0. So lieu dinh tinh dUdc tong hdp thanh cac bang ma tran va sd do ket qua. Ket qua: MUc dp trao doi va chia se thong tin chuS thudng xuyen va chii yeu bang van ban, cac kenh trao doi thong tin nhanh nhU dien thoai va thU dien tU con han che. Cac cd quan, to chUc vien trd tai dia phUdng da phan chi thuc hien lap ke hoach dpc lap, diua CO ccf quan diuyen ve dieu phoi dU an/ vi?n tn?.
Da so mong muon thanh lap cd che dieu phcS vien trd phii hcfp va kha thi tai tuyen b'nh cilng quy djnh ro rang chUc nang nhiem vu ciia cac ben lien quan tham gia,
SUMMARY
AID COORDINATION MECHANISM IN THE HEALTH SECTOR AT 3 PROVINCES: BAC GIANG,
BAC NINH AND HA NAM Aid coordination mechanism in the health sector is not yet available at provincial level. The establishment of a mechanism for aid coordination is therefore essential to effectively use of external assistance in health sector. The survey was conducted with following objectives: (i) To investigate the situation of aid coordination at three provinces, namely Bac Giang, Bac Ninh and Ha Nam and (ii) To identify an appropriate coordination mechanism in order to implement foreign aid more effectively between the provincial and central levels using cross-sectional descriptive design combined with qualitative and quantitative methods and sampling methods by experts applied with the survey instruments that are semi-structured interview questionnaires. The
Nguyen VSn Huy*, Tran Thj Gidng Hu'dng**
quantitative research data was cleaned by Microsoft Excel program, analysed on STATA 10.0. Qualitative data was Integrated into the matrix and result chart.
Results: The level of information exchange and sharing is not frequent and mostly by written documents, other faster communication channels such as telephone and e-mail remain limited. Most INGOs in local areas only make independent planning. There has not been any speafic coondination organization/agency. An appropriate and feasible aid coordination mechanism at provincial level and dear definition of functions and responsibilities of the stakeholders involved are desired by majority of provinces.
I. O A T V A N €>E
Trong nh&ng nam qua, cong tac dieu phoi vien trtf nUcfc ngoai cho nganh y te da dUdc day manh. Bp Y te da thanh lap Dien dan "Nhom doi tac y t e " vdi sU ho trcf ciia To chiTc Y te The gl6i (WHO) nham tang cUdng hieu qua vien t r d cho nganh y te thong qua doi thoai chinh sach va dieu phoi giu'a Bo Y te va cac doi tac phat trien.
6 cap do trung Udng, hoat dpng dieu phoi hieu qua vien trd da dddc thdc hien lien tuc. Tuy nhien, d cap tinh hoat dong nay con nhieu bat cap. Qe cai thien van de tren, Vu HTQT va Nhom doi tac y te tien hanh mot nghien ciTu nham khao sat, thiet ke va thiT nghiem cd che dieu phoi vien t r d tai tuyen tinh va cai thien trao doi thong tin vien trd giUa cac tuyen va cac doi tac phat trien tai 3 tinh Bac Giang, Bac Ninh va Ha Nam, tiT do CO the md rong va ap dung tai 15 tinh khac ciia d u an. Vdi muc dich tim hieu cd che dieu phoi vien t r d y te thong qua do xac dinh nhu cau nang cao nang lUc ciia nganh y te ve hoat dong dieu phoi vien trd y te ciia nUdc ngoai tai tuyen tinh, nghien ciTu co cac muc tieu sau; (i) Tim hieu tinh hinh dieu phoi vien t r d y te tuyen tinh tai 3 tinh Bac Giang, Bac Ninh va Ha Nam; va (ii) Xac djnh cd che dieu phoi vien t r d kha thi phii hdp de tliuc hien vien trd y te co hieu qua hdn giu^ tuyen tinh va tuyen trung Udng vdi sU ho trd ciia BYT/Vu HTQT/Nhom Doi tac Y te. "
* Dai h<?c y Ha Ndi; '* Bd y ti Phan bien khoa hoc: GS.TS. Dao Van Diing
Y HQC VI|T NAM THANG 7 . SO 1/2013
II. Odl TUpNG VA PHUONG PHAP NGHIEN COU
2.1. Thiet keva phu'dng phSparSu tra , . . , , . . , „ ,uini, n Su- dung thiet ke mo ta cSt ngang, ket h(?p 2 phi/dng phap djnh tinh va dmh li/Ong (Hinn 1]
Giai do^n 1:
Phong vSn b^n cau true (dinh lu'Ong+
dinh tinhl
Giai doan 2;
Hpi tho^i mcf (djnh tinh - c3u hoi
thdm do)
Moi tinh phong van 9-10 dai dien sd nganh: UBND, SYT, Sd KHOT, Sd TC, 1 so ddn vi y te: BV, TTYT, TT PC HIV...)va mpt so NGO
Hoi thao trinh bay ket qua khao sat va trao doi y kien vdi cac dai dien nganh, ddn vj lien quan vdi cac thanh Dhan nhu tren ^ ^ ^ _ ^ _
q/ N
isd / Phong
van daidien lanh
daoVu«TQT-
BYT
Hinh 1. Sd do thiet ke dieu tra
2.2. Dia diem dieu tra
Nghien cu^ dUdc tien hanh tai 3 tinh ciia Viet Nam: Bac Giang, Bac Ninh va Ha Nam.
