Home / Training

Distribution of Traditional Medicine Staff by Geographic Region


+ Nurses - NDs, NHS, KTVs practicing in clinical departments: 5 points

-. Over 10% have college or university degrees, the rest are high school graduates: 4 points

- Less than 10% have college or university degrees, the rest are high school graduates: 3 points

- 100% have high school degree: 2 points

Maybe you are interested!

- 80% have secondary education, the rest are primary: 1 point

Currently, only 0.03% of professors/associate professors and 8.02% of medical staff with postgraduate degrees work at provincial traditional medicine hospitals (Table 3.4), which shows that there is still a great shortage of medical staff with postgraduate degrees working at hospitals. According to Circular 03/2004/TT-BYT dated March 3, 2004 of the Minister of Health on hospital ranking guidelines, the higher the proportion of staff with postgraduate degrees, the higher the bonus points for ranking. At traditional medicine hospitals, if we consider medical staff with traditional medicine majors, the proportion of postgraduate medical staff is similar to the proportion of medical staff in general. At hospitals, only 0.1% of medical staff have the level of professor/associate professor, 0.2% of medical staff have the doctorate degree (Table 3.5). Compared to a traditional medicine hospital in Son La province, the entire hospital has no staff with a PhD degree, only 1 Pharmacist I participating in pharmaceutical work, and the rest are staff with intermediate qualifications [9]. Compared to the rate of medical staff with post-graduate degrees in central traditional medicine hospitals, the rate of medical staff with post-graduate degrees in provincial traditional medicine hospitals is very low. Currently, the whole country has about 9 professors/associate professors in traditional medicine working in traditional medicine hospitals, most of whom are concentrated in central hospitals. The whole country has 27 doctors in traditional medicine, but in provincial traditional medicine hospitals, there are only 6 staff with a PhD degree, which shows that the difference in qualifications of medical staff in provincial traditional medicine hospitals is very large compared to the qualifications of medical staff in central traditional medicine hospitals [77].

Distribution of Traditional Medicine Staff by Geographic Region


The characteristic of traditional medicine hospitals is that the staff working at the hospital, in addition to staff with specialized training in traditional medicine, also have medical staff trained in general medicine. Comparison between hospital levels shows that: level III hospitals have a higher rate of medical staff specialized in traditional medicine than the rate of medical staff specialized in traditional medicine in level II hospitals, and the rate of medical staff trained in other specialties in level III hospitals (21.9%) is also higher than the rate of general medical staff in the hospital and is the highest among hospital levels (chart 3.5). The total number of medical staff in level III hospitals is less than the total number of medical staff in level I and level II hospitals, while the number of medical staff with other specialized training is equivalent to the number of medical staff trained in other specialties in level I and level II hospitals.

4.1.2.2. Type of training and training location

In terms of training types for traditional medicine practitioners, from the survey in 08 provinces/cities, there are many places that train traditional medicine practitioners and pharmacists. These are the Oriental Medicine Association (53.4%); Acupuncture Association (16.2%); Traditional Medicine High School (22.5%) and 45.3% practice traditional medicine. In addition, 15.7% of traditional medicine practitioners and pharmacists learn through friends, relatives, self-study... The rate of people studying at the Oriental Medicine Association, practicing traditional medicine and learning from others in the traditional medicine group (66.2%; 49.3% and 25.4%) is higher than that of the traditional medicine group (44.7%; 51.5% and 14.2%), while the rate of people studying at Traditional Medicine High School in the traditional medicine group (23.1%) is higher than that of the traditional medicine group (18.3%), the difference is statistically significant with p<0.05 [55].

Regarding the training contents, the specialized contents trained in the group of traditional medicine and pharmacy account for a high proportion: basic theory (79.7%), internal medicine (73.8%), pathology (70.9%), therapeutics (71.6%), acupuncture (63.9%), gynecology (65.6%), pediatrics (63.2%). The specialized contents trained


less than surgery (58.2%), nursing (47.0%) and geriatrics (29.7%). The specialized content trained in the traditional medicine group was more than that in the traditional medicine group (p<0.01) [55].

According to the 1998 survey data of the Ministry of Health [64], traditional medicine practitioners and pharmacists were trained in traditional medicine associations (17.3-23.4%), in hospitals and institutes (12.8%), in traditional medicine schools (13.2-21.1%) and 30.8-34% were family practitioners; 13.2-30.8% were self-taught. The 2001-2002 national health survey also showed that up to 24.5% of traditional medicine practitioners were family practitioners [15].

