TAI LI$U THAM KHAO
1. Angelucci, E„ Brittenham, G.M., McLaren, C.E., et alft^OOO), "Hepatic iron concentration and total body iron stores in thalassemia major", New England Joumal
^Medicine. 343; 327-331.
TlzlGandon Y. (2009), "Iron, liver and MRI".
irera^' of Rennes Web site.
Ar.rBdio.univrennes1.fr/Satjrces/EN/Hemo.html,
@tan 6 , Terzoll S, Mauri R. Borghetti L, Di Palma P^a A, et al. (1984), "Cirrtiosis associated vvith
'i transfusions in ttialassaemia". Arch Dis Child, .. 7-70.
J,£Marcony Queiroz-Andrade, Roberto Blasbatg, Cintliia D. Ortega, et al. (2009)," MR Imaging Findings of Iron Overload", RadioGr^hics, 29,1575-1589.
| ^ ? M a z z a P, Giua R, De Marco S, BonettI MG, Amurri B, Masi C, et al. (1995), " Iron overload In thalassemia: comparative analysis of magnetic resonance imaging, senam ferritin and iron content of ttie
liver", Haematologica, 80(5):398~404.
6. Olivieri NF, Brittenham GM, Matsui D, et al.
(1995), "Iron-chelation therapy with oral deferiprone in patients with thalassemia major", N Engl J Med.
332:918-22.
7. Taher A, El Rassi F, Isma'eel H, Koussa S, Inati A, Cappellint MD. (2008), "Correlation of liver iron concentration determined by R2 magnetic resonance imaging with serum ferritin in patients with thalassemia intemiedia". Haematologica, 93(10): 1584-6.
8. Timotiiy G. St. Pierre, Paul R. Clark, Wanida Chua-anusom, et al. (2005). " Noninvasive measurement and imaging of liver iron concentrations using proton magnetic resonance", Blood, vol. 105 no. 2 855-861.
9. Xiaozhou Ma, Nagaraj-Setty Holalkere, Avinash Kambadakone R, et al. (2009), "Imaging-based Quantification of Hepatic Fat: Methods and Clinical Applications", RadioGraphics. 29,1253-1277.
D i XUAT M O H I N H N A N G CAO HOAT DfiNG TRUYDN THONG
D&N S6 - KE HOACH HdA GIA D I N H T R E N M O T SO KHIA CANH DAN TOC VA XA HOI TAI HUYiN VD NHAI TINH THAI NGUYEN
PHAM H 6 N G HAI, NGUYEN X U A N BAI, N G U Y £ N D Q C TRQNG management of communication activities family planning pmgmm. Solution 2: To enhance professional training for staff woridng population.
Solution 3: Pmmote education and communication behavior change on population and family planning.
Solution 4: Mobilize community involvement in reproductive health, population - family planning is based on a number of aspects of socio-cultuml cham(^eristics of each ethnic gmup.
Keywords: reproductive, Vo Nhai district DATVAND£
D g ^ tr&n kM qud cOa nghiSn ci>u m& td da thu du'p'c vd phfln tfch cdc y6u t6 Ii6n quan d6n t j 1$ c6 con thCr ba trfr I&n cao t^i huy$n VO Nhai, Thdi NguySn, cg thS: Sd hO gia dinh c6 con thO' 3 trd* I3n chi^m 12%. Cd m6i liSn quan giOa d\hu ki&n kinh t4 vd vi$c sinh con thO' ba trd ISn (p < 0,05; OR = 2,2);
ddn tOc thifeu s6 (p < 0,05; OR = 2.12); ki6n thtrc, s y hidu biSt cOa ngvir\ ddn vh cdc BPTT (p < 0,05; OR = 0,4); quan diSm phdi c6 con trai ndi dOi tdng dird'ng (p < 0,05; OR = 2,78); hdnh vi khOng dp dgng bi$n phdp trdnh thai (p < 0,05; OR = 2,59); quan didm ddng con nhidu phOc, t^m con nhidu cOa (p < 0,05;
OR - 2,59), 0 6 5,7% khdng hdi Idng vd thdi d$ cue cdn bO tmydn ttiOng vd 14,4% khdng hdi Idno vd trtnh dO vd k^ ndng tmydn thdng cOa cdn bO y td. Tdt cd cdn bO truydn thdng DS - KHHGD ddu chu^ du^c tdp hudn vd (^uwng trinh ddn sd cc bdn. T f 1$ cdn bO y td xdp lo9i tmng blnh vd kidn thi>c Id 27% vd k?