2.3. Mau nghien cu'u va chon mau Chpn mau theo phUdng phap chuyen gia, tai moi tinh nhom nghien ciTu co lien he va phong van cac dai dien lanh dao ban, nganh lien quan tai dja phUdng bao gom UBND, Sd Y te, Sd KHDT, Sd Tai chinh, Benh vien tinh, Trung tam y te huyen, ... Ngoai ra, nghien ciTu con phong van dai diin lanh dao Vu HTQT (BYT) va mpt so INGOs hoat dpng tai dja phUdng nhU Quy Toan cau (Global Fund), To chiTc FHF, Maries Stopes Quoc te (MSI), Hoi CUu chien binh My tai Viet Nam (WAF), To cliiTc Samaritan's Purse, Dtch vu Vien trd ciia Cong giao (CRS)...
2.4. Cong cu va ky thu$t thu thap thong tin: Cong cu dieu tra chu yeu la bo du hoi phdng van ban cau true (gom cac cau hoi dong va md) giup tim hieu nhieu thong tin trong mpt lan phong van. Cong cu dieu tra trong hgi thao trao doi y kien la mpt so cau hoi md.
2.5. Phan tich so lieu
So lieu nghien ciTu djnh lUdng (ap dung dio cac cau hdi dong) dUdc lam sach trUdc khi phan tich, nhap vao may tinh bang chUdng trinh phan mem Excel, sau dd dUdc chuyen sang phan tich tren phan mem STATA phien ban 10.0.
So lieu dinh tinh dUdc dpc ky de \da chgn cac chu diem quan trong lien quan den muc tieu nghien culi, dUdc tong hdp thanh cac bang ma tran va sd do ket qua.
III. KET QUA VA BAN LUAN
3.1. €)ac diem chung cua dol tu'dng nghien cuTu
Cac ddn vj chu'c nang Sd Y te (lanh dao + cac phonq chu'c nSnq) UBND (ianh dao + Phonq Nqoai Vu) Sd Ke hoach Oau tu'
Sd Tai chfnh
Benh vien da khoa/chuyen khoa tinh TTYTDP, TTPC HIV/AIDS (bao qom ca du an) Khac
Tong
Bac Giang 2 1 1
\
2 1 3 1 1Bac Ninh 4 2 2 2 2 3 6 2 1
Ha Nam 7 2 1 1 4 6 2 23
Chung 13 5 4 4 8 10
u
55
Y HQC VIET NAM THANG 7 - SO 1/2013
3.2. Unh hmh chia se va trao doi thong tin vi$n trd giu'a cac tuyen
i^ut do: 3=thUdng xuyen/rat thudng xuyen; 2=it khi/doi khi; l=rat it/rat han che; 0=kh6ng co Hinh 2. Hinh thu'c va tan suat trao doi thong tin tif trung Udng xuong tinh
3.3. Tinh hinh dieu phoi vien trd tai dja phu'dng Cd quan va to chu'c tham gia hdp tie va vien trd
Ca 3 tinh, dac biet la tinh Bac Giang va Ha Nam.nhan dUdc kha nhieu cac dU an va/hoac vien trd.