Thus, the educational level and expertise of the group of physicians and pharmacists

very diverse and uneven.

In the group of traditional medicine practitioners, many people have just graduated from high school or junior high school, mainly studying as "apprentices" or studying with some traditional medicine practitioners or traditional medicine doctors, short-term training, often not following a unified professional document. They are mainly trained in how to treat some diseases according to traditional medicine prescriptions, thus lacking general medical knowledge and qualifications. Therefore, the health sector in general and traditional medicine professional associations need to have policies and measures to manage and improve the quality of the traditional medicine team, contributing to improving health care for the community.

Currently, the training system includes universities, colleges, central hospitals, provincial and municipal hospitals. The country has 21 public medical universities (17 civil schools, 1 military school) and 3 private medical schools/faculties. These schools train one, several or many different types of medical staff. Most provinces have intermediate or junior medical colleges. There are 30 colleges in 30 provinces training nursing, midwifery, medical technology, and medical testing. There are 35 intermediate medical schools in 35 provinces training intermediate and primary medical staff [32]. In general, the number of medical schools developed


developed nationwide. The training forms are diverse, of which the two most common are: regular and specialized/on-the-job training. Different training forms also lead to different quality of medical staff. The regular training form creates a class of medical staff that is relatively uniform in quality, while the specialized/on-the-job training form has differences in the quality of students after graduation. It can be said that in the traditional medicine hospitals of class II and class III, the majority of medical staff are formally trained, at 73.9% and 65.2% (Table 3.14), so the quality of medical staff in class II and class III hospitals is relatively uniform in quality in medical examination and treatment.

4.1.3. Distribution of traditional medicine staff by geographical region

Currently, our country is divided into 6 different geographical economic regions: Red River Delta, Northern Midlands and Mountains, North Central and Central Coast, Central Highlands, Southeast, Mekong River Delta. The economic characteristics of each geographical region are different, leading to different health care needs of people in the region. Analyzing a geographical region shows that the health care needs there are different from those of other regions.

The Red River Delta: has great advantages, has abundant labor resources, this labor source has a lot of experience and tradition in production, high labor quality, creating a market with great purchasing power. There is a lot of investment from the State and foreign countries. Strongly developed infrastructure (transportation, electricity, water ...), roads have National Highway 1A, National Highway 5, 2, 3, 6, 32, 18 ... North - South railway and radiates to other cities; Noi Bai international airport, Cat Bi airport, Hai Phong; major ports such as Hai Phong port, Cai Lan port ...; Technical facilities for industries are increasingly complete: irrigation systems, stations, farms protecting crops, livestock, processing factories ... requiring health care forces


extremely large here, traditional medicine plays an important role in health care.

health of people, especially in remote areas.

Analyzing the distribution of medical staff by geographical region shows that the distribution of medical staff is unbalanced in both quality and quantity. In terms of quantity: medical staff in region I are mainly doctors (19.2%), the university nursing force also accounts for the highest proportion in the regions (1.3%); specifically in Hai Phong, the medical examination and treatment force accounts for 31/145 people (21.4%) [8], region II has the lowest proportion of medical staff with medical qualifications in the regions (13.1%), most of them are secondary nurses (22.3%) and medical doctors (26.5%); in region III, the distribution of medical staff is relatively similar to region I (Table 3.15); In region V, medical staff working at traditional medicine hospitals are distributed relatively evenly, medical staff with university nursing qualifications still account for a low proportion (0.9%), however, in region III, medical staff with university nursing qualifications account for the lowest proportion (1.8%) (Table 3.15). Regarding quality: in most socio-economic regions, there are no medical staff with professor/associate professor and doctoral qualifications, only region I has 0.3% professor/associate professor and 1.3% doctorate (Table 3.16), and region VI has 0.1% doctorate, in socio-economic regions, medical staff with level I specialist qualifications account for a high proportion, region III has the lowest proportion of medical staff with level I specialist qualifications (0.7%). In addition, there is a small proportion of medical staff with master's and level II specialist qualifications; Medical staff with university degrees in all regions still account for a large proportion and in all regions the proportion is relatively similar, the lowest in region IV (accounting for 5.3%), the highest in region V (accounting for 8.7%) (Table 3.16). All socio-economic regions have medical staff with college, intermediate, bachelor's degrees and other qualifications outside the medical sector. In terms of the quality of medical staff specializing in traditional medicine: only in region I there are staff with the level of Professor/Associate Professor (0.3%) and Doctor (2.1%), the distribution of medical staff with qualifications is uneven between regions. Region II and region VI have a low proportion of medical staff with Master's degrees, medical staff with


Traditional medicine specialists, like general health workers, have a high rate of level I specialist degrees. The highest rate of level I specialist medical staff is in region I (8.2%), the lowest rate is in region III with a rate of 1.3%; in most regions, the rate of medical staff with university degrees is relatively even (Table 3.15).