ndng tmydn thdng Id 20%. Co sd v$t chdt: 53,4%
tr^m y td xd khdng cd gdc tmydn thdng; 33,3% trgm y T6M TAT
Nghidn cOv dl/pc tiin hdnh trdn 299 cip VQ chdng trong di tuii sinh di§ t$i xd mit s6 xS miin nl3i tinh Tt)6i Nguydn. Phuvng phdp nghicn cOv: Xdy di/ng m hlnh /j? thuyit sau khi c6 kit qud nghidn cOv md
"^fd phdn tich cde yiu ti lidn quan c^n t$ 1$ sinh con m ba trd ldn cao t^i huyin V6 Nhai. Thii Nguydn.
1^'qud: Di xuit mit so gidi phdp vd xdy di/ng mQ
^h nhim ndng cao hiiu qud ho$t ding truyin thdng
^-KHHGD t^i huyin VO Nhai. Giii phip 1: Tdng
^ i n g Idnh tfgo, ti chOc vi quin 1^ cic ho^t ding tiuyin thdng DS - KHHGD. Giii phip 2: Tdng cudng ddo t$o tip huin chuydn mdn cho cin bi lim (Arjg tdc ddn so. Giii phip 3: Biy m^nh truyin thdng gido dijic ehuyin Si hdnh vi vi DS - KHHGD.
Giii phip 4: Huy ding st/ tham gia cOa cing ding ttong vide chdm sdc sOc khde sinh sin, DS - KHHGD dya trdn mdt si khIa e$nh d$c thO vdn hda - xS h^i ciia timg ddn tie.
Ti> khda: di tudi sinh di. huyin V6 Nhai SUMMARY
The sfody was earned out on 299 couples of reprodur^ive age in some mountainous pmvlnce of Thai Nguyen. Research Mettiodology: Building a ttteoretKal model after research results am described
^ analyzed the factors mlated to the mte of a third W d or mom high in Vo Nhai district, Thai Nguyen.
Results: Pmposal for a number of solutions and
^Oodeling to enhance the periormance of '^'rnmunication family planning program In Vo Nhai.
Solution 1: Stmngthen leadership, organization and
^ C THV'C HANH (856) - SO 1/2013
t i cd g6c truyin thOng nhu'ng chua ho^t ding. Klnh phi cho host ding truyin th6ng DS - KHHGB chl3 yiu id tir nguin ngdn sdch cOa Quic gla (94,6%).
Hoat ding tmyin thOng DS - KHHGD: Phucng phip nil chuyin chuySn d i it du'cc cSc cin b i truyin thing dp dung. Hoat ding truyin thSng khOng duvc thg'C hiin thu&ng xuy6n theo dOng qui djnh (g3,3%).
Chang til ai xuit m6 hinh 1^ thuyit ndng cao hoat ding truyin thSng DS - KHHGB nhim glim t} i i sinh con thi> ba tri' I6n.
OOi TUVNG vA PHlTONG P H A P NGHIEN C l / U 1. D i l tu'Q'ng nghiin ciru; C i c c i p va ching trong d i tuii sinh d i
2. D|a bjtn nghiin eO'u: Chon chi3 dich huyin v e Nhai tinh Thii Nguyen.
3. ThM glan nghiin ciru: TCr thing 1 din thing 10 nim 2012.
4. Phirang phip nghiin cOu: X i y dung m i hlnh ly thuyit dua theo kit qui d i thu ducc cilia phuang phip m i t i v i phin tich cic yiu t i Ilin quan din ty
l i sinh con thi> ba trir iin cao.