Mpt so cd quan, to cliiTc hdp tac vien trd tieu bieu nhU Life/gap, Global Fund, FHF, MSI, WAF,... Tuy vay, phan ldn cac to chiTc vien trd khong tham gia lap ke hoach va tai chi'nh ciing dja phUdng, ma chu yeu mang tfnh chat hudng dan mot so bUdc ban dau de lUa chon van de Uu tien chiT khong tham gia trUc tiep hoac chi'nh thii'c. Da phan la chi thUc hien lap ke hoach dpc lap.
Quy trinh phe duyet, tiep nhan vien trd/di/ an vien trd tai dja phu'dng
Cd quan vien trd dieu tra nhu cau
Thil tuc tai cd quan
QLTW
— •'
Cd quan vien trd thong bao cho dia phUdng (UBND hoac sd nganh)
Sd nganh hoSc ccJ quan thu hu'dng chuan bi cac tai lieu, v3n b^n theo yeu cau cua vien trcf
Hinh 3. Quy trinh phe duyet/ tiep nhan vien trd/dU an vien trd
6 ca 3 tinh deu theo quy trinh kha thong nhat (Hinh 3). Bat dau tCr viec cd quan dieu tra nhu CSU dU kien se cap vien trd hoac dU an tai dja pbUdng nao, roi tiT dd trinh cac van ban vien trd tdi cac cd quan trung Udng phe duyet, sau do giji tdi UBND tinh va/hoac ca sd nganh de duyet trien khai tai dja phUdng. Tai dja phUdng, UBND tinh se giao cho cd quan nganh dpc quan ly dieu phoi cac hoat dpng dU an va vien trd, chang han neu la vien trd y te thi giao cho SYT lam dau moi chi dao, lap ke hoach, thUc hien (ca 3 tinh).
Oieu phm va giam sat, danh gia vien trd
Ve cong tac dieu phoi, to chiTc trien khai vien trd (Bang 2), d ca 3 tinh deu chUa cd cd
quan chuyen ve dieu phdi dU an/vien trd. Tuy
nhien, sau khi co thong bao vien trd ciia UBND
tinh thi cd quan nganh dpc (Sd, nganh) deu
thanh lap hoac da thanh lap trUdc do. Ban QLDA
hoac Ban dieu hanh dU an ciia tinh do Giam ddc
Sd lam trudng ban dieu phoi hoat dpng. Ban nay
se quyet djnh ciing vdi nha tai trd dua ve ddn vj
de trien khai. Ve hoat dong theo doi, giam sat va
danh gia, cd quan tai trd se theo doi ke hoach
tong the dU an, Ban QLDA tinh hoac cd quan QL
nganh dpc tinh chju trach nhiem theo doi va
giam sat, cd quan/to chdcjca nhan chuyen mon
hoac to chiTc NGOs dpc lap se thUc hien danh gia
cuoi ky ve hieu qua dU an. Ddn vi thy hUdng dU
an se chiu trach bao cao tien dp giai ngan dU an.
Y Hpc VigT HAM THANG 7 • S6 1/2013 Bang 2. Oieu phoi va giam s^t danh gia vien t r d
Theo d5i, giam s^t v^ danh gl6 DiHu ph61 tc! ChuTc trien khai vign tr^
- Djnh ky cd quan tiep nhan^vien trd bao cao bSng vSn ban ve tien do gial ngan gUi vS cd quan chuyen mon.
- Cu6i ky, bao cao danh gia dU an.
- HoSc Ban QL dU an TW djnh kv' cif chuydn gia kiem tra, danh gia hole co danh gia dpc ISp. Hoat dpng giam sat theo quy djnh ciia nha nUdc va theo yeu cau nha tai trd
B k Giang
- Chua CO CO quan chuyen ve tJieu phoi dU an ciia tinh, tiiy theo tUng di/ an ma thanh lap Ban QLDA hoSc Ban dieu hanh DA ciia tinh do Giam doc Sd iSm trUdng ban dieu phoi hoat d§ng. Chii yeu do nh^ t&l tn? va ddn vj thu hudng ciing phoi hdp trien khai,
- BYT CO ke ho?ch tfing the, giao ddn vj tai dja phuong xay dUng ke ho^ch trifin khai tiTng nSm, to chiTc trien khai theo hudng dan ciia trung Udng va nha tai trd.
