UNDP Final Low

Dch v x hi
phc v
pht trin con ngi
Bo co Quc gia v Pht trin Con ngi nm 2011
Bn quyn thng 11 nm 2011

Chng trnh Pht trin Lin hp quc
25-29 Phan Bi Chu, H Ni, Vit Nam
Bn quyn thuc v Chng trnh Pht trin Lin hp quc. Khng c sao in, ti bn, lu tr trong mt h
thng m hoc chuyn ti bt k phn no hoc ton b ni dung ca bo co ny di mi hnh thc nh in
t, sao in, ghi m hoc cc hnh thc khc khi cha c s ng .
Hiu nh (bn ting Anh): Juliette Elfick
Thit k bn in: Inis (www.iniscommunication.com)
Trong trng hp bn in c li, vui lng truy cp bn in t ti trang web www.undp.org.vn
Dch v x hi
phc v
pht trin con ngi
Bo co Quc gia v
Pht trin Con ngi nm 2011
LI TA
Mi nm trc, Bo co pht trin con ngi u

tin ca Vit Nam c cng b. Bo co ny
tp trung vo cc ci cch chnh sch ca qu trnh
i mi v tc ng ca ci cch ti gim ngho
v pht trin con ngi. Mi nm sau k t nm
2001, Vit Nam c bc thay i nhanh chng.
Tng trng n tng trong hai thp k qua
gip gim ng k t l ngho i. Pht trin con
ngi ca Vit Nam v ang tng dn v hin
nay Vit Nam ang bc vo giai on pht trin
con ngi mc trung bnh, cng vi cc nc
nh n , Indonesia v Philippines. Tuy nhin,
nhng ng lc ca tng trng to ra trong thi
k i mi ang bt u mt i, do c nhn t bn
trong v bn ngoi.
L nc thu nhp trung bnh, Vit Nam hin ang
c nhiu c hi pht trin mi. Tuy nhin cng c
nhiu thch thc cn phi gii quyt, c bit nu
Vit Nam mun vt qua ci gi l by thu nhp
trung bnh. Nhng thch thc ny bao gm c s
h tng km pht trin, mc chuyn mn ha
v kh nng cnh tranh km, trnh khoa hc v
cng ngh yu cng nh lc lng lao ng thiu
k nng. Nhng thch thc ny ang e da s
bn vng ca nhng thnh tu m Vit Nam
t c v cn tr pht trin con ngi ln mc
cao hn.
Do vy cn c mt cch tip cn pht trin mi
nu Vit Nam mun t c tng trng c cht
lng v bn vng hn. Trong , Vit Nam cn
tp trung khng ch vo vic nng cao thu nhp
m cn vo ci thin pht trin con ngi, v d
thng qua cung cp cc dch v y t v gio dc
cht lng cao hn, to vic lm bn vng cho lc
lng lao ng tr ngy cng ng, tng cng
qun tr nh nc v to ra cc th ch mnh v
hiu qu. m bo s cn i hn gia tng trng
kinh t v cc mc tiu pht trin x hi, con ngi
v bn vng l iu cn thit m bo rng mi
ngi dn c th hng thnh qu t qu trnh
pht trin v Vit Nam t c mc tiu tr
thnh nc cng nghip ha v hin i.
IV
Bo co Pht trin Con ngi 2011
Khi nim pht trin con ngi c cp

nhiu trong cc chnh sch ca Vit Nam. Khi
nim ny c ghi nhn trong Hin php ca
Vit Nam, v cc Chin lc v K hoch Pht trin
kinh t x hi u nhn mnh n tm quan trng
ca cng bng x hi v thc y cht lng cuc
sng. m bo dn s khe mnh v c hc thc
c tip cn cc dch v x hi c cht lng v
h thng bo tr x hi l mt trong nhng mc
tiu trung tm ca cc chnh sch ca chnh ph.
Nh cp trong Chin lc Pht trin kinh t
x hi mi, vn con ngi v pht trin con ngi
ng vai tr quan trng trong vic hin thc ha
tm nhn pht trin ca Vit Nam.
Nguyn l trung tm ca Bo co pht trin con
ngi ny, vi ch Dch v x hi cho pht trin
con ngi, l tng trng kinh t trong ni hm v
v bn cht khng t ng mang li s pht trin
con ngi cao hn. S thnh cng ca mt quc
gia khng th o lng mt cch n gin bng
thu nhp quc dn. Thay vo , con ngi l ti
sn thc s ca cc quc gia v u t pht trin
con ngi l cch tt nht t c tng trng
v pht trin bn vng. Trong bi cnh bt bnh
ng v thu nhp gia tng cng nh tn ti khong
cch ng k v kinh t-x hi mt s vng v
cc tnh ca Vit Nam, chng ti cho rng y l
thi im ph hp nh gi li s pht trin con
ngi Vit Nam.
Bo co pht trin con ngi quc gia ny a ra
mt phn tch da trn bng chng v s tin b
trong pht trin con ngi ca Vit Nam cp a
phng, tp trung c bit vo cc vn v sc
khe v gio dc. Bo co xem xt nhng thch
thc m nhiu ngi Vit Nam ang phi i mt
trong vic tip cn cc dch v x hi c bn. Bo
co cho thy gia tng bt bnh ng v kinh t i
km vi s chnh lch dai dng trong cc ch tiu
v gio dc v y t c bn nh th no. Bo co
kt lun rng nu Vit Nam mun tip tc t c
mc pht trin con ngi cao hn, th vic m bo
tip cn ton dn v cng bng i vi dch v y t
v gio dc l v cng cn thit.
Ln u tin ti Vit Nam, Bo co cng gii thiu

ch s Ngho i a chiu quc gia. Ch s mi ny
c xy dng trn nhng cng trnh c thc
hin bi chnh ph v cc c quan Lin Hp Quc
ti Vit Nam, c bit l ch s ngho tr em a chiu
v ngho i th.
Ch s ngho i a chiu trong Bo co ny o
lng s thiu ht v y t, gio dc v mc sng
gia cc tnh v vng ca Vit Nam. Ln u tin
ch s ny c tnh ton cho c nc v cp a
phng, a ra mt nn tng quan trng cho vic
nh gi ngho i phi tin t trong tng lai.
Chng ti hy vng cc nh hoch nh chnh sch,
cc i biu quc hi, cc nh nghin cu v cc
bn lin quan khc s thy Bo co ny l thi im
khi u ng lc v hu ch cho cc cuc tho
lun v cch thc tip tc thc y pht trin
con ngi Vit Nam. Cc phn tch trong Bo co
Setsuko Yamazaki
Gim c quc gia
UNDP Vit Nam
cung cp mt c hi cn nhc xem lm th no

xy dng c mt m hnh pht trin cng bng
v ton din, c th m rng cc la chn v to ra
c hi cho mi ngi. Mt m hnh nh vy s gip
m bo rng cu chuyn pht trin thnh cng ca
Vit Nam c th tip tc. Tuy nhin, iu ny cng
i hi s cn nhc thn trng trong cch thc u
t cng v cc dch v cng trong lnh vc x hi.
Bo co l kt qu ca s hp tc su rng ca nhiu
ngi tm huyt. Bo co da trn nhiu cng trnh
nghin cu cht lng tt chun b ring cho Bo
co ny. Cc tc gi cng nhn c nhng kin
gp ca cc c quan chnh ph, cng ng nghin
cu, trong c cc nh nghin cu ca Vin Khoa
hc X hi Vit Nam, cc i tc pht trin v cc c
quan khc ca Lin Hp Quc ti Vit Nam. Chng
ti xin chn thnh cm n tt c nhng ngi
ng gp thi gian v cng sc cho Bo co ny.
Gio s-Tin s Nguyn Xun Thng

Ch tch
Vin Khoa hc X hi Vit Nam
Cc kin, phn tch v khuyn ngh trong ti liu ny khng nht thit phn nh quan im ca
Chng trnh Pht trin Lin hp quc. Bo co l mt xut bn phm c lp do Chng trnh Pht
trin Lin hp quc t chc thc hin.
LI CM N
Bn bo co pht trin con ngi (HDR) ny l kt

qu ca qu trnh hp tc, ng gp v h tr cht
ch ca rt nhiu ngi. c bit, UNDP xin cm n
Vin Khoa hc X hi Vit Nam (VASS), trong c
gio s-tin s Nguyn Xun Thng, gio s-tin s
Hoi Nam, b Trn Th Lan Anh v ng Nguyn
Thanh H, v nhng t vn chin lc v h tr
mnh m trong sut qu trnh nghin cu v d
tho bo co ny.
Tc gi chnh ca bo co l Ingrid FitzGerald, da
trn d tho ban u ca James Chalmers. Cc
tc gi ng gp khc l Phm Th Lin Phng
(Chng 3) v Jairo-Acua-Alfaro (Chng 6). Bo
co cng da trn cc cng trnh nghin cu ca
cc chuyn gia nhiu lnh vc v t chc khc
nhau nh lit k di y.
Setsuko Yamazaki v Patricia Brandun c nhng
hng dn v h tr chung cho vic hon thin
bo co ny. Xin ghi nhn v cm n ti nhng
ngi c bnh lun v tng ban u cng
nh cc bn d tho ca bo co, bao gm cc ng
b: Nguyn Thng, H S Qu, ng Bch Thy, Phan
S Mn, Phm Thanh Ngh, Trn M Hnh, Phm Th
Lin Phng, Alex Warren-Rodriguez, Jairo AcuaAlfaro, Jonathan London, Martin Painter, Jonathan
Pincus, Stefan Liller, Christophe Bahuet, Nguyn Bi
Linh, Peter Chaudry, Pernill Goodall, Amanda Tyrell,
Graham Harrison, Filip Lenaerts v Toomas Palu.
c bit cm n ch Trn M Hnh v nhng h tr
khng mt mi trong qu trnh chun b bo co
ny v cm n ch Phm Th Lin Phng v ch L
Th c Tng cc thng k v nhng h tr qu
bu trong vic xy dng Ch s ngho i a chiu
(MPI) ln u tin c gii thiu trong bo co ny.
Cc sai st nu c thuc v trch nhim ca cc tc
gi chnh.
Nhiu cuc tham vn c t chc trong thi
gian t thng 2 nm 2009 n thng 2 nm 2010
chun b cho bo co ny, vi s tham gia ca cc
chuyn gia v hc gi ln. Cc nghin cu phc v
cho Bo co pht trin con ngi quc gia (NHDR)
nm 2011 bao gm mt lot cc ch quan trng
VI
v c lit k trong mc Ti liu tham kho. Bo

co c s phi hp cht ch vi tc gi ca cc
cng trnh nghin cu, v c s h tr ca Jim
Benson v Nancy White, thnh vin ca Modus
Cooperandi/Full Circle Associates Washington,
Hoa K.
Aimee Gaye v Tim Scott t vn phng HDR ton
cu, Anuradha Rajivan t phng bo co pht trin
con ngi khu vc v Joachim Nahem t Trung
tm qun tr cng Oslo h tr t vn chuyn
mn v k thut trong qu trnh chun b bo co.
Paul Quarles Van Ufford v Geetanjali Narayan ca
UNICEF t vn kp thi v phng php o lng
ngho i a chiu m UNICEF tin phong thc
hin Vit Nam.
c bit xin cm n ng Nguyn Mnh Th, ng
Nguyn Vn Tin v ng Bjern Surborg v tnh
ton s liu thng k s dng trong bo co ny.
c bit, UNDP xin chn thnh cm n nhng
ngi chun b d liu t iu tra mc sng h
gia nh Vit Nam (VHLSS) v Tng iu tra dn s
v nh . Chng ti xin c bit cm n Tng cc
Thng k Vit Nam v tnh ton kp thi cc ch
s pht trin con ngi (HDI), ch s pht trin gii
(GDI), ch s ngho i con ngi (HPI) v ch s
ngho i a chiu (MPI) theo cp tnh.
Cui cng, xin chn thnh cm n v nh gi cao
cc tc gi v c gi ca cc cng trnh nghin
cu lm c s cho bo co ny: Jairo Acua-Alfaro
(UNDP), Soma Chakrabarti (UNDP), Koos Neefjes
(UNDP), T Th Thanh Hng (UNDP), Saskia Blume
(T chc di c quc t - IOM), Nguyn c Nht
(Trung tm nghin cu chnh sch v pht trin Depocen), Nguyn Ngc Anh (Trung tm nghin
cu chnh sch v pht trin - Depocen), Giang
Thanh Long (Trung tm nghin cu v t vn
ng Dng- IRC), Jonathan London (i hc
City University - Hng Kng), Nguyn Vit Cng
(Trung tm nghin cu v t vn ng Dng IRC), Bjrn Surborg (t vn c lp, i hc British
Columbia), V Hong Linh (Trung tm nghin cu
v t vn ng Dng - IRC), o Hong Mai (Vin
Kinh t, VASS), Nicola Jones (Vin pht trin quc

t - ODI), Elizabeth Presler-Marshall (Vin Pht trin
quc t - ODI), L Thc Dc (Trung tm phn tch
v d bo - CAF, VASS), ng Hong Giang (Trung
tm nghin cu pht trin h tr cng ng CECODES), Phm Thi Hng (Trung tm nghin cu
v t vn ng Dng - IRC), Trn Th Vn Anh (Vin
Gia nh v gii - VASS),Nguyn Ngc Thng (i
hc Kinh t v Qun tr Kinh doanh, i hc quc
gia Vit Nam), ng Nguyn Anh (Vin Khoa hc X
hi Vit Nam - VASS), Trn Nguyt Minh Thu (Vin
X hi hc, VASS), o Th Sn (Trung tm nghin
cu kinh t v pht trin cng ng), Santosh Khatri
(UNESCO Vit Nam), Martin Gainsborough (Trung
tm nghin cu ng , i hc Bristol), Jonathan
Pincus (Chng trnh ging dy Kinh t Fulbright,
trng Harvard Kennedy School), Duncan Green
(Oxfam Anh), Scott Fritzen (Trng Chnh sch cng
L Quang Diu, i hc Quc gia Singapore), Khut
Th Hi Oanh (B mn y t x hi, Vin nghin cu
pht trin x hi, Vit Nam), Gouranga Dasvarma
(Khoa Mi trng, i hc Flinders, c), Phm
Thanh Ngh (Vin Nghin cu con ngi, VASS),

Nguyn Th Kim Chung (Khoa nh nc v qun
l, Hc vin hnh chnh quc gia), Nguyn Mai Chi
(Australia Aid), David Koh (Vin nghin cu ng
Nam , Singapore), Nguyn Trng An (B Lao ng,
Thng binh v X hi), Trn Ngc Anh (Trng
cc vn cng v mi trng, i hc Indiana,
M), Brian Quinn (i hc Lut Boston, USA), Jim
Taylor (trng Khoa hc X hi, i hc Adelaide,
c), Phm Thu Hin (B mn nghin cu Gii, Hc
vin hnh chnh quc gia H Ch Minh), Nguyn Th
Thanh H (Oxfam Hng Kng), Sidney Ruth Schuler
(Chng trnh nghin cu v trao quyn cho ph
n, Vin pht trin gio dc Washington DC), ng
Kim Chung (Vin Khoa hc Lao ng v X hi ILSSA, B Lao ng, Thng binh v X hi), Trng
Quang (Trng qun l Maastricht, H Lan), V
Thiu (Chng trnh cao hc Vit Nam H Lan), V
Mnh Li (Vin X hi hc, VASS), v Adam Fforde
(Trung tm nghin cu chin lc kinh t, i hc
Victoria , c).
VII
CC T VIT TT
ADB
Ngn hng Pht trin Chu
B GD&T
B Gio dc v o to
B LTBXH
B Lao ng, Thng binh v X hi
CECODES
Trung tm nghin cu pht trin h tr cng ng
Chng trnh 135-II Chng trnh gim ngho 135 giai on II

CHXHCN Vit Nam Nc Cng ha X hi Ch ngha Vit Nam
CIEM
Vin Nghin cu Qun l Kinh t trung ng
CPHCSC
Ban ch o Tng iu tra dn s v nh quc gia
CPR
Ngho i tr em
DRG
Nhm cc bnh lin quan
BSCL
ng bng sng Cu Long
EU
Lin minh chu u
FDI
u t trc tip nc ngoi
ESEA
Khu vc ng v ng Nam
FSWS
Gi mi dm
GDI
Ch s pht trin gii
GDP
Tng sn phm quc ni
GER
T l nhp hc chung
GII
Ch s bt bnh ng gii
GNI
Tng thu nhp quc gia
HD
Pht trin con ngi
HDI
Ch s pht trin con ngi
HDR
Bo co pht trin con ngi
HDRO
Vn phng bo co pht trin con ngi, New York
HIV
Hi chng suy gim min dch ngi
HPI
Ch s ngho i con ngi
ICT
Cng ngh thng tin v truyn thng
IDUs
Ngi s dng ma ty
ILO
T chc Lao ng Quc t
IPCC
y ban Lin chnh ph v bin i kh hu
MDGs
Cc mc tiu pht trin thin nin k
VIII
MICS
iu tra nh gi cc mc tiu tr em v ph n
MPI
Ch s ngho i a chiu
MSM
Quan h tnh dc ng gii nam
NER
T l nhp hc ng tui
NHDR
Bo co pht trin con ngi quc gia
NTP
Chng trnh mc tiu quc gia
NTPPR
Chng trnh mc tiu quc gia v gim ngho
ODA
Vin tr pht trin chnh thc
PAPI
Ch s hiu qu qun tr v hnh chnh cng cp tnh Vit Nam
PCI
Ch s cnh tranh cp tnh
PPP
Ngang gi sc mua
SAVY
Kho st nh gi v thanh nin Vit Nam
SEDP
K hoch pht trin kinh t x hi
SEDS
Chin lc pht trin kinh t x hi
SHI
Bo him y t x hi
SOE
Doanh nghip nh nc
TCTK
Tng cc Thng k Vit Nam
TP HCM
Thnh ph H Ch Minh
UN
Lin hp quc
UNDP
UNICEF
Qu Nhi ng Lin hp quc
USD
la M
VASS
Vin Khoa hc X hi Vit Nam
VDGs
Mc tiu pht trin ca Vit Nam
VHLSS
Kho st mc sng h gia nh Vit Nam
VND
ng Vit Nam
WHO
T chc Y t Th gii
WTO
T chc Thng mi Th gii
IX
MC LC
li ta............................................................................................................................................................................................................................ xii
li cam n.....................................................................................................................................................................................................................iv
cac t vit tt.............................................................................................................................................................................................................vi
Tm tt...............................................................................................................................................................................................................................1
C s ca bo co............................................................................................................................................................................................1
Cc thng ip chnh ca bo co.......................................................................................................................................................1
nh hng chnh sch................................................................................................................................................................................5
Phn Mt
Chng 1: Tng quan v cc khi nim chnh v xu hng pht trin con ngi............................................... 8
Khi nim pht trin con ngi...............................................................................................................................................................8
Pht trin con ngi trong bi cnh chnh sch ca Vit Nam........................................................................................ 11
Pht trin con ngi Vit Nam v khu vc................................................................................................................................ 13
Ci thin y t v gio dc l cha kha pht trin con ngi...................................................................................... 15
Chng ng ti mc pht trin con ngi cao hn............................................................................................................ 18
V bo co ny................................................................................................................................................................................................ 18
Chng 2: Chuyn i kinh t x hi ca Vit Nam....................................................................................................................24
Chng ng tng trng kinh t v tin b t c....................................................................................................... 24
Mi trng kinh t v m bt n.......................................................................................................................................................... 26
Nhng thay i v cu trc trong nn kinh t v th trng lao ng....................................................................... 28
Thi k chuyn i v nhn khu....................................................................................................................................................... 32
th ha v di c trong nc vi tc cao........................................................................................................................... 35
Bin i kh hu v thin tai.................................................................................................................................................................... 37
Cc gi tr mi, cc th ch mi........................................................................................................................................................... 39
Chng 3: Pht trin con ngi Vit Nam tnh hnh s b cp tnh.................................................................44
Pht trin con ngi giai on 1998-2008: nhng xu hng chnh............................................................................. 44
Pht trin con ngi cc tnh............................................................................................................................................................ 48
Bt bnh ng gii cp a phng............................................................................................................................................... 54
Ngho i v tnh trng thiu thn phi tin t.......................................................................................................................... 58
Ngho i v bt bnh ng.................................................................................................................................................................. 66
Phn Hai
Chng 4: Tip cn dch v y t v gio dc.....................................................................................................................................72
Chnh lch v y t v gio dc vn cn dai dng.................................................................................................................... 72
Tip cn dch v y t.................................................................................................................................................................................... 72
Cc khc bit v kt qu y t.................................................................................................................................................................. 75
Tip cn dch v gio dc........................................................................................................................................................................ 77
Chnh lch trong kt qu gio dc................................................................................................................................................... 80
Chng 5: Chnh sch v cung cp ti chnh cho dch v x hi......................................................................................86
Cc khun kh chnh sch....................................................................................................................................................................... 86
Cung cp ti chnh cho y t v gio dc......................................................................................................................................... 92
Cung cp ti chnh cho y t.................................................................................................................................................................... 93
Cung cp ti chnh cho gio dc.......................................................................................................................................................101
Chi tiu ca h gia nh v pht trin con ngi....................................................................................................................108
Chng 6: Mc sn c, cht lng v qun l cc dch v x hi..........................................................................110
Mc sn c ca cc dch v y t v gio dc......................................................................................................................110
Dch v y t......................................................................................................................................................................................................111
Dch v gio dc..........................................................................................................................................................................................113
Cht lng ca cc dch v x hi....................................................................................................................................................116
S hi lng ca ngi dn i vi cc dch v.........................................................................................................................119
Qun tr v pht trin con ngi.......................................................................................................................................................120
Qun l cc t chc cung cp dch v...........................................................................................................................................127
Gim st v trch nhim gii trnh....................................................................................................................................................129
o c v vn ha ngh nghip.....................................................................................................................................................133
Cc h thng hin i..............................................................................................................................................................................135
Cc nh hng chnh sch.........................................................................................................................................................................138
Ch thch v ti liu tham kho...............................................................................................................................................................138
Ch thch...........................................................................................................................................................................................................141
Ti liu tham kho......................................................................................................................................................................................154
Ph lc.........................................................................................................................................................................................................................162
Ph lc 1: danh sch tc gi ca cc nghin cu thnh phn cho bo co quc gia
V pht trin con ngi..........................................................................................................................................................................162
Ph lc 2: ch thch k thut v cch tnh cc ch s..........................................................................................................164
Ph lc 3: ch thch k thut v cch tnh ch s ngho i a chiu (MPI) cho Vit Nam.........................167
Ch thch v cc vng ca Vit Nam..............................................................................................................................................160
Cc bng s liu..........................................................................................................................................................................................169
XI
HNH, BNG,
BN V HP
HNH
Hnh 1.1: Mi quan h yu gia tng trng kinh t v thay i v y t v gio dc 1970-2010...................22
Hnh 1.2: Chi tiu cho gio dc v y t ca mt s quc gia ng v ng Nam , 2007-2008...............30
Hnh 2.1: Tng trng GDP v GDP bnh qun u ngi ca Vit Nam (la M), 2000-2010.......................36
Hnh 2.2: Tng trng GDP thc t hng nm vi ng gp ca cc thnh phn kinh t
(nm gc 1994)...............................................................................................................................................................................40
Hnh 2.3: Phn phi vic lm theo ngnh 2000-2009 (%).........................................................................................................41
Hnh 2.4: D bo dn s theo tui Vit Nam 2009-2049 (%).......................................................................................44
Hnh 2.5: c tnh v d bo dn s thnh th v nng thn Vit Nam, 1950-2050...............................................47
Hnh 3.1: Gi tr HDI, Vit Nam v 6 vng 1999-2008...................................................................................................................58
Hnh 3.2: Cc ch s thu nhp v phi thu nhp ca HDI, theo tnh ca Vit Nam, 2008........................................60
Hnh 3.3: Thay i trong cc ch s thu nhp v phi thu nhp ca HDI theo cc tnh,
1999-2008..........................................................................................................................................................................................61
Hnh 3.4: T l nhp hc chung theo dn tc v vng 2008..................................................................................................61
Hnh 3.5: Thay i GDI, c nc v 6 vng, 1999-2008...............................................................................................................66
Hnh 3.6: Ch s ngho a chiu (MPI) theo HDR ton cu nm 2010, Vit Nam 2010..........................................67
Hnh 3.7: HPI, MPI v t l ngho i tin t ca 6 vng Vit Nam 2008....................................................................69
Hnh 3.8: HPI, Vit Nam v 6 vng, 1999-2008..................................................................................................................................71
Hnh 3.9: Tip cn nc sch theo dn tc v vng, 2008.......................................................................................................72
Hnh 3.10: ng gp ca 9 ch s thnh phn vo MPI Vit Nam v 6 vng 2008.................................................73
Hnh 3.11: Ngho i v bt bnh ng v thu nhp 8 vng ca Vit Nam, 2004-2008......................................75
Hnh 3.12: Ngho i v bt bnh ng theo tnh Vit Nam, 2008....................................................................................77
Hnh 4.1: Trnh hc vn, 25-34 tui, 2008.....................................................................................................................................87
Hnh 5.1: T trng chi tiu cng thng xuyn trong GDP, 1990-2010..........................................................................97
Hnh 5.2: Chi tiu cho y t ti Vit Nam, 1995-2008......................................................................................................................99
Hnh 5.3: Chi t tin ti theo u ngi cho chm sc sc khe (2004-2008)........................................................ 100
XII
Hnh 5.4: Bo him y t ca ngi dn trn 5 tui, 2004-2008 (%).................................................................................. 105

Hnh 5.5: Chi tiu cng cho gio dc, 2001-2008....................................................................................................................... 106
Hnh 5.6: Chi tiu cng v t cho gio dc 2004-2008............................................................................................................ 107
Hnh 5.7: Chi tiu bnh qun u ngi cho gio dc (000 VND, mc gi nm 2008), 2004-2008............. 107
Hnh 5.8: c tnh phn chi tiu ca h gia nh, theo khon chi, 2002-2008........................................................ 108
Hnh 6.1: S lng c s y t cng 2000 v 2004-2009........................................................................................................... 115
Hnh 6.2: S lng cc trng hc 2005-2010.............................................................................................................................. 117
Hnh 6.3: T l nhng ngi c hi hi lng hoc rt hi lng vi cc dch v y t v
gio dc su vng, 2008.................................................................................................................................................... 123
Hnh 6.4: Mi lin quan gia ch s PAPI tng hp v ch s HDI cp tnh............................................................. 127
Hnh 6.5 Mi tng quan gia cc ni dung ca ch s PAPI vi ch s HDI cp tnh.................................... 128
BNG
Bng 1.1. ng gp ca cc ch s thnh phn vo tng trng ch s HDI, 1992-2008....................................27
Bng 1.2: Gi tr v xp hng ch s HDI trong giai on 1990-2007 ca mt s nc chu ........................28
Bng 2.1: T l ngho v tc gim ngho giai on 1998-2008 (%)...........................................................................37
Bng 3.1: Tng trng ch s HDI nhanh nht v chm nht, theo tnh, giai on 1999-2008........................58
Bng 3.2: T l tng GDI nhanh v chm nht, 1999-2008......................................................................................................64
Bng 3.3: Ch s GDI theo 6 vng ca Vit Nam, nm 2008....................................................................................................66
Bng 3.4: i ngho a chiu cc tnh ca Vit Nam nm 2008.....................................................................................69
Bng 3.5: Cc tnh gim HPI nhanh v chm nht, 1999-2008..............................................................................................72
Bng 4.1: T l dn s s dng dch v y t giai on 2004-2008 (%)..............................................................................80
Bng 4.2: T l nhp hc chung giai on 2006-2008 (%).......................................................................................................84
Bng 4.3: T l nhp hc ng tui, 2009 (%)..................................................................................................................................84
Bng 5.1: Cc chnh sch quc gia chnh c iu khon tc ng n tip cn dch v y t, gio dc..............93
Bng 5.2: Tng chi tiu y t v chi tiu cng cho y t ca mt s nc chu , 2008..........................................99
Bng 5.3: T l % chi tiu y t trong chi tiu bnh qun u ngi 2004-2008 (%)...............................................101
Bng 5.4: Chi tiu cng cho gio dc v s nm i hc mt s nc chu , 2007-2008..........................106
Bng 5.5: T l phn trm chi tiu cho gio dc tnh trn u hc sinh trong tng
chi tiu bnh qun u ngi ca cc h gia nh, 2008 (%)........................................................................109
Bng 6.1: S lng c s v cn b y t cng theo 8 vng, 2008....................................................................................115
Bng 6.2: T l hc sinh ng k ti cc trng cng v t theo cp hc, 2000 v 2005-2008.....................117
Bng 6.3: Mi tng quan gia cc ni dung ca ch s PAPI vi ch s HDI cp tnh, 2010.....................127
Bo co Pht trin Con ngi 2011 XIII
BN
Bn 3.1: Cc vng ca Vit Nam...........................................................................................................................................................56
Bn 3.2: Ch s pht trin con ngi (HDI) cc tnh ca Vit Nam nm 2008......................................................57
Bn 3.3: Ch s pht trin gii (GDI) 2008........................................................................................................................................63
Bn 3.4: Ch s ngho i v mt con ngi (HPI) 2008.......................................................................................................67
Bn 3.5: T l t vong tr s sinh ca Vit Nam 2008..........................................................................................................74
Bn 3.6: Ngho i v bt bnh ng, cc tnh ca Vit Nam 2008...............................................................................76
HP
Hp 1.1: nh ngha pht trin con ngi............................................................................................................................................21
Hp 1.2: o lng pht trin con ngi...............................................................................................................................................23
Hp 1.3 So snh pht trin con ngi n va Bangladesh.............................................................................................26
Hp 1.4: Bo co pht trin con ngi quc gia u tin nm 2001: i mi v pht trin
con ngi Vit Nam....................................................................................................................................................................32
Hp 2.1: Nc thu nhp trung bnh, mc pht trin con ngi trung bnh v
by thu nhp trung bnh..........................................................................................................................................................39
Hp 2.2: Th trng lao ng phn tch theo gii.........................................................................................................................42
Hp 2.3: Dn s gi ha...................................................................................................................................................................................44
Hp 2.4: Cc dch v x hi c kh nng thch ng vi bin i kh hu.........................................................................50
Hp 2.5: Nhng gi tr v k vng ca tng lp thanh nin ang thay i....................................................................51
Hp 3.1: Cc vng ca Vit Nam tm tt tnh hnh....................................................................................................................56
Hp 4.1: Chnh lch v t l nhim HIV.................................................................................................................................................82
Hp 4.2: Ngi khuyt tt gp kh khn trong tip cn dch v c bn..........................................................................83
Hp 4.3: Chnh lch dai dng trong cc cng ng dn tc thiu s..............................................................................85
Hp 4.4: Chnh lch v tip cn y t, gio dc trong nhm di c........................................................................................89
Hp 5.1: Chnh sch x hi ha.................................................................................................................................................................95
Hp 5.2: Th trng ha, t nhn ha v thng mi ha cung cp dch v x hi.................................................97
Hp 5.3: Cc c ch thanh ton cho dch v y t.........................................................................................................................103
Hp 5.4: Hng ti bo him y t ton dn.....................................................................................................................................104
Hp 5.5: H tr tin mt c iu kin trong y t v gio dc...............................................................................................111
XIV
Hp 6.1: Phn quyn.......................................................................................................................................................................................114

Hp 6.2: Ci cch gio dc i hc........................................................................................................................................................118
Hp 6.3: PAPI ngi dn tham gia cc dch v x hi v hnh chnh..................................................................125
Hp 6.4: Lut khm cha bnh................................................................................................................................................................134
Hp 6.5: Hng dn ca T chc Y t Th gii v lu gi y bc s ti nng thn.....................................................138
XV
TM TT
C S CA BO CO
Bn Bo co Pht trin Con ngi quc gia (NHDR)
ny phn tch mi quan h gia pht trin con
ngi v cung cp dch v x hi. Bo co tp trung
vo cc dch v y t v gio dc do tm quan trng
ca hai loi hnh dch v ny t c mc
cao hn v pht trin con ngi. Bo co s dng
ba ch s pht trin con ngi chnh bao gm Ch
s Pht trin con ngi (HDI), Ch s Pht trin gii
(GDI) v Ch s Ngho i con ngi (HPI), v mt
phng php o lng ngho i v thiu ht phi
tin t l Ch s ngho i a chiu (MPI) xem xt
nhng thay i v kha cnh thu nhp, tui th, gio
dc v mc sng trong pht trin con ngi cp
a phng trong giai on 1999-2008.
Bo co Pht trin Con ngi u tin nm 2001 tp
trung vo cc ci cch ca thi k i mi v nhng
nh hng ca n ti gim ngho v pht trin con
ngi, cn Bo co ln ny tp trung vo nhng thch
thc m nhiu ngi Vit Nam hin phi i mt trong
tip cn cc dch v c bn. Trong bi cnh Vit Nam
tr thnh quc gia c thu nhp bnh qun u
ngi mc trung bnh v mong mun tip tc pht
trin ln mc cao hn na v pht trin con ngi,
chnh ph cn phi gii quyt cc thch thc ny.
Bo co ny xem xt cc nhn t ng gp vo s
thay i trong cc ch s pht trin con ngi, c
bit cc ch s v tui th v gio dc. Bo co cng
phn tch khong cch trong tip cn cc dch v y t
v gio dc cp a phng v gia cc nhm kinh
t x hi c th - iu ny c th tc ng n tc
pht trin trong ch s HDI cp quc gia v cp tnh.
Cui cng, bo co tho lun v vic cung cp cc
dch v x hi v cc c ch ti chnh v qun l hin
nay nh hng nh th no ti vic tip cn v cht
lng ca cc dch v y t v gio dc cng nh mc
hi lng ca ngi s dng.
Bo co la chn phng php c s dng

trong bo co pht trin con ngi ton cu nm
2009 tnh ton cc ch s HDI, GDI v HPI cp
vng v cp tnh, ng thi vi ch s mi c xy
dng MPI. S liu ny do Tng cc Thng k (TCTK) v
Vin Khoa hc X hi Vit Nam (VASS) tnh ton. Mc
d nhng thay i trong phng php tnh ton cc
ch s a ra trong bo co pht trin con ngi nm
2010 cho php nh gi chnh xc hn v nhng
thnh tu trong cc kha cnh chnh nh gio dc, th
cc ch s theo phng php ban u vn ph hp
i vi vic phn tch xu hng theo thi gian v do
vn c s dng trong bo co ny. Phn tho
lun v cc ch s pht trin con ngi c b sung
bng cc ngun d liu quc gia, c bit l iu tra
Mc sng h gia nh Vit Nam (VHLSS) v Tng iu
tra dn s v nh quc gia nm 2009 phn tch
theo cc nhm kinh t x hi. D liu t cc iu tra
quy m nh v cc nghin cu khc do Chnh ph,
cc t chc Lin hp quc v cc i tc khc tin
hnh cng c s dng b sung v cung cp
thng tin a chiu i vi cc ngun chnh thc.
CC THNG IP CHNH CA
BO CO
1. TIN B GN Y TRONG CH S PHT
TRIN CON NGI CA Vit Nam CH YU
DO TNG TRNG KINH T MANG LI
Vit Nam tip tc t c tin b v Ch s Pht
trin con ngi (HDI) v cc ch s lin quan, v xp
th 113 trong tng s 193 nc trn ton cu v
ch s HDI nm 2010. Thnh cng v tng trng
kinh t nhanh ca Vit Nam c th hin th
t xp hng ch s HDI mc kh cao. Tuy nhin,
trong thp k qua, tng trng v thu nhp c
ng gp quan trng hn so vi kha cnh gio
dc v/hoc tui th trong tin b v ch s HDI.
Trong giai on ny, Vit Nam thot khi nhm

nc c thu nhp thp nh tng trng kinh t n
tng. Trong khi , tin b v pht trin x hi,
trong c y t v gio dc c ng gp t hn vo
s thay i ca ch s HDI cp quc gia v cp a
phng.
Tng trng v thu nhp c ng

gp quan trng hn so vi kha cnh
gio dc v/hoc tui th trong tin b
v ch s HDI.
T nm 1992 n 1999, nhng thnh tu v ch s
tui th ng gp ln nht cho nhng tin b v
ch s HDI, nhng trong giai on 1999-2008, nhng
tin b v HDI ch yu do kha cnh thu nhp mang
li. Mc d tui th Vit Nam vn tip tc tng,
nhng tc tng trong giai on 1999-2008
chm li. Mc d mc tng tui th c d on
l s bt u chm li khi mt quc gia t n mt
mc tui th cao, nhng i vi mt s quc gia
trong khu vc, v d nh Hn Quc th tui th vn
tip tc tng ngay c khi mc rt cao.
Tng trng v ch s gio dc ca Vit Nam dng
nh chm li trong thp k qua, c bit trong
giai on 2004-2008. y l iu cn quan tm do
tm quan trng ca gio dc trong pht trin con
ngi v do gio dc c khng nh l mt
trong nhng u tin pht trin trong K hoch Pht
trin kinh t x hi 2011-2015 v Chin lc Pht
trin kinh t x hi 2011-2020.
V vy, k t nm 2000, so vi mt s nc khc
trong khu vc nh Indonesia v Hn Quc vi nhng
tin b vng chc v c cc kha cnh thu nhp v
phi thu nhp trong ch s HDI, Vit Nam c s tin
b trong cc kha cnh phi thu nhp chm hn.
V im ny, xu hng pht trin Vit Nam c s
tng ng vi mt s nc nh Trung Quc ni
c tc tng trng kinh t rt cao nhng c s
ci thin chm hn v ch s tui th v v ch s
gio dc.
2. TNG TRNG KINH T N THUN

KHNG PHI LC NO CNG MANG LI
MC PHT TRIN CON NGI CAO HN
Bo co ny nhn mnh thng ip a ra trong
Bo co Pht trin con ngi ton cu u tin nm
1990: tng trng kinh t, mc d c tm quan
trng trong vic ci thin mc sng v c hi, song
khng phi lc no cng mang li mt cuc sng
c ci thin hn v cht lng cuc sng cao hn
cho mi ngi dn. Tng trng kinh t ton din
v theo ngha rng l cn thit m bo tt c
mi ngi c hng li t qu trnh pht trin,
bao gm tip cn cc dch v gio dc v y t c
cht lng v c gi c ph hp.
Xu hng pht trin Vit Nam c s

tng ng vi mt s nc nh Trung
Quc ni c tc tng trng kinh
t rt cao nhng c s ci thin chm
hn v ch s tui th v v ch s
gio dc.
Y t v gio dc l nn tng ca pht trin con ngi.
Y t v gio dc c vai tr quan trng xt v chnh
ni hm ca n, ng thi l phng tin c
c cuc sng tt p cng nh pht trin nng
lc v la chn ca con ngi. Y t v gio dc cng
l iu kin tin quyt t c nhng mc tiu
pht trin truyn thng nh thnh vng hn. Tm
quan trng ca vic ci thin mc sng v phc li
ca con ngi ng thi m bo mi ngi c
tip cn cc dch v x hi v an sinh x hi c
nhn mnh trong cc vn kin ca chnh ph, K
hoch v Chin lc Pht trin kinh t x hi cng
nh trong nhiu chin lc ngnh ca chnh ph v
khung chnh sch. Tuy nhin cc chnh sch v chi
tiu ca chnh ph i khi c xu hng u tin t
tc tng trng kinh t cao, hn l cc kt qu
rng hn v pht trin con ngi.
T sut thu hi trn vn u t cho pht trin kinh
t ca Vit Nam mc thp hn so vi cc nc
khc trong khu vc. Mc u t hng nm rt cao
Tm tt
t tng trng GDP (h s s dng vn ICOR)

cho thy u t hin nay khng hiu qu. m bo
u t c hiu qu cao hn ph thuc mt phn
vo lc lng dn s khe mnh, c trnh . Do
Vit Nam cn u tin pht trin con ngi v u
t vo con ngi t c mc tiu ny, qua
chuyn sang mt nn kinh t v x hi tri thc, c k
nng v cng ngh cao m Vit Nam mong mun
xy dng. T l u t vo y t v gio dc t c khu
vc nh nc v t nhn trn tng GDP Vit Nam
nhn chung c th so snh vi cc nc trong khu
vc. V thm ch Vit Nam c mc chi tiu t khu vc
t nhn cho gio dc v y t cao hn cc nc trong
khu vc. Cc nc chu khc c mc pht trin
con ngi cao hn u c tng u t cng cho y
t, gio dc v an sinh x hi cao hn Vit Nam. Hn
Quc v Thi Lan l hai v d: Hn Quc u t nhiu
cho bo tr x hi v y t, trong khi Thi Lan u t
vo gio dc nhiu hn so vi mc u t ca Vit
Nam.
Vit Nam cn y nhanh nhng tin b v y t v
gio dc t c mc pht trin con ngi
cao hn v thc hin thnh cng cc mc tiu pht
trin kinh t v x hi rng hn. iu ny cng tr
nn quan trng hn trong bi cnh Vit Nam ang
phi i mt vi cc thch thc mi. C cu kinh
t ang thay i, m ra nhng c hi vic lm mi;
v Vit Nam cn phi chuyn sang mt nn kinh t
hiu qu cao hn, c k nng v cng ngh cao nu
mun duy tr tc tng trng kinh t cao v trnh
c by thu nhp trung bnh. C cu nhn khu
ca Vit Nam ang thay i, vi lc lng trong
tui lao ng ang trong giai on dn s vng v
sau n thi k gi ha dn s nhanh chng vo
nm 2050. Tc th ha v di c nhanh ang
khin cho cc thnh ph ca Vit Nam phnh to v
gy sc p ln cc dch v x hi. Vit Nam l mt
trong nhng nc b nh hng nng n nht bi
bin i kh hu trn phm vi ton cu v cn hnh
ng ngay m bo cc dch v x hi thch nghi
c vi bin i kh hu v c th h tr kh nng
chng chi v hi phc t bin i kh hu.
3. MC D C NHIU TIN B SONG TC

TNG CHM LI CA CH S HDI TH
HIN R CP A PHNG
Du hiu tng chm li trong ch s HDI cp quc
gia ca Vit Nam, th hin qua mc tng chm ca
ch s tui th v gio dc cng ng thi th hin
r cp a phng. Khong cch lu nay trong cc
ch tiu gio dc v y t gia cc tnh v gia cc
nhm kinh t x hi c lin quan ti xu hng ny.
Chnh lch ln gia cc vng, cc tnh, gia nhm

dn tc thiu s vi ngi Kinh/Hoa, v gia cc
h giu v ngho biu hin rt r trong ch s
HDI v cc ch s lin quan. Nhng chnh lch
ny khng ch tip tc m cn gia tng trong mt
s trng hp c th, v d cc ch tiu gio dc
trong ch s HDI, v tip cn nc sch v v sinh
trong ch s HPI. Mc d cc tnh ngho hn
t c mt s tin b v HDI, khong cch gia
cc tnh ngho v cc tnh giu vn cn rt ln.
Mc d cc tnh ngho hn t c
mt s tin b v HDI, khong cch
gia cc tnh ngho v cc tnh giu
vn cn rt ln.
ng thi, tin b v HDI mt s tnh giu hn c
xu hng tng chm li do tin b chm v ch s
gio dc, c th l t l nhp hc chung. Lin quan
ti ch s GDI o lng bt bnh ng v gii, trong
khi khong cch v gii ni chung v ang dn
c thu hp, th mt s tnh ngho hn li c s
chnh lch v gii trong gio dc tng ln. Trong khi
, mt s tnh pht trin nng ng li c khong
cch chnh lch thu nhp gia tng gia nam v n.
Tin b trong ch s HPI l rt r song chnh lch vn
cn tn ti trong mt s tnh c t l thiu ht rt
cao ch yu do khng c tip cn vi nc sch.
Ch s ngho i a chiu (MPI) c a ra trong
bo co ny cho thy mc thiu ht rt cao v
phng din phi tin t cc tnh v cc khu vc
ngho hn ca Vit Nam.
Chnh lch trong cc kt qu y t v gio dc va
l du hiu, cng va l nhn t tim tng dn
ti bt bnh ng kinh t. Trong mt thp k qua,
bt bnh ng v thu nhp ang gia tng c
cp quc gia v gia cc vng Vit Nam. iu
ny c bit r nhng vng c t l ngho thp
nhng c mc tng trng kinh t cao hn. cp
tnh, bc tranh rt khng ng u, v t l ngho
thp hn khng tng quan cht vi bt bnh
ng thu nhp cao hn. T quan im pht trin
con ngi, khng nn xem nh bt bnh ng
kinh t gia tng hay coi l nh hng bnh
thng ca tng trng kinh t nhanh.
Trong trng hp ca Vit Nam, khi bt bnh ng
kinh t i km vi chnh lch dai dng v cc kt
qu gio dc v y t chnh, th bt bnh ng kinh t
c th lm trm trng thm nhng chnh lch hin
c. iu ny c th gy cn tr n tin trnh i ln
mc pht trin con ngi cao hn.
4. VIC CHI TR V CUNG CP CC DCH V

X HI HIN NAY L THCH THC I VI
KHT VNG V MC TIU PHT TRIN CON
NGI CA Vit Nam
Mt iu rt r Vit Nam l tip cn dch v y t
v gio dc c mi tng quan mnh m vi v
tr a l, dn tc v thu nhp: ngi dn vng
thnh th, nhm ngi Kinh/Hoa v nhm c thu
nhp cao hn c mc tip cn y t v gio dc
cao hn ng k so vi ngi dn khu vc nng
thn, nhm dn tc thiu s v ngi ngho. Bt
bnh ng gii, v d trong tip cn gio dc trn
tiu hc v gio dc bc cao gia tr em trai v tr
em gi thuc mt s nhm dn tc thiu s cng
nghim trng. Bt bnh ng trong tip cn dch v
y t v gio dc cng xy ra i vi cc nhm d
b tn thng v thit thi khc nh ngi tn tt
hay ngi di c. Trong mt s trng hp c th,
khong cch dng nh ang gia tng, v d nh t
l nhp hc chung mt s tnh.
T quan im pht trin con ngi,

khng nn xem nh bt bnh ng
kinh t gia tng hay coi l nh
hng bnh thng ca tng trng
kinh t nhanh.
Hin nay, c ch ti chnh, cung cp dch v v qun
l cc dch v x hi Vit Nam dng nh u
ang gp phn lm su sc hn tnh trng bt bnh
ng trong tip cn cc dch v x hi v trong cc
kt qu y t v gio dc. y l mt thch thc i
vi cc mc tiu pht trin ca Vit Nam v cn tr
tin trnh i ln mc pht trin con ngi cao hn.
R rng c s cng thng gia mt bn l cam kt
mnh m v nguyn tc ca Vit Nam trong tip cn
ph cp cc dch v x hi c cht lng v mt bn
l mc tiu h tr nhm dn c d b tn thng
v thit thi thng qua mt h thng phc tp cc
chng trnh v can thip m bo tip cn dch
v v bo tr x hi. H thng tr cp v cc li ch
hin ti dnh cho ngi ngho v ngi b thit
thi cha m bo tip cn ph cp cc dch
v x hi. Chnh sch x hi ha, mc d c mc
tiu l m bo tnh bn vng ca ngun ti chnh
cho dch v x hi, song trn thc t dn ti tnh
trng thng mi ha ngy cng nhiu cc dch v
x hi cng, v s ph thuc qu nhiu ca cc t
chc cung cp dch v vo ngun ph thu t ngi
s dng. Dch v y t v gio dc c cng v t ngy
cng c cung cp da trn c s thng mi. Khu
vc phi nh nc, phi li nhun cha tham gia y
vo vic cung cp cc dch v x hi, trong c
dch v y t v gio dc cho nhng ngi cn nht.
Cc h gia nh dnh mt t l chi tiu ln cho

cc dch v y t v gio dc, cao hn nhiu so vi
mc c coi l ti u 30% m bo bnh ng
v pht trin con ngi. iu ny to ra tc ng
tiu cc ti cc h ngho v kh khn, nhng h
khng th chi tr mc chi ph ny. Chi ph y t v
gio dc hin ang tng ln v chim mt t trng
ln trong chi tiu h gia nh, c bit i vi dch
v y t cho bnh nhn ni tr v gio dc bc cao.
Nhng khon chi khng chnh thc rt ln v c
coi l bnh thng trong c gio dc v y t. V vy,
h thng dch v hai cp ang pht trin, theo
ai c kh nng chi tr s c hng cc dch v
c cht lng cao hn, c quan tm hn v thit
b tt hn bnh vin, hay hc thm trong trng.
Thc t ny cng dn ti vic phn b v s dng
ngun lc khng hiu qu. tuyn di, cht lng
ca cc bnh vin xt v trang thit b v nhn vin
buc ngi tiu dng phi s dng cc dch v y t
t hn do bnh vin tnh v trung ng cung
cp. Cht lng ca dch v gio dc v y t ang b
nh hng tiu cc bi xu hng ny.
Ngoi ra, qun l nh nc i vi dch v y t v
gio dc cng b nh hng ng k t c ch phn
cp v ti chnh v qun l cho t chc cung cp
dch v. Khu vc t nhn tham gia cung cp dch v
y t v gio dc ngy cng c vai tr quan trng, v
c dch v nh nc v t nhn u cha c qun
l cht ch do vy cng gy ra nhng ri ro ln cho
cc c nhn v c x hi.
Vic cung cp cng bng cc dch v x hi c bn
(y t v gio dc) c cht lng v vi gi chp nhn
c cho mi cng dn c th gip ci thin cuc
sng ca ngi dn Vit Nam. Tip cn cng bng
cc dch v y t v gio dc cht lng c th pht
trin nng lc v s la chn ca ngi dn, gip
cc gia nh thot ngho, ph v vng xoy ngho
i lun qun v thit thi, v ci thin cc kt qu
chung v pht trin con ngi ca Vit Nam ng
thi gp phn thc hin cc mc tiu kinh t. Tuy
nhin, hin nay, tim nng ny cha c hin thc
ha y . Kt qu l, mt s khu vc v nhm kinh
t x hi c nguy c tt hu thm, nh hng ti
tin b chung ca Vit Nam trn con ng tin ln
mc pht trin con ngi cao hn.
y l mt vn quan trng i vi Vit Nam, i
hi s u tin nhiu hn ca cc nh hoch nh
chnh sch. Pht trin con ngi, v c bit l ci
thin cc kt qu y t v gio dc phi l trung tm
ca s pht trin trong tng lai ca Vit Nam, theo
ng ngha ca n ch khng ch l mt cng c
t c s thnh vng v tng trng kinh t
cao hn.
Tm tt
NH HNG CHNH SCH

Bo co xc nh cc nh hng chnh sch ln sau
y:
cao v u tin u t vo con ngi hn
so vi pht trin kinh t: Cn u tin v u
t cho xy dng nng lc, m rng s la chn
ca ngi dn v tng cng cc kt qu pht
trin con ngi ngang vi mc dnh cho tng
thu nhp bnh qun u ngi.
Tip cn cc dch v x hi cht lng cao
v nm trong kh nng chi tr ca ngi
dn c vai tr quan trng trong vic gim
chnh lch v hn ch bt bnh ng gia
tng: Bng vic to c hi cho ngi dn pht
trin nng lc v kh nng ca mnh v ci thin
phc li, ng thi bo m cc kt qu bnh
ng hn gia cc nhm kinh t x hi v gia
cc khu vc, tip cn ton dn i vi cc dch
v x hi c cht lng c th gip hn ch bt
bnh ng v chnh lch gia tng hin nay.
Cn mt cch tip cn mi v an sinh x
hi: Cc dch v x hi c cht lng v nm
trong kh nng chi tr ca ngi dn v mt
h thng an sinh x hi ton din l nn tng
cho mt x hi n nh v thnh vng v l
iu kin tin quyt ci thin pht trin con
ngi. m bo mi cng dn c quyn tip
cn an sinh x hi v cc dch v x hi c cht
lng l du n nh gi mt x hi v mt nn
kinh t thnh cng.
Cn c mt h thng phc li thng nht
nhm h tr tip cn ton dn vi cc dch
v x hi c cht lng: H thng cc chng
trnh v sng kin hin thi h tr vic tip cn
vi cc dch v y t v x hi l phc tp, chng
cho v khng c kh nng p ng cho tt c
nhng ngi c nhu cu.
n lc cn xem li chnh sch x hi
ha: Cn to mi trng thun li hn khu
vc phi nh nc, phi li nhun c th tham gia
cung cp dch v v ngi dn cn tham gia
nhiu hn vo vic lp k hoch v gim st cc
dch v x hi.
Phn b chi ph cho cc dch v x hi cng

bng hn gia h gia nh v nh nc:
Hin nay, cc h gia nh phi tr t l chi ph
khng cn i v mc chi ph ngy cng gia
tng. Cc khon chi ph ny hin cao hn
nhiu so vi mc c coi l ti u ha thc
y bnh ng v ci thin cc kt qu pht
trin con ngi.
Gii quyt s pht trin ca h thng hai
cp trong cung cp dch v y t v gio
dc: Trong ngi giu hn c kh nng chi
tr cao hn s nhn c dch v x hi c cht
lng tt hn. Cn c tho lun chnh sch ci
m v mnh m xem mc khc nhau bao
nhiu l chp nhn c v tiu chun ti thiu
v dch v, m bo ph hp vi cc mc tiu
bnh ng v x hi ca Vit Nam.
Tng cng qun l nh nc v nng cao
cht lng dch v: cp hnh chnh v
trong cc t chc cung cp dch v. Qun l
nh nc mnh hn, gim st v tng cng
trch nhim gii trnh i vi cc dch v cng
v cc t chc cung cp dch v cng l iu
mu cht; c bit trong bi cnh phn cp v
ngn sch v qun l dch v x hi.
Cn cc quy nh hiu qu hn na cho c
khu vc nh nc v t nhn: Chnh ph
Vit Nam cn hnh ng quyt on hn na
gii quyt cc xung t gia ng lc th
trng vi nguyn tc cng bng, v cn x l
nhng hnh ng sai tri v cung cp dch v
km cht lng.
Lp k hoch cho tng lai: chnh ph Vit
Nam cn ch ng xy dng k hoch v
nhng loi hnh dch v x hi m mt quc gia
pht trin nhanh vi nhiu nhu cu khc nhau
cn c th ng ph vi nhng thay i v
nhn khu, mi trng v kinh t x hi, ng
thi p ng c nhng k vng v mong
mun ca ngi dn Vit Nam trong tin trnh
i ln mc pht trin con ngi cao hn.
PHN MT
1
Chng 1
TNG QUAN V CC KHI

NIM CHNH V XU HNG
PHT TRIN CON NGI
KHI NIM PHT TRIN CON NGI

CON NGI L CA CI THC S CA
QUC GIA
Con ngi l trung tm ca s pht trin. y l
nguyn l c bn c a ra trong Bo co Pht
trin Con ngi ton cu (HDR) u tin nm 1990
theo a ra tnh hung nh hng li mt
cch c bn cc u tin pht trin. Nh Bo co Pht
trin Con ngi ton cu nm 1990 ch r:
Con ngi l ca ci thc s ca mt quc gia.
Mc tiu c bn ca pht trin l to ra mt
mi trng thun li con ngi c cuc
sng di, mnh khe v sng to. iu ny c
v nh mt s thc n gin. Song n thng
b lng qun trc mi quan tm trc mt
nhm tch ly hng ha v ca ci ti chnh. 1
Khi nim pht trin con ngi c lch s kh di v

pht trin qua thi gian, song nguyn tc chnh
vn gi nguyn: con ngi l ca ci ca mt quc
gia, v s pht trin, quyn t do, kh nng v s la
chn ca con ngi l mc tiu cui cng ca qu
trnh pht trin. Vic nh gi ng v mc pht
trin ca mt quc gia khng phi l tc tng
GDP hay tng thu nhp gia tng m chnh l pht
trin con ngi. l mc m tt c mi ngi c
th pht trin v th hin cc kh nng v la chn
ca h v c ting ni trong cc quyt nh c nh
hng ti cuc sng ca mnh. Giai on pht trin
ca mt quc gia c nh gi thng qua mc
m tt c mi ngi dn c th ci thin sc khe,
mc hc vn, phc li v mc sng. ng thi,
giai on pht trin cng c nh gi da trn
nhng c hi c to ra mi ngi la chn
cch sng ph hp vi nhng g h mong mun v
coi trng.
HP 1.1: NH NGHA PHT TRIN CON NGI

Bo co HDR ton cu 20102 tm tt nhng yu t chnh ca khi nim pht trin con ngi nh sau:
Th nht, pht trin con ngi nhm m rng s t do con ngi c lm nhng vic h coi
trng v c l do coi trng. Pht trin con ngi ch yu lin quan ti quyn t do c bn v
nhng la chn, bao gm la chn c mt cuc sng mnh khe lu di, c hc hnh, hng
th mc sng tt, c t do v chnh tr, nhn quyn v t tn trng bn thn. Khi nim pht
trin con ngi cng bao gm nhng la chn quan trng khc dn ti ci thin i sng cho
ngi dn nh an ninh, tham gia vo i sng vn ha, sinh k an ton v c ngha, v c i sng
tinh thn tt p.
Tngquan
quanv
vcc
cckhi
khi nim chnh v xu hng pht trin con ngi
Tng
Th hai, khi nim ny coi pht trin va l qu trnh m rng nhng s la chn ng thi cng l tp
hp cc kt qu theo o lng mc ci thin i sng m cc c nhn v x hi c c. Quan
trng hn, khi nim ny cng ni ti qu trnh xy dng nng lc ca con ngi cng nh s dng cc
nng lc : d c hay khng, v mc m con ngi s dng nng lc m mnh xy dng nn.
Cui cng, pht trin con ngi c lin quan ti ch th. Khi nim ny coi con ngi l ch th ch
ng trong tin trnh pht trin ch khng phi l bn th hng b ng. Pht trin con ngi
khng ch lin quan ti mc hi lng vi nhng nhu cu c bn m cn lin quan ti mc con
ngi c th ch ng tham gia vo tin trnh pht trin. Ni cch khc n c lin quan ti quyn t
do v la chn ca con ngi v c hi cng nh v qu trnh.3
TNG TRNG V I SNG CON NGI

KHNG PHI LC NO CNG TNG
QUAN TI NHAU
Khi nim pht trin con ngi ngy nay vn ph
hp nh ln u tin c a ra nm 1990. Kinh
nghim trong bn thp k qua cho thy thu nhp
tng khng phi lc no cng mang li nhng kt
qu pht trin con ngi tt hn. Trong khi tin
b ng k v pht trin con ngi c th t c
nhng nc c GDP bnh qun u ngi tng chm.
Thu nhp tng khng phi lc no cng

mang li nhng kt qu pht trin con ngi
tt hn. Trong khi tin b ng k v pht
trin con ngi c th t c nhng nc
c GDP bnh qun u ngi tng chm.
Khi xem xt xu hng ca ch s HDI trong giai on

1970-2010, Bo co Pht trin Con ngi ton cu
nm 2010 ch ra rng khng phi lc no cng c mi
tng quan trc tip gia thu nhp tng v nhng
tin b v cc kha cnh phi tin t trong i sng con
ngi v pht trin con ngi (Hnh 1.1).4 Trong khi
thu nhp tng c vai tr quan trng- v d nh gip
tng cng tip cn cc dch v x hi - th thu nhp
tng cng c th phn nh s giu c ln ca nhng
ngi vn kh gi ch khng phi ca ton b dn
chng. V vy, nhng nc t c tc tng
trng kinh t cao th thng chnh lch v bt bnh
ng cng tng ln. nhng nc ny, li ch ca
tng trng khng c phn phi ng u, gy cn
tr cho s pht trin con ngi rng hn thng qua
vic hn ch kh nng tip cn ca nhng i tng
b tt li pha sau i vi hng ha v dch v bao gm
c nhng dch v x hi c bn nh gio dc v y t.
Hnh 1.1: Mi quan h yu gia tng trng kinh t v thay i v y t v gio

dc 1970-2010
Ngun: Bo co pht trin con ngi ton cu ca UNDP nm 2010
CN BNG GIA PHT TRIN KINH T V

PHT TRIN CON NGI
Phn tch trong Bo co Pht trin Con ngi ton
cu nm 2010 nghing v lp lun trn c s ngay
sau cuc khng hong kinh t 2008 v cng l lp
lun chnh trong bo co ny. Cc chnh ph cn
theo ui l trnh pht trin rng ln hn, khng
ch nhm to ra ca ci m cn gip ci thin i
sng v mc sng cho con ngi. Quan im ny
cng c a ra trong bo co nm 2009 ca y
ban nghin cu bao gm Stiglitz, Sen v Fitoussi do
Tng thng Php Nicolas Sarkozy thnh lp nhm
xy dng cc cch thc mi o lng i sng
con ngi v tin b v mc sng. Bo co c mc
tiu c th nhm xc lp li mi quan tm tp trung
ca cc nh hoch nh chnh sch v ra quyt nh
theo hng mt b cc mc tiu x hi v phc li
rng hn. Trong bo co tng quan, y ban StiglitzSen-Fitoussi nhn mnh rng: Chnh sch cn hng
ti tng cng phc li x hi, ch khng phi GDP, 5
v cn c nhng bin php mi cung cp thng
tin v tc ng ti qu trnh hoch nh chnh sch:
Cht lng cuc sng bao hm mt lot cc
yu t lm i sng ng sng hn trong
bao gm c nhng yu t khng c mua
bn trn th trng hay khng th nm bt
c bng cc bin php tin ty ban
ny nh gi rng n lc cn chuyn t
o lng sn xut sang o lng phc li, v
c gng thu hp khong cch gia cc bin

php o lng kinh t v nhn thc hin nay
v phc li.6
Pht trin con ngi v ci thin i sng cng nh
cht lng cuc sng bn thn n c ngha
quan trng. ng thi, cc yu t ny cng c kh
nng ng gp vo cc mc tiu pht trin. V d,
dn s khe mnh v c tri thc tt s c nng sut
lao ng cao hn.7 Cc x hi u t vo bnh ng
gii v trao quyn cho ph n v tr em gi, v d
thng qua vic gim khong cch gii trong gio
dc thng c t l tng trng kinh t cao hn.8
To vic lm tt vi thu nhp tt hn c th gip
gim t l ngho ng thi cng gim p lc ln ti
nguyn thin nhin.9
Mc d tng trng kinh t l mt kt qu quan
trng ca qu trnh pht trin song tng trng kinh
t cha m bo hnh phc v i sng cho
ngi dn, v cn cn bng vi cc u tin pht trin
khc khi cc u tin khc cng c tim nng ng
gp cho vic ci thin cht lng sng v phc li.10
Cc u tin ny bao gm tnh hnh sc khe v kt
qu y t, trnh gio dc, ting ni chnh tr, v kh
nng tham gia vi t cch cng dn y , mi lin
h x hi v vn x hi; iu kin mi trng nh tip
cn vi nc sch v v sinh; an ton c nhn v tnh
ton vn th cht, cng vic tt v hi lng v cc
yu t khc.11
HP 1.2: O LNG PHT TRIN CON NGI

c th o lng tin b trong pht trin theo cch khng ch da vo tng trng thu nhp hay
GDP, cc bo co pht trin con ngi a ra cc ch s da trn cc ch bo khc nhau v pht
trin con ngi. Ba ch s chnh c s dng lm c s cho phn phn tch trong bo co ny l
Ch s pht trin con ngi (HDI), Ch s pht trin gii (GDI) v Ch s ngho kh con ngi (HPI).
Ch s pht trin con ngi (HDI) l thc o tng hp v y t, gio dc v thu nhp c thit k
nh gi mc v tin b v pht trin con ngi theo ngha rng hn ch khng ch s dng
cch o da trn thu nhp. Nh trong bo co ny v trong cc Bo co pht trin con ngi ton
cu cho ti nm 2009, ch s ny bao gm bn ch bo chnh: tui th, t l nhp hc chung, t l
bit ch ngi ln v GDP bnh qun u ngi iu chnh ngang gi sc mua (PPP).
Ch s pht trin gii (GDI) s dng bn ch bo tng t nh Ch s HDI song o lng khong
cch gia nam v n trong tng ch bo: cc nc thng b xp hng thp hn do ph n b b
li sau so vi nam gii trong vic t c cc kt qu v y t, tip cn kin thc v thu nhp bnh
ng.
Tng quan v cc khi nim chnh v xu hng pht trin con ngi
10
Cui cng ch s ngho kh con ngi (HPI) o lng thiu ht v y t, gio dc v thu nhp (mc
sng) bng vic o lng t l ngi chu thit thi nht. l t l ngi khng sng ti tui 40,
t l m ch ca ngi ln, t l dn s khng tip cn c nc sch v t l tr em di 5 tui
b suy dinh dng.
Ch s HDI c iu chnh v cc ch s mi s dng trong bo co HDR ton cu nm 2010 nhm
phn nh chnh xc hn nhng thnh tu trong gio dc v cc kha cnh khc ca pht trin con
ngi. Tuy nhin, cc ch s c ng tin cy hn khi phn tch xu hng theo thi gian, v l l
do bo co ny vn s dng b ch s c ny.
PHT TRIN CON NGI TRONG BI

CNH CHNH SCH CA Vit Nam
KHI NIM PHT TRIN CON NGI Vit
Nam
Khi nim pht trin con ngi c nu trong
Hin php ca Vit Nam cng nh trong cc K
hoch v Chin lc Pht trin kinh t x hi quc
gia. Hin php nm 1992 v Hin php sa i nm
2001 nu r trch nhim ca nh nc l m bo
v lin tc tng cng quyn lm ch ca cng
dn trn mi lnh vc, [v] thc hin mc tiu xy
dng mt cuc sng thnh vng cho ngi dn,
xy dng mt quc gia ln mnh v mt x hi
cng bng, dn ch v vn minh, m bo phc
li, t do v hnh phc cho tt c cc cng dn
cng nh cc iu kin cho ngi dn pht trin
ton din.12
Vit Nam ni a ha Cc Mc tiu pht trin
thin nin k (MDGs) bng cch a cc Mc tiu
pht trin ca Vit Nam (VDGs) vo Chin lc
tng trng v xa i gim ngho ton din
(CPRGS) nm 2002 v K hoch Pht trin kinh t
x hi (SEDP) giai on 2006-2010.13 Cc mc tiu
pht trin Vit Nam t ra cc ch tiu c th v
pht trin con ngi trong gio dc tiu hc v
c s, sc khe b m v tr em, cc bnh truyn
nhim v nc v v sinh.
Chin lc Pht trin kinh t x hi (SEDS) giai
on 2011-2020 v K hoch Pht trin kinh t x
hi (SEDP) giai on 2011-2015 nu r u tin v
tm quan trng ca vic nng cao i sng v cht
lng cuc sng cho ngi dn cng nh m
bo tng trng v n nh kinh t. SEDS giai on
2011-2020 nu r cam kt ca chnh ph Vit Nam
nhm: Hi ha ha tng trng kinh t vi tin b
11
v cng bng x hi, khng ngng ci thin cht

lng cuc sng cho ngi dn, pht trin vn ha
mnh m v y mnh dn ch.14 Chin lc cng
cam kt nng cao nng lc v xy dng cc c ch
ngi dn thc hin y quyn lm ch ca
mnh, c bit nh dn ch trc tip, thc y
mnh m tt c kh nng sng to v m bo
mc ng thun cao trong x hi, qua to
ng lc thc y t nc pht trin.15
Tng t, SEDP giai on 2011-2015 ghi nhn s
cn thit phi m bo phn phi rng ri li ch
ca pht trin v thu hp khong cch gia cc
vng v gia ngi giu vi ngi ngho trn c
nc.
SEDP giai on 2011-2015 ghi nhn

s cn thit phi m bo phn phi
rng ri li ch ca pht trin v thu
hp khong cch gia cc vng v gia
ngi giu vi ngi ngho trn c nc.
SEDP nu r tng trng kinh t phi i i hi
ha vi tin b v cng bng x hi, v ci thin
tip tc trong cht lng sng ca ngi dn.16
C SEDP v SEDS u xc nh cc t ph c bn
cn t c trong giai on 5-10 nm ti bao gm
cn xy dng dn s khe mnh v c tri thc, v
thc y s cng bng v ton din x hi.17
S DNG CC CH S PHT TRIN CON

NGI Vit Nam
Cc ch s pht trin con ngi s dng trong bo
co ny ngy cng c tm quan trng Vit Nam
trong nhng nm gn y. Chnh ph Vit Nam s
dng nhng thay i trong ch s HDI v GDI theo
thi gian o lng tin b trong pht trin con
ngi v bnh ng gii. Nhng ci thin trong th
t xp hng v gi tr HDI c a vo lm mc
tiu trong SEDS giai on 2001-2010. SEDP giai on

2011-2015 cp n nhng tin b v ch s HDI
nh l mt ch bo v tin b trong cc mc tiu
pht trin trong khi bo co Mc tiu pht trin
thin nin k quc gia 2010 ch ra nhng thay i
tch cc trong ch s GDI l tn hiu tt trong tin b
nhm thc hin bnh ng gii v trao quyn cho
n gii.
Cc ch s pht trin chnh cng c ni a
ha. Bo co HDR nm 2010 gii thiu ch s ngho
i a chiu (MPI), v trc trong nm 2008, Tng
cc Thng k (TCTK), B Lao ng Thng binh v
X hi v UNICEF xy dng ch s ngho i a
chiu tr em Vit Nam (CPR). CPR bao gm cc ch
s thuc nhiu lnh vc pht trin con ngi khc
nhau nh gio dc, dinh dng, y t, ch , nc v
v sinh, lao ng tr em, vui chi, ha nhp x hi v
an sinh x hi, v nhng thng tin ny c a
vo trong iu tra mc sng h gia nh Vit Nam
nm 2008 (VHLSS).18 Tng t, iu tra i ngho
th nm 2010 ca TCTK v UNDP gii thiu
ch s ngho i a chiu o lng cc kha cnh
sau: thu nhp, gio dc, y t, tip cn an sinh x hi,
nh , tham gia cc hot ng x hi v an ton.19
Nhng cch o lng ngho i v thiu ht phi
tin t ny hin ang c s dng rng ri hn
Vit Nam so vi trc y, cho thy cc nh hoch
nh chnh sch ngy cng nhn thc v chp nhn
nhiu hn i vi cc ch bo o lng thiu ht
v thit thi khng da trn yu t vt cht.
KHUNG CHNH SCH QUC GIA VN TIP

TC U TIN TNG TRNG KINH T
Vit Nam c lch s hng mnh v truyn thng
v pht trin bnh ng v ton din v thnh
cng trong vic nng cao mc sng ni chung cho
ngi dn, ci thin cc kt qu v y t v gio dc.
Ngay c trc thi k i mi khi thu nhp cn thp
v ngho i thu nhp cn ph bin, Vit Nam
t c nhng thnh tu v t l ngi bit c
bit vit, tip cn gio dc v cung cp cc dch v
y t ti cp x.20 Trong hai thp k qua, tng trng
kinh t cao v nhng yu t tin b ca chnh sch

y t v gio dc ca Vit Nam mang li nhng
ci thin v tnh hnh y t gio dc ni chung cho
ngi Vit Nam. Vit Nam cng c li th ng ghi
nhn so vi nhiu nc khc: nh nc th hin
cam kt chnh tr mnh m v lin tc nhm m
bo cung cp dch v x hi mc c bn cho mi
ngi dn.21 Cam kt ny th hin r trong cc chnh
sch pht trin v x hi ca Vit Nam. V d nh
cam kt gn y v vic ph cp bo him y t ton
dn vo nm 2014 v vic tp trung vo cc sng
kin an sinh x hi trong ngh quyt 11 nhm i
ph vi nhng bt n kinh t v m v lm pht cao.
Tuy nhin, hin nay chnh ph Vit Nam vn c xu
hng u tin m bo tng trng kinh t nhanh
hn l ci thin pht trin con ngi v x hi. V d,
mc d pht trin ngun nhn lc c xc nh
l khu t ph quan trng trong K hoch v Chin
lc Pht trin kinh t x hi, nhng vn u tin cho
vic thc y tng trng kinh t bng cch to
iu kin cng bng hn cho cnh tranh. Vic m
bo ngun nhn lc c k thut v h thng c s
h tng v giao thng pht trin v y h tr
t mc tiu tng trng kinh t cng l iu quan
trng. u t cng nhm to ra tng trng kinh t
c tnh chim 24,7% trong tng chi tiu ngn sch,
tng ng vi 7,9% GDP nm 2008.22 Trong khi
chi tiu cng cho gio dc c tnh ch chim
5,3% v y t 2,8% GDP (xem hnh 1.2 pha di). Tuy
nhin, u t vo tng trng kinh t km hiu qu
hn so vi cc nc khc trong khu vc.23 T l chi
tiu cng trong tng chi tiu cho y t v gio dc
t c ngun cng v t nhn thp hn so vi cc
nc khc trong khu vc ni c mc pht trin
con ngi cao hn Vit Nam nh Thi Lan v Hn
Quc. Hiu qu u t tt hn s gip gii phng
ngun lc cho u t x hi.
Ri ro l, nh cc nc nhn ra, to ra nhiu ca
ci mc d c vai tr quan trng trong ci thin mc
sng v to c hi, song khng phi lc no cng
mang li phc li cao hn, cht lng cuc sng tt
hn hay lm tng s hi lng ca mi ngi dn vi
chnh ph.
12
To ra nhiu ca ci mc d c vai tr
quan trng trong ci thin mc sng v
to c hi, song khng phi lc no cng
mang li phc li cao hn, cht lng
cuc sng tt hn hay lm tng s hi
lng ca mi ngi dn vi chnh ph.
Nhng vn x hi nh hng tiu cc n nhng
ngi bnh thng bao gm s chnh lch ln v
dai dng gia cc nhm kinh t x hi v gia cc
khu vc khc nhau, cht lng cc dch v x hi
c bn nh y t v gio dc ngho nn, qun l nh
nc v php quyn yu v tnh trng tham nhng
c h thng. Nhng vn ny c nguy c gy xi
mn nhng li ch ca tng trng kinh t, ph hy
tnh gn kt x hi v cui cng l ph hy tnh hp
php v chnh tr nu nh nhng vn trn khng
c gii quyt v kim sot.
Nh bo co ny ch ra, chnh ph Vit Nam hin

nay ang gp phi nhiu thch thc c cp chnh
sch v thc t trong vic hin thc ha cam kt
mnh m ca chnh ph v pht trin con ngi.
Gii quyt nhng thch thc ny trong giai on ti
y khi thc hin SEDP v SEDS s c vai tr quan
trng thc hin tham vng ca Vit Nam nhm
tip tc con ng pht trin con ngi v tng
trng bn vng, qua m bo mi ngi dn
Vit Nam c hng mt cuc sng mnh khe
v thnh vng. Bo co ny nhm ng gp cho
nhng tranh lun v chnh sch lin quan ti vn
ny thng qua vic phn tch v tnh hnh cung cp
dch v x hi hin nay Vit Nam v tho lun cch
thc nhng thay i chnh sch trong cc lnh
vc cung cp dch v c th c th gii quyt mt
s cc thch thc v hn ch ny.
HP 1.3 SO SNH PHT TRIN CON NGI N V BANGLADESH

Trong mt bi bo gn y trn t im bo New York, Amartya Sen nhn mnh rng n c th
hng HDI cao hn ng k so vi Bangladesh, v iu ny ch yu do tc tng trng kinh t gn
y ca n cao hn. Tuy nhin, trong khi GNP u ngi tnh theo ngang gi sc mua ca n
l 1.170 la so vi 590 la ca Bangladesh, th Bangladesh lin tc gi th hng cao hn n
v cc ch s pht trin con ngi chnh l y t v gio dc. Tui th trung bnh ca Bangladesh
l 66,9 tui so vi 64,4 tui ca n . S nm i hc trung bnh l 4,8 nm Bangladesh so vi 4,4
nm, v t l bit ch ca tr em gi Bangladesh cao hn nhiu so vi tr em trai trong khi t l
ny tr em gi n thp hn nhiu so vi tr em trai. V y t, t l t vong tr em l 50/1000
trng hp n v 41/1000 Bangladesh v t l t vong tr di 5 tui l 66/1000 n
so vi 52 Bangladesh. Nh Sen nhn mnh, mt trong nhng l do khin cc kt qu v y t n
km hn l do c mt t l ln dn s ph thuc vo y t t nhn trong khi chi tiu cng dnh
cho y t ca nc ny tng i thp.
Mc d c mc thu nhp bnh qun thp hn song Bangladesh c th ci thin mc sng ca
ngi dn nhanh hn so vi nc lng ging n . Nh Sen ch ra, trong khi tng trng kinh t
c th ng gp ln cho vic ci thin cuc sng ca ngi dn song nu ch tp trung vo tng
trng kinh t n thun cng c nhng hn ch cn c hiu r. 24
PHT TRIN CON NGI Vit

Nam V KHU VC
TNG TRNG KINH T Y NHANH TIN
B CA Vit Nam TRONG CH S PHT
TRIN CON NGI (HDI)
K t khi Bo co Pht trin Con ngi quc gia u
tin nm 2001 c xut bn, Vit Nam c s thay
13
i ng k v t mc pht trin con ngi

mc trung bnh v tr thnh nc c thu nhp bnh
qun u ngi mc trung bnh vi mc thu nhp
bnh qun u ngi GNI nm 2010 l 1.200 USD.
Trong 10 nm qua, Vit Nam t c tc tng
trng GDP cao, ngay c sau cuc khng hong
kinh t ton cu nm 2008. Vit Nam thnh cng
trong vic gip hng trm nghn ngi dn thot
ngho vi tc nhanh hn hu ht cc nc khc
trn th gii. T l ngi ngho ca Vit Nam gim
t 37,8% nm 1998 xung 14,5% nm 2008. Thnh
cng ca Vit Nam trong gim ngho c ton

th gii ghi nhn v Chnh ph Vit Nam c
ngh chia s kinh nghim thnh cng ny vi cc
nc ang pht trin khc trn th gii.25
Vit Nam t c nhng tin b vng chc
v pht trin con ngi, th hin thng qua ch
s HDI tng ln trong thi gian ny. Gi tr HDI ca
Vit Nam tng 19% trong giai on t nm 1992
n nm 2008.26 Tuy nhin mc tng xt theo
tng ch s thnh phn ca HDI l kh khc nhau.
Ch s thu nhp tng 45% trong giai on t 1992
n 2008, do tng trng kinh t cao. Ch s tui
th cng c ci thin ng k, tng 19% trong
giai on t nm 1992 n nm 2008. iu ny
phn nh s tng ln trong tui th t 65,2 tui
nm 1992 ln 72,7 tui nm 2008. Ch s gio dc,
vi mc khi im kh cao vo nm 1992, tng vi
mc thp hn l 7% vo nm 2008. Nh vy, k
t nm 1992, GDP tng cao, cng vi tui th tng
l ng lc chnh lm tng ch s HDI ca Vit Nam.
K t nm 1992, GDP tng cao, cng vi

tui th tng l ng lc chnh lm tng
ch s HDI ca Vit Nam.
Bng 1.1 cho thy ng gp ca tng ch s thnh
phn i vi nhng thay i v HDI trong giai on
1992-2008. ng gp ca ch s thu nhp l ln nht
vi t l 49%; tip theo l ch s tui th v ch s gio
dc. Tuy nhin, trong giai on 1992-1999, ch s
tui th c ng gp ln nht vo s tng ln trong
ch s HDI vi 41,8% so vi 36,1% ca ch s thu nhp
v 22,1% ca ch s gio dc. Trong thp k va qua
1999-2008, ch s thu nhp ng gp 55,7% so
vi 31,8% i vi ch s tui th v 12,6% i vi ch
s gio dc. Trong giai on 2004-2008, ch s thu
nhp ng gp 79,1%, ch s tui th 15,2% v ch
s gio dc 5,1%. iu ny cho thy tng trng thu
nhp ngy cng tr thnh nhn t quan trng hn
trong nhng tin b v gi tr HDI theo thi gian.
Bng 1.1. ng gp ca cc ch s thnh phn vo tng trng ch s HDI, 1992-2008
Nm
HDI
Ch s tui th
ng gp ca ch
ng gp ca
ng gp ca
s tui th vo
ch s gio dc vo
ch s thu nhp
Ch s gio
Ch s thu
tng trng HDI so
tng trng HDI so
vo tng trng
dc
nhp
vi thi k trc
vi thi k trc
HDI so vi thi
(%)
(%)
k trc (%)
1992
0,611
0,670
0,776
0,386
1995
0,639
0,690
18,8%
0,808
25,9%
0,420
55,3%
1999
0,651
0,721
86,1%
0,803
-13,9%
0,430
27,8%
2004
0,701
0,782
40,7%
0,826
15,3%
0,496
44,0%
2008
0,728
0,794
15,2%
0,830
5,1%
0,559
79,7%
ng gp ca tng ch s vo tng trng