The training forms in economic regions are relatively similar, most of the medical staff in different economic regions are trained in a centralized form. Region VI has a larger number of medical staff trained in specialized/in-service training (44.7%) (Table 3.17), while region II has a high proportion of medical staff trained in a centralized form (76.9%), in region V there are no medical staff trained in other fields, but it is still in the general situation of the training of medical staff in the whole country. The training majors of medical staff working in provincial-level traditional medicine hospitals are also somewhat different, although most of the medical staff are trained in traditional medicine. However, the proportion of medical staff trained in general and other fields is uneven. In regions II, IV, VI, the proportion of medical staff trained in other specialties is higher than that of medical staff trained in general medicine, while in regions I, III, and V, the proportion of medical staff trained in general medicine is higher than that of medical staff trained in other specialties. Medical staff trained in other specialties usually do not directly participate in medical examination and treatment in hospitals, but only serve general work in hospitals. Thus, in regions where the proportion of medical staff trained in other specialties is higher than that of medical staff trained in general medicine, the ability to participate in medical examination and treatment is limited, affecting people's response to traditional medicine health care.


4.2. NEED FOR CONTINUOUS TRAINING FOR MEDICAL STAFF AT HOSPITALS

PROVINCIAL INSTITUTE OF TRADITIONAL MEDICINE

4.2.1. Current status of continuous training needs for traditional medicine staff

Although the State has issued Circular No. 07/2008/TT-BYT, dated May 28, 2008, guiding the continuous training for medical staff, the implementation of continuous training still has many shortcomings: such as the lack of a mechanism to assess the quality of training programs and a mechanism to force all medical staff to comply with regulations, and the lack of general coordination for effective implementation of programs.

The topics of the short-term training courses chaired by the Ministry of Health are determined to meet the needs of public administrative reform, such as state administrative management, hospital management principles, leadership skills, international economic integration and basic principles of health economics. The Ministry of Health has established a Retraining Board, with the participation of the Department of Organization and Personnel, the Department of Science and Training and a number of training units such as the University of Public Health, the Ho Chi Minh City Institute of Public Health and Hygiene, the Ministry of Health's Information Technology Center, under the leadership of the Deputy Minister in charge of training. The University of Public Health and the Ho Chi Minh City Institute of Public Health and Hygiene are the two units assigned to organize retraining courses for the North and the South. In the future, the Hue University of Medicine and Pharmacy's retraining center will participate in the training process. During the period of implementing autonomy under Decree 43, leaders of units need to learn more about management skills [46]. The Ministry of Health is currently orienting to standardize a number of mandatory leadership and management skills for leaders and managers.

Regarding medical expertise, disadvantaged areas and grassroots health facilities have medical staff.


lower level, need to be strengthened, updated and improved to a higher level than elsewhere. The Government has a large investment program to build, renovate and upgrade medical facilities at district and commune levels, both in terms of medical examination and treatment [4 5], and at commune levels in difficult areas [49]. This includes the goal of improving the professional and technical capacity of medical staff, prioritizing training and fostering in the first 2 years of implementing the Project to have enough qualified staff to use and promote the effectiveness of newly invested equipment.

Many other short-term training courses organized by projects often have overlapping topics [76]. These topics may not meet the actual needs of the units. Currently, there is a type of training under contract with training facilities. This type meets the real needs of medical staff at the grassroots level. Medical facilities that want to train under contract must have a source of funding to pay for the training contract.

The quality of the training courses is not high, and they mainly teach theory, with few opportunities for practice [76], so health workers are somewhat uninterested in participating in the above short-term courses.

A major limitation for short-term training courses is the lack of funding, partly due to low standards. Currently, the Ministry of Health's retraining budget is limited, only enough for 50 classes with about 2,000 students in units under the Ministry of Health. Therefore, many health workers have the need but cannot participate. For the training program according to Decision 225/2005/TTg investing in district-level hospitals in the period 2005-2008, each year the budget is about 5 billion VND [45]. However, according to Decision 47/2008/QD-TTg investing in district-level hospitals in the period 2008-2010, the budget for training and improving professional capacity for health workers is used in the annual regular expenditure estimate according to

Comment


Agree Privacy Policy *