5. Phuwng p h i p thu th^p v l sO If « i liiu - Phuang phip phing vin siu: Phing vin cic linh dao cing ding, c i n b i y t i d i giii quyit cic vin d i da tim ra trin ca s * phin tich c i y vin d i
- Phuang phip thio luin nhim; Thio luin nhim v*! CBYT, vfti c i c c i p va ching d i giii quyit cic vin d i d i tim ra.
6. T l i u c h u i n d i n h g l i c i c chl s i nghiin c(hi ChF s i dinh g i i kit q u i hoat ding truyin thing D S - K H H G D :
' Chiin luac D i n s i v i Sl>c khie sinh sin Vi$t Nam giai doan 2011 - 2020 [4].
- Chuang trlnh hinh ding Tmyin thing chuyin dii hinh vi v i D i n s i - K i hoach h i a gia dinh giai doan 2 0 1 1 - 2 0 1 5 [5]
- K i hoach hinh ding thuc hiin Chiin luoc Din s i v i Si>c khie sinh s i n Viit Nam tinh Thii Nguyin glal doan 2 0 1 1 - 2 0 1 5 [12]
KeTQUANGHlENCCrU
1. C i y v i n d i v i tf l i sinh con t h i ' ba trir l i n cao tfl huyin VO Nhai, T h i l Nguyin 2. K i t q u i thio luin nhim, phing v i n s i u
N^i dung Khd khfin cOa cAng tic
truy&n thfing DS - KHHGD
Quan 6\im "Phdi c6 con trai nAi d&i tOng Ovtmq',
"lim con nhiigu cua' Ly do smh con thi> ba trdr
I6n
K«t q u i - Kf nflng TT chi/a tAt - Chi/a 6\ivc ddo t^o v^ dfln s&
- Kinh phi cho TT DS KHHGD thip, thCi lao ChO CTV DSn 56 thfip - Thiiu gfic TT t^i TYT - ThiAu Phu'O'ng tl$n T T - Bilt d&ng ng&n ngl>
- Chua am hidu phong tgc S\a phiKmg - Ngu'di dfin l<hfing nh^n di/?c thfing tin - Kay l&ng gh6p qud nhiiu nOi dung trong m0t buii
T T
- NOi dung T T chl t4p tmng vfto cdc BPTT - Thiiu dich vu K H H O e - T h i i u dich vu k h i m chC^a binh phu khoa
- Do quan n i ^ lAu d M
- Ngireri dSn thIAu kifin thi>c thdi dO vi thvc hAnh v i DS - KHHGD
- Oo nghio - DQc thCi vfin hda. dftn tOc
G i i i phdp - Ddo t f o v i k f n3ng T T
• T^p hu^n v i chircmg trlnh DS - Huy dOng nguAn kinh phi cho ho^t tS^ng TT DS -
KHHGD - Thiit l«p gdc T T - Huy d^ng cdc t i chi>c - Hoc ngfin ngO bdn d|a - Tich ofc ldm v ) ^ v6i cfing ding - Thfing bdo cdc ho^t dOng T T M n vdl ngtrfii ddn
- C f i k i h o f c h T T c h i t l i t - N9i dung T T c i n OB dfng -Cung cJ4> dich vu KHHGD t9l T V T
• Cung c i p DV khdm chOa b ^ phu khoe t?!
T Y T - T m y i n tttfing tdc dOng idu ddi
- Tdng a r t m g T T DS-KHHGO
- Xfia ddi, gidm nghto - Truvin thfing tiu ddi
3 . o d x u d t m A h t n h n f l n g c a o h l $ u q u d c A n g t d c t r u y d n U i A n g D S - K H H G D
TrAn c a s * p h S n tich t h i / c t r e n g cOa cAng t d c tmyfen thAng D S - K H H G B , n h O n g khA k h f l n , t h u ^ n M c u a h 0 9 t AAng t m y ^ n thAng D S - K H H G D t^i d j a b d n nghidn ci>u n h S m gAp p h i n n d n g c a o h i ^ u q u d cAng t d c t n j y d n t h A n g , p h d n d d u d^t v d V I / Q I c h l tidu cOa c h i d n l u ^ d d n s o v d si>c k h A e s i n h s d n giai d o $ n 2 0 1 1 - 2 0 2 0 , ChQng tAi d d x u d t mA h i n h 1^
thuydt g A m t)6n gidi p h d p c h u y d u s a u :
GUI phip 1: L d n h d ^ o , tA chi>c v d q u d n ly c d c h o g t dOng t n i y d n thAng D S - K H H G D
T d n g atdng sg- I d n h d ^ o , chT d ^ o c u a c d c c d p i)y D d n g v d c h f n h q u y d n dii v A i c A n g t d c d d n s 6 tir h u y $ n x u 6 n g x d , thAn, bin.
