Quản lý nhà nước về phát triển nguồn nhân lực y tế trình độ cao tại sơn la tt tiếng an

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INTRODUCTION
1. Necessity of the topic
President Ho Chi Minh asserted: "No matter what, are made by people,
and from small to large, from near to far, all are." Matsushita Konosuke has
proved that: "Human resources, the key to success". Susan R. Meisinger has
stated: "Human is our most important asset". The above-mentioned
summarized statements, although appearing at different times, cultures are
not the same, have also affirmed the special importance of human resources
for each country, each industry, each organization..
The health sector of Son La province has the responsibility and
mission to carry out health care for more than 1.2 million people in the
province and some provinces of Laos in the border with Son La province.
In order to complete the assigned tasks, the Son La health sector needs to
have a strong enough system with a sufficient health network covering the
provinces and communes, a high quality medical workforce ... Currently
In Son La province, the state management of highly qualified health
human resources is still limited such as: the elaboration and
implementation of master plans, plans on development of the health sector
in general, development of health human resources. High level in
particular has not kept up with development requirements. Some plans
have shown signs of inadequacy, contradiction and lack of feasibility; to
organize the state management apparatus on the development of highly
qualified health human resources, with a lack of concentration and unity;
inspection, operation inspection and handling of violations in the field of
development of highly qualified health human resources, though being
paid attention to directing and implementing, are still sparse, post-bar
handling. checking each time, every place is not definitive; The
effectiveness, efficiency, suitability and sustainability of state
management on the development of highly qualified health human
resources in the province have improved, but there are still many

shortcomings. There is a shortage of doctors, especially doctors with postgraduate and in-depth qualifications; a team of leading experts in a
number of fields; human resource structure by region and field is not
consistent with the regulations; the number of doctors working in the
whole province is not enough and meets the provincial health sector
development plan and natural population development plan. The shortage
of doctors in the field of health units in specific fields such as:
Tuberculosis; Leprosy; HIV AIDS; Forensics; Psychiatry and at Medical
station of commune, ward and town. For the above reasons, Post-graduate
chose the topic: "State management on the development of highly
qualified health human resources in Son La" as a doctoral thesis.


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2. Overview of the research situation
2.1. Research situation on health human resources and development of
health human resources
Research topics on human resources for health development of health
human resources have also been studied by many domestic and foreign
authors. These studies have clarified the important role of health human
resources and the requirements for health human resources in the world.
At the same time, studies have also shown the need of health human
resources in terms of quality and quantity. However, the researches are
generally on the development of health human resources without any indepth research on the development of highly qualified health human
resources in localities and in Son La province.
2.2. Research situation on state management for development of highly
qualified health human resources
The studies also identify factors affecting the state management of
health human resources. Specifically: (i) research on state management on
human resource development in the industry; (ii), researches on state
management of health human resources.

Realizing that some works and documents have been provided with
relatively complete content and state management tools. In the mentioned
studies, there has been a work on state management of health but it has only
stopped at general institutional management or state management on a
specific human resource aspect. research on state management according to
health human resources associated with occupational characteristics; No
study has fully evaluated and analyzed the scientific basis for state
management of the development of highly qualified health human resources
in localities and specifically in Son La province.
2.3. Comments and research gaps
Through researching the reviewed works, a number of issues have been
specifically addressed:Firstly, there are different approaches to health human
resources in general and the current status of the structure, qualifications of
the global health human resources system, priorities for development and
development policy. in subsequent stages; general policies for health human
resources for developing countries; joint action program of the world to
improve the health system, its mission to improve the capacity of health
workers and improve the quality of healthcare for patients. Content of
management and policies on health human resources in some localities and
regions around the world such as India, Asia Pacific, Africa ...
Secondly, a number of studies have focused on the analysis of the
Vietnamese health system, the concept of human resources for health, the
status of health human resources, including: development status, size and
distribution; recruitment and remuneration policies for health workers in a


