State management on the development of highly qualified health human resources in Son La

development of highly qualified health human resources in Son La Province 8 CHAPTER 1 THEORETICAL BACKGROUND AND EXPERIENCE IN STATE MANAGEMENT FOR HIGH-LEVEL MEDICAL HUMAN RESOURCE DEVELOPMENT IN LOCAL 1.1. Overview of developing highly qualified health human resources in locality 1.1.1. Highly qualified health human resources - Definition + Medical human resources is a group of people with professional qualifications and medical ethics suitable to professional characteristics who directly participate in people's health care activities. + Highly qualified health human resources are people with a college degree or higher, with professional qualifications and medical ethics suitable to professional characteristics who directly participate in people's health care activities. - Classification of highly qualified health human resources: There are many criteria for classifying highly qualified health human resources, for each classification criteria are shown as follows: By job title, by route, by training specialty, by job nature, by qualification, according to source. In addition, Medical human resources is also classified by gender, ethnicity, seniority .... 1.1.2. Basic characteristics of highly qualified health human resources It is a special profession, therefore, it has specific characteristics: Firstly, highly qualified health human resources carries out work directly related to people's health, the lives of patients so they should be humane; Secondly, highly qualified health human resources has its own ethical characteristics. Thirdly, highly qualified health human resources carries out work that requires a lot of labor; Fourthly, health human resources does its job with risks and uncertainty. Fifthly, highly qualified health human resources needs large investment and close, planned coordination in education and training. Sixthly, highly qualified health human resources carries out work with the advantage of the market but is controlled. 1.1.3. Development of highly qualified health human resources in local - Definition: Development of highly qualified health human resources in local is the increase of the quantity and quality, appropriately creating the structure of training college degree or higher from improving the professional and medical capacity of people directly involved in the activities. Health care for people in the locality. - Content: Some basic contents of locally qualified health careers 9 development are identified as: (i) attracting, recruiting and allocating highly qualified health human resources ( should be calculated, forecasted scientifically and closely followed the practical implementation organization in terms of identifying needs, the process of attracting, recruiting and using; forms of attraction, placement, recruitment and use); (ii) training and retraining of highly qualified health human resources; (iii) remuneration for highly qualified health human resources. 1.2. State management on development of highly qualified health human resources in locality 1.2.1. Concept, characteristics of State management on development of highly qualified health human resources in locality - Definition: State management on development of highly qualified health human resources in locality is the use of the State's power to adjust the process to increase the quantity and quality, to create a rational structure of health human resources with a college degree or higher degree from the improvement of professional and medical ethics of people directly involved in health care activities of local people. - Characteristics: Firstly, the objectives of State management on development of highly qualified health human resources Secondly: The subject of state management depends on political institutions. Thirdly: Object of State management on development of highly qualified health human resources activities. Fourthly: The content of State management on development of highly qualified health human resources includes: Fifthly: Method of management Sixthly: Management tools 1.2.2. Content of State management on development of highly qualified health human resources in local * Content 1: Develop plans and promulgate policies for development of highly qualified health human resources - Developing plans, strategies for development of highly qualified health human resources: A plan sually has vision of 5-10 years. The human resources development strategy plays an important role as a component of the socio-economic development strategy, while the strategy for development of highly qualified health human resources constitutes the development strategy of the health sector; - Issue policies to develop highly qualified health human resources: Policies for developing highly qualified health human resources are listed as: - Policies to attract, recruit and use highly qualified health human resources; 10 - Training - Improving highly qualified health human resources policy; - Remuneration policy for highly qualified health human resources ... Main contents: Objects and scope of application of attractive policies; Attractive policy targets; Solutions of policy attract; Funds to implement policy attract; Organize the implementation of policies to attract ... Usually those policies are integrated into the laboratories or general irrigation facilities. * Content 2: Execute state management on the development of highly qualified health human resources. - Organize state management apparatus: The state management apparatus for the development of highly qualified health human resources in the locality is set up under a unified system ensuring the principle of transparency. - Carry out activities of highly qualified health human resources development activities + Attraction, recruitment, arrangement and use of highly qualified health human resources: State management agencies must focus on the key activities: Elaborate employment placement schemes in local health stations; Forecast