N d n g c a o n d n g i v c dOi ngO c d n t>0 I d m cAng tdc t r u y d n thAng D S - K H H G D tai t r a m y t d , chO bpng n d n g c a o n d n g l i / c c h o dOi ngQ c A n g t d c vidn ddn so v d n h d n v i d n y t d thAn b d n .
T A chi>c c d c hoQt d A n g t r u y d n thAng c d n d a d^ng v d nOi d u n g , v d p h u o n g p h d p phCi h o p vAi ti>ng n h A m ddi t u v n g , d d n tAc v d d i d u k i $ n kinh td, v ^ hAa - x d hOi. T d n s u d t c d c h o ^ t d $ n g t m y d n fiiAng c d n cA k d h 0 9 c h c v t h d t h e o tO-ng t h d n g , tCmg qui.
I 4 i p d a n h s d c h v d ttieo dAi, q u d n tjf d & t u ^ n g cOa c h u v n g trinh d d n t $ n hO g i a d f n h . N d n g c a o vai tr6 g i d m sdt cOng d d n g t r o n g v i $ c thi,rc hidn c d c ho^t dOng cOa c h u v n g trlnh D S - K H H G D t^i t h ^ , x A m , x d .
Giii phip 2: D d o t ^ o t d p h u d n c h u y d n mAn cho c d n bO t d m cAng t d c d d n s 6
Y H O C THV'C HANH (856) - SO1/2013
f._ , — . j ^ . ^ J.14, v 2 , \ | p huir* V'fe i_*!uy:dS^: iifiAn nglii$p vy, vd k? ndng tmydn thAng cho cdn bO ldm cfing tdc tmydn thAng DS - KHHGD, cAng tdc vidn
t
;6 NSn cA nhidu khAa tdp hudn ngdn ngdy, nAi da d^ng, di sdu vd k? ndng truydn thAng nhdt Id ing n6i chuydn chuydn dd, ndng cao k? ndng ti^p v^i ngu-A-i ddn tOc thidu s6 thAng qua vide .™ i^ng ddn tAc vd tim hidu phong tuc tdp qudn cOa Img ddn tOc,Giii phip 3; Tmydn thAng gido dye chuydn ddi hSnhvivd DS-KHHGD
Tdng cu^ng truydn thAng gido dgc vd ddn s6, SCPC
^bie sinh sdn, KHHGD, d$c bidt lu'U y vd nOi dung milt cdn bdng giAi tinh khi sinh vd gidm t^ 1$ sinh con thi>batrdl6n.
^ TriSn khai cA hidu qud cdc hoat dOng truydn thAng v^ nAi dung, hinh tht>c vd cdch tidp cdn phCi hp'p v6i tCmg nhAm d6i tuvng, tCrng ddn tAc. Hdng qui cA thd triln khai hoat dAng tmydn thAng vd DS - KHHGD dird'i d^ng hAi thi, didn kjch, vdn nghd, tho ca... dd t9ng thdm sy chCi y cua cAng ddng.
Cdn kdt hp'p tdt tmydn thAng qua hd thdng loa ddi ciia thfln xAm vd'i tmydn thAng t n ^ tidp qua dAi ngO c$ng tdc vidn ddn so. Cdn xdy dg'ng kd hoach, nOi dung bdi vidt tmydn thAng vd kd ho^ch phdt trdn h$
th6ng loa phAng thanh cua thAn xAm.