HDI giai on 1992-2008.
35,2%
15,9%
48,95%
Ngun: Bo co pht trin con ngi quc gia 2001; HDI 1999, 2004, 2008
Tin b ln lao ca Vit Nam v HDI l minh chng

cho tc tng trng kinh t cao v nhng tin
b m t nc t c. Tuy nhin, tc tng
ca ch s gio dc chm hn so vi hai ch s thnh
phn cn li. ng gp ca ch s gio dc vo tng
trng chung ca ch s HDI gim dn t 25,9%
trong giai on 1992-1996 xung cn 5.1% trong
giai on 2004-2008. Gn y, trong khi nhng tin
b v ch s thu nhp vn c duy tr, tc tng
ca ch s gio dc v ch s tui th chm li.
Trong giai on 2004-2008, ch s thu nhp tng
13% so vi 15% thi k 1999-2004, ch s tui th
tng 2% so vi 8% giai on 1999-2004 v ch s
gio dc tng 1% so vi 3% giai on 1999-2004.27
Tc tng v tui th c d on l s chm

li khi tui th t n mt mc cao nht nh no
, mc d rt ng ch l tui th mt s nc
trong khu vc tip tc tng ngay c khi mc
cao. Hn Quc l mt v d. Tuy nhin, nhng tin
b chm li v ch s gio dc cng ng lo ngi.
T l bit ch ngi ln Vit Nam cao song
tin b v t l nhp hc chung cn hn ch nh
tho lun Chng 3. Nh vy, dng nh nhng
tin b trong ch s HDI ca Vit Nam ang chm
li l do tc tng ca ch s gio dc v ch s
tui th tng i chm hn so vi giai on trc.
Nhn chung, nhng tin b trong ch s HDI trong
giai on 1999-2008 ch yu do thu nhp tng.
14
SO SNH CH S HDI KHU VC
Bng 1.2: Gi tr v xp hng ch s HDI trong giai on 1990-2007 ca mt s

nc chu
Gi tr HDI
nm 1990
Gi tr HDI
nm
2000
Gi tr HDI
nm
2007
Xp hng
HDI nm
2007
Hn Quc
0,802
0,869
0,937
26
8%
8%
17%
Malaysia
0,737
0,797
0,829
66
8%
4%
12%
Nc
Thay i
Thay i
Thay i
1990-2000 2000-2007 1999-2007
Thailand
0,706
0,753
0,783
87
7%
4%
11%
Trung Quc
0,608
0,719
0,772
92
18%
7%
27%
Philippines
0,697
0,726
0,751
105
4%
3%
8%
Indonesia
0,624
0,673
0,734
111
8%
9%
18%
Vit Nam
0,599
0,690
0,725
116
15%
5%
21%
Lo
0,566
0,619
133
9%
Campuchia
0,515
0,593
137
15%
Ngun: HDR ton cu 2009
Vit Nam xp th 116 trong tng s 182 nc

trong Bo co pht trin con ngi ton cu nm
2009 v ng v tr th 113 trong s 169 nc
trong Bo co pht trin con ngi nm 2010
trong gii thiu phng php tnh ch s
HDI mi nh tho lun phn sau ca bo co ny.
So vi cc nc khc trong khu vc t c
nhng tin b n nh trong tt c cc kha cnh
ca ch s HDI, nhng tin b v cc ch s phi thu
nhp ca Vit Nam chm hn trong thi gian k
t sau nm 2000. V d, Indonesia v Hn Quc, cc
nc c trnh pht trin con ngi kh khc nhau
u lin tc c nhng ci thin ng k v c ch
s thu nhp v phi thu nhp. ng ch , y l hai
nc duy nht nm trong nhm 10 nc c tin b
ln nht c ch s thu nhp v phi thu nhp ca
ch s HDI trong Bo co Pht trin Con ngi ton
cu nm 2010. Mc d trong giai on 1990-2000,
HDI ca Vit Nam tng nhanh hn so vi Indonesia
v Hn Quc song tnh hnh tri ngc trong
giai on 2000-2007, nh th hin trong Bng 1.2.
V mt ny, xu hng pht trin ca HDI ca Vit
Nam ging nh mt s nc nh Trung Quc vi
tc tng trng kinh t mc cao. Theo Bo co
pht trin con ngi quc gia ca Trung Quc nm
2008, ch s thu nhp ng gp 52,2%, ch s gio
dc 29,8% v ch s tui th 18% vo tc tng ca
HDI trong giai on 1980-2005.28 Ch s HDI ca c
Vit Nam v Trung Quc trong giai on 2000-2007
15
tng chm li hn so vi cc nc c mc pht

trin cn bng hn c v kha cnh thu nhp v phi
thu nhp ca ch s HDI.
CI THIN Y T V GIO DC L
CHA KHA PHT TRIN CON
NGI
HNG TI MT LC LNG DN S
KHE MNH V C TRI THC
V mt ny, cn nhn mnh rng cc mc tiu pht
trin kinh t v x hi ca Vit Nam ph thuc rt
ln vo lc lng dn s khe mnh v c tri thc.
V d, cc mc tiu MDG m Vit Nam kh c th
th t c vo nm 2015 hu ht u c lin
quan ti y t nh HIV, nc v v sinh.29 Nh vy,
vic bo v ngi dn trc cc c sc v y t, thu
nhp v mi trng cng nh nhng nh hng
ca vic phi chi ph qu cao cho y t khin cc
gia nh ti ngho tr li thm ch cn ngho hn
trc kia, cng vi vic cung cp cc dch v y t
cha bnh v phng nga c th tip cn c
v c kh nng chi tr c chnh l cha kha
thc hin cc mc tiu MDG m Vit Nam ang b
tt hu. Y t v gio dc l nn tng ca pht trin
con ngi v c vai tr quan trng trong vic pht
trin kh nng v la chn ng thi to iu kin
mi ngi th hin nng lc ca mnh ph hp

vi nhng g h coi trng v mong mun. Nh Bo
co Pht trin Con ngi ton cu nm 2010 lp
lun, v nh phn tch tm tt v HDI ti Vit Nam
trn xut, nhng tin b v y t v gio dc
khng phi lc no cng i km vi tng thu nhp.
Nhng tin b v y t v gio dc

khng phi lc no cng i km vi
tng thu nhp.
Mt lot nhng nhn t c mi quan h qua li vi
nhau ng gp vo vic t c cc kt qu y t v
gio dc tt hn. Cc nhn t ny bao gm hp tc
quc t phng chng bnh dch c th v cc
vn y t, truyn b kin thc v cng ngh mi,
h tr v u t ca cc h cng nh u tin ca
chnh ph cho u t vo cc dch v y t v gio
dc c cht lng, c kh nng chi tr v c th tip
cn.30 Trong bi cnh tn ti s khc bit ng k

theo vng v nhm dn s trong vic t c cc
mc tiu y t v gio dc chnh, vic nng cao cc
dch v y t v gio dc l cn thit ci thin cc
kt qu pht trin con ngi. iu ny cng quan
trng khi gii quyt l trnh thc hin MDG cn cha
kt thc v t c cc mc tiu MDG cp
a phng cho tt c mi ngi dn Vit Nam. Trn
thc t, ci thin cc kt qu y t v gio dc l iu
kin tin quyt nu Vit Nam mun t c cc
t pht chnh nu ra trong SEDP v SEDS v tr
thnh nn kinh t c k nng v cng ngh cao v
m bo tng trng kinh t ton din nh mong
mun. Bo co Pht trin Con ngi quc gia ln ny
do s tp trung vo y t v gio dc vi vic c
bit nhn mnh kh nng tip cn, ngun ti chnh
cng nh cung cp cc dch v y t v gio dc.
CHI TIU Y T V GIO DC CNG CA Vit Nam
Hnh 1.2: Chi tiu cho gio dc v y t ca mt s quc gia ng v ng

Nam , 2007-2008
Ngun: Vin Thng k ca UNESCO http://stats.uis.unesco.org; Ti khon y t quc gia ca WHO, http://www.who.int/gho/en/index.html. Cc ch
s chnh ca ADB i vi khu vc Chu Thi Bnh Dng nm 2010, http://www.adb.org/Documents/Books/Key_Indicators/2010/Country.asp
Vit Nam c mc chi tiu cng cho y t thp hn

v chi cho gio dc cao hn so vi cc nc khc
trong khu vc. Mc d tng chi tiu cho y t v
ang tng ln v Vit Nam dnh t l chi cho y t
trong tng GDP tng i cao hn so vi mt s
nc khc mc thu nhp tng ng, song Vit
Nam vn dnh t l u t cng cho y t thp hn
so vi nhiu nc trong khu vc. Nm 2008, tng chi

tiu cho y t t tt c cc ngun bao gm chi tiu
ca khu vc t nhn ca Vit Nam tng ng vi
7,3% GDP. Chi tiu ca chnh ph ch tng ng
vi 2,8% GDP. Hn 50% chi tiu cho y t chnh l chi
tiu t tin ti ca bnh nhn.
16
Chi tiu cng cho y t chim khong 8,7% tng chi

tiu cng Vit Nam so vi mc 14,1% Thi Lan
v 9,9% Trung Quc. Trong khi Vit Nam c t l
chi ngn sch cng cho y t ln hn mt s nc
nh Indonesia v Malaysia, song gi tr thc ca chi
tiu cho y t li thp hn. Chi tiu cng cho y t
Vit Nam c tnh khong 77 la/ngi tnh theo
ngang gi sc mua (PPP), cao hn so vi Indonesia,
Campuchia, Philippines v Lo song thp hn nhiu
so vi Thi Lan 242 la, Malaysia 273 la v Trung
Quc 121 la.31 Mt phn l do khin tng chi tiu
ca Vit Nam cho y t trong c chi tiu t tin ti
c nhn cao hn tng i so vi mt s nc l do
chi ph y t tng nhanh.
Chi tiu cho gio dc ca Vit Nam cao hn so vi
cc nc trong khu vc, vi t l chi tiu cng cho
gio dc tng ng vi khong 5,3% GDP. Vit
Nam dnh khong khong 19,8% tng chi ngn
sch nh nc cho gio dc, tng ng so vi
nhiu nc trong khu vc song thp hn Thi Lan.
Tuy nhin, chi tiu ca khu vc t nhn cho gio
dc cng cao, mt phn do hc ph tng cao v cc
khon chi t tin ti c nhn nh phn tch trong
Chng 5. Hnh 1.2 th hin chi tiu cho y t v gio
dc mt s nc ng v ng Nam trong
giai on 2007-2008.
T l chi tiu cng cho y t ca Hn Quc cao hn
nhng cho gio dc thp hn ca Vit Nam, trong
khi hai t l ny Indonesia u thp hn Vit Nam.
Tuy nhin c hai nc ny tip tc t c nhng
tin b vng chc trong ch s HDI bao gm c
nhng ch s phi thu nhp. Ngc li, Trung Quc
c t l chi tiu cng cho y t tng t v t l chi
cho gio dc cao hn. y l mt trong s t cc
nc c t l nhp hc chung gim st trong nhng
nm 1990 cho d gn y t l ny c ci
thin.32 Nh vy mc d c vai tr quan trng song
u t cng ch l mt trong nhng nhn t quyt
nh n cc kt qu y t v gio dc.33 Hiu qu
ca u t cng cng vi cc yu t khc nh chi
ph dch v y t v gio dc i vi h gia nh, cht
lng dch v, tnh sn c v mc c th tip cn
c ca dch v p ng nh cu ca ngi
s dng cui cng cng nh vic qun l nh nc
i vi cc t chc cung ng dch v cng c vai tr
17
quan trng khng km. V d, mc d c nhng

nh hng u t trong thp k qua trong vic xy
dng nhiu trng hc ph thng, cao ng v i
hc mi nhng mi ngi u thng nht rng Vit
Nam cn ci cch v nng cp c bn h thng gio
dc, c bit gio dc bc cao. Nhng ci cch ny
l cn thit nu Vit Nam mun cnh tranh hiu qu
trong nn kinh t ton cu, t c cc mc tiu
kinh t ca mnh ng thi tip tc t c tng
trng kinh t.34
Nh Bo co ch ra, trong khi Vit Nam ng h mnh
m cc nguyn tc v tip cn ton dn di cc
chnh sch hng ti cc nhm dn c c th, cn
c rt nhiu nhn t kt hp gy nh hng ti kh
nng tip cn vi cc dch v x hi c cht lng v
gi c ph hp cn thit mi ngi c cuc sng
bn vng v thc hin c kht vng ca mnh.
Nhng nhn t ny lin quan ti c ch ti chnh v
cung cp dch v hin nay, cht lng dch v thp
v cc quy nh khng y i vi c dch v
cng v t.35 Quan trng l, tnh trng thng mi
ha trn lan trong cung cp dch v x hi, cng vi
phn ng gp ln ca h gia nh trong chi ph
gio dc v y t t ra cu hi v kh nng chi tr v
tip cn dch v i vi nhng ngi cn s dng
nht. ng thi vic xem xt cc vn ny cng
lm ny sinh mi quan ngi lm cch no m
bo cht lng ca cc dch v x hi. V mt ny,
Vit Nam cha c c ch chu trch nhim v gim
st mnh cn thit gip cho c ch ti chnh nh
nc t nhn v vic cung cp dch v x hi hot
ng hiu qu v li ch ca ngi s dng, v cui
cng v li ch ca c x hi Vit Nam. Vai tr ca
nh nc trong cc lnh vc kinh t v x hi r rng
ang thay i, v trong lnh vc dch v x hi, cng
nh nhng lnh vc khc, nh nc ang tr thnh
ngi qun l c trch nhim h tr, iu hnh v
gim st vic cung cp cc dch v ch khng phi
l nh cung cp dch v, v do vy i hi nh nc
phi c cc chnh sch mi v m rng, c nng
lc thc hin v iu hnh.36 Thch thc trc mt
l cn m bo rng nh nc chuyn i vai tr
nhm bo v ngi dn hiu qu hn trc nhng
tc ng tiu cc, trong khi ti a ha li ch ca
nn kinh t th trng.
CHNG NG TI MC PHT
TRIN CON NGI CAO HN
thu nhp bt bnh ng v b qua tnh bn vng

ca tng trng.
Y T V GIO DC L CHA KHA CHO THNH

CNG TRONG TNG LAI CA Vit Nam
Tng trng kinh t nhanh khng nn l

mc tiu chnh sch v mc tiu ny thng
gy ra phn phi thu nhp bt bnh ng
v b qua tnh bn vng ca tng trng.
Trong hai thp k qua, Vit Nam tng dn thu nhp,

gim ngho v nng cao mc sng ca ngi dn Vit
Nam. Nhng thnh tu ny mt phn nh vo qu
trnh pht trin tng i cng bng ca Vit Nam, v
trc y trong vic u t vo cung cp dch v x
hi l nhng n lc ng k ca chnh ph thc
y cng bng x hi thng qua cc chnh sch
mang li cc nh hng tch cc hu hnh.37 Hin nay,
khi tr thnh nc c mc thu nhp trung bnh
thp, Vit Nam cn xy dng nn tng vng chc cho
tng trng kinh t bn vng, pht trin con ngi v
cng bng x hi.
Khi tr thnh nc c mc thu nhp trung

bnh thp, Vit Nam cn xy dng nn tng
vng chc cho tng trng kinh t bn vng,
pht trin con ngi v cng bng x hi.
Vit Nam ang c nhiu thay i nhanh chng: bt
bnh ng v thu nhp gia tng, v nhng bt cng
trong vic tip cn y t v gio dc vn cn tn ti.
V nh cp trong Chng 5, chi ph ca h gia
nh cho cc dch v y t v gio dc ang ngy
cng tng cao. Nhng thnh tu tng i d dng
trc y trong gim ngho v pht trin con ngi
t c v c bn, song tnh trng ngho i v
chnh lch dai dng cn li s kh gii quyt hn.38
ng thi, cc chng trnh gim ngho v an sinh
x hi hin nay rt phc tp, chng cho v gp
phi nhng thch thc trong vic tip cn cc i
tng cn h tr v gip .39
Hin nay, mt mt Vit Nam phi i mt vi kh
nng bt cng gia tng gia cc cng ng v cc
khu vc, v mt khc ngho i v chnh lch dai
dng c th lm chm li hoc thm ch o ngc
nhng tin b khng h d dng m Vit Nam
t c. Nh Chng 2 trong bo co ny phn
tch, Vit Nam ang thc hin mt lot cc chuyn
i v kinh t x hi. Nhng p lc mi ny sinh lin
quan ti thay i v nhn khu, chuyn dch dn s
v p lc v mi trng trong c bin i kh
hu c nguy c lm trm trng thm nhng hnh
thc i ngho v bt bnh ng hin ti nu nh
khng c lp k hoch v qun l thn trng.
Tng trng kinh t nhanh khng nn l mc tiu
chnh sch v mc tiu ny thng gy ra phn phi
cp quc gia, Vit Nam tip tc c nhng tin b v

nhiu ch s y t trong c t l t vong b m v
tr s sinh. Tuy nhin, vn cn tn ti mt vi ngoi l
ng ch , v d nh t l tr em suy dinh dng v
t l dn s khng c tip cn nc sch v v sinh
cn cao. Tin b cp a phng v trong cc nhm
dn tc thiu s, vng su vng xa cn cha ng
u.40 Vit Nam c t l bit ch cao, gn t mc ph
cp tiu hc v khng cn khong cch v gii cp
tiu hc v trung hc c s. Tuy nhin, nhng ch s
gio dc chnh khc c rt t ci thin k t u nhng
nm 2000. V d trong khi t l bit ch ngi ln
tip tc tng trong giai on t nm 2000 n nm
2008, th t l nhp hc chung vn khng thay i.
Trong thp k qua s nm i hc d on ch tng
nh; v mc d s nm i hc trung bnh tng ln, tc
tng vn thp hn so vi mt s nc khc khu
vc ng Nam . cp a phng, mc tin b
thm ch c s chnh lch ln hn. Khong cch ln
trong c hai lnh vc y t v gio dc vn tn ti gia
cc vng, tnh v cc nhm kinh t x hi.
Bo co ny xut rng cam kt mi v nh hng
li cc u tin pht trin ni chung l cn thit
m bo tng trng v pht trin con ngi mt
cch cng bng v ton din, v m bo tip cn
ton dn v cng bng cho mi ngi dn Vit Nam
i vi cc dch v y t v gio dc c cht lng
v gi c phi chng. N lc ny cn i km vi vic
xem xt thn trng v tc ng ca cc cch tip
cn v chnh sch i vi vn ti chnh v cung
cp dch v x hi. Ngoi ra cng cn cn nhc ti
vic thit k v cung cp cc sng kin gim ngho
v bo tr x hi cho vic tip cn vi cc dch v x
hi, cng nh cc u tin ni chung v hiu qu ca
u t cng nhm tng chi tiu x hi.
V BO CO NY
TNG QUAN V TIN B TRONG PHT
TRIN CON NGI CA Vit Nam, TP
TRUNG VO Y T V GIO DC
Bo co ny phn tch tnh hnh hin nay trong pht
trin con ngi cp a phng, tp trung c th vo
18
y t v gio dc, s dng 3 ch s pht trin con ngi

chnh l HDI, GDI v HPI, cng vi vic a ra ch s MPI
c ni a ha trong bo co ny. Da trn phn tch
v cc xu hng trong cc ch s pht trin con ngi
cp tnh v cp vng trong thp k va qua, bo co
ny s xem xt cc nhn t c th ng gp vo s tng
chm trong ch s tui th v gio dc. c bit, bo co
phn tch s chnh lch trong cc kt qu y t v gio
dc cp a phng v gia cc nhm dn s khc
nhau - iu c th ng gp vo nhng thay i trong
ch s HDI cp trung ng.
Bo co cng tm hiu vic tip cn vi dch v y t v

gio dc, c ch ti chnh v cung cp dch v y t v
gio dc cp quc gia v nhng vn cn lm i
vi vic cung cp dch v c s c th tc ng n kh
nng tip cn v cht lng dch v. Trong khi Bo co
Pht trin Con ngi quc gia ln u tin nm 2001 tp
trung vo qu trnh i mi v cc tc ng ca n ti
gim ngho v pht trin con ngi (xem Hp 1.4), bo
co ln hai ny phn tch cc thch thc m nhiu ngi
Vit Nam hin ang gp phi trong vic tip cn vi cc
dch v x hi c bn, vn m chnh ph s cn gii
quyn trong bi cnh quc gia tr thnh nc c
mc thu nhp trung bnh.
HP 1.4: BO CO PHT TRIN CON NGI U TIN NM 2001:

I MI V PHT TRIN CON NGI Vit Nam
Bo co Pht trin Con ngi quc gia c xut bn ln u tin nm 2001 trong a ra bc
tranh ton cnh v nhng tin b mnh trong cc ch s pht trin con ngi ch yu. Bo co
phn tch tc ng ca qu trnh i mi n cc kt qu pht trin con ngi, lp lun rng cc
ci cch do i mi a ra, ng ch l vic chuyn t nn kinh t k hoch ha tp trung sang
nn kinh t th trng vi nh hng x hi ch ngha; hi nhp vo cc cng ng quc t v
khu vc mang li nhng tin b cho pht trin con ngi v m rng s la chn cho con ngi
cng nh gim i ngho.41 Thnh cng ca i mi l to ra mt mi trng thun li ngi
dn tham gia vo nn kinh t, th hin trn ch s HDI cp quc gia, c bit l s ci thin trong
GDP bnh qun u ngi (PPP).
Tuy nhin bo co cng cho thy nhng chnh lch ng k gia cc vng tt c cc ch s pht
trin con ngi: mt s tnh vng ng Nam B v ng bng sng Hng c mc pht trin
tng ng vi cc nc nh Hungary v Estonia, trong khi cc tnh khc c bit l vng ng
Bc, Ty Bc v Ty Nguyn c mc pht trin tng ng vi Lo, Nepal v Butan. S dng s
liu thu nhp ca TCTK tnh h s Gini o lng bt cng thu nhp, bo co cng cho thy bt
cng thu nhp tng ng k c bit vo na sau ca thp k va qua. Dng nh cng c mi
quan h gia cc kt qu pht trin con ngi cao v mc bt cng thu nhp gim. Cc tnh c thu
nhp thp song c HDI cao dng nh c mc chnh lch thu nhp thp hn so vi cc tnh c thu
nhp bnh qun u ngi cao song li xp hng thp hn v pht trin con ngi.
Bo co cng khuyn ngh 5 hp phn trong chin lc pht trin ton din nhm tng cng pht
trin con ngi Vit Nam: (i) y mnh ci cch th ch c bit thc hin cc lut v chnh sch
tt c hiu qu hn; (ii) tip tc c cu li nn kinh t; (iii) thc y pht trin nng thn; (iv) ci
cch gio dc v o to, khoa hc v cng ngh; v (v) m rng v ci thin cc dch v cng. 42
CC PHN CA BO CO
Phn Mt ca bo co phc tho bi cnh tng
quan ca phn tch ny. Chng 1 a ra khung
phn tch v mc ch ca bo co, a ra phn
tng quan v khi nim pht trin con ngi v cc
ch s pht trin con ngi chnh cng nh nhng
xu hng ca ch s HDI Vit Nam. Chng 2
19
cp ti nhng chuyn i kinh t x hi phc tp

m Vit Nam ang tri qua khi tr thnh nc thu
nhp trung bnh bao gm nhng xu hng v thch
thc v kinh t, th trng lao ng, x hi, dn s v
mi trng c nh hng ti pht trin con ngi.
Chng 3 phn tch chi tit v xu hng pht trin
con ngi cp a phng trong giai on t nm
1999 n 2008, v nhng tin b cng nh chnh

lch gia cc vng v gia cc tnh trong c nc.
Phn Hai tp trung c th vo nhng thch thc m
ngi dn ang gp phi trong tip cn cc dch
v y t v gio dc. Chng 4 tho lun v tip cn
dch v y t v gio dc v xc nh nhng chnh
lch dai dng cng nh nhng vn mi ni v
tnh trng bt bnh ng gia tng gia cc vng, cc
tnh v cc nhm kinh t x hi. Chng 5 tho lun
v cc khun kh chnh sch hin nay trong cung
cp dch v x hi, bao gm c nhng cng thng
gia cam kt chnh sch ca Vit Nam v tip cn
ton dn v h tr nhm mc tiu thng qua cc
sng kin gim ngho v an sinh x hi c th; lch
s hnh thnh v tc ng ca chnh sch x hi
ha; v c ch ti chnh i vi cc dch v y t v
gio dc. Cui cng, Chng 6 tho lun v tnh sn
c v cht lng ca dch v v nh gi ngn gn
v nhng vn chnh lin quan ti vic ci thin
hot ng cung cp dch v trong bao gm c
vn ha t chc v cc bin php khuyn khch, s
tham gia v phn hi ca ngi s dng vo vic
lp k hoch v cung cp dch v, vic s dng cc
phng php lp k hoch v gim st hin i v
pht trin chuyn mn ca nhn vin. Bo co kt
thc vi phn tho lun v nh hng chnh sch
da trn cc kt qu phn tch.
CC CH S PHT TRIN CON NGI S

DNG TRONG BO CO NY
Bo co ny s dng b ch s pht trin con ngi
gc, l ch s HDI, GDI v HPI nh c tnh ton
trong bo co HDR ton cu nm 2009 v nh
ngha hp 1.2. Bo co cng da trn phn tch
cp vng v cp tnh s dng d liu ca Tng cc
Thng k (TCTK) v Vin Khoa hc X hi Vit Nam
(VASS) p dng phng php tnh ton trong cc
Bo co Pht trin con ngi ton cu cho ti nm
2009. Bo co ny cng da trn cc bn bo co
pht trin con ngi ton cu cung cp so snh
Vit Nam vi cc nc khc trong khu vc, s dng
ch s HDI theo cch tnh ton ban u v ba ch
s thnh phn ca HDI l: gio dc (t l bit ch
ngi ln v t l nhp hc chung); tui th v thu
nhp (GDP bnh qun u ngi tnh theo sc mua
tng ng).
Mi ch s trong ba ch s pht trin con ngi s
dng trong bo co pht trin con ngi ton cu
nm 2009 u c nhng im hn ch ca n. V d
i vi ch s HDI, t l nhp hc chung khng phn
nh cht lng hc ca hc sinh v c th che du
nhng khc bit quan trng gia cc nc do

tui tng ng vi tng cp hc khc nhau v thi
gian ca cc chng trnh gio dc.43 T l bit ch
cng tr nn t ngha hn khi quc gia t c
mc pht trin cao hn.44 Ch s GDI da trn s liu
c tnh cho hu ht cc quc gia hn l s liu thc
t, c bit i vi chiu v thu nhp.45 Ch s HPI
o lng nhng thiu ht mc tng hp v
khng th xc nh cc nhm hay cc h c th b
thiu ht ng thi nhiu chiu.46
gii quyt nhng hn ch ny, bo co pht trin
con ngi ton cu nm 2010 gii thiu mt
phng php mi tnh ton ch s HDI. Cc ch
s gio dc c c thay th bng s nm i hc
trung bnh v s nm i hc d kin, nhm a ra
mt thc o chnh xc hn v cc thnh tu gio
dc. GDP bnh qun u ngi c thay th bng
thu nhp quc gia bnh qun u ngi (GNI). Ngoi
ra, bo co ton cu 2010 cng gii thiu ba ch s
mi, l: ch s ngho i a chiu (MPI), ch s bt
bnh ng gii (GII) v ch s HDI iu chnh bt bnh
ng (IHDI).47
Ch s MPI, c ni a ha trong bi cnh ca Vit
Nam, c s dng trong bo co ny. Tuy nhin,
bo co ny cha s dng ch s HDI iu chnh,
cng nh cc ch s mi l IHDI v GII vn c
tnh ton cho Vit Nam cp quc gia trong bo
co ton cu 2010. C nhiu l do cho thc t ny.
Th nht, nh trong bo co ton cu nm 2010
ghi nhn, cc ch s thnh phn c ca ch s HDI
l tui th, t l bit ch ngi ln, t l nhp hc
v GDP bnh qun u ngi, vn c th d dng
thu thp v c ngha i vi vic phn tch so
snh.48 Bo co ny nhm phn tch xu hng theo
thi gian cp trung ng, vng v tnh. Cc ch s
mi nm 2010 vn cha c TCTK tnh ton cho
cp vng v cp tnh. V cc ch s ny cng cha
c tnh ton cho cc nm trc y so snh s
thay i theo thi gian. V vy bo co ny khng s
dng cch tnh mi cho ch s HDI hay ch s iu
chnh bt bnh ng IHDI. Tuy nhin, nhng hn ch
ca ch s HDI theo phng php c, c bit lin
quan ti thnh tu gio dc cn c lu tm khi
c bo co ny.
Th hai, v quan trng hn trong bi cnh Vit Nam,
l Bo co HDR ton cu 2010 tnh ton ch s
MPI cho Vit Nam da trn cc s liu t iu tra y t
nhn khu nm 2002. iu tra ny c s dng
c th cung cp s liu so snh vi cc nc khc v
khng c iu tra gn y no ca Vit Nam c tt
c cc ch s s dng trong ch s MPI ton cu.
20
Tuy nhin, do iu kin Vit Nam c s thay

i ng k trong thp k va qua, nn cn c s
l gii thn trng i vi ch s MPI ton cu ca
Vit Nam. Ch s MPI ton cu l s liu t cp nht
hn so vi cc ch s o lng ngho i a chiu
khc hin c s dng s liu gn y, trong c
ch s HPI, ch s ngho a chiu tr em (CPR) do
B LTBXH v UNICEF xy dng, v ch s MPI s
dng trong iu tra i ngho th.
Bo co ny gii thiu ch s MPI mi,

c ni a ha cho Vit Nam da trn
9 ch bo thnh phn tnh ton t b s
liu VHLSS nm 2008.
Bo co ny gii thiu ch s MPI mi, c ni a
ha cho Vit Nam da trn 9 ch bo thnh phn
tnh ton t b s liu VHLSS nm 2008. Ch s MPI
l c s o lng ngho i phi tin t trong
cc bo co pht trin con ngi quc gia trong
tng lai s dng cc ch bo quc gia sn c thu
thp nh k t iu tra VHLSS. Phn ch thch k
thut m t cch tnh ch s ny c a vo
phn ph lc 3. Ch s HPI vn l ch s ph hp
o lng mc thiu ht trm trng v thu
nhp v cc kha cnh phi thu nhp ca con ngi
theo thi gian.
Ch s bt bnh ng gii (GII) a ra trong Bo co
HDR ton cu nm 2010 bao gm cc ch bo v
sc khe sinh sn nh t l cht b m v t l
sinh tui v thnh nin cng nh s tham ga ca
n gii vo th trng lao ng, i din ca n
gii trong quc hi v s nm i hc. Ch s GII mi
ca Vit Nam tng ng vi mc pht trin con
ngi cao, xp th 58 trong s 137 nc. Tuy nhin
cc ch bo ny khng phi l thc o nh gi
chnh xc nht v nhng tin b theo hng bnh
ng gii Vit Nam nc c t l ph n tham
gia chnh tr v tham gia th trng lao ng kh
cao. Mc d t l n tham gia lc lng lao ng
cao song phn ln lao ng n tp trung khu vc
lm vic khng chnh thc. Trong khi khong cch
v lng theo gii l khong 12% trn ton quc,
mc chnh lch ln ti 50% khu vc phi chnh
thc. Nhng ch s khc nh chnh lch v lng
theo gii, t l mt cn bng gii tnh khi sinh ca
c nc tng ln mc l 110,5 tr em trai/100 tr
em gi v tnh trng bo lc gia nh ph bin vi
khong 34% ph n tng chu bo lc t nht mt
ln trong cuc i cho thy tnh hnh thc s v
gii Vit Nam. 49
21
CC NGUN D LIU KHC

Bo co b sung phn tho lun v cc ch s thnh
phn ca HDI bng cch s dng cc ngun s liu
quc gia c bit l VHLSS v Tng iu tra dn s
v nh c c cc s liu ph hp khng c
trong b ch s pht trin con ngi nh t l t vong
tr s sinh, t l hon thnh cc cp, t l ngho i
v bt bnh ng cp quc gia, vng v cp tnh.
Vic s dng s liu VHLSS v Tng iu tra dn s v
nh cng cho php bc tch gia cc nhm kinh
t x hi bao gm ngi dn tc, n gii, ngi gi v
nhng ngi c trnh gio dc v mc thu nhp
khc nhau phn tch s khc bit cng nh mc
thiu ht ca cc nhm dn c khc nhau Vit
Nam. S liu t cc ngun khc nh cc iu tra quy
m nh ca Chnh ph, LHQ v cc i tc pht trin
cng c s dng b sung v kim chng vi
cc d liu t cc ngun chnh thc ni trn.
Cc ch s pht trin con ngi, tng

iu tra dn s v VHLSS a ra mt bc
tranh kh ton din v cc kha cnh y
t, gio dc v mc sng vi nhng thay
i theo thi gian Vit Nam.
Tng iu tra dn s v VHLSS u c nhng im
mnh v im yu ring: v d Tng iu tra dn
s nm 2009 s dng mu i din l 15% dn s
Vit Nam nhng ch c tin hnh 10 nm mt
ln v c rt t thng tin lin quan ti nhng c
trng v kinh t x hi ca khu vc dn c. Tng
iu tra dn s ch a ra bc tranh rt khi qut
v nhng xu hng thay i trong y t, gio dc
v mc sng. VHLSS c tin hnh 2 nm mt
ln, do c th phn nh nhng thay i ngn
hn theo thi gian. VHLSS c dn mu iu tra nh
da trn cch ly mu ngu nhin n gin do
mc d c th i din cho ton b dn s song
s liu t chnh xc hn mc mu nh, v d nh
trong cc nhm dn s nh nh nhm dn tc
thiu s. Tuy nhin, c Tng iu tra v VHLSS u
khng iu tra mt vi nhm dn s c th l ngi
ngho v b thit thi nh lao ng nhp c theo
ma v v tm thi.50 Tuy nhin, khi c s dng
kt hp vi nhau, cc ch s pht trin con ngi,
tng iu tra dn s v VHLSS a ra mt bc tranh
kh ton din v cc kha cnh y t, gio dc v mc
sng vi nhng thay i theo thi gian Vit Nam.
Cc phng php o lng i ngho v thiu ht
a chiu nh ch s HPI cng b sung thm cc
bng chng quan trng.
22
2
Chng 2
CHUYN I
KINH T X HI
CA Vit Nam
CHNG NG TNG TRNG
KINH T V TIN B T C
Vit Nam C TC TNG TRNG KINH
T CAO V GIM NGHO NHANH
Nm 2009, Vit Nam chnh thc tr thnh nc
c thu nhp trung bnh vi tng thu nhp quc gia
(GNI) bnh qun u ngi l 1.020 la M nm 2009
v 1.110 la M nm 2010.1 iu ny c cng c
vng chc trn c s Vit Nam t c mc pht
trin con ngi trung bnh. Nhng du mc trong qu
trnh pht trin ny ca vit Nam l minh chng cho
nhng thnh tu ca quc gia trong c kha cnh thu
nhp v phi thu nhp ca pht trin con ngi, mc d

nh chng trc phn tch, tng trng thu nhp
l ngun ng lc chnh thc y tin b ca Vit
Nam v ch s HDI, c bit trong giai on 1999-2008.
Trong giai on t nm 2000 n 2010, Vit Nam tip
tc t c mc tng trng kinh t cao. GDP hng
nm tng t 6 n 8% trong thp k qua tr nhng
nm ngay sau khi xy ra khng hong kinh t: trong
tc tng GDP ch t 6,31% vo nm 2008 v 5,32
% nm 2009 trc khi phc hi ln mc 6,8% vo nm
2010 (Hnh 2.1).2 GDP bnh qun u ngi tng
nhanh trong thi gian ny t mc 402 la M nm
2000 ln 1.168 la M nm 2010. Tuy nhin, GDP bnh
qun u ngi ca Vit Nam vn thp hn hu ht
cc nc trong khu vc ngoi tr Lo v Campuchia. 3
Hnh 2.1: Tng trng GDP v GDP bnh qun u ngi ca Vit Nam (la
M), 2000-2010
Ngun: TCTK, www.gso.gov.vn
Chuyn i kinh t x hi ca Vit Nam
24
T l ngi ngho da trn chi tiu cng gim

ng k trong thi gian ny t 37,4% nm 1998
xung 14,5% nm 2008. i ngho nng thn gim
t 44,9% xung 18,7% trong khi i ngho thnh th
gim t 9,5% xung 3,3%.4 Mc d t l ngho c
kh nng b nh gi thp hn thc t do chun
ngho ca Vit Nam kh thp so vi tiu chun quc
t5 v mt s nhm d b tn thng nht thng
nm ngoi cc cuc iu tra quc gia, song tc
gim ngho ca Vit Nam c coi l mt thnh tu
ng k. V lnh vc ny, Vit Nam t c tin
b rt ng ch v c ghi nhn ti Hi ngh
thng nh thin nin k vo thng 9 nm 2010. 6
Cho d c nhng thnh tu trn song tin b
v gim ngho vn din ra khng ng u
gia cc vng v cc nhm dn c khc nhau.
Ngho i c mi tng quan mnh vi v tr a l

v dn tc cng nh vi nhng thiu ht phi tin t
nh mc sng thp hn v tnh trng y t v gio
dc km hn. T l ngho cao nht l vng trung
du v min ni pha Bc v thp nht l ng Nam
B.7 Trong 2 ngi dn tc thiu s th c mt ngi
ngho trong khi trong 11 ngi Kinh mi c mt
ngi ngho. T l i ngho ca ngi Kinh l 8,9%
nm 2008 so vi 50,3% ngi dn tc thiu s.
T l gim ngho din ra nhanh hn khu vc
th, nhm ngi Kinh cng nh vng ng bng
sng Hng v ng Nam B. Trong khi , bt bnh
ng v thu nhp dng nh ang tng ln mc d
tc tng chm hn so vi cc nc khc trong
khu vc. H s Gini v thu nhp tng t 0,418 nm
2002 ln 0,434 nm 2008. Khong cch v thu nhp
gia ng phn v ngho nht v giu nht l 8,94 ln
trong nm 2008, tng so vi mc 8,1 ln nm 2002. 8
Tin b v gim ngho vn din ra khng ng

u gia cc vng v cc nhm dn c khc nhau.
Bng 2.1: T l ngho v tc gim ngho giai on 1998-2008 (%)9

Vit Nam
1998
2002
2004
2006
2008
T l gim ngho (%)

1998-2008
34.7
28.9
19.5
16
14.5
58
Thnh th
9.5
6.6
3.6
3.9
3.3
65
Nng thn
44.9
35.6
25
20.4
18.7
58
ng bng sng Hng
30.7
21.5
11.8
8.9
8.0
74
Trung du v min ni
pha Bc
64.5
47.9
38.3
32.3
31.6
51
Bc Trung B v duyn hi
Nam Trung B
42.5
35.7
25.9
22.3
18.4
57
Ty Nguyn
52.4
51.8
33.1
28.6
24.1
54
ng Nam B
7.6
8.2
3.6
3.8
2.3
70
ng bng sng Cu Long
36.9
23.4
15.9
10.3
12.3
67
Ngi Kinh
31.1
23.1
13.5
10.3
8.9
71
Cc dn tc khc
75.2
69.3
60.7
52.5
50.3
33
Ngun: VHLSS nm 2008; Bo co MDG Vit Nam 2010.
Vit Nam ANG TRN CHNG NG T

C MC TIU PHT TRIN THIN NIN K
Vit Nam t c nhng tin b quan trng
trong nhiu ch s Mc tiu pht trin thin nin k
(MDG) trong mt thp k qua, bao gm c nhng
mc tiu y t v gio dc chnh v ang i ng
hng t c cc MDG cp quc gia. T l
bit ch ca ngi trn 10 tui tng t 89,5% nm
1998 ln 93,1% nm 2008. Mt khc t l nhp hc
25
ng tui cp tiu hc l 97% v trung hc c s

83% trong nm hc 2008/09. Khong cch v gii
cc cp hc thp hn c thu hp, vi t l
ngang bng 94% s tr em trai v gi tui t 6
n14 tui nhp hc trong nm 2008. T l hc sinh
n nhp hc cao hn so vi hc sinh nam cc cp
trung hc ph thng v i hc cao ng.10
V cc ch s lin quan ti y t, t l t vong tr em
di 5 tui gim t 58 trng hp trn 1.000 ca nm
1999 xung cn 24,4 trn 1.000 nm 2009 trong khi

t l t vong tr s sinh gim t 44,4 trn 1.000
xung 16 trn 1.000 ca trong cng thi gian ny.
Theo s liu ca B Y t, t l t vong b m hin
nay l 69 trong 100.000 ca sinh v 94,8% ca sinh c
nhn vin y t c chuyn mn vo nm 2008.
Ngoi ra hin nay c 83% dn s nng thn c
tip cn nc sch, tng so vi mc trn 30% nm
2000 v 63% s h gia nh nng thn c nh v
sinh tiu chun. Tuy nhin, Vit Nam khng c
kh nng t c MDG s 6 v HIV, v dng nh
nhng tin b trong vic gim t l cht b m khi
sinh chng li trong nhng nm gn y.11
Tuy nhin, nh Chng 3 phn tch, cc kt qu tch
cc trn cp quc gia dng nh khng cho thy
thc trng chnh lch ln v dai dng gia cc vng
v cc tnh khc nhau v gia cc nhm dn s khc
nhau. Ngoi ra, Vit Nam hin cn gp phi nhng
thch thc v thay i phc tp v kinh t x hi c
nguy c lm o ngc nhng thnh tch ny v ph
hy cc kt qu pht trin con ngi trong tng
lai nu nh nhng thch thc ny khng c gii
quyt v qun l tt. Nhng thch thc v pht trin
con ngi s c tho lun k cc phn sau.
MI TRNG KINH T V M
BT N
MI TRNG KINH T V M V CC THCH
THC I VI PHT TRIN CON NGI
Mc d c nhng thnh tu tch cc trong tng
trng GDP v gim ngho trong thp k va qua,
song Vit Nam cng tri qua nhng thi k bt
n v kinh t v m trong nhng nm gn y. T
l lm pht ca Vit Nam cao nht trong khu vc
vi ch s gi tiu dng (CPI) bnh qun trong giai
on t 2004 n 2009 l 10,2% so vi 2,9% ca
Trung Quc v 3,1% ca Thi Lan.12 Lm pht tip
tc mc cao v bin ng phc tp trong nm
2010 v 2011.13 Ngoi ra, trong thp k qua, nn kinh
t Vit Nam lin tc trong tnh trng thm ht ti
khon vng lai trong cn cn thanh ton, vi mc
thm ht chim khong 12% GDP nm 2010.14 Tnh
trng thm ht ny cho thy s khng tng xng
gia u t nc ngoi v u t trong nc trong
nn kinh t Vit Nam - ci gi l khong cch u
t. Khoang cach nay xut pht mt phn t m
hnh kinh t u tin tng trng da trn u t,
vi t l u t chim 42% GDP nm 2010.15 ng
thi, t l thu hi trn u t lin tc gim, cho thy
u t ang ngy cng tr nn km hiu qu Vit
Nam.16 iu ny to ra nhng p lc khng cn

thit ln ti khon vng lai ca Vit Nam, khin Vit
Nam ph thuc nhiu hn vo cc ngun vn pht
trin t bn ngoi v khin Vit Nam tr nn d b
tn thng hn trc cc c sc kinh t ton cu
nh cuc khng hong ti chnh gn y.17 Mc d
Vit Nam duy tr c tc tng trng GDP
trong giai on suy thoi kinh t, nhng nh hng
ca cuc khng hong i vi sinh k v i sng
ca nhiu ngi Vit Nam l rt ln.
Mc d Vit Nam duy tr c tc tng

trng GDP trong giai on suy thoi kinh
t, nhng nh hng ca cuc khng hong
i vi sinh k v i sng ca nhiu ngi
Vit Nam l rt ln.
Vic lm cc khu vc sn xut hng xut khu v
cc lng ngh th cng b thu hp v nhiu cng
nhn nhp c buc phi tr v qu hng. Cng
vic khng n nh v thu nhp thp nh hng
ti nhiu h gia nh, trong khi gi c thc phm
v cc hng ha thit yu khc vn mc cao.18
Nhiu h gia nh ct gim chi tiu cho gio dc
v trong mt s trng hp, khng th cho con i
hc na. Nhiu gia nh cng ct gim chi tiu thc
phm v do tc ng ti sc khe v dinh dng
ca ph n v tr em.19
Bt n kinh t v m khin Vit Nam tr thnh im
n km hp dn hn i vi nh u t: Vit Nam
ng th hng thp hn so vi hu ht cc nc
trong khu vc ng Nam xt v tnh cnh tranh
quc t, ch trn Campuchia v Philippines nhng
li di Indonesia, Thi Lan v Malaysia.20 iu ny
cng nh hng ti mc sng ca con ngi thng
qua vic gim sc mua ca ngi tiu dng v lm
tng chi ph ca cc dch v x hi, bao gm c y t
v gio dc. Ngoi ra c s h tng yu km, trong
c tnh trng thiu in thng xuyn, k nng
v nng sut thp, mi trng php l khng
minh bch v n nh cng cn tr cc nh u t
c trong v ngoi nc.21 C s h tng yu cng
lm xi mn s tng trng ca cc doanh nghip
trong nc trong c s pht trin ca khu vc
doanh nghip siu nh, nh v va.22 Trin vng
kinh t v m hin nay ca Vit Nam cng t ra
nhng thch thc c th trc xu hng chuyn
i kinh t v x hi an xen m t nc ang tri
qua. Nhng chuyn i ny c th ph hy s pht
trin trong tng lai ca t nc v kh nng hin
thc ha ln mc pht trin con ngi v cc kt
qu cao hn cho tt c mi ngi Vit Nam.
26
DN S KHE MNH V C HC THC L CHA

KHA TIP TC TNG TRNG KINH T
Trong phn tho lun v pht trin con ngi v cc
kha cnh thu nhp v phi thu nhp, c mt s vn
chnh ni ln t nhng phn tch gn y. Th nht,
hin cc nh phn tch v nn kinh t Vit Nam ang
ngy cng c s ng thun rng m hnh tng trng
hin nay ang lm cn kit nhanh chng tim nng
v kh c th tip tc t c tng trng kinh t
cao trong di hn vi mi trng kinh t v m nh
hin nay. Thc vy, nhn t c ng gp ln gy ra bt
n kinh t v m l do cc nh hoch nh chnh sch
khoang cach thng c xu hng u tin cho u t
quy m ln, v thng km hiu qu lm ng lc cho
tng trng kinh t.23 Gn y, c du hiu cho thy
chnh ph nhn thc c tm quan trng ca vic
tp trung vo cht lng tng trng v n nh kinh
t trong di hn.24 Th hai v quan trng trong khun
kh ch ca bo co ny, c s ng thun r rng
trong cc nh hoch nh chnh sch v gii phn tch
rng Vit Nam cn phi xy dng lc lng lao ng c
k nng, cng ngh v tri thc cao nng cao nng
sut. Vit Nam cng cn chuyn dch sang cc ngnh
c k nng cao hn nhm trnh ci gi l by thu nhp
trung bnh (Hp 2.1).25 Nh trong Bo co v Kh nng
cnh tranh ca Vit Nam nm 2010 nu r:
Vit Nam ang i mt vi tnh trng

thiu ngun nhn lc cht lng cao, mt
cn tr chnh tng nng sut. Nu Vit
Nam hi lng vi nhng thnh tu v cc
ch s nng lc con ngi c bn nh hin
nay, Vit Nam s kh c th pht trin vt
ra khi mc hin nay v tin ln nc thang
cnh tranh cao hn trn th gii.26
Trc tnh d b tn thng vi cc nh hng ca cc
c sc ti chnh ton cu v nhng yu km hin nay
ca u t nc ngoi Vit Nam cng nh nhu cu
bn ngoi thp i vi cc sn phm xut khu ca
Vit Nam, nhu cu v cc th trng trong nc ang
ni ln l ngun ng lc quan trng ca tng trng
kinh t. Tuy nhin tng cu trong nc khng ch i
hi phi c cc sn phm hng ha v dch v trong
nc sn xut ra c cht lng tt p ng nhu cu v
mong mun ca ngi tiu dng v c th cnh tranh
vi sn phm tng t t nc ngoi. Nhu cu ni a
tng cng i hi phi c lc lng dn chng giu
c, c tri thc v khe mnh hn.27 Nh vy, ci thin
cc kt qu v y t v gio dc (bao gm c cc kt qu
c o lng trong ch s HDI) c vai tr quan trng
tip tc tng trng kinh t v to iu kin Vit
Nam c th tr thnh quc gia c mc sng v thu
nhp cao hn.
HP 2.1: NC THU NHP TRUNG BNH, MC PHT TRIN CON

NGI TRUNG BNH V BY THU NHP TRUNG BNH
Nc c thu nhp trung bnh (MIC) theo phn loi ca Ngn hng th gii da trn tng thu nhp quc
dn bnh qun u ngi (GNI) hng nm: cc nc trong nhm thu nhp bnh qun u ngi mc
trung bnh thp nh Vit Nam l nc c GNI bnh qun u ngi t 996-3.945 la M trong nm 2009.28
Pht trin con ngi mc trung bnh l phn loi c s dng trong Bo co HDR v l cc nc ri vo
nhm t phn v th ba trong s cc nc da trn cc tin b v ba kha cnh chnh l y t (tui th); gio
dc (t l bit ch ca ngi ln v t l nhp hc chung); v mc sng (GDP bnh qun u ngi theo sc
mua tng ng PPP) o lng bi ch s HDI.29
L mt ch s a chiu, HDI cung cp nh gi a dng hn v pht trin con ngi so vi nh gi ch
n thun da trn ch s GNI bnh qun u ngi. Tuy nhin h thng phn loi ca Ngn hng Th gii
c s dng quyt nh mc v cc iu kin mt quc gia c nhn H tr pht trin chnh
thc (ODA). Hin nay Vit Nam tr thnh nc MIC, ngun vn vin tr trong tng lai s gim xung
vi mc cam kt vin tr thp hn cho Vit Nam.30 Chuyn i sang v th ca mt nc MIC do c
ng quan trng i vi pht trin con ngi, nh hng ti h tr pht trin dnh cho gio dc, y t v
cc sng kin an sinh x hi.
By thu nhp trung bnh cp n kinh nghim ca cc nc ang pht trin t ti mt mc thu
nhp nht nh nhng cha th t c mc pht trin cho php cc nc ny c th tr thnh nc
thu nhp cao. Cc nc trong trng hp ny thng tn dng thnh cng chi ph nhn cng gi r, s
dng t hn t ai v cc ngun lc ti chnh thu ht u t. iu ny to iu kin cc nc ny
chuyn t sn xut nng nghip vi trnh thp sang sn sut nng nghip vi trnh cao hn v cng
nghip s dng k thut thp, tng thu nhp v to ra tng trng kinh t nhanh chng. Nhng khi thu
27
nhp tng, gi lao ng khng cn r na v cng nhn i hi v cn lng cao hn, t khng c tn
dng dng y v ngun vn khng cn sn c v chi ph bt u tng ln, lm gim tnh cnh tranh
ca cc ngnh cng nghip c cng ngh thp. Gii php x l ci gi l by chnh l nng cp chui
gi tr trong cc ngnh cng ngh cao v k thut cao v ng thi cng quan trng l ci tin v u t
vo nghin cu v pht trin. ng thi quan trng l m bo c sn lc lng lao ng trong nc c
trnh , k nng cao, c o to lm cng vic chuyn mn cao h tr cho s thay i ny. y l
qu trnh chuyn i kh khn.31
V d, cc nc MIC nh Thi Lan, Philippines v Malaysia trong mt thp k qua v ang tri qua thi
k tng trng chm li v th hng cnh tranh khng c ci thin. Trong khi c ba nc ny u c
s phc hi trong mc tng trng GDP sau khi khng hong kinh t, song ch c Philippines c s lng
vic lm trong ngnh cng nghip phc hi tr li bng mc trc khng hong. Cc nc ny u b tc
khi nhm nc MIC trong vi thp k qua. Philippines v Malaysia c t l u t nm trong nhm thp
nht trong cc nc MIC trn ton cu, v quan trng l, c ba nc ny u gp phi tr ngi l kh nng,
chuyn mn v k nng ca cc doanh nghip trong vic i mi v sn xut ra cc sn phm mi.32
NHNG THAY I V CU TRC

TRONG NN KINH T V TH
TRNG LAO NG
TH TRNG LAO NG THAY I
K t khi i mi bt u nm 1986, Vit Nam tri qua
giai on chuyn i t nn kinh t k hoch ha sang nn
kinh t th trng c nh hng x hi ch ngha v
dn dn m ca th trng cho u t v thng mi quc
t. Qu trnh ny c y mnh sau khi Vit Nam gia
nhp T chc thng mi th gii (WTO) nm 2007. Nhng
thnh cng kinh t ca Vit Nam da trn nng sut nng

nghip cao, tng trng xut khu c bit l du m v
cc ngnh nh giy da, may mc v u t trc tip nc
ngoi (FDI). Qua thi gian, c cu kinh t thay i ng
k, t trng ng gp ca ngnh cng nghip v xy dng
trong GDP tng ln trong khi t trng nng nghip gim
xung v ngnh dch v khng thay i trong giai on t
nm 2000 n2009.33 C ba ngnh ny u c tc tng
trng n nh t nm 2000, mc d gim st vo nm
2008-2009 do tc ng ca khng hong ti chnh song
sau phc hi li vo nm 2010, cho d cha t c
mc trc khng hong.34 Ngnh sn xut b nh hng
nhiu nht vi tc tng trng gim t 12,4% nm 2007
xung 2,8% nm 2009 (Hnh 2.2). 35
Hnh 2.2: Tng trng GDP thc t hng nm vi ng gp ca cc thnh phn

kinh t (nm gc 1994)
Cng nghip
Ngun: Ti khon quc gia, TCKT, trch dn trong B LTBXH/ILO/EU 2011
28
M ca v t do ha nn kinh t Vit Nam to

s bng n cc doanh nghip ch yu l doanh
nghip nh v h t doanh: trong tng s 355.000
doanh nghip t nhn hin ng k kinh doanh,
98,4% l doanh nghip va v nh.36 Nh mi trng
kinh doanh c ci thin, nht l t sau khi gia
nhp WTO, Vit Nam vn c coi l im n hp
dn i vi nh u t nc ngoi bt chp nhng
thch thc v kinh t v m nh tho lun trn.
Kt qu l, khu vc FDI v khu vc t nhn ngy cng
c vai tr quan trng trong nn kinh t. Khu vc FDI
v khu vc t nhn to ra phn ln vic lm mi,
do tc to vic lm cc khu vc ny nhanh
hn nhiu so vi khu vc doanh nghip nh nc
(SOE).37 T l vic lm ti cc doanh nghip t nhn
tng t 29% nm 2000 ln 50% nm 2009, v t 16
ln 33% trong khu vc FDI trong khi khu vc SOE
gim t 55% xung cn 15%.38 iu ny c ng
quan trng i vi iu kin lm vic v tnh n nh
ca ngi lao ng cng nh chnh lch v lng
theo gii nh ch ra Hp 2.2. C hai im chnh
minh ha cho thc t ny: th nht, lu rng trong
giai on t nm 2007 n 2009 din ra suy thoi
kinh t, s lng cng nhn c hp ng chnh thc
v di hn gim xung trong khi s lng ngi lm
c thi hn v da trn cam kt ming tng ln,
phn nh s gia tng bt n v vic lm trong bi

cnh khng hong.39 Nh ghi nhn trc , vic
lm trong nhng khu vc nh ngnh sn xut nh
hng xut khu b nh hng nng nht. Th hai,
phn ln cc hot ng sn xut cng nghip
Vit Nam u lin quan ti cc doanh nghip FDI,
v nhng nguyn nhn chnh ca cc cuc nh
cng l do doanh nghip khng thc hin cc quy
nh v lao ng, lng thp, lm thm qu nhiu
v iu kin lm vic ti t.40
Ngoi vic thc y tng trng kinh t v tng thu
nhp, nhng thay i ny mang li tc ng ln
lao ti th trng lao ng ca Vit Nam v cc c hi
vic lm. Th trng lao ng Vit Nam ang ngy
cng c cng nghip ha v th ha. Trong khi
phn ln lc lng lao ng vn tip tc lm vic
khu vc nng nghip, t l ngi lm trong khu
vc cng nghip v xy dng gia tng ng k.
V vy m t l lao ng nng nghip gim t
65,3% nm 2000 xung 47,6% nm 2009 trong khi t
l lao ng trong ngnh cng nghip tng t 12,4%
ln 21,8% trong thi gian ny. Lao ng khu vc
dch v tng t 22,3% nm 2000 ln 30,6% nm 2009
(Hnh 2.3).41
Hnh 2.3: Phn phi vic lm theo ngnh 2000-2009 (%)
Ngun: B LTBXH, iu tra lao ng v vic lm (nhiu nm) trch dn trong bo co ca B LTBXH v ILO (2010); bo co ca TCTK v lao ng
v vic lm nm 2010) Bo co v iu tra lc lng lao ng Vit Nam 1/9/2009
29
Tng trng vic lm kh n nh vi tc tng

trung bnh 2,6%/nm, tng ng vi tc
tng thu nhp bnh qun u ngi.42 Ngay c sau
khng hong kinh t, Vit Nam vn tip tc c t
l tng trng vic lm cao trn mc 2,2%/nm
trong giai on 2007- 2009. a s nhng vic lm
mi ny nm trong khu vc cng nghip v dch
v.43 Trong thi gian t nm 1997 2007, t l vic
lm khu vc thnh th tng t 20,9% ln 24,7%
v tip tc tng ln 27,8% vo nm 2009.44
Ngi lao ng phi chnh thc thng thiu

c hi tip cn tr cp v c hi o to,
thng phi lm vic trong iu kin kh
khn, khng n nh, vi thu nhp thp.
Mc d nhng thay i c cu ang din ra trong
nn kinh t song t l ngi lm vic trong khu vc
c tr lng vn cn thp v phn ln lc lng
lao ng Vit Nam tip tc tp trung khu vc nng
nghip v phi chnh thc. Theo T chc lao ng
quc t (ILO), 65,1% lc lng lao ng Vit Nam tp
trung khu vc khng chnh thc trong khi ch c
33,4% l ngi lm cng n lng. Tuy nhin, trong
s ny c ti 44,7% lm vic theo cc tha thun
ming hoc khng c hp ng.45 Ngi lao ng
phi chnh thc thng thiu c hi tip cn tr cp
v c hi o to, thng phi lm vic trong iu
kin kh khn, khng n nh, vi thu nhp thp
hn nhiu so vi nhng ngi lm vic khu vc
chnh thc.46
LC LNG LAO NG C K NNG V

TIP CN CNG VIC BN VNG
Gio dc l cha kha m bo c mt lc lng
lao ng c k nng v nng sut cao ng thi
tip cn vic lm bn vng, tuy nhin lc lng lao
ng Vit Nam a phn khng c k nng v trnh
hc vn thp. Trong s nhng cng nhn lao
ng trong nm 2007, ch c 24% hc ht trung

hc ph thng v 35% c mt hnh thc o to
k thut hoc bc cao hn: 29% i vi n v 40%
i vi nam.47 Mc d t l tht nghip mc thp
khong 2,8%, song t l ny cao hn nhiu nhm
tui t 15-24: hn na s ngi tht nghip trong
nm 2009 l ngi trong tui 15-24 v s ngi
thuc tui 15-29 chim 65% tng s ngi tht
nghip.48 Nhng ngi tht nghip thng khng
c bng cp g, 70,5% khng c bng cp trn mc
tt nghip trung hc c s, 67% l nam gii v 74%
l n gii.49
Hn th na, t l thiu vic lm, mt ch s hu
ch hn so vi tht nghip hiu c nhng hn
ch ca th trng lao ng cc nc ang pht
trin nh Vit Nam, cng kh cao, vo khong 5,4%
nm 2009; 6,3% khu vc nng thn v 3,2%
khu vc thnh th,50 gy ra nhng thch thc ln v
nhiu cng nhn ch lm nhng cng vic ma v
v chn tay, do vy khng c thu nhp duy
tr mt mc sng bn vng.
Thc vy, Vit Nam gp phi nhiu thch thc ln
trong vic to ra lng vic lm bn vng m
bo ngi lao ng c th tip cn vi cc dch
v bo h lao ng v cc dch v x hi, v thch
thc trong vic xy dng mt lc lng lao ng
c k nng cao v c trnh c th h tr qu
trnh chuyn i sang nn kinh t c k nng v
cng ngh cao.51 Tip tc pht trin con ngi c
bit trong lnh vc gio dc v dy ngh c vai tr
quan trng to iu kin cho ngi dn c th
chuyn khi nhng cng vic d tn thng v tm
c vic lm bn vng. Nh Hp 2.2 ch ra, iu
ny c bit cn thit i vi ph n, nhng ngi
ch yu lm trong lnh vc phi chnh thc v thng
khng c hng lng.
30
HP 2.2: TH TRNG LAO NG PHN TCH THEO GII

Phn quan trng trong thnh cng xut khu ca Vit Nam l nh hng trm nghn ph n tr
lm vic trong khu vc giy dp v may mc.52 Tuy nhin, mc d c nhiu c hi mi m ra cho
ph n khi nn kinh t Vit Nam thay i, th trng lao ng vn cn c s khc bit theo gii.
N gii ch yu tp trung khu vc sn xut, bn l v thng mi, dch v kinh doanh n v
gio dc; trong khi nam gii tp trung trong ngnh xy dng, giao thng v kho bi v cc t
chc chnh tr x hi. Phn tch theo gii trn th trng lao ng l do bt bnh ng v gii
ng thi lm tng bt bnh ng v gii trong x hi v l mt cn tr i vi s pht trin con
ngi ca ph n.
V iu kin lm vic, nam gii thng c hng iu kin tt hn v khong cch dng nh
ngy cng tng. T l nam gii c cng vic c tr lng cao hn nhiu: 38,9% so vi 27,5%
n gii; v vic lm c tr lng ca nam gii cng tng cao hn so vi ph n: 3,1% so vi
2,5% trong giai on 2007 - 2009. Ph n tp trung nhng vic lm d b tn thng k c t
lm cho mnh hoc lm vic nh khng c thu nhp: 69,1% ph n so vi con s 54,4% nam gii.
Tuy nhin, t l ph n lm cng vic gia nh khng c thu nhp cao hn nhiu: vi 22,2% so vi
t l ca nam gii l 11,8%. T nm 2007 ti nm 2009, c mt t l ln hn nam gii chuyn
sang nhng cng vic c tr lng trong cc ngnh cng nghip trong khi nhiu ph n li
tr thnh lao ng trong h khng c thu nhp trong lnh vc nng nghip v dch v. T l ph
n lm vic nh khng c thu nhp tng thm 8,2% trong thi gian t nm 2007 n 2009,
trong khi t l n gii t lm cho mnh v c thu nhp gim 11,2%. iu ny cho thy ph n c
th gp nhiu bt li hn khi xy ra khng hong kinh t, phi ngng kinh doanh bun bn nh
v quay tr li lm cc cng vic gia nh khng mang li thu nhp.
S liu t iu tra mc sng h gia nh Vit Nam (VHLSS) 2008 cho thy phm vi c nc,
chnh lch tin lng theo gii ang gim dn song li tng ln i cht khu vc th k t
nm 2006. Trn ton quc, tin lng ca n gii bng 90% ca nam gii, trong 85% khu
vc thnh th v 91% khu vc nng thn, so vi s liu tng ng thnh th l 87% v nng
thn l 88% trong nm 2006.53 Trong khi cha c d liu ng tin cy v khu vc khng chnh
thc, cc nghin cu c tnh ph n trong khu vc phi chnh thc c thu nhp ch bng 50% so
vi nam gii.54
mt s lnh vc v ngh nghip c th, ph n c th kim nhiu tin hn nam gii v d nh
mt s cng vic trong chnh quyn cc khu vc nng thn, hay cc v tr hnh chnh v qun
l hoc kinh doanh thng mi nng thn. Tuy nhin, ng ch l trong cc doanh nghip
FDI v c bit trong ngnh sn xut ni ph n chim a s th tin lng ca h ch bng 2/3
so vi nam gii.55 Trn thc t, chnh lch tin lng theo gii gip Vit Nam c th h tr
u t v thnh cng trong xut khu v, c bit khu vc thnh th, ch lao ng trong cc
ngnh sn xut tm cch ct gim lng ca ph n nhiu hn so vi nam gii duy tr kh
nng cnh tranh ca mnh trn th trng th gii.56 Cch tip cn ny khng bn vng v lu
di nu Vit Nam mun thnh cng trn con ng chuyn ln nhng ngnh cng ngh cao v
k thut cao hn.
31
THI K CHUYN I V
NHN KHU
XU HNG NHN KHU S NH HNG
TI TNG LAI CA Vit Nam
Song song vi nhng thay i v c cu ang xy ra
trong nn kinh t Vit Nam, nhng thay i v nhn
khu v dch chuyn dn s ang gy p lc ln th
trng lao ng, y nhanh qu trnh di dn v
th ha.
Nhng thay i v nhn khu v dch

chuyn dn s ang gy p lc ln th
trng lao ng, y nhanh qu trnh di
dn v th ha.
Nm 2009, dn s ca Vit Nam l hn 85 triu ngi,
tng kh khim tn vi t l tng trung bnh mi
nm khong 1,2% k t nm 1999. Tc tng dn
s cao nht l vng Ty Nguyn (3,2%) v ng
Nam B (2,3%), v thp nht l ng bng sng
Hng (0,9%) v ng bng sng Cu Long (0,6%).57
Tng trng dn s thp c l gii mt phn do
t l sinh gim t 2,33 tr em trn mt ph n nm
1999 xung di mc thay th l 2,03 tr em vo
nm 2009. C s khc bit r gia cc vng v gia
khu vc nng thn v thnh th.58 t tr em c
sinh ra cng gp phn lm t l ngi ph thuc
thp hn: T l ngi ph thuc ca Vit Nam gim
xung cn 46,3% nm 2009 so vi 63,6% nm 1999.
L do c bn ca t l sinh thp hn l ba xu hng
nhn khu quan trng nh hng ti s pht trin,
thnh vng v kh nng nng cao mc sng ca
Vit Nam trong tng lai. Th nht, Vit Nam ang
bc vo thi im gi l giai on dn s vng. Do
t l sinh v t l cht u gim i nn nhm dn
c ng nht hin trong tui 15-24.59 Nhm dn
c trong tui ny chim 19% lc lng lao ng
vi hng trm nghn thanh nin tham gia lc lng
lao ng mi nm.60 Do vy, trong vng 40 nm na
t nm 2010 n 2049, c mi ngi di 15 tui
hoc trn 65 tui th s c t nht 2 ngi trong
tui lao ng t 15-65. y l tim nng ln cho Vit
Nam song cng c th l mi e da ln ty thuc
vo cch qun l vn ny th no. Vit Nam s
cn xy dng k nng v kh nng cho lc lng
lao ng tr ny, to vic lm bn vng v cho

nhng ngi mi gia nhp th trng lao ng v
m bo h c c li ch trong tng lai ca t
nc bng cch to cho h cc c hi h tham
gia c ngha vo i sng chnh tr v x hi.61
Nu khng thc hin c cc mc tiu ni trn,
khng ch mt th h ngi Vit Nam ng trc
nguy c tht nghip v mt c hi m c th cn
gy ra nhiu vn x hi khc. Mong mun ca
th h tr ang thay i rt nhanh chng v ngy
nay h c nhng k vng v cuc sng vt cht
kh khc bit so vi th h cha m. c nhng
du hiu v khong cch th h xut hin Vit
Nam gia nhng ngi tr tui v th h cha m
h, trong gii tr khng cng chia s nhng gi
tr hay mong mun ging nh th h nhng ngi
gi (xem Hp 2.5). Thi quen chp nhn ri ro hin
ang gia tng ngi tr tui vi t l s dng ma
ty v ru cao hn, c bit l nam gii tr tui, t
l no ph thai cao nhm n gii tr cha kt hn
v t l ly nhim HIV ngy cng tng trong nhng
ngi tr tui.62 Tt c nhng thay i ny c ngha
quan trngi vi cc dch v x hi c bit l dch
v y t, cng nh an sinh x hi v dch v phc li
x hi h tr tng lp ngi tr tui. V d, dch
v y t hng vo i tng ngi tr tui trong
tui sinh cng vi cc dch v phc li x hi
bao gm sc khe tm thn, cc dch v cai nghin
ru v ma ty cn c tng cng.63 Trng hc
v cc c s o to cn thay i hn na thch
nghi vi tnh hnh v nhu cu ang thay i ca th
h tr; v d nh thng qua vic xy dng k nng
sng v o to v sc khe sinh sn hiu qu cho
ngi tr tui.64
DN S GI HA
Vo cui vng i, dn s Vit Nam ang gi ha,
v nh tho lun trong Hp 2.3, dn s gi ha cn
c chm sc y t v bo tr x hi. n nm 2049,
d bo s c hn 26% dn s Vit Nam trn 60 tui;
tng ba ln so vi nm 2009 (Hnh 2.4).65 Tui th
ang tip tc tng v hin nay mc trung bnh l
70,2 tui i vi nam v 75,6 tui i vi n.66 Do cu
trc gia nh thay i v con ngi sng lu hn,
Vit Nam s c ngy cng nhiu ngi gi sng mt
mnh, v phn ln trong l n gii.
32
Hnh 2.4: D bo dn s theo tui Vit Nam 2009-2049 (%)
Ngun: Giang Thanh Long trch theo UNFPA 2010
HP 2.3: DN S GI HA 67
Cng trong thi k dn s vng, Vit Nam c th s thy tnh trng dn s gi ha dn. Nh hnh 2.4 cho thy
s lng ngi cao tui (nhng ngi trn 60 tui) s tng t 9% nm 2009 ln 14% nm 2024 v 26% nm
2049. Ch s gi ha (s lng ngi trn 60 tui trong 100 ngi di 15 tui) cng s tng ln 100 t nm
2035, v gi ha dn s Vit Nam s din ra trong vng 35 nm, vi tc nhanh hn nhiu so vi cc nc
nh Php (115 nm) song chm hn Nht Bn nc c qu trnh gi ha dn s ch trong 26 nm. T l ngi
gi trn 80 tui nhng ngi cn c chm sc v h tr nht cng s tng nhanh hn so vi t l tng
cc nhm dn s tr hn. Vit Nam ang c nguy c gi hn trc khi giu hn, vi mc thu nhp bnh qun
thp hn nhiu so vi cc nc khc hin ang phi i mt vi tnh trng gi ha dn s, v d nh Nht Bn.
Ngoi ra, tc gi ha v phn phi ngi gi cng kh khc nhau gia cc khu vc v cc tnh v hu ht
ngi gi sng khu vc nng thn v vng sn xut nng nghip. Nguyn nhn v cc hnh thc m au
ca ngi gi cng ang thay i, t cc bnh truyn nhim ti khng truyn nhim, cng vi t l cc vn
bnh tt c lin quan ti li sng nh trm cm v huyt p cao ngy cng tng.
Nhng thay i ny c ng quan trng i vi cc dch v y t v bo tr x hi. Ngy cng c nhiu ngi
gi s dng cc dch v ngoi tr c bit l cc dch v y t v lin quan ti bnh vin; v h ang dng cc
dch v ngoi tr nhiu hn. H cng chi tr nhiu hn cho cc dch v ny, vi chi ph trung bnh t tin ti
trn mt ln s dng dch v ngoi tr tng 17% t 152.400 VND nm 2004 ln 178.400 VND nm 2008
(gi c nh nm 2004). Chi ph iu tr ni tr tng ng k vi t l tng 12% t 1.433.300 VND nm 2004 ln
33
1.606.800 VND nm 2008 (gi c nh nm 2004). y c th l l do cho s gim st nh trong t l ngi gi

s dng cc dch v y t ni tr trong giai on t nm 2004 n 2008 cng nh s ln s dng dch v ni
tr thp hn vo nm 2008.
iu ng lo l, trong bi cnh chi tiu cho y t tng cao, rt nhiu ngi gi li khng c bo him y t. Theo
s liu t iu tra VHLSS 2008, khong 40% ngi gi tui trn 60 khng c bo him y t trong nm 2008
mc d c nhng tin b ng k so vi nm 2004 khi c ti 67% ngi gi khng c bo him y t. T l
ngi gi c bo him y t min ph cng tng t 28,4% nm 2004 ln 37% nm 2008. T l ngi trn 80 tui
c bo him y t min ph cao hn, cng ging nh nhng ngi thuc din ngho, l ngi dn tc thiu s,
l n gii, v cc nhm ny c hng bo him min ph hoc c tr cp bo him mt phn thng qua
nhiu chng trnh mc tiu v chng trnh bo tr x hi khc nhau. Khong 22% ngi gi c lng hu
v 18,5% c nhn mt hnh thc h tr chm sc ngi gi no .
Trc tnh hnh chi ph y t tng cao cng thm tnh trng gi ha dn s, r rng l cn m rng lnh vc bo
tr x hi, c bit l bo him y t v qu lng hu chi tr cho tt c ngi gi. Qu lng hu cho ngi
gi gip ngn chn t l ngho i tng 50% trong nhm dn s trn 60 tui. Mt chng trnh lng hu
x hi theo cung cp mc h tr bng 60% mc chun ngho nm 2004 cho tt c ngi cao tui khu
vc nng thn s lm gim 59,7% ch s khong cch ngho i ngi gi v gim 65,5% su ngho i.
Mt chng trnh nh vy s tiu tn khong 7.197,2 t VND tng ng vi 1% GDP ca nm 2004 v l
mt phn nh trong tng s 42% GDP hin ang c u t nhm to tng trng kinh t.
GNH NNG V BNH DCH ANG THAY I

Nhng chuyn i v nhn khu v x hi cng gp
thm vo gnh nng v bnh dch hin ang thay
i Vit Nam.68 Gnh nng v nhng bnh dch
khng truyn nhim lin quan ti li sng ang
ngy cng gia tng. L do gy t vong nhiu nht
c nam gii v n gii l t qu trong khi ung th
gan v tai nn giao thng l nguyn nhn th hai
v th ba gy t vong nam gii, cn bnh phi v
vim phi gy tc nghn mn tnh l nguyn nhn
th hai v th ba gy t vong n gii. ng lu
l 6% s ca t vong ca nam gii l do tai nn giao
thng v 3% l do nhim HIV/AIDS. 2/3 s nm trong
cuc i b mt do cc bnh khng truyn nhim.
Bnh tim, ung th v nhng thng tch khng c
cng l nguyn nhn chnh gy cht sm c nam
v n. Cc bnh khng truyn nhim cng chim
khong 3/4 s trng hp tn tt Vit Nam. Quan
trng hn, l do chnh dn ti mt tui th do tn
tt nam gii l do cc ri lon do s dng ru
bia qu nhiu, tip theo l trm cm v tai nn giao
thng, trong khi l do ph n l trm cm, mt th
lc, vim xng khp v cc ri lon do lo lng. Mc
d cc bin php kim sot bnh dch ly nhim
c vai tr quan trng, cn c nhiu n lc hn trong
vic ngn nga cc bnh dch khng ly lan ang
ni ln.
MT CN BNG GII TNH KHI SINH TI

Vit Nam
Xu hng nhn khu quan trng th ba nh hng
ti Vit Nam l t l mt cn bng gii tnh khi sinh
ang tng cao. T l gii tnh khi sinh ca Vit Nam
hin nay l 110,5 tr em trai so vi 100 tr em gi,
tng ng vi cc nc nh n mc d vn
thp hn so vi t l ca Trung Quc l 120 tr em
trai/100 tr em gi. Tuy nhin Vit Nam t t l
ny nhanh hn bt k nc no khc trong khu vc
v nm 2003, t l ny ch l 107 tr em trai/100 tr
em gi. C ba yu t chnh l: s dng rng ri cng
ngh la chn gii tnh, chnh sch mi gia nh ch
c hai con (hin i tn thnh m hnh gia nh
nh) v phong tc truyn thng thch con trai hn
khin cc gia nh mong mun c con trai v coi
trng con trai cao hn con gi. C s khc bit ng
k trong t l gii tnh khi sinh gia cc tnh, vng
v cc nhm kinh t x hi khc nhau. T l gii tnh
khi sinh l 115,3 tr em trai/ 100 tr em gi vng
ng bng sng Hng so vi 105,6 tr em trai/100
tr em gi (mc trung bnh) vng Ty Nguyn v
dao ng trong khong t 100,5 130,7 tr em trai/
100 tr em gi cc tnh khc nhau.69
T l chnh lch gii tnh khi sinh tng cao xut hin
cc h gia nh giu c hn v l ngi Kinh nhiu
hn so vi nhng gia nh ngho v nhm dn tc
34
thiu s.70 Mt l do ca s khc nhau ny lin quan

ti chi ph thc hin la chn gii tnh thng ph
bin hn khu vc thnh th v thng ch ngi giu
mi c kh nng chi tr. Ngoi ra, c nhiu ng c
thng mi dn ti vic cc nhn vin y t thc hin
siu m bit gii tnh thai nhi v tin hnh no ht
thai, cho d tri php lut cng gp phn lm tng t
l gii tnh nam khi sinh. Tuy nhin, nh kin cng nh
vic la chn gii tnh cng din ra nhiu hn cc
h gia nh theo ch ph h truyn thng v c
con trai c coi l mt biu hin ca tnh trng c
v th trong cc gia nh kh gi. Cc cp v chng
chu nhiu p lc x hi v vic phi c con trai v la
chn gii tnh chc chn khin t l no ph thai
rt cao Vit Nam so vi cc nc trong khu vc. T l
gii tnh khi sinh c d bo s tng ln 115 nam/100
n vo nm 2025 nu khng c bin php can thip
no, v iu ny s dn n tnh trng d tha khong
12% nam gii di 50 tui cho vo nm 2049 - v hng
triu ph n Vit Nam b bin mt.71 Nh Amartya Sen
nhn nh, y l vn phn bit gii tnh cng ngh
cao.72 Bt bnh ng ngay t khi sinh phn nh v lm
trm trng thm bt bnh ng v gii c ngun gc
su xa v tnh trng phn bit i x cp h gia nh.
Bt bnh ng ngay t khi sinh phn

nh v lm trm trng thm bt bnh
ng v gii c ngun gc su xa v tnh
trng phn bit i x cp h gia nh.
Nh cc quc gia c t l chnh lch gii tnh khi sinh
cao nh n v Trung Quc tri qua, tnh trng
khan him ph n lm gia tng p lc i vi vic
kt hn sm, v c th dn ti tng nhu cu vi hot
ng mi dm cng nh gy cng thng hn v tnh
trng bun bn ph n v tr em gi.73 Do bnh ng
gii v trao quyn cho n gii c mi quan h mt
thit vi mc pht trin con ngi cao hn nn
nhng thay i nhanh chng trong t l gii tnh khi
sinh ca Vit Nam l iu ng quan ngi.
TH HA V DI C TRONG
NC VI TC CAO
TH HA Vit Nam ANG TNG CAO
Cc c hi kinh t v th trng lao ng thay i, cng
vi nhng hn ch c ni lng hn i vi vic di
chuyn dn s ng gp vo tc th ha cao
v dng ngi nhp c trong v ngoi nc tng, khi
hng triu ngi Vit Nam phi di chuyn tm kim
c hi to thu nhp. Trong 10 nm gia hai k Tng iu
tra dn s 1999 v 2009, dn s thnh th Vit Nam
tng 3,4%/nm trong khi dn s nng thn ch tng
35
0,4%/nm. n nm 2009, 29,6% dn s sng khu vc

thnh th so vi 23,7% nm 1999. Nh vy trong mt
thp k dn s tng 7,3 triu ngi so vi con s
tng 2,17 triu ngi khu vc nng thn trong cng
thi gian ny.74 Tuy nhin nhng con s ny c th thp
hn nhiu so vi tc tng dn s thc t ca khu vc
thnh th, do nhng ngi di c tm thi khng c
a vo, v nhiu vng ln cn quanh khu vc ngoi
thnh ca hai thnh ph ln nht Vit Nam l thnh ph
H Ch Minh v H Ni vn c tnh l nng thn mc
d c din mo th r rng. V vy c tnh c khong
33% cho ti 40% dn s Vit Nam hin ang sng khu
vc thnh th.75 Cc d bo dn s cho thy tc tng
trng dn s khu vc thnh th s t 2,91% mi nm
trong giai on 2015-2050; v ch tng 0,13% mi nm
khu vc nng thn.76 Nh hnh 2.5 cho thy, dn s
thnh th s ln hn dn s nng thn k t nm 2045.
NHNG NH HNG TIU CC CA TH