• Cd quan QL nganh dpc tinh meo doi, giam sat
- Cd quan chuyen mon ho3c cd quan/to chUc danh gia dpc lap - Nha tai trd theo doi tong the ke hoach phe duyet, ban QLDA kiem tra giam sat cac ddn vj trien khai cac ngi dung lien quan, sau do bao cao cd quan QL cap tren (SYT, BYT, UBND tinh...)
Bac Ninh
- Tiiy theo lo?i vi^n trp vci quy mo dU an m^ cich thiTc co khic nhau
+ Cd quan QL nginh doc tinh tiep nhan thong tin d ^ bao cao UBND tinh xm quyet djnh phan bo, roi giao nganh/cd quan chu tri thich hop di'eu phoi to chUc thUc hi§n + Nha tai tn? trUc tiep thong bao UBND tinh roi giao cho nganh/cd quan thich hpp chii tri dieu phoi to chUc thuc hi?n
+ Phan cong trach nhiem cho cac ddn vj thanh vien tham gia
Tuy theo tirng du an, co du an vien tr? do don vj thu hudng tnen khai, co dU an thi cd quan chii quan trien khai nhUng deu qua UBND tinh phe duyet ke hoach - Sau khl vien trd dUdc phe duyet, giao cho cac chii dau tU quan ly trUc tiep trie'n khai, theo doi, giam sat, danh gia
Chil yeu do ban quan ly dUan thi/c hien giam sat
- Bao cao danh gia giTj tdi cd quan chu quan
- 1 so to chUc phi chinh phu tham gia Kinh nghiem thu'c hien va di'eu phoi
vien t r d
Qua phan tich diem manh, diem yeu, cd hpl va thach thiTc (Bang 3) cho thay diem manh chii yeu la dja phUdng co nhu cau vien t r d thUc sU, xuat phat tiT cac van de y te can Uu tien tai dja phUdng. Dia phudng co Ban QLDA rieng se tao dieu kien_ cho viec dieu phoi va trien khai thuan ldi hdn. 6 ca 3 tinh deu cd cd hpi thuan ldi ben ngoai la dUdc sU quan tam ciia BYT va chi'nh quyen dja phUdng cho cong tac vien t r d , sU ho trd ciia cd quan dau moi nganh dpc.
Kho khan ton tai chii yeu la chUa co cd che quan ly dieu phoi hdp ly tai tinh, chUa co van ban hudng dan rd rang va day dii, nang lUc dieu phoi
va thUc thi vien t r d cua c d quan sd tai cung nhiT nang IUc can bp dU an cua ddn vj thu hudng con han che, chUa dUdc dao tao d3y d i i . Tien do trien khai d U an con cham, mpt so can bp cd sci kiem nhieu viec nen han che kha nang huy dong nhan IUc. Cong tac tuyen truyen con han che dan den ngUdi dan it biet den cac hoat dpng ciia cac to chiTc vien t r d . Thach thu'c chii yeu la mot so thil tuc hanh chi'nh con cham d tuyen trung Udng, quan he va sU phoi ket hdp g i u ^ cac ddn vi lien quan trong tinh con c h u ^ chat che. Mpt so tinh khdng chii dong dUdc cong tac dieu phoi do mpt so d u an ma tinh khdng dUdc giao lam dau moi dieu phoi vien t r d .