: (jiii phip 4: Huy dAng s\jr tham gia cda cAng il6ng ti^ng vi$c chdm sdc si>c khAe sinh sdn, DS - KHHGD di,ra trdn mAt s6 khIa cgnh d$c thO vdn hAa - y& hfli cOa tCrng ddn tAc.
, Huy dflng rAng rdi cAng ddng tham gia cdc hoat dOng tmydn thAng di/a trdn ddc thCi cua tCrng ddn tAc.
l^liSt huy cdc gid trj tmydn thdng vdn hAa cA Ipi cho sCrc khde. Hgn ehd vd bdi tn> cdc hu tgc ho$c cde tdp quSn khflng tdl cho SCPC khAe. Phdt huy cdc didm mgnh cua gid trl tri Bii>c y hpc ddn gian trong vide di&a bdnh tgi gia dinh.
Huy dflng cAng ddng khAng nhCrng tham gia cdc hp9t dflng truydn thAng md cAn tham gia gidm sdt cdc hoat dflng ndy trong vide thgx; hidn chinh sdch, phdp luHt.
BAN LUiBLN
Vfi Nhai Id mflt huydn vDng cao eOa tinh Thdi Nguydn, vdt quy mA ddn sd td 66.232 ngu-AI, phg nO trpng dfl tudi sinh dd 19.523 ngu-A-i, phg nQ* 15 ddn 49 tiiSi c6 c^dng 13.957 ngu'di. Ho?t ddng truydn thflng OS - KHHGD cua huydn dd dgt dupe mflt sd kdt qud nhUt dinh nhu': ty suat sinh thA gidm tu-17,93 (ndm 2p10} xudng cdn 17,69 {ndm 2011), t? 1§ cdc c$p vp- ch6ng trong dfl tudi sinh dd dp dgng cdc bidn phdi trdnh thai hidn dgi cao 8 1 % {ndm 2011). Tuy nhidn, v^n cfin mflt sd chl sd hogt dflng tmydn thAng chu-a
^|t du'pc nhu': t^ Id ede c$p vp' chdng sinh eon thi> 3 tro Idn cao so vd'i chung todn tinh (todn tfnh 5%), t j s6 gi6i tinh khi sinh cao 129%, ty 1$ bd me mang thai 'lu'TC sdng lpc tru-Ac sinh thdp 54%, t f Id trd so sinh (Ju'P'c sdng Ipe thdp 23%, ty Id nhiSm khudn dupc sinh sdn 40%, sd ngu-Ai diu'a thdnh nidn cA thdi ngodiymudn 145 ngu'di [10], [11].
'J&i xit qud ban ddu thu du'p'c, dg'a trdn vide phdn tich sd lidu dinh lupng, sd lidu i^nh tfnh vd mdi lidn quan, cdn cCr vdo cde cht tidu eOa ehldn luvc ddn sd vd sCrc khde sinh sdn giai dogn 2011 - 2020 duqrc phd duydt theo quydt djnh sd 2013/QD - TTg cOa Thd tU'A'ng Chinh phCi, ngdy 14 thdng 11 ndm 2011 [5], chOng tAi dd xudt mflt sd gidl phdp nhu' trdn.