HA NHANH
th ha nhanh t ra nhng thch thc to ln i
vi Vit Nam. Vit Nam l mt trong nhng nc c
mt dn s cao nht trong khu vc ng Nam
vi 259 ngi/km2, ch xp sau Philippines v
Singapore.77 Khng c g ngc nhin l mt dn s
hai thnh ph chnh l H Ni v thnh ph H Ch
Minh mc cao nht c nc. Hai thnh ph ny ang
ngy cng phi chng kin nhng triu chng ca
ca th ha nhanh v tnh trng tc nghn, trong
n tc giao thng, nhim khng kh v ting n
mc rt kh chu.78 Cht lng nc v khng kh
v ang suy gim dn vi mc nhim c vt
mc c th chp nhn c c hai thnh ph.79 C
s h tng cng khng pht trin kp vi tc tng
dn s v ang cho thy khng kh nng p
ng vi giao thng gia tng. Ngp lt trong ma ma
l hin tng ph bin cc khu vc thnh th nh
H Ni do h thng thot nc v x l nc ma bo
khng c nng cp . Quy hoch th v thc
thi yu km dn ti tnh trng khng th kim sot
nhim cng nghip v xy dng, vic ph duyt qu
nhiu ta nh vn phng, bn l v dn c quy m
ln to ra gnh nng ln cho c s h tng xung
quanh. Ngoi ra, dch v cng thiu nh cc c s y t
v trng hc khng p ng nhu cu ca dn
s thnh th ang gia tng nhanh chng.80
Ging nh cc thnh ph ln khc chu , mt
mi quan ngi t kha cnh an sinh v y t cng l
s pht trin ca cc khu nh chut thnh th
gp phn gy nhim ngun nc v cht thi, v
lm tng nguy c lan truyn cc bnh truyn nhim.
UN-Habitat c tnh rng khong 40% s dn thnh
th Vit Nam hin ang sng trong cc khu nh
chut.81
Tnh trng qu ng dn c cc khu th cng

lm tng gi bt ng sn v tnh trng u c, v
hu qu l ngi ngho ngy cng kh c kh nng

mua c nh cc thnh ph.82
Hnh 2.5: c tnh v d bo dn s thnh th v nng thn Vit Nam, 1950-2050
Ngun: Van Arkadie v cng s, 2010) trch t d liu dn s ca UNFPA.
NGI DI C Vit Nam

Di c l yu t quan trng nht v duy nht
ca tnh trng th ha nhanh Vit Nam
Di c l yu t quan trng nht v duy nht ca
tnh trng th ha nhanh Vit Nam, ng gp
57% vo tng trng dn s thnh th. D liu v di
c Vit Nam cn c xem xt thn trng v cc
iu tra quc gia u c tnh thp t l di c: v d,
Tng iu tra dn s c iu tra nhng ngi di c
vnh vin nhng li khng tnh ti nhm ngi di c
theo ma v v tm thi.83 Theo Tng iu tra dn
s mi nht, di c trong nc tng t 4,5 triu
ngi nm 1999 ln 6,6 triu ngi nm 2009. C di
c gia thnh th v di c t nng thn ra thnh th
u tng gp i trong thi gian t 1999-2009: vi
1.719.056 ngi di c gia thnh th nm 2009 so vi
con s 971.468 nm 1999; v 2.062.171 ngi di c
t nng thn ra thnh th nm 2009 so vi 855.943
nm 1999.84 Trong khi Tng iu tra dn s khng
a ra quy m di c ra nc ngoi song c tnh c
khong 400.000 n 500.000 ngi Vit Nam ang

l lao ng di c tm thi ra cc nc trong khu vc
v khu vc Trung ng.85
D liu ca Tng iu tra dn s cho thy xu hng
n ha trong di c, vi t l n chim mt na s
dn di c trong nc vo nm 2009, v t l ngi
di c l n ang tng dn trong hai thp k qua k
t cuc Tng iu tra nm 1989.86 Hu ht s ngi
di c t nng thn ra thnh th l ngi tr tui vi
tui trung bnh l 25 tui, v 23 tui l tui trung
bnh ca di c t nng thn ra thnh th. c tnh
cho thy s c s tng ln trong tng s ngi di
c v t l ngi di c trong nc n nm 2019:
t khong 10,4 triu ngi, chim 12% tng dn s
Vit Nam.87 T l ngi di c t nng thn ra thnh
th trong tng dn s thnh th s tng t 9% nm
2009 ln 11% nm 2019. Nhng ngi di c trong
Tng iu tra nm 2009 c th c o to
nhiu hn nhng ngi khng di c, c mc sng
cao hn, c nh ca tt hn, v hu ht u hc
ht tiu hc. y l im tri ngc so vi nhng
nghin cu khc nh iu tra i ngho th nm
36
2009 theo pht hin s khc nhau ln v mc

sng, iu kin lm vic v thu nhp ca nhng
ngi lao ng di c trong mu nghin cu. c
bit, iu tra ny pht hin ra rng trong khi ngi di
c c mc thu nhp tng ng vi ngi khng
di c v kh nng ngho vt cht ca h ch cao
hn ngi khng di c mt cht song xt v ngho
i phi tin t, th t l ngho ca ngi di c cao
hn nhiu, c bit h thiu ha nhp x hi so vi
ngi bn x.88
THCH THC I VI NGI DI C

Ngi di c Vit Nam phi i mt vi vic tip cn
c hi thiu cng bng pht trin nng lc v ci
thin i sng. Nhng ngi di c tm thi, theo ma
v v vn tr v qu sng (nh k) thng ngho
hn v d b tn thng hn so vi nhng ngi di
c vnh vin nhm i tng c a vo trong
Tng iu tra.89 Nhng ngi di c tm thi v khng
ng k thng khng c tip cn vi cc dch v
x hi v bo tr x hi. H cng thng tp trung
trong nhng ngnh ngh d b tn thng vi mc
lng thp v khng c tip cn vi bo h lao
ng. Ngay c vi ngi di c vnh vin th vic tip
cn dch v x hi cng c th b gin on do phi di
chuyn gia cc n v hnh chnh khc nhau. S liu
Tng iu tra cho thy di c gy nh hng ti vic
hc hnh ca tr em: t l khng i hc ca ngi di
c cao hn so vi ngi bn x, c cp tiu hc v
trung hc. T l khng i hc cao nht i vi nhng
ngi di c gia cc tnh: 9% i vi ngi trong
tui 6-10 v 56% vi ngi trong tui 11-18 khng
i hc so vi t l 3% ngi bn x khng hc tiu
hc v 26% ngi bn x khng hc trung hc.90 T
l khng i hc ca ngi di c tm thi, theo ma
v v vn tr v qu c th cn cao hn nhiu. iu
tra i ngho th cho thy ngi nhp c thng
t c kh nng hc cc trng cng lp hoc c
hng min gim hc ph so vi ngi khng nhp
c. Ngi nhp c cng thng t c kh nng c
chm sc y t khi b m hn so vi ngi bn x, ch
yu do h thiu thi gian v tin bc.91
K t gia nhng nm 2000, nhng quy nh mi
nhm ci thin iu kin sng cho nhng ngi di
c trong nc c a ra, ng ch l Lut
h khu nm 2007 gim bt nhng yu cu nu
ngi nhp c tm thi mun nhp h khu thng
tr.92 y l mt thay i ln lao trong h thng
ng k h khu ca Vit Nam vn c xy dng t
nhng nm 1950 hn ch s di chuyn ca ngi
dn v th ha v h tr hot ng phn phi
lng thc trong thi k k hoch ha tp trung.93
Tuy nhin trn thc t, nhiu ngi nhp c vn
37
khng c tip cn vi cc dch v x hi chnh,

c bit l y t v gio dc. Rt nhiu ngi khng
th tn dng c mi trng php l mi chnh
thc ha a v ca mnh c th tip cn vi cc
dch v ny.94 iu ny dn ti tnh trng mu thun
l ngi nhp c ni a, nhng ngi ng vai tr
chnh l xng sng ng gp cho tng trng kinh
t ca Vit Nam v h tr cho khong 50% h gia
nh Vit Nam thng qua tin gi v nc,95 trn
thc t li khng c hng y li ch ca
ngi cng dn Vit Nam. Tnh hnh ny nh hng
ti hng triu nam gii, ph n v tr em Vit Nam
nh tho lun trong Hp 4.4 Chng 4.
BIN I KH HU V THIN TAI

Vit Nam D B TN THNG TRC BIN
I KH HU V THIN TAI
Mt trong nhng thch thc chnh i vi qu trnh
tng trng v pht trin trong tng lai ca Vit Nam
trong nhng thp k ti y c kh nng l bin i
kh hu v thin tai lin quan ti kh hu. Vit Nam l
mt trong nhng nc d b tn thng nht trc cc
tc ng ca bin i kh hu trn ton cu, xp th 6
trong s cc nc trn th gii v t l ngi sng cc
vng duyn hi thp. y ban lin chnh ph v bin i
kh hu (IPCC) xc nh ng bng sng Cu Long l
mt trong ba im nng ca ton cu xt theo s dn
c kh nng b mt ch khi mc nc bin tng.96
Hin nay, Vit Nam xp th 5 trn ton cu trong s cc
nc b nh hng mnh nht bi cc c sc v thin
tai lin quan n bin i kh hu trong hai thp k qua,
v xp th hai v mc nh hng kinh t ca cc s
kin ny vi gi tr c tnh 1.861.000 la M (PPP),
tng ng vi 1,31% GDP mi nm.97
Vit Nam ngy cng gp phi nhiu thm ha v cng
thng lin quan ti bin i kh hu. Bin i kh hu
dn ti cc thm ha thin tai v cc c sc khc nghit
hn ng thi cng lm tng t l nhng cng thng
dn dn v tch t ln i sng v sinh k ca con
ngi. Hin nay Vit Nam phi hng chu ngy cng
nhiu thin tai v c sc hn hu ht cc nc khc
c xp hng l c ri ro cao do tc ng ca bin i
kh hu. L mt trong 10 nc b nh hng nhiu nht
trong giai on 1990 2009, trung bnh mi nm Vit
Nam phi gnh chu khong 203 s kin thin tai, ch
t hn Philippines v Bangladesh. Ring nm 2009, Vit
Nam phi hng chu 113 thin tai, lm cht 334 ngi
v gy thit hi 1,15% GDP. 98
Tc ng ca bin i kh hu v thin tai khng ng

u gia cc khu vc Vit Nam. Khng ch cc ri ro
v thin tai, bo lt v hn hn c s khc nhau cc
a phng khc nhau, m thin tai cn c kh nng
nh hng nhiu hn ti nhng h nng thn, nhng
gia nh ngho hn v ph n - nhng ngi c xu
hng ph thuc vo cc ngun t nhin v cc hot
ng chu nh hng bi kh hu trong vic to thu
nhp, v do nhng i tng ny c bit b tn
thng trc nhng cng thng do bin i kh hu.99
Ma bo chim 80% trong tng s cc thin tai nh
hng ti Vit Nam v min Trung Vit Nam b nh
hng nhiu nht, trong khi ng bng sng Cu
Long li c bit chu tc ng ca tnh trng ngp
nc t sng, v cc vng pha Nam bao gm c vng
Ty Nguyn thng xuyn b nh hng ca hn hn
v nhng ri ro c lin quan ti chy rng.100
Bin i kh hu t ra nhng thch thc c

th v lp k hoch v cung cp dch v x
hi trong c y t v gio dc.
Thin tai cng nh hng ti cc cng ng dn c
thnh th v d nh hn hn nm 2010 khu vc ng
Nam nh hng ti ngun cung ca cc nh my
thy in dn ti tnh trng mt in thng xuyn xy
ra cc trung tm ln nh thnh ph H Ch Minh v H
Ni.101 Trong hn hai thp k qua, c tnh c 9.743.000
ngi cht, hn 100.000 ngi b thng v 8.243.226
triu ngi b nh hng bi thin tai. Bin i kh
hu t ra nhng thch thc c th v lp k hoch
v cung cp dch v x hi trong c y t v gio
dc,iu ny s c tho lun chi tit hn Hp 2.4.
HP 2.4: CC DCH V X HI C KH NNG THCH NG VI BIN

I KH HU 102
Xy dng kh nng thch ng vi bin i kh hu trong y t v gio dc i hi cc dch v ny cn
hiu v ng ph vi cc p lc b sung do bin i kh hu. Quan trng nht l cc bin php khng
hi tic c li bt k nhng sc p do bin i kh hu gy ra nng hay nh. Lp k hoch ng ph vi
bin i kh hu ng ngha vi vic cc c s y t trong c cc trm y t x c th tip cn c i
vi ngi dn ngay c khi c bo. Cc cn b y t cng cn hiu c tc ng tim nng ca nhng
cng thng do bin i kh hu gy ra vi sc khe. Bin i kh hu c tc ng trc tip ti y t v gio
dc, v d nh thin tai c th gy ra t vong, thng vong v cc bnh dch truyn nhim v lm gin
on vic i hc. ng thi bin i kh hu cng lm gia tng nhu cu v cc dch v y t v i hi
cn nhiu trang thit b hn p ng nhu cu tng ln ca bnh nhn b tn thng.
Kh nng ng ph trong bi cnh ca dch v y t v gio dc c bit lin quan ti tnh lin tc ca cc
dch v ny khi xy ra thin tai, m khng nh hng ti cht lng dch v. Cn c-cc bin php
bo v nhn vin v ti sn chnh nh thit b, nhm duy tr nhng chc nng c bn, gim thiu hoc
ngn chn tnh trng dn on ca dch v v gip hi phc hiu qu.
Trong giai on t nm 1990-2009, c tnh c 23.831 bung bnh cc trm x v bnh vin v
khong 142.206 lp hc b h hng hoc ph hy do thin tai. c th lp k hoch hiu qu v
thch nghi vi bin i kh hu, cc t chc cung cp dch v cn m bo c s h tng c thch nghi
vi kh hu, bao gm c cc yu t kt cu v phi kt cu. iu quan trng l phi m bo tnh lin tc
ca dch v, v d nh tip cn vi cc c s y t cho nhng ngi d b tn thng nht vng su
vng xa hoc cho nhng ngi gi yu khng c kh nng di chuyn. Tng t, tr em nh cn c cc
c s y t chm sc v gio dc an ton trong v sau l, v cn thu xp cc phng tin vn chuyn c
bit a h ti cc a im ny. Cc dch v di ng nh thuyn y t s dng trong cc trn l
vng ng bng sng Cu Long c th gip m bo tnh lin tc ca dch v.
Khng nhng cn chun b dch v sn sng i ph v thch nghi vi bin i kh hu v ri ro do
thin tai, m dch v cng l mt phn ca gii php. V d, s dng nng lng mt tri trong hoc
gn cc trm y t a phng c th gim thiu tnh trng gin on dch v trong trng hp ct in
cng cng trong thi gian thin tai. Nng lng mt tri cng c th l ngun to thu nhp bng cch
bn lng in tha cho h thng cung cp in ca nh nc. Tng cng i mi v nghin cu
cng ngh cao v o to ngh cng ng vai tr trung tm trong cc n lc thch nghi v nng cao
kh nng chng chi ca a phng v trung ng. y mnh u t gio dc khoa hc v k thut c
vai tr quan trng trong vic ng ph vi bin i kh hu v pht trin cc c hi kinh t x hi t cc
hnh ng c lin quan ti bin i kh hu.
38
CC GI TR MI, CC TH
CH MI
K VNG V I SNG V CHT LNG
CUC SNG ANG THAY I
Vit Nam ang tri qua nhng thay i v cu trc th
trng lao ng v c cu kinh t; thay i v dn s
v nhn khu; th ha v nhp c; v nhng thch
thc mi ni t bin i kh hu. Nhng thch thc ny
i hi cc cch thc phn ng mi ca cc nh hoch
nh chnh sch v ra quyt sch, ng thi cng t
ra nhng thch thc c th i vi h thng qun l
v cc th ch ca Vit Nam. V nhiu thch thc lin
quan ti nhng chuyn i Vit Nam c tnh cht
lin ngnh nn i hi phi c s phi hp gii quyt
t nhiu c quan chnh ph lin quan. ng thi cng
i hi tng cng minh bch, chu trch nhim v c

tnh k thut tt hn ca cc th ch Vit Nam.
c cng c t nhng thay i ny l nhng thay i
trong thi v gi tr chuyn bin v pht sinh, khi
k vng v mong mun ca con ngi, trong c
c mong mun i vi chnh ph v cc nh lnh o
chnh tr thay i trong tnh hnh kinh t x hi bin
ng. Ngi Vit Nam ngy cng nm bt c nhiu
thng tin hn: ngy cng nhiu ngi tip cn internet
v phng tin truyn thng. Khong 25% ngi dn
s dng Internet,103 v s lng h gia nh c in
thoi cng tng gp i trong thi gian t 2006 2008
t 33,5% ln 61,7%. 87% s h c mt tivi trong
84% h nng thn v 94% h thnh th.104 Nhng gi
tr v thi thay i cng c th nhn thy r tng
lp thanh nin Vit Nam nh Hp 2.5 minh ha.
HP 2.5: NHNG GI TR V K VNG CA TNG LP THANH NIN

ANG THAY I
Kinh nghim sng v gi tr sng ca tng lp thanh nin Vit Nam ang thay i nhanh chng, mc
d nhiu ngi tr tui vn tip tc theo ui cc gi tr truyn thng. C th thy nhng thay i to
ln trong thi v hnh vi gii tr trong nhng khong thi gian kh ngn theo Kho st nh gi
v thanh nin Vit Nam (SAVY II) tin hnh vo nm 2003 v 2008.105 T l thanh nin Vit Nam s dng
cc phng tin truyn thng khc nhau tng ln rt nhanh: gn nh ton b thanh nin c xem ti
vi; 77,8% nghe i v 79,3% c bo, tng so vi cc mc tng ng 86,5%, 66,5% v 63% nm 2003.
Khong 61% thanh nin s dng internet, cao hn nhiu so vi 17% trong ln kho st trc. Ngy cng
nhiu thanh nin cho rng quan h tnh dc trc hn nhn l iu c th chp nhn c, vi 44% so
vi con s 36% trc y. T l thanh nin ung ru cng tng ln, vi 60% tng ung ru trong
80% nam v 36% n, so vi 69% nam v v 28% n trong ln kho st trc. T l ht thuc l
gim nh, tuy nhin vn cn 40% thanh nin ht thuc l. 106
Nhiu thanh nin tr trong kho st SAVY II cho bit phi chu p lc rt ln, trong c vic khng
thtm c vic lm hoc khi gp kh khn c trng hc ln nh. Trong khi nhiu thanh nin by
t mong mun v k vng cao vo tng lai, mt b phn ln li cho bit h khng tin c th c ngun
thu nhp tt sng; v khong 59% cho bit l tm vic rt kh. ng lo ngi hn, c 5 ngi th c 1
ngi tr li cho bit gio vin trng tng e da hoc trng pht hc sinh v 35% cho bit khng
mun i hc. Ngy cng nhiu thanh nin cm thy kh c th tho lun cc vn kh khn vi mt
thnh vin trong gia nh, vi 41% so vi 32% trong ln iu tra trc. C khong 40% ngi tr li
tng chng kin mt hnh thc xung t no trong gia nh. Ngy cng c nhiu ngi tr tui tri
qua cc vn v sc khe tm thn do cc p lc trn: mt t l ln (khong 1/3) cho rng thnh thong
cm thy h khng c ch cht no; v a s (73%) cm thy bun chn (tng hn gp 2 so vi ln kho
st trc vi t l 33%), v 4% tha nhn h tng c ngh t t. Do cn c nhng dch v v hnh
thc h tr x hi mi bn ngoi gia nh tr gip cho th h tr ny ca Vit Nam.
39
K VNG CA NGI DN NGY CNG

NHIU V VAI TR CA CHNH PH
Mong i ca ngi dn i vi chnh ph v cc dch
v x hi cng ang thay i khi Vit Nam pht trin.
Ngi Vit Nam mong i chnh ph lm c nhiu
hn ngoi vai tr to ra tng trng kinh t. Phn kho
st v qun l nh nc trong iu tra VHLSS nm 2008
cho thy, mc d ngi dn thng bo c s ci
thin trong vic cung cp dch v hnh chnh v x hi,
h cng by t s khng hi lng cc lnh vc cung
cp dch v bao gm chi ph tham nhng, cht lng
dch v v nhng kh khn trong th tc hnh chnh.107
Mc d ngi dn thng bo c s ci
thin trong vic cung cp dch v hnh
chnh v x hi, h cng by t s khng
hi lng cc lnh vc cung cp dch v bao
gm chi ph tham nhng, cht lng dch
v v nhng kh khn trong th tc
hnh chnh. 107
Nh Acuna v cng s ch ra trong mt nghin cu
cho Bo co ny:
Nhng cng dn c nui dng v gio
dc tt hn i hi chnh ph cung cp cc
dch v hnh chnh tt hn v hiu qu hn,
t quan liu, tham nhng, bao che, gia nh
tr, lng ph hoc tham cng qu. H i
hi mt h thng qun l cng c th thc
y s pht trin, bnh ng v cho php
ngi dn tham gia nhiu hn vo cc qu
trnh ra quyt nh cng nh thc hin v
gim st cc chnh sch cng. 108
V vn ny, c mt s du hiu thay i tch cc.
Cc phng tin truyn thng v Quc hi ngy
cng ng vai tr gim st mnh m, v ngy cng
th hin sn sng khuyn khch v tham gia vo
cc cuc tranh lun cng khai c lin quan n cc
quyt nh chnh sch quc gia.109 Qu trnh ra quyt
nh ca a phng v s tham gia ca ngi dn
trong cng ng c tng cng. Sng kin
dn ch c s c a ra vo cui nhng nm
1990 c thit k vi mc tiu tng cng s
tham gia ca ngi dn, tng cng tip cn thng
tin v chng tham nhng cp a phng, ph
hp vi cu chm ngn: dn bit, dn bn, dn lm,
dn kim tra.110 Phn cp hnh chnh v ti chnh
bao gm vic giao mt t l ngy cng tng cc loi
thu cho chnh quyn a phng, v giao quyn
hn chi tiu trong mt lot cc hot ng cho cc
chnh quyn a phng. Trong bao gm c nng
lc u tin ngun lc, phn b ngn sch v quyt
nh cc d n u t cng no.111 Cc tnh c t l

ngi ngho cao nhn c mc h tr u ngi
ln hn, do , vic phn cp c tc dng ti phn
phi. Vic phn b quyn lc trao quyn ln hn
cho cc tnh p ng tt hn nhu cu ca ngi
dn v cng khuyn khch cnh tranh gia cc tnh,
to iu kin cho cc tnh thc hin tt nht c th
thu ht u t v tng mc sng ca ngi dn.112
HIN I HA CC TH CH CA Vit Nam

Tuy nhin, Vit Nam ang gp phi nhng thch
thc to ln trong lnh vc l nh nc, nh c
nhn nhn trong SEDS giai on 2011-2020 theo
xc nh nhu cu cn ci thin b my nh nc,
to ra chuyn bin mnh trong ci cch hnh chnh
v tp trung xy dng mt h thng hnh chnh
mnh v trong sch, m bo qun l hiu qu,
hiu sut, thng nht v n nh.113 Vit Nam vn
cha c mt th ch hin i v tinh vi cng nh
mt nn vn ha chuyn nghip v dch v cng
cn thit ng ph vi nhng thch thc phc
tp c lin quan ti qu trnh chuyn i sang nc
c thu nhp trung bnh v mc pht trin con ngi
trung bnh. Tip tc ci cch hnh chnh cng v h
thng qun l nh nc a phng cung cp
cc dch v hnh chnh x hi cng c cht lng
cao hn cho ngi dn Vit Nam l cn thit h
tr cho qu trnh chuyn i ny. Quan trng l vic
thc hin qu trnh xy dng chnh sch v lp k
hoch da trn thc chng. Tng cng s tham gia
ca mi ngi dn Vit Nam v to sn chi thun li
cc t chc x hi dn s c th tham gia nhiu
hn vo qu trnh ra quyt sch cng nh trong vic
cung cp dch v x hi cng c vai tr quan trng
thc y nhng tin b tip tc nhm t c
nhng mc pht trin con ngi cao hn.114
Vi ch chnh ca bo co ny v y t v gio dc,
n lc ng b gii quyt vn tham nhng
vn trn lan Vit Nam v gy nh hng ti kh
nng tip cn dch v c bn ca ngi dn, c vai tr
c bit quan trng v c chnh ph Vit Nam
cng nhn. SEDS nhn mnh s cn thit tin hnh
thng xuyn, trit v c hiu qu cuc chin
chng tham nhng v lng ph l mt nhim v lu
di, cp bch v quan trng.115 Tham nhng dng
nh tr thnh cn bnh a phng trong c
dch v y t v gio dc; c c bn cung cp dch
v v khch hng coi l chuyn bnh thng. V d
mt nghin cu nm 2009 ca Trng i hc Y H
Ni cho thy hn 70% nhn vin y t c phng
vn tha nhn tng vi phm o c ngnh y: i
hi l tin l li ph bin nht.116 Tng t, mt cuc
kho st ca Thanh tra chnh ph cho thy 67% cc
40
bc cha m cho thy vic tr tin cho con mnh

ng k nhp hc l chuyn chp nhn c v bnh
thng.117 Tham nhng khng nhng nh hng tiu
cc nht ti ngi ngho v ngi d b tn thng
m cn c nguy c cn tr pht trin con ngi v
tin b kinh t.
Trc nhng gi tr v k vng thay i ca ngi dn
i vi chnh ph v vi vic cung cp dch v x hi
cng vi ci thin qun tr nh nc v s tham gia
ca ngi dn trong qu trnh lp k hoch, theo di
v gim st vic cung cp dch v x hi v nhng
cch chnh ci thin cc kt qu pht trin con
ngi. Ci thin qun l nh nc v nng cao s
tham gia vo qu trnh lp k hoch, gim st v cung
cp dch v x hi l iu quan trng. nh hng li
cc dch v x hi nhm hng ti khch hng hn,
m bo tnh chu trch nhim v tnh minh bch
trong cch thc cc dch v ny c chi tr v cung
cp, thc y s tham gia ca cc bn phi nh nc
trong cung cp dch v, v u tranh chng li nhng
ng c thc y tham nhng v li dng l nhng
u tin chnh trong thi gian ti, nh c cp
trong Phn 2 ca bo co ny.
CON NG TIP TC PHT TRIN

CON NGI
Hng ti tng lai trong mt thp k ti khi Vit
Nam tip tc thc hin nhng chuyn i v kinh
t x hi phc tp nh phn tch trong chng ny,
r rng nh xut trong Chng 1, Vit Nam cn
tp trung v cam kt m bo tng trng kinh
t ton din v cn bng hn gia cc mc tiu
pht trin x hi, con ngi, kinh t v bn vng.
Con ng t c tng trng kinh t v thnh
41
vng trc y dng nh nay bt tnh kh thi:

nu Vit Nam mong mun tip tc t tc tng
trng kinh t cao, cn c s chuyn i c bn
sang cc ngnh cng nghip c k nng v cng
ngh cao v ci tin nng sut. Nhng p lc c lin
quan ti s thay i nhn khu hn bao gi ht s
gip Vit Nam tip tc to ra tng trng v to vic
lm mi cho hng trm nghn thanh nin gia nhp
th trng lao ng mi nm. Tnh di ng ca dn
s, th ha, thay i nhn khu v cc c sc v
p lc do bin i kh hu ang gy sc p ln c s
h tng v cc dch v hin nay v to ra nhng yu
cu mi i vi dch v v h tr x hi.
Ci thin qun l nh nc i vi cc
dch v x hi l yu cu c bn ca mt
x hi hin i v pht trin v cng
ngh m Vit Nam ang hng ti.
y nhanh ci cch qun l nh nc l cn thit
m bo Vit Nam c kh nng v c nhng th
ch mnh v gii p ng vi nhng thay i
ny cng nh nhng k vng v i hi ang thay
i ca ngi dn. Ci thin qun l nh nc i
vi cc dch v x hi l yu cu c bn ca mt x
hi hin i v pht trin v cng ngh m Vit Nam
ang hng ti.
Nh phn hai ca bo co ny lp lun rng a ra
nhng la chn chnh sch cn thit m bo
tip cn ton dn vi cc dch v y t v gio dc
c cht lng v thc hin hiu qu trong thc t
c vai tr quan trng nu Vit Nam mun gii quyt
thnh cng cc p lc ny v tip tc tin ti mc
pht trin con ngi cao hn.
42
3
Chng 3
43
PHT TRIN CON NGI

VIT NAM TNH HNH
S B CP TNH
PHT TRIN CON NGI GIAI

ON 1998-2008: NHNG XU
HNG CHNH
S DNG B CH S PHT TRIN CON
NGI
Chng 1 trnh by cc xu hng chung v
pht trin con ngi, trong s dng ch s HDI
v cc ch s thnh phn phn tch nhng tin
b Vit Nam t c trong thi gian qua v
so snh s thay i trong ch s HDI ca Vit Nam
vi cc nc khc trong khu vc. Chng ny tp
trung phn tch nhng thay i trong pht trin
con ngi cp a phng trong giai on t
nm 1999 n 2008. B ch s v pht trin con
ngi, gm HDI, GDI v HPI cng vi cc ch s
thnh phn c s dng phn tch nhng tin
b cp quc gia v cp tnh. Cc ch s ny cng
phn tch mc ng gp ca ch s thu nhp
v phi thu nhp vo pht trin con ngi. Ln u
tin ti Vit Nam, bo co gii thiu Ch s ngho
i a chiu (MPI) c ni a ha v s dng
b s liu iu tra VHLSS 2008. Mc d cc ch s
ngho i a chiu trc y c xy dng
c lin quan n ngho tr em v ngho thnh
th, nhng y l ln u tin ch s MPI c p
dng cp a phng v c nc. Chng ny s
phn tch nhng tnh c bc tin ln nht, cng
nh nhng tnh tin b chm hn. ng thi xem
xt cu hi phi chng s chnh lch gia cc tnh
ang ngy cng tng v nu vy th u l nhng
kha cnh c th trong cc ch s v pht trin con
ngi dn ti s tng ln ny.
cp quc gia, nh tho lun trong Chng

1, Vit Nam lin tc t c tin b trn lnh
vc pht trin con ngi. Ch s HDI tng t 0,651
nm 1999 ln 0,728 nm 2008, tng ng vi t
l tng 11,8%. Nh phn tch trong chng 1, mc
tng ln nht l ch s thu nhp, tng t 0,430 nm
1999 ln 0,559 nm 2008, tng ng vi t l
tng 30%. Ch s tui th tng 10%, trong khi ch s
gio dc ch tng 3,4% trong giai on 1999-2008.
Hu ht cc tin b ny t c trong giai on
1999-2004, thi im ch s HDI tng 7,7%, ch s
tui th tng 8,5%, ch s gio dc tng 2,9% v
ch s thu nhp tng 15,3%. Trong giai on 2004
n 2008, ch s thu nhp tng 12,6%, trong khi ch
s tui th tng 1,6% v ch s gio dc ch tng
nh. Nh vy, theo nh phn tch trong Chng 1,
thu nhp tng nhanh hn ng gp quan trng
vo nhng tin b v ch s HDI trong thp k qua.
Giai on 2004 n 2008 khi mc tng trong cc
ch s phi thu nhp chm li.
Ch s GDI s dng cc ch bo tng t nh HDI
nhng so snh khong cch gia nam v n to
nn ch s tng th. Ch s GDI tng t 0,650
nm 1999 ln 0,728 nm 2008, vi t l tng 12%.
Trong nm 2007, nm cui cng c th so snh
vi s liu GDI ton cu, ch s GDI ca Vit Nam
l 0,723, cao hn Nepal, n , Campuchia v
Lo, nhng thp hn Indonesia, Philippines, Trung
Quc v Thi Lan.1 Ch s HPI phn nh mc
nghim trng ca tnh trng thiu thn trn cc
phng din phi thu nhp cng cho thy bc
tin b lin tc, gim t 21,13 nm 1999 xung
10,93 nm 2008. Nm 2007, ch s HPI l 12,4 mt ln na a Vit Nam vt qua n , Nepal,
Campuchia v Lo, nhng vn ng sau Indonesia,
Phttrin
trincon
conngi
ngi vit
Vitnam
Nam- tnh
Tnhhnh
hnh s b cp tnh
Pht
44
Philippines, Trung Quc v Thi Lan.2 Tin b trong

ch s HPI phn ln nh vo s ci thin trong vic
tip cn nc sch v t l suy dinh dng tr em
gim trong giai on ny.
y l ln u tin bo co ny gii thiu ch s
MPI cp tnh ca Vit Nam, s dng d liu iu
tra VHLSS nm 2008. Ch s MPI s dng 9 ch bo
o lng thiu thn v y t, gio dc v mc
sng. Ch s MPI gm hai ch s ph o lng thiu
ht: l t l ngi l ngi ngho a chiu (ch
s ngho i m u) v su ngho i (s
lng thiu ht trung bnh ca mi ngi ngho
a chiu). Nm 2008, t l ngi ngho (da trn
chi tiu) l 14,5%; trong khi t l ngho phi tin
t l 23,3%, cho thy t l cao hn ca cc hnh
thc thiu ht khc. Ngoi ra, su ngho i
cao hn nhiu vo khong 40,2%, phn nh tnh
trng thiu ht nhiu phng din nhng
ngi ngho. Ngoi ra c ti 20,2% ngi dn
ng trc nguy c ri vo ngho i a chiu.
Do mt s ch bo s dng trong ch s MPI ni a
ha da trn d liu ca VLHSS c s khc bit so
vi nhng ch bo dng trong bo co HDR ton
cu3 nn kt qu cng khc nhau: trong bo co
HDR ton cu 2010, t l ngho i a chiu m
u ca Vit Nam l 14,3% v su ngho i l
52,5% . Ch s MPI nm 2008 ca Vit Nam l d
liu c s cho cc Bo co pht trin con ngi
quc gia (NHDRs) trong tng lai.
B ch s pht trin con ngi c tha nhn c
nhng hn ch nht nh. V d, ch s HDI s dng
t l nhp hc chung v ch bo ny c coi l t
tin cy hn khi nh gi v tin b trong gio dc
so vi cc ch bo khc nh t l nhp hc ng
tui, t l tt nghip v s nm i hc trung bnh.
Tuy nhin t l nhp hc chung t lu vn thng
c s dng lm d liu so snh c th sn c
nhiu quc gia. Tng t, tui th c dng l ch
bo thay th cho lnh vc y t. Nh cp trong
Chng 1, b ch s pht trin con ngi gc c
s dng trong bo co ny v cc ch s ny cho
php so snh vi cc nc trong khu vc v trn
th gii v cho php nh gi nhng tin b qua
thi gian cp a phng Vit Nam. Tuy nhin
45
cc kt qu phn tch tin b trong pht trin con

ngi xt v cc ch s v cc ch bo ph s dng
trong b ch s v pht trin con ngi cn c
xem xt mt cch thn trng, v c th n khng
thng nht vi tt c cc ch bo y t v gio dc
chnh khc.
KHONG CCH V BT BNH NG THEO

VNG
Nh tho lun trong Chng 2, nhng tin b ln
ca Vit Nam v ch s thu nhp phn nh nhng
thnh tu v tng trng kinh t v gim ngho
trong thp k qua. Cng lc , tin b kha cnh
phi thu nhp li khim tn hn v ch yu do tng
trng chm hn trong ch s gio dc. Tuy nhin,
nhng tin b chung t c trong ch s HDI
cp quc gia dng nh che du mc chnh
lch ln cp tnh. Cng vi tnh trng kinh t v
ngun gc dn tc, s khc bit v a l v khu vc
cng l nhng yu t quan trng nht gy nn bt
bnh ng Vit Nam. V tr a l ng vai tr quan
trng n kh nng tip cn cc dch v v c hi:
v d, ni c tr cho thy c vai tr trong vic lm
gim hoc tng kh nng b hc tr em t 11
n 18 tui.4 V tr a l cng c lin quan cht ch
vi bt bnh ng thu nhp, vi nhng s chnh
lch gia cc vng v cc tnh rt ln v r rt.
Vit Nam, ngho i v thiu thn tp

trung cc vng ni, vng su vng xa
v khu vc nng thn.
Vit Nam, ngho i v thiu thn tp trung cc
vng ni, vng su vng xa v khu vc nng thn,
c bit l min ni v trung du Bc B, duyn hi
Bc Trung B v Ty Nguyn. Khu vc kh gi nht
tp trung ng bng sng Hng, ng Nam B
v mc thp hn l ng bng sng Cu Long.
Cc yu t khu vc ny th hin rt r trong phn
phn tch v 4 ch s pht trin con ngi di y.
Trc khi chuyn sang phn tch cc ch s ny, Hp
3.1 cung cp thng tin tng quan v cc vng
Vit Nam.
HP 3.1: CC VNG CA Vit Nam TM TT TNH HNH 5

ng bng sng Hng c dn s 19,5 triu ngi v l khu vc ng dn nht ca Vit Nam. Vng
ny c t l ngi bit ch cao nht v hon thnh nhng bc hc cao ln nht trong c nc. Vng
ny ang tri qua qu trnh th ha nhanh chng, ch yu tp trung H Ni. Cc c quan u
no ca chnh ph v h thng lp k hoch trung ng t y, v cc h thng gio dc v y t
vng ny cng c lch s lu di. C s h tng x hi pht trin tng i tt hn; v Nh nc
vn chim u th trong vic cung cp cc dch v x hi. Tuy nhin, tnh hnh hin nay ang thay
i, v ti H Ni, t l hc sinh ph thng trung hc hc cc trng ngoi nh nc tng ln (hn
40% nm 20076). Chuyn i sang nn kinh t th trng lm thay i cc chnh sch gio dc v
y t cng nh vic thc hin cc chnh sch ny.
Vng duyn hi Bc v Nam Trung B c tng dn s 18,8 triu ngi. Trong vng duyn hi
Nam Trung B giu c hn so vi duyn hi Bc Trung B - mt trong nhng vng cn tng i
ngho ca Vit Nam. Sinh thi t nhin v lch s x hi phn no nh hng ti s pht trin
kinh t v i sng ngi dn ca vng ny. Cc khu dn c tp trung dc quc l 1 (con ng cao
tc chnh Bc-Nam) to cho Nam Trung B c c tnh ven th trong nhiu lnh vc. Cc thnh
ph ln, c bit l Nng, Nha Trang v Quy
Nhn ang ng gp vo tng trng kinh t
v sc sng ca vng nh vo nhng li th t
nhin v thu ht khch du lch, mc d cng c
cc vng su vng xa, ni tng trng kinh t
tng i chm. Cng ging nh cc vng khc
min Nam, vng duyn hi Nam Trung B t
chu nh hng ca c ch k hoch tp trung
hn so vi duyn hi Bc Trung B v cc vng
pha Bc khc. Do , duyn hi Nam Trung B,
cc yu t th trng t lu c vai tr ln hn.
Bn 3.1: Cc vng ca Vit Nam
ng bng sng Cu Long c s dn khong

17,2 triu ngi. Mc d vng ny ch yu l
nng thn, song ng th ba c nc v mc
thu nhp bnh qun u ngi, sau ng Nam
B v ng bng sng Hng ni tp trung cc
thnh ph ln ca Vit Nam. Tuy thu nhp tng
i cao hn, cc ch s x hi ng bng sng
Cu Long km hn. Tnh trng khng c t v
tp trung t ai mang tnh lch s v ang
tr nn ph bin hn vng ny. Cc c im
kh hu v a l a phng cho thy nhng
vn khc bit c bit v gio dc v y t,
nh kh khn trong do v tr a l, giao thng
v vn v sinh.
ng Nam B l vng ng dn tip theo
Vit Nam, vi 14 triu ngi. Cng vi ng
bng sng Hng, vng ny c mc hc vn
cao nht, vi hn 27% ngi ln hon thnh
trung hc ph thng. Vng ny c thnh ph
Ngun: UNHCR, trch t http://www.nationsonline.org
Pht trin con ngi Vit

vit Nam
nam - Tnh
tnh hnh s b cp tnh
46
H Ch Minh nng ng v l vng giu c nht v pht trin nhanh nht c nc - c v phng
din kinh t v nhn khu hc. C th thy y nhiu c quan Nh nc v cc th ch th trng
cng nh cc mi quan h m rng nhanh chng ca Vit Nam vi cc nn kinh t khu vc v ton
cu. Vi mc giu c tng i cao, v tp trung ca cc trung tm th v gn cc vngngho
hn, ng Nam B l mt im n quan trng ca c hai loi hnh di c nng thn- th v
th- th. th ha ang gia tng nhanh chng, song h tr v th ch v c s h tng khng
ng u. Cng nh cc vng khc, ng Nam B phi i mt vi nhng thch thc trong vic
bo m cung cp cc dch v x hi cho tt c ngi dn.
Vng min ni v trung du Bc B c dn s 11 triu ngi, sng hai tiu vng ring bit, l
trung du ven bin ng Bc v min ni Ty Bc. Vng ny c t l i ngho thu nhp cao nht v
t l bit ch thp nht trong c nc, vi t l bit ch di 60% ti mt s tnh. Ty Bc, nhiu
h gia nh vn tip tc sng da vo nng nghip t cung t cp. Vic cung cp cc dch v x
hi da trn cc lc lng th trng khng ng k v cc dch v ca nh nc khng p
ng nhu cu a phng. S a dng v dn tc, xa xi v a l v iu kin kinh t yu km gy ra
nhng thch thc ln khc bit vi nhng vng khc ca t nc.
Ty Nguyn l vng t dn c nht ca Vit Nam, vi 5,1 triu ngi. Ni y tp trung cc nhm c
dn bn a nhiu hn cc vng khc. T l sinh tng i cao v do dn s nhn chung tr hn
so vi nhng ni khc. Ngi di c ti vng ny, bao gm c ngi Kinh v cc nhm dn tc thiu
s, cng xut pht t tnh trng tng dn s. Vng ny v ang l mt trong nhng vng ngho
nht trong c nc: vi gn 50% thu nhp h gia nh c chi tiu cho lng thc. Trong khi mc
sng c ci thin ng k, phn phi thu nhp ngy cng khng ng u, mt phn do dng
ngi nhp c tng i giu c gn y. Cc ngnh kinh t vng ny thay i do dng ngi
nhp c ln trong vi thp k qua v gn y l s bng n cc hot ng nng nghip phi truyn
thng. Bin i x hi cng ang din ra do nhng thay i v kinh t v vic xy dng c s h
tng mi. Cng thng x hi rt r nt khi cc nhm dn tc t ngi t nhiu vng khc nhau sinh
sng cnh nhau, trong khi mi trng x hi v kinh t ang chuyn i xung quanh h, lm thay
i sinh k v cc h thng gi tr truyn thng ca ngi dn.
47
PHT TRIN CON NGI CC TNH

SO SNH CP TNH
Bn 3.2: Ch s pht trin con ngi

(HDI), 2008
pht trin con ngi thp hn, trong khi hu ht cc

tnh giu c hn tip tc tin v pha trc. Trong c
hai nm 1999 v 2008, cc tnh ngho nht l nhng
tnh c gi tr HDI thp nht, bao gm H Giang
ng Bc v Lai Chu Ty Bc. Cc tnh c gi
tr HDI cao nht trong c hai nm 1999 v 2008 l
nhng tnh nng ng nht ca Vit Nam, gm B
Ra Vng Tu v TP H Ch Minh ng Nam B, H
Ni min Bc v Nng Nam Trung B (Bn
3.2).
Hnh 3.1: Gi tr HDI, Vit Nam v 6 vng

1999-2008
Ngun: VASS/TCTK; HDI 1999, 2004, 2008

Xem bng s liu trong Ph lc.
Ngun: B. Surborg cho NHDR 2011
Ch s HDI c s bin ng ln gia cc tnh ca

Vit Nam, cng nh s thay i ca ch s ny theo
thi gian. Hu ht cc tnh Vit Nam t tin b
v HDI t nm 1999 n nm 2008. Cc tnh ngho
hn c tin b nhanh hn, nhng vn ng mc
So snh ch s HDI ca cc tnh ca Vit Nam vi

cc nc trong nm 2009 (nm gn nht c ch s
HDI tng ng so snh) cho thy mc pht
trin con ngi cc tnh Lai Chu v H Giang
tng ng vi cc nc nh Papua New Guinea
v Swaziland. Cn mc pht trin con ngi
H Ni v thnh ph H Ch Minh c th so snh
tng ng vi Jordan, Belize v Trung Quc. Mc
pht trin con ngi cc tnh Lai Chu v H
Giang tng ng vi cc nc nh Papua New

vit Nam
nam - Tnh
tnh hnh s b cp tnh
48
TNG TRNG TRONG CH S HDI MT

S TNH NGHO NHT V GIU NHT
Guinea v Swaziland. Cn mc pht trin con

ngi H Ni v thnh ph H Ch Minh c th so
snh tng ng vi Jordan, Belize v Trung Quc.
Mc d vn cn khong cch ln vi cc tnh giu

c, gi tr HDI ca nhiu tnh ngho nht ca Vit
Nam tng ng k trong giai on t nm 1999
n nm 2008. Cc tnh ny gm Gia Lai v Kon
Tum Ty Nguyn, Sn La Ty Bc v Lo Cai, H
Giang, Cao Bng, Bc Cn ng Bc. Cc tnh ny
nm trong s nhng tnh ngho nht trong nc v
thuc 10 tnh c HDI cui bng xp hng trong c
hai nm 1999 v 2008. Mc d pht trin con ngi
c ci thin nhiu, nhng cc tnh ny vn cn
tt hu so vi cc vng giu c hn Vit Nam v
cha th thay i ng k v tr xp hng trong thp
k qua. Mt s tnh, nh Bn Tre v Cn Th vng
ng bng sng Cu Long tin b ng k trong
th bc xp hng.
Mc pht trin con ngi cc tnh

Lai Chu v H Giang tng ng vi
cc nc nh Papua New Guinea v
Swaziland. Cn mc pht trin con
ngi H Ni v thnh ph H Ch
Minh c th so snh tng ng vi
Jordan, Belize v Trung Quc.
Tng t, cc vng nng ng nht c gi tr HDI
cao nht trong c hai nm 1999 v 2008. Nm 2008,
HDI dao ng t 0,756 ng Nam B n 0,660
min ni v trung du Bc B. Trong khi mt s vng,
c bit l Ty Nguyn v ng bng sng Cu Long
c ci thin ng k v ch s HDI, th vng ng
Nam B li c tc tng chm nht mc d c
xut pht im ban u cao hn nhiu. (Hnh 3.1).
Bng 3.1: Tng trng ch s HDI nhanh nht v chm nht, theo tnh, giai on
1999-2008
Xp hng
HDI 2008
Xp hng
HDI 1999
Gi tr
HDI 2008
Gi tr
HDI 1999
Tc thay i
1999-2008 (%)
Gia Lai (TN)
53
59
0,667
0,519
28,5%
Lo Cai (B)
57
57
0,644
0,527
22,3%
Sn La (TB)
59
58
0,641
0,527
21,7%
Cao Bng (B)
55
55
0,658
0,541
21,7%
Lng Sn (B)
35
52
0,702
0,581
20,8%
Kon Tum (TN)
58
56
0,641
0,535
19,8%
H Giang (B)
62
60
0,570
0,477
19,4%
Bn Tre (BSCL)
14
43
0,728
0,610
19,3%
c Lc (TN)
41
49
0,694
0,583
19,1%
Cn Th (BSCL)
31
0,751
0,633
18,7%
ng Thp (BSCL)
43
50
0,691
0,582
18,7%
Hng Yn (BSH)
24
13
0,718
0,661
8,7%
Bnh Phc (NB)
38
18
0,701
0,649
8,0%
Ty Ninh (NB)
21
10
0,721
0,672
7,4%
0,805
0,759
6,0%
0,744
0,702
6,0%
0,744
0,703
5,8%
Nng (DHNTB)
0,761
0,724
5,1%
TP H Ch Minh (NB)
0,773
0,755
2,4%
Bnh Dng (NB)
17
0,724
0,731
-0,9%
Tnh
Cc tnh c
HDI tng
nhanh hn
B Ra -Vng Tu (NB)
Cc tnh c
HDI tng chm ng Nai (NB)
hn
Hi Phng (BSH)
Ngun: HDI 1999, 2008

*Thu nhp t du kh khng c tnh vo s liu thu nhp ca B Ra-Vng Tu
BSH = ng bng sng Hng, TN = Ty Nguyn; B = ng Bc, NB = ng Nam B, DHNTB = duyn hi Nam Trung B, DHBTB =
duyn hi Bc Trung B, BSCL = ng bng sng Cu Long, TB = Ty Bc.
49
Mt khc, mt s tnh giu nht vi gi tr HDI cao

nht trong c hai nm 1999 v 2008 c s tng
trng chm hn v ch s HDI trong giai on ny.
Cc tnh ny bao gm TP H Ch Minh, Nng, Hi
Phng v B Ra Vng Tu, cng l cc tnh ng u
v ch s HDI trong c hai nm 1999 v 2008. Nhng
tnh ny c mc pht trin con ngi cao trong
nm 1999 v tip tc t c ci thin khim tn
trong ch s HDI trong giai on 1999-2008. Tnh
Bnh Dng l trng hp ngoi l khi tt hng t
v tr th 4 nm 1999 xung th 17 nm 2008 trong
bng xp hng HDI. Mt l do cho s tt hng ny
ca Bnh Dng l t l nhp hc chung gim
xung, mt phn do dng ngi nhp c ln vo
tnh. Theo s liu ca tng iu tra dn s v nh
nm 2009, Bnh Dng c t l nhp c cao nht c
nc, c 3 ngi th c mt ngi nhp c.7
C hai xu hng c quan tm. Th nht, mc d
cc tnh ngho hn c nhng ci thin ng k
trong ch s HDI v thu hp dn khong cch vi

cc tnh c th bc trung bnh - cc tnh ngho vn
khng th thay i c th bc trn bng xp
hng HDI, hay ni cch khc h vn cha th ui
kp cc tnh giu. Trong khi , mc d tc tng
ca ch s HDI mt s tnh giu ca Vit Nam
chm li, song gia cc tnh giu v ngho hn vn
cn khong cch ng k.
Mc d tc tng ca ch s HDI mt
s tnh giu ca Vit Nam chm li,
song gia cc tnh giu v ngho hn
vn cn khong cch ng k.
Nh phn tch di y cho thy, trong khi tt c
cc tnh u t c tng trng kinh t, th nhng
tin b chm hn v cc ch s tui th v gio dc
ang lm chm li tin b chung v ch s HDI c
cc tnh giu v cc tnh ngho hn.
PHN TCH CP TNH S DNG CC CH S THNH PHN CA HDI
Hnh 3.2: Cc ch s thu nhp v phi thu nhp ca HDI, theo tnh ca Vit Nam, 2008
Ngun: t tnh ton, VASS/GSO, HDI 2008. Lu : ch s tui th v thu nhp c tng hp thnh mt ch s phi thu nhp. r=0,55265.
Xem www.hdr.org v cc ch s tng hp s dng s liu t bo co HDR ton cu.

vit Nam
nam - Tnh
tnh hnh s b cp tnh
50
So snh cc kha cnh thu nhp v phi thu nhp ca

ch s HDI cho thy, cng ging nh cc xu hng
nu trong Bo co Pht trin Con ngi ton cu
nm 2010, khng phi lc no cng c mi tng
quan gia tin b trn cc phng din thu nhp v
phi thu nhp ca HDI cc tnh ca Vit Nam.
Khng phi lc no cng c mi tng

quan gia tin b trn cc phng din
thu nhp v phi thu nhp ca HDI cc
tnh ca Vit Nam.
Trong khi cc tnh c tin b ln v ch s HDI chung
l nhng tnh t c gi tr cao hn v cc ch
s phi thu nhp (tui th v gio dc) v ch s thu
nhp, th vn c s khc bit rt ln gia cc tnh
ny. Mt s tnh c mc thu nhp tng i cao,
nhng cc gi tr phi thu nhp li di mc trung
bnh, trong c cc tnh ng bng sng Cu
Long nh Sc Trng, An Giang. Cc tnh khc c mc
thu nhp trung bnh thp hn, nhng li c mc
pht trin con ngi v phng din phi thu nhp
cao hn tng i. Cc tnh ny bao gm nh H
Tnh vng duyn hi Bc Trung B v Thi Bnh
ng bng sng Hng. Hai tnh ny c mc pht

trin con ngi trn cc phng din phi thu nhp
cao hn so vi H Ni, Nng v TP H Ch Minh.
hiu c cc nhn t ny, cn xem xt nhng
thay i theo thi gian v cc ch s thu nhp v phi
thu nhp trong ch s HDI. R rng l, nhng tnh t
tin b chung ln nht v ch s HDI trong giai on
1999-2008 (cc tnh ngho hn c lit k trong
bng 3.1) l nhng tnh t c tin b trn c cc
phng din thu nhp v phi thu nhp ca HDI, mc
d cc tnh ny thng c xut pht im rt thp.
Tuy nhin, trong nhiu trng hp cc tnh ci thin
c ch s thu nhp li c s ci thin rt hn ch
v cc ch s phi thu nhp trong ch s tng hp HDI,
khin tng trng chung v HDI chm li. Hnh 3.3
(CHECK HINH 3.3) minh ha iu ny, v tng t vi
phn tch trong Bo co Pht trin Con ngi ton
cu nm 2010 (hnh 1.1), cho thy s thay i tch cc
trong gi tr ca ch s thu nhp c tng quan vi
tin b trong ch s HDI tng th, nhng li t c lin
h vi tin b trong cc ch s phi thu nhp. Ni cch
khc, tng trng kinh t thc y s ci thin ch s
HDI cp tnh, nhng khng phi lc no cng tng
quan vi nhng tin b v ch s tui th v gio dc.
Hnh 3.3: Thay i trong cc ch s thu nhp v phi thu nhp ca HDI theo cc
tnh, 1999-2008
Ngun: t tnh ton; VASS/GSO; HDI 2008, 1999. r=0,60393; r=0,18795
51
Tht vy, mt s tnh c tc tng trng thu

nhp mnh m trong giai on 1999-2008 trn
thc t li c cc ch s phi thu nhp gim st trong
cng k; trong c Lo Cai, Sn La v Tin Giang.
a phn cc tnh c ch s thu nhp tng trn 30%
trong giai on ny, cn mc tng v ch s tui th
v gio dc khim tn hn, v mt vi tnh, ch s
tui th v gio dc gim nh. Mt phn ba s
tnh c t l nhp hc chung gim: tuy nhin a
phn nhng trng hp ny t l bit ch ngi
ln tng ln trit tiu nh hng do t l nhp

hc gim, dn n ch s gio dc chung tng ln.
Ni cch khc, nhiu tnh c ci thin khim tn v
ch s HDI c mc tng trng thu nhp bnh qun
u ngi GDP tnh theo PPP tng nhanh nhng t
l nhp hc chung gim: nh vy ngha l tin b
mt ny che lp nhng tht li mt khc. Khong
mt phn ba trong tng s 63 tnh c xu hng
ny trong c hai nm 1999 v 2008.
Hnh 3.4: T l nhp hc chung theo dn tc v vng 2008
Ngun: VHLSS 2008
Trong khi GDP bnh qun u ngi ca c nc

tng 115,7% trong giai on 1999-2008, t l nhp
hc chung ch tng 2,4%. Hu ht nhng tin b v
ch s tui th v gio dc din ra trong na u
ca thp k t nm 1999 n 2004. Trong giai on
tip theo t 2004-2008, t l nhp hc chung ca c
nc ch tng cha y 1% trong khi GDP bnh qun
u ngi (theo PPP) tng mnh ti 45%. Nh vy,
ph hp vi phn tch trong Chng 1, trong khi thu
nhp ca Vit Nam ang tng ln, th cc kt qu v

phng din gio dc ca ch s HDI ang chm li.
Mt l do gii thch cho xu hng t l nhp hc
chung tng chm li l tnh trng thng mi ha
cc dch v gio dc ang tng ln v c mt b
phn dn s trc y c th tip cn dch v gio
dc bao cp b gt ra ngoi, nh c tho lun
trong cc chng sau. Tuy nhin nhng xu hng

vit Nam
nam - Tnh
tnh hnh s b cp tnh
52
ny cn c l gii mt cch trng v nhng hn

ch khi s dng t l nhp hc chung lm ch s o
lng tin b trong gio dc.
Mc d GDP bnh qun u ngi tnh theo PPP
tng ln ng k hu ht cc tnh trong giai on
1999-2008, nhng vn cn khong cch r rt v thu
nhp gia cc tnh giu nht v ngho nht. TP H
Ch Minh c mc thu nhp GDP bnh qun u ngi
tnh theo PPP l 4.834 la M trong nm 2008, gp
gn 6 ln so vi tnh H Giang l tnh c GDP bnh
qun u ngi PPP ch t 801 la M. Tuy nhin
khong cch ny gim xung t mc 9,6 ln nm
1999, phn nh tng trng kinh t mnh Vit Nam.
Trong khi thu nhp ca Vit Nam ang

tng ln, th cc kt qu v phng din
gio dc ca ch s HDI ang chm li.
Tng t nh vy, trong giai on 1999-2008, chnh
lch v tui th v t l bit ch gia cc tnh c t l
cao nht v thp nht gim nh. Trong nm 2008,
khong cch v tui th l 12% v t l bit ch l
36% gia cc tnh c t l cao nht v thp nht. Tuy
nhin, khong cch v t l nhp hc chung gia
cc tnh c t l cao nht v thp nht tng ln,
t 33% nm 1999 ln 40% nm 2008.
Ni bt l mt s tnh/thnh giu c ca Vit Nam
nh TP H Ch Minh v Hi Phng (c hai tnh ny
u c t l nhp c thun cao) c t l nhp hc
chung thp hn mc trung bnh ton quc trong
nm 2008. Trong giai on 1999-2008, t l nhp
hc chung gim Bnh Dng (31%), Hi Phng
(13,4%), v Nng (12%); tnh trng tng t cng
din ra ti cc tnh ngho nh Kon Tum v H Giang.
S suy gim ny din ra ch yu trong giai on 2004
- 2008 mt s tnh giu khi t l nhp hc chung
gim 14% TPHCM, gim 12% Hi Phng ,12%
Nng v 3% H Ni. Kt qu ny c s khc bit
so vi s gim st nh hoc thm ch ci thin ca t
l nhp hc chung trong giai on 1999 n 2004.
C mt s l do gii thch cho xu hng ny: trc
ht y l nhng khu vc c dng ngi nhp c
ln v con ci ca ngi nhp c c nhiu kh nng
khng c i hc, nh tho lun trong Chng
2. Th hai, nh phn tch trong cc chng sau, chi
ph gio dc tng ln ng k, c bit cc khu
vc thnh th v iu ny c th hn ch vic tip
cn vi gio dc ca con ci cc gia nh di c. ng
ghi nhn l Tng iu tra dn s 2009 cho thy t l
hc sinh b hc cao trong dn s tui t 5-18
mt s tnh thnh ny. V d tnh Bnh Dng c t
l b hc l 30,8% nm 2009.8
53
KHONG CCH V GIO DC TRONG CC

NHM DN TC THIU S V GIA CC
KHU VC
Vn tn ti chnh lch ng k v t l nhp hc
chung gia cc dn tc thiu s v ngi Kinh, cng
nh gia cc vng v iu ny c th gii thch cho
nhng tin b chm chp v ch s gio dc trn
ton quc. Theo VHLSS nm 2008, cc nhm dn tc
thiu s c t l nhp hc chung cp trung hc
c s l 88% so vi 97,4% ngi Kinh, v 47,9%
ngi dn tc v 78,3 % ngi Kinh cp trung
hc ph thng. Khong cch tng t nh vy cng
tn ti gia cc tnh: nh t l nhp hc trung hc
ph thng vng ng bng Sng Cu Long, Ty
Nguyn, Trung du v min ni Bc B l rt thp
(Hnh 3.4). Nh vy mt l do gii thch cho nhng
tin b hn ch v t l nhp hc chung c th l
mt s nhm dn c ang b tt hu, trong khi cc
nhm giu c hn v ngi Kinh vn ang tip tc
t c nhng thnh tu gio dc cao hn.
CC KT QU HN CH V GIO DC NH
HNG TI TIN PHT TRIN CON
NGI CP A PHNG
Nh phn tch trn cho thy, tng trng kinh t th
hin qua GDP bnh qun u ngi tnh theo PPP l yu
t ng gp chnh cho tin b v HDI c mc quc gia
v cp tnh. Tuy nhin, thu nhp tng khng phi lun
lun tng quan vi tin b trn cc phng din phi
thu nhp ca ch s HDI, v trong trng hp ca Vit
Nam che y nhng tin b hn ch trong ch s gio
dc mt s tnh. Nhng tin b chm v ch s gio
dc cp a phng do t l nhp hc chung chng li
xy ra c cc tnh giu c v cc tnh ngho hn.
Nhng tin b chm v ch s gio dc

cp a phng do t l nhp hc chung
chng li xy ra c cc tnh giu c v
cc tnh ngho hn.
iu ny ang km hm nhng tin b v HDI ca
Vit Nam cp tnh v quc gia. T l nhp hc
chung ang chng li mt s vng, nhm kinh t
x hi v cng ng dn tc thiu s; v suy gim
mt phn ba trong tng s cc tnh trong giai
on 2004-2008. ng ch l tnh trng ny th
hin r rt mt s vng nng ng ca Vit Nam
nh ng bng sng Hng v ng Nam B. Mc
d mt s tnh ngho nht ca Vit Nam tin b
trn c cc phng din thu nhp v phi thu nhp
ca HDI, mt s tnh giu c hn tin b chm hn
do kt qu gio dc b chm li hoc suy gim. Nh

Chng 1 nu, v gio dc c xc nh l lnh
vc u tin trong cc mc tiu pht trin ca Vit
Nam trong giai on 2011-2020, nn vn ny cn

c quan tm v cn phi l mt u tin i vi
cc nh hoch nh chnh sch.
BT BNH NG GII CP A
PHNG
BT BNH NG GII VN TN TI TRONG H

GIA NH V TRN TH TRNG LAO NG
Bn 3.3: Ch s pht trin gii

(GDI) 2008
Vit Nam c cng nhn l nc thc hin tt v

bnh ng gii trong khu vc, tuy nhin bt bnh ng
gii vn tn ti, c bit l trong h gia nh v trn th
trng lao ng. Mt s thnh tu ca Vit Nam l t
l ph n tham gia vo hot ng kinh t cao, c nhiu
i biu trong quc hi v bnh ng gii cao trong
gio dc bc tiu hc v trung hc c s. Tuy nhin,
vn tn ti nhng bt bnh ng ng k, trong mc
tham gia ca ph n trong chnh quyn a phng
cn thp, chnh lch tin lng trong cng vic chnh
thc v phi chnh thc v ph n tp trung nhiu trong
cc cng vic d b tn thng v khng chnh thc.9
Vit Nam c cng nhn l nc thc hin tt

v bnh ng gii trong khu vc, tuy nhin bt
bnh ng gii vn tn ti, c bit l trong h
gia nh v trn th trng lao ng.
Nhng nghin cu gn y cng cho thy bt bnh
ng gii trong gia nh vn tip tc tn ti. Tnh trn
ton quc, 34% ph n tng b bo hnh v sc khe
hoc tnh dc t ngi chng trong cuc i ca h, v
con s ny tng ln n 58% khi tnh c lm dng tnh
cm. Hn mt na s ph n ny khng tm kim s
gip no.10 Nh phn tch trong Chng 2, t l gii
tnh khi sinh tng ln mt s tnh phn nh s thch
c con trai tn ti lu nay. Bng chng cho thy cc
gia nh u t nhiu hn cho vic chm sc sc khe
ca con trai so vi con gi. Mc d khm cha bnh cho
tr em di 6 tui c min ph, mt nghin cu nm
2008 ca B Y t cho thy c 39% b gi so vi 61% b
trai c iu tr ti 3 bnh vin quc gia.11 Trong cc h
gia nh ngho hn, tr em gi c nhiu kh nng phi
ngh hc hn khi gia nh gp kh khn. iu ny cng
thng xy ra trong cc cng ng dn tc thiu s. 12
KHONG CCH V GII GIA CC TNH

V CC KHU VC
Ch s pht trin gii (GDI) o lng khong cch

v gii trong pht trin con ngi, cho thy s khc
bit v gii trong bn ch bo v ba ch s to nn
HDI. Vit Nam, t l tui th cao ph n, bnh
ng gii trong gio dc, cng vi chnh lch
tin lng ang dn c thu hp gp phn
ci thin ch s GDI c cp quc gia v cp tnh.
hng ci thin trong ch s GDI gip lm gim
khong cch gii gia cc tnh v vng Vit Nam.

vit Nam
nam - Tnh
tnh hnh s b cp tnh
54
Khng ch ch s GDI tng ln theo thi gian tt

c cc tnh, khong cch gia cc tnh c gi tr
GDI cao nht v thp nht dn thu hp, t 65%
nm 1999 xung 62% nm 2004 v 51% trong nm
2008. Khong cch v GDI gia cc vng ca Vit
Nam cng thu hp theo thi gian, vi gi tr GDI
cao nht ng Nam B v ng bng sng Hng.
Hnh 3.5 cho thy xu hng ca ch s GDI cp
quc gia v vng. Ch s GDI tng tt c cc
vng trong giai on 1999 n 2008, mc d tin b
vng ng Nam B din ra chm hn so vi cc
vng khc trong giai on t nm 2004 n 2008.
Hnh 3.5: Thay i GDI, c nc v 6

vng, 1999-2008
KHONG CCH GII TRONG THU NHP V

GIO DC
Trong nm 2008, cc tnh ng u v GDI cng l
nhng tnh ng u v HDI, l nhng tnh giu
c v nng ng nht Vit Nam: B Ra-Vng Tu,
TP H Ch Minh, H Ni v Nng vi ch s GDI
cao nht trong nm 2008. Cc tnh xp hng di
cng l nhng tnh ngho nht, gm in Bin v
Lai Chu Ty Bc v H Giang ng Bc. Bn
3.3 cho thy cc gi tr GDI trong nm 2008.
Tuy nhin, xt v tin b tng th trong ch s GDI
trong giai on 1999-2008, mc d khong cch gii
vn l km nht cc tnh ngho nht, song cc tnh
ny c s ci thin ln hn theo thi gian. Cc
tnh ny bao gm Gia Lai v Kon Tum Ty Nguyn,
Sn La v Lo Cai Ty Bc, v Lng Sn v Cao Bng
ng Bc, u nm trong 10 tnh xp hng cui
cng trong nm 1999 v nm 2008 (xem Bng 3.2).
Ngc li, cc tnh c tin b chm hn v ch s
GDI trong giai on 1999-2008 l nhng tnh giu
c hn nh B Ra-Vng Tu, TP H Ch Minh, Bnh
Dng, Nng v Hi Phng nhng ni c gi
tr GDI cao trong nm 1999.
Cng nh HDI, ci thin v GDI ch yu do thay i
trong thu nhp - c do tng thu nhp ni chung
v mc bnh ng gii ln hn trong phn
phi cc khon thu nhp . T 1999-2008, ch s
bnh ng gii trong phn phi thu nhp tng
31%, ch s bnh ng trong tui th tng 10%
v ch s bnh ng v gio dc tng 3%. Trong
khi thu nhp tng v khong cch gii v thu
nhp thu hp em li nhng ci thin v GDI,
cng cn xem xt khong cch gii trong cc ch
s khc nhau trong nm 2008 v mc khong
cch ny thu hp hay m rng theo thi gian.
Ngun: VASS/GSO; GDI 1999, 2004, 2008

Xem bng s liu trong Ph lc
55
Bng 3.2: T l tng GDI nhanh v chm nht, 1999-2008

Xp hng
GDI 2008
Xp hng GDI
1999
Ch s GDI 2008
Ch s GDI
1999
Thay i
1999-2008 (%)
Gia Lai (TN)
52
58
0,667
0,512
30,41%
Lo Cai (B)
57
57
0,643
0,520
23,59%
Cao Bng (B)
55
54
0,658
0,536
22,69%
Sn La (TB)
59
56
0,637
0,521
22,28%
Lng Sn (B)
35
50
0,702
0,578
21,51%
H Giang (B)
62
59
0,566
0,467
21,25%
Kon Tum (TN)
58
55
0,641
0,530
20,94%
c Lc (TN)
40
51
0,694
0,578
20,13%
Bn Tre (BSCL)
14
41
0,728
0,609
19,55%
Qung Ngi
(DHNTB)
44
49
0,689
0,579
19,04%
Hi Dng (BSH)
15
11
0,723
0,663
9,06%
Hng Yn (BSH)
25
12
0,718
0,661
8,69%
Bnh Phc (NB)
37
18
0,702
0,648
8,33%
Ty Ninh (NB)
19
10
0,720
0,670
7,45%
ng Nai (NB)
0,744
0,701
6,11%
B Ra-Vng Tu
(NB)
0,803
0,759
5,82%
Hi Phng (BSH)
0,744
0,703
5,76%
Nng (DHNTB)
0,760
0,721
5,46%
TPHCM (NB)
0,771
0,753
2,35%
Bnh Dng (NB)
17
0,723
0,729
-0,94%
Tnh
Cc tnh c
t l tng GDI
nhanh nht
Cc tnh c tc
tng GDI
thp
Ngun: GDI 1999, 2008

BSH = ng bng sng Hng, TN = Ty Nguyn; B = ng Bc, NB = ng Nam B, DHNTB = duyn hi Nam Trung B, DHBTB = duyn hi Bc
Trung B, BSCL = ng bng sng Cu Long, TB = Ty Bc.
Nhng tnh c khong cch gii trong gio dc ln

nht nm 2008 gm vi tnh ngho nht c nc nh
Lai Chu, in Bin v Sn La Ty Bc, H Giang, Lo
Cai v Yn Bi ng Bc v Tr Vinh ng bng
sng Cu Long. iu ny l do khong cch gii trong
t l bit ch ln n 20-30% vn tn ti mt s tnh
ngho nht Vit Nam. V d Lai Chu, t l bit ch
ph n l 48% so vi 75,5% nam gii, in Bin l
60,5% so vi 83,4% v H Giang l 62,7% so vi 84,1%.
Tng t, ti mt s tnh khong cch gii trong t l
nhp hc chung ln ti 30%. Ti in Bin, t l nhp
hc chung ph n l 55,3% so vi 78,5% nam gii,
ti Sn La l 55% ph n so vi 71,3% nam gii v
ti Lai Chu l 51,4% so vi 65,6%.
Sc Trng, Bc Liu, Tr Vinh, An Giang, Kin Giang v

Tin Giang vng ng bng sng Cu Long, cng
vi Bnh Dng, B Ra-Vng Tu v TP H Ch Minh
ng Nam B. mt s tnh, GDP bnh qun u
ngi theo PPP ca ph n ch bng 50% n 60%
GDP bnh qun u ngi theo PPP ca nam gii,
trong c C Mau (51%), Sc Trng (58%), B RaVng Tu, Bc Liu, Tr Vinh (tt c u l 59%).
Mt ln na, nhng xu hng ny ang chu nh
hng ca s khc bit theo vng cng nh s khc
bit v thu nhp v dn tc. Bng 3.3 cho thy nhng
thnh tu khc nhau v t l ngi ln bit ch, t l
nhp hc chung v GDP bnh qun u ngi gia
nam v n cc vng ca Vit Nam trong nm 2008.
Mt khc, cc tnh c khong cch gii ln nht v

ch s thu nhp nm min Nam, bao gm C Mau,

vit Nam
nam - Tnh
tnh hnh s b cp tnh
56
Bng 3.3: Ch s GDI theo 6 vng ca Vit Nam, nm 2008

Tui th
trung bnh
(nam s
nm)
GDP bnh GDP bnh

T l
T l nhp T l nhp qun u qun u
Tui th
ngi ln T l ngi
hc chung hc chung
ngi
ngi
Ch s
trung bnh bit ch ln bit ch
ca nam gii ca n gii ca nam ca n
GDI
(n- s nm) (nam
(n - %)
(%)
(%)
(PPP
(PPP
- %)
US$)
US$)
Min ni v
Trung du Bc
B
67,17
72,88
92,85
83,47
64,41
59,61
1349,1
1493,0
0,660
ng bng
sng Hng
71,55
76,68
98,56
94,64
63,25
61,91
3265,4
2759,1
0,741
Duyn hi
Bc Trung B
68,93
74,46
96,67
91,84
66,73
70,60
2040,6
1768,5
0,707
Ty Nguyn
67,54
73,25
92,74
87,06
66,23
69,08
1940,0
1766,4
0,689
ng
Nam B
72,68
77,68
97,52
94,94
52,97
54,53
5064,7
3350,6
0,755
ng bng
Sng Cu
Long
70,87
76,13
94,22
89,34
55,76
57,04
3092,1
2004,1
0,712
Ngun: GDI 2008
cp quc gia, khong cch gii trong thu nhp bnh qun u ngi thu hp t mc 27% nm 1999
xung 17% trong nm 2008, v khong cch v t l nhp hc chung gim t 7% v n nm 2008 khng
cn khong cch gii. Khong cch gii trong t l
bit ch ca ngi ln gim nh t 7% xung 5%.
Khong cch v tui th tng nh; trong nm
1999 tui th ca n cao hn nam gii 3,5 nm v
n 2008 khong cch tng ln trn 5 nm.
Tuy nhin, trong khi phn ln cc tnh c khong
cch gii trong gio dc gim dn v thnh cng
v phng din bnh ng gii, th ti mt s tnh
khong cch gii v t l nhp hc chung tng ln
trong giai on 1999-2008. Cc tnh ny bao gm
Thi Nguyn v Qung Ninh vng ng Bc, Sn
La v Ha Bnh Ty Bc, Khnh Ha vng duyn
hi Nam Trung B v Ninh Bnh vng ng bng
sng Hng. ng ch , H Ni, Nam nh, Ninh Bnh
v Thi Bnh vng ng bng sng Hng, cng vi
Ninh Thun ng Nam B v Thi Nguyn vng
ng Bc c khong cch gii trong t l nhp hc
chung tng ln trong giai on 2004 v 2008.
Ngoi ra, trong khi thu nhp tng mnh thc y
ci thin ch s GDI v khong cch gii v GDP bnh
qun u ngi c thu hp r rt ti hu ht
cc tnh t nm 1999 n 2008, nhiu tnh thuc cc
vng giu nht ca Vit Nam trong giai on ny
vn c khong cch gii tng ln trong GDP bnh
qun u ngi theo PPP gia nam v n. Cc tnh
57
ny bao gm TP H Ch Minh v B Ra-Vng Tu

vng ng Nam B; An Giang, Bc Liu, Cn Th, C
Mau, Kin Giang, Sc Trng, Tin Giang v Tr Vinh
vng ng bng sng Cu Long; H Ni, Hi Phng,
H Nam v Nam nh ng bng sng Hng v
Lm ng Ty Nguyn.
Bt bnh ng gii trong thu nhp l

ng k v r rt mt s tnh nng
ng nht ca Vit Nam, ni thu nhp
ang tng ln nhanh chng.
Nh vy, r rng trong GDI c hai m hnh khc bit
v bt bnh ng gii. Th nht, vn tn ti bt bnh
ng gii ng k trong gio dc cc tnh ngho
nht Vit Nam. Th hai, Bt bnh ng gii trong
thu nhp l ng k v r rt mt s tnh nng
ng nht ca Vit Nam, ni thu nhp ang tng ln
nhanh chng. Bt bnh ng gii trong thu nhp l
ng k v r rt mt s tnh nng ng nht ca
Vit Nam, ni thu nhp ang tng ln nhanh chng,
c bit ng Nam B v ng bng sng Cu
Long. ng thi, cc tnh giu c, bnh ng gii
trong gio dc cao hn r rt, trong khi mt s
tnh ngho hn dng nh c s bnh ng gii ln
hn v thu nhp (mc chung gim) . an xen vi

nhng xu hng ny l s gim nh v khong cch
nam-n trong t l nhp hc chung mt s tnh.
Thc t ny ph bin cc tnh ngho min Bc
cng nh mt s tnh giu ng bng sng Hng,
v khong cch thu nhp tng ln mt s vng
nng ng hn ca Vit Nam nh ng bng sng
Cu Long, ng bng sng Hng v ng Nam B.
iu ny cho thy khong cch ngy cng ln trong
tip cn gio dc mt s tnh, trong , ph n
ang b tt hu, v c th cho thy ph n mt s
tnh c hng li mt phn thp hn t qu trnh
tng trng kinh t nhanh chng ca Vit Nam, nh
nu trong Chng 2.
Bn 3.4: Ch s ngho i v mt con

ngi (HPI) 2008
NGHO I V TNH TRNG

THIU THN PHI TIN T
S DNG CC CH S NGHO A CHIU
O LNG CC PHNG DIN THIU HT
PHI TIN T
Ch s chnh th ba trong t hp cc ch s v pht
trin con ngi l ch s ngho i con ngi (HPI).
Ch s ny o lng mc thiu thn v mc sng
trn cc phng din tui th, m ch ngi ln,
tip cn nc sch v suy dinh dng tr em. Do
, HPI l ch s quan trng b sung cho bng xp
hng ngho i da trn cc thc o v thu nhp
v chi tiu. Nh cp phn trc, bo co ny
gii thiu v tho lun v ch s ngho i a chiu
(MPI) o lng 9 dng thiu ht khc nhau trong y
t, gio dc v mc sng. Tuy nhin trong khi ch s
MPI ch mi c a vo tnh ton s dng s liu
ca nm 2008, th ch s HPI c dng tho
lun nhng thay i v s thiu ht phi tin t trong
giai on 1999-2008.
Nh nu Chng 2, t l ngi ngho tnh theo
chi tiu ca Vit Nam nm 2008 l 14,5%. Ch s HPI
ca Vit Nam trong nm 2008 l 10,93%. Tuy nhin
t l ngho i a chiu trong ch s MPI (t l ngi
ngho a chiu trong tng dn s) ca Vit Nam
cao hn nhiu, mc 23,3%.
iu ny kh thng nht vi t l i ngho tr em

(CPR) do B LTBXH v UNICEF xy dng, trong
s dng 10 ch s ca i ngho v thiu thn. Vit
Nam c t l CPR cao vi t l ngho i tin t l
20,7% v t l ngho i a chiu l 28,9% trong
nm 2008.13
vit Nam
nam - Tnh
tnh hnh s b cp tnh
58
Hnh 3.6: Ch s ngho a chiu (MPI)

theo HDR ton cu nm 2010, Vit
Nam 2010
nhng ngi ngho ny phi gnh chu rt nhiu

nhng thiu ht khc nhau. Ngoi ra, t l dn s c
nguy c tr thnh ngho a chiu ln ti 20% trong
tng dn s. Trong khi phn ln cc vng c t l
ngho da trn chi tiu cao hn so vi ch s HPI, th
ng Nam B v ng bng sng Cu Long, tnh
hnh l ngc li, vi gi tr HPI tng ng l 5,1% v
14,3%. y l mt kt qu ng ch trong bi cnh
mc nng ng kinh t c bit ca vng ng
Nam B, h tr cho pht hin ca bo co ny, rng
tng trng kinh t v gim ngho khng phi lun
lun i lin vi nhng tin b v mc sng v cc
kt qu pht trin con ngi phi thu nhp.
Tuy nhin, t l ngi ngho a chiu MPI (t l m
u) cao hn so vi t l ngho tin t 4 trn 6
vng ca Vit Nam. T l ngho m u MPI cao
nht vng ngho nht c nc, l min ni v
trung du pha Bc vi t l i ngho phi tin t
l 40%. Tuy nhin t l ngho i m u ca ch
s MPI cng c bit cao ti ng bng sng Cu
Long vi gn 50% s dn trong tnh trng ngho phi
tin t trong khi t l ngho tin t ch l 11,7%, do t
l cao nhng ngi thiu thn v phng din gio
dc v mc sng. Hnh 3.7 cho thy t l HPI, MPI v
t l ngho tin t 6 vng ca Vit Nam.
Ngun: HDR ton cu 2010
T l ngho i phi tin t s dng ch s MPI cao

hn so vi HPI c th gii thch l do MPI s dng
nhiu ch s ph hp hn i vi mc pht trin
ca Vit Nam; trong khi ch s HPI o lng cc
nhu cu v thiu thn c bn v l mt ch s c
bit ph hp cho cc nc thu nhp thp. Mt nh
ngha rng hn v tnh trng thiu thn s ph hp
vi Vit Nam - mt quc gia thu nhp trung bnh v
v vy MPI c la chn a vo Bo co Pht
trin con ngi quc gia nm 2011.
ng ch , su ngho i da trn s liu MPI
ca Vit Nam mc cao l 40%. iu ny cho thy
trong khi t l ngho a chiu tng i thp,
59
Xt theo cc nhm kinh t x hi khc nhau, t l

ngho i m u MPI khu vc nng thn cao
hn 5 ln khu vc thnh th vi con s tng ng
l 29,9% v 5,9%, trong khi t l ngho a chiu
ca nhm dn tc thiu s l 61,9%, cn ca nhm
dn tc Kinh v Hoa l 17,4%. Theo ng phn v thu
nhp, 49% nhm ngho nht l ngi ngho i
a chiu theo MPI, tuy nhin rt ng ch l 5,7%
trong nhm giu nht, 12,8% nhm giu th hai v
21,9% nhm c mc thu nhp trung bnh cng ri
vo tnh trng ngho a chiu do h gp phi cc
hnh thc thiu thn phi tin t. Cng ging nh i
ngho tin t, t l ngho i a chiu nam gii
v n gii cng chch lch nh vi t l 24,3% n
v 22,3% nam.
Hnh 3.7: HPI, MPI v t l ngho i tin t ca 6 vng Vit Nam 2008
Ngun: VASS/GSO; HPI v MPI 2008; VHLSS 2008
NGHO I PHI TIN T CC TNH

NGHO HN CA Vit Nam
T l ngho i m u MPI cc tnh ngho nht
rt cao, trong Lai Chu 82,3%, in Bin 75% v H
Giang 73%. Trn thc t, tng cng 12 tnh c trn
50% dn s l ngi ngho a chiu da theo ch s
MPI. Hu ht cc tnh c t l ngho phi tin t tin
cao u nm trong s nhng tnh c t l ngho tin
t cao nht. Lai Chu c t l i ngho tin t cao
nht trn ton quc vi 61.3%, in Bin ng th hai

vi 49% v H Giang ng th ba vi 43%.14 Tuy nhin,
ng ch l tnh Vnh Long c t l i ngho tin
t ch l 10% thp hn nhiu so vi 30,2% ca HPI v
71,3% v MPI. iu ny ch yu do mt lng ln dn
s gp phi nhng thiu thn v mc sng trong
c thiu tip cn nc sch v v sinh. Bn 3.4 cho
thy phn b gi tr HPI trong nm 2008 theo tnh, v
bng s liu kt qu v MPI c trnh by Bng 3.4.

vit Nam
nam - Tnh
tnh hnh s b cp tnh
60
Bng 3.4: i ngho a chiu cc tnh ca Vit Nam nm 2008
Ch s
MPI
61
Tnh
i ngho tin t
T l ngho
m u
su ngho
Dn s c nguy c
ri vo i ngho a
chiu *
H*A
(H) (%)
(A) (%)
(%)
(%)
Xp
hng
Dn s i
ngho a chiu
Chun ngho quc gia**
H Ni
0,0053
1,5
34,9
7,5
1.7
TP H Ch Minh
0,0071
2,1
34,1
4,6
0,5
Hi Dng
0,0087
2,5
35,0
11,4
8,9
Bc Ninh
0,0091
2,7
34,0
10,9
5,9
Hng Yn
0,0100
2,8
35,0
11,2
7,1
Hi Phng
0,0108
3,0
35,8
10,8
4,9
Nng
0,0110
3,0
36,3
5,0
3,0
Thi Bnh
0,0137
3,9
35,1
16,7
8,5
B Ra Vng Tu
0,0151
4,2
36,1
13,4
7,0
10
Nam nh
0,0185
5,0
36,7
16,7
7,7
11
H Nam
0,0197
5,5
36,1
22,6
8,4
12
Bnh Dng
0,0211
5,9
35,8
17,4
0,5
13
Qung Ninh
0,0299
6,8
43,9
10,3
7,2
14
Vnh Phc
0,0244
7,0
34,8
28,7
11,3
15
Ninh Bnh
0,0324
9,2
35.3
31,8
12,9
16
Bc Giang
0,0392
10,5
37.4
22,4
17,5
17
H Tnh
0,0441
11,7
37.8
23,3
28,2
18
Ngh An
0,0534
12,8
41.6
23,7
24,9
19
Ph Th
0,0549
14,8
37,1
24,2
17,4
20
Thanh Ha
0,0570
15,0
38,0
23,5
26,3
21
Bnh nh
0,0552
15,4
35,8
36,3
13.3
22
Qung Bnh
0.0599
16,1
37,2
26,6
23.6
23
ng Nai
0,0662
16,8
39,5
18,4
4,3
24
Khnh Ha
0,0685
17,4
39.4
18,9
10,7
25
Lm ng
0,0658
17,4
37.9
23,8
18,3
26
Ph Yn
0,0694
19,2
36.0
33,1
17,6
27
Thi Nguyn
0,0751
19,7
38,1
22,6
17,5
28
Bnh Thun
0,0784
20,2
38,8
21,1
9,3
29
Hu
0,0814
20,3
40,0
23,2
15,7
30
Qung Tr
0,0783
20,4
38,5
30,6
27,6
31
Qung Nam
0,0822
21,3
38,6
25,3
20,7
32
Bnh Phc
0,0928
23,2
40,1
25,9
10,1
33
Qung Ngi
0,0881
23,4
37,6
27,2
21,7
34
c Nng
0,1009
27,0
37,4
36,4
26,7
35
Ha Bnh
0,1160
31,2
37,2
36,0
32,3
36
Ty Ninh
0,1210
31,9
37,9
26,1
5,6
37
Ninh Thun
0,1373
33,5
41,0
21,2
21,2
38
Long An
0,1309
35,0
37,4
31,5
7,6
39
c Lc
0,1341
36,0
37,3
28,7
24,6
Ch s
MPI
Dn s i
ngho a chiu
T l ngho
m u
su ngho
Dn s c nguy c
ri vo i ngho a
chiu *
i ngho tin t
Chun ngho quc gia**
40
Tin Giang
0,1449
38,3
37,8
32,3
10,7
41
Cn Th
0,1676
39,3
42,6
19,5
6,9
42
Tuyn Quang
0,1577
41,2
38,2
29,0
23,3
43
An Giang
0,1899
45,0
42,2
23,1
8,5
44
Lng Sn
0,1716
45,0
38,1
34,1
21,2
45
Bc Cn
0,1817
45,2
40,2
28,4
39,9
46
Yn Bi
0,1997
45,4
44,0
22,4
24,6
47
Bc Liu
0,1773
46,1
38,4
24,2
12,4
48
C Mau
0,1806
46,2
39,1
26,2
13,7
49
Gia Lai
0,1916
46,3
41,4
24,9
29,1
50
Kin Giang
0,1987
49,2
40,4
23,8
9,5
51
Kon Tum
0,2074
50,1
41,4
23,2
32,0
52
Bn Tre
0,2006
51,0
39,3
29,2
15,5
53
Tr Vinh
0,2143
55,0
38,9
25,6
20,7
54
Lo Cai
0,2591
57,0
45,4
19,4
37,7
55
Sc Trng
0,2363
57,7
41,0
21,0
19,2
56
Sn La
0,2513
60,1
41,8
25,3
42,4
57
Hu Giang
0,2379
60,6
39,3
26,9
13,8
58
Cao Bng
0,2819
60,9
46,3
22,0
42,0
59
ng Thp
0,2800
65,6
42,7
19,4
10,3
60
Vnh Long
0,2898
71,3
40,7
14,8
10,0
61
H Giang
0,3325
73,0
45,6
11,4
43,0
62
in Bin
0,3622
75,0
48,3
11,3
49,0
63
Lai Chu
0,4119
82,3
50,0
7,8
61,3
C nc
0,0936
23,3
40,2
20,2
14,6
Ngun: TCTK tnh ton trn s liu VHLSS 2008.