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number of localities and regions in the country; The current situation of
health human resources with successes and inadequacies needs to be
addressed, at the same time, forecasting the factors affecting human

resource development and proposing some development orientations as well
as providing similar solutions to develop health human resources.
Thirdly, a number of studies have mentioned medical human resources
institutions, the role and importance of training content, quality monitoring
content, and the use of remuneration policies when recruited. for human
resources for health. Some studies also mention the link between economic,
cultural, political and social conditions of each region, region and locality for
the development of the health system and health human resources under the
following angles. degrees and degrees vary.Fourthly: a number of works and
documents have relatively completed the elements, content and tools of state
management of labor safety. In the mentioned documents, there are documents
that mention state management on health but only at general institutional
management, there are no studies on state management according to specific
fields. can be associated with career specificity.
In a nutshell: the study of related works shows that "gaps" need to be
further studied, namely:
- Systematic theoretical framework associated with specific health
sector including: the concept of health human resources, health human
resources-tcc; content of state management on development of highly
qualified health human resources in localities; criteria for evaluating state
management on development of highly qualified health human resources
in localities; Factors affecting state management on development of
highly qualified health human resources in localities.
- Analyze and assess scientifically the situation of state management
on the development of highly qualified health human resources in Son La
province associated with specific conditions.
- Assessing the situation of factors affecting the state management of
the development of highly qualified health human resources in localities,
the case study of Son La province.
- Comprehensive and feasible system of solutions and

recommendations for perfecting state management of highly qualified
health human resources development in Son La province.
From the identified void, the research direction of the thesis is new
with the inheritance and development of a research result from published
works on the principles of state management and human resource
development. International.
Accordingly the research questions of the thesis are identified as: (i) the
scientific basis of state management on the development of highly qualified
health human resources in localities and the status of state management on the


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development of highly qualified health human resources in Son La
Province?(ii) What factors affect the state management of the development of
highly qualified health human resources in Son La?(iii) what should we do to
improve the state management of the development of highly qualified health
human resources in Son La Province?
3. Aims and tasks of the study
3.1. Aims of the study
The thesis proposes major solutions and recommendations with
scientific and practical basis to improve the state management of the
development of highly qualified health human resources in Son La
province, Vietnam.
3.2. Task of the study
Firstly, systematize and clarify the theoretical basis of state management
for the development of highly qualified local health human resources.
The second is to study the experience of state management of highly
skilled human resources in some provinces and cities in Vietnam to draw
lessons for the health sector of Son La province.
Thirdly, conducting surveys and assessing the state management of

highly qualified health human resources in Son La province; analyzing the
situation of factors affecting the state management of health human
resources in Son La province from which to draw conclusions about the
successes, limitations and causes of these limitations.
Four are: researching the orientation, goals of developing highly
qualified health human resources of Son La Province to 2025 and vision to
2030; propose a view to perfect the state management of the development of
highly qualified health human resources in Son La province to provide
scientific and practical basis for solutions and recommendations.
4. Subject and scope of the study
4.1. Subject of the study
The subject of the study is state management of the development of
highly qualified health human resources in localities in general and in Son
La province, Vietnam in particular.
The subject of state management of the development of highly qualified
medical human resources in localities is the People's Council and the
provincial People's Committee, of which the Health Service is a specialized
advisory agency. Subject to state management are activities to develop highly
qualified health human resources, including attraction, recruitment,
arrangement and use; training and retraining; create motivation for highly
qualified health human resources at local health facilities.
4.2. Scope of the study
Spatial scope: State management research on developing high-level local
health human resources, practical research in Son La province.


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Scope of time: the reality of state management of highly qualified health
human resources of Son La province in the period of 2015-2019. Proposing
solutions to improve state management on development of highly qualified

health human resources in Son La Province by 2025 with a vision to 2030.
Scope of content: Within the scope of the thesis, a research
framework is formed with a number of key aspects (see Figure 1):
State management on the
development of highly qualified
health human resources in
localities
Contents of State
management on
Development of highly
qualified health human
resources in locality
Organize the
Inspect and
Develop
implementatio
supervise the
strategies,
n of state
development of
master
management
highly qualified
on the
plans, and
health human
development
resources in
foundations
of highly

localities
for
qualified
developing
health
human
highly
resources
qualified
in
localities
health
Subjective
factor
Economic conditions; Cultural and social
human
characteristics;
Capacity of State management
resources
in
officials; Facilities, medical equipment in localities
localities

Effic
iency

Criteria for evaluating
state management on
development of highly
qualified health human

resources
Effec in localities
Suita
tiven
ess

bility

Sustai
nabili
ty

Objective factor
Legal policy; Health sector development strategy;
Training facility system of health human resources
with high qualifications

Factors affecting state management on development of highly qualified health human
resources in localities