of demand for highly qualified health human resources in accordance with health care needs; Identify sources of attraction, recruit highly qualified medical human resources; Design and implement procedures to attract, recruit science and regulations; Comply with the principles of attraction and recruitment according to the following stages: Before recruitment, prequalification, formal recruitment, after recruitment; Arranging and using highly qualified health human resources appropriately + Organize training courses for highly qualified health human resources: Training - Improving activities is intended to reduce the time and effort of apprentices in learning by themselves and drawing out the rules and experiences of phenomena. In which: Content of Training - Improving: Appropriate (ethical qualities; professional knowledge and skills; soft skills); Form of training and education: There are many forms (full-time and part-time training; long-term, short-term and specific training courses; direct and indirect training.) In addition, forms of self- training and self-study are also featured). + Organization of treatment of highly qualified health human resources: Two basic groups of instruments: financial and non-financial remuneration. *Content 3: Examine and supervise the development of highly qualified health human resources: - Regarding the content of test and inspection: Examining and supervising input and output resources of high-level health human resource development activities. - Regarding the form of test and inspection: To be held regularly 11 according to plans and irregularly. 1.2.3. Criteria for evaluating state management on highly qualified health human resources in localities Inheriting from the research of scientists, the criteria for evaluating "State management on development of highly qualified health human resources" include: * Efficiency: Measure the efficiency by comparing the results of the implementation of state management contents of agriculture and forestry development and resettlement with the set goals. Determining the efficiency of state management on development of highly qualified health human resources is answering two questions: Firstly, are the objectives of state management for agriculture and rural development, is it correct? Secondly, how is the implementation of state management on highly qualified health human resources? *Effectiveness: The effectiveness of state management on development of highly qualified health human resources is assessed through the achievement of the goal with the lowest cost of input resources. Accordingly, the effectiveness of state management on development of highly qualified health human resources is measured by quantitative and qualitative indicators. * Suitability: It is expressed through a number of indicators such as: (i) State management on Development of highly qualified health human resources in local in accordance with the policy framework, the law on Development of highly qualified health human resources; (ii) consistent with the goals of using highly qualified health human resources; (iii) in accordance with the national strategy for highly qualified health human resources; (iv) suitable to local socio-economic conditions (v) suitable to local cultural and social conditions; *Sustainability: Reflecting the ability of state management to maintain the efficiency criteria of the state management on Development of highly qualified health human resources. Some of the criteria for assessing sustainability are: (i) Policy of Development of highly qualified health human resources locally is competitive; (ii) The appropriateness of the quantity, structure of highly qualified health human resources infrastructure with the sustainable development strategy of the local health sector; (iii) The appropriateness and improvement of the quality of highly qualified health human resources with the sustainable development strategy of the local health sector; (iv) Inspection and supervision in Development of highly qualified health human resources in local work is carried out regularly and promptly to detect errors and shortcomings. 1.3. Several factors influence the state management on Development of highly qualified health human resources locally 12 1.3.1. Subjective factors Firstly, economic conditions in the locality: As an important factor, in the context of state management of an area in a locality, when considering the impact of economic conditions to analyze: (i) The situation of economic growth in the locality; (ii) Financial resources are determined for the local health sector; (iii) The proportion of the local service sector facilitates the development of the health sector. Secondly, cultural and social characteristics in the locality Thirdly, capacity of State management officials on the development of highly qualified health human resources in the locality: All studies on state management consider the impact of the capacity of state management staff on state management, indicating that if the state management staff has: (i) knowledge to meet the requirements of performing functions and duties; (ii) Skills to meet requirements of performing functions and tasks; (iii) Qualities that meet the requirements of performing functions and duties; (iv) Perform functions and duties well; (v) Properly exercising authority ... positively affecting state management. If the state management officials are incompetent, lack of accountability will hinder the construction of the policy. Fourthly, physical conditions, local medical equipment: Most researches on state management have shown the influence of the factor of science and technology development on the state management; The effectiveness of state management is strongly influenced by the conditions of facilities, equipment and the application of scientific and technological achievements. In the era of technology 4.0, the sustainable development and development of health depends on grasping and mastering advanced science and technology so that professional activities are highly effective and do not fall behind. Therefore, health human resources must promply adapt to survive. 