*Nhng ngi c nguy c ri vo ngho i a chiu: l ngi chu bt k 2 thiu ht no trong s 9 ch s s dng **Chun ngho quc gia nm
2008 l 290,000 VND /ngi/ thng khu vc nng thn v 370,000 VND /ngi/thng khu vc thnh th.
Hu ht cc tnh ng bng sng Hng c t l

ngho m u rt thp di mc 10%, nhng vi
mc thm ht trung bnh dao ng t 40-50%,
cho thy y c su i ngho cao. 10%, vi
mt chia s tc trung bnh t 40 n 45%, cho thy
cng i ngho cao. Ngc li, hu ht cc tnh
trong vng min ni v trung du pha Bc c t l
ngho i m u cao vi trn 30% v mc
thiu thn ng k, t 35 n 50%. Lai Chu c t
l ngho i m u cao nht l 82,3% cng nh
su ngho ln nht mc 50%. Cc tnh vng
duyn hi Bc v Nam Trung B c t l ngho dao
ng t 10-30% v su ngho i t 35-40%. C
s chnh lch ng k Ty Nguyn, trong mt

s tnh nh Lm ng c t l ngho m u MPI
thp hn vi t l 17,4%, trong khi k Lk v Kon
Tum c t l tng i cao vi 36% v 50% tng
ng. Hu ht cc tnh trong vng ng bng sng
Cu Long c t l ngho m u MPI rt cao t
30% tr ln, v su ngho i cng rt ln t 35
n 45%. Ngay c trong vng ng Nam B, cc tnh
nh Bnh Phc v Ty Ninh cng c t l ngho i
cao vi 23% v 32% tng ng. V vy, ch s MPI a
ra bc tranh phc tp hn v ngho i cp tnh
so vi t l ngho tin t n thun.

vit Nam
nam - Tnh
tnh hnh s b cp tnh
62
CH S HPI V CC TNH NGHO

Nm 2008, ch s HPI c s khc bit ng k gia cc tnh,
t mc 2,84% ti TP H Ch Minh n mc 38,63% Lai
Chu, gim so vi cc mc tng ng 7,37% v 47,63%
trong nm 1999. So snh cho thy chnh lch gia cc tnh
c tnh trng thiu thn cao nht v thp nht ch gim nh
trong giai on 1999 - 2008, vn cn khong cch dai dng
trong mc sng gia cc tnh giu nht v ngho nht, vi
s thay i tng i hn ch trong ch s HPI tnh
ngho nht l Lai Chu trong giai on t 1999 n
2008. Trong nm 2008, cc tnh c t l i ngho
thp nht da trn ch s HPI l TP H Ch Minh, H
Ni, Hi Phng v Nng; v y cng l nhng
tnh c xp hng trong 10 tnh ng u v ch
s HDI v GDI. Tng t, H Ni, TP H Ch Minh, Hi
Phng v Nng u c t l ngho i a chiu
thp, cng nh Hi Dng, Bc Ninh v Hng Yn.
Hnh 3.8: HPI, Vit Nam v 6 vng,

1999-2008
Vn cn khong cch dai dng trong

mc sng gia cc tnh giu nht v
ngho nht.
Da trn ch s HPI, tt c cc vng v cc tnh u
c t l i ngho gim trong giai on 1999-2008.
Nhng vng c t l gim ngho nhanh nht l
ng bng sng Hng, ng Nam B v ng bng
sng Cu Long. ng bng sng Cu Long c t l
gim ln nht trong ch s HPI trong giai on ny
(hnh 3.8).
Nhng tnh t tin b ln nht v tin b ln nht
v phng din gim ngho l H Ni v Hi Phng
ng bng sng Hng, Tin Giang, Bn Tre, Long
An, C Mau, Cn Th, Bc Liu ng bng sng
Cu Long, TP H Ch Minh v B Ra-Vng Tu
ng Nam B. Nhng tnh c mc gim ln nht
v t l % HPI l Bn Tre, Cn Th, Tin Giang ng
bng sng Cu Long, v Sn La Ty Bc, cc tnh
ny nm trong s nhng tnh c t l i ngho cao
nht trong nm 1999.
Ngun: VASS/GSO; HPI 1999, 2004, 2008

Xem bng s liu trong Ph lc
Trong khi tt c cc tnh gim c t l i

ngho trong giai on 1999-2008, mt s tnh gim
vi tc chm hn. Lai Chu Ty Bc, Yn Bi v
H Giang ng Bc, Kon Tum Ty Nguyn v
Vnh Long ng bng sng Cu Long, tt c u
c t l gim ngho chm hn trong giai on 19992008. Nhng tnh c % HPI thc t gim t bao gm
c cc tnh c t l i ngho thp vo nm 1999,
nh TP H Ch Minh v Nng, v mt s tnh nh
Yn Bi ng Bc vn c t l i ngho cao trong
nm 1999 v t tin b t trong thp k ny.
Nh cp trn, khong cch gia tnh ngho
nht v giu nht (Lai Chu v TP H Ch Minh)
gim nh theo thi gian. mc tng th, t l
ngi dn c kh nng khng sng n 40 tui
gim tng i hn ch; tng t nh s gim st
63
trong t l ngi ln m ch. y l tin b tt, do t

l thiu thn ban u cc kha cnh ny thp vo
nm 1999. T l khng tip cn c vi nc sch v
suy dinh dng tr em gim ng k, so vi mc
ban u cao vo nm 1999. Khong cch gia cc tnh
ngho nht v cc tnh c mc thiu thn thp nht
mt trong 4 kha cnh ca HPI cng thu hp theo
thi gian. y l nhng du hiu ng khch l.
Khong cch gia tnh c t l ngi dn c kh

nng khng sng n 40 tui thp nht (TP H Ch
Minh - 3,24%) v tnh c t l cao nht (16,12% - Lai
Chu) gim xung di 13% hoc cao hn 5 ln
so vi tnh Lai Chu. Tuy nhin, i vi ba ch s khc,
khong cch vn cn rt ln vi mc thiu thn
khc nhau r rt gia cc tnh giu nht v ngho
nht ca Vit Nam. T l suy dinh dng tr em
c Nng l 30,5%, cao hn 6,6 ln so vi TP H Ch
Minh l 4,6%. Khong cch v t l ngi ln bit
ch l 14 ln vi 38,4% Lai Chu so vi 2,77% TP
H Ch Minh. Ni bt nht l 100% ngi dn Thi
Bnh c tip cn vi nc sch, trong khi c ti
68% ngi dn Lai Chu khng c tip cn vi
nc sch.
Khong cch gia cc tnh ngho nht

v cc tnh c mc thiu thn thp
nht mt trong 4 kha cnh ca HPI
cng thu hp theo thi gian.
Bng 3.5: Cc tnh gim HPI nhanh v chm nht, 1999-2008

Xp hng
HPI nm
2008
Xp hng HPI
nm 1999
Gi tr HPI nm
2008 (%)
Gi tr HPI nm
1999 (%)
Thay i
1999-2008 (%)
Tin Giang (BSCL)
17
44
8,24
27,86
-70,41%
H Ni (BSH)
3,75
11,73
-68,01%
Bn Tre (BSCL)
41
55
12,70
39,54
-67,88%
Long An (BSCL)
15
33
7,67
22,19
-65,45%
C Mau (BSCL)
10
32
7,20
20,67
-65,18%
Bc Liu (BSCL)
12
30
7,25
20,40
-64,46%
Cn Th (BSCL)
43
50
12,89
34,70
-62,84%
Hi Phng (BSH)
5,42
14,52
-62,65%
Tnh
Gim ngho
nhanh hn
Gim ngho
chm hn
TP HCM (NB)
2,84
7,37
-61,42%
B Ra-Vng Tu
(NB)
5,64
14,47
-60,99%
Cao Bng (B)
57
54
25,59
38,94
-34,29%
Lo Cai (B)
58
53
25,78
38,37
-32,81%
ng Thp (BSCL)
59
58
27,83
41,28
-32,56%
Tuyn Quang (B)
48
39
16,20
23,86
-32,11%
Thi Nguyn (B)
31
12
10,60
15,52
-31,75%
H Giang (B)
60
59
29,26
41,78
-29,98%
Vnh Long (BSCL)
61
57
30,02
40,73
-26,31%
Yn Bi (B)
51
42
19,90
26,10
-23,75%
Kon Tum (TN)
56
47
23,92
31,16
-23,23%
Lai Chu (TB)
63
60
38,63
47,63
-18,88%
Ngun: HPI 1999, 2008. BSH = ng bng sng Hng, TN = Ty Nguyn; B = ng Bc, NB = ng Nam B, DHNTB = duyn hi Nam Trung B,
DHBTB = duyn hi Bc Trung B, BSCL = ng bng sng Cu Long, TB = Ty Bc.

vit Nam
nam - Tnh
tnh hnh s b cp tnh
64
TIN B CP TNH TRONG GIM THIU

HT PHI TIN T
mt s t tnh, c s tng ln mt s kha cnh thiu
ht phi tin t trong ch s HPI t nm 1999 n nm
2008. Cc tnh ny bao gm Kon Tum, c Lc v Thi
Nguyn vi t l ngi dn khng c tip cn vi
nc sch tng ln, v Sc Trng vi t l ngi ln m
ch tng nh. Mt khc, mt s tnh, t l ngi dn
khng c tip cn vi nc sch gim ng k v
cc tnh ny gm nhng tnh c tc gim ngho
phi tin t nhanh, nh Bn Tre v Tin Giang. T l
suy dinh dng tr em gim tt c cc tnh
trong giai on ny.
mt s tnh, t l ngi dn khng

c tip cn vi nc sch gim
ng k
Trong giai on na sau ca thp k, t 2004-2008,
trong khi t l suy dinh dng tr em c ci thin
tt c cc tnh, t l m ch ngi ln tng nh
t 1-2% v mt s tnh t l ngi dn khng c
tip cn vi nc sch tng. V d, t l ngi dn

tip cn vi nc sch Nng, H Ni, Gia Lai,
Lai Chu, Ph Yn, Hu v Tuyn Quang u gim.
Mt ln na, iu ny cho thy bt bnh ng trong
y t v gio dc ang tng ln mt s tnh. Mt
khc, nhiu tnh t c tin b ng k trong giai
on ny. Sn La, Cn Th, An Giang, Lai Chu, in
Bin, Hu Giang vi cc kt qu ng k trong gim
ngho phi tin t trong giai on ny, ng ch
nht l nh tip cn nc sch c ci thin.15
Nh cp phn trn, chnh lch ln nht v
dai dng nht trong ch s HPI l vic tip cn nc
sch. Tip cn nc sch l mt vn quan trng
do nhim nc l mt nguyn nhn chnh gy
bnh tt, t vong v Vit Nam vn cha t c
mc tiu MDG v nc sinh hot an ton.
Tip cn nc sch l mt vn quan

trng do nhim nc l mt nguyn
nhn chnh gy bnh tt, t vong v Vit
Nam vn cha t c mc tiu MDG
v nc sinh hot an ton.16
Hnh 3.9: Tip cn nc sch theo nhm thu nhp v theo vng, 2008
Ngun: VHLSS 2008.
65
D liu VHLSS 2008 cho thy vn c s khc bit

ng k trong tip cn nc sch gia cc nhm
kinh t-x hi. Nm 2008, 86,6% trong nhm ngi
ngho nht c tip cn vi nc sch so vi 97%
nhm ng phn v giu nht, v s khc bit trong
phm vi cc vng cng r rt. Gn 100% h gia nh
ng bng Sng Hng c tip cn vi nc
ung sch so vi 80,6 % vng ng bng sng
Cu Long (Hnh 3.9). Tng t, t l suy dinh dng
tr em Ty Nguyn, ng Bc, Ty Bc v duyn
hi Bc Trung B vn cn cao hn so vi cc vng
khc.17
Bn 3.5: T l t vong tr s sinh

ca Vit Nam 2008
Trong ch s MPI, thiu thn v mc sng cng c

ngha quan trng c bit l thiu nc v v sinh.
Thiu nh c nh, v thiu thn v tip cn gio
dc cng l cc yu t quan trng. Hnh 3.10 cho
thy ng gp ca 9 ch s thnh phn vo ch s
tng hp MPI: trong thiu thn nh c nh, v
sinh v tip cn nc sch l nhng nhn t quan
trng nht.
Cc ch s khc khng c s dng trong HPI
v MPI, chng hn nh t l t vong tr s sinh,
cng cho thy s khc bit ng k gia cc tnh,
cc vng v cc nhm dn c. im nht qun l,
nhng tnh ngho nht l nhng tnh c gi tr HDI
v GDI thp nht v HPI cao nht, v t l thiu ht
phi tin t cao hn rt nhiu, bao gm t l t vong
tr s sinh v tr em, t l suy dinh dng chiu cao/
tui v suy dinh dng cn nng/chiu cao v t l
t vong m. V d, t l t vong tr s sinh l 48%
Kon Tum, 40% H Giang v 33% Lai Chu trong
nm 2008, cao hn gp 5-6 ln so vi H Ni (7%)
v gp 2-3 ln mc trung bnh ca ton quc (15%)
(Bn 3.5).
NGHO I V BT BNH NG
NGHO TIN T GIM, CHNH LCH THU
NHP TNG
Nh phn tch cho thy, bt bnh ng Vit Nam
v cc ch s v y t, gio dc v mc sng c lin
quan cht ch ti v tr a l, v tnh trng kinh
t x hi. Bt bnh ng gii trong th trng lao
ng v h gia nh vn ko di, mc d tin
b tin tc trn mt s phng din, c bit l
tip cn gio dc ca ph n v tr em gi.

vit Nam
nam - Tnh
tnh hnh s b cp tnh
66
Hnh 3.10: ng gp ca 9 ch s thnh phn vo MPI Vit Nam v 6 vng 2008
Ngun: MPI 2008, based on VHLSS 2008, Xem bng s liu trong Ph lc.
Nh phn tch cho thy, bt bnh ng Vit Nam

v cc ch s v y t, gio dc v mc sng c lin
quan cht ch ti v tr a l, v tnh trng kinh t x
hi. Bt bnh ng gii trong th trng lao ng v
h gia nh vn ko di, mc d tin b tin tc
trn mt s phng din, c bit l tip cn gio
dc ca ph n v tr em gi.
Nh tho lun trong Chng 2, Vit Nam c qu
trnh pht trin tng i cng bng, thnh cng
trong gim ngho tin t v kh thnh cng trong
vic kim ch bt bnh ng kinh t so vi cc nc
khc trong khu vc. Tuy nhin, c nhng du hiu
cho thy tnh hnh ny ang thay i. Ngoi cc
bng chng cha chnh thc, nh cc du hiu
chnh lch giu ngho ang gia tng v bng n
v tiu dng cc thnh ph ln ca Vit Nam, d
liu t VHLSS cho thy bt bnh ng thu nhp ang
tng ln trn ton quc. Trong khi ngho v thu
nhp gim, t 18,1% nm 2004 xung cn 15,5%
nm 2006 v 13,4% nm 2008, bt bnh ng v thu
nhp li tng ln. H s Gini cho thy bt bnh ng
thu nhp tng t 0,420 nm 2004 ln 0,424 nm
2006, 0,434 nm 2008 v 0,433 nm 2010. y l mc
tng nh song rt c th cc cuc iu tra VHLSS
67
khng bao ph ht nhng ngi rt giu v nhng

ngi rt ngho. D liu VHLSS cng cho thy thu
nhp ca nhm giu nht so vi ca nhm ngho
nht tng t 8,1 ln nm 2002 ln 8,2 ln nm 2004
v ln 8,9 ln nm 2008 v 9,2 ln vo nm 2010.
Theo cch o lng ny, Vit Nam c mc chnh
lch thu nhp thp hn Philippines v Singapore
song cao hn so vi Indonesia, Malaysia v Thi Lan.
T l thu nhp ca ng phn v giu

nht so vi ng phn v ngho nht
cng tng ln tt c cc vng trong
giai on 2002-2010.
Cng c th quan st thy xu hng tng t cp
vng. Hnh 3.11 cho thy t l i ngho v h
s Gini ca cc vng ca Vit Nam trong giai on
2004-2008. Trong khi t l i ngho gim tt c
cc vng trong giai on ny, bt bnh ng v thu
nhp tng ln tt c cc vng tr Ty Nguyn v
ng Nam B. T l thu nhp ca ng phn v giu
nht so vi ng phn v ngho nht cng tng ln
tt c cc vng trong giai on 2002-2010.
Hnh 3.11: Ngho i v bt bnh ng v thu nhp 8 vng ca Vit Nam,

2004-2008
Ngun: VHLSS, 2004, 2006, 2008
ng Nam B c t l i ngho thp nht, nhng

cng c h s Gini v bt bnh ng thu nhp cao
nht. R rng c hai m hnh khc bit l: t l i
ngho thp hn nhng bt bnh ng cao hn
ng bng sng Hng v ng Nam B, v t l
i ngho cao hn nhng bt bnh ng thp hn
vng duyn hi Bc v Nam Trung b. Trng hp
ngoi l l Ty Nguyn, ni c bt bnh ng v thu
nhp v t l i ngho u tng i cao. y c
th do s tp trung ng cc nhm dn tc thiu s
ngho trong vng ny, cng vi mt s lng nh
ngi Kinh/Hoa c th lm giu thng qua khai thc
ti nguyn thin nhin. Tuy nhin, nhn chung cc xu
hng theo vng cho thy bt bnh ng gia tng l
mt c im ca m hnh tng trng ca Vit Nam.
Cc xu hng theo vng cho thy bt bnh

ng gia tng l mt c im ca m hnh
tng trng ca Vit Nam.
T L NGHO V BT BNH NG V THU

NHP KHNG C MI TNG QUAN R
RNG
Khi so snh t l i ngho vi t l bt bnh ng v
thu nhp, trong trng hp ny, t l ca nhm c
thu nhp cao nht so vi nhm thu nhp thp nht
cho thy mt m hnh hn hp nhiu hn. Trong nm
2008, mt s tnh vi t l ngho rt cao c mc bt
bnh ng v thu nhp tng i thp (Bn 3.6).
Cc tnh ny bao gm H Giang, Lai Chu, in Bin
v Sn La. Cc tnh khc nh Lo Cai, Cao Bng, Gia Lai,
c Nng v c Lc c c t l ngho v t l bt bnh
ng v thu nhp u cao. Mt khc, mt s tnh nh
Kin Giang, B Ra-Vng Tu v Qung Ninh c t l
ngho i thp nhng bt bnh ng tng i cao.

vit Nam
nam - Tnh
tnh hnh s b cp tnh
68
Hnh 3.12: Ngho i v bt bnh ng theo tnh Vit Nam, 2008
Nhng tnh nh Nng, Cn Th v TP H Ch Minh

th tnh hnh li khc. Hnh 3.12 cho thy s phn b
ca cc tnh theo 4 m hnh: i ngho cao/bt bnh
ng cao, i ngho cao/bt bnh ng thp, i
ngho thp/bt bnh ng thp, v i ngho thp/
bt bnh ng cao.
Nh vy, khng c s tng quan r rng gia t l i
ngho v bt bnh ng v thu nhp cp tnh, tri
ngc vi mi tng quan r rng hn cp vng.
Tuy nhin, mc d cc m hnh bt bnh ng v thu
nhp cp tnh kh bin thin v bt bnh ng thu
nhp v ngho i khng phi lc no cng c mi
tng quan r rng, nhng bt bnh ng thu nhp
ang tng ln hu ht cc vng ca Vit Nam v hin
ang mc tng i cao mt s tnh, bao gm c
cc tnh rt ngho v cc tnh tng i giu c.
CHNH LCH TNG E DA TIN B PHT

TRIN CON NGI CA Vit Nam
Phn tch trong chng ny cho thy thu nhp tng l
yu t chnh thc y nhng tin b gn y ca Vit
Nam v HDI v cc ch s pht trin con ngi lin quan,
trong khi cc kha cnh phi thu nhp trong HDI b
69
tht li pha sau. Kt hp vi phn tch ngn gn v bt

bnh ng v ngho i cho thy thu nhp tng khng
phi lc no cng ci thin kt qu pht trin con ngi
hay nng cao mc sng ca mi ngi dn Vit Nam.
Nhng tin b v cc ch s y t v gio dc, c bit l
t l nhp hc chung v tip cn nc sch v v sinh,
ang b tt hu v ang km hm s tin b ca Vit Nam
trn con ng hng ti mc pht trin con ngi cao
hn nh o lng bi ch s HDI v cc ch s pht trin
con ngi khc. Vit Nam, ngho i phi tin t v
thiu thn c bit nghim trng vi cc nhm d b
tn thng. Khong cch gii ang c thu hp trn
mt s phng din, nhng cng ang tng ln mt
s phng din khc.
Chnh lch v bt bnh ng gia tng l mt nguy c i
vi tin trnh pht trin con ngi ca Vit Nam. Chi ph
ca cc dch v y t v gio dc ang tip tc gia tng
Vit Nam nh cc chng sau phn tch. Khi ca ci c
phn phi km cng bng, th sc mua ca nhiu ngi
dn thng Vit Nam tip cn cc dch v x hi thit
yu tr nn t bnh ng hn. Do , khong cch chnh
lch trong cc ch s pht trin con ngi c th s tip
tc m rng trong tng lai.
Bn 3.6: Ngho i v bt bnh ng cc tnh ca Vit Nam 2008

vit Nam
nam - Tnh
tnh hnh s b cp tnh
70
PHN HAI
4
Chng 4
73
TIP CN DCH V
Y T V GIO DC
CHNH LCH V Y T V GIO
DC VN CN DAI DNG
CHNH LCH V KT QU Y T, GIO DC
V TIP CN DCH V
Chnh lch v cc kt qu y t v gio dc c lin
quan trc tip ti cc mc tip cn rt khc nhau vi
dch v y t v gio dc gia cc tnh, vng, dn tc
v nhm kinh t x hi. Chng ny tho lun v tip
cn dch v y t, gio dc v mi quan h gia cc xu
hng s dng vi nhng khc bit v kt qu y t,
gio dc. Tip cn dch v y t ch yu c phn nh
qua d liu v tnh hnh s dng cc dch v y t v
s lng bnh nhn. Cn t l nhp hc chung v t
l nhp hc ng tui cung cp thng tin v tip cn
dch v gio dc cc cp khc nhau. Nh tho lun
trong Chng 5, chnh ph c nhiu chng trnh
nhm tng cng kh nng tip cn dch v y t v
gio dc cho cc nhm thit thi v d b tn thng.
Nhng bin php ny bao gm bo him y t (th
bo him), min ph khm cha bnh cho tr em di
6 tui v min hc ph cng nh cc chi ph khc cho
tr em. Nhng tr cp ny gp phn lm tng kh
nng tip cn cc dch v y t v gio dc, nhng cac
mc tip cn dch v gio dc v y t khc nhau
vn tip tc tn ti Vit Nam.
Cc mc tip cn dch v gio dc v

y t khc nhau vn tip tc tn ti Vit
Nam.
iu ny t ra cu hi v tnh hiu qu v mc
bao ph ca cc chng trnh ny, nh s tho lun
trong Chng 5.
TIP CN DCH V Y T
TNH HNH S DNG DCH V Y T CA
NGI NGHO V NGI DN TC
THIU S
S dng dch v y t c lin quan cht ch vi thnh
phn dn tc, v tr a l v a v kinh t x hi. Theo
d liu v s dng dch v y t t iu tra Mc sng
h gia nh (VHLSS) nm 2008, 51,6% s ngi c
hi tng b m. 10% cn nm iu tr, cn ngi
chm sc v ngh lm trung bnh 4,5 ngy (i vi
nhng ngi cn ngh lm). 34% ngi dn c tip
cn cc dch v y t, trong 30% s dng cc dch
v y t ngoi tr v mt t l tng i nh hn
(6,6%) s dng cc dch v ni tr gi cao. Mt tn
hiu tch cc l trong giai on 2002-2008, t l s
dng cc dch v y t tng ln ng k. Nm
2002, ch 19% ngi dn Vit Nam tip cn cc dch
v y t, 5,7% s dng cc dch v ni tr v 14% s
dng dch v ngoi tr. ng ch l vic s dng
dch v tng tt c cc nhm thu nhp v c
nng thn ln thnh th. Tng t, tn sut s dng
cc dch v ngoi tr cng tng trong giai on
2004-2008, trong khi tn sut s dng dch v ni
tr c gim nh. Vic s dng dch v y t ch yu
l di hnh thc ti khm cha bnh ti cc c s
y t ca nh nc; dch v y t do t nhn cung cp
ch chim 38% i vi dch v ngoi tr v 2% vi
dch v ni tr.
Nhng con s ny l rt ng khch l, cho thy ngy
cng nhiu ngi s dng dch v y t; tuy nhin
vn cn c nhng mc khc bit nht nh. R
rng vic s dng dch v y t lin quan trc tip ti
vng i ca con ngi nhng ngi trn 60 tui
l nhng ngi s dng c dch v ngoi tr v ni
Tip cn dch v y t v gio dc
74
tr nhiu nht trong nm 2008; v so vi nam gii,

t l ph n s dng c hai dch v cao hn do nhu
cu sinh n v chm sc sc khe sinh sn ca h.1
Ngoi ra, cn c s khc bit ng k gia cc vng,
dn tc v cc nhm kinh t x hi. Trong khi s
khc bit gia nng thn v thnh th l rt nh, s
khc bit gia cc vng li rt ln, vi mc s
dng dch v y t cao nht vng ng bng sng
Cu Long v thp nht vng Ty Bc. Ngi dn
vng Ty Bc c t l s dng dch v ngoi tr thp
nht nhng li c t l s dng dch v ni tr cao
nht; trong khi ngi dn ng Nam B t s dng
dch v ni tr hn nhng li s dng dch v ngoi
tr nhiu hn. ng bng sng Cu Long v Ty
Nguyn cng tng t nh vy. Dch v y t sn c
v d tip cn hn khu vc thnh th; min Nam
hn l vng Ty Bc. Tuy nhin, t l s dng dch
v ngoi tr thp cng phn nh mt xu hng ca
ngi ngho v vng su vng xa l h thng
tr hon vic cha tr cho ti khi vn sc khe tr
nn tht s trm trng l cch h ti thiu ha
chi ph chm sc y t trong ngn hn.2
Nm 2008, cc nhm dn tc thiu s t s dng cc
dch v ngoi tr hn so vi ngi Kinh/Hoa nhng
li s dng dch v ni tr nhiu hn, ngc li vi
tnh hnh nm 2004. iu tra c s ca Chng trnh
153 giai on 2 cho thy ngi dn tc thiu s
thng trnh s dng cc dch v y t, tr hon vic
cha tr cho ti khi iu kin sc khe tr nn ti t
v thng s dng cc bin php cha tr truyn
thng v t cha bnh hn so vi ngi Kinh/Hoa.3
Xt theo nhm thu nhp, ngi ngho t s dng
cc dch v y t (c ni v ngoi tr) hn. iu th
v l t l s dng dch v y t ca ngi Kinh/Hoa
v ca nhm ng phn v giu nht dng nh
gim nh trong giai on 2004 - 2008.4
Mt s nhm s dng cc dch v ngoi tr thng
xuyn hn, bao gm ngi trn 60 tui, ph n,
75
ngi Kinh/Hoa, ngi khng ngho v ngi

thnh th. Tn sut s dng dch v ngoi tr
cng khc nhau ng k gia cc vng: tn sut
cao hn vng ng Nam B v ng bng sng
Cu Long; thp hn vng Ty Bc, Bc Trung B
v ng Bc. Mt khc s lng bnh nhn ni
tr gim nh i vi a s cc nhm, c bit vi
nhm trn 60 tui, song li tng nh vi nhm di
15 tui, nhm ngho v nhm dn ng Nam B.
T l tip cn dch v y t ca ngi c

bo him y t l cao hn (bt k l bo
him bt buc hay t nguyn).
Khng ngc nhin l nhng ngi trn 60 tui c
s ngy m nhiu hn (12,76 ngy khng lm vic
v 8,82 ngy phi nm ging trong nm 2008);
ph n cng tng t nh vy do yu cu v sc
khe sinh sn. Ngi Kinh/Hoa v ngi khng
ngho cng c s ngy ngh m khng lm vic
v nm ging cao hn.5 iu ny c th do ngi
ngho v ngi dn tc thiu s vi mc thu nhp
thp kh c th ngh mt ngy m khng lm vic.
iu ng ch l, trong s nhng ngi m trong
nm va qua, 61% nam v 65% n c i khm, gim
i so vi con s ca VHLSS nm 2006 (77% nam gii
v 78% n gii khi m c i khm).6 Khng c g
ngc nhin khi bo him y t l l do khin ngi
dn quyt nh s dng dch v y t hay khng. T
l tip cn dch v y t ca ngi c bo him y
t l cao hn (bt k l bo him bt buc hay t
nguyn).
Do t l ngi c bo him y t ang tng dn nh
tho lun trong Chng 5 nn y l mt trong
nhng l do gii thch t l ngi s dng dch v
y t tng ln. Tuy nhin, bo him y t khng l gii
cho vic t l ngi s dng dch v y t khi m
thp hn nhiu trong nm 2008 so vi nm 2006.
Bng 4.1:T l dn s s dng dch v y t giai on 2004-2008 (%)

Dch v ngoi tr
2004
Dch v ni tr
2008
2004
2008
C nc
31,1
31,76
6,88
6,61
Di 15
29,49
33,09
4,17
5,02
16-60
28,49
27,87
6,65
5,95
Trn 60
53,61
54,65
16,11
14,7
Gii tnh
Nam
27,42
28,36
6,24
5,97
34,71
35,02
7,49
7,23
Dn tc
Kinh v Hoa
32,04
32,68
6,88
6,54
Dn tc thiu s
24,65
25,76
6,82
7,13
Khng ngho
32,39
32,5
7,1
6,72
Ngho
25,78
27,38
5,93
5,98
Thnh th
34,58
31,83
6,76
5,97
Nng thn
29,9
31,73
6,92
6,86
ng bng sng Hng
29,2
27,27
7,03
6,52
Ty Bc
21,28
24,77
6,82
7,73
ng Bc
23,57
21,87
6,98
8,42
Tui
Nhm thu
nhp
Nng thn
Thnh th
Vng
Bc Trung B
21,36
24,63
8,07
6,94
Nam Trung B
32,11
31,49
7,79
7,93
Ty Nguyn
36,85
35,65
7,14
6,47
ng Nam B
37,52
33,13
5,89
5,27
ng bng sng Cu
Long
38,69
44,31
6,29
6,2
Ngun: VHLSS 2004 v 2008, trch trong Nguyn Vit Cng 2010
TIP CN Y T D PHNG
Mt hn ch chnh v d liu trnh by trn l s
liu v s dng dch v y t khng phn tch c
tip cn y t d phng - thm khm phng bnh,
mt vn c tc ng trc tip ti cc kt qu y t.
Nhng v d chnh v tip cn y t d phng l tim
vc-xin cho tr em, khm sc khe tin sinh sn v
s dng cc bin php trnh thai hin i trong k
hoch ha gia nh.
Phn tch gii trong iu tra VHLSS 2008 cho thy
ph n thng s dng cc bin php phng bnh
hn bao gm tim vc-xin: 27% n gii tim vc-xin
so vi 20% nam gii, do ph n c s dng cc dch
v chm sc sc khe tin sinh sn v cc dch v y
t khc lin quan ti sc khe sinh sn. Tuy nhin,
c nam v n thnh th u s dng cc dch v
phng bnh nhiu hn so vi nng thn.7 S liu

t iu tra nh gi cc mc tiu tr em v ph n
(MICS) 2006 cho thy s khc nhau v t l tr em
trong tui t 2-4 khng c tim phng cc
bnh ca tr nh. Nm 2006 t l ton quc l 31%,
khu vc th l 20% v nng thn l 35%, dao
ng t 17% vng ng bng sng Hng ti 59%
vng Ty Bc v 53% vng ng Bc. 25% tr
em ngi Kinh v Hoa khng c tim chng y
, trong khi con s ny tr em dn tc thiu s l
58,5%.8 Mc d 86,4% ph n trn ton quc c
kim tra sc khe tin sinh sn song t l ny li dao
ng t 68% Ty Bc ti 98,5% ng bng sng
Hng.9 Nm 2008, 69% ph n c gia nh trong
tui 15-49 c s dng bin php trnh thai, dao
ng t 72,5% Bc Trung B v Nam Trung B
xung 59,4% Ty Nguyn.10
76
Mt nghin cu ca UNICEF v bnh ng trong y t

xc nh cc xu hng sau trong tip cn dch v
y t. Ngi ngho v ph n khu vc nng thn
ngy cng s dng nhiu bin php trnh thai hin
i, nhng bt bnh ng v thu nhp vn tip tc
nh hng ti vic tip cn cc dch v chm sc
tin sinh sn. ng thi, thu nhp, dn tc v tip
cn dch v y t vn l cc yu t quyt nh vic
tr c c tim phng hay khng.11 S khc bit
trong tip cn dch v y t cng b nh hng bi
chi ph dch v gia tng (c v con s tuyt i v v
t l trong tng chi tiu ca h gia nh) v bi s
sn c ca bo him y t, v bo him y t gip tng
s dng dch v y t v gim chi tiu t tin ti nh
tho lun trong Chng 5.
CC KHC BIT V KT QU Y T
CI THIN TNH HNH SC KHE KHNG
NG U V CC VN MI V SC
KHE
Cng vi tip cn y t tng ln nh phn tch t d
liu VHLSS, Vit Nam tng i thnh cng trong
vic thu hp nhng khong cch ln v y t. V d,
t l t vong tr em di 5 tui gim t 58 trn
1.000 nm 1999 xung 24,4 trn 1.000 nm 2009;
trong khi t l t vng tr s sinh gim t 44,4 trn
1.000 nm 1999 xung 16 trn 1.000 nm 2009. T l
t vong b m gim t 233 trn 100.000 nm 1990
xung 69 nm 2009. a s tr em u c tim

chng (82%); 94,8% ca sinh c nhn vin y t h tr.
83% dn s nng thn c tip cn vi nc ung
sch trong nm 2010 so vi 30% nm 2000.12
Chnh lch dai dng v cc kt qu y t

v nhng vn sc khe mi ni i hi
phi c nhng ci thin trong dch v y t.
Tuy nhin, nh Chng 3 phn tch, chnh lch ln
vn cn tn ti. Trong khi t l tr em ci xng trn
ton quc l 31,9%, t l tr em ci xng v suy dinh
dng khu vc nng thn v vng su xa min ni
cao gp 2-3 ln so vi khu vc ng bng v thnh
th. Cc tnh nh Kon Tum, H Giang v Lai Chu c
t l t vong tr s sinh cao gp 2-3 ln t l trn
ton quc. Chnh lch v t l t vong tr em
tng ln gia ng phn v giu nht v ngho nht
khong cch l 33 trn 1.000 nm 1993 ln 39 trn
1.000 nm 2006. T l suy dinh dng tr em di
5 tui ng bng sng Cu Long l 16,7% v Ty
Nguyn l 28,5%.13 Ch c 79,9% ph n Ty Bc khi
sinh c nhn vin y t h tr trong khi ng bng
sng Hng v ng bng sng Cu Long, con s ny
l 100%. T l t vong b m ti cc khu vc nng
thn cao gp hai ln khu vc th.14 T l ngi
nhim HIV cao nht b phn dn s di 40 tui
v nam gii, trong khi mt s tnh c t l nhim HIV
cao hn mc trung bnh i vi cc nhm nguy c
cao (Hp 4.1). 15
HP 4.1: CHNH LCH V T L NHIM HIV

T l nhim HIV cng rt khc nhau gia cc tnh. Nm 2008, khong 20 tnh c trn 200 ca nhim
trn 100.000 dn, tp trung min Bc v thnh ph H Ch Minh v Vng Tu min Nam. T l
nhim cao nht cc tnh mi c dch v hn 600 ca nhim trn 100.000 dn in Bin v Sn
La thuc vng Ty Bc v Qung Ninh thuc ng Bc. Tuy nhin, s lng ln ngi nhim HIV
ch yu tp trung cc thnh ph ln, c bit l thnh ph H Ch Minh, H Ni v Hi Phng.16
Theo d on ca B Y t, s lng ngi c HIV s tng t 220.000 nm 2007 ln 280.000 nm
2012. ng thi, t l nhim mi gim t 67 trng hp trn 100.000 dn nm 2000 xung 39
trn 100.000 dn nm 2007, lm gim t l nhim mt s tnh nh thnh ph H Ch Minh v An
Giang. Trong khi nam gii tip tc chim a s trong b phn ngi c HIV, t l ph n c thai
sng chung vi HIV s tng ln 4.800 vo nm 2012. ng thi t l sng chung vi HIV ca nam
so vi n d tnh s gim t 3,0 ln nm 2007 xung 2,6 ln nm 2012 do nhiu ph n b nhim
t bn tnh ca mnh hn. S lng tr em c HIV d tnh tng t 3.750 nm 2007 ln 5.100 nm
2012.17 Bnh dch ny d tnh s tng cao trong nhm i tng s dng ma ty (IDUs) vng Ty
Bc, gi mi dm Ty Bc v ng bng sng Hng v khch hng s dng gi mi dm Ty Bc
v Cn Th. 18
77
Vi mc th ha ngy cng tng v c cu dn

s thay i, nhng bnh tt lin quan ti li sng
ang ni ln vi t l cc bnh khng ly nhim ang
gia tng, gy nh hng khc nhau ti cc nhm dn
c. Theo Bo co Y t chung nm 2009, cc bnh
v mu v tim mch, ung th v sc khe tm thn
chim 34% s bnh xy ra vi nam gii v 43% vi n
gii.19 T l tai nn giao thng, s dng ru, thuc
l v cht c cn v ma ty bt hp php cng tng
cao, c bit nam gii.20
Chnh lch dai dng v cc kt qu y t v nhng vn

sc khe mi ni i hi phi c nhng ci thin
trong dch v y t. Khng nhng cn tng s sn c ca
cc dch v y t m cn cn tng cng cht lng, quy
nh v gim st hiu qu. S tham gia ca ngi s
dng vo thit k v cung cp cc dch v cng cn
thit, nh tho lun trong cc chng tip theo. Chi ph
cho dch v y t i vi h gia nh cng l mt vn
chnh nh phn tch trong Chng 5.
HP 4.2: NGI KHUYT TT GP KH KHN TRONG TIP CN

DCH V C BN
Ngi khuyt tt Vit Nam c bit chu thit thi v tip cn y t v gio dc. Mt nghin cu nm
2006 v ngi khuyt tt ba tnh21 cho thy c ba ngi khuyt tt th c mt ngi cha tng i
hc Thi Bnh v Qung Nam Nng, v c hai ngi khuyt tt th c mt ngi khng i hc
ng Nai. Ph n khuyt tt thng t i hc hn so vi nam gii. Khong 70-80% ngi tr li thuc
tui 6-30 tng gp kh khn khi i hc, c bit l trong tip thu bi, giao tip vi gio vin v
cc hc sinh khc, i li v tham gia cc hot ng trng hc. B tru chc v khng c cc bn
cng lp n nhn cng l mt vn . Mt t l ln nhng ngi c phng vn khng i hc v
nhng tr ngi ny. T l hc sinh khuyt tt b hc c bit cao: Thi Bnh l 60%, Qung Nam/
Nng 46% v ng Nai 54%. Phn ln hc sinh b hc cp tiu hc v trung hc c s. Khuyt tt
l nguyn nhn chnh ch khng phi kinh t hay cc l do khc v nhng kh khn c nu ra nh
trn. ng lo ngi hn l c khong 25-30% s ngi c hi khng lm g trc nhng kh khn
m h gp phi hay ni cch khc, h t b con ng hc hnh ca mnh. Mt s khc c gng
chng chi vi hon cnh ca mnh bng cch ngh ngi khc t vn v gip , hoc dng cc
dng c h tr c th i li, hc tp v c gng thch nghi. H cho bit h tr cn thit nht l ci
tin phng php v k nng dy hc, h tr i li v min gim hc ph. Ci thin c s h tng, chm
dt k th v phn bit i x cng c coi l c vai tr quan trng.
Ngi khuyt tt cn c chm sc y t nhiu hn ngi bnh thng, nhng khng phi lc no h
cng c chm sc y . Khong 70-80% s ngi c hi tng b m v c tm kim dch v
y t; mt s ngi (c bit Thi Bnh) c thm khm ti nh, song vn c mt t l ln t chm
sc v iu tr. Khong mt na s ngi c hi cho bit h gp kh khn trong tip cn dch v y
t. Kh khn chnh l do chi ph iu tr. Tuy nhin, thiu phng tin i li thch hp, khong cch a
l xa, c ch quan liu, thiu cc dch v ph hp v phn bit i x cng c cho l cc l do chnh.
Trong khi mt b phn nh khng tm kim s gip na th phn ln vn ngh ngi khc gip
hoc t iu tr nh. H tr cn thit nht ngi khuyt tt gii quyt nhng kh khn m h
gp phi l min gim ph, c chnh sch v chng trnh c th p ng nhu cu ca ngi khuyt
tt, c s h tng thn thin vi ngi s dng, v gim bt quan liu. Mt t l ln ngi c phng
vn khng c bo him y t, dao ng t 28% Qung Nam- Nng n 60% ng Nai, nn chi
ph y t cao cn tr mong mun c cha tr ca h.
Vit Nam k Cng c Lin hp quc nm 2008 v quyn ca ngi khuyt tt v nm 2010 ban
hnh mt lut mi v ngi khuyt tt trong ghi r v s tham gia bnh ng ca ngi khuyt tt
trong x hi k c v tip cn y t v gio dc. Tuy nhin, ngi khuyt tt vn ang phi gng mnh
i ph v thch nghi vi nhng dch v y t v gio dc sn c, ch ngi cung cp dch v cha cm
thy sc p phi m bo rng dch v ca h l d dng tip cn i vi ngi khuyt tt v h phi
cung cp h tr ph hp m bo c hi tip cn bnh ng cho mi ngi dn.
78
TIP CN DCH V GIO DC

BT BNH NG TRONG TIP CN GIO
DC
T l nhp hc chung22 cp tiu hc gim t
105% nm 2006 xung 104,2% nm 2008. Gim nh
v t l nhp hc chung cp tiu hc l mt tn
hiu tch cc v n cho thy t l hc sinh i hc tiu
hc ng tui tng ln. Tuy nhin t l nhp hc

chung cp tiu hc vn rt cao vng Ty Bc v
cc dn tc thiu s nh Thi, Kh me, Hmng v
Dao, c ngha l nhiu tr em vng ny khng i
hc ng tui.23 T l nhp hc chung nm 2008 l
96% cp trung hc c s v 73,8% cp trung hc
ph thng. Trong mt nghin cu cho Bo co ny,
V Hong Linh c tnh t l nhp hc chung bc
i hc v cao ng tng gn gp i, t 18,3%
ln 30,2%, trong giai on 2004-2008.24
Bng 4.2: T l nhp hc chung giai on 2006-2008 (%)

Tiu hc
C nc
2006
2008
Trung h c s
2006
2008
105,0
104,2
92,5
95,9
Trung hc ph thng
2008
2006
69,9
73,8
Nng thn
101,2
101,1
91,8
95,9
65,1
70,0
Thnh th
106,0
105,1
94,8
96,9
87,1
86,9
Kinh/Hoa
103,4
103,3
97,6
97,4
77,2
78,3
Dn tc thiu s
112,3
108,2
88,4
88
53,9
47,9
Ngun: VHLSS 2006, 2008; V Hong Linh 2010
Tng iu tra dn s 2009 cng cho thy Vit Nam

gn hon thnh ph cp tiu hc, vi t l nhp
hc ng tui trn ton quc l 95,5%; 82,6% cp
trung hc c s v 56,7% trung hc ph thng.

Khong 16,3% dn s hc i hc.
Bng 4.3: T l nhp hc ng tui, 2009 (%)

Tiu hc
Trung hc c s
Trung hc ph thng
Cao ng
C nc
95,5
82,6
56,7
6,7
i hc
9,6
Thnh th
97,2
88,8
68,4
12,9
23,3
Nng thn
94,9
80,6
52,8
3,7
3,0
Ngho nht
88,9
59,0
23,2
0,3
0,3
Ngho
95,3
78,7
44,2
1,8
1,0
Trung bnh
97,0
86,7
56,1
7,8
5,5
Kh
97,5
89,6
64,6
8,6
10,6
Giu nht
98,3
94,9
82,3
11,6
26,3
Ngun: Tng iu tra dn s v nh 2009, trch dn trong TCTK 2011a
T l tr hc mu gio v nh tr vn tng i thp

so vi cc cp khc, vi t l 23% s tr 3 tui, 37%
s tr 4 tui v 40% s tr 5 tui i hc mu gio v
nh tr trong nm 2008.25
Mc d t c nhng kt qu tch cc, chnh
lch dai dng vn tip tc tn ti mi cp hc, gia
79
cc nhm kinh t-x hi khc nhau. V d trong nm

2006, khi c tch khong 57% tr em c i hc nh
tr v mu gio Vit Nam mt hnh thc o to
c bit quan trng i vi s pht trin ca tr, th
t l ny tr em ngi Kinh v Hoa l 61%, cn
tr em dn tc thiu s l 40%; tr em thnh th l
75%, cn tr em nng thn l 51%. So snh gia cc
vng ca Vit Nam: t l ny l 40% ng bng

sng Cu Long v 80% ng bng sng Hng.26
Chnh lch tng t cng xy ra cp tiu hc
cp hc c tr cp nhiu nht Vit Nam. T
l nhp hc ng tui cp ny l 88,9% i vi
ng phn v ngho nht, 98,3% i vi ng phn v
giu nht; 97% vi nhm ngi Kinh/Hoa, 72,6% vi
ngi Hmng; v dao ng t 92% vi vng Trung
du v Min ni pha Bc ti 98% vi vng ng
bng sng Hng.27
Khong cch tip tc m rng cc cp hc cao
hn: cp trung hc c s, t l nhp hc ng
tui l 59% ng phn v ngho nht v 95% ng
phn v giu nht. cp trung hc ph thng, t
l chnh lch l 59,1% (ng phn v ngho nht
l 23,2% v ng phn v giu nht l 82,3%). Xt
theo dn tc, t l nhp hc ng tui cp trung
hc c s l 86,7% vi ngi Kinh, 34,1% vi ngi
Hmng v 46,3% vi ngi Kh me. cp trung
hc ph thng, t l ny l 6,6% vi ngi Hmng,
15,4% vi ngi Kh me, trong khi ngi Kinh v

Hoa l 61,8%. So snh gia cc vng, ng bng
sng Cu Long c t l nhp hc ng tui l 71,5%
cp trung hc c s, trong khi t l ny ng
bng sng Hng l 93,9%. i vi cp trung hc
ph thng, chnh lch l 34,4% gia ng bng
sng Hng (74,9%) v ng bng sng Cu Long
(40,4%).
cp i hc v cao ng, gio dc tip tc dnh
cho nhng ngi kh gi hn. Nm 2009, t l nhp
hc ng tui cp ny ch l 0,6% ng phn v
ngho nht so vi 37,9% ng phn v giu nht;
di 1% i vi ngi Hmng v 2% vi ngi Kh
Me, so vi 18,8% ca ngi Kinh/Hoa; 5,7% vng
Trung du v min ni pha Bc so vi 27,1% vng
ng bng sng Hng. Mc chnh lch ny l rt
quan trng do mi quan h cht ch gia gio dc
bc cao vi cc k nng cn thit v c hi vic lm
cng nh thu nhp.
HP 4.3: CHNH LCH DAI DNG TRONG CC CNG NG DN

TC THIU S 28
Cc nhm dn tc thiu s tip tc i mt
vi cc ro cn ln trong tip cn dch v y
t v gio dc. iu tra c bn ca Chng
trnh 135-II nm 2007 cho thy tnh hnh
chung ca nhng kh khn ny v tc
ng ca chng i vi sc khe v gio
dc. Cc x thuc Chng trnh 135-II l nhng x ngho nht Vit Nam: t l i ngho l 26%
trong cc h gia nh ngi Kinh v Hoa so vi 51% trong cc nhm dn tc thiu s v 54% i vi
nhng ngi khng ni ting Vit. Bt bnh ng thu nhp cao v r rt vi h s Gini l 0,53; con
s ny l 0,43 i vi dn tc thiu s v 0,59 i vi dn tc Kinh v Hoa.
Cc h gia nh c xu hng coi

trng v u tin u t gio dc cho
con trai hn con gi.
Hu nh tt c cc x (97,7%) c trm y t x, 78,2% x c trng tiu hc, 66,9% c trng trung

hc c s; tuy nhin ch c 2,3% c trng trung hc ph thng. Khong 53% h gia nh tip cn
vi nc sch, v 13% c nh v sinh hp v sinh.
Kt qu l, t l nhp hc ng tui l 77,46% i vi cc trng tiu hc, 56,1% i vi cc trng
trung hc c s v 33,27% i vi trung hc ph thng. T l nhp hc ca cc dn tc thiu s
cc x ngho c kho st thp hn ng k so vi mc trung bnh ton quc.29 Ngoi ra, t l
nhp hc l rt thp trong mt s nhm, c bit l nhng ngi c kh nng ni ting Vit hn
ch, cng nh cc dn tc HMng, Bana, Hre v Kh Me.30
Tr em dn tc thiu s c t l b hc cao hn ng k, vi hu ht cc trng hp b hc xy ra
trong qu trnh chuyn tip t tiu hc ln trung hc c s v t trung hc c s ln trung hc ph
thng.31 iu ny c bit ng i vi tr em gi ngi dn tc thiu s do phi i mt vi hng
80
lot ro cn v gii trong tip cn gio dc. Cc h gia nh c xu hng coi trng v u tin u t
gio dc cho con trai hn con gi. Cc nguyn nhn khin t l b hc ca tr em gi dn tc thiu
s cao bao gm cc ro cn kinh t, s cn thit phi c tr em gi gip vic nh hoc lao ng,
nhn thc ca tr em gi v cha m cho rng gio dc khng c my gi tr, cht lng ging dy
v hc tp km ti cc trng hc, thiu c s h tng ph hp (chng hn k tc x v nh v sinh
ring cho nam v n).32 Trong khi d liu VHLSS 2008 cho thy cc nhm dn tc thiu s, tr em
gi ang bt kp tr em trai v bnh ng gii c ci thin bc tiu hc v trung hc c s, th
chnh lch gii li xut hin tr li cc bc hc cao hn trong mt s nhm dn tc thiu s. Ch
29% tr em gi dn tc min ni pha Bc trong tui 15-17 c i hc so vi 53% tr em trai.
i vi ngi Kh Me/Chm, t l ny l 22% tr em gi so vi 30% tr em trai trong nhm tui ny
c n trng.33
Theo iu tra Chng trnh 135-II, l do chnh khin tr em khng i hc l do qu tui (38%), trong
khi 17% ang i lm. Nhng tr ngi ln nht trong tip cn gio dc tiu hc l khng c s vt
cht v trang thit b, ngn sch trng hc hn ch v iu kin sng thiu thn ca gio vin, dn
n kh thu ht cn b c trnh . Hu ht hc sinh c min hc ph v cc khon ng gp
91% hc sinh trng tiu hc, 81% hc sinh trung hc c s v 69% hc sinh trung hc ph thng
- mt t l cao hn nhiu so vi mc trung bnh trong VHLSS 2006.34 iu ny gii thch ti sao mt
s hc sinh c th theo hc cc trng trung hc ph thng m khng c mt trng hc no
trong khu vc ca h. Tuy nhin, cc can thip gii quyt vn cht lng gio dc cn hn
ch. Ngoi ra, nhiu h gia nh cho bit vn cn gp kh khn v chi ph - 32,7% ni rng h thiu
tin np hc ph t l ny cc h dn tc thiu s l 37%.
Cc trung tm y t cc x ngho thng ch c trang b c s vt cht v cc loi thuc thit
yu nht, vi iu kin thp hn nhiu so vi mc trung bnh.35 a s nhng ngi b bnh hay b
thng n khm ti c s y t thn/bn hoc x ni h ang sng phi vt qua khong cch
trung bnh 3,87 km. C 17% cc trng hp c iu tr ti bnh vin c trang thit b tt hn
vi khong cch i li trung bnh l 39 km hoc 3 ting ng h bng phng tin cng cng, do
khong cch trung bnh ti bnh vin huyn l 27 km v ti bnh vin tnh l 91 km. Khong 30%
khng s dng bt k dch v y t c sn no, m ch da vo cc phng php khc nh t iu tr,
n cc c s y t t nhn hoc phng php truyn thng. Tuy nhin, iu tra ca Chng trnh
135-II cho bit rt t ngi trong cc nhm dn tc thiu s tip cn dch v y t: ch c 53% s dng
dch v y t cng v 47% trnh bt k iu tr no t cc dch v ny. Khong 84% s ngi c
kho st c bo him y t - 90% i vi ngi dn tc thiu s. Mc d bao ph ca bo him
y t cao, 48% h gia nh trong cc x 135 cho bit h khng c thuc t l ny l 52,7% i vi
cc h dn tc thiu s. Nhm ny c t l c bo him y t kh cao, nhng mc s dng dch v
y t cn thp; iu ny cho thy c th cc ro cn i vi tip cn dch v y t l rt ln v cc nh
hoch nh chnh sch cn lu iu ny.
i tng tham gia iu tra ban u ca Chng trnh 135-II cng c hi v nhn thc i vi mc
sng hin nay ca h. 51% h gia nh dn tc thiu s t nh gi mnh l ngho, trong khi con s
ny l t hn (28%) nhm h gia nh dn tc Kinh/Hoa. 53% s ngi c hi khng hi lng vi
mc sng hin nay, trong khi mt phn ba cho rng iu kin sng hin nay ca h bnh thng.
Khng c g l ngc nhin khi vi mc sng thp hn ng k, 56,6% h gia nh dn tc thiu s
khng hi lng vi mc sng ca h, trong khi t l ny l 46% h gia nh dn tc Kinh/Hoa.
81
CHNH LCH TRONG KT QU

GIO DC
TRNH HC VN V T L BIT CH
TRONG NHM NGI NGHO V DN TC
THIU S
T l ngi ln bit ch trn ton quc l 93,1%, v
t l ngi bit ch trong tui 10-40 nam v
n l nh nhau, 96%.36 Theo VHLSS 2008, mc d
21% ngi Vit Nam cha bao gi i hc hoc cha
bao gi c bng cp c bn nht, nhng c 23%
hon thnh gio dc tiu hc v 42% hon thnh
mt lp no ca gio dc trung hc. Ngy cng

c nhiu ngi Vit Nam c trnh gio dc cao
hn: 14% c trnh k thut hoc cao ng, i
hc trong nm 2008.37
T l bit ch ng phn v giu nht l 98%, cn
ng phn v ngho nht l 84,7%. 80,2% ph n
v 89,8% nam gii ng phn v ngho nht bit
ch, so vi 96,9% ph n v 99,2% nam gii trong
ng phn v giu nht. V hc vn, c s khc bit
ng k gia cc vng v nhm dn c. 36,7% ng
phn v ngho nht c trnh gio dc di tiu
hc, trong khi 35,4% ngi dn sng ng bng
sng Cu Long c trnh thp hn tiu hc, so vi
10,3% ng bng sng Hng nm 2008.38
Hnh 4.1: Trnh hc vn, 25-34 tui, 2008
Ngun: V Hong Linh 2010
Trong khi trnh hc vn ca nhng th h tr l

cao hn, th ngay c trong nhm 25-34 tui cng
c s khc bit ng k (Hnh 4.1). 40% ng phn
v ngho nht khng hon thnh gio dc tiu hc,
trong khi 53% ng phn v giu nht c trnh
cao ng, i hc hoc k thut. Tng t nh vy,
49% ngi dn tc thiu s khng hon thnh bc
tiu hc, trong khi 24% ngi Kinh/Hoa c bng k

thut hoc cao ng, i hc. S phn ha cng r
rt gia cc vng: tui 25-34 ng bng sng
Hng c trnh hc vn cao nht, trong khi tui
ny Ty Nguyn v ng bng sng Cu Long c
trnh hc vn thp nht.39
82
T L B HC V T L TT NGHIP THEO
VNG
T l b hc v t l tt nghip cho php nh gi
chnh xc hn v kt qu gio dc so vi t l nhp
hc, v cc t l ny dng nh cng khng nh
l c s khc bit ng k trong kt qu gio dc
gia cc nhm dn khc nhau v gia cc vng
Vit Nam. T l hon thnh tiu hc rt khc nhau
theo vng, t 80,3% ti Ty Bc n 93,9% ti ng
Nam B trong nm hc 2008-2009.40 T l tt nghip
trung hc ph thng cho thy s khc bit tng t,
vi 91,9% tt nghip trung hc ph thng ng
bng sng Hng, so vi 75,1% ng bng sng
Cu Long.41 Tng t, phn tch d liu Tng iu
tra dn s nm 2009 cho thy s khc bit ng k
v t l hc sinh b hc gia cc vng: ng bng
sng Hng c t l b hc gim nhiu nht trong
nhm 5-18 tui trong giai on 1989-2009, v c t
l b hc thp nht trong nm 2009. Tuy nhin, cc
vng pha Nam c t l b hc gim chm hn v
li c t l b hc cao hn trong nm 2009, c bit
l ng Nam B v ng bng sng Cu Long. T
l tt nghip trung hc v sau trung hc cao hn
nhiu ng bng sng Hng, v thp hn ng k
ng bng sng Cu Long v Ty Nguyn. Trong
khi t l b hc gim t 17,1% nm 1999 xung
15,5% nm 2009, khu vc thnh th t l b hc l
11,3% v khu vc nng thn l 16,9% nm 2009, so
vi con s tng ng l 13,3% v 18% nm 199942.
khu vc nng thn, t l ny nm trong khong
10% vi n v 11,1% vi nam vng ng bng
Sng Hng, v 22% vi n v 24,3% vi nam ng
bng sng Cu Long; trong khi th, t l ny
dao ng t 5,5% vi nam v 5,6% vi n ng
bng sng Hng ti 17,6% vi nam v 16,4% vi n
ng bng sng Cu Long.43
KHONG CCH GII TRONG GIO DC

Cn bng gii th hin r rt trong gio dc tiu hc
nm 2008; v t l nhp hc ng tui ca n cao
hn mt cht tt c cc bc hc khc - gm c
gio dc i hc. Nm 2008, 22,4% n ang hc
cao ng, i hc, so vi 19,8% nam.44 y l mt
tin b tch cc. Tuy nhin, phn b theo lnh vc
hc cho thy s khc bit theo gii ng k, theo
cng c quan h cht ch vi s khc bit v gii
trn th trng lao ng xt theo ngh nghip v
ngnh. Nam gii c xu hng chuyn v k thut,
sn xut v xy dng, trong khi ph n li chuyn
v khoa hc x hi, gio dc, khoa hc nhn vn v
ngh thut.45
Trong khi khong cch gii cc vng v cc nhm
dn tc thiu s ni chung gim theo hng c
83
li cho tr em gi v ph n, th tnh hnh li khc

vng Ty Bc, vi 53% tr em gi tui t 15-17 nhp
hc so vi 68% tr em trai. Trong cc nhm dn
tc thiu s, ch c ngi Kh Me/Chm v nhm
dn tc min ni pha Bc c t l nhp hc ca tr
em gi thp hn trong nm 2008.46 Ngoi ra, mc
d khong cch gii trong gio dc gim dn,
khong cch v t l ngi ln bit ch vn cn tn
ti nhm ph n ln tui, nhm dn tc thiu s
cng nh ng phn v ngho nht. V hc vn,
ph n tui 25-34 c t l hc tiu hc hoc
di tiu hc cao hn mt cht so vi nam gii
(50% n so vi 43% nam). T l nam v n c trnh
i hc l nh nhau, cng mc 10,3%, nhng
t l nam gii c trnh chuyn mn k thut hoc
gio dc trung hc l cao hn ph n, vi 13% so
vi 8% (k thut) v 33% so vi 30% (trung hc c s
hoc trung hc ph thng).
IU KIN KINH T V DN TC TRONG

TIP CN GIO DC
Phn tch hi quy ca V Hong Linh cho Bo co Pht
trin Con ngi ca Vit Nam nm 2011 gii thch mt s
yu t dn ti s khc bit v kt qu nhp hc nm 2008
cp sau tiu hc.47 Theo phn tch ny, Trnh hc vn
ca cha m c tc ng ng k n vic nhp hc
Trnh hc vn ca cha m c tc ng
ng k n vic nhp hc.
vi trnh hc vn ca b c vai tr quan trng
cp trung hc c s, v trnh hc vn ca c hai b
m c lin quan n gio dc trung hc ph thng
v cao ng, i hc. Quy m h gia nh cng c lin
quan: cc h gia nh nh hn (nhng h c t ngi
ph thuc hn) c nhiu kh nng cho con ci i hc,
do h c nhiu ngun lc cho gio dc hn. Khng
ngc nhin khi chi tiu bnh qun u ngi c lin
quan cht ch vi t l nhp hc tt c cc cp, v
c tc ng quan trng hn cc bc hc cao hn.
Cui cng, dn tc l mt yu t quan trng cc
bc hc cao hn, c bit l trung hc ph thng
v cao ng, i hc, mt phn do nhng kh khn
khi phi cnh tranh trong cc k thi tuyn sinh v cht
lng ging dy km cc bc hc thp hn v v ro
cn ngn ng, nh tho lun trong Chng 5.48
Nh phn tch cho thy, chnh lch trong tip cn
dch v y t v gio dc c lin quan cht ch vi cc
kt qu y t v gio dc, bao gm c cc ch s chnh
trong HDI v ton b cc ch s pht trin con ngi.
Nhng chnh lch ny ko di dai dng v ph bin
gia cc tnh v vng, gia cc dn tc thiu s v
a s (Kinh/Hoa), v gia cc nhm thu nhp. S
chnh lch ny cn xut hin trn kha cnh gii,
c bit l trong gio dc, mc d khong cch gii

c thu hp cp tiu hc v trung hc c s.
Bt cng bng trong tip cn y t v gio dc gp
phn cng c v duy tr s bt bnh ng hin nay
gia cc nhm dn tc, cc nhm kinh t-x hi v
cc khu vc a l.
Bt cng bng trong tip cn y t v gio

dc gp phn cng c v duy tr s bt bnh
ng hin nay gia cc nhm dn tc, cc
nhm kinh t-x hi v cc khu vc a l.
Theo thi gian, nhng thiu thn trong pht trin

con ngi tr nn c th v kh thay i hn: y l
mt kinh nghim ca Vit Nam trong xo i gim
ngho cc cng ng dn tc thiu s v vng
su vng xa. Thiu tip cn vi cc dch v x hi c
bn khin khng c ng thot khi i ngho v
kh khn, hng ti mc cao v cc c hi la
chn, nng lc v pht trin con ngi. Do , quan
trng hn ht l Vit Nam phi gii quyt cc ro cn
chnh v tnh sn c ca cc dch v, chi ph tng,
cht lng km v kh p ng ca cc dch v x
hi, nh Chng 5 phn tch.
HP 4.4 CHNH LCH V TIP CN Y T, GIO DC TRONG

NHM DI C
i vi ngi di c t nng thn ra thnh th, tip cn dch v y t v gio dc ph thuc nhiu
vo h thng ng k h khu, trong c bn loi ng k. l nhng c dn chnh gc ti
a bn sinh sng (KT1), ngi ng k trong cng mt tnh, nhng hin ang sng mt huyn/
qun khc (KT2), ngi ng k ti mt tnh, nhng c php c tr lu di ti mt tnh khc
(KT3); ngi lao ng theo ma v sinh vin sng tm thi mt tnh khc vi tnh ng k h
khu (KT4). Ngi di c khng ng k l nhng ngi vn cn tn trong h khu gia nh cc
x, phng gc nhng trn thc t li sng tm thi hoc lu di ti mt huyn hoc tnh khc m
cha ng k. Khi ngi di c mt h s ng k ban u, h s rt kh c th ng k mt ni
khc: trn thc t, h khng c giy t.49
Con em ca c dn KT1 v KT2 c u tin
hc ti cc trng tt ca nh nc, cn con
Nhiu ngi lao ng di c ngho
em ca ngi di c KT3 v KT4 ch c th hc
sng trong iu kin nh ti tn
nhng trng cn li. Nhng ngi di c
v cc khu nh c thu nhp thp,
v nhng ngi khng ng k h khu c
phi i mt vi ro cn ng k
hai la chn: hoc xin vo cc trng bn
trong tip cn v bo m v quyn
cng hoc t thc vi hc ph cao hn, hoc
s dng t, s hu nh , cng nh
tr thm tin con ca h c nhn vo
cc dch v in, nc v v sinh.
cc trng cng. Tng t nh vy, ngi di
c khng c h khu ti ni mi v nhng
ngi KT3 v KT4 thng khng iu kin
c hng cc dch v x hi trong cc chng trnh xo i gim ngho quc gia, bao gm
c cc khon vay li sut thp, khm cha bnh min ph v min hc ph. Nhiu ngi lao ng
di c ngho sng trong iu kin nh ti tn v cc khu nh c thu nhp thp, phi i mt vi
ro cn ng k trong tip cn v bo m v quyn s dng t, s hu nh , cng nh cc dch
v in, nc v v sinh.
Ngi di c lm vic trong cc khu cng nghip v khu ch xut - chim 70% lc lng lao ng
ti cc khu vc ny, thng khng ng k h khu v thay i vic lm thng xuyn nhng
kh khn chnh ca h khng trc tip lin quan n h khu. Thay vo , mc lng thp, nh
ti tn v chi ph sng cao tc ng trc tip kh nng chm sc sc khe v phc li ca h.
Thng th cc cng nhn ng vi ch lao ng khng trch np bo him x hi t tin lng
ca h, h chi tiu rt t cho n ung v chm sc sc khe; phi tr chi ph cho nh v in cao
hn mc trung bnh. H thng d b tn thng do thu nhp khng n nh, lm vic trong iu
kin khng an ton v iu kin sng thiu thn.
84
Lao ng khng chnh thc th lm vic trong cc lnh vc nh xy dng him khi ng k v
hay di chuyn. Phn ln h khng th p ng cc tiu chun nhp h khu nn con ci i hc
gp kh khn. Mt i din ca U ban Nhn dn TP HCM ni: Nu khng c giy khai sinh, cc em
khng iu kin c khm cha bnh min ph (cho tr em di 6 tui) hoc ng k tiu hc.
Cc trng t vi tiu chun cht lng thp hn c th chp nhn nhng tr em khng c giy
khai sinh song vi mc hc ph cao hn. Nhng tr em ny l cng dn Vit Nam nhng khng c
i x nh cng dn ca Vit Nam. S tr em ny chim khong 5-10% tr em di c thnh ph ny.
Thng thng nhng ngi di c ti th hoc s phi tr l ph cao con ci i hc ti cc trng
t thc hoc c gng s dng cc mi quan h x hi v tr thm chi ph xin hc ti trng cng
lp. Nhiu ngi di c con ci ca h li qu vi gia nh hoc hng xm v chuyn tin kim
c v h tr hc hnh v chm sc cho con ci. Cch thc ny gy cng thng ln v tnh cm
gia ngi di c v con ci h. Mt ph n bn rong 34 tui TP H Ch Minh ni: Ti gi v mt
khon tin v cha m ti trang tri hc ph v chi ph sinh hot ca con ti, v mt khon h
tr cha m ti chm sc con ti. i khi ti cm thy thng con v n phi xa m, nhng nu ti
khng lm vic y ti s khng c tin cho n. Chng ti s khng c tin n, ch cha ni g
n n ngon vi tht, sa,...
Nhng ngi di c c vic lm, quan h v
Ngi di c thng phi chi tr cho
iu kin sng tt c th c hng li t
v th KT3 tr thnh c dn thng tr,
cc dch v y t nhiu hn ng k, do
nhng ngi di c ny kh gi hn v c th
h khng c bo him y t hoc
tr thm chi ph tip cn cc dch v x hi.
trnh chm tr trong tip cn
Tuy nhin, ngay c nhng c dn thng tr
dch v y t.
cng khng s dng th khm cha bnh
tip cn dch v y t. Theo mt i din Ban
Tuyn gio trung ng: Ngi dn, bt k tnh trng di c, t khi s dng th bo him y t cho vic
khm cha bnh, do cht lng dch v dnh cho ngi s dng bo him y t rt km. Ti cc bnh
vin trung tm thnh ph, trn 50% s bnh nhn n t cc tnh v a s s dng knh y t ngoi
bo him c cht lng iu tr tt hn.
Ngi di c cc khu vc th thng c sc khe km hn v tnh trng sc khe ca h xu
i nhanh hn nhng c dn thng tr. Cc vn v sc khe t mt gnh nng ln ln ngi
di c, c bit l nhng ngi lm vic trong khu vc khng chnh thc vi tin cng thp. Nhiu
ngi trnh s dng cc dch v y t do chi ph cao. Mt n cng nhn ni trong mt cuc tho lun
nhm TP H Ch Minh: i vin rt tn km. Chng ti ch n bnh vin nu chng ti cm thy
bnh nng hoc lo lng. i vi cc bnh thng thng chng ti ch mua thuc ti cc hiu thuc.
Nhng ngi bn thuc cng c th cho chng ti li khuyn nn s dng thuc no.
Ngi di c thng phi chi tr cho cc dch v y t nhiu hn ng k, do h khng c bo him y
t hoc trnh chm tr trong tip cn dch v y t. Nhng ngi KT4 hoc nhng ngi khng
ng k h khu thng khng c th bo him y t cho con ci v khng nhn c cc thng
tin hoc chng trnh ung vitamin hoc tim vc xin. Thi ca cc nhn vin y t i vi nhng
ngi s dng th bo him y t cng l mt l do khin ngi dn s dng dch v ngoi bo
him. Nhm tho lun c c nam v n cng nhn TP H Ch Minh cho bit: Nu s dng dch v
bo him ca bnh vin, chng ti khng ch phi i lu m thi ca nhn vin bnh vin cng
khng tt. H c xu hng l chng ti i, bt chng ti ch i v i khi h khng lch s lm.
Nu chng ti s dng dch v c bn, khng qua bo him hoc n cc phng khm t nhn th
hon ton khc. Nu s dng th bo him y t, chng ti ch c th nhn c dch v km hoc
c cp cc loi thuc r tin.
85
86
5
Chng 5
CHNH SCH V
CUNG CP TI CHNH
CHO DCH V X HI
CC KHUN KH CHNH SCH
CAM KT CHNH SCH V TIP CN TON
DN
Nh Chng 4 cho thy, vn tn ti chnh lch ng k
trong tip cn y t v gio dc, c bit gio dc bc
cao. Chng ny phn tch cc yu t chnh gp phn
to nn cc chnh lch ny, bao gm c khun kh v
nh hng chnh sch, ti chnh cho y t v gio dc,
cung cp v cht lng dch v x hi c bn ti Vit
Nam. Chng ny lp lun rng mc d mc tiu nu
trong cc chnh sch ca Vit Nam l to kh nng tip
cn ph cp vi cc dch v x hi cho tt c ngi dn
Vit Nam, tnh hnh cung cp dch v x hi Vit Nam
hin nay dng nh ang gy bt bnh ng ko di v
gia tng. y l mt thch thc i vi kht vng pht
trin con ngi ln mc cao hn ca Vit Nam.
cp chnh sch, Vit Nam cam kt

m bo tip cn ph cp dch v x hi,
c bit l gio dc v y t.
cp chnh sch, Vit Nam cam kt m bo tip
cn ph cp dch v x hi, c bit l gio dc v
y t, nhm t c mc pht trin con ngi
cao hn v t c cc mc tiu pht trin ca Vit
Nam. Cam kt chnh sch mnh m ca Vit Nam v
tip cn ph cp th hin r trong nhiu vn bn
v khun kh chnh sch x hi quan trng. V d
theo Ngh nh 26/2005/N-PC v lut Bo v, chm
sc sc khe v gio dc tr em nm 2005, chm
sc sc khe c xem l mt quyn c bn v tr
em di 6 tui c hng cc dch v y t min
ph. Lut Bo him y t c thng qua nm 2009
nhm m bo tip cn ph cp dch v y t bng
cch m rng bo him y t ton dn vo nm 2014.
Chng trnh Mc tiu quc gia v gio dc cam kt