Figure 1: Research framework of thesis
Source: Proposed by postgraduate
5. Research method
5.1. Methods of collecting information
Using the method of dialectical materialism and historical
materialism based on objective phenomena and economic law as the
methodology and are applied throughout the research. Sources of
information and data for the research of the thesis include all secondary

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and primary data sources. For each of the above data types, postgraduate
has her own collection methods to get the most correct and reliable data
source for analyzing the current situation of developing highly qualified
health human resources of Health sector in Son La province.
5.1.1. Document research method
- Document study method: Applied to collect secondary data sources
from the Ministry of Health agencies; Department of Health, Department
of Home Affairs of Son La province, some hospitals or health care
facilities at all levels of Son La province, summary reports on professional
tasks, summary data of scientific conferences, journals related to highly
qualified health human resources under the research scope of the thesis.
- Case study method: Conducted at Son La General Hospital and
Thuan Chau District General Hospital are two hospitals used to illustrate
the assessment of provincial and district health facilities.
- Expert method: Topic refer to and use the opinions of experts in the
medical field; Experts are consulted in the fields of: Principals of highly
qualified health human resources training institutions; Leaders at Service,
Department of Health; Leaders of Son La Department of Health; Leaders
of the provincial hospitals, leaders of district hospitals in the health sector
of Son La province.
- In-depth interview method: On the basis of document review and
conducting preliminary research on state management on development of
highly qualified health human resources in the locality, the postgraduate
conducted in-depth interviews with 08 representatives at the Ministry of
Health; Department of Health of Son La province; leaders of the provincial
and district hospitals; leaders of highly qualified health human resource
training institutions to correct, screen, and remove the manifestations of the
statements to develop survey questions and supplement some detailed
information about state management on development of highly qualified

health human resources in Son La province.
- Investigation, survey method: About survey content; objects;
sample size.
5.2. Information processing method:
Secondary data processing: Collected data are sorted by time,
specific content and encoded by subject data and performed analysis
according to specific criteria using method of statistics, analysis,
comparison.
Primary data processing: It is done through the form of quantitative
research (postgraduate gives 529 valid votes in 700 questionnaires) to
analyze and create descriptive statistical data for the scale, rate or rank
(such as: gender, seniority, education level, job position, ...); describe
scales such as the content scale of the state management on the


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development of highly qualified health human resources, the influencing
factors, ..... In summary: By a combination of research methods,
postgraduate has obtained full, multi-dimensional and objective
information on the state management status on developing highly
qualified health human resources in Son La province.
6. Significance of the thesis
6.1. Scientific significance
The thesis has systematized and developed a basic theoretical step on
state management for the development of highly qualified health human
resources in localities, including: (i) establish the concept of state
management on development of highly qualified health human resources
in localities; (ii) develop a theoretical framework on the content and
criteria for evaluating state management on development of highly
qualified health human resources in localities; (iii) identify the key factors

affecting state management on the development of highly qualified health
human resources in localities.
6.2. Practical significance
(i) The thesis gives experience learned for Son La province in state
management on development of highly qualified health human resources
through the study of state management experience in development of
highly qualified health human resources in some localities in the country
has similar characteristics. (ii) carry out an assessment of the status of
state management on the development of highly qualified health human
resources in Son La province with content and measurement criteria; (iii)
analyze the situation of factors affecting the state management of the
development of highly qualified health human resources in Son La
Province.(iv) synthesize and propose key viewpoints and solutions to
improve state management on the development of highly qualified health
human resources in Son La Province on the basis of summary on
successes, limitations and causes leads to limitations; research and
development orientation of Son La province's health sector; The goal of
developing highly qualified health human resources for the health sector
in Son La Province is up to 2025 and a vision to 2030.
7. Organization of the thesis
In addition to the introduction, conclusion, references, appendixes,
the thesis is divided into 3 chapters:
Chapter 1: Theoretical basis and experience on state management of the
development of highly qualified health human resources in localities.
Chapter 2: Current situation of state management on development of
highly qualified health human resources in Son La province.
Chapter 3: Some solutions to perfect the state management on
development of highly qualified health human resources in Son La Province

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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


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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;


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- 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 selftraining 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


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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


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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


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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


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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


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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 healthhighly 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 development of highly
qualified health human resources:
(i) Policies to attract, recruit, train, foster and treat highly qualified
health human resources gradually synchronize, stabilize and improve the
legal corridors, create motivation for the develop the Health sector,
including Highly qualified health human resources.
(ii) Policies to attract, recruit and use; Training - Fostering and
treating High Qualified Health Human Resources in Son La has attracted