Bang 3. Kinh nghiem dieu phoi vien t r d thong qua phan tfch SWOT (diem manh, diem yeu, cd hoi, thach thiTc)
Diem manh^thuan lOi (yeu to ben trong) •-^d hgi (yeu to" ben ngoai) - Co ban quan ly dU an neng, nen viec dieu phoi tot
hdn (BN)
- Nhu cau vien trd cua dia phUdng la ro rang (BN) - SUchii dong va kinh nghiem QLciia dia phUdng (BG)
- Co sU phoi hdp giUa cac ban nganh trong tinh (BN, NGO)
- Phan cap ro rang chUc nang nhiem vu cho tUng ai quan tai dia phUdng (BN)
- SU quan tam, iing hp cua BYT va chi'nh quyen da phUOng doi vdi cac dU an (thii tuc phe duyet, phan bo von doi Ung, chi dao su phoi hdp cac ban nganh doan the (BG, BN, HN, NGO)
Y HOC VIET NAM THANG 7 - S6 1/2013 Diem yeu/kho khan ion tpi (yeu to' ben trong]
- ChUa CO cd che quan ly dieu phot, van ban chl dao hudng dan chUa ro rang (BN, HN)
- Nang lUc dieu phoi va thUc thi vien trd cua cd quan sd tai con han che (BG, BN, HN)
- Nang luc trien khai ciia cd quan thu hUdng chu'a tot, chua dUdc dao tao (BG, HN)
- Tien dp trien khai dU i n cham (giai doan thii tuc tai TW va can bo thUc hien tai cd sd cham do kiem nhieu dau viec) (BG, BN)
- Conq t i c tuyen truyen con han che (NGO)
Thach thufc (yeu t& ben ngoai) - Mot so thil tuc hinh chinh con cham (BN) - Moi quan he va sU phoi ket hdp giu'a Ban QL dU in/vien trd giiJa TW v i mot so ddn vi lien quan tai dia phUdng cfiuS chat che (BG, BN, HN, NGOs) - Quy djnh ciia Vi|t Nam va doi tic co mot so di^m khic nhau kho thUc hien (BN)
- Mpt so DA m i tinh khong phii la cd quan dieu phoi vien trd (chi ti^p nhin + thut hien) thi kh6ng chii dong diTdc cho dieu phoi, trie'n khai, theo doi danh gia (HN) - Dieu kien tiep can cic nquon vien trd kho l<han (BG) 3.4. Cd che dieu phoi vien t r d mong ddi
tai d^a phu'dng
O Bang 4, can bp dUdc hoi cho rang ly do can cai thien cd che la nham tao ra sU thdng nhat ve quy djnh va thii tuc, ve cd che dieu phoi ro rang, ve chu'c nang nhiem vu ciia cac ben lien quan tham gia, day nhanh tien dp thii tuc giup d u an vien trd trien khai nhanh, can bo dUdc tham gia nang cao nang IUc, tang cUdng chia se thong tin g\da cac tuyen nham tang cUdng hieu
qua vien trd. Mot so can bp cho rang ly do chi'nh khong can thiet lap cd che dieu phoi la do quy trinh cii la kha tot, chi can cai thien thii tuc hanh chi'nh de giiip cho viec thUc thi nhanh hdn. Mot dai bieu hpi thao cung khang djnh: Quy trinh cu la kit gua cua hoat dgng nhieu nam, nen khong thay doi, ma chu yeu la duy tri va bo sung cai thien. Hoan thien thu tuc lim sao de phia doi tic va dia phu'dng thdc hien dddc thuin ldl (Lanh dao SYT).
Bang Tinh Bac Giang Bac Ninh
Hi Nam
4. Ly do can va khonq can cai thien cd che dieu phoi Ly do can cai thien
- Giiip du i n vien trd dUOc trie'n khai nhanh, gpn va ro rang, cin lip dUdc nang cao nang IUc, tang cudng chia se thong tin gife cic tuyen nham tang cUdng hieu qua vien trd.
- Thil tyc phe duyet con chua nhanh
- C3n cai thien de tao ra sU thong nhat ve quy dmh va thii tuc giiJa nUdc vien trd v i nUdc nhan vien trd
- Tien dp trien l<hai cac di/ an thu'dng cham so vdi ke hoach, can phai cai thien thii tuc va cong tic giam sat - Giup cong tac vien trd thuan ldi, hieu qua va ben vij'ng hdn.
- Neu xay dUng dUdc cd che dieu phoi ro rang (nhiem vu, trach nhiem,.,) se giiip cho viec thUc thi thuan ldi va hieu qui - Tao dieu kien cho cac phong va cd quan chifc nang tham gia dieu phoi cic dU an vien trd
Ly do khong can cat thien - Quy trinh cu cung tam on, chii yeu l i can cii thien tliu tyc hanh chinh.