1.3.2. Objective factors Firstly, policies and laws of the State: Develop and promulgate policies legal policies on human resource development in general and developing highly qualified health human resources in particular is an important task at the national level, which has a decisive influence on state management on development of highly qualified health human resource in locality. The more comprehensive, consistent and transparent state laws and policies are ensured, the more motivational will be created to promote the development of highly qualified health human resources in the locality. Secondly, health sector development strategy: For the health sector, the central state management plans the strategy of the health sector so that the local health sector develops in line with the trajectory and common 13 health goals of the whole society. The planning and implementation of strategies and policies on agriculture and forestry development in localities must ensure compliance with the general development strategies and plans of the region and the whole country; At the same time, it must be suitable with the needs of deeper and wider integration into the world economy in association with the country's development process. Thirdly, the system of training medical human resources: The quality of the health human resource training system is the decisive factor in the quality of highly qualified health human resources; The number and distribution of the system of health human resource training facilities create barriers or motivations for the development of highly qualified health human resources in the locality. To have a reputable highly qualified medical human resource training facility is a serious and formal investment process with huge funding. 1.4. Experience in state management on development of highly qualified health human resources in localities 1.4.1. Experience of some localities Firstly, experience of Quang Nam province: Considering the following factors: Regarding training policies, attraction policies, Secondly, experience of Quang Ninh province: Considering some outstanding solutions such as: (i) Reserving payroll quotas for recruiting doctors; (ii) Training of Highly qualified health human resources; (iii) Transfer technical packages and Highly qualified health human resources for Medical specialties: Thirdly, experience of Hoa Binh province: (i) About policies to attract and recruit; (ii) Regarding training policies: Training scale, type of training and place of training, conditions, criteria of training subjects, regime of payment of training expenses, training funding. 1.4.2. Lessons learned through study of experiences Firstly, defining the key viewpoint of Development of highly qualified health human resources, building a leading team of experts, preserving ethics is a key factor to improve the quality of Medical Examination and Treatment. Satisfying and maintaining the trust of the people, empowering the local health sector to create destinations for people to always choose. Secondly, focusing on building a Master Plan for Health Human Resources Development Program, international integration is a strategic activity, with both synchronous and key investment and development with breakthrough, ensuring training, using and coordinating local Health Human Resources. Thirdly, concretizing the project with specific policies in accordance with local conditions and characteristics to develop Highly qualified 14 health Human Resources. Fourthly, innovating and organizing the state management apparatus of the local health sector to ensure leanness and efficiency. Fifthly, organizing specific programs and activities to bring the project and Policy on Developing Highly qualified health human resources into life; Sixthly, doing well the inspection and supervision activities of Health Human Resources Development at High Level periodically. Implement reporting, synthesizing and keeping data on Health Human Resource Development. CHAPTER 2 CURRENT SITUATION OF STATE MANAGEMENT ON DEVELOPMENT OF HIGHLY QUALIFIED HEALTH HUMAN RESOURCES IN SON LA PROVINCE 2.1. Overview of Son La province's health sector 2.1.1. The process of forming and developing the medical industry in Son La province Son La Department of Health Care was established in February 1949. Throughout the journey of formation and development, Son La Health Sector has made constant efforts, making an important contribution to the care, protection and improvement of People's health, achieving great strides with comprehensive innovation, creating a new face for the industry. 2.1.2. Organization structure of the health sector in Son La province. Son La's health system is managed by industry, from province to grassroots level has been gradually strengthened and reorganized in a synchronized manner, focal points have been reduced. 2.2. Situation of state management on development of highly qualified health human resources in Son La province 2.2.1. Situation of content of state management on development of highly qualified health human resources in Son La province - Develop planning, plans and promulgate policies. - Organize the implementation of State Management for Highly qualified health human resources development: Organize the apparatus, execute development of highly qualified health human resources activities - The situation of inspection and supervision on the development of highly qualified health human resources in Son La province 15 Figure 2.3: Number of inspections, tests of development of highly qualified health human resources in Son La Source: Son La Department of Health 2.2.2. Evaluation of the development of highly qualified health human resources in Son La Province through criteria Firstly, efficiency: Survey results of the postgraduate’s survey on "State management’s Effect on development of highly qualified health human resources in Locality" shows that: