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Subject and Scope of Thesis Research


limitations in the management of capital of this agency;

- Proposing solutions to improve the management of public investment capital at the Ministry of Health in accordance with the socio-economic situation in the new conditions.

4. Subject and scope of thesis research

4.1. Research subjects

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The research object of the thesis is theoretical and practical issues of public investment capital and public investment capital management for healthcare.

4.2. Scope of research

Subject and Scope of Thesis Research

Regarding the content: The research limits the management of public investment capital from the central budget to meet the investment needs of the health sector and the Ministry of Health as the investment management agency. Therefore, the decentralization of management and the process of managing public investment capital at the Ministry of Health are the main research contents of the thesis.

Regarding space: The research on capital investment management is limited to investment projects directly managed by the Ministry of Health and implemented nationwide; however, the information of each project does not have the opportunity to appear in the entire content of the thesis, but is only selected to illustrate each specific content. International experience on capital investment and capital investment management is studied in countries and regions with similar conditions to Vietnam.

Regarding time: Research on the current status of public investment capital management at the Ministry of Health in the period of 2016 - 2020; research solutions and recommendations applicable until 2025 and vision to 2030;

5. Research methods

The scientific research methodology used in the thesis is the methodology of dialectical materialism, historical materialism and the application of Ho Chi Minh's thought to the medical career.

Specific methods used in the study include:

Economic statistical methods are applied in project selection.


projects, select the necessary information in each project to proceed with the classification, collection and analysis of information according to the established research objectives. On that basis, draw comments and assessments appropriate to the objectives, research objects, and appropriate to the actual circumstances of each DTC project included in the assessment.

The synthesis and analysis method is applied when the collected database is relatively sufficient compared to the requirements. Through comparison and contrast between the practice of capital investment management in projects and the management requirements established based on the theoretical foundations and legal framework currently in effect, it points out the strengths, weaknesses, and causes leading to that situation. This will be one of the bases for proposing solutions to improve capital investment management at the Ministry of Health in the following years.

The sociological survey method was applied to develop the questionnaire. 250 questionnaires were issued; of which 178 were answered and sent back to the researcher. The questionnaire form and the results of post-survey information processing are presented in Appendix 1.

The forecasting method is applied to determine the demand and capacity of public investment capital at the Ministry of Health in the medium and long term. On that basis, the goals and implementation methods are established, aiming at the expected result that through public investment capital management at the Ministry of Health, there will be a more positive contribution to improving the operational efficiency of the health sector and continuously improving the level of fairness in the consumption of health services in Vietnam.

6. Scientific significance in theory and practice of the thesis topic

In terms of theory , the thesis synthesizes, systematizes, and analyzes, contributing to enriching and clarifying theoretical issues on capital management for health care; emphasizing the concepts, characteristics, principles, processes, evaluation criteria, and factors affecting capital management for health care.


In practice , the thesis synthesizes international experience in managing public investment capital for health care and draws some reference lessons for Vietnam in general and the Ministry of Health in particular; synthesizes, analyzes, demonstrates and clearly points out the achievements, limitations and causes of the current situation of public investment capital management at the Ministry of Health; builds public investment capital needs for the health sector, proposes solutions and recommendations based on scientific theory and practice to improve public investment capital management at the Ministry of Health by 2025, with a vision to 2030.

7. Structure of the thesis

In addition to the Introduction, Conclusion, References and Appendix, the main content of the thesis is structured in 3 chapters:

Chapter 1: Theoretical and practical basis of public investment capital management for health care.

Chapter 2: Current status of public investment capital management at the Ministry of Health of Vietnam.

Chapter 3: Perfecting public investment capital management at the Ministry of Health for the period 2022 - 2025, with a vision to 2030.


Chapter 1

THEORETICAL AND PRACTICAL BASIS OF MANAGEMENT OF PUBLIC INVESTMENT CAPITAL FOR HEALTH

1.1. HEALTH AND PUBLIC INVESTMENT IN HEALTH

1.1.1. Medical Overview

1.1.1.1. Concept of health

Healthcare and the use of healthcare services seem to be familiar terms to everyone; because from the moment we are born, we have to use healthcare services. But what is healthcare? What services are within the scope of healthcare? These seemingly simple questions are still not easy to get a unified answer.

In the East (mainly Asia), which is greatly influenced by Chinese culture, the term medical is often interpreted in the sense of ancient Chinese words, and is read as “ hygiene medicine ” or “ hygiene and health care ”; in which “hygiene” means medical treatment , “hygiene” means protecting life , and “health care ” means protecting health [23, p.938]. Whether read as “hygiene and health care” or “hygiene and health care” , it implies the relationship between one side being the medical service provider - medical practitioners such as orthopedists, dentists, nurses, pharmacists, allied health professionals, and health care service providers; and the other side being the medical service user. Both sides have the responsibility to care about the development of medical treatment and hygiene, improving the health of each individual in the community.

Nguyen Nhu Y (1998) again considers medicine as " the medical profession that specializes in disease prevention and treatment " [63, p.1884]. Nguyen Nhu Y's concept of medicine comes from the context of a national economy that has developed quite strongly, leading to the formation of economic sub-sectors; in which medicine is a sector with the main function of preventing and treating diseases for everyone. To do this


To perform that function, healthcare must be organized into a system from central to local levels, implementing many different tasks to ensure the best disease prevention and treatment.

In Western countries where English is widely used, people often use the word " Health " or " Healthcare " to mean health assistance or care; the implication is that the result of this activity is to care for and protect human health. Obviously, in countries with early industrial development, the approach to the concept of health is also different. They choose the result of health activities as a measure; because health is one of the most basic potentials that bring value to human life. However, the concept of health depends on the approach associated with the development trend of the times and the vision of each individual and organization.