18
a large number of Highly qualified health human resources, expressed in
scale, number of Health Human Resources increasing per day.
(iii) The quality of Highly Qualified Health Human Resources in Son
La province has been increasingly improved, reflected in the increasing
proportion of Health Professionals with university and higher
qualifications.
(iv) Inspection and examination are carried out in collaboration with
ministries and departments from the central to local levels.
2.4.2. Limitation
Restrictions on State Administration of Highly qualified Health
Human Resource Development in Son La Province. Also revealed many
limitations, which are: (i) The work of developing and implementing the
health plan and development plan of the health sector in general,
development of highly qualified health human resources in particular has
not kept up with the development requirements. Some plans have shown
signs of inadequacy, contradictions and lack of feasibility; (ii) The

organizational structure of the State Management System for development
of highly qualified health human resources is still fragmented, lacking
concentration and unity; (iii)The inspection, operation inspection and
handling of violations in the development of highly qualified health
human resources have been interested in directing, but generally sparse,
handling after the inspection bar each time, each place is not definitive;
(iv) The effectiveness, efficiency, suitability and sustainability of the State
management on the development of Highly qualified health human
resources in the province has improved, although there are still many
shortcomings.
2.4.3. The cause of the limitations
About subjective reasons:(i) The capacity of the State management
on development of highly qualified health human resources in Son La
province has not kept up with the great local needs affecting the quality of
advisory work; (ii) The economic development conditions associated with
the industry transition are not strong, have not created strong financial
resources for the Development of Highly qualified health Human Resources;
(iii) Traditional cultural and social conditions still exist, low levels of
education among ethnic people are major barriers to the development of
highly qualified health human resources in Son La; (iv) Infrastructure and
equipment for preventive medicine at district and commune levels are
inadequate to facilitate the development of agricultural and rural
development in Son La.
On objective reasons: (i)The legal and policy system governing the
development of highly qualified health human resources has been in effect
for a long time, is now outdated, and does not match changes in the new


19
context of world medicine; (ii) The health sector development strategy has

not been updated to fit the context and challenges of the complex
integration and disease development process; (iii) The basic training
system for highly qualified health human resources is lacking in quantity,
limited in quality and unreasonable in structure.
CHAPTER 3
SOME SOLUTIONS TO PERFECT THE STATE
MANAGEMENT ON DEVELOPMENT OF HIGHLY QUALIFIED
HEALTH HUMAN RESOURCES IN SON LA PROVINCE
3.1. Health Sector Development Goals and Orientations for
Developing Highly qualified health human resources Son La Province
to 2025, Vision to 2030
3.1.1. Goal to develope the health sector of Son La
General goal: Build and develop the health system of Son La step by
step modern, perfect, and synchronous from province to commune
Specific goal: (i) Invest in developing preventive medicine network;
(ii) Invest, arrange the medical examination and treatment; (iii) Develop
pharmaceutical industry; (iv)Strengthen and improve the grassroots of
local health network
3.1.2. Goal and orientations to develop the medical human resource –
high qualification of Son La province
Firstly, Strengthening the protection, care and improvement of
people's health in the new situation..
Secondly, develop highly qualified health human resources based on
practical basis, inherits and promotes achievements, experiences,
overcome inadequacies and weaknesses.
Thirdly, , develop highly qualified health human resources based on the
necessity, urgency, feasibility and suitability among socio-economic regions.
Fourthly, Medical ethics education is parallel with professional training,
simultaneously with the development of medical science research capacity.
Fifthly, enhance cooperation, attract financial resources and absorb

advanced technology
3.2. Viewpoint of perfecting the state management on medical human
resource development with high quality in Son La province
3.2.1. Perfect the state management on medical human resource
development with high quality Towards ensuring target coverage
To ensure the goal of health capacity coverage on all aspects of
quantity, quality and structure
3.2.2 Improve the state management on medical human resource
development wit high quality the towards capacity to providde


20
Vocational standards and training standards must be promulgated by
state management agencies at all levels and concretized as a basis for the
development of quality of medical human resource with high quality
3.2.3. Improve the state management of the development of highly
qualified health human resources towards motivational goals
3.3. Proposing solutions to improve state management on development of
highly qualified health human resources in Son La province
- Reviewing, amending and supplementing plannings, plans, and
policies for developing highly qualified health human resources in Son La
province
- Completing the policy for developing highly qualified health human
resources in Son La, including: Completing the policy of attracting,
recruiting, arranging and using highly qualified health human resources.
3.3.2. Improve the state management organization for development of
highly qualified health human resources in Son La province
Firstly: Raise awareness of levels, sectors and the whole society about
human resource development.
Secondly: Improve the quality of advisory work, proposing