Vit Nam t ph cp gio dc c bn, bao gm gio
dc mm non, tiu hc, trung hc c s v gio dc
khng chnh quy.
Tuy nhin, trong khi chnh sch ca Vit Nam tip tc
cam kt tip cn ton dn i vi cc dch v gio
dc v y t, trn thc t chnh ph da vo h tr
chn lc m bo nhng ngi d b tn thng
v thit thi nht c th tip cn cc dch v c bn,
bao gm c thng qua cc chng trnh gim ngho
ln. Cc chng trnh ny bao gm Chng trnh
Mc tiu quc gia v xa i gim ngho v Chng
trnh Pht trin kinh t x hi cc x c bit kh
khn ti cc vng ng bo dn tc v min ni
(Chng trnh 135-I v 135-II). Ngoi ra, mt c im
chnh trong cch tip cn chnh sch ca Vit Nam
v cung cp dch v x hi l chnh sch x hi ha,
nhm m bo tnh bn vng ca ngun ti chnh v
vic cung cp cc dch v x hi. Can thip chnh sch
ch yu th ba l phn cp vic qun l dch v x hi
cho cc t chc cung cp dch v. Nh Chng ny
cho thy, trn thc t, mi phng php tip cn u
to ra nhng thch thc trong vic bo m tip cn
ph cp vi dch v x hi c cht lng cho tt c
ngi dn Vit Nam.
PH CP HAY H TR CHN LC
K t khi i mi, mc d c cam kt chnh tr v
chnh sch v tip cn ph cp, chnh ph ngy
cng chuyn trch nhim cung cp dch v v ti
chnh cho y t v gio dc t nh nc v khu vc
cng sang cho khu vc t nhn v h gia nh. Trn
thc t, iu ny th hin s thay i t ph cp sang
vic cung cp cc mng li an sinh trong chnh
ph ch yu h tr nhng ngi thiu thn nht,
ng thi vic cung cp dch v da vo th trng
v chi tr ca h gia nh ng mt vai tr ln hn.1
Chnh sch v cung cp ti chnh cho dch v x hi
88
Trn l thuyt, khng c vn g khi kt hp cc

nguyn tc ph cp vi h tr chn lc bng cch
bo m mi cng dn c tip cn vi mc sn
ca dch v y t v gio dc, ng thi hng ti cc
nhm c th gii quyt tnh trng kh khn, bt
bnh ng v bo m h c th tip cn cc dch
v trn thc t. H tr chn lc cng gip ti a ha
li nhun trn vn u t, v d nh m bo phng
nga v can thip sm cho cc nhm dn c th.
Hu ht cc quc gia u cao vic kt hp cc
chnh sch x hi theo nhm i tng vi ph cp2,
v cc ti liu chnh sch x hi khng kt lun chc
chn v cu hi liu ph cp hay h tr chn lc l
la chn hiu qu hn.3
v min ph. V vy, m bo tip cn cng bng

cc dch v x hi, Vit Nam cn trnh cc chng
trnh nhm vo cc i tng mc tiu, m nn
hng ti mt h thng an sinh x hi ph cp. H
thng ny c th h tr ngi dn trong nhiu hon
cnh khc nhau, gip gim nh cc c sc v kinh
t, mi trng v sc khe, cng nh h tr v bo
v cc nhm d b tn thng v thit thi nht.5
lm nh vy, Vit Nam c th hc hi t cc nc
khc trong khu vc c mc an sinh x hi cao hn
v tin ti ph cp, nh Nht Bn, i Loan, Hn
Quc v Thi Lan. Cc quc gia ny cng c mc
pht trin con ngi cao hn nh o lng bng
HDI v cc ch s pht trin con ngi khc.6
Tip cn ph cp cc dch v x hi cng

l mt nguyn tc chnh v quyn con
ngi v l iu kin tin quyt thc
y pht trin con ngi mt cch
cng bng.
H THNG PHC LI V TR CP PHC TP
D hiu qu hay khng th tip cn ph cp cc dch

v x hi cng l mt nguyn tc chnh v quyn
con ngi v l iu kin tin quyt thc y pht
trin con ngi mt cch cng bng. Tip cn ph
cp cc dch v x hi cng l mt nguyn tc chnh
v quyn con ngi v l iu kin tin quyt thc
y pht trin con ngi mt cch cng bng.
ng thi, trong bt k h thng y t v gio dc no
cng cn cc h tr theo i tng mc tiu nh dy
tr em dn tc thiu s bng ting m , o to n
h sinh n t cc cng ng dn tc thiu s, vng
su vng xa, tim chng cho tr nh, m bo ph
n mang thai c th tip cn chm sc thai nghn ti
cng ng ni h sinh sng.
Vn l h thng y t v gio dc hin nay ca Vit
Nam cha cung cp c mt mc sn dch v
gio dc v y t c bn cho mi ngi dn v km
theo h tr chn lc cho cc i tng mc tiu.
Trn thc t, vic tip cn cc dch v ngy cng ph
thuc vo ph thu t ngi s dng, to ra mt gnh
nng ln cho nhng ngi c hon cnh kh khn
hoc c thu nhp thp, khin h khng th tip cn
dch v ti a phng.4 Trong khi tr cp c dnh
cho nhng ngi cn h tr nht thng qua mt
lot cc chng trnh ca chnh ph, vn cn nhng
chng cho v khong trng v i tng bao ph.
Ngoi ra, vic xc nh i tng mc tiu hin nay, v
d thng qua cc chng trnh xo i gim ngho
ang gp phn to nn mt h thng dch v hai
cp. Kt qu l mc dch v gio dc v chm sc
sc khe dnh cho ngi c kh nng tr ph khc
hn so vi dch v dnh cho ngi ngho v ngi
c hon cnh kh khn thng qua cc khon tr cp
89
Cc khun kh chnh sch ca Vit Nam th hin

cam kt mnh m ca quc gia v tip cn ph cp
cc dch v x hi. Tuy nhin vn cn khong cch
ln gia chnh sch v thc hin. H thng phc
li hin c trong cc chng trnh an sinh x hi v
gim ngho ca Vit Nam (bao gm c cc chng
trnh tr cp cho tip cn cc dch v y t v gio
dc) rt phc tp, chng cho, v khng phi lc
no cng hiu qu trong vic tip cn nhng ngi
cn nht. V d, mt nh gi nm 2009 ca y ban
cc vn x hi ca quc hi v cc chng trnh
gim ngho ca Vit Nam pht hin 75 can
thip chnh trn mt lot cc lnh vc khc nhau.
nh gi ny cng pht hin 14 d n v tiu
hp phn h tr tip cn gio dc m phn ln
nm ngoi gio dc ph thng v Chng trnh
quc gia v ph cp gio dc. Ngoi ra cn c 7
chng trnh h tr tip cn o to ngh. 5 can
thip c lin quan n sc khe, cha k cc can
thip nhm ci thin tip cn nc sch v v sinh.
Hu ht cc can thip nhm m bo kh nng
tip cn cho cc nhm dn ngho v dn tc thiu
s, cng nh pht trin c s h tng trong cc lnh
vc y t v gio dc.7
mt mc nht nh, Lut Bo him y t
hp l ha v n gin ha cc khon tr cp
h tr tip cn chm sc sc khe, song cc vn
v cht lng v kh nng chi tr vn tn ti. Tng
tip cn bo him y t gip kim ch bt bnh
ng trong tip cn cc dch v m nu khng c
lut ny th tnh hnh c th trm trng hn. Din
bao ph bo him y t ngy cng tng, nh ,
vo nm 2010 c tnh 61% dn s c bo
him y t.8 Tuy nhin, Vit Nam vn khng th t
c bo him y t ton dn vo nm 2014 (xem
Hp 5.4). Do mc phc li thp ca cc chng
trnh gim ngho, ngay c bo him y t ph cp
cng khng m bo tip cn ton dn i
vi cc dch v y t. Cc khon tr cp thng qua

cc chng trnh khc nhau h tr tip cn
gio dc, c bit l cp tiu hc v trung hc
c s, dng nh khng b p chi ph tng
cao ca trng hc v cc ro cn khc. Nh tho
lun trong Chng 4, c nhng du hiu ca s

chnh lch ln gia cc nhm kinh t-x hi v cc
vng v t l nhp hc v t l hon thnh bc hc,
mt phn do chi ph tng cao i vi cc h gia
nh, ngay c cho gio dc c bn.
Bng 5.1: Cc chnh sch quc gia chnh c iu khon tc ng n tip cn

dch v y t, gio dc
Chnh sch/ can thip
Khun kh chnh sch hoc

php l
Nhm i tng mc tiu 9
Khm cha bnh

min ph cho tr em
di 6 tui
Ngh nh s 36/2005/
N-CP, Lut Bo tr, chm
sc v gio dc tr em;
Lut Bo him y t
Tt c tr em di 6 tui c hng dch v y t min ph ti cc c

s cng cng. Nay c trong Bo him y t x hi.
Bo him y t
Khm cha bnh cho

ngi ngho (Quyt nh
39/2002/Q-TTg ngy
15/10/2002); Lut Bo
him y t 2008
1. Nhng ngi lm vic trong cc doanh nghip chnh thc v khu

vc nh nc c hng ch bo him y t bt buc nh mt
phn ca bo him x hi bt buc.
2. Cc nhm dn c c th c hng bo him y t min ph hoc
tr gi. Cc nhm ny gm tr em di 6 tui (xem trn), ngi
ngho, ngi v hu, cu chin binh... Chnh sch bo him y t x
hi mi theo Lut Bo him y t bao gm ni dung khm cha
bnh cho ngi ngho v tr em di 6 tui.
3. Bo him y t t nguyn bao gm nhng ngi khng iu kin
theo mc 1 v 2, gm sinh vin, nng dn, ngi lao ng khng chnh
thc,... Din bao ph vn cn hn ch. Ph tham gia bo him cho
nhng ngi khng phi sinh vin l 4,5-6% lng ti thiu. C cc ch
u i ti chnh cho nhng ngi cn ngho tham gia bo him. Tr
cp mt phn (50%) dnh cho cc h cn ngho.
Bo him x hi bt
buc
Lut Bo him x hi
2006
Bo him x hi bt buc gm cc phc li v lng hu cng nh

bo him y t bt buc (xem trn), tr cp thai sn, bo him tai nn
ngh nghip v khuyt tt. Cng nhn c hp ng chnh thc c
bo him, bao gm c cng chc, vin chc ca Chnh ph, ngi lao
ng c hp ng lao ng trn 3 thng, s quan qun i v cnh
st, cn b, nhn vin trong cc c quan ca ng.
Chng trnh mc
tiu quc gia v Xa
i gim ngho
(CTMTQG-XGN)
Quyt nh 20/2007/
Q-TTg ngy 05/02/2007
Chun ngho ca B LTBXH c s dng xc nh cc i tng

hng li. Theo Chng trnh Mc tiu quc gia, cc h gia nh thuc
nhm mc tiu c h tr dy ngh, y t v gio dc. H tr ca chng
trnh cng bao gm th khm cha bnh, h tr v tin mt hoc min
hc ph, cc khon cho hc sinh/sinh vin vay, hc bng v pht trin c
s h tng (trng hc, bnh vin v c s y t).
Chng trnh kinh t-x Quyt nh s 07/2006/

hi cho cc x c bit Q-TTg ngy 10/1/2006
kh khn min ni v
vng ng bo dn tc
thiu s (Chng trnh
135 II)
Cc x c chn trn c s a bn, dn tc, t l i ngho,v.v.

Pht trin c s h tng (trng hc v c s y t); dy ngh.
Chng trnh Gim

ngho nhanh v bn
vng cho 62 huyn
ngho nht (Chng
trnh 62 huyn)
Ngh quyt 30a
H tr trc tip cho gio dc, h tr tin mt v min hc ph, o to

ngh cho ngi ngho, pht trin c s h tng (trng hc, bnh
vin v c s y t).
Chng trnh khc
Thng t 109/2009/
TTLT-BTC-BGDT ngy
29/5/2009; (Thng t s
43/2007/TTLT-BTC-BGDT
ngy 2/5/2007
H tr hc sinh ca cc trng dn tc ni tr. Hc bng v tr gip x

hi cho hc sinh/sinh vin dn tc thiu s.
Ngun: o Th Hong Mai 2010, Jones v Nguyn Ngc Anh 2010, y ban Cc vn x hi ca Quc hi 2009
90
BO TR X HI Vit Nam
Vit Nam u t cho bo tr x hi t hn cc nc khc
trong khu vc, nhng li c s ngi c bo tr x hi
trn mc trung bnh. Mc d Vit Nam u t khong
4,1% GDP cho an sinh x hi, nhiu hn so vi Indonesia,
Philippines v Malaysia, nhng vn thp hn mc trung
bnh ca khu vc chu l 4,8%, v thp hn cc nc
nh Trung Quc 4,6%, Hn Quc 7,5% v Nht Bn
16%.10 c tnh 71% ngi ngho Vit Nam nhn c
t nht mt hnh thc an sinh x hi, cao hn kh nhiu
so vi mc trung bnh 56% ca chu . 11 Cc chng
trnh gim ngho tng i thnh cng trong vic
tip cn i tng mc tiu, vi 84% h ngho c
min ph y t v 51% c min ph gio dc trong
nm 2008.12 Tuy nhin, cch xc nh i tng mc
tiu ca cc chng trnh ny vn cn c vn .
c tnh 71% ngi ngho Vit Nam

nhn c t nht mt hnh thc an sinh
x hi, cao hn kh nhiu so vi mc
trung bnh 56% ca chu .
Cc chng trnh gim ngho s dng chun ngho
tin t xc nh iu kin hng li; trong giai
on 2006-2010 chun ngho ca chnh ph ch l
200.000 ng/thng i vi khu vc nng thn v
260.000 ng/thng i vi khu vc th. Nhiu
ngi Vit Nam sng gn hoc ngay trn chun
ngho d b ti ngho do hu qu ca nhng c sc
nh bnh tt, kinh t suy thoi, tn tt hoc thin
tai, nhng khng c h tr.13 Nh nu trong
Chng 2, chun ngho chnh thc ca Vit Nam
thp hn nhiu so vi hu ht cc nc khc trong
khu vc, ngoi tr Trung Quc. Vit Nam gn y
a ra mt chun ngho mi trong bao gm c
ngng cho ngi ngho v ngi cn ngho
ph hp vi chi ph sinh hot gia tng v tng din
91
bao ph.14 Tuy nhin, nhng nhm nht nh, chng

hn nh ngi di c khng c h khu, vn nm
ngoi din c chnh ph tr gip. Ngoi ra, cc
cng c o lng i ngho a chiu l tng i
mi v cha c chp nhn nh mt cch hiu qu
hn xc nh h tr cho ngi ngho v ngi
thit thi. Cc ch s ny bao gm Ch s ngho i
a chiu mi c a ra trong Bo co Pht trin
Con ngi ton cu nm 2010, T l ngho tr em v
Ch s ngho i con ngi nh tho lun trong
Chng 3.
CHNH SCH X HI HA
Trc i mi, Nh nc chu trch nhim cp vn v
cung cp cc dch v y t v gio dc. Tuy nhin, sau
khng hong ti chnh ca Vit Nam vo cui nhng
nm 1980 do qu trnh chuyn i t k hoch ha
tp trung sang nh hng th trng, Nh nc
khng kh nng ti tr v cung cp dch v cho
tt c ngi dn Vit Nam. Cn c mt gii php cho
vn ny. Chnh sch x hi ha (Hp 5.1) th hin
n lc ca Vit Nam trong vic tm kim gii php .
Tt c mi thnh phn trong x hi u ng gp v
cung cp cc dch v x hi. Tuy nhin, trong thc t,
x hi ha Vit Nam c ngha l s tham gia nhiu
hn ca khu vc t nhn trong vic cung cp cc
dch v x hi, ca cc h gia nh trong chi tr cho
y t v gio dc, cng nh l s thng mi ha cc
dch v y t v gio dc cng.
X hi ha Vit Nam c ngha l s

tham gia nhiu hn ca khu vc t nhn
trong vic cung cp cc dch v x hi,
ca cc h gia nh trong chi tr cho y t
v gio dc, cng nh l s thng mi
ha cc dch v y t v gio dc cng.
HP 5.1: CHNH SCH X HI HA 15

Trc i mi vo nm 1989, mi cng dn c hng cc dch v y t v gio dc min ph. Cc h
thng y t v gio dc quc gia u l dch v cng,16 c cp kinh ph thng qua ngn sch trung ng
v cung cp bi cc n v a phng, gm c doanh nghip nh nc, n v hnh chnh, hp tc x
nng nghip. Mc d kh nng tip cn v cht lng dch v b hn ch do thiu kinh ph, Vit Nam
t c mc tip cn y n tng v cc kt qu y t, gio dc cao hn so vi cc nc khc c mc
thu nhp tng ng. Cc c ch ny vn c hiu lc cho n cui nhng nm 1980, khi nhng iu kin
thiu thn chung v kinh t li tip tc b nh hng bi ca cuc khng hong ti chnh nm 1989. Cuc
khng hong lm suy yu cc chc nng ca nh nc bao gm c cung cp cc dch v y t v gio dc,
y nhanh ci cch th trng v bo trc s chuyn i t c quyn cung cp v thanh ton cng sang
cc c ch a dng hn v th ch v ti chnh.
i mt vi cuc khng hong ti chnh, nh nc Vit Nam thiu cc ngun lc ti chnh duy tr h
thng gio dc v y t da hon ton vo ngn sch cng. Do , cc chnh sch x hi ca Vit Nam
tri qua mt cuc ti c cu mang tnh quyt nh. Qu trnh ny c h tr bng vic p dng chnh sch
x hi ha. Vo u nm 1989, cc nh lnh o tm kim mt phng cch m rng thanh ton ngoi
nh nc cho cc dch v thit yu v bt u vn ng cho chng trnh ngh s chnh sch c gi l
x hi ha. Ban u, x hi ha c d tnh nh mt chin lc huy ng x hi, ku gi tt c cc
lnh vc x hi ng gp vo gio dc, y t. Chnh sch ny ra trch nhim ca cc ch th trong x hi:
ngi dn, cc t chc on th, khu vc t nhn cng tham gia; nh nc ng vai tr hoch nh chnh
sch, iu phi ngun lc v m bo thi hnh nhm m bo cht lng, hiu qu v cng bng.17 Theo
mt quan chc y t lu nm v l mt trong nhng kin trc s ca chnh sch x hi ha:
Khi nim x hi ha phi c hiu nh mt s hp tc hiu qu v c k hoch ca tt c cc lc lng
x hi theo mt hng v mt chin lc quc gia nhm gii quyt mt vn x hi... i vi mi cng
ng, gia nh, cng dn, x hi ha c hiu l mt qu trnh hng ng v tham gia phong tro vn
ng ca cc nh lnh o, sau tr thnh mt qu trnh hot ng tch cc v c thc v li ch ci thin
cht lng cuc sng ca ring mnh... X hi ho c hiu nh mt gii php x hi c tnh lin ngnh
cao vi s tham gia ca nhiu lc lng x hi.18
Khi ngn sch nh nc khng cn kh nng duy tr h thng y t v gio dc, ph dch v c a ra
vo u nm 1989 i vi dch v y t v gio dc cng. Ban u cc bin php ny c a ra nh mt c
ch hon chi ph di ci tn thu ph mt phn. Dn dn, tm quan trng ca ph dch v tng ln r rt.
Tinh thn ca chnh sch x hi ha l nhm huy ng s tham gia ca cc ch th khc nhau trong vic
gii quyt cc vn x hi. Nh nu ti i hi ng ln th 8: Vn chnh sch x hi u phi c
gii quyt vi tinh thn huy ng x hi. Nh nc gi vai tr ch o v ng thi khuyn khch ngi
dn, doanh nghip, t chc x hi, c nhn, t chc nc ngoi cng lm vic gii quyt cc vn x
hi.19 Tuy nhin trn thc t, chnh sch x hi ho khng thu ht c s tham gia ca cc ch th
khc nhau trong x hi, bao gm c h gia nh, trong vic thit k, cung cp v chi tr cho cc dch v y
t v gio dc. Thay vo , chnh sch ny khin c quan nh nc c trch nhim to thm doanh
thu, tng s tham gia ca khu vc t nhn trong cung cp dch v trn c s v li nhun v buc cc h
gia nh phi chu trch nhim chi tr cho cc dch v ny. Do , hiu bit v x hi ha Vit Nam hon
ton khc vi ngha quc t ca n: nh nc p dng trch nhim th ch trong vic cung cp v chi tr
cho cc dch v. 20
Tc ng ca chnh sch x hi ha tr nn su sc. Cc phng thc cung cp dch v c a
dng ha, vi s tham gia ln hn ca khu vc t nhn hoc ngoi nh nc. Mc d vy, khu vc cng
vn chim u th trong y t, gio dc v vic cung cp cc dch v x hi ngoi nh nc, phi li nhun
nhn chung cha pht trin.21 Nhng cho ti gi, tc ng ln nht ca x hi ha l i vi vic to kinh
ph cho cc dch v, bao gm c thng mi ha ngy cng tng v m rng cc khon chi tr chnh thc
92
v khng chnh thc.22 Cc khon chi tr khng chnh thc bao gm thng l tng qu hay phong b cho
nhn vin y t v gio vin v th ch ha cc lp hc thm trong h thng gio dc. Nhng thng l do
cc nh cung cp dch v to ra ng ph vi mc tin lng v chi tiu cng thp trong y t v gio dc
vn tn ti t nhng nm 1990 v 2000 v c ko di cho n ngy nay. Ngoi ra, c ch cp kinh ph
cho cc dch v y t, ch yu l t ph dch v, to iu kin cc n v cung cp dch v nh nc v
t nhn to thm nhu cu cho cc dch v v sn phm khng cn thit, v d k thm thuc.
Do chnh sch x hi ha chuyn trch nhim chi tr cc dch v x hi sang cho h gia nh v do chi
ph ca h gia nh v y t v gio dc tng, chnh ph cn c cc chnh sch gim bt tc ng ca
cc chi ph ny i vi ngi ngho v d b tn thng.23 V mt ny, c mt mi lin h trc tip gia
thng mi ha cc dch v y t, gio dc v vic xc nh i tng mc tiu: do t nhn ha v thng
mi ha nn cn xc nh i tng mc tiu cung cp mt mng li an sinh cho nhng ngi khng
c kh nng chi tr.24 Tuy nhin, xc nh i tng mc tiu khng phi lc no cng c th m bo kh
nng tip cn hiu qu: din bao ph khng v k h l nhng vn thng gp trong cc can thip
cho i tng mc tiu.25 Vit Nam, vic s dng chun ngho tng i thp xc nh tiu ch hng
li l mt v d quan trng: nhiu ngi Vit Nam sng gn chun ngho nhng khng c tip cn cc
chng trnh v tr cp.26
R rng l c nhng cng thng v khong cch ngy cng ln gia cc cam kt chnh tr v chnh sch v
tip cn ph cp y t, gio dc vi thc t cung cp v chi tr cc dch v ny Vit Nam. Hu ht cc nc
c ch hn hp v chi tr v cung cp cc dch v x hi: vn l phn b chi ph nh th no v tc
ng i vi cc mc tiu rng ln hn v pht trin con ngi v cng bng. y l nhng vn chnh
sch quan trng i vi Vit Nam. C l gi l lc cn xem xt li tinh thn v mc ch ca chnh sch x hi
ha, c th l thc y s tham gia hiu qu ca tt c cc khu vc ca x hi trong vic thit k, cung
cp v chi tr cho y t v gio dc.
X HI HA V THNG MI HA CC
DCH V X HI
Trong thc t Vit Nam, khng ch th
trng ho v t nhn ha cc dch v y
t v gio dc ngy cng tng, m thng
mi ha cng tng ln nhanh chng.
Bn thn vic m ca ngnh gio dc v y t
cc lc lng th trng tham gia khng phi l
mt iu xu. Cnh tranh c th ci thin c v cht

lng v kh nng tip cn dch v, cho php cc
c s t nhn cung cp dch v hp dn v sinh
li hn. Trong khi , Nh nc tp trung iu tit,
gim st, chi tr cho cc dch v t li nhun hn
nhng rt thit yu, cho cc nhm d b tn thng
v bo m cng bng x hi. Tuy nhin, trong thc
t Vit Nam, khng ch th trng ho v t nhn
ha cc dch v y t v gio dc ngy cng tng,
m thng mi ha cng tng ln nhanh chng v
phn nhiu khng c kim sot, d l khu vc
nh nc hay t nhn.
HP 5.2: TH TRNG HA, T NHN HA V THNG MI

HA CUNG CP DCH V X HI
Th trng ha cc dch v x hi l vic m rng cung cp dch v x hi ra ton th trng, qua
ci thin cnh tranh v, t nht l v mt l thuyt, cung cp nhiu s la chn hn cho ngi tiu
dng. T nhn ha ni n vic cung cp dch v x hi ca cc doanh nghip do t nhn s hu v
qun l, ngoi cc dch v do cc khu vc nh nc v phi li nhun ngoi nh nc cung cp. Cn
thng mi ho l vic cung cp cc dch v x hi trn c s ph dch v, trong n v cung cp
dch v thu ph trc tip t ngi tiu dng. Vit Nam, cc dch v y t, gio dc cng v t u
thu ph t ngi s dng v u hot ng trn c s thng mi.
93
Thng mi ha th hin mt s tc ng tiu

cc. Th nht, thng mi ha y chi ph y t v
gio dc vt qu mc m ngi ngho v ngi
b thit thi c th chi tr. Th hai, trong rt nhiu
trng hp, thng mi ha lm gim cht lng
v tnh sn c ca cc dch v ny v bn cung ch
cung cp cc dch v sinh li cho nhng ngi c kh
nng chi tr. Th ba, n to ra nhng ng lc theo
hng tiu cc lm suy i o c v t cch ngh
nghip ca bn cung cp dch v nh tho lun
trong Hp 5.1. Nh nc tp trung cung cp mt
mng li an sinh cho nhng nhm ngho v thit
thi nht thng qua cc chng trnh gim ngho
mc tiu v an sinh x hi. Nhng chng trnh ny
c nh gi l phc tp, chng cho, kh tip cn
v h tr nhng ngi ang cn nht. Kt qu l qu
trnh pht trin con ngi theo hng cng bng v
ton din m cc nh lnh o Vit Nam khao kht
v ton th ngi dn mong i ang b e da.
CUNG CP TI CHNH CHO Y T

V GIO DC
TNG CHI TIU CHO Y T V GIO DC
ANG TNG LN
Tng chi tiu cho y t v gio dc (t tt c cc ngun,
bao gm nh nc v h gia nh) tng ln mt
cch u n v khng h c du hiu chm li. Nh
cp trong chng 1, Vit Nam c t trng chi tiu
cng cho y t v gio dc so vi GDP mc tng
i cao so vi cc quc gia khc trong khu vc. Tuy
nhin, ngun chi t khu vc t nhn vn ng vai
tr ln nht trong tng chi cho y t v gio dc, vi
cc khon chi t tin ti ca ngi dn chim phn
chnh ca ngun chi tiu ny. C chi tiu cng v t
ang tip tc tng v gi tr thc t, nhng chi cng
cho gio dc ang dn vt xa chi cng cho y t.
Hnh 5.1 cho thy t trng chi tiu cng cho y t v
gio dc trong GDP trong hai thp k qua.
Hnh 5.1: T trng chi tiu cng thng xuyn cho y t v gio dc trong GDP,
1990-2010
Ngun: B Ti chnh, trch dn trong London (2010b)
94
Chi ph y t v gio dc cao m ngi s

dng phi trc tip chi tr c xu hng
lm su sc thm nhng bt cng hin
c trong tip cn cc dch v x hi.
Ngi dn Vit Nam ang phi tr tin ti cho y t
v gio dc mc cao nht so vi cc nc khc
trong khu vc. Cc khon ng gp t h gia nh
khng ch chim phn ln nht trong ngun chi
cho y t v gio dc m cn chim t trng ln
trong chi tiu h gia nh. Theo thi gian, ngun chi
t nhn tng tc nhanh hn so vi chi tiu cng
trong hai lnh vc ny mc d tng c v n nh
nh trnh by sau y. Chi tiu h gia nh khc bit
ng k gia cc vng v cc nhm kinh t-x hi,
qua phn nh khc bit trong thu nhp hin
ti. Chi ph y t v gio dc cao m ngi s dng
phi trc tip chi tr c xu hng lm su sc thm
nhng bt cng hin c trong tip cn cc dch v
x hi, do lm trm trng thm bt bnh ng v
cc thnh qu y t v gio dc. 27
PHN QUYN DN N MC CHI

TIU KHC NHAU GIA CC TNH
Mt c im quan trng trong h thng ti
chnh ca Vit Nam l ngy cng c phn cp
v phn quyn cho a phng. Theo , thm
quyn chi tiu ngy cng c phn quyn, vi
a s cc khon chi cho y t v gio dc ang
c thc hin ti cc cp qun l a phng
nh bn lun sau y.28 iu ny c th h tr
chuyn cc ngun lc ti ni cn nht song vic
cc a phng s dng ngun lc ny nh th
no vn cn ht sc khc nhau, do gy kh
khn cho trung ng trong vic m bo cc
ngun lc cng c s dng hiu qu. Khc bit
trong chi tiu cng cho y t v gio dc ti cp
tnh ang l mt trong nhiu yu t gp phn
gy chnh lch v thnh qu pht trin con ngi
c bn lun trong Chng 3 v Chng 4 ca
bo co ny.
95
CUNG CP TI CHNH CHO Y T

CHI TIU CHO Y T
Theo s liu ca WHO v Ti khon y t quc gia, nm
2008 Vit Nam chi 7,3% GDP hay 77 la M/ngi
(theo sc mua tng ng) cho y t. Trong chi
t ngn sch nh nc chim 38,5% v t khu vc t
nhn chim 61,5%, m mt phn ln l chi t tin ti
ca ngi dn.29 Chi t tin ti chim 90% ngun chi
t nhn hay 56% tng chi tiu cho y t.31 Chi t tin
ti ca ngi dn t ti nh, mc 66-67% tng
chi tiu y t trong nm 2005, nhng sau gim
xung, phn ln do chnh ph tng chi tiu cho y t v
m rng bo him y t (Hnh 5.2). H tr bn ngoi ch
chim di 2% tng chi y t v khong 10% chi ngn
sch nh nc.31 Trong khi t trng chi tiu y t trong
GDP ca Vit Nam vt xa nhiu nc khc trong khu
vc th t l ng gp t ngn sch nh nc ca cc
nc ny vn cao hn, nh m t trong Bng 5.2. T
trng chi tiu cng trong tng chi tiu y t Vit Nam
thp hn so vi hu ht cc nc trong khu vc,ngoi
tr Phillippines. Ch c Indonesia v Philippines c
chi tiu y t tnh theo u ngi thp hn Vit Nam.
Ni mt cch tm tt, Vit Nam c chi tiu cng
cho y t thp hn cc nc khc, v hu ht chi tiu
l t cc ngun t nhn.
T trng chi tiu cng trong tng chi tiu

y t Vit Nam thp hn so vi hu ht
cc nc trong khu vc.
CHI TIU CNG CHO Y T ANG TNG LN

Ngun chi t chnh ph nhn chung thp hn so vi
cc nc khc trong khu vc, song tng mt cch
u n t 4,8% ln 10,2% tng ngn sch quc gia
trong giai on 2002-2008.32 Nm 2008, ngn sch
cho y t t mc 43.048 t ng, tng t 5.098
t ng trong nm 2000, vi tc tng cao hn
nhiu t l lm pht.33 Chnh ph cam kt tng
ngn sch hng nm cho y t nhanh hn tc
tng ngn sch nh nc ni chung.34 Ngh quyt
18 th hin cam kt ca Chnh ph nhm tng
chi ngn sch hng nm cho y t, m bo tc
tng chi tiu cho y t cao hn so vi tng chi tiu t
ngn sch nh nc ni chung v dnh t nht 30%
ngn sch y t quc gia cho y t d phng.35
Hnh 5.2: Chi tiu cho y t ti Vit Nam, 1995-2008
Ngun: WHO Ti khon y t quc gia, truy cp ti http://www.who.int/nha/en/
Bng 5.2: Tng chi tiu y t v chi tiu cng cho y t ca mt s nc chu , 2008
Quc gia
T l% ca tng chi tiu cho y t T l% ca chi tiu cng cho y t

trong GDP
trong tng chi tiu cho y t
USD /u ngi PPP($)
Indonesia
2,0
55,3
45
Thi lan
4,0
75,1
242
Philippines
3,8
32,9
44
Trung Quc
4,3
46,7
121
Malaysia
4,3
44,1
279
Hn Quc
6,6
54,9
999
Vit Nam
7,3
38,5
77
Ngun: London 2010b, c cp nht s liu t Ti khon y t quc gia ca WHO 2008
Chi tiu cng cho y t bao gm phn b ngun lc

ti cc cp dch v y t v phn b thng qua bo
him y t.36 Chi ph u t cng vi mt phn chi ph
thng xuyn, c bit l lng, do ngn sch trung
ng chi tr. Chi tiu thng xuyn chim khong
93% ngn sch nh nc, trong khi chi cho u t
chim 6-7%.37 Mc d chi tiu quc gia cho y t tng,
phn ln ngn sch nh nc cho y t vn m
bo duy tr dch v v tr cp cho bn cung cp
dch v, cn chi tiu cho bo him y t gm c tr
cp cho ngi ngho v ngi thit thi th t hn
nhiu.38 Tuy nhin, t trng ca bo him y t trong

chi tiu cng cho y t lin tc tng, t 7,9% nm
2005 ln 17,6% nm 2008, phn nh bao ph ca
bo him tng ln trong cc nhm ny.39 Nhng kh
khn trong vic tng bao ph ca bo him y t
lin quan n thc t nguyn tham gia c trnh
by trong Hp 5.4.
Mc d tng lin tc, nhng chi tiu quc gia li th
hin s km hiu qu hoc khng gn kt vi cc
u tin ca chnh ph v nng cao cc thnh qu y
96
t. V d, Bo co chung y t thng nin nm 2008

v ti chnh y t cho thy chi tiu cng khng ph
hp vi cc u tin ca chnh ph v chm sc d
phng, chm sc cp a phng v h tr cho
cc vng kh khn.
Hnh 5.3: Chi t tin ti theo u ngi

cho chm sc sc khe (2004-2008)
Chi tiu cng khng ph hp vi cc

u tin ca chnh ph v chm sc d
phng, chm sc cp a phng v h
tr cho cc vng kh khn.
Nguyn nhn l do kinh ph cho pht trin ang
c tp trung vo cp quc gia v cp tnh, v phn
ln chi tiu ang dnh cho khm cha bnh hn l
y t d phng.40 Chi tiu cho chm sc d phng
bin ng theo thi gian v t mc khong 28%
trong nm 2007 trn ton quc, t hn so vi mc
tiu 30% trong Ngh quyt 18.41
CHI TIU CNG CHO Y T CP TNH

Ngn sch chi cho y t ti cc a phng chim t
l cao hn, c t khong 63,2% trong nm 2005.
Cc m hnh chi tiu cp tnh r rng hn so vi
cp trung ng - v d, chnh quyn tnh chi t cho y
t d phng v dnh phn ln ngun lc cho khm
cha bnh. Chi tiu cp tnh cho y t ch dao ng t
5,5%-8% tng chi chung, mt s a phng thm
ch gn nh cn khng dnh mt khon ngn sch
no cho hot ng y t d phng.42 Chi tiu thp
cc cp huyn v x, cp chu trch nhim qun l
cc trm y t x, dn n c s h tng cht lng
thp, cc vn v thu ht v gi nhn vin v ngn
sch thp cho chi thng xuyn. Tt c nhng iu
ny khin cht lng dch v nhn chung l thp.43
Chi tiu cng cho cc dch v y t c th cng thay
i ng k theo tng khu vc v a phng. V d,
nh trong phn tch chi tiu ca UNICEF v dch v
chm sc sc khe b m v tr em: chi tiu bnh
qun u ngi trn a bn tnh Ninh Thun cao
gp i so vi ti An Giang. 44
97
Ngun: VHLSS 2004 v 2008, trch t Nguyn Vit Cng 2010
CHI TIU T TIN TI L GNH NNG I

VI H GIA NH
Hin nay Vit Nam, chi tiu t h gia nh ang
chim khong 60% tng chi tiu y t, trong
56% l t tin ti. T l ny c coi l rt cao i
vi cc nc c thu nhp thp v trung bnh. T l
ny cng cao hn nhiu so vi mc ti a l 30%
vn c coi l l tng t c mc tiu ph
cp y t. Nu vt qu mc ny, ngha l khi phi
chi 40% tng chi tiu h gia nh cho y t, th cc
gia nh s thng xuyn phi i mt vi cc chi
ph y t qu kh nng chi tr. Mc chi t tin ti
cho y t khu vc chu -Thi Bnh Dng chim
hn 60% tng chi tiu y t v t l bn cng ha
do chi ph y t ti Trung Quc v Vit Nam l mt
trong nhng t l cao nht th gii. 45
Chi ph y t i vi h gia nh Vit Nam ang

gia tng. Chi t tin ti bnh qun u ngi
tng 20%, t 503.800 ng nm 2004 ln 603.500
ng nm 2008 (theo thi gi thng 1/2008),
chim khong 7% chi tiu cho sinh hot ca h
gia nh trong nm 2008. Cc h gia nh ngi
Kinh/Hoa, nhng ngi kh gi, ngi dn thnh
th v vng ng Nam b chi cho y t nhiu nht,
trong khi trong cc h ngho v dn tc thiu s
chi t nht (Hnh 5.3). Mc d chi tiu y t - mt
phn ca chi tiu sinh hot - mc tng
i n nh trong giai on 2004- 2008, nhng
xt v gi tr, tt c cc nhm kinh t x hi v
ngi dn cc vng vn ang chi nhiu hn so
vi trc y. Ngi dn tc thiu s v ngi
ngho chi cho y t t nht, tng ng mc 4,7%
v 5,6% chi tiu h gia nh. Trong khi nhng
ngi khu vc thnh th chi cho y t gp 1,7
ln nhng ngi khu vc nng thn th nhm
nhng h giu nht v ngi Kinh/Hoa chi gp 3

ln so vi ngi ngho v ngi dn tc thiu s.46
T l bn cng ha do chi ph y t ti
Trung Quc v Vit Nam l mt trong
nhng t l cao nht th gii.
Chi t tin ti cho dch v y t mi ln thm khm
tng 20%, t 189.100 ng nm 2004 ln 227.000
ng nm 2008 i vi cc dch v ngoi tr, v 16%
t 1.909.000 ng nm 2004 ln 2.218.000 ng nm
2008 i vi cc dch v ni tr (theo thi gi thng
1 nm 2008). Chi tiu cho cc dch v ngoi tr cng
tng vi tt c cc nhm dn c v cc vng, ngoi
tr vng Bc Trung B v ng Bc. Chi tiu cho dch
v khm cha bnh ni tr cng tng i vi tt c
cc nhm dn c v cc vng giai on 2004-2008,
tr bng sng Cu Long v min Nam Trung B47. Chi
t tin ti cng khc bit ng k gia cc nhm dn
c khc nhau theo vng v iu kin kinh t x hi.
Bng 5.3: T l % chi tiu y t trong chi tiu bnh qun u ngi 2004-2008 (%)
Bnh nhn ngoi tr
Tui
Gii
Dn tc
2004
2008
2004
2008
C nc
2.9
29.6
28.9
Di 15
1.8
1.6
19.5
17.2
16-60
3.2
3.2
30.2
30.2
Trn 60
3.2
3.6
31
32
Nam
3.1
33.2
32.3
2.8
2.8
26.6
26.1
Kinh v Hoa
2.9
2.9
30.1
29.3
21.6
26.1
Khng ngho
2.8
2.9
29.6
28.9
Ngho
3.7
3.5
19.2
21.1
2.3
2.5
24.9
24.3
Dn tc thiu s
Nhm thu
nhp
Thnh
Thnh th
th-nng thn
Vng
Bnh nhn ni tr
Nng thn
3.4
3.2
33.4
32.6
ng bng sng
Hng
3.2
3.2
28.7
28.3
ng Bc B
3.9
3.2
23.9
26.5
Ty Bc b
4.1
3.8
31.9
23.3
5.6
4.2
28.9
38.5
3.2
3.2
27.7
21.9
Duyn hi Bc Trung
b
Duyn hi Nam
Trung b
Ty Nguyn
3.3
3.3
27.3
34.7
ng Nam B
2.1
2.9
30.8
32.1
ng bng sng
Cu Long
2.1
2.1
37.3
28.8
98
Nhng ngi trn 60 tui, ngi trong tui

16-60, ngi khng thuc din ngho, ngi Kinh/
Hoa v nam gii thng c mc chi t tin ti nhiu
hn so vi cc nhm kinh t x hi khc. Mc chi
thp nht thuc v nhm ngi ngho, ngi dn
tc thiu s v tr em di 15 tui. Theo khu vc,
ngi dn thnh th v c dn min ng Nam b
chi nhiu nht. Ngi dn vng ng bng sng
Cu Long v vng ng Nam B chi cho cc dch
v ngoi tr mc thp nht, trong khi ngi dn
ng bng sng Cu Long v ng Bc chi cho cc
dch v ni tr mc thp nht. Mt l do khc gii
thch mc chi thp hn ca i tng ngi ngho,
tr nh v ngi dn tc thiu s l mc bao
ph ngy cng cao ca bo him y t nh bn lun
di y. Chi ph t tin ti thp hn cng c th do
mc s dng dch v t hn v do chi ph ti
chnh gim i. Mc chi tiu ca ph n thp hn so
vi nam gii l iu kh bt ng v h s dng dch
v ni tr v ngoi tr nhiu hn nam gii, nhng
mc bao ph ca bo him y t trong nhm ny
thp hn.48
Trong khi mc chi tiu cho y t tng trong giai
on 2004-2008, t l chi t tin ti cho mi ln
thm khm tnh theo u ngi trong thi k ny
vn duy tr kh n nh mc trn di 3% i
vi chm sc ngoi tr v 29% cho chm sc ni
tr (Bng 5.3). Chi bnh qun u ngi cho mt
ln khm ngoi tr ca ngi gi, nam gii, ngi
dn tc thiu s, ngi ngho v ngi dn nng
thn nhiu hn so vi trung bnh, tng t i vi
ngi dn Bc Trung B v ng Bc. Mt khc,
ngi trong tui t 16-60, nam gii, ngi
Kinh/Hoa, ngi khng thuc din ngho v
ngi dn vng Bc Trung B v Ty Nguyn chi
tiu bnh qun u ngi cho mt ln khm ni
tr cng nhiu hn so vi mc trung bnh. Qu
thc, chi ph cho mi ln iu tr ni tr chim ti
29% th hin t trng ng k ca chi tiu y
t trong chi tiu bnh qun u ngi, k c cc
nhm thu nhp thp, v ang phn nh gnh
nng v chi ph y t i vi cc h ngho trong
x hi.49
CHI TIU Y T VT KH NNG CHI TR

Chi t tin ti vn tip tc l mt gnh nng ng
k i vi h gia nh, thm ch cn c th vt
kh nng chi tr.50 iu tra mc sng h gia nh
nm 2008 cho thy 8,1% h gia nh tiu tn hn
20% tng chi tiu h gia nh bnh qun u ngi
cho y t. T l h khng thuc din ngho v h
ngi Kinh/Hoa chi tiu trn 20% tng chi ton h
vo chm sc sc khe l 8.6%, ln hn so vi t l
99
tng ng ca cc h dn tc thiu s v h ngi

ngho (4%). Tuy nhin, nu coi chi tiu cho y t l
mt phn ca chi tiu phi lng thc th t l h
phi i din vi cc khon chi vt kh nng chi
tr c th s cao hn ng k. c tnh nm 2008 c
khong 12% s h chi ti trn 25% tng chi tiu phi
lng thc vo chm sc sc khe, con s ny i
vi cc h chi trn 40% l khong 5%.51 Mt nghin
cu ca WHO v i hc Y H Ni v gnh nng ti
chnh ca cc khon chi cho y t cho bit 5,7% s h
gia nh dnh hn 40% thu nhp ca h cho y t v
3,7% b bn cng ha v khon chi ny.52
Chi t tin ti vn tip tc l mt gnh

nng ng k i vi h gia nh, thm
ch cn c th vt kh nng chi tr.
CC KHON CHI KHNG CHNH THC

LM TNG CHI PH Y T
Cc khon chi khng chnh thc ang ng
mt vai tr quan trng y chi ph y t ln
cao. Tnh trng a phong b cho nhn vin
y t tr nn qu i quen thuc. Nhn vin
cng c ng lc tm kim nhng khon
thu nh vy, v mt s c s y t nh cc bnh
vin th c th tng lng cho nhn vin
hn ch tnh trng ny, nhng cc bnh vin
tuyn di li khng kh nng, dn ti vic
nhn vin y t tm kim c hi c thm thu
nhp. 53 Trong Kho st Ch s hiu qu qun
tr v hnh chnh cng (PAPI) nm 2010, 28%
s ngi tr li tha nhn tng a hi l
khi ti cc c s y t. Phn ln cc h gia nh
u cp ti nn tham nhng trong ngnh y
t; c 4 ngi c hi th c 1 ngi cho rng
tham nhng l mt vn trm trng ngay ti
cc c s y t trung ng, v 22% cho rng
tham nhng ngy cng honh hnh ti nhng
c s ny giai on 2006-2008. 54 Cc chi ph
khng chnh thc ny l phn khng d bo
c trong chi ph cho y t do cc chi ph ny
khng phi lc no cng bit trc c. y
cng l gnh nng bt cng cho nhng ngi
t c kh nng chi tr nht, lm gim lng tin
v s tn trng ca ngi dn i vi cc c s
y t cng v nhn vin y t.
c nhiu trng hp c a ln bo ch,
theo tng nhn vin ca bnh vin c
bnh vin giao ch tiu cn nhn bao nhiu
bnh nhn, k bao nhiu thuc v bt bnh
nhn phi nm vin bao nhiu ngy bt k nhu
cu cn cha tr th no. 55 H thng thu ph cho
dch v y t to ng lc cho nh cung cp dch

v a ra cc dch v b sung nhiu hn mc cn
thit, v d ko di s ngy nm vin hay k thm
nhng thuc khng cn thit. Khng c c ch chu
trch nhim r rng nh th tc khiu kin t co,
bnh nhn khng c cch no gii quyt hay
ngh iu tra.
Tc ng ca chnh sch x hi ha v giao trch
nhim qun l hnh chnh cho bn cung cp dch
v, nh tho lun di y, cho php nhn vin
cc bnh vin cng c th gp vn mua cc thit
b cng ngh y t, nht l cc cng c chn on.
Nhng nhn vin ny sau c ng c yu cu
ngi bnh s dng cc dch v ca h, bt k c

cn thit hay khng, v h c th kim li t vic
s dng cc cng ngh h gp tin mua. Thc
t ny cc nc khc l iu khng c php.
Ngoi ra, cc cng ty ty nhn cng thng cung
cp cc cng ngh v tha thun c cng
vi bnh vin chia s v hng mt phn li nhun
lm ra. Theo c ch t ch ti chnh, bnh vin c
khuyn khch to cng nhiu thu nhp cng tt, nn
bnh vin tn dng cc c hi tip cn vi cng
ngh v theo nhn vin c giao ch tiu to
thu nhp.
HP 5.3: CC C CH THANH TON CHO DCH V Y T

Hai c ch thanh ton cho y t ang c Vit Nam tho lun l: thanh ton theo nh sut (tc l
thanh ton theo nh mc chi ph khm cha bnh nhn vi s lng dch v) v thanh ton theo
nhm cc bnh lin quan (DRG) (ngha l thanh ton theo chi ph khm cha bnh c xc nh
trc cho tng nhm bnh). Vit Nam, mt ngh nh ca chnh ph ban hnh nm 2009 nu
r l phng php thanh ton theo nh sut cn phi c a vo cc c s y t chnh. Phng
php ny c th nghim t nm 2001, v cho n nay c p dng 43 c s y t, hu ht l
tuyn huyn. Tuy nhin, cc qu thanh ton theo nh sut b tiu qu hu ht cc bnh vin,
v chi ph khm cha bnh tng ln trong thc t.56 Cc nc lng ging nh Trung Quc v Thi
Lan cng th nghim c ch thanh ton theo nhm cc bnh lin quan, trc ht l tp trung
vo nhm cc bnh thng gp. C ch ny cho thy c th gim thi gian nm vin trung bnh
v c th ngn nga tnh trng k n thuc v iu tr qu mc cn thit.57
Mt nghin cu gn y v cc c ch thanh ton cho y t Vit Nam cho rng c ch thanh ton
theo nhm cc bnh lin quan c trin khai cc nc lng ging c th p dng c
Vit Nam. Nghin cu khuyn ngh l Vit Nam c th p dng mt hnh thc hn hp bao gm c
thanh ton theo nh sut cho cc iu tr chnh v thanh ton theo nhm cc bnh lin quan cho
cc chm sc bnh vin, trc mt l tp trung vo cc dch v y t u tin v d phng.58
BAO PH CA BO HIM Y T
Bo him y t ang ng mt vai tr ngy cng
quan trng trong vic h tr chi tr chi ph y t. S
liu VHLSS cho thy bao ph ca bo him
tng ln nhanh chng, t 39% tng dn s trn 5
tui nm 2004 ln 53% nm 2008 (tr em di 6 tui
c chm sc y t min ph). Trong tng dn s c
bo him, 21% c bo him y t min ph, 10% c
bo him bt buc, 16% c bo him hc sinh, sinh

vin v 6% c bo him t nguyn. Trong nm 2008
c 69% ngi ngho, 76,2% dn tc thiu s v 59%
ngi 60 tui tr ln c bo him y t. bao ph
ca bo him y t i vi n thng t hn so vi
nam.59 Trong nm 2009, c tnh bo him y t
bao ph khong 58,4% dn s, trong khi s cn li l
35,7 triu dn vn cha c bo him.60
Chnh sch v cung cp ti chnh cho dch v x hi 100
Trong mt nghin cu phc v cho Bo co ny,

Nguyn Vit Cng nhn nh bo him y t ang
ng mt vai tr tch cc gip tng kh nng tip cn
ca ngi dn vi cc dch v y t v gim chi t tin
ti ca ngi dn. S tham gia ca ngi dn vo tt
c cc loi bo him y t c mi tng quan vi s ln
thm khm, k c ni v ngoi tr. Bo him y t cng
gp phn lm gim chi ph cho cc dch v y t, c
bit l bo him y t min ph, bo him bt buc v
bo him cho hc sinh, sinh vin.61 Vic tng chi tiu
cng cho bo him y t cho ngi ngho v ngi
thit thi, m rng bao ph ca bo him vi cc
nhm dn c khc nhau gip tng cng tip cn cc
dch v y t v gim chi ph cho c chm sc ni v
ngoi tr.
Chnh ph cam kt s ph cp bo him y t vo nm
2014, tuy nhin h thng bo him y t phi i mt
vi nhng thch thc ng k. T gc ngi s
dng, cht lng ca cc dch v, s chm tr trong
iu tr v thi ca nhn vin cung cp dch v bt

k l dch v min ph hoc thanh ton qua bo him
ang l ro cn i vi vic mua v s dng bo him y
t.62 Nhng ngi c kh nng chi tr thng s chn
cc dch v khng nm trong danh mc bo him
trnh phc iu tr hng hai. Nhng ngi khng
c kh nng chi tr th thng tr hon vic thm khm
cho n khi vn sc khe tr nn trm trng. Mc
phc li t bo him thng l thp, c bit l vi bo
him thuc din gim ngho v an sinh x hi. Kt qu
l khong 30% s ngi c bo him y t cho ngi
ngho vn phi i mt vi cc khon chi ln cho
chm sc sc khe.63 bao ph ca bo him y t
Vit Nam vn duy tr mc c 5 ngi th 2 ngi vn
cha c bo him, trong c rt nhiu ngi v h
gia nh thuc din ngho v cn ngho. Do , vic
m rng din bao ph ca bo him y t, to ra doanh
thu tng cc phc li ca bo him v m bo
tnh kh thi ca c ch bo him phi c nhn nhn
nh cc u tin chnh sch quan trng (Hp 5.4).
Hnh 5.4: Bo him y t ca ngi dn trn 5 tui, 2004-2008 (%)
Hp 5.4: HNG TI BO HIM Y T TON DN

Hin ti Vit Nam ang lu hnh 3 loi bo him y t cho ngi dn (xem Bng 5.1): bo him y t
bt buc dnh cho ngi lao ng/cng chc, bo him min ph hon ton hoc tr cp mt phn
cho ngi ngho v cc nhm thit thi, bo him y t t nguyn i vi hc sinh, sinh vin v i
tng lao ng khc. Tnh n 2008, 53% ngi dn Vit Nam c bo him y t v c tnh
tng ln 58,4% trong nm 2009.64 Mc d bo him y t c ch trng hn i vi nhm ngi
thit thi trong x hi, song vn cn mt t l ln trong cc nhm ny vn cha c bo him. Trong
nm 2008, 41% s ngi trn 60 tui, 24% ngi dn tc thiu s v 31% ng phn v ngho nht
vn cha c bo him y t. T l c bo him ti mt s vng ngho ca Vit Nam cng mc thp:
34% ngi dn ti vng ng Bc B, 39% ti duyn hi Bc Trung b v 38,5% ti Ty Nguyn
cha c bo him y t. Mt khc, cng trong 2008, bo him y t li bao ph ti 50% ng phn v
101 Bo co Pht trin Con ngi 2011
giu nht.65 Trong khi cc i tng nh tr em di 6 tui, ngi trn 60 tui, ngi ngho, ngi
dn tc thiu s v ngi dn nng thn thng c h tr bo him y t min ph th t l ngi
Kinh/Hoa v ngi khng thuc din ngho c bo him y t t nguyn, bt buc v bo him cho
hc sinh, sinh vin u cao hn. Tuy nhin, c ti 14,6% ngi khng thuc din ngho li c bo
him y t min ph trong nm 2008.
Mt t l cao trong mt s nhm dn c khng c bo him y t, c bit l nhng ngi lao ng
khng iu kin c tr cp v khng c hng chng trnh bo him y t bt buc. c
tnh khong 23 triu ngi lm vo hon cnh ny v ch c 11% trong s h c bo him y t trong
nm 2008.66 H iu kin tham gia bo him t nguyn, nhng h khng tham gia; phn ln s
ngi c bo him y t t nguyn l sinh vin, do i tng ny d dng c thu np thng qua
cc trng hc. Trong khi i tng khng phi sinh vin vn gp nhng cn tr ng k trong
tip cn bo him t nguyn nh gi bo him cao (chim 4,5-6% lng ti thiu), cht lng dch
v thp; mc thu nhp thp; v thiu mt chin lc tip th tp trung v hiu qu.67 Phn ln ngi
tham gia bo him cng chi tr vi c quan bo him mc 20% i vi cc dch v y t thng
thng v 50-80% i vi cc dch v c chi ph cao v xt nghim. Nhng trng hp ngoi l
l ngi ngho, hu tr, ngi ang hng tr cp x hi ch phi tr 5%, cn cc i tng qun
nhn, tr em di 6 tui c bo him chi tr hon ton.68 Do c mc trn v tng s tin ti a
c chi tr t bo him y t nn bo him y t cng khng cung cp mc h tr hon ton y
cho cc h gia nh.
Thm ht ngn sch ca qu Bo him x hi c tnh ln ti 1.400 t ng trong nm 2008. Cc
khon thm ht ln lin quan n chm sc sc khe min ph cho tr em di su tui v qu
khm cha bnh t nguyn.69 Mt phn ca vn l la chn ngc theo ngi cn chm
sc y t nht mi mua bo him y t v thc trng ny lm tng chi ph m bo him phi chi
tr. iu ny c bit ng i vi bo him y t t nguyn Vit Nam: hu ht cc i tng lao
ng khng chnh thc u khng mun tham gia loi bo him ny, v vy ch nhng ngi mc
bnh hoc d kin s phi chi nhiu cho chm sc sc khe mi mua bo him y t.70 Nu Vit Nam
mun t c mc tiu bo him y t ton dn v to doanh thu cho qu Bo him x hi th phi
huy ng c ngun vn t nhng ngi ang trong tui lao ng v phi thu ht c hng
triu ngi lao ng khng chnh thc, nhm kh thu ht nht. Nhng ngi c thu nhp thp
ang phi gng ln chi tr, trong khi nhng ngi thu nhp cao hn li khng nhn thy li ch
ca vic tham gia bo him y t.71 Qu Bo him x hi cng cn tr thnh mt bn mua ch ng
cc dch v m bo cc dch v m qu chi tr thc s l cn thit v khng lng ph (trong
c n thuc) v cn ch ng gim st, phn tch hot ng ca cc bn cung cp dch v y t v
cung cp thng tin cho ngi dn.
c tnh da trn VHLSS 2006 cho thy t c ph cp bo him y t, chnh ph cn tng
ng k chi tiu y t ln khong t 0,7% n 1,6% GDP. Tng doanh thu t bo him y t bt buc
ca ngi lao ng trong khu vc chnh thc v tng tr cp cho ngi s dng c th gip ct
gim chi tiu t tin ti ca ngi dn n 30% v em li doanh thu cho qu Bo him y t x
hi, gip qu ny c th to nh hng vi cc c s y t, v d nng cao cht lng dch v cho
ngi c bo him.72 iu ny s i hi chnh ph phi xem xt li u tin cho pht trin con
ngi thng qua cc u tin khc trong u t cng.
Hnh 5.5: Chi tiu cng cho gio dc, 2001-2008
Ngun: B Gio dc v o to, trch t V Hong Linh 2010
CUNG CP TI CHNH CHO

GIO DC
nc ny, vi s nm i hc trung bnh v s nm

i hc k vng thp hn, cho thy Vit Nam u t
km hiu qu hn (Bng 5.4).
CHI TIU CHO GIO DC
CHI TIU CNG CHO GIO DC CP TNH
Vit Nam chi tiu cho gio dc nhiu hn cho y t,

vi t l chi tiu cng trong ngn sch nh nc
tng t 15,5% nm 2001 ln 20% nm 2008. Chi
tiu cng cho gio dc chim 5,6% GDP nm 2008,
gp i chi tiu cng cho y t. Hnh 5.5 cho thy s
thay i trong chi tiu gio dc: trong khi t trng
chi tiu cng trong ngn sch nh nc tng ln gp
bn ln t nm 2001-2008, t trng trong GDP vn
gi kh n nh. So vi cc nc khc trong khu vc,
Vit Nam chi tiu cho gio dc cao hn ng k.
Nm 2008, phn ln chi tiu cng trong gio dc

dnh cho bc tiu hc v trung hc, mc d chi tiu
cho gio dc mm non, dy ngh v i hc tng
t nm 2001. Chi tiu cho gio dc c bn (tiu hc
v trung hc c s) chim 52%, gio dc mm non
7,5%, ph thng trung hc 11%, o to i hc
v dy ngh 24,4% trong ngn sch gio dc nm
2008.74 Cng ging nh chi tiu y t, c s khc bit
ng k gia cc vng v cc tnh, vi chnh lch
chi tiu gia cc tnh giu hn v ngho hn l bn
ln.75 Chi tiu gio dc ch yu c phn cho a
phng, vi 89% tng s chi tiu gio dc l cp
tnh. Ch c gio dc i hc l c chi tiu ng k
t cp quc gia.76 H tr bn ngoi i vi ngnh
gio dc Vit Nam ch yu l cho gio dc c bn.
Tuy nhin iu ny c th thay i, khi Vit Nam hin
nay l nc thu nhp trung bnh thp v c th
dn n suy gim vin tr cho gio dc.77
So vi cc nc khc trong khu vc,

Vit Nam chi tiu cho gio dc cao hn
ng k.
Theo s liu ca UNESCO,73 Vit Nam dnh mt t
l ngn sch cho gio dc cao hn so vi phn ln
cc nc trong khu vc, tr Thi Lan. Tuy nhin, hiu
qu gio dc ca Vit Nam km hn so vi tt c cc
CHI TIU CHO GIO DC CA H GIA NH
khu vc t nhn gim tt c cc bc hc. L do

l mc d chi tiu t h gia nh tng, nhng chi tiu
cng cng tng tt c cc bc hc.79
Chi tiu t h gia nh tng mnh i vi tt c

cc vng, cc nhm kinh t-x hi v c tnh chim
ti 50% chi tiu chung cho gio dc Vit Nam, ty
vo cp hc. 78 Chi tiu cng chim phn ln chi tiu
trong gio dc tiu hc v trung hc c s, trong khi
chi t khu vc t nhn chim hn mt na chi tiu
cho cp i hc (Hnh 5.6). Tuy nhin, t l chi tiu t
Chi tiu cng chim phn ln chi tiu

trong gio dc tiu hc v trung hc c s,
trong khi chi t khu vc t nhn chim
hn mt na chi tiu cho cp i hc .
Bng 5.4: Chi tiu cng cho gio dc v s nm i hc mt s nc chu ,

2007-2008
Chi tiu cng cho
gio dc trong tng
GDP (%)
Chi tiu cng cho gio dc

trong tng chi tiu chnh
ph (%)
S nm i hc trung bnh
S nm i hc k vng
Indonesia (2007)
3.5
18.7
5.7
12.7
Thi Lan (2008)
4.7
25.7
6.6
13.5
Philippines (2007)
2.7
15.9
8.7
11.5
Malaysia (2007)
4.5
18.2
9.5
12.5
Hn Quc(2007)
4.2
14.8
11.6
16.8
Vit Nam (2008)
5.3
19.8
5.5
10,4
Trung Quc (2007)
3.4
18.2
7.5
11.4
Nc
Ngun: Vin Thng k UNESCO, http://stats.uis.unesco.org; ADB 2010; Bo co HDR ton cu
Hnh 5.6: Chi tiu cng v t cho gio dc 2004-2008
Ngun: VHLSS 2004 v 2008, B Gio dc v o to, trich dn trong V Hong Linh 2010
Hnh 5.7: Chi tiu bnh qun u ngi cho gio dc (000 VND, mc gi nm 2008),
2004-2008
Ngun: VHLSS 2004, 2008
Tuy nhin, chi tiu thc t ca h gia nh cho gio

dc tng 44%, t 1.280.300 ng nm 2004 ln
1.844.000 ng nm 2008 (tnh theo mc gi nm
2008). Trong khi chi ph tng ln tt c cc vng v
cc nhm kinh t-x hi, nh Hnh 5.7 cho thy, mc
tng mnh nht l khu vc thnh th, ng phn v
giu nht v vng ng Nam B. ng thi, khong
cch gia thnh th v nng thn, gia nhm giu
nht v ngho nht, gia ng Nam B v Ty Bc
cng tng ln ng k. Nm 2008, ngi dn khu
vc thnh th chi tiu cao hn ngi dn khu vc
nng thn 2,3 ln; ngi dn ng Nam B chi tiu
cao hn 4,3 ln so vi ngi dn vng Ty Bc; ng
phn v giu nht chi tiu cao hn 5,4 ln so vi ng
phn v ngho nht.
ng ch l phn ln chi tiu trong gio dc khng
phi cho hc ph, m cho cc chi ph lin quan. Nm
2008, hc ph chim 29% chi ph gio dc, trong khi

hc thm chim 12% v cc chi ph khc chim 25%
bao gm i li, n ung, qu tng v cc khon chi
cho gio vin. Hnh 5.8 cho thy t l ca cc chi ph
ny trong giai on 2002-2008.
Nm 2008 cng c nhng khc bit ng k trong
chi tiu cc bc hc, gia cc nhm kinh t-x hi
v cc khu vc. Hc ph chim t l ngy cng tng
trong tng chi ph cc bc hc cao hn, cn hc
thm tr nn c bit quan trng bc trung hc
ph thng. Cc gia nh th chi tiu nhiu hn
cho hc thm, trong khi cc gia nh nng thn
chi tiu nhiu hn cho sch gio khoa v dng
hc tp.80 Cc chi ph ny l gnh nng ln cho cc
gia nh ngho nht, nhng gia nh chi nhiu hn
vo cc khon ng gp cho trng v ng phc,
trong khi cc gia nh kh gi hn li chi tiu nhiu
hn cho hc thm v cc chi ph khc.
Hnh 5.8: c tnh phn chi tiu ca h gia nh, theo khon chi, 2002-2008
Ngun: VHLSS 2008, trch dn trong London 2010b
CHI TIU CHO HC THM L YU T

QUAN TRNG I VI KT QU HC TP
Vit Nam hin nay, kt qu hc tp ang ngy cng
ph thuc vo kh nng theo hc cc lp hc thm.
cp tiu hc, cp hc c coi l min ph, khong
50% h gia nh chi tr cho cc lp hc thm trc
khi con em h vo lp mt v tng ti 70% t lp nm
khi cc em chun b vo trng trung hc.81 cp
trung hc, cc kha hc thm c coi l thit yu
i vi nhng hc sinh mun tip tc hc sau trung
hc. Cc h gia nh kh gi nht dnh hn mt phn
ba chi tiu gio dc ca h cho hc thm cp trung
hc, trong khi cc h gia nh ngho nht chi c 12%.
iu ny cho thy c s khc bit trong tip cn gio
dc cht lng cao, v d nhin nh hng n tip
cn gio dc i hc (c da trn kt qu thi tuyn
sinh).82 Nh vy, iu kin kinh t gia nh gip l gii
mc chnh lch 26% trong gio dc i hc gia
ng phn v giu nht v ngho nht nh nu trong
Chng 4. Nhng gia nh giu c hn chi tiu nhiu
hn cho hc ph, c bit l cp tiu hc, ngha l
con em h ang theo hc cc trng tt hn v t
hn trong khi hc sinh ngho ang hc cc trng
cng min ph. Chi ph hc cao hn do cc khon chi
ph khng chnh thc cho cc lp hc thm gy ra.83
Mt khc, cc gia nh ngho, dn tc thiu s v gia
nh nng thn c xu hng chi tiu cho hc ph t

hn, c bit l bc tiu hc v trung hc c s, do
c min ph.
CC CHI PH KHNG CHNH THC TRONG

GIO DC
Cng nh trong y t, cc khon chi khng chnh
thc trong gio dc rt ph bin v thng xuyn,
bao gm tham nhng trong tuyn sinh u vo, hc
ph, l ph v hc thm. Mt nghin cu nm 2010
ca Thanh tra Chnh ph cho thy cc bc cha m
c kho st ti H Ni, TP H Ch Minh v Nng
coi hi l l vic bnh thng trong qu trnh tip
cn dch v gio dc, k c cp tiu hc. Trong khi
ch 10% cha m tha nhn tr tin con em h
c n trng, 67% ni rng hnh vi ny l chp
nhn c.84 Tng t, trong cuc iu tra PAPI nm
2010, 47% s ngi c hi ng rng gio vin
thin v hc sinh c cha m hi l, 61% ni rng cc
khon chi khng chnh thc trong gio dc tiu hc
l ph bin v 43% ni rng hi l cho gio vin l
ph bin.85
bc i hc, tham nhng c tha nhn l ph
bin trong mt s chng trnh o to, khi trong
mt s trng hp c th mua bng sau i hc v
bng o to ti chc, t xa v lin thng.86 Trong

VHLSS nm 2008, 15-16% s ngi tr li cho rng
trong giai on 2006-2008 nn tham nhng tr
nn ti t hn trong o to ngh v gio dc i

hc; con s ny l 11% trong gio dc trung hc v
9% trong gio dc tiu hc.87
Bng 5.5: T l phn trm chi tiu cho gio dc tnh trn u hc sinh trong
tng chi tiu bnh qun u ngi ca cc h gia nh, 2008 (%)
Tiu hc
Trung hc c s
Trung hc ph thng
i hc & cao ng
Vit Nam
9,8
13,2
22,2
51,4
Thnh th-nng thn Thnh th
Vng
Dn tc
Nhm ng phn v
14,1
16,7
24,4
43,1
Nng thn
8,5
12,0
21,4
57,7
ng bng sng
Hng
12,2
16,4
24,0
44,8
ng Bc
8,0
11,1
18,7
51,3
Ty Bc
2,8
0,8
12,7
33,0
Duyn hi Bc Trung
B
12,0
14,1
24,0
59,9
Duyn hi Nam
Trung B
8,0
12,2
23,4
51,6
Ty Nguyn
7,5
11,0
17,2
49,7
ng Nam B
14,3
16,1
26,0
50,8
ng bng sng
Cu Long
6,5
10,7
19,3
61,8
Dn tc Kinh v Hoa
11,0
14,4
23,4
51,5
Cc dn tc thiu s
4,2
5,7
11,3
49,9
Ngho nht
9,0
12,6
24,4
41,4
Ngho
9,1
13,1
23,9
78,5
Trung bnh
10,5
12,7
22,4
63,5
Kh
9,4
13,2
21,7
57,0
Giu nht
12,4
14,5
19,7
40,0
Ngun: VHLSS 2008, trch dn trong V Hong Linh 2010
CHI TIU BNH QUN U NGI CA H

GIA NH CHO GIO DC TNG LN
Cui cng v quan trng l, chi tiu bnh qun u
ngi ca h gia nh dnh cho gio dc tng
trong giai on 2004-2008 tt c cc bc hc, tr
trung hc c s. Trn ton quc, chi tiu cho gio
dc chim t trng 6,4% trong chi tiu bnh qun
u ngi ca h gia nh. Tuy nhin, nm 2008,
trong chi tiu bnh qun u ngi ca h gia nh,
t l chi cho gio dc (tr tt c cc khon phc li
gio dc nh tr cp v hc bng) bc tiu hc
l 9,8%, bc trung hc c s l 13,2%, bc trung
hc ph thng l 22,2% v ng kinh ngc l 51,4%
cho gio dc i hc v cao ng (Bng 5.5). Cc

h gia nh thnh th, nhm dn tc chim a s
Kinh/Hoa, nhm giu nht, ng bng sng Hng,
ng Nam B v duyn hi Bc Trung B dnh
t trng cao nht trong chi tiu ca h cho gio
dc tiu hc v trung hc c s.
cp trung hc ph thng, cc h gia nh
thnh th, ng Nam B, ng bng sng Hng
v Bc Trung B cng nh ngi Kinh/Hoa dnh t
trng cao hn trong chi tiu h gia nh cho gio
dc, nhng nhng h gia nh trong hai nhm
ng phn v thp nht li dnh t trng cao hn
trong chi tiu ca h cho gio dc so vi cc h
kh gi hn. Tuy nhin, bc i hc, cc h gia

nh nng thn, Bc Trung B, ng bng sng
Cu Long v nhm di trung bnh chi tiu nhiu
nht, mt phn do chi ph i li v cc chi ph khc
lin quan n gio dc i hc. R rng l, chi
tiu gio dc l mt gnh nng ln i vi cc h
ngho v kh khn, c bit l cc bc hc cao
hn, iu ny th hin t l b hc cao hn bc
trung hc ph thng. V Hong Linh c tnh mt
gia nh vi hai con hc i hc s phi dnh ti
25,7% tng chi tiu h gia nh cho gio dc ca
con em mnh.88
Chi tiu gio dc l mt gnh nng ln

i vi cc h ngho v kh khn, c
bit l cc bc hc cao hn.
CHI PH GIO DC V MIN GIM HC PH

Min hc ph v cc chi ph khc gp phn hn ch
chi ph gio dc m h gia nh phi trc tip chi
tr, ng k nht l bc tiu hc. D liu VHLSS
2008 cho thy mt t l ng k hc sinh c
min hc ph v cc khon thanh ton: 35,5% hc
sinh tiu hc c min trong nm 2008. Trong s
ny, 50% c min do l hc sinh tiu hc, 17%
thuc cc h ngho, 13% thuc cc dn tc thiu
s, 12% sng vng su vng xa, min ni, 4,5% c
cha m l lit s hoc cu chin binh, v phn cn
li hoc c hon cnh kh khn hoc c min
ph v cc l do khc.89 C th thy cc vng nng
thn, Ty Bc, Ty Nguyn v nhm ng phn v
ngho nht c t l min ph cao hn. 61,1% hc
sinh ng phn v ngho nht c min ph, ch
yu l gia nh ngho, dn tc thiu s hoc sng
vng su, vng xa, min ni. Tuy nhin, 17% hc
sinh trong ng phn v giu nht cng c min
ph, ch yu l do hc tiu hc, nhng c mt t
l nh ang c hng cc chng trnh mc
tiu ca chnh ph, cho thy c s r r trong cc
chng trnh ny.90
Ti Vit Nam, min hc ph c p dng ch yu
bc tiu hc: 14% cc chu nh tr/mu gio,
80% hc sinh tiu hc, 26% hc sinh trung hc c
s, 17,5% hc sinh ph thng trung hc v 12,5%
sinh vin cc trng trung hc chuyn nghip v
dy ngh c min hc ph trong nm 2008. Hc
sinh tiu hc ch yu c min hc ph do bc
tiu hc l min ph, tuy nhin trong gio dc mm
non, phn ln tr em c min gim hc ph l
do dn tc hoc a bn c tr. Trong khi , cc
bc hc cao hn, hc sinh, sinh vin c min
hc ph do ngho hoc a bn c tr. Ni cch
khc, min gim hc ph c thc hin thng qua

cc chng trnh gim ngho chnh bao gm c
Chng trnh 135-II, Chng trnh 61 huyn ngho
nht v Chng trnh mc tiu quc gia v gim
ngho. Quan trng l, 35,7% hc sinh c ng k
h khu tt c cc bc gio dc c th c min
hoc gim ph so vi 14% hc sinh khng c ng
k h khu (di c), iu ny cho thy nhng kh
khn ca con em ngi di c trong tip cn gio
dc. H thng min hc ph, theo cch no , l
gii cho s khc bit trong cc khon chi ph gio
dc c phn tch trn y, trong t trng chi
cho gio dc trong chi tiu bnh qun u ngi
ca ng phn v ngho nht v cc nhm dn tc
thiu s thp hn cc nhm khc.
CC LOI PH TNG CAO LM TNG

CHI PH GIO DC
Min hc ph v gim l ph phn nh cam kt ca
Chnh ph Vit Nam trong vic m bo tip cn
gio dc cho mi cng dn nhm thc y pht
trin con ngi v tin ti mt x hi cng bng
hn. Tuy nhin c khong cch ng k v ngy
cng tng gia chnh sch v thc t thc hin. V
d, theo lut cc trng tiu hc khng c php
thu hc ph, m cn phi rt cng bng, cho php
tr em ngho v c hon cnh kh khn hc xong
t nht l bc gio dc c bn. Tuy nhin trn thc
t, ngoi hc ph, nhiu trng tiu hc cn thu l
ph, v quan trng l trong nhiu trng hp cc
khon l ph cao hn hn mc quy nh. Mc d
c cam kt chnh tr v gio dc tiu hc min ph,
chi tiu h gia nh vn chim 17,5% tng chi tiu
bc tiu hc.91
Chi ph vn l mt ro cn ln i vi
tip cn gio dc ca cc h gia nh
kh khn v c thu nhp thp, c bit
l cc cp sau tiu hc.
Min hc ph c thc hin mt cch ty tin, v
cc h gia nh ngy cng phi chi tr nhiu cho
hc thm, c bit l cc khu vc th. iu
ny gii thch ti sao chi ph thc t bnh qun u
ngi cho gio dc tiu hc khu vc thnh th,
ng bng sng Hng v ng Nam B li cao
hn. a s cc trng hp min gim l cho ton
b hc ph - 28,7% trong nm 2008, nhng trn
thc t mt t l nh cc trng hp min gim
l min mt phn hc ph v cc chi ph khc; iu
ny c ngha l cc h gia nh phi np khon
chnh lch.92 Nh phn tch trn y, cc bc
hc cao hn, chi ph leo thang v bao gm khng
ch hc ph v cc l ph khc, ng thi chi tiu

ca h gia nh cho cc kha hc thm cng tng
ln. T l tham gia ca khu vc t nhn cng tng
ln cc bc hc cao hn, c bit l t cp trung
hc ph thng, lm tng cc l ph cn thit
theo hc.93 Do , chi ph vn l mt ro cn ln

i vi tip cn gio dc ca cc h gia nh kh
khn v c thu nhp thp, c bit l cc cp sau
tiu hc.
HP 5.5: H TR TIN MT C IU KIN TRONG Y T V GIO DC