- Quy trinh cu kha tot, chl can cii thien ve thii tyc phe duyet ban dau
Ve de xuat cd che dieu phoi vien trd (Bang 6), cac can bp 3 tinh deu cho rang neu can thanh lap mpt cd che dieu phoi kha thi va phii hdp thi cd che dieu phoi dd can dap u'ng cac yeu cau:
ddn gian hoa thii tuc, tang cUdng trao doi thong tin 2 chieu giu'a cac cap, cd van ban hudng dan ro rang, va day nhanh tien dp thUc hien. Can bp Ban QLDA cijng nhU can bp dU an dja phUdng khi tham gia dU an hoac tiep nhan vien trd can dUdc tap huan quy tnnh va hUdng dan day dii.
TiT phan tich cac de xuat ciia 3 tlnh, Vu HTQT va mpt so To chu'c phi chinh phii (NGO) cho rang qua trinh dieu phoi vien t r d y te can tap trung vao 3 trpng tam sau:
1. Cai thien quy trinh phe duyet, tiep nhan
vien trd thong qua viec ddn gian hda cac thii tuc hanh chinh, thiet lap quy trinh dau thau nhanh, tang cUdng trao doi thong tin 2 chieu giij'a Bp Y te va Sd Y te de phat huy tinh chii dpng ciia dja phUdng trong viec trien khai cac quy trinh tiep nhan, quan ly va sir dung vien trd.
2. Cach thiTc dieu phoi to chiTc tnen khai vien trd can co quy djnh chat che ve each thiTc phdi hdp giUa cac cap va nganh, co hUdng dan chi tiet ve quy trinh, tap huan trien khai va can CO sU tham gia ciia cd quan thy hUdng dU an.
Ngoai ra moi dU an/ vien t r d can thanh lap BQL d u an de cong tac dieu phoi va quan ly dUdc thUc hien mot each he thong va hieu qua.
3. Quy trinh theo doi, giam sat va danh gia
27
Y HQC VigT NAM THANG 7 - Sfl' 1/2Q13 can dUdc thUc hien tiT cap dp tong t h ^ (Nha tai
trd theo dol chung) d^n chi tiet (Sd Y te, Ban QLDA trUc tiep giam sat trien khai dU an). Bao cao danh gia ciin gui tdi cd quan phe duyet vien trd, cd quan thu hUdng, cd quan qucin ly cap tren, va Ban Quan ly dU an.
Ngoai cac y kien de xuat tren, trong hpi thao, mgt so dai bieu bay to mong muon dai di?n ciia tinh tham gia tiT gial doan bSt dau xay dUng dU an va dja phUdng can duVc thdng tin thUdng xuyen hdn ve hoat dpng vien t r d , khong nen chi khi CO d u ^n hoSc co vien t r d thi tinh mdi dUdc thong bao. Oe cd che dieu phoi vien t r d hoat dpng CO hieu qua, "£J/a phu'dng can chuan bj cic cdsd thiit yeu nhd xiy duttg ki hoach dau nim, chui'n bi von doi uTig, muon vay cac nha tai trd/
vien trd phai sdm co thong bao hoic len ki hoach vien trd sdm trudc dau nim cho dfa phddng dedi'a phddng chu dgng hdn" (Dai dien Sd Tai Chinh, dai bieu tham dU hoi thao).
Lien quan den de xuat cai thien viec chia se va trao doi thong tin vien t r d , ca 3 tinh deu cho rang can tang cUdng nang cao nang IUc cho can bp lanh dao, dpi ngu can bp dd an ve ky nang dieu phoi va trao doi thong tin. Cac NGO de xuat Vu HTQT lam cd quan dau moi vdi PACCOM de CO thong tin ve hoat dpng ciia cac NGO tai cac tinh; To chiTc hpp djnh ky cuoi nam de chia se kinh nghiem va gdp ^ giu'a S'YT, Sd ngoai vu va cac NGO cho ky lap'ke hoach sau. Vu Hdp tac Quoc te cho rang can phan cap va giao trach nhiem cho cac tuyen va dja phUdng trong viec cung cap va trao doi thong tin dong thdi tang cudng hoat dpng theo doi, giam sat va danh gia.