Vdi gidi phdp th& nhit, chCing tAI nhdn thdy vai trA cCia cAng tdc Idnh dgo, cht dgo, td eht>e vd qudn ly cdc hogt dflng truydn thAng DS - KHHGD id rat quan tnpng. Mdc dCi tgi dja bdn nghidn ci>u, dd cA sg* cht dgo to cdp Ciy, dd cA kd hoach tridn khai, cA hogt dflng Idng ghdp, cA sg' phdi hpp cda cdc ban ngdnh, dodn thd nhu'ng chu'a cA tinh nhdt qudn, thdm chl nhidu hogt dflng Idng ghdp khAng phO hp'p, nhidu nfli dung cOa chu'ong trinh chua dupc cung cdp cho nguAi ddn, nhidu hogt dflng tmydn thAng DS - KHHGD bj gidn dogn do nhdn vidn y td qud bdn khAng thd ddm nhdn hdt vide dupc giao... Chinh vl v$y, hidu qud cda hogt dflng truydn thAng DS - KHHGD cAn nhidu cht tidu chua dgt dupc nhu t j 1$
hA gia dinh sinh eon thCr 3 cAn khd cao Id 12% eao hon so vAi todn ttnh Thdi NguySn [12], cA su mdt cdn bdng vd t9 sd glAi tinh khi sinh 154 trd so sinh tral/100 trd so sinh gdi. KhAng c6 bd mg mang thai ndo dupc sdng Ipc trud'c sinh vd khAng cA trd so sinh ndo dupc sdng Ipc. Do dA, cdn phdi tdng cuAng sy idnh dgo, cht dgo cua cdc cdp Ciy Ddng vd chinh quydn ddi vd'i cAng tde ddn sd tir huy$n xudng xd, thAn, bdn. Ndng cao ndng \\fc dfli ngQ cdn bfl Idm cAng tdc mjydn thAng DS - KHHGD tgi trgm y td, ehd trpng ndng cao ndng Ii,rc cho dAi ngQ cAng tdc vidn ddn sd vd nhdn viSn y td thAn bdn. Td chO'C cdc hogt dAng tmydn thAng cdn da dgng vd nfli dung, vd phuong phdp phd hp'p vAi tCrng nhAm ddi tupng, ddn tAc vd didu kidn kinh td, vdn hAa - xd hfli. Tdn sudt cdc hogt dAng tmydn thAng cdn cA kd hogch cg thd theo td'ng thdng, td'ng qui. L$p danh sdch vd theo dAi, qudn i f ddi tupng cda chuong trlnh ddn tdn hfl gia dinh. Ndng cao vai trA gidm sdt cAng ddng trong vi$c thuc hidn cdc hogt dflng cua chuong trinh DS - KHHGD tgi thAn, xAm, xd.
Vdi gidi phdp thd- hai, Tdng cuAng ddo tgo, tdp hudn vd chuySn mAn nghidp vg, vd k j ndng tmydn thAng cho cdn bfl Idm cAng tdc tmydn WiAng DS - KHHGD, cAng tdc vidn ddn sd Id nhl$m vg cdp bdch vd hdt sd'c cdn thidt, Tgi dja bdn nghiSn cd'u, chdng tAi nhdn thdy 100% trgm y td xd cA bdc sT; 127,9%
thAn bdn cA cflng tdc vidn ddn sd, ddy Id ngudn nhdn Ig'c nAng cdt cua hogt dflng tmydn thAng DS - KHHGD tgi cdp co sA. Ndu xdt vd sd lupng, thi nguin nhdn luc cho hogt dflng tmydn thAng DS - KHHGD tgi ddy Id ddm bdo, nhung vd chdt lupng thi cdn phdl cA nhidu khAa ddo tgo, tdp hudn, ddo tgo di, ddo tgo Igi dd ndng cao ndng Ig'c cda dAi ngd cdn b$
ndy. NAi dung ddo tgo thi cA nhidu, nhung vAi nhO-na phdt hidn ban ddu cCia nghidn cd'u ndy chdng tAt dd xudt ndn cA nhidu khAa tdp hudn ngdn ngdy, nfli d u | ~ da dgng, di sdu vd k? ndng tmydn thAng nhdt 1:
^ ^ THV'C HANH (856) - SO 1/2013
ndng ndi chuydn chuydn dd, ndng cao k^ ndng giao tidp vd'i nguAi ddn tflc thidu sd thAng qua vide hpc tidng ddn tflc vd tim hidu phong tgc tdp qudn cda td'ng ddn tflc.