H tr tin mt c iu kin l mt v d v chin lc thc y nhu cu thnh cng trong vic tng
cng tip cn cc dch v y t v gio dc, thng l hng ti ph n. Hin nay, nhiu quc gia
c cc chng trnh h tr tin mt c iu kin. mt s nc, bao gm c cc quc gia c trnh
pht trin con ngi cao v mc thu nhp trn trung bnh nh Brazil v Mexico, cc chng trnh
ny tip cn hng triu h gia nh, cung cp cc khon tin c gi tr ln ti 20% chi tiu h gia
nh trung bnh v c gi tr khong 0,5% GDP. Mc d c mt s khc bit, nhng cc chng trnh
u h tr tin mt trc tip cho h gia nh, yu cu tun th cc iu kin nh nhp hc, tham gia
chm sc y t d phng cho tr nh, v hng vo ngi ngho. Cc chng trnh ny nhm gim
ngho tiu dng, ng thi thc y ci thin kt qu pht trin con ngi. Nhiu chng trnh
dnh cho ph n nhm nng cao vai tr v v tr ca h trong gia nh.94 Cc khon h tr tin mt
c iu kin lm tng ng k vic s dng dch v, mc d tc ng ca chng i vi cc kt
qu lu di v y t v gio dc th phc tp hn.
Chng trnh Bolsa Familia Brazil bao ph ti 12 triu gia nh. Mi gia nh nhn c mt khon
tin nh, khong 12 la/thng, vi iu kin l con ci ca h phi theo hc n nm 17 tui,
tham d t nht 85% cc lp hc cho n khi 14 tui v khong 75% trong giai on 14-17 tui.
Cc b m c yu cu phi i khm trc v sau sinh, tr em di 5 tui phi c tim phng
tt c cc loi vc-xin theo khuyn co. trnh s r r cng qu cho nhng ngi khng iu
kin hng li, cc thnh vin ca chng trnh ny c nim yt cng khai trn mt trang web.
nh gi c lp cho thy 80% cc qu n c vi i tng mc tiu. K t khi chng trnh
c xy dng vo nm 2003, t l i ngho gim t 42,7% xung cn 28,8% v bt bnh ng
gim i 17%.95
Tng t, ti Mexico, PROGRESA (nay l Oportunidades) l mt chng trnh h tin mt c iu
kin, tp trung vo y t, gio dc v dinh dng, c tnh tip cn c khong 5 triu h gia nh.
Li ch ca chng trnh bao gm h tr tin mt trc tip cho cc b m ci thin dinh dng,
b sung dinh dng, tr cp gio dc cho tr em, u i cho hc sinh hon thnh trung hc, h
tr tin mt cho chi ph hc hnh, cc dch v y t v nng cao sc khe cho thanh thiu nin, h
tr tin mt cho nhng ngi trn 70 tui trong gia nh ngi hng li, v h tr tin mt b
p cho chi ph nng lng v thc phm. Chng trnh ny a ra cc u i c th ngn chn
t l b hc cao tr em gi trong gio dc trung hc c s v trung hc ph thng.
Chng trnh thnh cng trong vic gim 19% khong cch i ngho v gim 9% t l b hc
cc trng tiu hc v trung hc. S nm i hc cng tng trong cc i tng hng li; vic
s dng cc dch v y t cng khu vc nng thn tng 35%. Chng trnh cng ci thin sc
khe ca cc i tng hng li, v d thng qua gim t l thp ci, gp phn gim t l thp ci
chung trong ton quc nhm 20% ngho nht. Nhn chung, mt s kt qu cha c nh mong
i, v d kt qu gio dc th hin mc tin cng v kt qu thi. Cc sng kin to cu s l cha
nu cht lng dch v cho ngi ngho vn cn thp.96
CHI TIU CA H GIA NH V

PHT TRIN CON NGI
CHI PH Y T V GIO DC TNG LM
CHM TIN TRNH PHT TRIN CON NGI
CA Vit Nam
Chi tiu t khu vc t nhn vn tip tc chim t
l rt cao trong chi tiu cho c y t v gio dc.
Trong y t, cc h gia nh trc tip ng gp
hn 60% tng chi tiu y t, cn trong gio dc
h ng gp 17,5% trong gio dc tiu hc v
tng ln hn 50% trong gio dc i hc.97 Mc
ng gp cao ca h gia nh lm suy gim cam
kt ca chnh ph v vic m bo tip cn ph
cp vi cc dch v, gy ra chi ph ln cho cc h
gia nh, c bit l cc h ngho v c thu nhp
thp; lm tng tnh d b tn thng ca cc c
nhn v gia nh ngho, c hon cnh kh khn.
Chi t tin ti cho y t v gio dc cao mu thun
vi cch tip cn pht trin con ngi vi mc tiu
tng kh nng v la chn ca c nhn.
Chi t tin ti cho y t v gio dc cao

mu thun vi cch tip cn pht trin
con ngi vi mc tiu tng kh nng v
la chn ca c nhn.
Cc khon thanh ton khng chnh thc trong y t
v gio dc ang lm tng chi ph ca h gia nh v
cng nh hng n cht lng dch v, khi nhng
ngi c kh nng chi tr nhn c dch v tt hn
nhng ngi khng th chi tr. iu quan trng l,
nhng ngi c kh nng chi tr khng c ng c
s dng nh hng chnh tr v x hi ca mnh
nhm ci thin cht lng dch v cho ngi ngho
v ngi c hon cnh kh khn, v h ngy cng c
xu hng khng s dng cc dch v ny. Tht vy,
nhng ngi Vit Nam giu c nht ang ngy cng
c xu hng cho con em h i hc v cha tr bnh
nc ngoi, trong khi ngi ngho khng c la
chn no khc ngoi chp nhn cht lng ca dch
v sn c cho h.98
Nh vy, chi ph y t v gio dc tng c tc ng
trc tip n pht trin con ngi. Chi ph y t khng
ch l gnh nng i vi cc h ngho m cn c
th y cc h gia nh ri su hn vo i ngho,
v d nh nhng c sc v bnh tt y gia nh vo

n nn, s dng ht cc khon tit kim hoc bn
ti sn nh t ai. Tr hon iu tr bnh cng gp
phn lm tng chi ph y t (trong trng hp bnh
tr nng phi nm vin) v cng c kh nng lm
trm trng thm vn sc khe ca ngi dn.
Nhiu ngi Vit Nam thng tr hon iu tr v
t iu tr hoc n cc phng khm t nhn, iu
ny gip gii thch t l chi tiu tng i cao cho
cc loi thuc. Chi tiu cho y t vt qu kh nng
chi tr l mt ngun gy bt n kinh t cho nhiu
h gia nh Vit Nam.99 Tng t nh vy, chi ph cho
tr em i hc gy ra gnh nng ng k cho cc h
gia nh ngho, c bit l cc bc hc cao hn.
Khng c i hc c th khng to ra chi ph kinh
t trc tip, nhng n dn n cc chi ph c hi
ng k v mt thu nhp v c hi trong tng lai
v cng c th gp phn ko di chu k i ngho
gia cc th h.
Tr cp v phc li cho ngi ngho v ngi thit
thi thc s gp phn bo m tip cn y t, gio
dc, v chnh v vy c Chnh ph Vit Nam
u tin. Trong y t, l khm cha bnh min ph
cho tr em di 6 tui v cung cp th bo him
y t; trong gio dc, bc tiu hc min ph v cc
ch min gim hc ph c thit k m
bo cc h ngho v kh khn c th tip cn gio
dc c bn. Chnh ph cam kt r rng v vic
gim chi t tin ti cho y t thng qua kt hp tng
chi tiu ngn sch cho y t vi ph cp bo him y
t, mc d y vn cn l mt thch thc ln (xem
Hp 5.4). Tuy nhin, trong gio dc, hc ph c xu
hng tng ln cc bc sau tiu hc, da trn s
liu c tnh v chi tiu h gia nh (m chi tiu ny
cha bao gm nhiu khon lin quan n gio dc
bao gm c ng gp t nguyn).100 So vi y t, h
thng tr cp gio dc t ra t hiu qu hn v vn
cn nhiu ngi c iu kin hng h tr cha
c tip cn. Mc d c mc chi tiu gio dc kh
cao v ang bt kp vi cc nc lng ging v chi
tiu y t, Vit Nam vn cn cc ngun lc b sung, v
d m rng din bao ph bo him y t cho mi
ngi dn. Cc vn quan trng khc l hiu qu
phn b v s dng ngun lc, cch thc to ra v
s dng cc khon thu trong c khu vc cng v t
nhn, vai tr ca chnh ph trong vic iu tit khu
vc t nhn v cung cp da trn ph dch v. Nhng
vn ny s c tho lun trong Chng 6.
6
Chng 6
MC SN C,
CHT LNG V QUN L
CC DCH V X HI
MC SN C CA CC DCH
V Y T V GIO DC
DCH V CNG V T
Cc nhn t cung v cu u ang tc ng n
tip cn dch v y t v gio dc ti Vit Nam. Cc
nhn t v pha cung bao gm s sn c v d
dng tip cn cc dch v, cht lng dch v v
thi ca nhn vin. V pha cu, kh nng tip
cn tr cp v li ch, cng vi nhn thc v mc
hi lng l cc nhn t chnh. Nh cp
trong Chng 5, Vit Nam, chi ph cho y t v
gio dc l nhn t chnh gy nn chnh lch ngy
cng tng trong tip cn dch v v trong cc kt
qu y t v gio dc, to ra nhng hu qu ng k
i vi nhiu h gia nh.
Cc dch v y t v gio dc ngy cng sn c
Vit Nam. Cc dch v ny a phn vn do khu vc
nh nc cung cp, mc d s tham gia ca khi
t nhn tng ln ng k trong thp k qua, c
v y t v gio dc. iu ny c bit ng i vi
cc dch v iu tr ngoi tr v dc phm, gio
dc mm non, trung hc ph thng, i hc, cao
ng v dy ngh. Mt s dch v nh trm y t x
v bnh vin hu ht vn l ca nh nc, mc d

gn y chnh sch t ch ti chnh khin u
t t nhn vo bnh vin cng tng ln. Cc n v
cung cp dch v phi nh nc, phi li nhun vn
cn rt non tr Vit Nam. y l mt vn chnh
sch quan trng c tho lun trong chng ny.
Tuy nhin, vic phn chia rch ri gia cng v
t li tr nn phc tp do tnh trng thng mi
ha cc dch v cng trong c lnh vc y t v gio
dc.1 Vic cung cp dch v cng ang ngy cng
b thng mi ha thng qua vic thu ph dch v
c lnh vc y t v gio dc.
Vic cung cp dch v cng ang ngy

cng b thng mi ha thng qua vic
thu ph dch v c lnh vc y t v
gio dc.
Vic phn quyn mang li cho ngnh y t v
gio dc s t ch cao hn trong vic to ngn
sch v s dng ngn sch (Hp 6.1). V vy, c
ngun ngn sch do nh nc rt xung cng
vic thu ph cho cc dch v y t v gio dc
to nn nhng ng lc tiu cc trong c ngnh
y t v gio dc, lm tn hi n nhng cam kt
chnh sch ca chnh ph v thnh qu pht trin
con ngi.
Mc sn c, cht lng v qun l cc dch v x hi 112
HP 6.1: PHN QUYN

Ci cch hnh chnh Vit Nam nhanh chng phn quyn v cung cp v thu ph cc dch v y t
v gio dc, trao quyn t ch ti chnh cha tng c cho cc n v cung cp dch v cng. Mc tiu
l nhm khuyn khch cc ngnh huy ng mi ngun lc kinh t, m rng phm vi v nng cao cht
lng dch v cng nh tng kh nng p ng
cc nhu cu ca cng chng. Phn quyn a
Phn quyn a dng ha mnh m
dng ha mnh m cch thc cung cp v qun
l dch v cng trn cc vng min. Cc ngnh
cch thc cung cp v qun l dch v
c khuyn khch thng mi ha gim sc
cng trn cc vng min.
p ln ngn sch trung ng.2
Ngh nh s 10 (2004) v Ngh nh thay th s 43 (2006) trao quyn t ch v qun l v ti chnh,
cho php cc ngnh c ch ng hn trong cch t chc cng vic, qun l nhn vin, huy ng
v phn b cc ngun ti chnh. Cc nh cung cp dch v c khuyn khch u t vo ci tin,
chi tr lng cho nhn vin v m rng cc loi hnh dch v bng cc ngun thu ngoi ngn sch
nh nc.3 Mc d ai cng mong mun cc trng hc c th nng cp trang thit b, cc bnh vin
c kh nng tr lng thng tt hn cho nhn vin, nhng vic phn quyn li to cc ng lc
tiu cc cho nhn vin, thc y nh cung cp to thm nhu cu khng cn thit, v lm tng chi
ph y t, gio dc m ngi tiu dng phi tr.4 iu quan trng l qu trnh dch chuyn sang cc
dch v cng t ch khng din ra song song vi vic hnh thnh cc c ch thc hin hiu qu
nhm m bo s gim st v trch nhim gii trnh, v to iu kin ngi s dng dch v c
th gp v tc ng ti cch thc cung cp dch v.
DCH V Y T
cng.7 Cc nh thuc nh ca t nhn cng pht

trin bng n.
DCH V Y T NGY CNG PHT TRIN
Hnh 6.1 cho thy s lng cc phng khm v bnh

vin cng tng ln trong giai on 2000-2009. S
lng ging bnh trong cc bnh vin cng nm
2009 l 163.900. Tng t, s lng bc s v y t cc
bnh vin, trung tm y t cng tng thm tng
ng l 46% v 41% t nm 2000 n 2008.8 Tuy nhin
y t vn thiu trm trng, c bit l y t c trnh
cao.9 Trong cc c s y t, c 13.500 c s y t cng
v 35.000 c s t nhn, ch yu l cc phng khm
t. Nm 2008, ngoi 974 bnh vin cng vi 151.800
ging bnh, Vit Nam cn c thm 85 bnh vin t
vi 5.800 ging bnh. Nh vy, trung bnh Vit Nam
c khong 18 ging bnh trn 10.000 dn.10 Con s
ny thp hn ng k so vi 140 ging bnh trn
10.000 dn Nht Bn, 86 Hn Quc v 22 Thi
Lan.11 Thm vo , s lng cc c s v cn b y
t cng cc vng min khc nhau cng khc nhau
rt nhiu. Nhng vng ng dn c nh ng bng
sng Hng v ng bng sng Cu Long c nhiu
c s v cn b y t hn (Bng 6.1). Tuy nhin, do
cc vng ny c s lng dn c ng nn t l c
s y t v cn b y t trn 100.000 dn vn thp.
Dch v y t ch yu do nh nc cung cp, nhng

khu vc t nhn cng ang nhanh chng tham gia
cung cp dch v ny, c bit l iu tr ngoi tr.
Tuy nhin trn thc t, ranh gii gia khu vc cng
v t cng khng r rng, v bnh nhn phi tr tin
cho hu ht cc dch v m h nhn c, bt k
dch v do c s cng hay t cung cp. Nm
2008, 100% phng x c cn b y t, trong 65%
cc x c bc s, 93,3% s x c b hoc h l sn/
nhi v 87% cc thn bn c cn b y t.5 Cc phng
khm cng bao gm hn 12.000 trung tm y t x
(hoc trm y t x) hin din mi x hoc khu dn
c. Nhng c s ny gi vai tr xng sng ca h
thng y t d phng Vit Nam v chm sc y t d
phng ch yu do cc c s y t nh nc cung
cp.6 Tuy nhin, s lng cc phng khm v bnh
vin phi nh nc (t nhn) cng ang tng nhanh,
cng vi cc loi hnh dch v y t a dng c
cung cp trn c s thng mi (do ngi bnh
trc tip tr tin) cc phng khm v bnh vin
Hnh 6.1: S lng c s y t cng 2000 v 2004-2009
Ngun: Nguyn Vit Cng 2010; Nin gim thng k Vit Nam 2009
Bng 6.1: S lng c s v cn b y t cng theo 8 vng, 2008

Vng
S lng c s v cn b y t cng
T l c s v cn b y t cng trn 100.000 dn
Trm y
t x
Bnh vin
Bc s
Y t
Trm y
t x
Bnh vin
Bc s
Y t
ng bng sng Hng
2,546
170
9,764
23,621
13,7
0,92
52,6
127,4
ng Bc
2,434
155
6,160
17,495
25,2
1,61
63,8
181,3
Ty Bc
736
46
1,329
6,263
27,6
1,73
49,9
235,0
Duyn hi Bc
trung b
2,043
108
4,912
15,871
18,9
1,00
45,5
147,0
Duyn hi Nam trung

b
1023
88
3,930
10,741
14,1
1,21
54,2
148,1
823
67
2,402
7,330
16,4
1,34
48,0
146,5
ng Nam B
Ty Nguyn
1,259
127
8,288
20,349
8,6
0,87
56,8
139,4
ng bng sng Cu
Long
1,806
154
7,886
23,241
10,2
0,87
44,6
131,3
C nc
12,670
915
44,671
124,911
14,7
1,06
51,8
144,9
Ngun: Nin gim thng k ca TCTK, trch t Nguyn Vit Cng 2010
THNG MI HA DCH V Y T
Nhiu bnh vin cng Vit Nam cung cp dch v
thng mi ha, nh cc dch v theo yu cu hay
cc dch v b sung nh phng ring, iu ha, v
trong mt s trng hp l cc trang thit b hin
i hn vi mc gi cao hn. Kt qu l cht lng
dch v cng mt bnh vin v cc bnh vin
khc nhau cng khm cha mt loi bnh li c
nhiu khc bit.12 Nhu cu v cc dch v ny ngy

cng tng v ngy cng c nhiu ngi c kh nng
chi tr cho cc dch v t tin hn.
cc c s y t cng, thng mi ha c xu hng
khuyn khch lm dng thuc v k n nhng dch
v y t khng cn thit. Ngn sch nh nc c
phn b theo s ging bnh, v i vi y t d
phng l theo s dn. iu ny khuyn khch cc
bnh vin lm dng iu tr ni tr cho nhng bnh

nhn vn ch cn iu tr ngoi tr, lm trm trng
hn tnh hnh qu ti, m khng quan tm n cht
lng dch v hay hiu qu iu tr.13 Cc c s y t
c thu nhp t ba ngun: ngn sch nh nc, tin
ti ca ngi bnh, v qu bo him y t.14 Ngn
sch nh nc chim khong 29% tng ngun thu,
cn ngun thu chnh l t tin ti bnh nhn, chim
59,4%.15 Cc bnh vin tnh v trung ng ang qu
ti, do c th thu ph dch v cao hn cc bnh
vin huyn. iu ny cho php h c thu nhp
cung cp cc dch v hng u v thu ht i ng
nhn vin gii. Cc bnh vin c quyn t ch rt cao
trong cc quyt nh iu tr, p t gi thuc v c
th hng li v ti chnh nhiu hn khi ngun thu
t vin ph tng ln. Quyn ny li cng c tng
cng theo Quyt nh 10 v 43 (xem Hp 6.1). Ri
ro y l mt cuc chy ua v k thut trong y t
v mc s dng cc dch v khng cn thit tng
cao.16 Thc vy, nm 2008, c tnh c khong 180
triu lt khm bnh, 205 triu lt xt nghim v
trn 10,6 triu lt siu m c thc hin.17
lc v trang thit b thc hin nhim v ny. Vic

s dng cc dch v t nhn ly mt ngun thu
ca h thng y t cng, c bit cp c s. Hnh
vi ca ngi bnh cng ng gp mt phn, khi
ngi ngho thng t mua thuc ung hay n
khm cc phng khm t khi bnh khng trm
trng, v ch s dng cc dch v iu tr cng, c
bit l bnh vin, khi bnh nng.19 Tu chung li,
c ch cung cp ti chnh trong h thng y t Vit
Nam khng h tr vic cung cp dch v da trn
nhu cu y t.
Trong khi , cc bnh vin huyn li khng s

dng ht cng sut, t c u t hn v nhn vin
c nng lc v bng cp thp hn v khng thu ht
c cn b.18 Vic iu tr, thuc thang, trang thit
b cc trm y t x khc nhau ng k, ty theo v
tr a l, nh cp Chng 4. Cc trm y t
x c th ng vai tr quan trng hn trong y t d
phng, nhng h thng thiu nhn vin, ngun
Dch v gio dc ang c c c s cng lp v t

nhn cung cp. S lng c s gio dc cng v t
tng u theo thi gian, nh th hin trong Hnh
6.2, tr cc trng trung hc chuyn nghip. Cc
trng cao ng v i hc tng ln c bit nhanh
chng, t 277 nm hc 2005-2006 ln 403 nm hc
2009-2010. S lng gio vin cng tng tng t
theo thi gian tt c cc cp gio dc.20
C ch cung cp ti chnh trong h

thng y t Vit Nam khng h tr vic
cung cp dch v da trn nhu cu y t.
DCH V GIO DC
CC C S GIO DC CNG V T
Hnh 6.2: S lng cc trng hc 2005-2010
Ngun: Nin gim Thng k Vit Nam 2009
Cng ging nh ngnh y t, ngnh gio dc cng

do khu vc nh nc chim vai tr ch o. Tuy
nhin, s lng cc trng t tng u. S hc
sinh ng k vo cc trng t tng t 2,6 triu nm
2000 ln 3,4 triu nm 2008, tng ng vi 12%
n 15% tng s hc sinh ng k hc trong giai
on ny.21
Cc trng cng chim a s cp tiu hc v
trung hc, cn cc trng t tp trung nhiu hn
vo cp mm non, cao ng, i hc, v dy ngh.

Theo s liu ca B Gio dc v o to, khong
43% cc trng mu gio/nh tr, 19% cc trng
trung hc ph thng, 20% cc trng i hc, cao
ng v 34% cc trng trung cp chuyn nghip
v dy ngh l trng t.22 n nm 2008, 49% hc
sinh mm non, 21% hc sinh trung hc ph thng,
37% hc vin hc ngh, 18% hc sinh trng trung
cp chuyn nghip v gn 12% sinh vin i hc/
cao ng ang theo hc ti cc trng t (Bng 6.2).
Bng 6.2: T l hc sinh ng k ti cc trng cng v t theo cp hc, 2000 v

2005-2008
2000
2005
2006
2007
2008
Trng cng
88,16
85,12
84,34
84,6
84,94
Trng t
11,84
14,88
15,66
15,4
15,06
Trng cng
52,78
58,31
57,27
56,37
51,14
Trng t
47,22
41,69
42,73
43,63
48,86
Trng cng
99,72
99,55
99,46
99,42
99,4
Trng t
0,28
0,45
0,54
0,58
0,6
Trng cng
96,82
98,2
98,59
98,83
98,91
Trng t
3,18
1,8
1,41
1,17
1,09
Trng cng
65,21
69,54
69,4
72,9
79,03
Trng t
34,79
30,46
30,6
27,1
20,97
Trng cng
70,70
73,80
71,17
70,71
63,35
Trng t
29,30
26,20
28,83
29,29
36,65
Trng cng
97,1
84,49
81,78
81,57
81,33
Trng t
2,9
15,51
18,22
18,43
18,67
Trng cng
88,64
88,43
87,13
88,22
88,4
Trng t
11,36
11,57
12,87
11,78
11,6
Tt c cc cp
Mm non
Tiu hc
Trung hc c s
Trung hc ph thng
Dy ngh
Trung cp chuyn nghip
Cao ng, i hc
Ngun: B GD&T 2009a, trch dn trong V Hong Linh 2010
Ranh gii gia cng v t trong gio dc ang ngy

cng tr nn m nht v hu ht cc trng cng
u da vo cc ngun thu ngoi ngn sch nh
nc. Hin nay, cc trng c hng ngn sch
nh nc bao gm trng cng, bn cng v cc
trng c lp v ti chnh. Cc trng bn cng
vn do nh nc cp ngn sch v qun l (cho n
gn y b coi l khng hp php) thu ph cao hn
ng k so vi trng cng v thng nhm ti cc
hc sinh c thnh tch hc tp km. Cng lc ,
mt vi trng cng lp li c cc lp bn cng,

trong , hc sinh phi tr ph cao hn v i khi,
ngay c hc sinh bn cng vn theo hc cc lp
cng lp. Cc trng t cn bao gm cc trng
dn lp c lp nhng nhn h tr di hnh
thc c s h tng hay tr cp, v cc trng t
hot ng v li nhun hon ton khng nhn h
tr vt cht no ca nh nc.23 Trong mt chng
mc no , trng cng cung cp dch v gio dc
m khng thu thm nhiu ph ph l mt bin php
chng thng mi ha gio dc, v d nh bng

cch min ph gio dc tiu hc cho cc h gia nh
c thu nhp thp. Tuy nhin, s pht trin ca cc
lp hc thm m bo kt qu hc tp ph
nhn phn ln tc dng bo v ny.24
Ranh gii gia cng v t trong gio dc

ang ngy cng tr nn m nht v hu
ht cc trng cng u da vo cc
ngun thu ngoi ngn sch nh nc.
THNG MI HA LM TNG CHI PH

Ngoi gio dc bc tiu hc v trung hc c s, hc
ph l ngun thu ch yu ca cc trng cng. Vi
gio dc mm non, tin ti tr chim 50% tng kinh
ph hot ng ca cc trng bn cng v dn lp.
Nm 2008, c tnh cc trng ny huy ng
c khong 600 t ng xy dng c s vt
cht, bo dng v mua sm trang thit b.25 Gio
dc mm non ngy cng mang tnh cht hng ha
v ph thuc vo ng gp ca cc h gia nh v
ngn sch nh nc hn hp v c s vt cht a

phng i khi khng kh nng p ng nhu
cu ti a phng. V gio dc mm non trn thc
t c vai tr nh hnh thc trng tr cho cha m i
lm nn cc gia nh vn phi c gng tr hc ph
cho tr i hc, d hc ph kh cao. V gio dc tiu
hc, d c lnh cm thu hc ph, rt nhiu trng
tiu hc cng lp vn thu ph, ln ti 80.000 ng
mt s thnh ph, v nhiu trng cn thu cc
khon ph ph.26 Cc trng tiu hc gii thch l
do phi thu ph ph l chi ph hot ng dy v hc
qu cao. Cc trng im ph thng c s cng
lp thu ti 3 triu ng mt thng tin hc ph, tin
ng gp v hc thm, vt xa mc m hu ht cc
gia nh Vit Nam c kh nng chi tr. Cc hc sinh
c hc lc km hn b buc phi hc cc trng
t hoc trng bn cng, m nhng trng ny li
thu ph cao hn cc trng cng lp tng ng.
Cc trng i hc v dy ngh cng ang ngy
cng tr nn ph thuc vo hc ph. iu ny
nh hng ti loi hnh o to m cc trng cung
cp, thin v cc ngnh ang l mt hoc sinh li
nhiu, hn l nhng ngnh m x hi cn (Hp 6.2).
HP 6.2: CI CCH GIO DC I HC

Trong thp k ti, h thng gio dc i hc ca Vit Nam s ng trc mt bc chuyn mnh m v
nu khng c ngun nhn lc c tay ngh v c sng to cao, Vit Nam s khng th chuyn sang mt nn
kinh t c k nng v cng ngh cao nh mong c. Tuy nhin, nn gio dc i hc ti Vit Nam ang
phi i mt vi nhng thch thc to ln. Trong khi chi ph cho gio dc ca Vit Nam ang chim mt t
l trong GDP cao hn so vi nhiu nc trong khu vc, ch mt phn tng i nh c dnh cho gio
dc i hc v cao ng, khong 10% trong tng chi tiu cho gio dc, v khong 18% nu tnh gp tt
c cc loi hnh dy ngh. Gio dc i hc pht trin ht sc nhanh chng. Lng sinh vin tng t
918.228 nm 2000 ln 1.719.499 nm 2008, v s lng cc trng tng t 178 ln 369. Cc trng t cng
xut hin nhiu hn, vi khong 218.189 sinh vin theo hc ti 64 trng i hc v cao ng t nhn vo
nm 2008.27 Nhng cc tiu chun v cht lng v trch nhim gii trnh cha theo kp vi s thay i ny.
Cc thch thc ang t ra bao gm: kh khn trong vic t c cc ch tiu gio dc trong cc lnh vc
m chnh ph xc nh l u tin nh cng ngh thng tin v k thut; thiu cc tiu chun ti thiu v hc
thut v t chc cng nh bin php m bo thc hin; vic lp k hoch ch yu l t pht dn n tnh
trng xut hin rt nhiu trng i hc cp tnh; tp trung qu nhiu vo nhu cu hin ti hn l tng
lai khi sinh vin t la chn nhng ngnh nh k thut, cng ngh thng tin v khoa hc t nhin, nhng
ngnh c vai tr ht sc quan trng cho s pht trin kinh t ca Vit Nam trong tng lai; s ph thuc
ngy cng cao vo vo hc ph v cc ngun ti chnh t nhn v vic thng mi ha gio dc i hc;
vic qun l qu t m hn l gim st mt cch hiu qu cc tiu chun cht lng v ngi hc.28
Thng mi ha gio dc i hc din ra ht sc nhanh chng ti Vit Nam m khng c khung
php l bo v ngi tiu dng, trong trng hp ny l cc sinh vin v gia nh. Vic xut hin t cc
chng trnh i hc m, ti chc, hc t xa v cc chng trnh lin kt, trong cc trng c th thu
ph cao hn, ch l mt v d. Cc chng trnh ny thng c cc tiu chun gio dc thp hn, hot
ng khng c gim st v rt nhiu trng hp mua bng c ghi nhn.29 Nh nhn nh ca bo
co nm 2010 ca chuyn gia t i hc New School New York v i hc Harvard v ci cch gio dc
i hc: C th phn bit r s khc nhau gia vic c mt th trng gio dc v vic thng mi ha
gio dc, tc l t nhn ha mt cch t pht, khng theo mt tiu chun chung cho ton ngnh. 30
Chi tiu ngoi ngn sch nh nc chim khong 37% tng chi cho gio dc, khng bao gm 1 t
la M m cc gia nh b ra cho con em i du hc nm 2007. Tuy nhin, gio dc i hc, mc chi tiu
t nhn cn cao hn ng k. Thc vy, hc ph ang tng ln u n; ch ring t nm 2008 n 2009
tng 42% v d on s tng trong khong t 17% n 27% hng nm trong giai on 2009-2014.
Hc ph trung bnh ca mt sinh vin l 383.000 ng mt thng nm 2008 v 414.000 ng mt thng
nm 2009 (theo thi gi nm 2008). Tuy nhin, mt s trng i hc t thu ph t 7 n 20 triu ng
mt nm, tc l 700.000 n 2 triu ng mt thng.31 Mc d cc gia nh trung lu Vit Nam u sn
sng u t nhiu cho gio dc ca con ci, khong cch v kh nng tip cn gio dc i hc gia
ngi giu v ngi ngho s tng ln khi hc ph tip tc tng. Nh cp Chng 4, nm 2009,
ch di 1% dn thuc ng phn v ngho nht theo hc i hc, so vi 38% ng phn v giu nht.
Tht bi trong vic m bo cng bng s c kh nng tc ng ti nhn thc ca ngi dn v vic
liu chnh ph c th t c tng trng cng bng hay khng. 32
CHT LNG DCH V X HI

CC THCH THC TRONG Y T CNG
Nhng thch thc ln vn ang tn ti trong vic
cung cp dch v y t c s cho tt c cc cng
ng dn c, c bit nhng cng ng dn tc
thiu s v nhng vng su vng xa, v nhiu gia
nh sng cch trm y t x ti 5-10km v ch i b
mi c th n c. Khong cch v thi gian l
nhng nguyn nhn chnh dn n vic tip cn
dch v y t cc vng su vng xa ht sc kh
khn. Tuy nhin, cng nh thnh th, cht lng
c s h tng cng vi nng lc v thi nhit tnh
ca cc nhn vin y t cng ng vai tr quan trng.
Nhiu trm y t x thiu nhng iu kin vt cht ti
thiu nh in hay nc sch, c bit vng ni v
nhng vng i li kh khn. Tnh trng thiu cn b
y t; iu kin lm vic khc nghit; thiu c hi o
to v gim st yu km cng nh hng tiu cc
n cht lng dch v.33 Cn b y t thiu nghim
trng lnh vc y t d phng, cc trung tm y t
v phng khm cp c s v vng su vng xa,
mt phn do nhng v tr ny khng hp dn vi
bc s, y t v c hi thu nhp. Hn mt na cc y t,
bc s v 82% dc s c bng cp lm vic thnh
th.34 Ngoi ra, rt t cn b y t c bng cao hc
ch 2,1% c bng sau i hc v hu ht cn b
qun l v hnh chnh u c o to v ngnh y
ch khng c kinh nghim v k nng ph hp v
qun l.35
Cc trung tm y t qun huyn cha c s dng
ht cng sut trong khi cc bnh vin cp tnh v
trung ng li b qu ti nghim trng. Mt phn

nguyn nhn l do quan nim rng bnh vin tuyn
di th cht lng cng thp hn. Mt phn khc
l trn thc t, cc bnh vin cp tnh v trung ng
c i ng nhn vin v cc trang thit b t tin
hn. Cc bnh vin cp huyn v thm ch cp tnh
khng th x l cc ca bnh nng, v vy, ngi bnh
phi tm n cc bnh vin trung ng, ng ngha
vi vic chi ph i li, n cng b i ln. Nhu cu
v cc dch v phc tp hn Vit Nam ang tng
ln, mt phn l do vic thng mi ha dch v y
t cng dn n xu hng k n qu mc v tin
hnh nhng th tc y t khng cn thit. ng
nhin, tnh trng ny gp phn lm tng chi tiu
cho y t. Thm vo , rt nhiu loi bnh l ra ch
cn iu tr ngoi tr vi chi ph thp hn rt nhiu
li c ch nh iu tr ni tr.36 iu ny cng tc
ng ln ti cng bng x hi v thng mi ha cc
dch v y t s khin cho cc dch v cht lng cao
ch dnh cho ngi c tin. Thc vy, nhng ngi
i khm cha bnh min ph theo ch bo him
thng ni rng cc nhn vin y t khng i x
vi h tn tnh v tn trng nh khi h tr tin.
Nhng ngi i khm cha bnh min

ph theo ch bo him thng ni
rng cc nhn vin y t khng i x
vi h tn tnh v tn trng nh khi
h tr tin.
Mc d Lut khm cha bnh c quy nh v c ch
v trch nhim gii trnh vi bnh nhn, trong
bao gm c ch khiu ni, song vic thc hin li
cha hiu qu, nh tho lun di y.
CC THCH THC TRONG GIO DC CNG
CC C S T NHN
Tnh trng tng t cng din ra trong lnh vc gio

dc. Ngi dn vng su vng xa v ng bo dn
tc thiu s thng gp kh khn khi tip cn gio
dc, v cht lng gio dc dnh cho h cng thp
hn so vi ngi dn thnh th. Chi tiu cng cho
gio dc mm non thay i nhiu ty theo tnh,
khin cho cht lng v mc sn c ca gio dc
mm non cng khc bit. Ro cn v khong cch
a l v ngn ng cng l vn ln i vi ngi
dn vng su vng xa v ng bo dn tc thiu s.
cp mu gio, b m phi gi con di 5 tui ti
lp hc cch nh 30 pht i b ng gp ghnh,
ni tr phi hc bng mt ngn ng khc. Cho nn
cng d hiu v sao nhiu b m ngi dn tc thiu
s khng mun gi con i mu gio. Cc lp mu
gio cng thiu nhng iu kin vt cht ph hp
nh v sinh, chng trnh ging dy, dng c hc tp
v chi cho tr. Ngay c cht lng dy hc cng
c s khc bit ng k: thng l cc gio vin tr
c bng cp thp v c tr lng t ch yu l n
- v trong mt s trng hp, thm ch cn l nhng
tnh nguyn vin hon ton khng c bng cp lm
vic ti cc trng mu gio vn thiu gio vin.
Cc c s y t v gio dc t nhn ang pht trin

mnh m Vit Nam. Nhng tnh trng hin ti
cng t ra nhiu vn ng lu . Th nht, cc
nh cung cp dch v t nhn khng c qun l
cht ch, v hu nh khng c c quan no gim
st cc dch v h cung cp hay cht lng dch v.
Cc ro cn v vt cht v nhng hn ch v c s
h tng cng ph bin cp tiu hc, c bit
vng su vng xa, vng nng thn, ni giao thng
i li cn nhiu kh khn. Khc bit v cht lng
trng s v ging dy, thi gian trn lp, v cc ro
cn c th xut pht t ngn ng v nh kin x
hi cng nh hng n s lng tr n trng.
cc cp hc cao hn, thiu trng lp cc vng
ngho, vng su vng xa kt hp vi s khc bit
trong cht lng ca c s h tng gio dc v cht
lng ging dy to ra mt h thng hai cp.38
Cc ro cn ny cng cao hn i vi tr em dn
tc thiu s ngho, nht l tr em gi. Nguyn nhn
khng ch do ro cn v chi ph nh bn trn
m cn do nhu cu phi lm vic kim tin, nhn
thc khng y v gi tr ca gio dc nht l
cho con gi, cht lng dy v hc thp, v c s
h tng trng hc thiu thn. S khc bit ngn
ng v vic s dng song ng hn ch l vn ln
tt c cc cp hc.39 Cht lng ca cc trng
i hc v dy ngh c tha nhn l mt vn
ln v mt tr ngi cho tng lai pht trin ca
Vit Nam. Trnh gio vin thp, kin thc v mn
hc ngho nn v k nng s phm hn ch, cng
vi tnh trng thiu gio vin giu kinh nghim v
c trnh c nng thn v thnh th l nhng
thch thc dai dng. c bit nng thn, trng
hc thng thiu gio vin v cc gio vin thng
c k nng s phm thp hn chun quc gia.40
Cc nh cung cp dch v t nhn khng

c qun l cht ch, v hu nh khng
c c quan no gim st cc dch v h
cung cp hay cht lng dch v.
V y t, hu qu nh nht l vic iu tr khng cn
thit, v t hi nht l vic iu tr bt hp php,
thm ch nguy hi. V d, vic s dng cc loi thuc
khng an ton v bt hp l c tha nhn l
mt vn Vit Nam, nh c nu trong vi Bo
co chung thng nin v y t.41 Dc phm Vit
Nam nhn chung l t, chim mt phn ng k
trong chi tiu cho y t v y chi ph y t ln cao.
Cc bc s c ng c kinh t quan trng k cc
loi thuc t tin hn.42 Nhiu phng khm, bnh
vin t nhn Vit Nam cng ng thi l ni bn
thuc.43 H a ra mc gi no, k n c hp l hay
khng, h c bn thuc gi hoc cc loi thuc qu
thi hn s dng hay khng u khng b kim sot.
T l ngi dn t mua thuc ung cn cao, cc nh
thuc thng bn thuc m khng c n ca bc
s, v cc hng dn iu tr chun vn cha c sn
trong c bnh vin cng ln bnh vin t.44 Cc dch
v nh siu m v ph thai nhm chn lc gii tnh,
d bt hp php Vit Nam, vn rt ph bin ti cc
phng khm t vi chi ph rt thp, c bit ti cc
khu vc th. Nh Bo co chung thng nin v
y t nm 2010 nh gi: Vic theo di v gim st
cc c s t nhn cung cp cc dch v v dn s, k
hoch ha gia nh v sinh sn vn cn yu, c bit
l vic ph thai ti cc phng khm t. 45
Khng ngc nhin khi cc c s y t v gio dc t
nhn li tp trung cc vng min v cc dch v
to li nhun cao cho h, thay v cung cp cc dch
v cho nhng ngi b thit thi hoc nhng dch
v rt cn thit nhng khng sinh li. V vy, trong
khi y t t nhn ang trn pht trin th n c xu
hng tp trung cc khu vc kinh t giu c hn
v vng th, do m bo cho nhng ngi
kh gi sng cc khu vc ny c thm nhiu s la
chn. Nhng iu ny li buc nhng ngi ngho c
hon cnh kh khn v ngi dn vng su vng xa
phi ph thuc hon ton vo h thng y t cng.46
Tng t, cc nh cung cp dch v gio dc t nhn
c xu hng tp trung vo gio dc bc cao, nht l
dy ngh v i hc, v vo cc ngnh mang li nhiu

li nhun nh cng ngh thng tin v ngoi ng. Mc
d cc trng t c th dy cc ngnh khc nhng ...
cc trng t khng th thc thi hai nhim v c bn.
Trc tin, cc trng t hot ng v li nhun s
khng u t vo cc ngnh khng sinh li nh khoa
hc x hi, khoa hc t nhin, k thut v nhn vn.
Th hai cc trng t s nhn hc sinh da trn kh
nng chi tr hc ph ch khng da trn nng lc ca
hc sinh.47 iu ny khng v li ch ca x hi v cng
khng phc v mc tiu pht trin con ngi rng ln
hn. Bo co ny cho rng chnh ph phi ng vai tr
iu tit v gim st mnh m hn, v cung cp cc
dch v m khu vc t nhn s khng cung cp v li
nhun qu thp, k c dch v cho nhng ngi dn
c hon cnh kh khn v d b tn thng nht. Vic
m ca cho cc nh cung cp dch v phi li nhun
phi nh nc s l cha kha chia s gnh nng v
cho php nh nc tp trung vo vai tr hoch nh
chnh sch, gim st v iu tit ca mnh.
KHU VC PHI LI NHUN

Trong khi chnh sch x hi ha ku gi tt c cc
thnh phn trong x hi gp phn vo thit k v
cung cp cc dch v x hi, n nay ti Vit Nam,
khu vc phi nh nc, phi li nhun vn cn vng
bng trong cung cp dch v y t v gio dc. Vic
Chnh ph t ra thn trng v cc ng c v xu
hng chnh tr ca cc t chc phi chnh ph, t
chc t thin v t chc tn gio hn ch phm
vi tham gia ca h. Mt mi trng thun li cho
php cc on th phi li nhun hot ng vn
cha c hnh thnh y : mi trng php l v
hnh chnh cn gy nhiu tr ngi, v nhng n lc
thnh lp cc c s phi li nhun, v d trong lnh
vc gio dc i hc, b ngn cn.48 Kt qu l:
Vit Nam cha c truyn thng cc t
chc phi nh nc, phi li nhun cung cp
cc dch v x hi ... Do thiu m hnh kh thi
v cc t chc bn cng v x hi dn s, h
thng cc dch v x hi b y v hai cc
mt l nh nc cung cp dch v trc tip
v hai l thng mi ha cc dch v x hi
c cc c s cng v t.49
Tuy nhin, cc t chc phi nh nc, phi li nhun c
th gi vai tr quan trng trong cung cp cc dch v
y t v gio dc bng cch m rng kh nng tip cn
dch v n vi cc nhm dn c d b tn thng
v c hon cnh kh khn. Cc t chc phi li nhun
cng c th pht trin v th im cc h thng qun
l v hnh chnh minh bch v c trch nhim gii
trnh cao hn. Khu vc phi li nhun ny c th hnh
thnh cc hip hi v cc tiu chun ngh nghip,

nh h tr chnh ph trong vic gim st v theo
di hot ng ca cc c s cung cp dch v.
H THNG Y T V GIO DC HAI CP

Nh tho lun, cc dch v y t v gio dc Vit
Nam ang ngy cng b t nhn ha (do cc t chc
phi nh nc v hot ng v li nhun cung cp)
v thng mi ha (do cc c s t nhn, cng lp
hoc c s c nh nc tr cp cung cp trn c s
thu ph). Mc d cc t chc t nhn r rng l c vai
tr nht nh trong vic cung cp cc dch v x hi,
nhng trn thc t vic th trng ha dch v y t v
gio dc Vit Nam lm suy yu cam kt ca chnh
ph v tip cn cng bng cc dch v x hi, ng
thi gp phn ng k trong vic to ra s khc bit v
tip cn v kt qu dch v. iu ny lm tng chi
ph dch v cho cc gia nh Vit Nam, nhng ngi
ng gp phn ln cho ngn sch y t v gio dc.
Kt qu l mt h thng y t v gio dc hai cp
ang hnh thnh Vit Nam, trong nhng ngi c
tin c th c hng cc dch v tt hn hn, cn
nhng ngi khng c tin, bao gm nhng ngi
phi ph thuc vo tr cp v dch v sn c ti a
phng, phi chp nhn nhng g h c. Cc vn
v cht lng dch v y t v gio dc ang th hin r
vic ngy cng c nhiu gia nh Vit Nam mun s
dng dch v gio dc i hc v chm sc sc khe
nc ngoi. Trn thc t, h ri b cc dch v trong
nc, mang theo v tin ca h. Cc gia nh c thu
nhp thp khng c s la chn xa x ny. S khc bit
ln hn na trong thnh tch gio dc v y t trong
tng lai l h qu tt yu ca xu hng ny.
HI SINH CHNH SCH X HI HA

Chnh sch x hi ha th hin chin lc ca Vit
Nam nhm qun l mt s thay i khng th trnh
khi l nh nc khng cn c quyn cung cp
v ti tr cho cc dch v x hi, v nh nc khng
cn kh nng chi tr cho 100% cho cc dch
v cng. T phn phn tch ngun ti chnh v cung
cp cc dch v y t v gio dc hin nay, ta c th
thy r rng mc ch ca chnh sch x hi ha (
l s tham gia ng o hn ca mi thnh phn x
hi trong vic thit k, cung cp v gim st cc dch
v x hi) khng t c trn thc t. C mt
lot cc im quyt nh v chnh sch cn ang
pha trc - c bit l s cn thit phi thc hin tt
cc chnh sch v quy nh hin hnh kim sot
nhng tc ng tiu cc ca thng mi ha dch
v y t v gio dc, vai tr ca nh nc trong iu
tit th trng, lm th no thc hin cc cam
kt ph cp ton dn. Mt im quyt nh na l

xc nh i tng mc tiu nh th no h tr
nhng ngi b tt hu thay v to ra mt h thng
dch v hai cp, trong kh nng tip cn dch v
ca ngi dn (v thm ch c tnh trng sc khe
v gio dc ) ph thuc vo kh nng chi tr ca h.
iu khng may l h thng dch v hai cp thc
s tn ti Vit Nam, v y t v gio dc trong thc t
khng cn l mt quyn ph qut, m tr thnh
hng ha. Trong bi cnh l cc chnh sch ca chnh
ph v nhn thc ca cng chng u xc nhn
mnh m quyn ca mi cng dn c tip cn
y t v gio dc th thc t ny khng d chu cht
no. Nhng mt cuc tranh lun chnh sch ci m
v c c s thc t v nhng g ang xy ra l rt quan
trng, v chnh ph s phi i mt vi nhng thch
thc ln lao v s cn c h tr ng k, bao gm
t cc i tc pht trin, nu Vit Nam mun thnh
cng trong vic iu chnh cc lc lng th trng
cho ph hp vi nhu cu v li ch cng cng.
Chnh ph s phi i mt vi nhng thch

thc ln lao v s cn c h tr ng
k, bao gm t cc i tc pht trin, nu
Vit Nam mun thnh cng trong vic iu
chnh cc lc lng th trng cho ph hp
vi nhu cu v li ch cng cng.
Cc th ch v nng lc qun l s cn c xy
dng v cng c, cc hip hi ngh nghip v cch
lm mi cn c pht trin, v cc thnh phn mi
bao gm cc t chc phi nh nc, phi li nhun v
ngi s dng dch v s cn c tham gia.
S HI LNG CA NGI DN
I VI CC DCH V
MC HI LNG VI CC DCH V Y T
V GIO DC CN THP
Nh nhn xt trong Chng 2, cc mong i v
nguyn vng ca ngi dn Vit Nam ang thay
i. Kt qu l mc hi lng ca h vi cc dch
v y t v gio dc cng c kh nng s thay i,
tc ng n vic chp nhn v s dng cc dch
v ca h. iu tra mc sng h gia nh Vit Nam
nm 2008 t cc cu hi v vic ngi dn c hi
lng vi dch v y t v gio dc hay khng, h ngh
rng cc dch v c ci thin n mc no
v trong khong thi gian t nm 2006 n 2008
tham nhng tr nn ti t hn hay hn. Nhn
chung, ngi tr li hi lng nht vi gio dc tiu
hc cng, v t hi lng nht vi dch v y t ti a
phng v cc trng dy ngh cng lp. Mt phn

ln cng cho rng cc dch v c ci thin,
nht l gio dc tiu hc v trung hc, mc d
ngi tr li cng c ci nhn t tch cc hn v cc
trng i hc, dy ngh v dch v y t a phng.
Ni chung, nam gii c v hi lng hn n gii, v
nhng ngi tr li thuc thnh phn kh gi v
thnh th c nhn xt nghim khc hn, cho thy
vic c nhiu s la chn v nng lc cao hn cng
nh hng n mc hi lng.51
Khi c hi v cht lng ca cc bnh

vin cng cp huyn/x, bnh nhn
lun d kin s phi nm chung ging.
cp vng, cc xu hng cng tng t nh vy. Trong
gio dc, mc hi lng cao nht vi gio dc tiu
hc, trung hc v dy ngh c th hin r ng
bng sng Cu Long v ng Nam B. i vi gio dc
i hc, mc hi lng cao nht l ng bng sng
Cu Long v vng Duyn hi min Bc v Nam Trung B.
Mc hi lng l thp nht vng Trung du v
min ni pha Bc i vi gio dc tiu hc, ng
bng sng Hng i vi gio dc trung hc, v
Ty Nguyn i vi o to ngh v gio dc i
hc. Nhng ngi c hi ng bng sng Cu
Long cng hi lng nht vi cc dch v y t cp a
phng v trung ng. Tuy nhin, nhng ngi c
hi Ty Nguyn, duyn hi Bc v Nam Trung B v
ng bng sng Hng li t hi lng hn vi cc dch
v y t a phng, trong khi nhng ngi c hi
ng Nam B v ng bng sng Hng li t hi lng
vi dch v y t trung ng.
Cuc iu tra Ch s hiu qu qun tr v hnh chnh
cng cp tnh (PAPI) ca Vit Nam nm 2010 tin
hnh ti 30 tnh cng yu cu ngi c hi ni v
tri nghim ca h i vi dch v y t v gio dc.52
Khong 53% ngi c hi cho bit h c bo him
y t, v 52% c lin h trc tip vi mt bnh vin
cng trong nm qua. 74% ni rng cc h ngho
nhn c tr cp bo him y t, trong khi 87,4% cho
bit tr em di 6 tui c khm bnh min ph ph
hp vi chnh sch ca chnh ph. Khi c hi v
cht lng ca cc bnh vin cng cp huyn/x,
mt iu r rng l bnh nhn lun d kin s phi
nm chung ging, v chi ph y t cng nh thi gian
ch i khng c coi l hp l.
Cht lng ca phng bnh cng cn thp. Lin
quan n cht lng gio dc tiu hc cng, c s h
tng ca cc trng, cng cht lng ging dy ni
chung c nh gi l tt. Tuy nhin gio vin vn b
nhn xt l thin v cc em c i hc thm, v cc lp
hc vn qu ng hc sinh. Nhng ngi c hi
tt c cc tnh iu tra cng nu ln vn v cc

khon chi khng chnh thc v hi l. 53
QUN TR V PHT TRIN CON NGI

QUN TR V HNH CHNH CNG
Mc tiu cui cng ca ci cch v hin i ho ca cc
c quan cng quyn l nhm cung cp cc dch v cng
c cht lng tt hn cho ngi dn. V vn ny, vic
chuyn i sang cc mc pht trin cao hn ca h
thng qun tr v hnh chnh cng ca mt quc gia
to c hi cho cng dn pht huy hiu qu cc tim
nng v kh nng ca mnh. iu ny c ngha rng
pht trin kinh t cn c nhng vai tr khc ngoi h tr
gim ngho, l pht huy tim nng ca ngi dn
h ng mt vai tr ngy cng nng ng m ch mnh
s tng trng kinh t s khng th thc hin c.
Qun tr v hnh chnh cng l ng lc tng cng

pht trin con ngi. Qun tr l qu trnh m cc c
quan thc thi quyn lc v cng c khun kh cc
c nhn pht trin tim nng, cn hnh chnh cng l
phng tin nh nc v cng dn tng tc. Nh
nc khng ch cung cp cc dch v cng m cn to
nn khun kh cho vic tng cng cc kh nng ca
c nhn v tp th. Cng dn khng ch l ngi hng
li t cc dch v cng, m cn l ngi khuyn khch v
thc y cc thay i trong x hi.
Cc th ch qun tr vng mnh v hnh chnh cng
hiu qu l nhng yu t quan trng em li thnh cng
khng ch v tng trng kinh t, m cn v pht trin
con ngi. Cng ngy ngi ta cng nhn ra rng qun
tr c nh hng n pht trin: cc th ch, quy tc v
quy trnh chnh tr ng mt vai tr quan trng trong
tng trng kinh t v ci thin pht trin con ngi. 54
Hnh 6.3: T l nhng ngi c hi hi lng hoc rt hi lng vi cc dch v y

t v gio dc su vng, 2008
Ngun: VHLSS 2008
Ngy nay, chng ta ngy cng nhn ra rng qun tr

v hnh chnh cng ng vai tr ln trong vic tng
cng cc c hi pht trin. Ci cch hnh chnh
cng c mc tiu h tr v vn hnh nh xng
sng m bo rng tr em c i hc, tui th
c nng ln, c nhn c tip cn y c s
h tng c bn, an ninh ca cng dn c m
bo v cc mc ch khc na. Thc y pht trin
con ngi khng ch l mt thch thc v x hi,
kinh t v cng ngh, m cn l thch thc v qun
tr v hnh chnh cng.55 Qun tr tt v hnh chnh
cng hiu qu i i vi pht trin con ngi v vi
mc tiu cung cp dch v cng.
Thc y pht trin con ngi khng

ch l mt thch thc v x hi, kinh t
v cng ngh, m cn l thch thc v
qun tr v hnh chnh cng.
Cung cp dch v cng khng ch l nhim v ca
h thng hnh chnh cng. Nhng h thng ny c
nhim v cung cp khun kh cho vic pht huy kh
nng ca c nhn v tp th. Trong khi qun tr c
th c hiu l qu trnh cc c quan cng quyn
thc thi quyn lc v tng cng khun kh cho cc
c nhn pht huy tim nng, hnh chnh cng phi
c xem nh l phng tin cung cp cc c hi
ny mt cch cng bng, bnh ng v nht qun.
Nh nu trong Chng 1, cc khun kh v cam kt

chnh sch ca Vit Nam t con ngi vo v tr trung
tm ca chnh sch x hi quc gia vi mc tiu em
li hnh phc cho nhn dn, v chnh sch x hi ng
n s l mt ng lc pht huy ht tim nng sng
to ca con ngi.56 l l do chnh ti sao pht trin
con ngi lun ch trng u t vo gio dc v y t, v
thc y tng trng kinh t cng bng. Tuy nhin, mt
tr ct th ba ca pht trin con ngi gn y c
nhn mnh, l thc y s tham gia ca ngi dn
thng qua cc h thng qun tr v hnh chnh cng.
V vn ny, c hng cc c hi tham gia, c kin
thc v c sc khe tt, v c hng mt mc sng
y l ba iu kin tng cng ln nhau.
L mt nh nc theo nh hng x hi ch ngha, Vit
Nam cam kt cung cp cc dch v c bn cho cng
dn. Y t, gio dc, c s h tng c bn v an ninh cng
cng l nhng u tin ca nh nc, v l nhng lnh
vc c s tng tc thng xuyn v trc tip gia nh
nc v cng dn. K t ci cch kinh t u nhng nm
1990, cc nh cung cp dch v cng c gia tng
quyn t ch trong lnh vc ti chnh v qun l thng
qua qu trnh phn cp, phn quyn cc nhim v qun
l ngy cng cao nh nu trong Hp 6.1.57 Mc d
nhiu tin b c ghi nhn nh m rng quyn t
ch trong cung cp dch v,58 nhng nhng tin b ny
din ra khng u gia cc tnh, cc n v hnh chnh
v cc nhm kinh t x hi khc nhau.59
HP 6.3: PAPI NGI DN THAM GIA CC DCH V X HI

V HNH CHNH 60
Chnh sch x hi ha ku gi ngi dn tham gia cc dch v x hi - v khng ch vi t cch l ngi
s dng tr tin cho cc dch v m h s dng. Vic ngi dn tham gia rng ri hn v ng gp nhiu
hn cho cch thc thit k v cung cp cc dch v l ht sc quan trng nng cao cht lng tng
th v s ph hp ca cc dch v y t v gio dc tt c cc cp. Phiu iu tra kin ngi dn vn
l mt khi nim tng i mi Vit Nam, nhng cc cuc iu tra kin ngi dn c th cung cp
thng tin phn hi quan trng cho cc lnh o v cc nh qun tr cp a phng, nng cao trch
nhim gii trnh, tnh minh bch, v cung cp c s yu cu nhng ci tin thc s.61
Ch s hiu qu qun tr v hnh chnh cng cp tnh Vit Nam (PAPI) o lng cc tri nghim thc t trc
tip ca cng dn khi tip xc vi chnh quyn a phng v cc vn khc nhau. PAPI c pht trin
trong bi cnh nhu cu cng dn tham gia gim st v nh gi thc hin chnh sch ngy cng tng,
nhm cung cp bng chng cho cng tc hoch nh chnh sch sau . PAPI cung cp cc phng php o
lng da trn thc chng v khch quan cc tiu chun v qun tr cp tnh, hnh chnh cng v hiu qu
ca dch v cng. PAPI cung cp thng tin khch quan gip cc nh hoch nh chnh sch cp tnh v quc
gia hiu c tc ng ca cc quyt nh ca mnh v rt ra nhng bi hc c th nhm nng cao hiu qu
ca qun tr cng nh s hi lng ca ngi dn i vi hnh chnh cng v cung ng dch v cng.
Da trn kinh nghim quc t v nhng xem xt c th v bi cnh quc gia, PAPI nh gi cc mc
hiu qu trn su ni dung: (i) S tham gia ca ngi dn cp c s, (ii) cng khai, minh bch, (iii) trch
nhim gii trnh vi ngi dn, (iv) kim sot tham nhng, (v) th tc hnh chnh cng, v (vi) cung ng
dch v cng. Mi ni dung bao gm mt vi ni dung nh phn nh mt s lnh vc hnh chnh cng
v cung ng dch v c quan tm nht ti Vit Nam hin nay.
Nhng sng kin nh PAPI cn c pht huy v b sung cho nhng n lc khc nhm nh gi tri
nghim, nhn thc v s hi lng ca ngi s dng i vi cc dch v x hi. Cc v d khc bao gm
Ch s nng lc cnh tranh cp tnh (PCI) iu tra cm nhn ca cc doanh nghip v vic liu mt mi
trng thun li cho vic kinh doanh cc tnh ca Vit Nam hnh thnh hay cha, v cc cuc iu
tra cp tnh nh: Kho st ch s hi lng ca ngi dn v dch v cng nm 2008 Thnh ph H Ch
Minh, hay phiu kho st kin cng dn cp tnh. PAPI c thc hin 30 tnh trn ton quc, ln
u tin vo nm 2010 sau mt nghin cu th im trc nm 2009 v s c m rng n tt c
63 tnh thnh t nm 2011 tr i.
Ngoi tng cng kh nng v cc la chn ca ngi dn, khi nim pht trin con ngi cng nhn
mnh tm quan trng ca s tham gia, bao gm tham gia vo cc quy trnh qun tr v h thng hnh
chnh. PAPI s dng Php lnh v dn ch c s nh l khun kh nh gi mc tham gia ca
cng dn trong hnh chnh cng, cng vi mc hi lng vi dch v cng nh y t, gio dc, nh
tho lun trong Chng 4. iu quan trng l PAPI kim tra mc ngi dn nhn thc c cc li
ch c sn dnh cho h cng nh liu h c thc s c ting ni trong nhng quyt nh c nh hng
n cuc sng ca h.62 Khng c g ng ngc nhin khi thng tin v li ch v quyn li c ph bin
rng ri cc khu vc th c bit l thnh ph H Ch Minh, Nng v Hu, trong khi ngi dn
khu vc bin gii v cc tnh min ni nh c Lc, Qung Tr, Lai Chu, Kon Tum c mc nhn thc
thp hn nhiu. Tng t nh vy, cht lng cung cp dch v cng ni chung c nh gi l tt hn
nhiu ti cc thnh ph nh Hi Phng, Nng v Thnh ph H Ch Minh. Nhng H Ni b b xa
pha sau. Cc tnh ngho v cc tnh xa cc trung tm th ln xp hng kh thp, ch yu l do c s
h tng yu km.63 Nhng sng kin nh PAPI c mt vai tr quan trng trong pht trin con ngi, c
bng cch trc tip khuyn khch ngi dn tham gia theo di v gp cho hnh chnh v dch v cng,
cng nh bng cch ci thin cung cp dch v cng da trn quan im ca ngi s dng dch v.
QUN TR V PHT TRIN CON NGI

CP TNH
Khi cp n PAPI, chng ta cng nn xem xt
mi quan h gia PAPI v cc ni dung ca ch s
ny vi mc pht trin con ngi cp tnh
nhm hiu r hn mi quan h gia pht trin con

ngi ni chung v cc yu t khc nhau ca qun
tr. Bng 6.3 v Hnh 6.4 s cho thy iu ny thng
qua nh gi mi tng quan gia cc ni dung
ca PAPI vi HDI cp tnh.
Bng 6.3: Mi tng quan gia cc ni dung ca ch s PAPI vi ch s HDI cp

tnh, 2010
S tham gia
Cng khai,
minh bch
Trch nhim
gii trnh
Kim sot
tham nhng
Th tc hnh
chnh
Dch v cng
Ch s PAPI tng hp
(cha c trng s)
Ch s Pht trin
Con ngi
0.4763***
0.5402***
0.4660***
0.3588**
0.1805
0.6262***
0.6799***
Ch s PAPI tng
hp (cha c trng
s)
0.7507***
0.7149***
0.7513***
0.6614***
0.4099**
0.5047***
Dch v cng
0.4007**
0.5327***
0.2323
-0.0900
0.2643
Th tc hnh
chnh cng
0.3284*
0.1701
0.2106
0.0541
Kim sot tham

nhng
0.2708
0.3045
0.4619**
Trch nhim gii

trnh
0.5055***
0.3480*
Tnh minh bch
0.4908***
Ghi ch: Mi tng quan theo cp, *c ngha v mt thng k mc 0,1,** c ngha v mt thng k mc 0,05, *** c ngha v mt thng k mc 0,01.
Ngun: PAPI 2010, www.papi.vn; HDI 2008.
Bng 6.3 cho thy cung ng dch v cng l ni

dung c mc tng quan cao nht vi HDI (0,6262),
tip theo l tnh minh bch (0,5402), s tham gia
cp a phng (0,4763) v trch nhim gii trnh
vi ngi dn (0,4660) u c ngha v mt thng
k mc 0,01. Cc ni dung lin quan n kim
sot tham nhng cng c s tng quan cht ch
(0,3588) mc ngha 0,05. Ngoi ra, khc vi tt c
nm ni dung khc ca PAPI, cn lu rng khng
c s lin quan v mt thng k gia cc kha cnh
ca th tc hnh chnh cng vi mc pht trin

con ngi tng th cp tnh. iu ny cho thy
c s tng quan mnh m gia cc yu t ca
qun tr tt v mc pht trin con ngi cao hn.
C s tng quan mnh m gia cc yu

t ca qun tr tt v mc pht trin
con ngi cao hn.
Hnh 6.4: Mi lin quan gia ch s PAPI tng hp v ch s HDI cp tnh
Ngun: PAPI 2010; HDI 2008.
Mt cch khc nh gi s tng quan gia ch s

PAPI tng hp v cc ni dung ca n vi HDI cp
tnh c th hin trong cc hnh di y. Hnh 6.4
cho thy ch s PAPI tng hp c mi tng quan cht
ch vi HDI (r = 0,6799). Ni cch khc, nhn mt cch
tng th, cc a phng vi cc ch s PAPI cao hn
cng c xu hng t mc pht trin con ngi
cao hn. Tuy nhin, im quan trng cn nhn mnh
y l mc d s tng quan gia hai ch s l ng
bin v mnh m, nhng khng c ngha l ch s ny
l nguyn nhn hay kt qu ca ch s kia. S tc ng
ln nhau din ra theo hai chiu. Tuy nhin iu ny
cung cp bng chng ng k gip khng nh rng
Vit Nam, qun tr tt v mt hnh chnh cng v

cung ng dch v dng nh lun song hnh vi mc
pht trin con ngi cao hn cp tnh.
Vit Nam, qun tr tt v mt hnh

chnh cng v cung ng dch v dng
nh lun song hnh vi mc pht
trin con ngi cao hn cp tnh.
Hnh 6.5 cho thy tng quan gia cc ni dung khc
nhau ca PAPI v HDI cp tnh; v nh ni trn, mi
lin h gia cung ng dch v v HDI l c bit r rng.
Hnh 6.5 Mi tng quan gia cc ni dung ca ch s PAPI vi ch s HDI cp tnh
Ngun: PAPI 2010; HDI 2008
QUN L CC T CHC CUNG

CP DCH V
CC THCH THC I VI CC T CHC
CUNG CP DCH V
Thay i cch thc cung cp dch v x hi Vit
Nam khng ch l iu chnh cc nh hng chnh
sch nh tho lun trong Chng 5, m cn l
thay i cc quy chun v thc tin lm vic ca
cc t chc cung cp dch v x hi v ca nhn
vin cc t chc . Cn ci cch vn ha t chc
v lut chi, cc tiu chun, hnh vi ngh nghip,
cch qun l v c cu hnh chnh ca h thng
y t v gio dc Vit Nam nu Vit Nam mun t
mc pht trin con ngi cao hn cho mi cng
dn. Nhng ci cch ny cng quan trng v kh
khn nh nhng iu chnh v chnh sch. Tht vy,
kinh nghim ca Vit Nam cho thy trong khi cc
chnh sch v khun kh php l c th thay i
c, d khng phi lc no cng d dng, thay
i cch thc thc hin chnh sch v cc thng
l trong thc tin thng kh khn hn rt nhiu.
V t chc, c ba hnh thc t chc cung cp dch
v cng, trong cc t chc cung cp dch v
c hiu l nhng t chc b rng buc bi cc
mt lot nhng quy tc v thng l phc tp, chnh
thc v khng chnh thc vn to nn vn ha v
hnh vi ca t chc , v cc n v cung cp dch
v l cc b phn trc thuc ca cc t chc cung
cp dch v ln hn.64
Cc t chc cung cp dch v cng hoc nh
nc thng c hiu l cc t chc do nh
nc s hu v qun l theo nhng cp bc kim
sot v quy nh ca nh nc. Cc t chc ny
c thnh lp cung cp mt loi dch v
cng v nhim v ca h do nh nc quy nh.
Thng thng h c qun l theo phng
thc t trn xung theo ngnh dc v v nguyn
tc h phi chu trch nhim trc cc c quan
nh nc, chnh ph, v cng dn.
Cc t chc cung cp dch v t nhn do t
nhn s hu v qun l v do hot ng t
ch, hoc tng i t ch, khng ph thuc vo
nh nc. C hai loi t chc: t chc cung cp
dch v mang tnh cht thng mi c thnh
lp v hot ng nhm mc tiu li nhun. Cn
cc t chc cung cp dch v phi li nhun hot
ng nhm phc v ngi dn thay v to ra li
nhun trc tip. Nhiu t chc cung cp dch v
t nhn (hoc phi nh nc) phi li nhun c

nh nc tr cp ton phn hoc mt phn ln
v h tr bng nhiu hnh thc khc (nh min
thu). Cc t chc thng mi t nhn phi chu
trch nhim trc ch s hu v/hoc c ng,
trong khi cc t chc phi li nhun cng phi
chu trch nhim trc ch s hu hay c ng
nhng nhng ngi ch hay c ng ny c th
bao gm cc c quan nh nc, hoc thm ch l
cc cng ng dn c.
Cc t chc cung cp dch v bn cng bn t kt
hp mt s kha cnh ca quyn s hu v vic
cung cp dch v cng cng v t nhn, v d nh
hnh thc cng-t hp doanh v doanh nghip
x hi. Cc t chc ny c nhng hnh thc s
hu v kim sot hn hp. Mc tiu v hot ng
ca h thng c nhiu t chc cng nhau
qun l, vi quyn s hu va ca nh nc, va
ca t nhn, t dn n nhng trch nhim
bo co v gii trnh ht sc phc tp mang tnh
c trng ca loi hnh t chc ny.
C CH QUN L V TRCH NHIM GII

TRNH I VI DCH V CNG V T
Vit Nam s ln ln trong cung cp dch v cng
v t nh tho lun trn, trong c y t v gio
dc nh nc v t nhn cng hot ng trn c s
thng mi lm lu m ranh gii gia cc loi hnh
dch v cng nh vic t chc qun l v quy nh
trch nhim gii trnh. Trong thc t, rt nhiu ci
gi l t chc cung cp dch v cng, nhng xt v
cch thc hot ng li l nhng t chc bn cng,
v trch nhim gii trnh thng khng r rng v
phc tp. Mt v d l trng bn cng v dn lp
c nhn tr cp v h tr t nh nc. ng thi,
phn quyn cng thay i vic qun l cung cp
dch v cng, vi s gia tng quyn t ch v c
lp r rng trong hot ng ca cc t chc cung
cp dch v cng nh bnh vin. Cc nhn t th
trng cng tc ng mnh m ti cch thc hot
ng ca cc t chc cung cp dch v cng, v cc
loi hnh khuyn khch khen thng dnh cho nhn
vin ca h.
S xut hin cc hnh thc cung cp dch v hn
hp cng t ti Vit Nam din ra tng i t pht
v khng i km vi vic xy dng cc c ch vng
mnh nhm m bo tnh minh bch v trch
nhim gii trnh. Trong thc t, cc c ch m tnh
minh bch v trch nhim gii trnh trong khu vc
nh nc cn yu v cha hon thin, trong khi cc
c ch m bo trch nhim thng thy cc t
chc thng mi ln, chng hn nh hi ng qun

tr, khng phi lc no cng tn ti trong bi cnh
Vit Nam. Khi khng c cc c ch ny, cc t chc
cung cp dch v cng phi i mt vi nhiu thch
thc trong vic thch nghi vi nhng thay i kinh
t x hi nhanh chng ang din ra xung quanh h,
cng nh trong chnh t chc ca h. 65
CI CCH HNH CHNH CNG V DCH

V X HI
Tng cng th ch cho cc t chc cung cp
dch v nh nc v t nhn trong lnh vc y t v
gio dc r rng l cn thit. Phn ny s im qua
nhng m hnh khc nhau qun tr cung cp
dch v mt cch hiu qu, da trn cc tho lun
v ci cch hnh chnh cng, l thuyt mi v qun
l cng, v qun tr cc t chc phi li nhun. Khng
c g ngc nhin khi c rt nhiu im chung gia
cc phng php tip cn ny.
Mc ch ca ci cch hnh chnh cng l cung
cp dch v cng vi cht lng cao hn cho ngi
dn, c bit l ngi ngho. Mc d khng c mt
hnh mu th ch hon ho duy nht no, nhng
mt h thng hnh chnh cng hin i, hiu qu
v coi trng nhn ti vi mt i ng nhn vin c
tay ngh, nng ng v c nng lc l ht sc cn
thit nu Vit Nam mun gii quyt nhng thch
thc phc tp t ra cho mt quc gia c mc thu
nhp trung bnh thp v mc pht trin con ngi
trung bnh nh c tho lun trong Chng 2.66
Trong mt bi vit v ci cch hnh chnh cng v
nng cao cht lng cung cp dch v ti Vit Nam,
Koh v cc cng s nu ln ba nguyn tc chnh v
ci cch hnh chnh cng trong cung cp dch v.
Mt l, ly khch hng lm trng tm, ly s hi lng
ca cng chng l thc o cui cng v hiu qu
ca hnh chnh cng v cung cp dch v cng. Hai
l, m bo thch ng vi bi cnh a phng v
khng c mt m hnh cung cp dch v cng no
l tt nht. Ba l, c cu t chc chnh ph cn c
ci cch m bo chuyn mn ha vic sp xp
v phn cng cng vic, v m bo rng cc c
quan trong ton chnh ph c th cng gp phn
nng cao phc li cng, hn l trc tip tham gia
cung cp dch v. Ngoi ra, cc tc gi kin ngh
thnh lp cc c quan qun l c lp trong cc
ngnh v lnh vc c th nhm i din v thc thi
chc nng gim st ca chnh ph, ng thi xy
dng v p dng cc tiu chun c lp c th
m bo cung ng dch v cng tt nht. 67
CC NGUYN TC CA KINH T T NHN

V CUNG CP DCH V CA CHNH PH
Cc m hnh qun tr cng ty cng em li nhng bi
hc v nng cao hiu qu cung cp dch v cng ca
chnh ph, v cc c quan nh nc thng cng nhc,
t quan tm ti chi ph, cng nh nhu cu v li ch ca
khch hng. Mt gii php l p dng nhng hnh thc
khuyn khch ging nh trong th trng ci thin
dch v cng, da trn gi nh rng cc t chc t nhn
vn hiu qu hn v h buc phi hiu qu tn ti.
m bo tnh minh bch v trch nhim gii trnh, s
tham gia ca ngi dn v ca cc c quan, t chc h
tr thch hp l iu kin tin quyt - cng dn phi ch
ng tham gia qun l cc t chc cung cp dch v, ch
khng phi ch l ngi nhn dch v mt cch th ng.
Cng dn phi ch ng tham gia qun

l cc t chc cung cp dch v, ch
khng phi ch l ngi nhn dch v
mt cch th ng.
Nh London cp trong nghin cu phc v
cho Bo co ny, c nm nguyn tc i km vi cch
tip cn ny: th nht, chnh ph chu trch nhim
ch o vic cung cp dch v cng, mc d khng
nht thit phi trc tip tham gia cung cp dch v;
th hai, chnh ph v cc ban ngnh ti a phng
nn do cng dn lm ch, v ngi dn c trao
quyn t qun l cng ng ca mnh; th ba, cnh
tranh gia cc t chc cung cp dch v l cha kha
gim chi ph, m bo cung cp dch v p ng
ng nhu cu ca khch hng hn; th t, hiu qu
hot ng ca cc c quan nn c nh gi da
trn cc nhim v h c giao - cc mc ch v
mc tiu h phi chu trch nhim thc hin; v
th nm, nh ni trn, cng dn khng phi l
khch hng th ng, m l nhng ngi tch cc
tham gia thc hin quyn c la chn gia cc
dch v khc nhau v ng gp kin v cch thc
cung cp v nh gi dch v.68
Phng php ny c nhng im yu kh r - l
tc gi khng tnh n iu kin v bi cnh a
phng ca cng tc cung ng dch v, v khng
tha nhn nhng im yu c hu ca th trng
hoc nhng kh khn pht sinh khi th trng
khng hot ng tt. Cch tip cn ny cng khng
tnh n bi cnh chnh tr trong vic cung cp
dch v din ra, bao gm c tng quan quyn lc
gia cc nhm khc nhau. Tuy nhin cch tip cn
ny nu bt c mt s vn thc tin ca
vic qun tr cc t chc cung cp dch v cng. 69
HC HI T KHU VC PHI LI NHUN
li nhun v chnh ph, c bit l khi cc t chc phi

li nhun cung cp cc dch v do nh nc tr tin. 71
Mc d Vit Nam, cc t chc phi nh nc v phi

li nhun cha pht trin mnh, kinh nghim qun
tr trong cung cp dch v phi li nhun cc nc
khc c th cung cp cc bi hc hu ch cho cc t
chc cung cp dch v ti Vit Nam. V d, mt nh
gi mi y ca y ban nng sut c v ng gp
ca cc t chc phi li nhun ti c, bao gm c lnh
vc y t v gio dc, xc nh r vai tr c th ca
cc t chc ny v gi tr gia tng h mang li. Cc
t chc phi li nhun thng c xy dng nhm
phc v cng ng v vic cc thnh vin tham gia
nh gi xem t chc mnh t c mc tiu
ra hay cha l mt c im ni bt trong cch thc
hot ng ca t chc. Nhiu t chc phi li nhun
to nn gi tr gia tng thng qua phng thc hot
ng, bao gm c cch h c t chc nh th
no, thu ht mi ngi tham gia ra sao, a ra quyt
nh v cung cp dch v th no. Rt nhiu t chc
phi li nhun m trch cc hot ng m cc c
quan nh nc hay cc t chc t nhn khng lm
v nhiu nguyn nhn, trong bao gm li ch kinh
t thp, ri ro cao (bao gm c ri ro chnh tr), nguy
c cc hot ng c th khng hiu qu, hoc bi v
chnh ph v doanh nghip thiu lng tin hay thiu
cc mi quan h vi khch hng cn thit cung
cp dch v c hiu qu. Cc hot ng ca cc t
chc phi li nhun thng to ra nhiu li ch hn
nhng g m ngi hng li trc tip c th cm
nhn c, v d nh hnh thnh vn x hi v ha
nhp x hi bng cch khuyn khch s tham gia ca
cc gia nh v cc thnh vin cng ng trong cung
cp dch v cho nhng ngi d b tn thng.70
Mi phng php tip cn li cung cp mt cch

ngh v cch thc pht trin cc t chc cung cp
dch v x hi ti Vit Nam trong tng lai. Khi cc t
chc cung cp dch v ti Vit Nam ang ngy cng
tr nn cng t khng r rng, mt gii php bn
cng bn t nhm ci thin hot ng v hiu qu
ca cc t chc ny c th l thch hp nht. Vn
mu cht l phi c cc c ch gim st v m bo
trch nhim gii trnh r rng. Ly khch hng lm
trung tm, p ng ng nhu cu v li ch ca ngi
s dng v cng ng, khuyn khch ngi dn tham
gia vo lp k hoch v cung cp dch v cng khng
km phn quan trng. Nng cao thc trch nhim,
tng cng vn ha v o c ngh nghip, ng
thi a ra nhng hnh thc khuyn khch khen
thng ph hp ghi nhn nhng p lc m cc
t chc cung cp dch v v nhn vin ca h ang
phi i mt cng ht sc cn thit. Cui cng, ci
thin cng tc nh gi, gim st v c s d liu cho
qu trnh lp k hoch v ra quyt nh, bao gm c
s dng cng ngh mi, l ti quan trng gip
cc t chc cung cp dch v v cc nh hoch nh
chnh sch bit c hot ng no l hiu qu,
cng nh ln k hoch p ng nhng nhu cu ca
mt x hi v cng ng dn c ang i thay nhanh
chng. Mi ni dung trn s ln lt c tho lun
tm tt trong cc phn di y.
GIM ST V TRCH NHIM

GII TRNH
NHNG THCH THC TRONG VIC CI
TIN CNG TC QUN TR
Ci thin cng tc nh gi, gim st v

c s d liu cho qu trnh lp k hoch
v ra quyt nh.
V vn ci tin cch lm vic ca cc t chc phi li
nhun, y ban xc nh nm yu t chnh: xy dng
h thng tri thc nhm nng cao hiu bit v cch
thc hot ng ca cc t chc ny cng nh thit lp
v xy dng mt c s bng chng v cc iu kin
thnh cng; m bo c ch qun tr v trch nhim
gii trnh r rng thng qua mt khun kh php l
duy nht v thng nht cho tt c cc t chc phi li
nhun; bo m pht trin cc t chc phi li nhun
mt cch hiu qu hn na, bao gm k nng qun tr,
lp k hoch v nh gi hot ng; pht huy cc sng
kin x hi tm ra nhng cch lm mi v tt hn
nhm gii quyt cc vn x hi m li ch chnh l
phc v cng ng ch khng phi l thu nhp; v xy
dng quan h hp tc v i tc gia cc t chc phi
Ci tin cng tc qun tr l cha kha m bo trch

nhim gii trnh v hiu qu cng nh iu chnh
hot ng ca cc t chc cung cp dch v y t v
gio dc. Xy dng cc c ch qun tr m bo
trch nhim gii trnh ca cc t chc cung cp dch v
cng trc cc cp chnh quyn v trc nhn dn l
mt trong nhng thch thc chnh hin nay i vi h
thng y t v gio dc Vit Nam. Mt thch thc khc l
m bo qun l v gim st hiu qu cc t chc cung
cp dch v t nhn. Trong bi cnh phn cp phn
quyn hin ti, cc c quan cp cao hn gp rt nhiu
kh khn m bo trch nhim gii trnh ca cc t
chc cung cp dch v v h c trao quyn t ch
rt cao trong vic to thu nhp v s dng cc ngun
lc ti chnh cng cc kha cnh khc ca qun l. Tnh
hnh ti cc bnh vin ca Vit Nam l mt v d in
hnh. Mt thc t hin nhin l cc bnh vin c quyn
t ch rt cao, c bit l cc bnh vin trung ng ln

c kh nng to ra thu nhp ng k nh thu ph khm
cha bnh v do h c quyn quyt nh hn i vi
vic chi tiu cc khon tin kim c.72 Mc d nhiu
bnh vin kh thnh cng trong vic s dng ngun
tin thu c thu ht cc cn b c trnh cao v
cung cp cc dch v hng u nhng trch nhim gii
trnh s kh c m bo, v d nh cc c quan cp
trung ng kh c th gim st v hn ch vic cung
cp cc dch v t nhn trong bnh vin. 73
TNG CNG TRCH NHIM GII TRNH