Thirdly: Innovating management methods
Fourthly: Improve and enhance the coordination among levels, sectors
and entities involved in human resource development
Fifthly: Early establishment of a provincial-level Human resource
Training Council
Sixth: Son La Medical College has an appropriate solution to improve
the quality of training.
3.3.3. Strengthen inspection and supervision on the development of
highly qualified health human resources in Son La province
Firstly, strictly implement the legal system of inspection and
examination in Health activities, management and development of highly
qualified health human resources
Secondly, strengthen the contingent of health inspection officials
Thirdly, strengthening the inspection and regular inspection
Fourthly, publicize and make transparent the information related to
the implementation of Health tasks, strengthen the handling of violations
related to highly qualified human resources.
Fifth, renovate and perfect the information supply and processing
system..
Sixth, control the use of budget and finance
3.4. Proposing solutions to improve subjective factors to facilitate the
completion of state management of the development of highly
qualified health human resources in Son La Province
3.4.1. Improve the capacity of State management officials on the


21
development of health human resources in Son La province
Firstly: Research and promulgate standards for state management
personnel on human resource.

The second is: Implementing the work of planning and planning State
management personnel on human resource.
Thirdly: Innovating the recruitment and selection of State
management officials on human resources
Fourthly: Strengthen training of State management officials on
human resource. Conduct additional training and retraining for state
management officials at Son La Department of Health.
Fifthly: Performing the arrangement and use of State management
officials on human resource Health science.
Sixlthly: Innovating the work of assessing State management officials
on human resource.
Seventhly: Improving regimes and remuneration policies for State
management officials on human resources;
3.4.2. Promote the strengths in economic development of Son La
province to create resources for the development of human resource
health- high quality in Son La province
In general: To substantially restructure economic sectors, improve
productivity, quality and competitiveness of industries and fields, promote
growth and economic restructuring. Gradually transforming the growth model
in depth, applying modern technology, based on investment and export.
In each sector: Investment promotes the strengths of each industry.
3.4.3. Remove cultural and social barriers to stimulate the development
of highly qualified health human resources in Son La Province
Promote communication to raise awareness of ethnic minorities on the
values of the People's Health Care system, the benefits of scientific
examination and treatment, and the harmful effects of traditional practices.
Hau in the treatment of disease. Improving people's intellectual standard,
creating a sustainable source for human resource of health - high level.
3.4.4 Strengthen ensuring that medical facilities and equipment meet
the development requirements of human resource - high quality at the

grassroots level
Firstly, evaluate the current status of medical equipment at health
facilities.
Second: Review and update the list of essential medical equipment;
building database and equipment.
Thirdly: Supplement and upgrade medical facilities and equipment
for health facilities to ensure the requirements of technical division,
priority of grassroots levels and disadvantaged areas;
Fourthly: Strengthen the maintenance and repair of medical equipment;


22
improve the quality of human resources involved in the maintenance and
repair of medical equipment; allocate sufficient funding to the unit for
maintenance and repair of medical facilities and equipment;
Fifthly: Strengthen the province's network of calibration and testing of
medical equipment.
3.5. Some recommendations to create favorable conditions for the
completion of state management of the development of health- high
quality human resources in Son La Province
3.5.1. Perfecting policies and laws in line with changes from environment
and international integration to make a change in state management of
development of health-highly qualified human resource
Firstly, the Government submitted to the National Assembly to
supplement and amend a number of laws related to to renew training and
develop high-quality human resources for the health sector.
Secondly: The Government will soon develop and approve the
Master Plan for the development of the Vietnam Health System by 2025,
with a vision to 2035.
Thirdly, the Government soon approved the Scheme on strengthening

