(…)

3. Raising the quality of healthcare for the mothers and children

In 1999 efforts should be concentrated on the program for healthcare for the mothers and children with the following major contents:

1. To care for the mothers' health before during and after their childbirth, ensuring cleanness and safety therein. Each expecting mother is given three fetus checks during a period of pregnancy and at least one check within 42 days after the childbirth striving to achieve the goal that more than 80% of the mothers are tended by medical workers in their childbirths.
   
   

2. To step up the work of information. propagation, medium education and consultation on reproductive health safe motherhood clean childbirth among subjects in the fertility age group.
   
   

3. To reduce the number of abortions by 25% as compared to 1998 by closely coordinating with the National Committee for Population and Family Planning at all levels in providing contraceptive services.
   
   

4. To coordinate child healthcare programs such as the enlarged vaccination programme, ARI, CDD, Vitamin A... in order to reduce the mortality rate among children under one and under five years old to 3.5% and 4.2% respectively. To eliminate polio and infant tetanus by the year 2000.

4. To step up the target programs against child malnutrition in order to cut the malnutrition rate among children under five (weight by ages) by 3% annually with the following active measures:

1. To continue implementing the target programmes against malnutrition among children, paying attention to poor localities with high rates of malnourished children; to adhere to the objectives defined in Decision No.244/1998/QD-TTg of November 17, 1998 of the Prime Minister on adding the objectives of preventing and combating child malnutrition to the national target program for elimination of a number of social diseases and dangerous epidemics.
   
   

2. To intensify the work of health and nutrition propagation and education among expecting and nursing mother so as to help them acquire healthcare knowledge for preventing and combating malnutrition for their children most effectively.
   
   

3. To build children-friendly hospitals and medical examination rooms. as well as nutrition departments at hospitals in order to quickly restore nutrition for child patients when they have to hospitalized.

5. Consolidating the grassroots health networks

1. To continue implementing Decree No. 0l/1998/ND-CP of the Government on the system of local health organizations and Joint Circular No. 02/TTLT of the Health Ministry and the Government's Commission for Organization and Personnel guiding the implementation of the above-mentioned Decree. In 1999, priority shall be given to the definitive settlement of the question of medical investment for 1,000 particularly difficult continues among the total of 1,715 poor communes throughout the country with four contents: Building clinics or health stations having adequate medical equipment; having medical cadres in communes and medical workers in villages and hamlets. having capital for drug trading (on the basis of ODA capital and domestic budget).
   
   

2. In order to ensure that by the year 2000, 100% commune health stations have midwives or assistant doctors in obstetrics and pediatrics, 40% of the communes have physicians and 100% of the villages and hamlets have community-based health workers, the provincial/municipal Health Services shall have to draw up plans therefore and apply a number of measures as follows:

- Organizing refresher courses on obstetrics and pediatrics for general assistant-doctors and on midwifery for nurses; training primary-level midwifes at intermediate medical schools who shall be on probation at district health centrer and be recruited for communes; working out policies to encourage midwives in low-lying regions to move and work in highland regions.

- Implementing the regime of sending people from communes for being trained into physicians who, after finishing their study, will return to work in communes; rationally rearranging personnel in provincial and district medical establishments so as to be able to post physicians to communes on the rotation basis. At the same time, periodically sending commune doctors to work at clinical departments of the district medical centre so as to raise their professional skills; working out regimes to encourage retired military and civil doctors in localities to work at communes; coordinating with the Ministry of Defense in training doctors for border stations, army units in distant, border or island regions as well as difficult areas, who shall undertake the healthcare for army men and for local people as well.

- Quickly perfecting the hamlet health networks with 5 key requirements:

+ Unifying the hamlet health networks in term of organization, direction, tasks and functions according to the Health Ministry’s regulations.

+ Having their operation contents suitable to the level of cadres in each region.

+ Having timetables for regular meetings with the local medical establishments.

+ Enjoying the regime of monthly allowance from the State budget and contributions by community.

+ Having first-aid kits containing tools and drugs suitable to the professional level of the hamlet health personnel (according to the list prescribed by the Health Ministry).

- The Health Services of the provinces and centrally-run cities should well implement the assignment of plans and norms, particularly to the district health centres and commune health stations; to divide the managerial responsibility through medical norms so as to bring into full play the initiative and creativeness of the grassroots health networks; enhance the direction and supervision so as to help establishments tackle in time difficulties and problems that arise.