Vdi gidi phip thCr ba. ddy mgnh tmydn thAng gIdo dgc chuydn ddi hdnh vi cua nguAi ddn vd cdc nOI dung hogt dAng DS - KHHGD Id khdu then chdt cda su thdnh cAng hay thdt bgi cda tdt cd cdc chuong trinh tmydn thAng gido dgc sd'c khde nAi chung vd tnjydn thAng DS - KHHGD nAi ridng. Theo quan didm mAi, hdnh vi cdc nhdn bj dnh huAng bAi rdt nhidu ydu td. V) vdy tmydn thAng gido dgc ehuydn ddi hdnh vi cdn dupc nhin nhdn rflng hon vd cdc mdt tdc dOng tdm ly xd hfli vd mAi truAng. Thuc td cho thdy, dd thay ddi hdnh vi cdn phdi cA nhQ'ng didu kidn nhdt djnh: Thd- nhdt Id phdi do cd nhdn tu nguydn, thd' hai Id hdnh vi cdn thay ddi cA tinh ndi bdt vd cd tdc hgi tAI sd'c khAe, thCr ba Id hdnh vi dd thay ddi phdl duvc duy tri, thd' tu Id su thay ddi hdnh vi khAng qud gdy khA khdn cho cd nhdn, thCf ndm Id phdi cA su tri? gidp cda xd hfli [8]. VAi nhO'ng Idp iudn nhu trdn vd vdl nhQ'ng kdt qud thu dupe tgi dja bdn nghldn cd'u, chCing tAI dd xudt mflt sd nOI dung chlnh cda gidi phdp ddy mgnh truydn thAng gido dgc chuydn ddi hdnh vi nhu sau:
Tdng cuAng tmydn thAng gido dgc vd nOI dung mdt cdn bdng giAi tinh khi sinh vd gidm ty i$ sinh con thll' ba trA ISn.
Tridn khai cA hi$u qud cdc hogt dAng tmydn thAng vAi nAi dung, hlnh thd'c vd cdch tidp cdn phd hp'p vAI tCrng nhAm ddi tupng, td'ng dfln tflc, Hdng qui cd thd tridn khai hogt dflng tmydn thflng vd DS - KHHGD duAl dgng hfli thi, didn kjch, vdn nghd, tho ca... dd tdng thdm sg- ehd y cda cAng ddng.
Cdn kdt hp'p tdt tmvdn thAng qua h$ thdng loa ddi cda thAn xAm vAi tmydn thAng tn/c tidp qua dfli ngO cflng tdc wSn ddn sd. Cdn xdy dg'ng kd hogch, n^l dung bdi vidt tmydn thflng vd kd hogch phdt trdn hd thdng loa phAng thanh cda thAn xAm.
Vi nil dung thO- tw. huy dflng sg' tham gia cua cAng ddng trong vi$c chdm sAc sCrc khde sinh sdn, DS - KHHGD dua trdn mflt sd khia cgnh ddc thd vfln hAa - xd hAi cda tu-ng ddn tAc. Kdt qud cua thdo ludn nhdm vAi nguAl ddn vd dd xudt mftt sd gidi phdp ndng cao hidu qud cda cAng tde tmydn thAng DS - KHHGD, ngudi ddn cho rdng cdc hogt dflng truydn thAng cdn phdi thuAng xuySn han, nfli dung tnjydn thAng cdn phong phd hon. cdn cA thdm thAi gian cho hp dup-c thdo Iudn, chia sd vdi nhau. Cdn bO Idm cAng tdc tmydn thAng cdn nhidt tinh hon n&a, hidu bidt vd phong tgc tdp qudn cda ngvdi dfln tflc dd giao tidp vdi ngudi ddn tdt hon.
Huy dflng c^ng ddng trong chflm sAc sd'c khAe sinh sdn, DS - KHHGD gAp phdn xd hfli hAa cdc djch vg y td nAi Chung vd cdc djch vg DS-KHHGO nAi ridng.
Huy ddng cAng ddng gdp phdn ndng cao vai trA cOa nguAi ddn trong cAng ddng trong vide tgo ra du Iudn, hudng dng, thuc hidn, gidm sdt cdc hogt dOng ehdm sAc sdt: khde cho chlnh bdn thdn hp tgi cOng ddi^
Huy dAng cdng ddng trong chflm sAc sdc khd cAn glOp cho cdc nhd qudn \^. cdn bfl y td nfim bdt fc|
thdi cdc phdn hdi td- ngudi dfln, cdc bdt cdp, rdo c&
trong tidp cdn vd sd' dgng dfch vg y td... dd tCr dA ld|
kd hogch kjp thdi, cA gidi phdp hO'u hidu nhdm tdnj cudng dich vg y td cho ngudi ddn.