• V i cfing tac dieu phoi t o chii'c trien khai, cac tinh deu chUa c6 cd quan chuyen y e diey phoi d u ^n/vi^n t r d . Trong qua trinh trien khai, a\a phUdng chUa co cd che quan ly diSu phoi phu hdp tai tinh, chUa co v§n ban hUdng dan ro rang va day d i i , nSng IUc dieu phoi va thUc thi vien tro cua cd quan sd tai cung n h u nang IUc can bpdir
^ n con han che, chua dUdc dao tao day diJ, Thach thii'c chu yeu la mpt so thu tuc hanh chinh con cham d tuyen trung Udng, quan h$ va s;f phoi ket hdp giiJa cac ddn vj lien quan'trong tlnh cdn chUa chSt che. Mot so tinh khong chu dpng dUdc cong tac dieu phoi do tinh khong dUdcgiao lam dau moi dieu phoi vien t r d vdi mpt so diTan,
• Oa so CO mong muon thanh lap cd che dieu phoi vien t r d phii hdp va kha thi tai tuyen tinh de tao ra sU thong nhat ve quy dinh va thii tuc, quy dinh ro rang chiTc nang nhiem vu cua cac ben lien quan tham gia, day nhanh tien do thil tuc giup d U an vien t r d trien khai nhanh va nang cao hieu qua vien t r d . Cd che can dap u'ng cac yeu cau: ddn gian hda thu tuc, tang cudng trao doi thong tin 2 chieu giuci cac cap, co van ban hudng dan ro rang, va day nhanh tien dp thut hien. Trong cong tac theo doi, giam sat danh g'la, nmi dU an ran c6 nhuYig b'eu chi danh g'la thong nhat tir dau (khung hay bg chi so danh gia).
• Oai dien cua tinh can dUdc tham gia vao giai doan bat dau xay dUng d U an va dia phudng can dUdc thong tin t h u d n g xuyen. Cac nha tai trd/vien t r d phai sdm co thong bao hoac len ke hoach vien t r d sdm trUdc dau nam cho dja phUdng de dia phUdng chii dgng hdn phan bo von doi ifiig.
I V . KET LUAN
• MiTc dp trao doi va chia se thong tin chUa thudng xuyen (chu yeu bang van ban), cac kenh trao do'i thong tin thuan tien va nhanh hdn nhu dien thoai va thU dien tiT con han che. Viec chia se thong tin khong chi'nh thiTc g i u ^ cac tuyen it dUdc thUc hien. Phan ldn cac cd quan to chirc vien trd tai dja phUdng khong tham gia trUc tiep lap ke hoach va tai chi'nh ciing dia phUdng.
• Ve quy trinh dieu phoi vien t r d , cac tinh deu tuan theo quy trinh kha thong ntiat da quy djnh. Tuy vay, cd nhi/ng dU an, nha tai t r d khao sat nhu cau xong gui cac tai lieu vien t r d th§ng tdi UBND tinh phe duyet, trUdc khi thong bao nganh dpc quan ly dieu phoi trien khai.
TAI UEU T H A M KHAO
1. Tran Thj Giang Hu'dng, ( 2 0 0 8 ) , Nghien iM thi/c trang va de xuit mgt so giai phap nham tar^
cu'dng hiiu qua cua cac dd an ho trg phat tri^
chinh thut trong linh vut y te. Vien Ve sinh djch te Trung UOng, Hi Npi.
2. Bp Ke hoach va €>'au tu" ( 2 0 0 8 ) , Nhin laiSnSm thu hut va su'dung ODA d Viet Nam, Ha Ngi 3. Bp y t e , nhom doi tac Y t g ( 2 0 1 2 ) , Bao do
Chung tong quan nganh Yte nam 2012: Nang cao chat ludng dich vukhim, chO^ benh, Ha NpL 4. 8$ Y t e , Phong thong ke tin hoc, Vu Ke hoach tai
chinh, (1992-2008), Nien giam thong ke y ti 1992-2011.
J. Trung t a m nghien c i h i phat t r i e n y te cong dong (CORD) ( 2 0 0 6 ) , Bao cao nghien cuV danh gia ve Dieu phoi, quan ly va sddung vien trddio iinh vut phong chong HIV/AIDS d Viet Nam.