Before the 1970s, the World Health Organization (WHO) considered health to be the state of being free from disease; that is, every part of the body still fulfills its inherent functions. From then on, the task of medicine was to try to do a good job of disease prevention to minimize the malfunction of a part of the human body; and when someone got sick, try to cure them quickly. The above concept of health is called the concept of health in a narrow sense; because it only looked at human health from a biological perspective. Before 1970, there was also a concept of human health in a broad sense, that is, it should not be limited to the state of being free from disease; instead, it must ensure both factors: no disease, and mental comfort. However, in the context of many socio-economic limitations, this broad concept of health was less supported.

In 1946, in the context of the country's myriad difficulties, President Ho Chi Minh's concept of health was approached in a broad sense.


wrote: “… blood circulation, full spirit, that is health ” [2, p.241]. He emphasized the relationship between people’s health and the development of the country with an extremely short sentence: “ A strong people makes the country prosperous ” [2, p.241]. Receiving his instructions, the provisional government propagated and educated people to actively practice and constantly improve their health, contributing in many ways to protect the young people’s democratic government, preserve Independence, and wage a long-term resistance war to bring the country together. The miraculous victories from Dien Bien Phu in 1954 to Dien Bien Phu in the air in 1972, and the Ho Chi Minh Campaign in 1975 further affirmed the value of comprehensive health of the Vietnamese people throughout those two long-term resistance wars.

In September 1978, WHO in collaboration with UNICEF organized the Global Conference on Primary Health Care, with the participation of 134 countries; including Vietnam. The conference took place in Alma-Ata city, Republic of Kazakhstan from September 6 to 12, 1978. The conference affirmed: " Health, a state of complete physical, mental and social well-being, and not merely the absence of disease, is a fundamental human right to achieve the best possible state of health, is the most important social goal worldwide requiring action from many economic and social sectors, not just the health sector " [67, point 1].

Since the Alma-Ata Declaration on Health, governments in many countries have made efforts to respond to and organize comprehensive health care for their people. And most of the tasks of health care for their people, governments have assigned the main responsibility to the health sector.

Therefore, today, talking about healthcare means talking about the duty of caring for and protecting human health. In the context of the increasingly integrated world economy, the duty of caring for and protecting human health is not only limited to the scope of a country, but has continuously expanded.


regionally and globally. Therefore, the concept of healthcare must also be re-examined to suit socio-economic development in new conditions.

In this study, medicine is understood as medicine serving the care and protection of human health. It is medicine with the implication of having to study and research very meticulously and specifically about the structure of the human body, the mechanism of infection or disease, the properties of medicinal herbs, weather, climate, ... that affect the quality of medicinal herbs and human health, to advise people to know how to protect their health, make decisions to prevent epidemics, or treatment decisions for each specific case. Protecting and assisting human health care with the implication of promoting self-protection of each person's health through disease prevention, maintaining initial health care activities that need to be prioritized, promptly examined and treated when necessary. With so many tasks and directly related to human life, the medical profession requires to be carried out with extreme caution and a high sense of responsibility.

Medical activities imply illustrations and indicate more clearly and specifically the concept of medicine. From the perspective of theoretical research, medical activities are considered as a component part of the content when approaching general medical research. Depending on the purpose of approaching medicine, medical activities will be reflected through different criteria:

If considered in terms of the ability to cause impact on health and the socio-economic efficiency of healthcare , healthcare activities include: disease prevention and treatment.

Disease prevention in medicine includes activities that help people understand health; self-training to continuously improve the health of themselves and their families; being ready to respond and participate in activities to ensure environmental hygiene and food safety; knowing how to prevent common diseases for themselves and their families; researching and producing preparations for vaccination or epidemiological hygiene to limit the development of epidemics. In short, disease prevention is an activity aimed at the result of minimizing the possibility of disease occurrence for each individual and for


the whole society. Therefore, the benefits that disease prevention activities bring are enormous, if we know how to organize disease prevention activities properly.

Medical examination and treatment is the next activity that the health sector must perform when an individual or a community is sick. Medical treatment must follow a process: Diagnosis - Treatment - Assessment - Adjustment. This process cannot be reversed, and no step must be missed. Diagnosis is to find the cause of the disease and then proceed with treatment. Treatment is the process of using medical procedures combined with pharmaceuticals, foods, and tools to gradually push back the disease. Evaluate the treatment results after each application of each treatment regimen for each patient to have a basis for making adjustments. Adjustment is to find the most feasible treatment regimen for each patient. The effectiveness of medical examination and treatment, in addition to following the correct procedure, also depends a lot on the attentive and dedicated care of the workers in the medical examination and treatment facility and the active and effective cooperation of the patient. In practice, the medical examination and treatment process cannot be regulated by a general document; Instead, the Ministry of Health must develop and promulgate specific technical procedures for medical examination and treatment for each narrow specialty, such as: internal medicine, musculoskeletal; biochemistry; microbiology; pediatrics; ... [32], to serve as a basis for inspection and examination activities, assigning responsibility to each organization and individual in this activity.

If we consider the need for health care , health activities include: primary health care and continuing health care.

Primary health care is essential health care based on appropriate, scientific, socially acceptable methods and technologies that are easily accessible to individuals and families in the community through their full participation at a reasonable cost that can be maintained at all stages of development in the spirit of self-reliance and self-determination [67, section VI]. Primary health care includes at least 8 main contents: (i) education related to health issues

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