the grassroots health system to build infrastructure, upgrade equipment
and train human resources according to the Ministry of National Criteria
of Commune Health for the period to 2020. , associated with building a
new countryside (criterion 15 on Health)
Fourthly: The Government soon approved a number of new decrees,
supplementing and amending a number of important current decrees to
implement laws and projects related to human resources human resources.
Fifthly: The Government directs the Ministry of Education &
Training. Ministry of Health implements the planning of human resource of
health - Highly qualified at Training facilities and Health facilities; directing
the Ministry of Planning and Investment, the Ministry of Finance and the
Ministry of Home Affairs to research, review, develop and promulgate
policies to encourage non-state organizations to participate in human
resource training activities. international - high level;
Sixthly: The Ministry of Health is the focal point for coordinating the
development, adjustment and proposal policies in training and recruiting
remuneration for human resource health - high quality in accordance with
the views of the Central Resolution No. 20 Course XII "Medical
profession is a special job that needs special training, recruitment,
employment, and remuneration".
Seventhly: Ministry of Education and Training strengthens
coordination with Ministry of Health
Eighthly: Ministry of Labor and Social Affairs strengthens
coordination with Ministry of Health to issue a Policy on management of


23
vocational education activities. with Health Sector Training schools.
3.5.2. Developing the training system of human resource health- high
quality in Vietnam

- Arranging and developing the training system of highly qualified
health human resources to create conditions for Son La province and
Northern midland and mountainous provinces
Firstly, ensure the process and strict review, accreditation to ensure
the quality of training for newly established training institutions and
health training institutions in the field of Health Care.
Secondly: Deploying the scheme of arranging and developing a
number of training facilities into the University of Health Sciences. The
model of the University of Health Sciences includes many of its existing
universities in Vietnam like the Hanoi National Universities, Ho Chi Minh
National University, and regional universities in Thai Nguyen and Hue.
Da Nang, has been specified in the Law amending and supplementing a
number of articles of the Law on Higher Education.
Thirdly: Reviewing and selecting the plan to build an investment
project to establish a medical human resource training university at Son
La, providing human resources - high-quality human resources for the
Northwest region and a number of provinces of Laos.
- Comprehensively renovate training programs and improve the
quality of teaching staff at health human resource training institutions
with high qualifications
- Innovatd the comprehensive training program on health sector
- Actively renovate active training methods and invest in facilities
for training human resources for health - with high levels: training
methods and facilities for training.
- Improve the quality of teaching staff to meet innovation at health
human resource training institutions: Develop plans and plans for a
contingent of highly qualified human resources for health human
resources teaching force, Supplementing teaching staff, Developing
policies to attract and use highly qualified health workers, Improve the
quality of life of teaching staff.

- Organize national examinations before issuing practice certificates
to ensure that practitioners gain necessary competencies: In order to
improve the quality of medical school training and the quality of human
resources for health - with high qualifications, a comprehensive
renovation of the practice of issuing medical practice certificates is
required in the direction of implementing national examinations and
regulations. Validity period of certificate. The method of implementation
is as follows: Purpose, object of application, organization unit,
deployment time, form of examination.


24
CONCLUSION
In the field of health, highly qualified health human resources is the
most important resource, which determines the scope and quality of health
services and plays a decisive role in the implementation of medical
examination and treatment tasks. and take care of local people's health.
Due to the importance of this human resource, management levels,
domestic and foreign scientists have made many policies, scientific
research projects on solutions to improve the quality of highly qualified
health human resources, especially from a local state management
perspective.
To evaluate the content of state management on developing highly
qualified health human resources in Son La province, the thesis has used
criteria of effectiveness, efficiency, suitability and sustainability. The
practical research results show that in the state management of the
development of health human resources at high level in Son La province,
there are still limitations such as planning work has not kept up with
development requirements, organizational apparatus. State management of
highly qualified health human resource development is fragmented, and

examination work in this area remains sparse. The effectiveness,
efficiency, suitability and sustainability of state management on the
development of high quality health human resources in Son La province
still have many shortcomings.
The dissertation has also identified factors influencing the state
management of developing high-quality health human resources; The
impact of these factors on the development of high quality health human
resources in Son La province has been carried out in practice and found
that the impact of these factors is very large.
To overcome the inadequacies of the state management in developing
high-quality health human resources in Son La province, the thesis has
proposed solutions and recommendations to focus on completing the
contents of home management. feasible and practical guaranteed water.
The conclusions of the assessment of the current situation and the
solutions and recommendations proposed in this thesis can be useful for
many other localities with similar socio-economic conditions in the
country to refer and apply.
Despite their best efforts, the research topic is relatively wide and the
research experience of the graduate student is limited, so the research
results are definitely lacking. We hope to receive comments from
lecturers, scientists, colleagues ... so that postgraduate can develop further
research in the future.