The average value is assessed at a score of 3, 22 out of 5.0 points mean "Neutral". Secondly, effectiveness: There is an increase in the number but there is a shortage of Doctors and especially postgraduate doctors and in-depth specialties; a team of leading experts in a number of fields; human resource structure by region and field is not consistent with the regulations; Number of doctors on annual work throughout the province has not met the health sector development plan. Consider by factors: The total number of health workers and the increase in the number of health- highly qualified personnel; Degree of increasing the rationality of each type of Highly qualified health Human Resources (By title; By prevention and treatment division, by route); Increased level of capacity of Health Human Resources (qualifications; seniority). Thirdly, suitability: The survey results "The appropriateness of state management on the development of highly qualified health human resources in the locality", with average values with quite good assessment. at a score of 3.56 / 5.0 points which means "Agree" to the statements. Fourth, sustainability: The average value is rated at medium low with a score of 2.66 / 5.0. From the above analysis, it can be seen that the work of development of highly qualified health human resources in Son La province in the past 5 years has achieved certain successes, but it is still slow, unclear and unsustainable in all aspects of quantity, structure and quality. 2.3. Analysis of the situation of factors affecting the state management on the development of highly qualified health human resources in Son 16 La province 2.3.1. Subjective factor situation - Economic conditions in Son La province - Socio-cultural characteristics of Son La province - Capacity of State management officials on Health Human Resource Development in Son La Province: There is a big gap in management capacity of current officials compared to the needs. The State Administration of Health is mainly a doctor with good expertise, who is involved in Medical Examination, so the time and experience for management is limited. That explains the reasons for the limited planning, planning and human resource management at all levels. Monitoring and management of human resources has not been standardized. Lack of adequate, accurate and specific information on Health Human Resources in general, Development of Health Human Resources in particular; Lack of evaluation information The impact of Health Human Resources Policies impedes the ability to effectively plan and develop them. - Medical facilities, equipment in Son La province + Regarding medical facilities at all levels: The Director of Son La Department of Health said: "Overall, the Son La public health care system is quite adequate, although it has completed the organizational structure, but the infrastructure and Medical equipment at the Son La Province Health Care is still in need, especially at the Commune Health Care ". + Regarding equipment, medical equipment: Basic equipment provided with all essential lists; few hospitals participated in the Satellite Hospital Project 2.3.2. The situation of objective factors - Policies and laws related to the development of Vietnam's highly qualified health human resources: The law is the Law on Examination and Treatment; Health Insurance Law, Pharmaceutical Law, State policies are very diverse: (i) In terms of attracting, recruiting, arranging and using Highly qualified health human resources have a lot of policies have been issued (see Appendix 8); (ii) In terms of Training-Fostering Highly qualified health human resources; (iii) In terms of treatment of highly qualified medical human resources. Although there have been changes but slowly, the current law and Policy on Developing Human Resources for High-Level Health still have many inadequate regulations that are not commensurate with the dedication and nature of special work of human resources of Health professionals with High Level Health. - Vietnam health sector strategy: On January 10, 2013, the Prime Minister approved the Strategy for Health Sector Development with the 17 name "National Strategy for protection, care and promotion of People's Health for the Period of 2011-2020, with a Vision to Year" 2030 ". To accomplish that goal, the main solutions are proposed including: + Rearrange the network of training institutions for development of highly qualified human resources for health + Upgrade medical staff training facilities + Develop criteria for evaluating and evaluating the quality of training medical staff. + Expand forms of Training - Nursing to develop the contingent of Health Officers, giving priority to the training of local medical cadres. Ensure enough staff titles for health facilities, especially for mountainous, deep-lying, remote, disadvantaged, border and island areas; + Promote postgraduate training for provincial and district levels + Improve hospital management capacity + Deploy effective solutions, suitable to the local socio-economic conditions In addition, strengthening the state management of health. Step by step standardize the professional and managerial capacity for each position of the staff at both central and local levels ... Develop a system of standards and standards for the fields of Health sector - The system of grassroots medical human resources training institutions Survey results show that the assessment is all "neutral" with the average point of the scales: Firstly, the base system of Medical Human Resources Training is lacking in both quantity and quality. Secondly, the work of Training Highly qualified health human resources still has shortcomings about the Training program and the teaching staff. Third, there is no regulation on national examination before issuing practice certificates to ensure that practitioners gain necessary competencies. 2.4. General assessment 2.4.1. Success In the period of 2014-2019, Son La province has achieved remarkable results in the State management on developmen