Huy dflng cOng ddng cAn tgo ra cdu ndi giO'a c bd qudn ly, cdn bA y td vdi ngudi ddn, td dA tgo ^ thdn thidn trong giao tidp, gAp phdn vdo thdnh c cda cdc hogt dAng tmydn thAng.
Huy dflng rflng rdi cdng ddng tham gia cdc li dAng tmydn thAng dua trdn dflc thd cda td7>g ddn ti..
gAp phdn phdt huy cdc gid trj tmydn thdng vdn hda hgn ehd vd bdi tn> cdc hd tgc hoflc cdc tflp qudr khAng tdt cho 8d>c khAe, phdt huy gid tn tri thi>c y hpt ddn gian trong vide ehO'a bdnh tgi gia dinh.
KST LUAN
D i xuit mA hinh ndng cao hidu qui hogt d^{
truyin thdng DS-KHHGO tgi huydn VA Nhai gdm i gidl phdp:
GUI phip 1. TSng cudng Idnh dgo, td chdc vd quir ly cde hogt dflng tmySn thAng DS - KHHGD.
GUI phip 2: Tflng cudng ddo tgo tdp hudn chuyir mAn cho cdn bA Idm cdng tdc dfln sd.
GUI phip 3: Ddy mgnh ^ d n IhAng gido due chuydn ddi hdnh vi vd DS - KHHGD.
GUI phip 4: Huy dAng su tham gia cua cflng ding trong vide chflm sAc sue khde sinh sdn, DS - KHHGB dua trdn mAt sd khia cgnh dflc thd vfln hda - xd hfli cua td'ng ddn tAc.
T A I L I $ U THAM K H A O
1. Nguydn Ngpc Anh (2012), tidp cfln vd si> dung djch vg KHHGD/SKSS cua mflt sd nhAm ddn tflc thl^i sd c6 mi>c sinh cao, Bdo edo todn vdn hfli nghj khoa hpc todn qudc HAi y id cAng cAng Vidt Nam ldn thd 8 thdng 10 ndm 2012 • Hfli y td cAng cflng ViSt Nam, tr.211-217.
2. Bdo edo todn vdn hAi nghj khoa hpc todn qudc Hfii y td cAng cAng Vidt Nam ldn thd 8 thdng 10 n9m 2012 - Hfli y id cAng cAng Vi$t Nam.
3. Bdo edo thuAmg niSn 2011 Hfli y td cAng cflng ViSt Nam.
4. BA Y td (2010), Chiin luvc quic gia vi chSm sdc sOc khde s/n/i sin giai doan 2001 - 2010, Hd Nfli.
5. BA Y td (2011), Chuvng trinh hdnh ding Tniyk, thdng chuyin <sSi hdnh vi vi DS- KHHGD giai dbgn 2011-2015.
6. Chi cgc DS - KHHGD ttnh Thdi Nguydn, Bdo cdc tdng kdt cAng tdc DS-KHHGD ndm 2011.
7. Phgm Hdng Hdi ^011), Nghidn cdu m^t s6 yit ti lidn quan din difcft vu yti cho phv n& ngudi Dao vi khia cgn/) vin hda - xd hdi tai huyin Bgc/i Th&tg. M Bic C^n. Lufln fln tidn sT y hpc, Dgi hpc Thdi NguySn.
8. Trgm Y td xfl DSn Tidn, huyfln VA Nhai, Snh TTi4 NguySn, Bdo edo thdng kd chuySn ngdnh DS - KHHGG thdng 12 ndm 2011.
9. Trgm Y td xfl Binh Long, huyfln Vd Nhai, tint Thdi NguySn, Bdo edo thdng kd chuydn ngdnh DS • KHHGD thdng 12ndm 2011.
10. Taing Idm DS - KHHGD huySn Vfi Nhai. lint Thdi NguySn, Bdo edo thdng kS chuySn ngdnh DS|j
KHHGD thdng 12 nflm 2011. 2
Y HQC THVC HANH (856) - SO 1/20U