TRONG Y T V GIO DC
Tuy nhin, c nhiu n lc nhm tng cng cc c
ch m bo trch nhim gii trnh, t nht v nguyn
tc, trong c ngnh y t v gio dc. V d, Lut mi
v khm cha bnh c thng qua nm 2009 quy
nh r Vit Nam s cp giy php cho cc c s y t
v chng ch hnh ngh cho cc y bc s ca c nh
nc v t nhn. Theo cc thng l tt nht, mt h
thng cp php cp quc gia s c hiu qu hn,
v s m bo l nhng ngi b cm hnh ngh
mt tnh khng th hnh ngh cc vng min khc
ca t nc. Tuy nhin Vit Nam li ang p dng h
thng cp php kp, trong cc y bc s nc ngoi
v nhng ngi lm vic cc c s khm cha bnh
ca trung ng s c B Y t cp chng ch hnh
ngh, cn chng ch ca cc y bc s cp a phng
s c cp ti a phng. iu ny gy kh khn cho
chnh ph trong vic theo di nhng ngi hnh ngh
y mt cch hiu qu. Vit Nam cng cha c mt c
ch cp quc gia gii quyt khiu ni v p dng
cc bin php k lut i vi y bc s vi phm php lut.
Ngoi ra, trong khi php lut quy nh tt c cc c s
khm cha bnh nh nc cng nh t nhn phi c
giy php hot ng th cho n nay mt s lng ln
cc c s t nhn vn khng c giy php v do
khng th qun l c.74
Mt v d khc l s pht trin v p dng h thng
kim nh cht lng trong lnh vc gio dc. Cc tiu
chun cht lng ti thiu dnh cho cc trng tiu
hc c thng qua vo nm 2004, v bao gm rt
nhiu kha cnh, k c cht lng v kt qu mong i.
Cc tiu chun dnh cho hiu trng cng c p
dng. Tuy nhin, vic kim sot cc dch v gio dc t
nhn vn cn yu: vic gim st thc t xem cc trng
c tun th cc quy nh ca nh nc hay khng cn
rt t, mc d trong thc t vn khng phi l tun
th quy nh, m l vn hc ph qu cao.75 Vic gim
st h thng gio dc i hc ca B Gio dc o to
cn hn ch. Do gio dc i hc Vit Nam rt t
b gim st v nng lc m bo p dng cc tiu
chun cng khng cao. V d ch c 50% cc trng i
hc v cao ng tun th cc yu cu v bo co trong
nm hc 2008-2009. Qu trnh t kim nh c

hnh thnh ti cc trng i hc v mt hi ng quc
gia v kim nh cht lng gio dc c thnh lp
nh mt c ch kim nh cht lng gio dc c lp.
Khong 100 trng i hc thit lp cc trung tm
kim nh cht lng ni b, v khong mt na tin
hnh t nh gi, song n nay ch c 20 trng i
hc c nh gi c lp. Nhiu kin thng nht
rng cn c mt c quan kim nh cht lng c lp
v vng mnh m bo qu trnh kim nh thc s
c ngha v hiu qu. Ngoi ra, t nguyn p dng h
thng kim nh cht lng quc t s khng ch gip
cc trng c ng du chng nhn c lp v cht
lng m cn gip nng cao tiu chun cc trng trn
ton quc. 76
Tu chung, cc v d ny nhn mnh Vit Nam cn xem
xt thnh lp mt c quan c lp cp ngnh mt
c quan khng trc thuc b ch qun - c chc nng
kim nh v gim st cht lng. Mt c quan kim
nh y t c lp cp quc gia r rng c hiu qu hn
l trao quyn cp php hot ng v chng ch hnh
ngh y cho cc c quan y t cp tnh bi iu ny rt
d m ng cho trc li v tham nhng. y l iu
khng ai mong mun bi chnh bnh nhn s l ngi
gnh chu hu qu nu nh cc y bc s b cm hnh
ngh hoc khng nng lc li c th tr tin hi l
c hnh ngh. Cn xy dng mt c ch khiu
ni c lp gn lin vi h thng cp chng ch hnh
ngh v giy php hot ng, v c qun l cp
quc gia bi mt t chc c lp c nhiu thnh phn
tham d, bao gm x hi dn s v i din cc bnh
nhn.77 Tng t nh vy trong gio dc, cc sng kin
ca cc trng v B Gio dc v o to nhm m
bo kim nh cht lng c th c b sung bng
cch thit lp mt c quan c lp nh y ban cc
trng hc cung cp mt nh gi c lp v cht
lng dy v hc, theo di v cng khai thng tin v
cht lng cc trng. Cc hip hi ngh nghip c
lp cng c th ng mt vai tr quan trng trong vic
m bo cht lng ca i ng cn b chuyn mn
nh c tho lun di y.
S THAM GIA V NHN THC CA

NGI DN
Nh ni trn, cng dn tham gia vo lp k hoch
v cung cp cc dch v y t v gio dc l mt trong
nhng nguyn tc ca chnh sch x hi ha. nng cao
trch nhim gii trnh i vi ngi s dng dch v, cc
t chc cung cp dch v cn phi c nhng quy trnh thu
ht s tham gia ca khch hng v phi tm kim thng
tin phn hi ca h cng nh m bo khch hng
c nhng thng tin cn thit a ra nhng la
chn c c s v s dng dch v.
Cc t chc cung cp dch v cn phi c

nhng quy trnh thu ht s tham gia ca
khch hng v phi tm kim thng tin
phn hi ca h .
y l mt vn rt quan trng trong lnh vc
y t, ni thng tin khng c chia s y , v
ngi s dng dch v thng khng c thng
bo y v phng php iu tr bnh, cc la
chn v cch iu tr, hoc thuc men v cc nh
hng ca chng. Lut khm cha bnh quy nh
r rng v quyn ca bnh nhn, bao gm quyn
c thng tin v tnh trng sc khe ca h, cc
la chn v cch iu tr v chi ph iu tr. Lut
ny cng dnh cho bnh nhn quyn c tn
trng, c m bo b mt, khng b phn bit

i x v c t chi iu tr.78 Tuy nhin trong
thc t, mc nhn thc v cc quyn li v y t
cn rt thp, v d nh ngi dn khng c bit
nhiu v chng trnh bo him y t t nguyn. V
vic s dng thuc bt hp l mt phn c thc
y bi s thiu hiu bit v cc tc dng ph ca
thuc v nim tin rng thuc ngoi tt hn thuc
ni.79 Chnh ph Vit Nam u t ng k vo
cc chin dch truyn thng v nng cao nhn thc
v cc iu kin sc khe c th v cc bin php
y t d phng nh i m bo him, phng chng
HIV v cc loi bnh tng t. Nh nc cn u
t mc tng t cho vic nng cao nhn thc v
quyn v li ch ca bnh nhn theo lut mi..
HP 6.4. LUT KHM CHA BNH 80

Lut Khm cha bnh nm 2009 cung cp c ch cho bnh nhn phn hi v khiu kin. Lut quy
nh bnh nhn c quyn chn gii php khm cha bnh, c cung cp thng tin v h s bnh
n, chi ph khm cha bnh v t chi hoc chm dt cha tr. Chng 7 quy nh c ch khiu ni
bao gm c lp hi ng chuyn mn lng nghe khiu ni v xem xt nguyn nhn, v cho php
bnh nhn v ngi i din gp trc tip v khm cha bnh v iu tr. Theo Lut, c ch phn
hi ca bnh nhn s c thc hin, thng qua bnh nhn c th gp v dch v, gip cung
cp thng tin mt cch h thng v cht lng dch v. Tuy nhin c ch ny li cha c thc
hin, v hin nay cc c s vn ch t nh gi mnh v nh vy l khng khch quan.
Tng t nh vy, trong gio dc, ph huynh v

hc sinh cn c bit thng tin v cht lng ca
trng, cch t chc qun l v tnh hnh ti chnh.
mt mc nht nh, y chnh l trng hp
ca gio dc i hc, v cc trng i hc c
yu cu phi cng b thng tin v sinh vin, ging
vin, cc ngun lc v ti chnh. Mt s trng i
hc cn cng b cc kin phn hi v gio vin,
iu ny gip sinh vin v gia nh c th la
chn trng mt cch c c s hn. 81
THU THP V GII P PHN HI T

KHCH HNG
Mt trch nhim quan trng th hai ca cc nh
cung cp dch v l tm kim thng tin phn hi
cp ca t chc, n v cung cp dch v v
nhu cu v k vng ca khch hng, cng nh v
s hi lng ca khch hng i vi dch v c
cung cp. Thng tin ny s gip cc nh cung cp
iu chnh cc dch v ca mnh thch ng vi

nhu cu c th ca cng ng m h phc v. y
l mt khi nim tng i mi Vit Nam v trong
lch s Vit Nam tng p dng m hnh k hoch
tp trung xc nh nhu cu i vi cc dch v y
t v gio dc cp a phng. Mc d vic phn
cp phn quyn cho php cc bnh vin linh
hot hn trong vic xc nh cc dch v cung
cp, h vn cn nhn kinh ph da trn s ging
bnh v s lng bnh nhn, v vn c ng lc u
tin cung cp cc dch v sinh li hn l nhng dch
v m c nhn hoc cng ng cn nht.82
Mt khc, trong gio dc, cc chng trnh ging
dy c xy dng cho ton quc. m bo
chng trnh hc ph hp v d tip cn i
vi hc sinh, cc trng cn a dng ha v linh
hot hn trong vic la chn cch thc ging dy.
iu ny cng i hi gio vin phi c k nng
s phm cao hn. Cc trng dy ngh v i hc
thng khng p ng c cc xu hng v yu

cu ca th trng lao ng, v thiu thng tin v
th trng cng nh yu cu ca ngi s dng
lao ng. Mt thc t c cng nhn trn ton
ngnh gio dc l cn c cc phng php ging
dy linh hot hn, c s tham gia ca ngi hc v
cp nht hn khuyn khch thi hc tp tch
cc v tng cng pht trin k nng sng cng
nh t c kt qu hc tp cao.83
Mt s t chc cung cp dch v ti Vit Nam ang
bt u th nghim hi kin ngi s dng dch
v. V d, cc trng i hc ang thu thp thng
tin v s hi lng ca sinh vin vi cht lng ging
dy, v mt s bnh vin cng tin hnh kho st s
hi lng ca khch hng. Bnh vin Nhi Trung ng
ang thu thp d liu c bn v s hi lng ca
cha m vi vic chm sc m con ci h nhn c
nhm ci thin vic trao i thng tin gia nhn
vin bnh vin v ph huynh.84 Theo Bo co chung
thng nin v y t nm 2010, ngi s dng dch
v c mi ng gp kin thng qua ng dy
nng c thit lp ti cc bnh vin, cc cuc hp
hng tun ca y ban bnh nhn, v hm th gp
c t ti cc bnh vin.85 Mt trong nhng v
d c cp trong mt nghin cu nm 2009 v
h thng y t hai tnh: bnh vin cp tnh v cp
huyn Cn Th v Ninh Bnh t chc cc cuc
hp thng xuyn vi bnh nhn v gia nh bnh
nhn hi kin, y ban bnh nhn th hp mi
thng mt ln. Tuy nhin, ngi dn v cc t chc
x hi dn s khng ng bt k vai tr chnh thc
no trong vic gim st xem liu cc t chc cung
cp dch v c tun th cc tiu chun v thc hin
cc quy nh v cc b quy tc ng x hay khng.86
Nh vy, mc d c nhng du hiu ng khch
l nhng vic hi kin ngi s dng dch v - v
quan trng hn l lm theo nhng kin ng gp
vn cha hon ton c th ch ho trong
rt nhiu cc t chc cung cp dch v.
HC HI T CC T CHC PHI LI NHUN

y l mt lnh vc m cc t chc cung cp dch
v y t v gio dc ca Vit Nam c th hc hi kinh
nghim ca cc t chc phi li nhun. Bn cnh
nhng cuc kho st v mc hi lng trn quy
m ln nh PAPI nhm thm d kin cp tnh, cc
cuc iu tra v cc c ch tham vn khc ca tng
c s, cc t chc cung cp dch v c th xem xt p
dng cc phng php khuyn khch s tham gia ca
ngi dn ging nh nhng phng php c
cc t chc phi li nhun s dng khch hng v
cng ng tham gia vo hot ng ca h.
Cc t chc cung cp dch v c th xem xt

p dng cc phng php khuyn khch s
tham gia ca ngi dn ging nh nhng
phng php c cc t chc phi li
nhun s dng khch hng v cng
ng tham gia vo hot ng ca h.
Cc chin lc m cc t chc cung cp dch v c
th s dng tng cng s tham gia ca khch
hng bao gm: s dng khch hng v cc thnh
vin ca cng ng nh tnh nguyn vin, mi tham
gia hi ng qun tr v cc y ban t vn ngi s
dng dch v, tham vn rng ri vi cc bn lin quan
thu thp thng tin u vo cho lp k hoch v
ra quyt nh, cng khai cc d liu v hiu qu dch
v, bao gm kt qu iu tra mc hi lng ca
khch hng. V d, bang Andhra Pradesh, y ban
cc b m gim st cc dch v y t v gio dc dnh
cho tr em. y ban ny c thnh lp nhm
nng cao thc trch nhim, tng mc s dng dch
v v khuyn khch vic cung cp dch v theo nhu
cu.87 Cc y ban ngi s dng dch v v cc c
ch tham gia khc c th ng vai tr nh mt chin
lc c th to iu kin cho nhng ngi vn
thp c b hng c ni ln kin ca mnh v
cht lng dch v, v cho h c hi ng gp kin
trc tip vi cc nh cung cp dch v.
Ngi dn c quyn c thng tin v cc

dch v m h nhn c, v cht lng
dch v, v cc la chn c sn khi h
quyt nh s dng mt dch v no .
Ngh nh v dn ch c s ca Vit Nam to
khun kh cho s tham gia ca cng dn trong
cc quyt nh c nh hng n cuc sng ca
h. c thit k tng cng s tham gia ca
ngi dn vo qu trnh ra quyt nh cp thn x,
khun kh ny nn c m rng thc y s
tham gia v trao i thng tin nhiu hn gia cng
dn vi cc t chc cung cp dch v. Quyn c
thng tin, quyn c t vn, quyn c quyt
nh v quyn kim tra (gim st) u c th c
p dng cho cc t chc cung cp dch v. Nh vy,
Ngi dn c quyn c thng tin v cc dch v
m h nhn c, v cht lng dch v, v cc la
chn c sn khi h quyt nh s dng mt dch v
no ; quyn c t vn khi cc k hoch ang
c chun b thay i cc dch v ny v cch
cung cp dch v; quyn c tham gia vo vic
ra quyt nh, v d vi t cch thnh vin ca hi
ng nh trng v bnh vin. H cng c quyn

c nu ln kin v cht lng dch v v cch
cung cp dch v, v cc kin cn c xem
xt v thc thi mt cch nghim tc. Nhng quyn
ny chc chn s p dng c i vi nhng dch
v y t v gio dc do chnh ph ti tr hoc h tr,
nhng cc t chc cung cp dch v t nhn cng
cn tng tc vi khch hng v thu thp thng tin
phn hi ca h.
O C V VN HA NGH
NGHIP
CC NG LC TH TRNG ANG E
DA O C NGH NGHIP
Cc cch tip cn v qun tr cc t chc cung cp
dch v tho lun trn u nhn mnh tm quan
trng ca vic cn c mt s mnh ca tng t chc
v s mnh ny l c s nh gi hiu qu hot
ng ca t chc v nhn vin. Trong cc t chc
cung cp dch v (bao gm c nhng t chc c
nhn tr cp ca chnh ph), s mnh nn l li ch
cng hoc tp th c o bng mc hi lng
ca ngi s dng cc dch v cng ... da trn mt
tp hp cc tiu ch nh cht lng dch v, gi dch
v, v kh nng quan tm n cc nhm dn c khc
nhau vi cc nhu cu khc nhau .88 Tuy nhin, cc t
chc y t v gio dc ca Vit Nam, vic cc hnh thc
s hu v hot ng tr nn hn hp, bn cng bn
t, khin cc t chc cung cp dch v i chch
khi s mnh ny v ch trng vo li nhun hn l
cc nhu cu pht trin con ngi.89
Nhng ng lc th trng mnh m tc ng ng
k ln nhn vin ca cc t chc cung cp dch v,
nh hng xu n hnh vi ngh nghip v khng c
li cho pht trin con ngi. Cc nhn vin phi chu
p lc ng k v u tin iu tr hoc ging dy cho
nhng ngi c th tr ph, v cung cp dch v loi
hai cho nhng ngi khng th chi tr, iu ny ph
hy nguyn tc khng phn bit i x trn c s thu
nhp v tnh trng kinh t x hi. Nh ni trn,
cc loi ph ph c chp nhn rng ri c trong y
t v gio dc. y l h qu trc tip do lng ca
nhn vin y t v gio vin qu thp. Thu ph ph l
mt hnh vi c bnh thng ha cao v kh
c kh nng thay i. iu ny c tc ng trc tip
n tip cn dch v v s hi lng ca khch hng.
Tuy nhin, c nhiu n lc ng k trong lnh vc
y t v gio dc nng cao k nng, trnh v tnh
chuyn nghip ca nhn vin. Trong gio dc, cc
tiu chun v hiu qu ging dy dnh cho gio vin
c hnh thnh trn ton quc t nm 2007. B

Gio dc v o to cng gii thiu cc tiu chun
dnh cho hiu trng cc trng trung hc. Cc yu
cu v o c ngh nghip cng c tnh n, v
d nh trong cc tiu chun dnh cho hiu trng.
Lut khm cha bnh quy nh vic cp chng
ch hnh ngh cho cc nhn vin y t. Theo , cc
cn b y t cn p ng cc tiu chun v l thuyt
v thc hnh. Tuy nhin, n nay cc tiu chun
quc gia v nng lc chuyn mn ca cc cn b y
t vn cha c xy dng. Lut cng yu cu cc
nhn vin y t phi thng xuyn hc tp nng
cao nghip v y t. Mc d hin cha c cc tiu
chun quc gia v nng lc chuyn mn cho ngnh
y (v mt c quan cp trung ng gim st cc
tiu chun ny), nhng mt s ch th v quy nh
hin hnh cho nhn vin y t cng a ra mt
vi hng dn. Tuy nhin, nhng hng dn ny c
xu hng mang tnh k thut (ngha l c lin quan
n vic iu tr mt s bnh c th, qun l s
dng thuc v phc iu tr, v.v.) v khng c
ton din, v d nh cha c cc tiu chun y t v
hng dn iu tr cho mi trng hp.90 Cc nhn
vin y t c b quy tc ng x, bao gm c vic
iu tr cho bnh nhn. Tuy nhin, cc quy tc ny
khng c gim st hoc m bo thi hnh mt
cch hiu qu. Cc c ch gim st iu tr, nh gi
hiu qu khm cha bnh, hoc khuyn khch nng
cao cht lng v hiu qu hot ng cng vy.
Chnh ph Vit Nam xc nh nng

cao k nng, nng lc v trnh chuyn
mn ca cn b trong c hai lnh vc y t
v gio dc l vn quan trng.
Chnh ph Vit Nam xc nh nng cao k nng,
nng lc v trnh chuyn mn ca cn b trong
c hai lnh vc y t v gio dc l vn quan trng,
v cn u tin trong chin lc pht trin ca hai
ngnh ny. Phn cng cng tc cho cc nhn vin
c trnh cng l mt vn quan trng, v cc
cn b y t v gio vin thng khng mun lm
vic vng su vng xa v nng thn m nhng
ni ny li rt cn n chuyn mn ca h. Tc
ng ca vic phn cp phn quyn v ph dch
v trong cc bnh vin c tho lun trn:
mt trong nhng tc ng chnh l cc y bc s c
trnh cao tp trung trong cc bnh vin trung
ng v cp tnh, ni c ngun thu di do hn v
c th tr lng cao hn. Cc bc s thng khng
mun lm vic nng thn v cc u i ti chnh
khng h c mc thu nhp tng ng
vi cc ng nghip cng tc ti thnh th.91 Vn
tng t cng din ra trong lnh vc gio dc,

ngnh ny cng gp rt nhiu kh khn trong vic
tuyn dng cc gio vin sn sng lm vic ti cc
trng nng thn v vng su vng xa.
O C NGH NGHIP V CC BIN

PHP KHUYN KHCH
Hnh thnh vn ha o c trong cc t chc cung
cp dch v khng phi l mt nhim v d dng.
iu ny bao gm cc c ch r rng nhm qun l
hiu qu cng tc ca nhn vin, chnh sch sa thi
nhng nhn vin khng tn trng cc tiu chun
o c v ngh nghip, o to v cc tiu chun
c mong i v phi lm g khi cc tiu chun ny
b vi phm, v to mi trng thun li bn trong t
chc cng nh trong cng ng nhm nng cao
trch nhim c nhn, trch nhim gii trnh v hnh
vi o c. im mu cht l nhng hnh vi vi phm
phi b x pht v cc bin php x pht cn c
thc hin v cng khai. Cc hnh thc x pht c th
ln ti mc sa thi, thu hi chng ch hnh ngh.
Vic cp chng ch hnh ngh duy nht v trn i
cho cc nhn vin v chuyn gia y t theo nh Lut
mi v khm cha bnh cn c xem xt li, v theo
kinh nghim quc t, chng ch hnh ngh trn i
khng c tc dng khuyn khch cc nhn vin y t
n lc hc tp thng xuyn, khin h khng tng
tc nhiu vi cc ng nghip v khng c c hi
tip thu nhng tng v phng php lm vic
mi, bao gm c nhng hnh vi v o c v thc
tin iu tr bnh. Trung Quc chng hn, vic cp
giy php trn i c thay th bng mt quy
nh xt li giy php ba nm mt ln, trong cc
chuyn gia y t hoc phi tham d mt k thi hoc
phi tham gia mt chng trnh o to thng
xuyn nhm duy tr trnh ngh nghip ca h.
Cc c ch khiu ni c lp, c bit trong lnh vc

y t, cng l mt yu cu r rng duy tr cc tiu
chun ngh nghip v bo v bnh nhn khi b li
dng, lm dng v s sut trong iu tr. Cc hip
hi ngh nghip cng c vai tr quan trng trong
vic xy dng v duy tr cc tiu chun v gio dc
cc thnh vin ca h v nhng hnh vi thch hp,
cng nh khen thng v chia s cc thng l tt.
Cc hip hi ny cng c th gi vai tr cp giy
php v chng ch hnh ngh cho cc thnh vin.
Ngoi ra, o c ngh nghip v vn ha phc
v nhn dn c th thm nhun trong ngnh y t
v gio dc, cn tha nhn rng o c v vn
ha ngh nghip cn i i vi cc bin php khen
thng thit thc v tch cc. C hai bin php tin
t v phi tin t u cn thit. C nhiu bin php
khuyn khch, khen thng nh tng lng trc
tip, c hi hc thm v pht trin k nng, thng
chc trc thi hn, v phn thng, bng khen v
cht lng cng vic. Vn l la chn nhng bin
php ph hp vi vn ha v quan nim ca cc cn
b y t v gio dc Vit Nam. Cng cn hiu bit
su sc hn v thi v ng c lm vic c th
xy dng c cc chin lc hiu qu. V d, mt
nghin cu gn y v khuyn khch cc bc s v
sinh vin y khoa lm vic nng thn cho thy ch
u i v tin lng l khng thu ht cc bc
s v h c th kim c nhiu hn ng k khi lm
vic th, v cc bc s tr thng trnh hai nm
bt buc phc v nng thn bng cch chuyn
sang lm vic cho cc bnh vin t hoc tr li cc
khu vc th. Cc sinh vin y khoa thng quan
tm nhiu hn n cc u i phi tin t nh trin
vng ngh nghip lu di, cn cc bc s nhiu
nm cng tc li ch yu quan tm ti thu nhp.92
HP 6.5: HNG DN CA T CHC Y T TH GII V LU GI

Y BC S TI NNG THN 93
Nm 2010, T chc Y t Th gii (WHO) ban hnh hng dn lu gi nhn vin y t ti cc vng
su vng xa v nng thn. Trong khi tha nhn rng u i phi ph hp vi nhu cu a phng
v hon cnh, hng dn ca WHO xut kt hp cc u i v gio dc, qun l v ti chnh cng
vi h tr ngh nghip v c nhn.
Hng dn ny xut nhm vo cc sinh vin nng thn o to ngnh y; t cc trng y
ngoi cc thnh ph ln, to iu kin cho sinh vin tip xc vi cc vng nng thn thng qua
kinh nghim lm vic ti cng ng v lun chuyn cng tc, a cc ch v y t nng thn vo
chng trnh ging dy, v gip cc y bc s ti nng thn c iu kin tip tc hc ln cao. Ngoi
ra, cc yu cu bt buc v phc v ti nng thn v vng su vng xa cn c i km vi cc u
i v h tr; cc loi hc bng v tr cp gio dc khc phi bao gm cc tha thun rng buc l
ngi i hc s phi tr v lm vic nng thn v cc vng su vng xa.
u i v ti chnh bao gm tr cp kh khn, tr cp nh , i li min ph, cc k ngh c tr
tin, b p cc chi ph c hi khi lm vic nng thn. V iu kin sng l mt ro cn ln
i vi cn b y t cc nc nh Vit Nam, ci thin iu kin sng, c s h tng v dch v rt
quan trng thu ht v gi chn cc nhn vin y t nng thn. Mi trng lm vic tt v an
ton cng c tc dng tng t. Mng li ngh nghip, c hi tip xc, to ra nhng v tr cn
b y t cao cp nng thn, v mt h thng khen thng v ghi nhn thnh tch cng c vai tr
quan trng.
CC H THNG HIN I
nhp v ng lc lm vic cho nhn vin y t, v

gip cc t chc cung cp dch v t nhn tham gia
vo th trng. 96
CC H THNG QUN L HOT NG

HIN I
nng cao kh nng ca cc t chc cung cp
dch v y t v gio dc trong vic p ng nhng
nhu cu v mong i khng ngng thay i ca
khch hng, ng thi nng cao trch nhim gii
trnh v tnh minh bch, cn p dng mt h thng
hin i theo di, bo co v nh gi hiu qu
cng vic v m rng quy m. Hai phng php
chnh c tho lun ngn gn y: cp kinh ph
da trn hiu qu cng vic v p dng cng ngh
thng tin.
Ngnh y t cng nhn s cn thit phi chuyn
sang phn b ngn sch da trn hiu qu hot
ng, v mt ngh nh c d tho h tr
phn b ngn sch da trn hiu qu hot ng.94
y l mt bc tin quan trng theo hng nh
gi v phn b kinh ph cho cc t chc cung cp
dch v y t trn c s h c hon thnh nhim v
hay khng, hn l da trn s lng bnh nhn
hoc s ging bnh. Bo co y t ton cu 2010
ca WHO v ti chnh y t cho rng vic cp ngn
sch da trn hiu qu c th l mt chin lc tt
khen thng vic cung cp cc dch v c th
nhm khuyn khch s dng dch v, nng cao cht
lng hoc ci thin kt qu iu tr.95 thnh
cng, cn nghim tc xc minh kt qu nhm m
bo cc mc tiu t ra t c: im mu cht
l cn i cc ch s nh lng vi cc bin php
nh gi cht lng. Vic thu ht khch hng v cc
t chc x hi dn s tham gia gim st, phn hi
v cht lng dch v v xy dng cc quy chun
v dch v nh mc thu l ph cng gip m bo
s tham gia v ting ni ca khch hng c lng
nghe. cc quc gia nh Rwanda, phn b ngn
sch da trn hiu qu hot ng c chng
minh l tng mc s dng cc dch v y t, tng thu
Tng t nh vy, trong gio dc, ngn sch nh

nc c th c s dng khuyn khch cc t
chc hon thnh nhim v ca mnh v p dng cc
thng l tt. Trong gio dc i hc, vic cp ngn
sch da trn hiu qu hot ng c ph bin
rng ri to ra s cnh tranh gia cc trng v
nng cao cht lng tng th cng nh hiu qu
hot ng ca ton ngnh. Chnh ph vi t cch
nh ti tr v cc trng i hc hoc cao ng
vi t cch nh cung cp dch v s tho thun vi
nhau v cc mc tiu hay nhim v ca cc trng,
sau , ngn sch s c cp da trn mc cc
trng t c mc tiu ca mnh. V d Hng
Kng, y ban ngn sch cc trng i hc lm
vic vi lnh o ca 8 trng i hc ca Hng
Kng xy dng cc mc tiu, nhim v c th
cho tng trng sao cho ph hp vi mc tiu rng
hn ca ton h thng gio dc i hc. Mc ngn
sch cc trng nhn c s tng ng vi kt qu
nh gi thng k v mc cc trng t c
mc tiu tha thun.97
Trong bi cnh Vit Nam, vic cp ngn sch c th
gn lin vi ci thin hiu qu hot ng v pht
trin thng qua cp kinh ph cho cc trng c k
hoch chin lc ci thin thnh tch hc tp,
tng mc ph hp ca cc chng trnh ging
dy vi cng ng hoc ci thin c cu qun l.98
Kinh ph cng c th c s dng nh ng c
nng cao cht lng v kh nng p ng ng
nhu cu khch hng ca cc trng i hc t, bng
cch cho php h cnh tranh xin ti tr ca nh
nc. Bng cch thay i cc u i ch trng
vo kt qu hot ng (s hi lng ca ngi s
dng dch v, mc s dng dch v tng ln, t l
bnh tt thp hn), thay v cc ch s u vo (nh
s ging bnh), vic cp ngn sch da trn hiu
qu hot ng s gn kt vai tr ca cc t chc
cung cp dch v vi cc mc tiu pht trin con

ngi. c th l mt bin php quan trng
khc phc tnh trng thng mi ha cc dch v y
t v gio dc ti Vit Nam.
H THNG THNG TIN TT L TI QUAN

TRNG
nh gi v bo co kt qu hot ng i hi phi
c nhng h thng thng tin tt, bao gm c s
dng cng ngh thng tin, thu thp v chia s
d liu v thng tin. nh gi chung thng nin v
y t nm 2010 xc nh cc h thng thng tin y
t l mt trong su nhn t c bn ca h thng y
t. Cc h thng thng tin tt rt quan trng khng
ch i vi vic lp k hoch v ra quyt nh hiu
qu cho ton ngnh, m cn qun l v gim st
hiu qu cc t chc cung cp dch v. V d, vic
cc bnh n c tp trung cp trung ng l mt
bin php quan trng theo di cc xu th bnh l
v cch iu tr trn ton quc. iu ny cng ng
thi gip cc bnh vin trung ng v a phng
lp k hoch lm vic cho ph hp vi nhu cu a
phng. Tuy nhin hin nay, vic lu tr v qun l
d liu y t Vit Nam c thc hin tt c cc
cp ca h thng y t, t cp x phng n cp
trung ng. Nhng cp x phng vic lu tr h
s ch yu l lu tr giy t.99 V vy, cc h thng
qun l d liu v thng tin cc c s khm cha
bnh vn cha c hon thin. Nhng h thng
thng tin tt c tim nng to ln, khng ch theo
di cc xu th bnh l v cch iu tr m cn gip
nh gi hiu qu hot ng ca cc bnh vin v
cc phng khm ri sau cung cp thng tin ny
ngc tr li cho ngi bnh.
B Gio dc v o to cam kt s dng cng
ngh thng tin trong cc trng hc v thit
lp quan h i tc vi Viettel cung cp dch
v internet min ph ti 39.000 trng hc trong
ton quc. Mc tiu ca Vit Nam khng ch l tng
cng dy cc k nng cng ngh thng tin m
cn m bo cc trng c kt ni internet
v c trang b my tnh; khng ch l h tr pht
trin cc k nng cng ngh thng tin m cn p
dng cc cch tip cn mi vo dy v hc.100 Ch
th 55 (nm 2008) a vic s dng cng ngh
thng tin trong dy v hc thnh mt u tin. Cc
s gio dc tnh c trch nhim lm vic vi Viettel
a vic kt ni gio dc thnh hin thc. Cng

nh trong y t, cng ngh thng tin c vai tr quan
trng trong vic gip cc trng ci thin v hin
i ha vic qun l, nh gi v bo co v cng tc
dy hc, v d thng qua lu tr cc thng tin v h
s ng k hc v kt qu hc tp ca hc sinh.101
Nguy c y l cc trng v hc sinh kh gi s
c tip cn vi cng ngh mi nhanh hn, lm
gia tng hn na khong cch gia ngi c tin v
khng c tin. Tuy nhin, cng ngh thng tin c vai
tr quan trng trong vic nng cao hiu qu hot
ng v kh nng p ng nhu cu khch hng ca
cc t chc cung cp dch v. Trong khi nhiu ngi
dn Vit Nam cha c tip cn vi cng ngh
mi, vic s dng internet ngy cng tr nn ph
bin, c bit gii tr, v in thoi di ng
tng theo cp s nhn mi la tui. Nhng cng
ngh khng ch c s dng chia s thng
tin v dch v v cht lng dch v m cn thu thp
thng tin v mong i v thch ca khch hng
theo mt cch bo mt.
iu quan trng l s dng cc h thng hin i
trong lp k hoch, bo co v gim st cn gip
cc t chc cung cp dch v tr nn nhanh nhy
hn trc nhng nhu cu v mong i ca khch
hng v cng ng, cng nh chun b tt hn cho
nhng nhu cu trong tng lai v rt nhiu thch
thc m Vit Nam i mt trong mt mi trng
ang thay i nhanh chng. Tuy nhin, xy dng
cc t chc cung cp dch v hin i vi i ng
nhn vin c chuyn mn, tiu chun cao, mt c
ch m bo trch nhim gii trnh hiu qu, v
hng ti khch hng khng phi l nhim v d
dng. Vit Nam s cn s h tr thng xuyn ca
cc i tc pht trin, cng cc th ch v c ch
m bo trch nhim gii trnh vng mnh c cp
quc gia v a phng, v mt mi trng hot
ng thun li hn, trong cc loi hnh t chc
nh t chc phi nh nc phi li nhun c th tham
gia cung cp dch v, v ngi dn bnh thng
cng c th gp cho vic lp k hoch v cung
cp dch v. Nu Vit Nam mun t c cc mc
tiu pht trin ca mnh, v m bo mt tng lai
lnh mnh v thnh vng cho mi ngi dn, Vit
Nam s khng th n trnh nhim v ny. Trn thc
t, tin b ca Vit Nam v thnh qu pht trin con
ngi u ph thuc vo nhim v ny.
nh hng
Chnh sch
CC NH HNG
CHNH SCH
COI TRNG CON NGI HN MC TIU
PHT TRIN KINH T
Con ngi l ti sn thc s ca quc gia. Nh nc
cn u tin v u t xy dng nng lc, kh nng
v s la chn ca ngi dn, cng nh ci thin
cc kt qu pht trin con ngi ngang mc vi u
tin nng cao GDP trn u ngi hng nm.
Nh nc cn u tin v u t xy
dng nng lc, kh nng v s la chn
ca ngi dn, cng nh ci thin cc
kt qu pht trin con ngi ngang
mc vi u tin nng cao GDP trn u
ngi hng nm.
Gio dc v y t l nhng nn tng chnh ca pht
trin con ngi. m bo c hi tip cn bnh ng
vi dch v y t v gio dc c cht lng cho mi
ngi dn c ngha quan trng trong qu trnh
tin ln mc pht trin con ngi cao hn. Vit
Nam, mc u t cng cho gio dc c th so snh
vi hu ht cc quc gia khc trong khu vc, v u
t cng cho y t cng ang tng ln. Cc chnh sch
v cam kt chnh tr ng h tip cn ph cp cc
dch v x hi v an sinh x hi cng hnh thnh.
Tuy nhin, trong thp k qua, nhng tin b v cc
ch s gio dc v y t bao gm HDI v cc ch s
pht trin con ngi khc vn i sau pht trin kinh
t. Cc dch v y t v gio dc tr nn ngy cng
t v ko theo l bt bnh ng gia tng. Hu
qu l tin trnh i ln mc pht trin con ngi cao
hn ca Vit Nam (c o lng bi HDI) b nh
tr, c cp quc gia v a phng. Nm bt xu
hng ny khng d dng cht no, i hi s ch
v n lc ng b ca cc nh hoch nh chnh
sch cng nh h tr ca cng ng pht trin.
Nhng tc ng v nh hng chnh sch chung
sau y c nhn mnh trong bo co ny.
CC DCH V X HI C VAI TR QUAN

TRNG TRONG KM CH BT BNH NG
ANG NGY CNG GIA TNG
Nh Bo co ny ch ra, khc bit trong tip cn
dch v y t v gio dc v bt bnh ng trong
kt qu gio dc v y t vn tn ti dai dng, v
trong mt s trng hp ngy cng m rng gia
cc vng min khc nhau, gia cc dn tc thiu
s v dn tc Kinh/Hoa a s, v mt vi tnh
l gia ph n v nam gii. Nu khng c gii
quyt, tnh trng bt bnh ng v khc bit c
th nh hng tiu cc n tin trnh i ln mc
pht trin con ngi cao hn ca Vit Nam, v v
lu di cn c th gy bt n x hi v ph hoi
khi on kt dn tc. Cc dch v x hi nh y t
v gio dc c th ng vai tr quan trng trong
gim thiu s cch bit bng cch to ra c hi cho
ngi dn pht huy nng lc v nng cao i sng,
v bng cch m bo pht trin cn bng hn
cho cc nhm kinh t x hi. Tuy nhin, mc d Vit
Nam t c nhng tin b ng k v y t,
gio dc v nng cao mc sng, tim nng ny vn
cha c khai thc. Ngc li, cc c ch ti chnh
v cung cp dch v y t v gio dc hin nay dng
nh li ang cng c, thm ch trong mt s trng
hp l tng cng tnh trng bt bnh ng v khc
bit sn c. Gii quyt vn ny l mt yu cu
chnh sch cp bch nu Vit Nam mun t c
mc tiu pht trin v mc pht trin con ngi
cao hn. Cc chnh sch hin ti cng ng h tip
cn ph cp v cng bng cc dch v x hi. Cc v
d bao gm: Lut bo him y t nm 2009, d tho
Chin lc an sinh x hi v Ngh quyt 80 v gim ngho
bn vng. Tuy nhin, m bo s thng nht v thc hin
hiu qu cc chnh sch vn l mt thch thc ln.
CCH TIP CN MI V AN SINH X HI

Nh nhng cng c chnh sch chnh ny tha
nhn, mc tiu ch yu ca u t vo cc dch v
Cc nh hng chnh sch 140
x hi v an sinh x hi khng phi l to nn nhng

mng li bo v dnh cho nhng nhm dn c d
b tn thng v thit thi nht. Cc dch v x hi c
cht lng vi gi c phi chng v mt h thng an
sinh x hi ton din l c s cho mt x hi n nh
v thnh vng, v l iu kin tin quyt ci thin
pht trin con ngi v cht lng cuc sng. Tip cn
dch v x hi v an sinh x hi l thit yu bo v x
hi v ngi dn khi cc c sc, v d v mi trng,
x hi, kinh t hay sc khe, cng nh nng cao kh
nng phc hi. Trn th gii, ngy cng nhiu ngi
tha nhn rng vic nhn nhn an sinh x hi v tip
cn dch v x hi l quyn ph qut ca mi cng dn
thay v l nhng mng li bo v dnh cho nhng
ngi d b tn thng v thit thi nht l du hiu
nhn bit ca cc x hi v nn kinh t thnh cng.
Vit Nam c nhng du hiu cho thy c s thay i
trong cch ngh ny, nhng cng cn lu mi t c
s thay i hon ton. Cc cam kt ph cp an sinh x
hi nhm h tr mt x hi lnh mnh v vng chc
cn c cng c, v cc bin php m bo thc hin
hiu qu cc cam kt ny cn c tng cng.
MT H THNG LI CH NHT QUN

HN NHM H TR TIP CN TON DN
H thng cc chng trnh v sng kin hin nay
nhm h tr tip cn ton dn i vi dch v x
hi rt phc to, chng cho v cha n c vi
nhng ngi thc s cn h tr: ngi di c trong
nc l mt v d. Lut bo him y t quy nh
nhng nguyn tc p dng cch tip cn thng
nht v ton din hn i vi vic cung cp dch
v y t - tuy nhin thc thi vn l mt th thch,
bi rt nhiu ngi dn vn cha c th bo him
y t hoc khng s dng th v gi li ch kh hn
ch v nhng ngi s dng th bo him thng
c nhn nhng dch v c cht lng thp hn.
Phng thc cp kinh ph trong ngnh y t cng
cn c xem xt li nhm gim thiu cc ng c
ch nh iu tr hoc k n qu mc cn thit. Cn
tng cng nghin cu nhng c ch cp kinh ph
thay th cho ph s dng dch v, v d nh c ch
thanh ton theo nh sut v thanh ton theo nhm
cc loi bnh lin quan (DRG). ngnh gio dc
hin nay, khi chi ph ang tng nhanh, c bit
gio dc cp cao, mc tr cp ca nh nc khng
th bt kp vi mc tng chi ph. Cn c cch lm
mi nhm m bo tip cn dch v, nh h thng
phiu tr tin, h tr tin mt c iu kin i hc
v kt hp tt hn cc h thng phc li khc nhau.
NH GI LI CHNH SCH X HI HA
Cng vi cam kt mi v ph cp dch v x hi v
an sinh x hi c cht lng, n lc Vit Nam
cn xem xt, nh gi li chnh sch x hi ha. Mc
tiu ban u ca chnh sch x hi ha l to iu
kin tt c cc bn tham gia vo qu trnh lp k
hoch, cung cp v gim st cc dch v x hi. Vn

ny tr nn cp thit. Mt mi trng hot
ng thun li hn cho cc t chc cung cp dch
v phi nh nc, phi li nhun cn c u tin
cng c. Cc i tc pht trin c nhiu li th
h tr chnh ph Vit Nam trong lnh vc ny, cng
nh hp tc cht ch vi cc t chc phi nh
nc, phi li nhun nhm xy dng nng lc cho h
trong vic cung cp cc dch v x hi Vit Nam.
S tham gia rng ri hn ca ngi dn vo lp k
hoch v gim st cc dch v x hi ch khng ch
l ngi tr tin cho cc dch v cng ng vai
tr quan trng. Ngi dn tham gia vo qu trnh lp
k hoch v qun l dch v thng qua tng tc vi
chnh quyn a phng v thng qua qu trnh thu
thp kin ngi dn; cng nh tng tc trc tip
vi cc t chc cung cp dch v thng qua cc y
ban ngi s dng dch v l rt cn thit. Cc c ch
khc nhm ng gp kin cho lnh o v nhn
vin cc t chc cung cp dch v cng quan trng.
GNH NNG TI CHNH C CHIA S

CNG BNG HN
Mt trong nhng c im nguy him nht ca h
thng cp kinh ph hin ti cho ngnh y t v gio
dc Vit Nam l s ph thuc nng n vo phn
ng gp ca cc h gia nh, trong bi cnh gi c
leo thang. Cn chia s gnh nng chi ph cng bng
hn gia Nh nc v ngi dn, gia ngi giu v
ngi ngho.
Cn chia s gnh nng chi ph cng

bng hn gia Nh nc v ngi dn,
gia ngi giu v ngi ngho.
Hin ti, cc h gia nh ang tr khong 60% chi ph
y t v khong 37% chi ph gio dc ring gio dc
i hc ln ti hn 50% - cao hn rt nhiu so vi mc
ti u thc y cng bng v tng cng pht trin
con ngi. Thm ch ngay c khi gio dc tiu hc l
ra c min ph, th cc h gia nh vn phi tr cc
khon ph ph ln ti 17%. Gnh nng ca cc khon
ph ph ch ri vo cc h gia nh. Cn t mc tiu
cn bng gia pht trin kinh t v pht trin con
ngi, v u tin u t vo cc dch v x hi v an
sinh x hi; tuy nhin, ch trng ch tng ngn sch
khng phi l gii php tt, m cn u t hiu qu,
ch trng cht lng v qun l tt hn vic cung cp
cc dch v x hi.
GII QUYT TNH TRNG HAI CP TRONG

CUNG CP DCH V
Hin ti Vit Nam, nhng ngi kh gi hn tr nhiu
tin hn cho cc dch v x hi v do nhn c
cc dch v c cht lng cao hn. V vy, h khng
quan tm hay u t vo cht lng cc dch v dnh
cho ngi ngho. Trong khi , nhng ngi ngho

c hon cnh kh khn c rt t la chn v phi chp
nhn nhng dch v c sn, thm ch ngay c khi
nhng dch v ny ch t cht lng di mc tiu
chun. iu ny khin cc dch v sn c, v d nh
cc bnh vin huyn v cc trm y t x, b xung
cp. ng nhin bt k quc gia no, s khc bit
nht nh trong cht lng cc dch v x hi l khng
th trnh khi do kh nng chi tr ca cc c nhn v
h gia nh l khc nhau. Tuy nhin, cn phi xem xt
xem mc khc bit nh th no l chp nhn c
trong bi cnh mc tiu cng bng x hi ca Vit
Nam. Cng cn c nhng cuc tho lun chnh sch
si ni hn v cc tiu chun dch v ti thiu dnh
cho ton dn nn nh th no v bao gm nhng g.
TNG CNG QUN TR V NNG CAO

CHT LNG DCH V
Bo co ny cao tm quan trng ca vic
tng cng qun tr, gim st v qun l cc
dch v x hi bi cc c quan ch qun cng
nh trong ni b mi t chc cung cp dch v.
Cn c c ch qun tr vng mnh trong bi
cnh phn cp ngn sch v qun l cc dch
v x hi xung cc t chc cung cp dch v.
Cn c c ch qun tr vng mnh trong

bi cnh phn cp ngn sch v qun
l cc dch v x hi xung cc t chc
cung cp dch v.
Cc i tc pht trin rt sn sng h tr chnh ph Vit
Nam tng cng gim st v nng cao trch nhim gii
trnh ca cc t chc cung cp dch v, tng cng
kh nng qun l, vn ha cng s v cc tiu chun
ngh nghip ca cc t chc ny. Tuy nhin, cn tha
nhn rng to ng lc cc t chc cung cp dch
v hot ng v li ch cao nht ca khch hng khng
phi l iu n gin, v cc bin php khuyn khch
v ti chnh cn i song song vi cc u i v ngh
nghip v gio dc. Nhng li ch thit thn phc tp
v c hu cn c ghi nhn, cht vn v gii quyt.
S tham gia v kin ng gp ca ngi s dng dch
v l nhn t chnh cho n lc ny. Cc ch s cp tnh
nh ch s PAPI l nhng cng c qu gi cc chnh
quyn tnh ci thin cng tc lp k hoch v cung cp
cc dch v x hi, cng nh khuyn khch s tham gia
su rng hn ca cc bn lin quan v cc cng ng
vo qu trnh ra quyt nh. Ch s HDI v cc ch s
pht trin con ngi khc trnh by trong bo co ny
cho thy nhng tnh no c th ci thin cc ch
s v y t v x hi cho d mc tng trng kinh t ca
h khng cao lm, v nhng tnh no phi chng kin
s chnh lch gia tng d h tr nn thnh vng

hn. HDI v cc ch s pht trin con ngi khc cng
ch r nhng tnh no ang hot ng km hn v
tnh no ang thnh cng trong nng cao mc sng,
cht lng cuc sng cho ngi dn, v ci thin cc
kt qu pht trin con ngi. Vi ngha , chng l
mt cng c v ngun thng tin qu bu cho cc nh
hoch nh chnh sch.
QUN L KHU VC CNG V KHI T

NHN HIU QU HN
Chnh ph cn phi iu tit mu thun gia cc ng
c th trng vi cc mc tiu v quy chun v cng
bng. Vic qun l khi t nhn v khu vc cng hiu
qu hn c vai tr quyt nh. Khu vc cng ngy cng
cung cp dch v theo cch thu ph v trong trng
hp y t, c nhng dch v c cung cp song khng
cn thit v trong trng hp t nht li gy tc hi.
Hin ti, s tham gia ca khi t nhn vo lnh vc y
t v gio dc ang n r bao gm c nh thuc v
phng khm t nhn, gio dc mm non, dy ngh
v gio dc i hc. Thng thng, cc t chc cung
cp dch v c t nhn v nh nc t b gim st v t
phi chu trch nhim trc nhng hu qu ca vic
cung cp dch v km cht lng, thm ch c nhng
sai lm ca h mc d nhng hu qu ny c th l
rt nghim trng i vi cc c nhn v h gia nh.
Nu Vit Nam mun t c mc tiu xy dng h
thng trng i hc t chun th gii, m bo tr
em c bc khi u tt p v ngn chn hiu qu
tnh trng iu tr v k thuc qu mc cn thit cc
phng khm, bnh vin t v trong trng hp
xu nht l nhng hnh vi phi o c Vit Nam
cn hnh ng ngay c ch ti cho nhng hnh vi
khng ph hp hoc dch v km cht lng.
K HOCH CHO TNG LAI

Cui cng, Vit Nam cn tch cc hng v pha trc
v chun b cho tng lai, cho nhng loi hnh dch
v v h thng an sinh x hi m mt t nc v
hon cnh ang thay i nhanh chng s cn n,
cho nhng vn v thch thc mi ni nh gi ha
dn s, bin i kh hu, v cho nhng nguyn vng
v mong i khng ngng thay i ca ngi dn Vit
Nam. p dng cc h thng v cc cch tip cn hin
i hn, nh s dng cng ngh thng tin v truyn
thng, cp kinh ph da trn kt qu, cng vi s dng
tt hn cc bng chng cho cng tc lp k hoch l
nhng vn mu cht Vit Nam c th p ng
nhng nhu cu ang ni ln v ng ph vi nhng
thay i nhanh chng v kinh t x hi, tip bc trn
con ng pht trin con ngi mc cao hn.
Cc nh hngchnh sch 142
Ch thch v
ti liu tham kho
CHU THICH VA TAI LIU

THAM KHAO
CH THCH
1
Ngi Kinh hay ngi Vit l nhm dn ln

nht Vit Nam v chim phn ng dn
s, 76 %. Nhm ngi Hoa hay Trung Quc
chim 1%, tuy nhin nhm ny thng
khng c coi l dn tc thiu s Vit
Nam v s ng ha cao ca h vi ngi
Kinh v v h tng i giu. Bo co ny
nh ngha dn tc bao gm c ngi Kinh,
ngi Hoa v ngi dn tc thiu s - nhm
cui ny chim 13% tng dn s.
19
UBND H Ni v UBND TP H Ch Minh

2010.
20
Trung tm khoa hc x hi v nhn vn

quc gia 2001: 19.
21
London 2010a: 39.
22
Vin qun l kinh t trung ng (CIEM) v

Vin cnh tranh Chu 2010.
23

Vin cnh tranh Chu 2010: 8.
24
Sen 2011.
25
V d Din n Quc t Vit Nam-Chu Phi

ln hai din ra ti H Ni vo thng 8 nm
2010 c t chc ch yu nhm mc tiu
chia s cc bi hc kinh nghim v thc
hin cc Mc tiu MDG v pht trin bn
vng.
26
Ngun d liu trc 1999 ly t Bo co

pht trin con ngi quc gia 2001.
27
Xem Ph lc bit chi tit thay i trong

cc ch s theo thi gian.
28
Vin ci cch v pht trin Trung Quc

2008: 13.
29
Chnh ph Vit Nam 2010b.
30
UNDP 2010: 50, 51.
CHNG 1
1
UNDP 1990: 9.
Alkire 2010.
Alkire 2010.
UNDP 2010
Stiglitz, Sen, v Fitoussi 2009: 4.
Stiglitz, Sen, v Fitoussi 2009: 63.
Bloom v Canning 2008.
UNDP Trung tm Khu vc Chu Thi Bnh

Dng Colombo 2008.

quc gia 2001.
31
Ti khon y t quc gia ca WHO 2008.
32
UNDP 2010: 30.
10
UNDP 2010.
33
Chng trnh Harvard Vit Nam 2008: 22.
11
Stiglitz, Sen, v Fitoussi 2009.
34
12
Chnh ph Vit Nam 2001.
13
GoV 2010b: 15.
14
GoV 2010d: 4.
Chng trnh Harvard Vit Nam 2008: 22;

Van Arkardie v cng s 2010; Vin qun
l kinh t trung ng (CIEM) v Vin cnh
tranh Chu 2010.
15
GoV 2010d: 5.
35
London 2010a; Van Arkardie v cng s

2010.
16
GoV 2010c: 4.
36
LHQ ti Vit Nam 2011: 3, 4.
17
GoV 2010c: 4-5.
37
18
B LTBXH v UNICEF 2008.
Van Arkardie v cng s 2010: 19; London

2010a.
144
38
Chnh ph Vit Nam 2010a: 32.
39
UB cc vn x hi ca Quc hi v UNDP
2009.
40
41

quc gia 2001: 28.
42

quc gia 2001: 9.
43
UNDP 2009.
44
UNDP 2010: 28.
45
UNDP 2010: 90.
46
UNDP 2010: 95.
47
Xem thm thng tin v cc ch s mi ny ti

www.hdr.undp.org.
48
UNDP 2010: 26.
49
Ch s GII mi l mt ch gy tranh
ci trn th gii. Xem Permanyer (khng
ngy thng).
50
Chun ngho ca Vit Nam thp hn chun

ngho quc t: nm 2008, chun ngho
chnh thc l PPP (ngang gi sc mua) $1,09
la mt ngy, thp hn tt c cc nc
khc trong khu vc tr Trung Quc v thp
hn ng k so vi nhng nc nh Thi
Lan l 2,49 la PPP mt ngy (i ngho
ng v Thi Bnh Dng: chng ta c
ang o lng nhng g cn thit? Ngn
hng Th gii 2010a.
V th, theo Bo co v cc Mc tiu Pht

trin Thin nin k nm 2010 trnh ln hi
ngh, Vit Nam ng th 6 ton th gii c
v nhng tin b tuyt i v tng i
trong thc hin cc Mc tiu Pht trin
Thin nin k. Overseas Development
Institute (ODI) 2010: 9.
Tng cc Thng k 2010d.
Tng cc Thng k 2010d.
Lu rng nhng con s ny da trn

mc chi tiu v tng i thp hn chun
ngho Vit Nam nh ghi ch trn.
10
Chnh ph Vit Nam 2010b: 43.
11
12

13
Xem Ngn hng Th gii 2011.
14
Ngn hng th gii 2010c: 5, 13.
15
Ngn hng th gii 2010c: 8.
16
V vy, h s hiu qu s dng vn ICOR

ang mc gn 7, tc l Vit Nam phi
u t 7 n v to ra 1 n v GDP. H
s ca Vit Nam cao hn rt nhiu so vi
Trung Quc v n . Vin qun l kinh t
trung ng (CIEM) v Vin cnh tranh Chu
2010: 40.
17
Pincus 2010.
18

2010: 106.
19

2010: 106; Trung tm Phn tch v D bo,
VASS, 2009.
20

21

Vin cnh tranh Chu 2010: 61; Pincus
2010.
Pincus v Sender 2007: 108-150.
CHNG 2
1
Tiu ch chnh ca Ngn hng Th gii

(WB) phn loi cc nn kinh t l GNI
trn u ngi. Cc nn kinh t c chia
thnh cc nhm theo GNI u ngi nm
2010 tnh bng Phng php Atlas ca WB.
Cc nhm ny bzao gm: thu nhp thp,
di 1.005 la M; thu nhp trung bnh
thp, t 1.006 n 3.975 la M; thu nhp
trung bnh cao, t 3.976 n 12.275 la
M; v thu nhp cao, 12.276 la M tr
ln. Xem http://data.worldbank.org/about/
country-classifications v http://data.
worldbank.org/indicator/NY.GNP.PCAP.CD
last accessed September 2011
S liu ca TCTK, ti www.gso.gov.vn.

Vin cnh tranh Chu 2010.
Tng cc thng k 2010d Nhng t l

ngho ny c da trn mc chi tiu, s
dng chun ngho ca Ngn hng Th gii
v TCTK. T l h ngho s thp hn i
cht nu c tnh da trn thu nhp bnh
qun u ngi mt thng, s dng s liu
iu tra mc sng h gia nh v chun
ngho mi ca Chnh ph cho giai on
2006-2010.
22
23
24
bit thm v cc tho lun chi tit v xu

th kinh t hin ti, xin mi tm c nhng
ti liu ca Ngn hng th gii, LHQ v cc
ti liu nghin cu c lp cp trong
chng ny.
Vin cnh tranh Chu 2010: 97; LHQ Vit
Nam 2009.
V d, Ngh quyt 11/NQ-CP th hin mt
bc ngot trong ng li chnh sch, v
ngh quyt ny u tin cht lng tng
trng v pht trin hon l ch tng trng
trong ngn hn.
25
Chng trnh Harvard Vit Nam 2010; Vin

qun l kinh t trung ng (CIEM) v Vin
cnh tranh Chu 2010.
26

27

28
http://data.worldbank.org/about/
country-classifications.
29
UNDP 2010: 139.
30
LHQ ti Vit Nam 2010a: 15.
31
bit thm v by thu nhp trung bnh,

xem Van Arkadie v cng s 2010; Vin
qun l kinh t trung ng (CIEM) v Vin
cnh tranh Chu 2010.
39
B LTBXH, ILO v EU 2011.
40
Cn ci thin iu kin lao ng lm gim

nhng tranh chp trong lao ng; Meissner,
v H S Hng 2008
41
B LTBXH v ILO 2010; TCTK 2010d.
42
Nguyn Ngc Thng 2010.
43
B LTBXH, ILO v EU 2011: 21.
44
B LTBXH v ILO 2010: 15; TCTK 2010d.
45
MOLISA v ILO 2010: 14.
46
Cling v cng s 2010.
47
B LTBXH, ILO v EU 2010. Lu rng

nhng d liu v gio dc cho ton lc
lng lao ng khng c trong Bo co
iu tra lao ng v vic lm nm 2009.
48
TCTK 2010d: 43.
49
TCTK 2010d: 38.
50
Mc thiu vic lm c tnh bng s

gi lm cng vic chnh v s sn sng lm
thm gi ca ngi lao ng. B LTBXH,
ILO v EU 2011: 19.
51
Nguyn Ngc Anh v Nguyn c Nht

2010.
52
Pincus 2010.
53
Rodgers v Menon 2010; Lee 2008
54
Cling v cng s 2010.
55
Rodgers v Menon: 2010.
32
Ngn hng th gii 2010a.
56
RodgersvMenon: 39.
33
Cng nghip v xy dng chim 42% GDP

nm 2009, so vi 36% nm 2000 v 25%
nm 1990. Trong khi , gi tr ca nng
nghip trong GDP gim xung 17% so vi
31% nm 1990. Dch v vn gi nguyn
t trng, khong 40-43% trong giai on
1990-2009. Con s tnh theo thi gi nm
1994, TCTK, ngun: www.gso.gov.vn, ly vo
thng 9/2011.
57
Ban Ch o Tng iu tra dn s v nh

trung ng 2010: 34.
58

trung ng 2010: 53.
59

trung ng 2010: 41.
60
61
Van Arkadie v cng s 2010.
Tc tng trng trong cng nghip v

xy dng gim t 10,2% nm 2007 xung
5,5% nm 2009, trong dch v t 8,9% xung
6,6% v trong nng nghip t 3,8% xung
1,8% trong cng k. Ngn hng th gii
2010c: 7
62
TCTK 2010b.
63
Van Arkadie v cng s 2010.
64
UNFPA 2011.
65
Giang Thanh Long 2010: 4
66

trung ng 2010: 70.
67
Da trn Giang Thanh Long 2010.
68
Phn ny da trn Trng Y t Cng cng

H Ni v i hc Queensland 2008
69

trung ng 2010: 62-63.
34
35
36

37

38
TCTK 2010a.
146
70
Guilmoto 2010.
98
Harmeling 2010: 7.
71
Guilmoto 2010.
99
T Th Thanh Hng v Neefjes 2010: 4
72
Sen 2001
100
73
Guilmoto 2010
101
74

trung ng 2010: 38
102
T Th Thanh Hng v Neefjes 2010
103
75
Van Arkardie v cng s 2010: 218
104
TCTK2010d.
76
105
Mi s liu trch t TCTK 2010b.
77

trung ng 2010:36
106
Cha n 1% ph n tr Vit Nam ht

thuc.
78
Dapice, Gomez-Ibanez, v Nguyn Xun

Thnh 2010.
107
Ngn hng th gii 2009.
108
Acua-Alfaro, Giang ng v Thanh

Huyn 2010: 1.
79
Van Arkardie v cng s 2010: 222, 223
80
109
LHQ ti Vit Nam 2010a.
81
UN-Habitat 2008: 178.
110
Ngn hng th gii 2009: 30.
82
Dapice, Gomez-Ibanez v Nguyn Xun

Thnh: 15.
111
83
Cuc iu tra khng tnh n bt k ngi

di c tm thi, theo ma v v i vng no,
nhng con s nhng ngi di c ny c
c tnh l kh ln Vit Nam. TCTK 2011b.
112
113
Chnh ph Vit Nam 2010d: 21.
114
LHQ ti Vit Nam 2010a.
115
Chnh ph Vit Nam 2010d: 22
116
Trch t Vian, Salomon, v Nguyn Th Kiu

Vin 2010:7
117
Thanh tra chnh ph 2010.
84
TCTK 2011b.
85
UNIAP 2008
86
TCTK 2011b: 9
87
TCTK 2011b: 9
88

2010.
89
TCTK 2011b; UBND H Ni v UBND TP H

Ch Minh 2010
90
TCTK 2011b.
91

2010: 23-24.
92
IOM 2010.
93
Pincus v Sender 2009: 116
94
IOM 2010.
95
Khong 89% h gia nh Vit Nam nhn

c tin ca ngi nh chuyn v theo
mt hnh thc no t nc ngoi hoc
trong nc. Tng gi tr ca cc khon tin
chuyn v ny ln ti khong 5,5 t la
M nm 2007. Tng gi tr ca cc khon
tin chuyn v nh t cc a phng khc
trong nc tng ln theo thi gian. LHQ ti
Vit Nam 2010b: 41
96
T Th Thanh Hng v Neefjes 2010.
97
Harmeling 2010.
CHNG 3
1
UNDP 2009.
UNDP 2009.
Xem Ph lc 3 v cch xy dng ch s MPI

ca Vit Nam.
Surborg 2010.
London 2010b. S liu dn s trch t Ban

Ch o Tng iu tra dn s v nh trung
ng 2010.
London 2011: 1-56.
TCTK 2010;Ban Ch o Tng iu tra dn s

v nh trung ng 2010: 85
TCTK 2011b.
Rodgers v Menon 2010; xem thm Chnh

ph Vit Nam 2010a.
10
TCTK v WHO 2010.
11
B Y t, Bnh vin nhi trung ng v UNICEF

2008.
12
UNICEF, B gio dc o to, v UNESCO.
13
TCTK 2010d: Bng 9.5.
23
V Hong Linh 2010; TCTK 2010d: Bng 2.3.
14
24
V Hong Linh 2010.
15
Xem bng s liu trong Ph lc 4 v nhng

thay i trong cc ch s ph ca HPI theo
thi gian.
25
London 2010a: 41.
26
TCTK v UNICEF (2007): 209.
27
TCTK 2011a: 36; xem thm Ban Ch o Tng

iu tra dn s v nh 2010: 91, Bng 7.4.
28
Phm Thi Hng 2010.
29
Phm Thi Hng 2010.
30
Phm Thi Hng 2010.
31
Phm Thi Hng 2010.
Rodgers v Menon 2010.
32
Xem UNICEF, B GD&T, v UNESCO 2008.
y ban dn tc v UNDP 2008.
33
Rodgers v Menon 2010: 81.
y ban dn tc v UNDP 2008.
34
Phm Thi Hng 2010.
Nguyn Vit Cng 2010: 23.
35
Phm Thi Hng 2010.
Sch dn: 19.
36
Phm Thi Hng 2010.
Rodgers v Menon 2010, p. 46.
37
TCTK 2010d, Bng 2.2
Sch dn: 48.
38
TCTK 2010d, Bng 2.1
Trch trong B LTBXH v UNICEF 2010: 44.
39
V Hong Linh 2010.
Chnh ph Vit Nam 2010a: 60.
40
Chnh ph Vit Nam 2010b: 40
10
TCTK 2009a: 112.
41
TCTK 2009b.
11
Knowles v cng s 2010.
42
TCTK 2011a: 38, 39.
12
43
TCTK 2011a: 38, 39.
13
Chnh ph Vit Nam 2010b: 55-57.
44
V Hong Linh 2010.
14
Chnh ph Vit Nam 2010b: 60-63.
45
V Hong Linh 2010: 14
15
T l mc HIV cao hn i vi ngi tim

chch ma ty cc tnh Qung Ninh, TP H
Ch Minh v Cn Th, i vi gi mi dm
Hi Phng TP H Ch Minh v Cn Th, i
vi khch mua dm Ty Bc B v Cn Th,
v i vi nam gii quan h tnh dc ng
tnh H Ni v TP H Ch Minh. Xem B Y
t Cc phng chng HIV/AIDS 2009.
46
Rodgers v Menon 2010: 16-17
47
V gio dc tiu hc l bt buc, vn ny

khng c xem xt cp hc ny.
48
V Hong Linh 2010.
49
IOM 2010.
16

Chnh ph Vit Nam 2010b:57.
CHNG 4
1
16
Surborg 2010.
17
B Y t Cc phng chng HIV/AIDS 2009.
18
B Y t Cc phng chng HIV/AIDS 2009.
19
B Y t v Nhm i tc y t 2009: 12.
20
LHQ ti Vit Nam 2010a; B Y t v Nhm

i tc y t 2010.
CHNG 5
1
London 2010a: 21.
Van Arkadie v cng s 2010: 85.
Pincus 2010: 27.
London 2010: 27.

21
L Bch Dng v cng s 2008.
22
T l nhp hc chung l t l gia s hc

sinh nhp hc mt cp hc (bt k
tui), chia cho tng dn s tui ca
cp hc . T l nhp hc ng tui l t l
gia s hc sinh thuc tui ca mt cp
hc nhp hc cp hc chia cho tng
dn s tui . V Hong Linh 2010.
Cook 2009; Baluch v cng s 2008.
U Ban cc vn x hi ca Quc hi v
UNDP 2009.
B Y t v Nhm i tc y t 2010: 149
148
Lu rng c th c hng bt k ch
no k ra di y, ngi dn cn ng
k h khu. Do vy, nhng ngi nhp c
tm thi v khng c h khu khng c
tip cn cc li ch ny. U Ban cc vn x
hi ca Quc hi v UNDP 2009.
10
Baluch v cng s 2008: 53
11
Baluch v cng s 2008: 66
12
TCTK 2010d.
13
LHQ ti Vit Nam 2010a: 49
14
Chun ngho mi cho giai on 2011-2015

l 500.000 ng/thng cho khu vc thnh
th v 400.000 ng/thng cho khu vc
nng thn, v mc cn ngho l 501.000
n 650.000 ng/thng khu vc thnh
th v 401.000-520.000 ng/thng khu
vc nng thn. Tuy nhin, rt nhiu khu vc
th v vng min tr ph hn t t
mc chun ngho cao hn.
15
Da trn London 2010a; Pincus 2010; v Van

Arkadie v cng s 2010
16
Nguyn Khnh Phng 2009: 126
17
Van Arkadie v cng s 2010: 135
18
Trch t London 2010: 23
19
Trch t B Y t v Nhm i tc y t 2010:

142
20

142
21
Pincus 2010: 26
22
London 2010a: 24
23
London 2010a: 25
24
Pincus 2010a: 27
25
Fischer 2010.
26
34
London 2010b: 38
35

15
36
B Y t v Nhm i tc y t 2008: 36; Giang

Thanh Long 2010: 11
37
38
Giang Thanh Long 2010: 11.
39
B Y t v Nhm i tc y t 2010: 150.
40
41
B Y t v Nhm i tc y t 2010: 148.
42
43
London 2010b: 34.
44
Trch t London 2010b: 38.
45
WHO 2009: 5, 18
46
TCTK 2010d: Table 4.13
47
Cng nn lu rng khu vc duyn hi

Nam Trung B dng nh p dng cch
tip cn ch trng ti khch hng nhm
khuyn khch ngi dn mua bo him y t
hn nhng khu vc khc. Khu vc ny t
mc ng k th bo him y t cao nht
(15,8%) so vi mc trung bnh ca quc
gia (11,1%). Nhng ngi c bo him
khu vc ny thng ng k bnh vin
(t ngi ng k cp x hn 18% so vi
mc trung bnh ca quc gia l 32%) v t
tr ph thm hn (9% so vi 12% ton quc).
Castel v Oanh 2010.
48
Rodgers v Menon 2010.
49
50
Chnh v l do ny m cc sng kin nh

Lut Bo him Y t mi cng tr cp cho
ngi cn ngho.
Mt khi h gia nh chi vo y t hn 40%

tng chi tiu ca h, hay 25% chi tiu ngoi
thc n, h s khng th tr ni nhng chi
ph sinh hot cn thit khc, c bit l
nhng gia nh c thu nhp thp.
51
27
London 2010b: 33.
52
Hong Vn Minh v Phng Nguyn 2011.
28
London 2010b: 34.
53
29
Lu rng cc s liu quc t c th khc

bit mt cht so vi s liu ca quc gia.
Theo Ti khon Y t Quc gia, chi tiu cho
y t chim 6,4% GDP nm 2008. B Y t v
Nhm i tc y t 2010: 144.
54
55
Xem mt v d ti Goal: Maximising profits

from patients illness 2011.
56
Thompson, Wittner, v Nguyn Th Thy

Nga 2011: 26.
57

Nga 2011: 27
58

Nga 2011: 42.
30
WHO Ti khon Y t Quc gia ti http://

www.who.int/nha/en/
31
32
LHQ ti Vit Nam 2010a: 53
33
London 2010b: 38
59
Nguyn Vit Cng 2010: 17
95
Bunting 2011.
60
Castel v Oanh 2010.
96
Bunting 2011.
61
Nguyn Vit Cng 2010:32.
97
62
Castel v Oanh 2010.
63
Castel v Oanh 2010: 154
B GD&T d tnh rng cc h gia nh

ng gp khong 25% tng chi tiu cho
gio dc. B GD&T 2009.
64
Castel v Oanh 2010; Nguyn Vit Cng

2010.
98
65
Nguyn Vit Cng 2010: 17, 18.
66
Castel v Oanh 2010.
67
Castel v Oanh 2010; Giang Thanh Long

2010: 11.
68
Castel v Oanh 2010.
69
London 2010b: 64. Mt bi bo gn y

khng nh xu hng ny. Theo s liu
mi y ca B Y t, my nm gn y, mi
nm c khong 40.000 ngi dn Vit Nam
ra nc ngoi cha bnh, tiu tn hn 1 t
USD. y mi ch l thng k trn s sch,
thc t con s ny c th ln hn nhiu ln.
http://vnexpress.net/gl/suc-khoe/2011/10/
che-hang-noi-dan-do-ra-nuoc-ngoai-chuabenh/
70
99
London 2010a: 54.
71
100
V Hong Linh 2010.
72
Lieberman v Wagstaff 2009.
73
Lu rng s liu ton cu c th khc bit

mt cht so vi cc con s thng k hin c
ca quc gia.
London 2010b: 33.
74
V Hong Linh 2010.
London 2010b: 28.
75
UNICEF 2010.
London 2010b: 28.
76
UNICEF 2010.
London 2010b: 28.
77
London 2010b: 36.
78
London 2010b:34.
79
London 2010b: 34.
London 2010b: 32.
80
V Hong Linh 2010.
81
London 2010b: 45.
B Y t v Nhm i tc y t 2009.
82
London 2010b: 25.
10
83
London 2010b: 25.
11
Economist Intelligence Unit 2011.
84
Thanh tra chnh ph 2010.
12
London 2010b: 33.
85
CECODES, Mt trn T quc v UNDP 2011.
13
B Y t v Nhm i tc y t 2010: 151.
86
New School v Harvard University 2010: 40.
14
Lieberman v Wagstaff 2009: 121.
87
15
88
V Hong Linh 2010.
16
89
TCTK 2010d, Bng 2.6.
17
London 2010a: 28.
90
TCTK 2010d, Bng 2.6.
18
London 2010a: 28.
91
London 2010b: 44.
19
London 2010a: 54.
92
20
TCTK 2009.
93
London 2010b: 47.
21
V Hong Linh 2010.
94
Fizbein v Schady 2009.
22
B GD&T, trch trong London 2010b: 30.
CHNG 6
150
56
Tp ch ng Cng sn Vit Nam

(24/04/2006). Ngh quyt i hi i biu
ton quc ln th VII ca ng: Thng
qua "Cng lnh xy dng t nc trong
thi k qu ln ch ngha x hi", ngy
27-6-1991, URL: http://123.30.49.74:8080/
tiengviet/tulieuvankien/vankiendang/
details.asp?topic=191&subtopic=8&leader_
topic=224&id=BT2440654662
57
Xem Ngh quyt ca chnh ph s 08/2004/

NQ-CP v tip tc y mnh phn cp qun
l nh nc gia chnh ph v chnh quyn
tnh, thnh ph trc thuc trung ng.
58
nh gi phn cp qun l ca UBND H Ni

cho thy mt bc tranh hn hp v nhng
g v cha t c (Xem H Ni Mi
Online (17/11/2010), Phn cp qun l: khc
phc bt cp, tng ng b, hiu qu URL:
http://www.hanoimoi.com.vn/newsdetail/
Kinh-te/399693/phan-cap-quan-ly-khacphuc-bat-cap-tang-dong-bo-hieu-qua.
htm)
London 20110: 32.
59
Xem Ngn hng Th gii 2009: 64,65.
41
B Y t v Nhm i tc y t 2010, 2009.
60
42
B Y t v Nhm i tc y t 2010: 126.
43
44
B Y t v Nhm i tc y t 2010: 119.
Ch s hiu qu qun tr v hnh chnh cng

cp tnh Vit Nam (PAPI) 2010: o lng t
kinh nghim thc tin ca ngi dn. Xem
trang web www.papi.vn
45
61

Huyn 2010.
46
62
47

Huyn 2010.
48
London 2010b: 61.
63
49
Pincus 2010: 26.
CECODES, Mt trn T quc Vit Nam v

UNDP 2011.
50
London 2010b; Pincus 2009.
64
London 2010a.
51
Ngn hng th gii 2010: 76, 77.
65
London 2010a: 23.
52

UNDP 2011.
66
Acua-Alfaro 2009: 21-40.
67
53

UNDP 2011: 80-82.
Koh, David, ng c m v Nguyn Th

Kim Chung 2009: 252-319.
68
London 2010a: 10.
54
Acuna v cng s 2010.
69
London 2010a: 12.
55
UNDP 2002 v Acua-Alfaro v nhng

ngi khc 2010.
70
Australian
Government
Commission 2010: xxix.
23
London 2010b: 31-32.
24
London 2010b: 31-32.
25
London 2010b: 42.
26
London 2010b: 44.
27
28
New School v Harvard University 2010: 18,

19.
29
30
31
32
33
34
B Y t v Nhm i tc y t: 19.
35
B Y t v Nhm i tc y t: 20.
36
B Y t v Nhm i tc y t: 53-54.
37
Castels v Oanh 2010.
38
London 2010b: 48.
39
London 2010b: 48.
40
Productivity
71
Australian
Government
Commission 2010: xxix.
Productivity
72
Ngn hng Th gii 2009: 64.
73
74
75
Ngn hng Th gii 2009: 65.
76
77
D tho Lut khm cha bnh c bao gm

mt iu khon v vic thnh lp Hi ng
Y t Quc gia c lp nhng trong vn bn
lut c thng qua th li khng c iu
khon ny.
78
79
Lieberman v Wagstaff 2009.
80
Lut khm cha bnh s: 2009/QH12.
81
Harvard University 2010: 47.
82
83
84
85
86
USAID 2009.
87
Jones v cng s 2007.
88
Koh v cng s 2009: 260.
89
London 2010a: 17.
90
91
Vujicic v cng s 2010.
92
Vujicic v cng s 2010.
93
WHO 2010a.
94
B Y t v Nhm i tc y t 2010: 208.
95
WHO 2010b.
96
Soeters v cng s 2006: 884-889.
97
98
99
100
B GD&T 2009; B GD&T 2000.
101
Peeraer v Trn 2010.
152
TI LIU THAM KHO
B LTBXH, ILO v EU (2011). Xu hng vic lm ti

Vit Nam 2010. H Ni: ILO
Acua-Alfaro, Giang ng v Thanh Huyn

(2010). o lng Qun tr v hnh chnh cng v
pht trin con ngi: Cch tip cn t quan im
cu, Ti liu phc v Bo co quc gia v Pht trin
con ngi. H Ni: UNDP
B Y t Cc phng chng HIV/AIDS (2009) c tnh

v d bo nhim HIV/AIDS ti Vit Nam nm 2007
2012. H Ni: B Y t
Acua-Alfaro, J. (2009). Gii thiu chung: nng cao

hiu qu qun tr quc gia v y mnh ci cch
hnh chnh Vit Nam trang 21-40 trong AcuaAlfaro. Trong Ci cch hnh chnh Vit Nam: Hin
trng v Khuyn ngh. H Ni: UNDP
Alkire, S. (2010). Ti liu nghin cu pht trin con
ngi 2010/01: Pht trin con ngi v nhng khi
nim lin quan, New York: UNDP
Australian Government Productivity Commission
(y ban Nng sut Chnh ph c) (2010). ng gp
ca cc t chc phi li nhun: Bo co nghin cu
ca y ban Nng sut. Melbourne: Commonwealth
of Australia.
Baluch. B., v cng s (2008). Ch s an sinh x hi
nhm thc hin cam kt gim ngho. Tp 2: Asia.
Manila: ADB
Ban Ch o Tng iu tra dn s v nh trung
ng (2010). Kt qu tng iu tra dn s v nh
Vit Nam nm 2009. H Ni: TCTK. C trn trang web
www.gso.gov.vn
Bloom, D.E. v Canning D. (2008). Sc khe ngi
dn v pht trin kinh t, Ti liu s 24 ca y ban v
tng trng v pht trin, Washington: Ngn hng
Th gii. C trn http://www.growthcommission.
org
B GD&T (2009). K hoch chin lc pht trin
gio dc Vit Nam 2009-2020. D tho 15b ngy 20
thng 4, H Ni.
B GD&T (2009); B GD&T (2000) Quy hoch tng
th vic p dng cng ngh thng tin trong gio dc
giai on 2000-2005. H Ni.
B LTBXH v ILO (2010). Xu hng lao ng v x
hi Vit Nam 2009/10. H Ni: ILO.
B LTBXH v UNICEF (2008). Tr em ngho Vit
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158
Ph lc
PH LC
PH LC 1: Danh sch cc tc gi v nhng ngi ng
gp cho cc nghin cu nn ca Bo co quc gia v pht
trin con ngi
Tc gi v cc nghin cu nn:
ti s
Tc gi
ti nghin cu
Giang Thanh Long
Hng ti mc pht trin con ngi cao hn: nhng thch thc i vi
dch v y t, cung cp ti chnh cho dch v y t v vai tr ca chnh ph
Jonathan London
Cn bng ga mc tiu v phng tin: trch nhim ca cc t chc

trong vic cung cp v chi tr cho cc dch v gio dc v y t
Jonathan London
Dung ha cc li ch ca t chc v nhu cu ca cng chng: cc thch

thc v cung cp dch v trong lnh vc y t v gio dc Vit Nam
4a
Nguyn Vit Cng
Cung cp v s dng dch v y t cng Vit Nam
4b
Bjrn Surborg
R sot qu trnh ci cch trong cung cp dch v y t ti Vit Nam: m

phng theo khu vc a l
V Hong Linh
Cc vn gio dc Vit Nam trong thin nin k mi: Tip cn, chnh
lch v u t
6a
o Hong Mai
R sot nhng ci cch trong cung cp dch v x hi cng Vit Nam:

Gim ngho v bt bnh ng
6b
Nicola Jones v Nguyn

Ngc Anh cng Elizabeth
Presler-Marshall
R sot nhng ci cch trong cung cp dch v x hi cng Vit Nam
6c
Giang Thanh Long
Trc mt dn s gi i: tng hp nhng ci cch trong cc dch v bo

tr x hi Vit Nam
L Thc Dc
Can thip sm: cch u t hiu qu nht trong pht trin vn con ngi
Vit Nam
Jairo Acua-Alfaro, Giang

ng v Thanh Huyn
o lng Qun tr v hnh chnh cng v pht trin con ngi: Cch tip
cn t quan im cu
Phm Thi Hng
nh gi kh nng tip cn cc dch v gio dc v y t cc dn tc

thiu s Vit Nam
10
Trn Th Vn Anh & Soma

Chakrabarti
nh gi vn trao quyn cho ph n trong khu vc nh nc
11
Koos Neefjes & T Th Thanh

Hng
Bin i kh hu v dch v x hi
12
Nguyn Ngc Thng
nh gi xu th vic lm ti Vit Nam trong bi cnh chuyn dch sang

nn kinh t c gi tr cao hn
13a
Nguyn c Nht v Nguyn

Ngc Anh
Xu th lao ng vic lm ti Vit Nam trong bi cnh chuyn dch sang

nn kinh t c gi tr cao hn.
13b
Saskia Blume, ng Nguyn

Anh, Trn Nguyt Minh Thu
v o Th Sn
C s php l lin quan n ngi di c Vit Nam v ngha x hi tip cn dch v cng c bn
Ph lc 160
X l s liu thng k:
Nguyn Vn Tin, Trung tm Phn tch v D bo (VASS), H Ni.
Nguyn Mnh Th, Trng i hc kinh t, H Ni.
V Bch Ngc, Trng i hc kinh t, H Ni.
Hng dn v h tr cho cc nghin cu nn:

Jim Benson, Modus Cooperandi/Full Circle Associates in Washington, USA.
Nancy White, Modus Cooperandi/Full Circle Associates in Washington, USA.
Jim Chalmers, UNDP.
Trn M Hnh, UNDP.
Ph lc 2: Ch thch k thut v cch tnh cc ch s

Cch tnh cc ch s pht trin con ngi
1. CCH tnh ch s HDI

Quy tc chung tnh cc ch s thnh phn ny l s dng cc gi tr ti thiu v ti a cho tng ch s v
p dng cng thc sau:
Ch s thnh phn =
Gi tr thc t Gi tr ti thiu
Gi tr ti a Gi tr ti thiu
HDI l gi tr trung bnh chung ca 3 ch s thnh phn v sc kho, tri thc v thu nhp. Hp di m t
cch tnh HDI.
Ph lc 162
Cc gi tr bin tnh HDI

Ch tiu
Gi tr ti a
Gi tr ti thiu
Tui th (nm)
85
25
T l ngi ln bit ch (%)
100
T l nhp hc chung (%)
100
GDP bnh qun u ngi (USD PPP)
40,000
100
Trc khi ch s HDI c tnh ton, cn to ra mt

ch s cho tng kha cnh/thnh phn. to ra cc
ch s thnh phn ny, bao gm ch s tui th, ch
s gio dc v ch s GDP, cc gi tr bin (gi tr
ti thiu v ti a) c la chn cho tng ch tiu
tng ng.
2. Cch tnh ch s HPI-1

Cng thc tnh ch s HPI-1 nh sau :
HPI - 1= [1/3(P1a + P2a+ P3a)]1/a
Trong :
P1 = T l ngi khng k vng sng n tui 40
(nhn vi 100)
P2 = T l m ch ca ngi ln (%)
P3 = Trung bnh n gin ca t l % dn s khng
tip cn c nc
sch v t l % tr em suy dinh dng cn nng theo
tui
=3
3. Cch tnh ch s GDI

Vic tnh ton ch s GDI c thc hin vi 3 bc:
Bc 1: Tnh ring cc ch s thnh phn cho n v nam theo cng thc chung, nh phn tnh HDI.
Ch s thnh phn =
Gi tr thc t Gi tr ti thiu
Gi tr ti a Gi tr ti thiu
Bc 2: Xc nh cc ch s phn b cng bng thnh phn trn c s cc ch s thnh phn tnh ring cho
nam v n Bc 1 phn nh s chnh lch gia nam v n. Cc ch s phn b cng bng c tnh
theo cng thc chung sau y:
Ch s phn b cng bng =
{[t l dn s n (ch s n1-)]

+ [t l dn s nam (ch s nam1- )]}1/1-
Trong , l h s phn nh mc thit hi (v phng din pht trin con ngi) m x hi phi gnh
chu do s bt bnh ng.
i vi vic xc nh GDI, gi nh tham s = 2. Do , phng trnh chung bin i thnh:
Ch s phn b cng bng =
{[t l dn s n (ch s n-1)]

+ [t l dn s nam (ch s nam-1)]}-1
which gives the harmonic mean of the female and male indices.
Bc 3: Tnh GDI bng cch tng hp 3 ch s phn b cng bng thnh mt gi tr bnh qun phi gia quyn.
Cc gii hn bin tnh GDI

Ch tiu
Gi tr ti a
Gi tr ti thiu
Tui th trung bnh ca n (nm)
87,5
27,5
Tui th trung bnh ca nam (nm)
82,5
22,5
T l ngi ln bit ch (%)
100
T l i hc cc cp gio dc (%)
100
40.000
100
Thu nhp k vng c tnh (USD PPP)
Ghi ch: Cc gi tr ti a v ti thiu v tui th ca n cao hn nam 5 nm. bo m mi quan h gia cc gi tr ca n v nam cho tng ch
tiu, cc gi tr t l c tnh ton v s dng nhng s ni m gi tr ca n hoc nam vt qu mc ngng (trong trng hp ca t l bit
ch ngi ln th gi tr ngng thc t l 99% c s dng). Gi tr t l c c bng cch nhn gi tr ca nam v n vi gi tr ngng thc
t chia cho gi tr ti a c thng bo ca nam hoc n.
Ph lc 164
Ph lc 3: Ch thch k thut
v cch tnh ch s ngho
i a chiu (MPI) cho Vit
Nam
Ch thch k thut: Tnh ton ch s
ngho i a chiu (MPI)
Da trn cch tnh ton trong bo co pht trin con
ngi ton cu s dng phng php ca Alkire v Foster
Ch s MPI gii thiu trong Bo co pht trin con
ngi ton cu (HDR) nm 2010 l sn phm kt
hp ca t l ngho i m u a chiu (l t l
ngi l ngi ngho a chiu) v su ngho
i ca h (tc l s lng thiu ht trung bnh ca
mi ngi ngho a chiu). Khng ging nh ch s
ngho i con ngi (HPI) vn ch phn nh thiu
ht tng th trong y t, gio dc v mc sng m
khng xc nh tng c nhn, h hay nhm dn s
c th, ch s MPI o lng t l ngi chu cc thiu
ht chng cho v tng ngi trong gp phi
trung bnh bao nhiu thiu ht. V kha cnh ny,
phng php MPI i hi tt c s liu cn phi xut
pht t mt cuc iu tra, v do vic la chn cc
chiu v ch tiu cho tnh ton ch s ny l kh hn
ch Vit Nam.
Ch s MPI c coi l ph hp nht i vi cc
nc km pht trin hn, v ch s ny c th o
lng c s thiu ht ph bin cc nc ny.
Tuy nhin, y cng l ch s hiu qu o lng
s thiu ht v mc ngho i phi tin t cc
nc thu nhp trung bnh nh Vit Nam.
Nhiu quc gia, c bit l chu Phi - ni c t l
ngho m u a chiu cao, cng c xu hng
c s lng thiu thn cao. Mt s nc nh
Bngladesh, Campuchia v Cng ha dn ch nhn
dn Cng, thng c t l ngho m u cao
nhng mc ngho i thp. Ngc li, nh
cp trong bo co pht trin con ngi ton cu
2010, Vit Nam, cng vi Myanmar v Philippin, c
t l ngho i m u thp (14.3%), nhng su
ngho li cao (52,5%), v Vit Nam c xc nh l
mt trong nhng nc trong nhm pht trin con
ngi mc trung bnh, c tnh trng nghim trng
nht xt v phng din mc thiu thn. iu
ny ng rng mc tiu ca cc chnh sch x hi
ca Vit Nam hng ti cc nhm d b tn thng
cn phi tp trung hn v s tn km hn so vi thi
im trc y.
Bo co pht trin con ngi quc gia 2011 s dng

ch s MPI, nhng ni a ha cho bi cnh ca Vit
Nam, s dng b s liu iu tra mc sng h gia
nh Vit Nam (VHLSS) nm 2008 s liu ny trc
y cng c s dng tnh ton t l ngho
tr em, ngoi ra ch s MPI cng c tnh ton t
s liu iu tra ngho i th (UPS) nm 2009. Ch
s MPI trong bo co pht trin con ngi ton cu
nm 2010 c tnh ton t iu tra Y t nhn khu
nm 2002. Cuc iu tra ny khng c t chc
cp nht thi gian gn y; v do khng phi l
ngun d liu tt nht tnh ton ch s MPI Vit
Nam. m bo rng ch s MPI c th c tnh
ton v so snh theo thi gian, cc ch tiu ca ch
s MPI c iu chnh, qua c th s dng
tnh ton ch s MPI t b s liu iu tra VHLSS
thc hin hai nm mt ln. Hai ch tiu v y t trong
ch s MPI ton cu c thay th bng mt ch tiu
y t. Cc ch tiu gio dc cng c iu chnh
i cht, tng t nh cc ch tiu v ti sn.
Phng php tnh ton: Phng php s dng
tnh ton ch s MPI gm cc bc sau y da trn
phng php ca Alkire v Foster trong bo co
pht trin con ngi ton cu nm 2010:
Bc 1: La chn n v phn tch.
Bc 2: Chn chiu phn tch. La chn 3 chiu
tng t nh cch tip cn ton cu, bao gm: y t,
gio dc v mc sng.
Bc 3: Chn ch tiu phn tch: tt nht nn la
chn cc ch tiu khng c mi tng quan cao vi
nhau. Ch s MPI cho Vit Nam gm 9 ch tiu: trong
1 ch tiu cho chiu y t, 2 ch tiu cho chiu gio
dc v 6 ch tiu o lng chiu mc sng.
n gin, 9 ch tiu ny s c p dng trng s
nh nhau.
Bc 4: t ng ngho i. Mi ch tiu c xc
nh mt ng ngho (xem chi tit trong bng
di). Mi ngi c xc nh l thiu ht hay
khng thiu ht i vi tng ch tiu xem xt.
Bc 5: p dng ng ngho i a din. Trong phn
tch, ngng ngho c xc nh ngi ngho l 3
(k=3), tc l c t nht bt k 3 ch tiu no b thiu ht,
hoc ngng ngho l 2 khi c ch tiu y t v t nht
mt ch tiu gio dc khng c m bo.
Nh vy, nu im ca thnh vin h t 3 tr ln i
vi bt k ch tiu no, hoc bng 2 tr ln i vi
ch tiu y t v 1 trong 2 ch tiu gio dc, th ngi
c coi l ngi ngho a din.
Nu im ca thnh vin h t 2 tr ln v di
3, tr trng hp k=2 khi kt hp ch tiu y t v
gio dc, ngi c coi l d tn thng hay c
nguy c tr thnh ngi ngho a din.
Bc 6: Tnh ton t l ngho m u (H). Bng
cch chia s ngi ngho a din cho tng s ngi.
Bc 7: Tnh ton su ngho i (A). A l s lng
thiu ht trung bnh m mt ngi ngho a din
ang chu. A c tnh ton bng tng t l ca cc
thiu ht m mi ngi ang chu, chia cho tng s
ngi ngho a din.
Danh sch 6 vng nh sau:

ng bng sng Hng
Min ni v trung du Bc b (cn gi l vng
min ni pha Bc)
Min Trung v duyn hi Trung b
Ty Nguyn
ng Nam B
ng bng sng Cu Long
Bc 8: Tnh ton ch s ngho a din MPI (hay M0)

= H*A. Tm li, M0 l t l dn s ngho a din (H),
c iu chnh theo su ca ngho i.
Danh sch 8 vng nh sau:
B s liu: Nh cp trong bo co pht trin con

ngi ton cu nm 2010, thng thng s liu v
y t l tng i hn ch, c bit i vi s liu v
dinh dng v iu ny ng trong trng hp ca
Vit Nam. Do thiu cc ch s tng t v y t nh
trong bo co ton cu, cng nh thng tin gii hn
t b s liu VHLSS 2008, chng ti ch s dng mt
ch tiu y t, v mt chng mc nht nh, ch tiu
y t ny c s khc bit vi ch tiu y t s dng
trong iu tra UPS. Hai ch s gio dc s dng
c thch nghi cho ph hp vi iu tra UPS. Su
ch tiu cn li v c bn ging nh cc mc tiu c
lin quan trong khun kh ca Mc tiu Pht trin
Thin nin k (MDGs) v/hoc cc ch tiu s dng
trong bo co pht trin con ngi ton cu nm
2010, c thm mt s thay i phn nh ngun
s liu trong nc s dng.
ng Bc
CH THCH V CC VNG CA
Vit Nam
ng bng sng Hng
Ty Bc
Duyn hi Bc b
Duyn hi Nam B
Ty Nguyn
ng Nam B
ng bng sng Cu Long
Hp 3.1 m t 6 vng ni trn. Thng thng, cc
cuc iu tra trc y phn tch cho 8 vng trong
khi cc cuc iu tra mi gm VHLSS 2008 v 2010
thng chia tch phn tch cho 6 vng. V vy, cho
cc mc ch ca bo co ny, trong khi mt s
phn tch chia tch theo 6 vng, th mt s trng
hp cn li so snh d liu theo thi gian, phn
tch theo 8 vng s c s dng.
i vi mc tiu phn tch thng k, Vit Nam c

th c phn chia thnh 6 vng hoc 8 vng.
Ph lc 166
Bng 1: Thc o, ch tiu v ng ngho ca ch s MPI

Lin h
Ch thch
Y t
Thc o
1. Thnh vin h bn sn
phm/ti sn, vay n thanh
ton cc dch v chm sc y t
hoc phi ngng cha tr do
khng c tin thanh ton
chi ph y t.
Thnh vin h c nguy c

hoc gp tn thng do
hn ch tip cn vi cc
dch v y t
L ch tiu
mi s dng
cho ch s MPI
quc gia ca
Vit Nam.
Khng c s liu sn
c p dng ch tiu
tng t trong MDG 1
hoc 4; tuy nhin, ch
tiu ny c o lng
cho tt c cc thnh
vin h.
Gio dc
2. Thnh vin h cha hon

thnh gio dc tiu hc
Thnh vin h t 15 tui tr

ln cha hon thnh gio
dc tiu hc
MDG2
3. Tr em trong tui i hc
hin khng nhp hc
Tr em trong tui i hc
t 6 n 18 tui hin khng
nhp hc
Ch tiu ny
tng t vi
ch tiu s
dng trong
iu tra UPS
Mc sng
Ch tiu
ng ngho
4. S dng in lm ngun thp Khng c in s dng

sng chnh
lm ngun thp sng chnh
Bo co HDR
ton cu 2010
5. Tip cn nc ung sch
Tip cn ngun nc khng

an ton hoc b nhim
MDG7
6. Tip cn v sinh
Rc thi khng c thu

dn, hay b nhim nghim
trng do rc khng c
thu dn
UPS
7. Tip cn nh v sinh tiu

chun
Nh v sinh nc trc
tip/ khng c nh v sinh
MDG7
8. Sng nh c nh
Sng nh tm
MDG7
9. S hu ti sn lu bn
Khng c t nht mt trong

3 loi ti sn sau y:
1.Phng tin i li: (Xe p
v/hoc xe my/thuyn s
dng ng c/thuyn t
li, ph)
2 .Phng tin lin lc (in
thoi c nh v/hoc in
thoi di ng)
3. Thng tin (Tivi mu v/
hoc tivi en trng v/hoc
i/bng catset).
MDG7
Ngng ngho cho ch

tiu ny cao hn so vi
ch tiu trong MDG 2
(xt ti nhng ngi
trong tui i hc
hin khng nhp hc t
lp 1 n lp 8.)
Ngng t ra cao hn
so vi mc trong bo co
HDR ton cu 2010 vn
s dng s liu nm 2002
khng cn ph hp vi
Vit Nam. S liu VHLSS
2008 cho thy khng ai
gp thiu thn khi ch xt
ti mt ti sn s hu. Ni
cch khc khng c h
no ch c mt trong 3
loi ti sn lit k y.
Ba loi ti sn ny i din
cho tip cn i li, lin
lc v thng tin c s
adng xy dng ch
tiu v ti sn. Cc h c
t nht mt ti sn tng
nhm ti sn khng b coi
l thiu ht v ti sn.
168
Thi Bnh
Bnh nh
Hng Yn
Ninh Bnh
22
23
24
25
Ph lc
Ty Ninh
21
Lm ng
18
Hi Dng
Bnh Dng
Tin Giang
Kin Giang
16
17
19
C Mau
15
20
Vnh Long
Long An
12
Bn Tre
Khnh Ha
13
Vnh Phc
10
11
14
ng Nai
Cn Th
Bc Ninh
Qung Ninh
Hi Phng
Nng
H Ni
B Ra-Vng Tu
TP H Ch Minh
C nc
Tnh
Xp hng HDI
72.71
73.73
71.74
74.32
73.42
74.24
73.87
73.2
75.27
73.05
73.05
73.82
74.24
74.66
72.46
73.87
75.27
74.32
73.73
75.38
72.64
74.66
74.78
75.7
75.19
72.66
Tui th
trung bnh
(nm)
96.6
95.84
95.36
96.48
92.43
92.78
96.39
92.91
96.46
90.09
96.63
94.23
95.04
94.08
95.53
96.4
96.05
96.66
96.14
94.59
95.83
97
97.13
97.23
95.34
93.6
T l ngi ln
bit ch
(% s ngi t 15
tui tr ln)
Ch s pht trin con ngi (HDI) 2008
CC BNG S LIU
66.23
60.8
73.57
69.7
54.48
58.46
63.62
69.11
39.66
58.94
56.61
69.36
61.38
57.85
64.26
58.84
55.84
56.35
65.05
48.96
63.74
62.08
60.96
53.1
63.95
61.78
T l nhp hc
chung
1913.6
1985.6
1940.6
1575.8
2810.3
2393.6
1992
2208.8
2830.4
3139.6
2553.2
2133.2
2402.7
2677.8
2942.3
3091.2
2996.2
3194.9
2964.6
4087.4
4114.1
3710
4342.5
4834.1
7911
2840.4
GDP bnh qun

u ngi
(PPP US$)
0.795
0.812
0.779
0.822
0.807
0.821
0.815
0.803
0.838
0.801
0.801
0.814
0.821
0.828
0.791
0.815
0.838
0.822
0.812
0.84
0.794
0.828
0.83
0.845
0.836
0.794
Ch s tui th
0.865
0.842
0.881
0.876
0.798
0.813
0.855
0.85
0.775
0.797
0.833
0.859
0.838
0.82
0.851
0.839
0.826
0.832
0.858
0.794
0.851
0.854
0.851
0.825
0.849
0.83
Ch s gio dc
0.493
0.499
0.495
0.46
0.557
0.53
0.499
0.517
0.558
0.575
0.541
0.511
0.531
0.549
0.564
0.573
0.567
0.578
0.566
0.619
0.62
0.603
0.629
0.647
0.73
0.559
Ch s thu nhp
0.717
0.718
0.718
0.719
0.721
0.721
0.723
0.723
0.724
0.724
0.725
0.728
0.730
0.732
0.735
0.742
0.744
0.744
0.745
0.751
0.755
0.761
0.770
0.773
0.805
0.728
HDI
10
24
-6
-4
-8
-1
-1
-1
-1
Chnh lch gia

xp hng GDP
v HDI
68.44
71.25
69.28
72.28
71.25
68.98
71.25
72.28
65.88
71.63
72.18
71.21
72.68
70.89
70.54
70.2
71.74
71.56
70.91
74.24
71.3
72.28
73.61
72.28
72.73
73.14
70.89
73.05
71.83
73.42
Cao Bng
55
Tr Vinh
52
Gia Lai
Ha Bnh
Bc Cn
c Nng
50
51
53
Tuyn Quang
49
54
Qung Tr
Ph Th
46
Sc Trng
Bc Giang
47
Qung Ngi
44
45
48
ng Thp
Tha Thin-Hu
40
43
Ngh An
c Lc
Bnh Phc
38
39
Ph Yn
Qung Bnh
41
Hu Giang
36
37
42
Lng Sn
35
An Giang
32
Nam nh
H Nam
Thanh Ha
Thi Nguyn
30
31
33
Qung Nam
29
34
H Tnh
Bnh Thun
27
28
Bc Liu
Tnh
26
Xp hng HDI
Tui th
trung bnh
(nm)
83.81
91.32
88
86.42
93.67
89.33
94.45
83.63
92.19
95.6
96.24
89.53
89.42
94.13
90.78
91.12
94.26
93.24
96.11
91.78
93
94.78
95.75
90.61
95.47
96.34
95.6
92.87
97.43
94.96
T l ngi ln
bit ch
(% s ngi t 15
tui tr ln)
77.11
66.56
64.43
53.85
62.34
66.9
60.71
54.34
79.23
59.73
61.95
69.11
53.67
62.34
69.01
68.76
66.5
63.15
67.57
57.28
68.41
69.5
63.81
51.69
67.23
57.15
66.17
65.21
79.65
51.75
T l nhp hc
chung
1340.7
1074.6
1586.7
1571.1
1384.1
1968
1461.3
2313.5
1975
1440.2
1295.9
1663.9
2028.3
1751.3
1842.8
1899.3
1692.2
1955.4
1703.9
1795.6
1845.5
1559.5
1545.1
2814.7
1665.9
1896.2
2061.6
2021.8
1524.8
2506.3
GDP bnh qun

u ngi
(PPP US$)
0.724
0.771
0.738
0.788
0.771
0.733
0.771
0.788
0.681
0.777
0.786
0.77
0.795
0.765
0.759
0.753
0.779
0.776
0.765
0.821
0.772
0.788
0.81
0.788
0.795
0.802
0.765
0.801
0.78
0.807
Ch s tui th
0.816
0.831
0.801
0.756
0.832
0.819
0.832
0.739
0.879
0.836
0.848
0.827
0.775
0.835
0.835
0.837
0.85
0.832
0.866
0.803
0.848
0.864
0.851
0.776
0.861
0.833
0.858
0.836
0.915
0.806
Ch s gio dc
0.433
0.396
0.461
0.46
0.439
0.497
0.448
0.524
0.498
0.445
0.428
0.469
0.502
0.478
0.486
0.491
0.472
0.496
0.473
0.482
0.487
0.458
0.457
0.557
0.469
0.491
0.505
0.502
0.455
0.538
Ch s thu nhp
0.658
0.666
0.667
0.668
0.681
0.683
0.684
0.684
0.686
0.686
0.687
0.689
0.691
0.693
0.694
0.694
0.700
0.701
0.701
0.702
0.702
0.703
0.706
0.707
0.709
0.709
0.709
0.713
0.717
0.717
HDI
-8
-5
-19
-27
-17
12
-18
-2
-3
-5
-6
15
17
-18
12
-5
-2
24
-8
Chnh lch gia

xp hng GDP
v HDI
Yn Bi
in Bin
H Giang
Lai Chu
60
61
62
63
63.38
65.99
65.44
68.44
74.04
71.61
70.31
75.11
73.42
ng bng sng Hng
Bc Trung B v duyn
hi min Trung
Ty nguyn
ng Nam B
ng bng sng Cu
Long
Ph lc
Ngun: tnh ton ca VASS v TCTK cho NHDR 2011
69.94
170
68.8
65.84
66.47
70.37
Tui th trung bnh

(nm)
Sn La
59
Trung du v min ni
pha Bc
Vng
Lo Cai
Kon Tum
57
58
Ninh Thun
Tnh
56
Xp hng HDI
Tui th
trung bnh
(nm)
91.67
96.18
89.83
94.14
96.5
88.03
T l ngi ln bit
ch (% s ngi t
15 tui tr ln)
61.59
73.1
71.55
83.44
81.19
83.38
80.6
85.68
58.65
57.86
66.9
58.07
63.24
68.14
60.46
66.29
T l nhp hc
chung
56.37
53.73
67.62
68.58
62.58
62.02
T l nhp hc chung
T l ngi ln
bit ch
(% s ngi t 15
tui tr ln)
2.541.8
4.185.8
1.853.0
1.903.0
3.008.4
1.421.6
GDP bnh qun u

ngi
(PPP US$)
901.7
801
1278.9
1221.7
1393
1562.9
2006.9
1221.4
GDP bnh qun

u ngi
(PPP US$)
0.807
0.835
0.755
0.777
0.817
0.749
0.606
0.68
0.7
0.75
0.752
0.783
0.739
0.792
0.367
0.347
0.425
0.418
0.799
0.82
0.824
0.856
0.852
0.794
0.44
0.459
0.501
0.418
0.538
0.570
0.600
0.631
0.641
0.641
0.644
0.655
HDI
0.536
0.613
0.486
0.487
0.554
0.439
Ch s thu nhp
Ch s thu nhp
Ch s gio dc
Ch s gio dc
Ch s tui th
0.64
0.683
0.674
0.724
0.73
0.681
0.691
0.756
Ch s tui th
0.714
0.756
0.688
0.707
0.741
0.660
HDI
-1
-3
-1
-5
-10
-30
Chnh lch gia

xp hng GDP
v HDI
Bn Tre
Bc Liu
24
25
H Nam
20
Thi Bnh
Qung Nam
23
Long An
18
19
Nam nh
Kin Giang
Tin Giang
Hng Yn
16
17
21
Vnh Long
15
22
Vnh Phc
Bc Ninh
12
C Mau
Cn Th
13
Hi Dng
10
11
14
Khnh Ha
Qung Ninh
ng Nai
Bnh Dng
H Ni (bao gm c
H Ty)
73.79
Hi Phng
74.20
Nng
75.04
71.10
70.82
72.90
73.32
72.66
74.77
72.00
73.06
72.98
72.90
74.10
72.10
73.08
72.38
72.36
74.50
73.16
72.76
72.08
72.48
76.10
76.20
B Ra-Vng Tu
TP H Ch Minh
71.90
Tui th trung bnh

(nm)
C nc
Tnh
Xp hng HDI
94.73
93.87
96.72
93.42
96.44
95.77
93.45
94.55
89.28
95.58
95.28
95.95
96.72
96.18
93.82
96.69
94.21
96.38
95.92
95.83
97.00
96.74
96.80
96.84
95.29
93.30
T l ngi ln bit
ch (% s ngi t
15 tui tr ln)
57.44
52.11
64.35
53.94
67.89
60.99
71.38
53.93
56.77
61.10
54.26
50.76
57.94
64.83
49.04
58.60
62.91
47.48
62.61
59.87
63.06
64.04
70.39
61.77
60.70
61.18
T l nhp hc
chung
1,448.7
1,785.5
1,028.5
1,396.3
1,014.6
993.8
1,187.9
1,463.2
1,775.2
1,330.9
1,372.3
1,775.3
1,399.0
1,444.5
2,246.2
1,481.1
1,964.4
2,729.6
2,435.3
2,508.0
2,886.4
2,151.9
2,628.1
4,581.1
7,134.5
1,954.0
GDP bnh qun u

ngi
(PPP US$)
0.768
0.764
0.798
0.805
0.794
0.830
0.783
0.801
0.800
0.798
0.818
0.785
0.801
0.790
0.789
0.825
0.803
0.796
0.785
0.791
0.813
0.820
0.852
0.853
0.834
0.782
Ch s tui th
0.823
0.799
0.859
0.803
0.869
0.842
0.861
0.810
0.784
0.841
0.816
0.809
0.838
0.857
0.789
0.840
0.838
0.801
0.848
0.838
0.857
0.858
0.880
0.852
0.838
0.826
Ch s gio dc
0.446
0.481
0.389
0.440
0.387
0.383
0.413
0.448
0.480
0.432
0.437
0.480
0.440
0.446
0.519
0.450
0.497
0.552
0.533
0.538
0.519
0.512
0.546
0.638
0.712
0.496
Ch s thu nhp
0.679
0.681
0.682
0.683
0.683
0.685
0.686
0.686
0.688
0.690
0.691
0.691
0.693
0.698
0.699
0.705
0.712
0.716
0.722
0.723
0.730
0.730
0.759
0.781
0.795
0.701
HDI
172
Ninh Thun
Ha Bnh
c Nng
c Lc
50
51
52
53
Ph lc
Qung Tr
49
Qung Ngi
46
Sc Trng
Ph Yn
Bc Giang
Lng Sn
44
45
47
Tuyn Quang
43
48
Tr Vinh
Hu Giang
40
Bnh Phc
An Giang
41
ng Thp
38
39
42
Qung Bnh
37
Ph Th
34
Thi Nguyn
Lm ng
Thanh Ha
Tha Thin-Hu
32
33
35
Ninh Bnh
31
36
Ngh An
Bnh Thun
29
30
H Tnh
Ty Ninh
27
28
Bnh nh
Tnh
26
Xp hng HDI
67.52
67.02
68.76
70.40
66.01
68.86
70.72
70.95
67.83
66.96
68.36
70.80
71.05
71.02
70.90
72.62
69.31
70.63
70.81
71.98
71.80
71.25
72.38
71.70
71.15
71.30
71.10
71.10
Tui th trung bnh

(nm)
88.37
90.70
93.85
85.68
90.64
96.37
86.02
89.51
94.82
93.08
94.74
93.83
84.77
90.35
88.35
90.57
95.06
95.20
96.07
96.04
92.11
90.89
96.87
93.51
94.31
91.78
96.66
94.77
T l ngi ln bit
ch (% s ngi t
15 tui tr ln)
68.29
62.87
56.83
60.02
71.14
62.06
51.91
62.98
58.98
65.42
69.25
57.33
53.40
49.85
48.48
54.64
71.91
66.92
58.78
61.65
65.96
68.36
63.19
62.36
68.02
52.81
73.92
67.36
T l nhp hc
chung
857.4
926.5
783.3
866.4
995.7
825.9
1,321.5
902.5
1,120.3
1,171.4
902.9
960.3
1,467.5
1,293.8
1,592.4
1,098.8
994.9
976.7
1,128.7
983.5
1,076.4
1,154.2
903.6
1,193.9
1,101.2
1,646.7
934.9
1,163.4
GDP bnh qun u

ngi
(PPP US$)
0.709
0.700
0.729
0.757
0.683
0.731
0.762
0.766
0.714
0.699
0.723
0.763
0.768
0.767
0.765
0.794
0.738
0.760
0.763
0.783
0.780
0.771
0.790
0.778
0.769
0.772
0.768
0.768
Ch s tui th
0.817
0.814
0.815
0.771
0.841
0.849
0.747
0.807
0.829
0.839
0.862
0.817
0.743
0.768
0.751
0.786
0.873
0.858
0.836
0.846
0.834
0.834
0.856
0.831
0.855
0.788
0.891
0.856
Ch s gio dc
0.359
0.372
0.344
0.360
0.384
0.352
0.431
0.367
0.403
0.411
0.367
0.378
0.448
0.427
0.462
0.400
0.383
0.380
0.405
0.382
0.397
0.408
0.367
0.414
0.400
0.468
0.373
0.410
Ch s thu nhp
0.628
0.629
0.629
0.629
0.636
0.644
0.646
0.647
0.649
0.650
0.651
0.653
0.653
0.654
0.659
0.660
0.665
0.666
0.668
0.670
0.670
0.671
0.671
0.675
0.675
0.676
0.677
0.678
HDI
74.35
72.07
ng bng sng Cu Long
67.04
Tui th trung bnh

(nm)
64.86
ng Nam B
Lai Chu
63
61.30
Ty nguyn
H Giang
62
66.56
59.70
71.05
Kon Tum
Bc Trung B v duyn hi min Trung
in Bin
60
61
67.95
64.16
68.21
Gia Lai
73.40
Sn La
58
59
64.71
Trung du v min ni pha Bc
Cao Bng
57
67.85
68.71
68.35
Tui th trung bnh

(nm)
ng bng sng Hng
Vng
Yn Bi
Lo Cai
55
56
Bc Cn
Tnh
54
Xp hng HDI
91.44
95.87
87.52
93.83
96.60
87.71
T l ngi ln bit ch
(% s ngi t 15 tui
tr ln)
59.18
69.67
81.71
71.72
82.67
78.65
80.53
80.09
84.94
90.40
T l ngi ln bit
ch (% s ngi t
15 tui tr ln)
61.25
52.87
59.04
64.89
67.19
62.91
876.8
1,533.2
3,746.1
914.4
1,176.0
1,873.2
0.785
0.823
0.701
0.767
0.807
0.720
Ch s tui th
0.664
0.605
0.578
0.693
0.653
0.716
0.662
0.714
0.728
0.723
Ch s tui th
GDP bnh qun u

ngi
(PPP US$)
511.3
609.3
890.8
877.0
843.1
729.1
921.7
926.3
831.5
694.2
GDP bnh qun u

ngi
(PPP US$)
T l nhp hc chung
45.93
59.63
71.56
62.34
57.56
57.66
65.52
61.61
63.64
66.26
T l nhp hc
chung
0.786
0.836
0.800
0.850
0.854
0.789
Ch s gio dc
0.548
0.663
0.783
0.686
0.743
0.717
0.755
0.739
0.778
0.824
Ch s gio dc
0.453
0.586
0.369
0.405
0.461
0.359
Ch s thu nhp
0.272
0.302
0.365
0.362
0.356
0.332
0.371
0.372
0.354
0.323
Ch s thu nhp
0.674
0.748
0.623
0.674
0.707
0.623
HDI
0.495
0.523
0.576
0.580
0.584
0.588
0.596
0.608
0.620
0.623
HDI
174
Nam nh
Thi Nguyn
H Tnh
25
26
27
Ph lc
H Nam
Tin Giang
22
Ngh An
Vnh Long
23
Thi Bnh
20
21
24
Bnh Thun
19
Khnh Ha
16
Ninh Bnh
Long An
Bnh Phc
Lm ng
14
15
17
Hng Yn
18
Bc Ninh
12
13
Hi Dng
Qung Ninh
11
73.23
H Ni (bao gm c
H Ty)
Vnh Phc
ng Nai
Ty Ninh
70.00
Hi Phng
72.60
Nng
10
73.56
Bnh Dng
74.46
70.17
70.06
71.74
70.14
71.78
72.19
71.70
72.00
72.52
72.63
71.66
67.78
72.30
72.59
71.82
70.03
71.74
74.81
73.69
74.36
75.72
78.07
B Ra-Vng Tu
TP H Ch Minh
68.26
Tui th trung bnh

(nm)
C nc
Tnh
Xp hng HDI
94.5
94.7
94.7
92.9
94.0
90.7
90.5
94.8
88.5
87.1
94.1
91.5
91.4
89.8
93.8
93.9
94.3
88.9
93.9
92.4
95.3
92.7
95.1
94.0
92.8
94.4
92.7
90.3
T l ngi ln bit
ch (% s ngi t
15 tui tr ln)
73.70
60.18
61.80
69.72
63.52
52.05
56.72
61.35
58.15
60.42
68.62
59.87
51.89
66.06
64.33
63.58
64.32
53.16
66.06
63.04
60.80
60.80
65.05
70.66
57.20
50.71
62.82
60.34
T l nhp hc chung
575.9
761.1
631.6
682.7
644.6
892.0
881.3
662.6
888.1
919.6
653.5
1,340.2
1,025.6
835.5
875.6
1,101.7
905.6
1,198.8
1,076.1
1,724.9
2,188.3
1,732.9
1,464.8
1,867.7
2,515.1
3,271.2
4,246.7
1,316.9
GDP bnh qun u

ngi
(PPP US$)
0.75
0.75
0.78
0.75
0.78
0.79
0.78
0.78
0.79
0.79
0.78
0.71
0.79
0.79
0.78
0.75
0.78
0.83
0.80
0.75
0.79
0.81
0.81
0.82
0.85
0.88
0.82
0.721
Ch s tui th
0.88
0.83
0.84
0.85
0.84
0.78
0.79
0.84
0.78
0.78
0.86
0.81
0.78
0.82
0.84
0.84
0.84
0.77
0.85
0.83
0.84
0.82
0.85
0.86
0.81
0.80
0.83
0.803
Ch s gio dc
0.29
0.34
0.31
0.32
0.31
0.37
0.36
0.32
0.36
0.37
0.31
0.43
0.39
0.35
0.36
0.40
0.37
0.41
0.40
0.48
0.47
0.48
0.45
0.49
0.54
0.58
0.63
0.430
Ch s thu nhp
0.640
0.640
0.641
0.642
0.643
0.643
0.645
0.645
0.647
0.649
0.649
0.652
0.653
0.656
0.661
0.663
0.663
0.672
0.682
0.684
0.700
0.702
0.703
0.724
0.731
0.755
0.759
0.651
HDI
Sn La
57
Cao Bng
54
Kon Tum
Ha Bnh
Lo Cai
Yn Bi
52
53
55
Lng Sn
51
56
ng Thp
c Lc
48
Qung Ngi
Bc Cn
49
Ninh Thun
46
47
50
Qung Tr
Bn Tre
42
45
Ph Yn
Thanh Ha
Qung Bnh
40
41
Tr Vinh
Sc Trng
43
An Giang
38
39
44
Bc Giang
37
Ph Th
34
Tuyn Quang
Bc Liu
Bnh nh
Tha Thin-Hu
32
33
35
Cn Th
31
36
Qung Nam
Kin Giang
29
30
C Mau
Tnh
28
Xp hng HDI
63.40
63.33
55.80
60.99
62.23
66.74
60.22
63.43
65.56
62.31
67.22
70.11
64.16
68.15
66.74
67.02
66.35
65.63
67.92
69.66
70.34
67.36
69.86
69.10
67.71
70.26
67.51
68.04
69.05
66.96
Tui th trung bnh

(nm)
69.1
65.0
75.6
75.0
91.9
83.2
89.4
87.4
85.7
87.1
85.0
81.6
87.0
82.6
91.8
90.3
90.0
91.9
85.3
84.7
93.3
92.3
88.8
94.6
88.7
85.8
89.2
87.7
90.4
92.5
T l ngi ln bit
ch (% s ngi t
15 tui tr ln)
57.90
59.50
79.42
67.57
63.54
61.30
67.52
65.09
49.26
66.77
69.76
60.88
71.31
54.39
66.86
52.85
62.75
67.23
53.74
46.76
59.55
61.62
69.71
61.44
53.40
67.17
49.84
53.97
66.31
54.94
T l nhp hc chung
554.5
638.0
694.2
594.3
529.7
549.9
746.5
617.6
746.9
695.2
453.7
593.2
712.7
813.5
597.5
826.4
739.8
676.2
924.5
1,039.6
545.0
753.5
605.2
626.4
1,167.7
780.4
1,300.5
1,214.0
797.1
1,158.1
GDP bnh qun u

ngi
(PPP US$)
0.64
0.64
0.51
0.60
0.62
0.70
0.59
0.64
0.68
0.62
0.70
0.75
0.65
0.72
0.70
0.70
0.69
0.68
0.72
0.74
0.76
0.71
0.75
0.74
0.71
0.75
0.71
0.72
0.73
0.70
Ch s tui th
0.65
0.63
0.77
0.73
0.82
0.76
0.82
0.80
0.74
0.80
0.80
0.75
0.82
0.73
0.83
0.78
0.81
0.84
0.75
0.72
0.82
0.82
0.82
0.84
0.77
0.80
0.76
0.76
0.82
0.80
Ch s gio dc
0.29
0.31
0.32
0.30
0.28
0.28
0.34
0.30
0.34
0.32
0.25
0.30
0.33
0.35
0.30
0.35
0.33
0.32
0.37
0.39
0.28
0.34
0.30
0.31
0.41
0.34
0.43
0.42
0.35
0.41
Ch s thu nhp
0.527
0.527
0.535
0.541
0.574
0.580
0.581
0.581
0.582
0.583
0.585
0.599
0.599
0.600
0.610
0.610
0.611
0.611
0.611
0.618
0.620
0.621
0.624
0.626
0.630
0.631
0.633
0.633
0.635
0.636
HDI
c Nng
Hu Giang
62
63
72.10
68.36
63.31
76.08
68.76
ng bng sng Hng
min Trung
Ty nguyn
ng Nam B
ng bng sng Cu Long
176
Ph lc
65.79
53.4
61.0
72.6
88.17
92.83
83.39
90.83
94.53
83.05
49.16
61.01
60.10
51.91
54.95
65.98
66.28
63.00
61.52
581.2
417.2
686.9
GDP bnh qun u

ngi
(PPP US$)
1005.9
2645.5
727.6
769.5
1309.6
595.8
GDP bnh qun u

ngi
(PPP US$)
T l nhp hc chung
T l nhp hc chung
T l ngi ln bit
ch (% s ngi t
15 tui tr ln)
T l ngi ln bit ch
(% s ngi t 15 tui
tr ln)
60.38
60.02
58.06
Tui th trung bnh

(nm)
Tui th trung bnh

(nm)
in Bin
61
Trung du v min ni pha

Bc
Vng
H Giang
Lai Chu
59
60
Gia Lai
Tnh
58
Xp hng HDI
0.73
0.85
0.64
0.72
0.78
0.68
Ch s tui th
0.59
0.58
0.55
Ch s tui th
0.76
0.80
0.78
0.83
0.84
0.76
Ch s gio dc
0.52
0.61
0.68
Ch s gio dc
0.38
0.53
0.33
0.33
0.40
0.30
Ch s thu nhp
0.29
0.24
0.32
Ch s thu nhp
0.624
0.728
0.582
0.627
0.674
0.578
HDI
0.468
0.477
0.519
HDI
Hng Yn
Ninh Bnh
Bc Liu
H Tnh
24
25
26
27
Bnh nh
23
Tin Giang
20
Ty Ninh
Hi Dng
19
Thi Bnh
Lm ng
18
21
Bnh Dng
17
22
C Mau
Kin Giang
15
16
Vnh Long
Long An
12
Bn Tre
Khnh Ha
11
13
Vnh Phc
10
14
ng Nai
Cn Th
Bc Ninh
Qung Ninh
Hi Phng
Nng
H Ni
B Ra-Vng Tu
TP H Ch Minh
C nc
Tnh
Xp hng HDI 2008
Thay i HDI 1999-2008
0.717
0.717
0.717
0.718
0.718
0.719
0.721
0.721
0.723
0.723
0.724
0.724
0.725
0.728
0.730
0.732
0.735
0.742
0.744
0.744
0.745
0.751
0.755
0.761
0.770
0.773
0.805
0.728
HDI 2008
0.677
0.681
0.671
0.690
0.678
0.682
0.676
0.683
0.705
0.670
0.716
0.688
0.691
0.679
0.691
0.686
0.712
0.693
0.723
0.730
0.698
0.699
0.722
0.759
0.730
0.781
0.795
0.701
HDI 2004
0.640
0.630
0.649
0.661
0.621
0.645
0.672
0.643
0.663
0.656
0.731
0.633
0.636
0.610
0.645
0.653
0.652
0.682
0.702
0.703
0.663
0.633
0.684
0.724
0.700
0.755
0.759
0.651
HDI 1999
5.82%
8.08%
3.43%
4.48%
9.15%
5.73%
0.61%
6.12%
6.26%
2.24%
-2.01%
8.74%
8.70%
11.29%
7.12%
5.09%
9.27%
1.61%
2.93%
3.82%
5.23%
10.54%
5.58%
4.79%
4.18%
3.45%
4.68%
7.66%
5.84%
5.22%
6.83%
3.99%
5.89%
5.39%
6.70%
5.62%
2.56%
7.88%
1.08%
5.22%
4.87%
7.19%
5.72%
6.66%
3.16%
7.04%
2.97%
1.89%
6.80%
7.40%
4.58%
0.25%
5.53%
-1.03%
1.30%
3.82%
12.00%
13.72%
10.49%
8.66%
15.58%
11.43%
7.36%
12.08%
8.99%
10.29%
-0.95%
14.42%
13.99%
19.29%
13.24%
12.08%
12.73%
8.77%
5.99%
5.78%
12.39%
18.72%
10.42%
5.06%
9.94%
2.38%
6.04%
11.77%
Thay i 1999-2004 (%) Thay i 2004-2008 (%) Thay i 1999-2008 (%)
178
Ph lc
Cao Bng
Lo Cai
Kon Tum
Sn La
57
58
59
Bc Cn
54
Ninh Thun
Gia Lai
53
55
Tr Vinh
52
56
Ha Bnh
51
Sc Trng
48
Tuyn Quang
Qung Tr
47
c Nng
Ph Th
46
49
Bc Giang
45
50
ng Thp
Ph Yn
42
Qung Ngi
c Lc
41
43
Tha Thin-Hu
40
44
Ngh An
39
Hu Giang
36
Qung Bnh
Lng Sn
35
Bnh Phc
Thanh Ha
34
37
Nam nh
33
38
H Nam
An Giang
31
32
Qung Nam
Thi Nguyn
29
30
Bnh Thun
Tnh
28
Xp hng HDI 2008
0.641
0.641
0.644
0.655
0.658
0.666
0.667
0.668
0.681
0.683
0.684
0.684
0.686
0.686
0.687
0.689
0.691
0.693
0.694
0.694
0.700
0.701
0.701
0.702
0.702
0.703
0.706
0.707
0.709
0.709
0.709
0.713
HDI 2008
0.588
0.576
0.608
0.629
0.596
0.623
0.584
0.653
0.629
0.629
0.651
0.646
0.636
0.670
0.644
0.647
0.660
0.649
0.628
0.671
0.675
0.653
0.665
0.654
0.650
0.666
0.683
0.659
0.685
0.668
0.686
0.675
HDI 2004
0.527
0.535
0.527
0.599
0.541
0.585
0.519
0.600
0.574
0.624
0.611
0.599
0.626
0.620
0.581
0.582
0.611
0.583
0.631
0.642
0.649
0.611
0.581
0.610
0.641
0.618
0.643
0.640
0.635
0.647
HDI 1999
11.66%
7.56%
15.52%
5.12%
10.20%
6.50%
12.52%
8.76%
9.55%
4.27%
5.74%
6.15%
7.11%
3.96%
11.22%
13.31%
6.19%
7.74%
6.32%
5.21%
0.57%
8.86%
11.75%
9.28%
6.58%
6.59%
6.50%
4.31%
8.02%
4.30%
9.01%
11.37%
5.86%
4.07%
10.41%
6.87%
14.24%
2.30%
8.21%
8.64%
5.10%
5.81%
7.84%
2.37%
6.64%
6.56%
4.72%
6.84%
10.51%
3.43%
3.70%
7.43%
5.40%
7.30%
8.08%
5.53%
3.30%
7.25%
3.53%
6.12%
3.39%
5.71%
21.72%
19.80%
22.29%
9.40%
21.67%
13.82%
28.55%
11.26%
18.55%
9.59%
11.87%
14.47%
9.65%
10.86%
18.52%
18.66%
13.45%
19.06%
9.96%
9.11%
8.04%
14.73%
20.78%
15.32%
10.10%
14.32%
10.26%
10.70%
11.69%
10.25%
0.748
0.688
0.756
0.714
Ty nguyn
ng Nam B
ng bng sng Cu Long
0.623
0.707
0.674
0.674
0.707
0.741
0.623
HDI 2004
0.495
ng bng sng Hng
HDI 2008
0.538
0.523
0.580
0.620
HDI 2004
0.660
Lai Chu
63
0.570
0.600
0.631
HDI 2008
Vng
in Bin
H Giang
61
62
Yn Bi
Tnh
60
Xp hng HDI 2008
0.624
0.728
0.582
0.627
0.674
0.578
HDI 1999
0.468
0.477
0.580
HDI 1999
8.74%
8.93%
3.39%
1.75%
15.04%
19.40%
8.84%
8.04%
2.72%
7.10%
7.43%
4.92%
7.72%
5.86%
1.03%
10.44%
4.88%
4.79%
5.97%
14.37%
3.78%
18.28%
12.68%
9.95%
14.15%
5.80%
9.61%
6.96%
0.728
Ch s thu nhp
HDI
0.662
Ch s thu nhp
HDI
0.746
Ch s thu nhp
HDI
0.708
Ch s thu nhp
HDI
HDI
Ph lc
0.689
Ch s thu nhp
180
0.824
0.487
Ch s gio dc
0.755
Ch s tui th
Ty nguyn
0.856
0.492
Ch s gio dc
0.777
Ch s tui th
Bc Trung B v Duyn hi min Trung
0.852
0.568
Ch s gio dc
0.817
Ch s tui th
ng bng sng Hng
0.794
0.443
Ch s gio dc
0.749
Ch s tui th
0.830
0.559
Ch s gio dc
0.794
Ch s tui th
C nc
2008
0.623
0.369
0.800
0.701
0.676
0.411
0.850
0.767
0.717
0.489
0.854
0.807
0.624
0.362
0.789
0.720
0.701
0.496
0.826
0.782
2004
0.582
0.331
0.776
0.639
0.630
0.341
0.826
0.723
0.685
0.429
0.840
0.785
0.579
0.298
0.759
0.680
0.651
0.430
0.803
0.721
1999
7.1%
11.5%
3.1%
9.7%
7.3%
20.8%
2.8%
6.2%
4.6%
13.9%
1.6%
2.8%
7.8%
21.7%
4.0%
5.9%
7.7%
15.3%
2.9%
8.4%
Thay i
1999-2004
(%)
10.5%
31.9%
3.1%
7.8%
4.7%
19.5%
0.8%
1.2%
4.1%
16.2%
-0.2%
1.3%
6.1%
22.3%
0.6%
4.0%
3.8%
12.6%
0.5%
1.6%
Thay i
2004-2008
(%)
18.4%
47.1%
6.2%
18.3%
12.4%
44.4%
3.6%
7.5%
8.9%
32.3%
1.4%
4.1%
14.3%
48.7%
4.6%
10.2%
11.7%
29.8%
3.4%
10.2%
Thay i
1999-2008
(%)
Thay i HDI v ng gp ca tng ch tiu vo HDI 1999-2008
7.1%
2.2%
1.4%
3.6%
7.3%
3.7%
1.2%
2.4%
4.6%
2.9%
0.7%
1.1%
7.8%
3.7%
1.7%
2.3%
7.7%
3.4%
1.2%
3.1%
ng gp
vo thay i
(im %)
1999-2004
10.5%
6.3%
1.3%
2.9%
4.7%
4.0%
0.3%
0.5%
4.1%
3.7%
-0.1%
0.5%
6.1%
4.3%
0.3%
1.5%
3.8%
3.0%
0.2%
0.6%
ng gp
vo thay i
(im %)
2004-2008
18.4%
8.9%
2.8%
6.7%
12.4%
8.0%
1.6%
2.9%
8.9%
6.8%
0.6%
1.6%
14.3%
8.4%
2.0%
4.0%
11.7%
6.6%
1.4%
3.8%
100.0%
30.7%
19.3%
50.0%
100.0%
51.0%
16.6%
32.3%
100.0%
62.9%
14.2%
22.9%
100.0%
47.8%
22.3%
29.9%
100.0%
44.0%
15.3%
40.7%
100.0%
59.9%
12.4%
27.7%
100.0%
83.4%
6.9%
9.7%
100.0%
90.0%
-2.0%
12.1%
100.0%
70.6%
4.1%
25.2%
100.0%
79.7%
5.1%
15.2%
100.0%
48.6%
15.1%
36.3%
100.0%
64.3%
12.7%
23.1%
100.0%
75.9%
6.4%
17.7%
100.0%
58.3%
14.0%
27.8%
100.0%
56.3%
11.8%
31.9%
ng gp vo
thay i
ng gp (%) ng gp (%) ng gp (%)
(im %)
1999-2004
2004-2008
1999-2008
1999-2008
0.760
Ch s thu nhp
HDI
0.715
Ch s thu nhp
HDI
0.675
0.456
0.786
0.785
0.754
0.605
0.836
0.823
2004
Ngun: Da trn tnh ton ca VASS v GSO cho NHDR 2011
0.799
0.540
Ch s gio dc
0.807
Ch s tui th
ng bng sng Cu Long
0.820
0.623
Ch s gio dc
0.835
Ch s tui th
ng Nam B
2008
0.625
0.385
0.761
0.729
0.733
0.547
0.802
0.851
1999
8.0%
18.3%
3.3%
7.6%
2.9%
10.6%
4.2%
-3.4%
Thay i
1999-2004
(%)
5.9%
18.5%
1.7%
2.9%
0.7%
3.1%
-1.9%
1.5%
Thay i
2004-2008
(%)
14.4%
40.2%
5.0%
10.7%
3.6%
14.0%
2.3%
-1.9%
Thay i
1999-2008
(%)
8.0%
3.8%
1.3%
2.9%
2.9%
2.6%
1.5%
-1.3%
ng gp
vo thay i
(im %)
1999-2004
5.9%
4.2%
0.7%
1.1%
0.7%
0.8%
-0.7%
0.6%
ng gp
vo thay i
(im %)
2004-2008
14.4%
8.2%
2.0%
4.1%
3.6%
3.5%
0.8%
-0.7%
100.0%
46.7%
16.6%
36.7%
100.0%
91.8%
53.6%
-45.4%
100.0%
70.3%
11.0%
18.7%
100.0%
119.6%
-100.9%
81.3%
100.0%
57.2%
14.1%
28.7%
100.0%
97.3%
23.2%
-20.5%
ng gp vo
thay i
(im %)
1999-2004
2004-2008
1999-2008
1999-2008
10 Vnh Phc
11 Khnh Ha 69.82
12 Long An
13 Vnh Long
14 Bn Tre
20 C Mau
18 Kin Giang 70.46
10
11
12
13
14
15
16
16 Lm ng
15 Hi Dng
22 Tin Giang
19 Ty Ninh
21 Thi Bnh
23 Bnh nh
Ph lc
17
17
18
19
20
21
22
23
182
Bnh
Dng
ng Nai
Hi Phng
Bc Ninh
69.08
71.86
70.84
71.76
71.34
70.61
72.88
70.46
71.28
71.76
72.25
71.34
72.88
71.86
71.18
72.99
70.03
Cn Th
72.25
Qung
Ninh
72.38
Nng
H Ni
73.31
TP H Ch
Minh
B RaVng Tu
72.79
C nc
70.04
Tnh
Tui th
(nam)
Xp
hng
GDI
Xp
hng
HDI
74.56
76.94
76.16
76.87
76.56
75.94
77.81
75.80
75.80
76.51
76.87
77.23
75.25
76.56
77.81
76.94
76.44
77.92
75.40
77.23
77.32
78.24
77.73
75.44
98.01
98.40
94.34
95.48
98.64
95.60
97.66
93.07
97.92
96.90
96.71
96.55
97.15
98.73
97.74
98.68
98.63
96.14
98.06
98.75
98.77
98.23
97.19
96.09
93.02
94.84
90.70
90.39
94.39
90.37
95.39
87.34
95.39
91.89
93.49
91.88
94.05
94.30
94.50
94.80
93.95
93.12
93.65
95.38
95.62
96.28
93.60
91.28
72.32
71.60
53.31
56.26
64.51
68.00
40.01
58.46
58.49
74.91
67.69
55.70
60.83
62.67
70.27
39.32
59.46
54.58
63.30
73.43
59.61
60.67
67.87
57.67
56.42
55.90
63.84
49.79
64.09
63.04
60.35
53.92
67.30
61.83
65.63
55.14
60.92
59.97
55.27
56.79
66.30
48.18
63.41
61.16
61.52
52.32
60.82
61.73
2,178.0
1,646.2
3,195.4
2,977.9
2,064.0
2,495.0
3,364.6
3,876.7
3,390.8
2,497.2
2,813.1
2,963.8
3,470.2
3,284.6
3,274.0
3,643.5
3,310.1
4,846.7
4,644.1
4,488.0
4,700.4
6,003.4
9,961.1
3,111.0
1,714.1
1,510.3
2,432.8
1,835.8
1,923.1
1,921.2
2,335.2
2,406.1
1,717.2
1,785.3
2,009.2
2,395.5
2,422.2
2,901.5
2,721.9
2,755.0
2,633.8
3,345.5
3,564.4
2,957.7
3,999.1
3,742.0
5,853.4
2,577.4
48.8
48.2
49.5
48.8
48.9
50.1
48.1
49.9
50.0
48.9
48.9
49.7
49.6
49.5
49.7
49.5
48.9
49.4
50.9
49.2
49.0
48.3
50.1
49.3
51.2
51.8
50.5
51.2
51.1
49.9
51.9
50.1
50.0
51.1
51.1
50.3
50.4
50.5
50.3
50.5
51.1
50.6
49.1
50.8
51.0
51.7
49.9
50.71
0.78
0.82
0.81
0.82
0.81
0.80
0.84
0.80
0.80
0.81
0.82
0.83
0.79
0.81
0.84
0.82
0.81
0.84
0.79
0.83
0.83
0.85
0.84
0.79
0.78
0.82
0.81
0.82
0.82
0.81
0.84
0.80
0.80
0.82
0.82
0.83
0.80
0.82
0.84
0.82
0.82
0.84
0.80
0.83
0.83
0.85
0.84
0.80
0.78
0.82
0.81
0.82
0.82
0.80
0.84
0.80
0.80
0.81
0.82
0.83
0.79
0.82
0.84
0.82
0.81
0.84
0.80
0.83
0.83
0.85
0.84
0.80
0.89
0.89
0.81
0.82
0.87
0.86
0.78
0.82
0.85
0.86
0.84
0.83
0.85
0.86
0.84
0.85
0.88
0.80
0.87
0.86
0.86
0.83
0.85
0.85
0.87
0.86
0.79
0.81
0.84
0.84
0.77
0.78
0.82
0.86
0.83
0.81
0.85
0.82
0.82
0.82
0.84
0.79
0.84
0.85
0.84
0.82
0.85
0.81
0.88
0.88
0.80
0.81
0.85
0.85
0.78
0.80
0.83
0.86
0.84
0.82
0.85
0.84
0.83
0.83
0.86
0.79
0.85
0.85
0.85
0.83
0.85
0.83
0.51
0.47
0.58
0.57
0.51
0.54
0.59
0.61
0.59
0.54
0.56
0.57
0.59
0.58
0.58
0.60
0.58
0.65
0.64
0.63
0.64
0.68
0.77
0.57
0.47
0.45
0.53
0.49
0.49
0.49
0.53
0.53
0.47
0.48
0.50
0.53
0.53
0.56
0.55
0.55
0.55
0.59
0.60
0.57
0.62
0.60
0.68
0.54
0.49
0.46
0.55
0.52
0.50
0.51
0.55
0.57
0.53
0.51
0.53
0.55
0.56
0.57
0.57
0.58
0.56
0.61
0.62
0.60
0.63
0.64
0.72
0.56
GDP
GDP
T l bit T l bit T l nhp T l nhp
Ch s thu
Ch s gio Ch s
Ch s tui
T l
Ch s thu
Ch s gio Ch s gio
Ch s tui Ch s tui
Tui th ch ca ch ca hc chung hc chung trn u trn u T l dn s
nhp cn
dc cn thu nhp
th cn
dn s
nhp (n)
dc (nam) dc (n)
th (nam) th (n)
ngi(nam) ngi(n) (nam)
(n)
(n) ngi ln ngi ln (nam)
bng gii
bng gii (nam)
bng gii
(n)
(PPP US$) (PPP US$)
(%)
(%)
(n)
(nam)
Ch s pht trin gii (GDI) 2008
0.718
0.719
0.720
0.719
0.723
0.723
0.723
0.722
0.720
0.728
0.729
0.732
0.735
0.742
0.744
0.744
0.745
0.750
0.755
0.760
0.770
0.771
0.803
0.728
GDI
24
27
26
28
29
30
31
33
32
34
35
39
36
37
38
41
40
42
43
44
45
46
47
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
71.04
69.64
Qung Tr
Ph Th
Bc Giang
62.93
68.96
69.55
69.00
74.47
74.96
74.10
68.48
Qung
Ngi
73.81
73.48
75.44
68.13
73.21
74.56
74.40
73.83
76.87
74.18
75.08
76.33
75.08
75.49
ng Thp 70.07
Ph Yn
67.77
67.37
c Lc
69.08
68.87
Bnh
Phc
Tha
Thin-Hu
68.16
Ngh An
71.76
Qung
Bnh
68.58
Hu Giang
Lng Sn
Thanh Ha 69.64
Nam nh
An Giang
70.12
70.55
Thi
Nguyn
H Nam
73.81
68.13
75.88
75.80
74.64
76.16
75.47
76.44
Qung
Nam
69.18
70.84
70.10
71.18
96.35
97.79
98.36
93.99
92.19
96.53
93.10
95.12
96.34
95.21
97.64
94.49
96.03
97.34
97.96
92.88
98.51
98.09
98.24
94.50
98.89
96.32
98.57
98.54
88.44
93.66
94.32
85.45
86.83
91.91
88.54
87.39
92.41
91.36
94.71
89.23
90.17
92.47
93.72
88.49
92.83
94.72
93.20
91.35
96.15
93.71
94.88
93.45
78.66
62.48
64.52
67.35
53.93
60.46
67.87
65.66
64.13
63.42
67.40
57.30
68.31
66.90
63.91
51.19
64.13
58.92
63.52
65.57
78.33
52.30
71.19
60.43
79.83
56.95
59.36
71.02
53.41
64.35
70.18
72.07
69.18
62.87
67.76
57.27
68.52
72.34
63.70
52.23
70.57
55.34
69.14
64.85
81.09
51.18
61.67
61.17
1,851.2
1,430.2
1,284.5
1,885.1
2,304.4
1,923.6
1,750.2
2,176.7
1,655.9
2,018.5
1,696.7
2,201.7
1,680.3
1,511.4
1,705.1
3,503.9
1,857.4
1,844.4
2,196.1
2,357.0
1,429.4
3,174.7
1,890.8
2,061.4
2,096.8
1,449.9
1,307.1
1,449.8
1,753.4
1,580.0
1,937.2
1,630.6
1,727.7
1,890.2
1,711.1
1,390.9
2,009.3
1,606.7
1,394.0
2,140.3
1,484.8
1,947.7
1,934.4
1,683.8
1,612.9
1,871.0
1,936.0
1,914.7
49.6
49.3
49.7
49.2
49.9
49.9
50.5
49.2
49.4
50.8
50.0
49.9
49.8
49.5
48.6
49.5
48.6
49.8
48.6
50.2
48.0
48.7
49.5
48.3
50.4
50.7
50.3
50.8
50.1
50.1
49.5
50.8
50.6
49.2
50.0
50.1
50.2
50.5
51.4
50.5
51.4
50.2
51.4
49.8
52.0
51.3
50.5
51.7
0.67
0.77
0.78
0.77
0.79
0.76
0.75
0.75
0.78
0.77
0.76
0.82
0.77
0.79
0.81
0.79
0.79
0.80
0.76
0.80
0.78
0.81
0.79
0.81
0.69
0.78
0.79
0.78
0.80
0.77
0.77
0.76
0.78
0.78
0.77
0.82
0.78
0.79
0.81
0.79
0.80
0.81
0.77
0.80
0.79
0.81
0.80
0.82
0.68
0.78
0.79
0.77
0.80
0.77
0.76
0.75
0.78
0.78
0.77
0.82
0.77
0.79
0.81
0.79
0.80
0.80
0.77
0.80
0.78
0.81
0.80
0.81
0.90
0.86
0.87
0.85
0.79
0.85
0.85
0.85
0.86
0.85
0.88
0.82
0.87
0.87
0.87
0.79
0.87
0.85
0.87
0.85
0.92
0.82
0.89
0.86
0.86
0.81
0.83
0.81
0.76
0.83
0.82
0.82
0.85
0.82
0.86
0.79
0.83
0.86
0.84
0.76
0.85
0.82
0.85
0.83
0.91
0.80
0.84
0.83
0.88
0.84
0.85
0.83
0.78
0.84
0.84
0.84
0.85
0.83
0.87
0.80
0.85
0.86
0.85
0.78
0.86
0.83
0.86
0.84
0.92
0.81
0.87
0.84
0.49
0.44
0.43
0.49
0.52
0.49
0.48
0.51
0.47
0.50
0.47
0.52
0.47
0.45
0.47
0.59
0.49
0.49
0.52
0.53
0.44
0.58
0.49
0.51
0.51
0.45
0.43
0.45
0.48
0.46
0.49
0.47
0.48
0.49
0.47
0.44
0.50
0.46
0.44
0.51
0.45
0.50
0.49
0.47
0.46
0.49
0.49
0.49
0.50
0.45
0.43
0.47
0.50
0.48
0.49
0.49
0.47
0.50
0.47
0.47
0.49
0.46
0.46
0.55
0.47
0.49
0.50
0.50
0.45
0.53
0.49
0.50
GDP
GDP
Ch s thu
Ch s gio Ch s
Ch s tui
T l
Ch s thu
Ch s gio Ch s gio
Ch s tui Ch s tui
nhp cn
dc cn thu nhp
th cn
dn s
nhp (n)
dc (nam) dc (n)
th (nam) th (n)
(n)
bng gii
bng gii (nam)
bng gii
(n)
(PPP US$) (PPP US$)
(%)
(%)
(n)
(nam)
Bnh Thun 70.46
H Tnh
Bc Liu
Ninh Bnh
Hng Yn
Tnh
Tui th
(nam)
25
Xp
hng
GDI
24
Xp
hng
HDI
0.686
0.687
0.688
0.689
0.690
0.693
0.694
0.694
0.701
0.702
0.702
0.700
0.702
0.704
0.706
0.705
0.709
0.709
0.710
0.712
0.717
0.714
0.718
0.718
GDI
68.53
65.53
67.59
Tuyn
Quang
49 c Nng
50 Ha Bnh
54 Tr Vinh
52 Gia Lai
53 Bc Cn
55 Cao Bng
Ninh
56
Thun
57 Lo Cai
58 Kon Tum
59 Sn La
60 Yn Bi
61 in Bin
62 H Giang
63 Lai Chu
Ph lc
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
184
60.38
63.06
62.48
65.53
65.90
62.89
63.55
68.53
66.43
69.64
68.53
66.10
69.64
51 Sc Trng
48
Tnh
Tui th
(nam)
Xp
hng
GDI
Xp
hng
HDI
66.57
69.11
68.58
71.53
71.87
68.96
69.56
73.32
71.53
74.14
72.31
75.08
74.14
72.04
74.14
75.08
75.50
84.05
83.41
88.40
90.45
89.17
86.73
89.97
88.44
94.31
91.24
91.39
96.21
91.45
96.66
87.22
48.05
65.59
78.48
61.23
60.47
59.74
71.27
67.40
61.47
66.58
77.96
64.85
62.04
55.04
60.85
65.97
56.64
55.85
62.71
78.74
72.33
77.90
74.58
81.73
79.55
88.45
84.93
82.08
91.35
87.26
92.35
80.31
51.42
54.39
55.33
56.31
55.01
68.90
59.35
66.00
76.23
68.41
67.00
52.63
63.89
67.84
65.19
52.71
965.4
681.2
1,071.3
1,158.1
1,243.2
1,525.9
2,020.0
1,437.1
1,284.7
965.5
1,741.6
1,977.3
1,313.8
2,141.0
1,306.9
2,946.1
836.2
918.4
1,488.0
1,285.0
1,540.7
1,599.7
1,993.7
1,008.7
1,394.7
1,185.0
1,432.2
1,173.6
1,451.1
1,795.0
1,612.1
1,702.6
50.7
49.5
50.2
49.9
49.6
49.8
50.2
49.7
49.1
50.3
49.9
49.5
48.8
50.0
49.4
49.1
49.3
50.5
49.8
50.1
50.4
50.2
49.8
50.3
50.9
49.7
50.1
50.5
51.2
50.0
50.6
50.9
0.63
0.68
0.67
0.72
0.72
0.67
0.68
0.75
0.72
0.77
0.73
0.79
0.77
0.73
0.77
0.79
0.65
0.69
0.68
0.73
0.74
0.69
0.70
0.76
0.73
0.78
0.75
0.79
0.78
0.74
0.78
0.79
0.64
0.68
0.68
0.73
0.73
0.68
0.69
0.76
0.73
0.77
0.74
0.79
0.77
0.73
0.77
0.79
0.72
0.76
0.82
0.79
0.84
0.82
0.78
0.82
0.85
0.84
0.82
0.79
0.84
0.83
0.83
0.77
0.49
0.60
0.59
0.71
0.67
0.75
0.70
0.76
0.78
0.82
0.79
0.72
0.82
0.81
0.83
0.71
0.59
0.67
0.68
0.75
0.74
0.78
0.74
0.79
0.82
0.83
0.80
0.76
0.83
0.82
0.83
0.74
0.38
0.32
0.40
0.41
0.42
0.45
0.50
0.44
0.43
0.38
0.48
0.50
0.43
0.51
0.43
0.56
0.35
0.37
0.45
0.43
0.46
0.46
0.50
0.39
0.44
0.41
0.44
0.41
0.45
0.48
0.46
0.47
0.37
0.34
0.42
0.42
0.44
0.46
0.50
0.41
0.43
0.39
0.46
0.45
0.44
0.50
0.45
0.51
GDP
GDP
Ch s thu
Ch s gio Ch s
Ch s tui
T l
Ch s thu
Ch s gio Ch s gio
Ch s tui Ch s tui
nhp cn
dc cn thu nhp
th cn
dn s
nhp (n)
dc (nam) dc (n)
th (nam) th (n)
(n)
bng gii
bng gii (nam)
bng gii
(n)
(PPP US$) (PPP US$)
(%)
(%)
(n)
(nam)
0.531
0.566
0.594
0.630
0.637
0.641
0.643
0.654
0.658
0.666
0.667
0.665
0.681
0.683
0.684
0.680
GDI
71.55
68.93
67.54
72.68
70.87
ng bng sng
Hng
Bc Trung B v
duyn hi min
Trung
Ty nguyn
ng Nam B
ng bng sng
Cu Long
76.13
77.68
73.25
74.46
76.68
72.88
Tui th (n)
67.17
Tui th (nam)
Trung du v
min ni pha
Bc
Vng
94.22
97.52
92.74
96.67
98.56
92.85
T l bit ch ca
ngi ln (nam)
89.34
94.94
87.06
91.84
94.64
83.47
T l bit ch ca
ngi ln (n)
55.76
52.97
66.23
66.73
63.25
64.41
T l nhp hc
chung (nam)
(%)
57.04
54.53
69.08
70.60
61.91
59.61
T l nhp hc
chung (n)
(%)
3,092.10
5,064.70
1,940.00
2,040.60
3,265.40
1,349.10
GDP trn u
ngi (nam)
(PPP US$)
2,004.10
3,350.60
1,766.40
1,768.50
2,759.10
1,493.00
GDP trn u
ngi (n)
(PPP US$)
0.712
0.755
0.689
0.707
0.741
0.660
GDI
16
18
19
19
20
21
186
20
17
17
14
16
18
22
15
14
15
11
13
12
13
12
11
Khnh Ha
10
10
Bnh Dng
Ph lc
Nam nh
H Nam
Qung Nam
Long An
Kin Giang
Hng Yn
Vnh Long
C Mau
Vnh Phc
Bc Ninh
Cn Th
Hi Dng
Qung Ninh
ng Nai
70.02
72.04
69.38
70.49
70.41
70.14
71.49
69.70
70.28
69.63
69.40
71.74
70.45
70.34
69.07
69.91
71.08
H Ni (bao
gm c H
Ty)
71.61
Hi Phng
73.52
73.58
TP H Ch
Minh
Nng
72.48
B Ra-Vng
Tu
69.10
Tui th
(nam)
C nc
Xp
hng Tnh
GDI
Xp
hng
HDI
75.47
77.66
74.78
75.79
75.70
75.84
76.86
74.64
76.06
75.30
75.50
77.42
76.04
75.32
75.27
75.21
76.67
76.95
78.84
78.98
77.76
74.90
96.44
97.69
96.11
96.13
89.97
96.42
96.27
95.87
96.29
96.79
94.79
97.52
95.36
96.63
99.35
96.97
98.69
97.39
99.75
96.30
95.46
94.84
96.45
93.96
90.95
93.02
88.61
94.80
94.35
96.04
97.13
95.60
92.89
95.91
93.07
96.15
92.41
94.71
95.41
96.11
94.04
97.35
95.13
91.81
T l bit ch T l bit ch
Tui th (n) ca ngi ln ca ngi ln
(nam)
(n)
63.93
61.29
69.63
54.76
59.90
60.86
55.54
52.84
61.08
66.43
47.98
59.12
64.02
48.77
62.10
60.42
61.01
64.80
71.71
64.14
60.35
62.12
T l nhp
hc chung
(nam)
(%)
72.07
60.67
73.25
53.08
53.52
61.36
52.95
48.63
54.97
63.19
50.20
58.04
61.77
46.18
63.16
59.31
65.66
63.23
69.05
59.40
61.07
60.20
T l nhp
hc chung
(n)
(%)
1,026.8
1,113.6
1,235.1
1,657.4
2,332.5
1,276.7
1,651.0
2,560.0
1,454.0
1,639.2
2,952.7
1,564.7
2,416.7
3,128.3
2,779.9
2,896.6
3,145.7
2,458.3
3,133.2
5,785.4
9,587.8
2,171.1
51.56
51.21
881.2
51.58
50.83
50.69
51.65
51.39
50.68
50.48
51.31
50.82
51.62
50.35
52.12
49.35
50.40
50.77
50.57
51.63
51.83
49.87
50.83
0.80
0.83
0.78
0.80
0.80
0.80
0.82
0.79
0.80
0.79
0.79
0.83
0.80
0.80
0.79
0.79
0.81
0.82
0.85
0.85
0.84
0.78
Ch s tui
T l dn s
th cn bng
(n)
gii
1,003.0
1,143.6
1,275.3
1,233.1
1,381.6
1,108.6
1,011.7
1,345.1
1,259.7
1,562.6
1,402.7
1,518.4
2,363.3
2,081.6
2,125.5
2,629.6
1,852.5
2,154.9
3,461.7
4,668.9
1,744.0
GDP
GDP
trn u
trn u
ngi(nam) ngi(n)
(PPP US$) (PPP US$)
0.87
0.84
0.86
0.81
0.78
0.84
0.82
0.81
0.84
0.86
0.79
0.84
0.84
0.80
0.85
0.84
0.86
0.86
0.88
0.85
0.84
0.83
Ch s gio
dc cn
bng gii
0.39
0.38
0.41
0.45
0.47
0.43
0.43
0.45
0.44
0.44
0.51
0.45
0.49
0.55
0.53
0.53
0.52
0.51
0.54
0.63
0.70
0.49
Ch s thu
nhp cn
bng gii
0.684
0.685
0.686
0.686
0.684
0.691
0.689
0.682
0.694
0.697
0.695
0.705
0.710
0.716
0.721
0.722
0.730
0.730
0.758
0.779
0.790
0.701
GDI
49
49
Thi Bnh
70.31
Qung Tr
Bc Giang
Sc Trng
Qung Ngi
Ph Yn
Lng Sn
Tuyn Quang
Bnh Phc
Tr Vinh
Hu Giang
An Giang
ng Thp
Qung Bnh
Thanh Ha
Thi Nguyn
Ph Th
63.11
66.10
68.12
68.17
65.29
63.91
65.63
68.22
68.37
68.20
68.21
69.77
66.57
67.92
67.93
68.88
68.79
68.50
Tha
Thin-Hu
Lm ng
69.63
68.93
68.40
68.88
68.62
68.39
68.32
68.36
Ninh Bnh
Bnh Thun
Ngh An
Ty Ninh
H Tnh
Bnh nh
Bn Tre
Bc Liu
70.72
Tui th
(nam)
47
48
45
45
46
44
44
48
43
43
46
40
42
47
42
41
40
38
39
41
37
39
37
36
36
38
32
34
33
35
33
32
34
31
31
35
28
30
29
29
28
30
25
24
26
26
25
27
21
27
23
24
23
22
Tin Giang
Xp
hng Tnh
GDI
Xp
hng
HDI
69.07
71.77
73.49
73.91
70.52
70.19
71.26
73.55
73.90
74.00
73.75
75.65
72.21
73.49
73.86
75.26
75.00
74.17
75.30
74.64
74.07
73.86
73.73
73.98
74.06
73.43
75.64
76.08
94.22
97.86
87.27
91.07
96.89
95.21
98.56
98.87
86.36
91.23
89.05
92.56
96.60
96.11
97.22
96.61
95.39
95.66
98.74
95.10
95.21
92.10
96.07
95.53
96.20
94.81
96.18
94.80
87.14
94.91
84.85
88.01
92.79
90.98
91.00
88.61
83.20
89.49
87.66
88.66
93.56
94.33
94.93
95.48
88.83
86.29
95.09
91.93
93.44
91.47
97.25
94.04
93.33
92.98
97.23
92.12
(nam)
(n)
72.63
67.11
54.03
64.14
60.56
65.79
71.27
57.51
55.11
53.58
49.17
55.89
73.63
64.47
57.68
63.78
67.62
71.14
64.60
61.61
71.99
54.03
72.00
69.61
56.86
60.21
61.08
54.61
T l nhp
hc chung
(nam)
(%)
69.55
56.77
49.68
61.75
57.31
65.04
67.10
57.14
51.57
45.99
47.75
53.35
70.09
69.54
59.95
59.43
64.29
65.56
61.77
63.15
63.85
51.52
76.07
65.03
58.07
43.82
67.79
53.25
T l nhp
hc chung
(n)
(%)
1,041.0
723.6
1,732.4
966.9
1,250.7
1,104.8
809.5
1,039.0
1,780.7
1,662.1
2,089.6
1,474.9
1,033.1
920.1
1,118.6
990.4
1,240.1
1,274.6
895.7
1,475.5
1,068.9
1,932.5
946.4
1,322.9
1,775.1
2,382.3
1,096.3
1,700.7
951.4
926.0
930.9
840.9
991.8
1,237.3
994.4
878.8
1,157.0
937.1
1,111.8
740.3
957.6
1,031.1
1,138.8
976.8
912.6
1,037.9
911.2
913.7
1,132.4
1,369.8
923.5
1,011.9
1,140.4
1,220.7
965.8
1,109.1
GDP
GDP
trn u
trn u
ngi(nam) ngi(n)
(PPP US$) (PPP US$)
0.72
50.56
50.56
51.26
51.12
50.37
0.68
0.73
0.76
0.77
0.72
0.70
50.49
50.28
0.76
0.77
0.77
0.77
0.80
0.74
0.76
0.76
0.78
0.78
0.77
0.79
0.78
0.77
0.77
0.77
0.77
0.77
0.76
0.80
0.81
49.11
50.22
50.80
50.84
51.20
50.55
51.01
50.02
50.84
49.98
50.88
51.13
50.12
50.85
50.79
50.34
51.29
51.42
51.38
51.95
51.45
Ch s tui
T l dn s
th cn bng
(n)
gii
0.84
0.85
0.75
0.81
0.83
0.84
0.86
0.82
0.74
0.77
0.75
0.79
0.87
0.86
0.84
0.85
0.83
0.83
0.86
0.83
0.85
0.79
0.89
0.86
0.82
0.80
0.86
0.80
Ch s gio
dc cn
bng gii
0.38
0.35
0.42
0.37
0.40
0.41
0.37
0.38
0.44
0.42
0.45
0.38
0.38
0.38
0.40
0.38
0.39
0.41
0.37
0.41
0.40
0.46
0.37
0.41
0.44
0.47
0.39
0.43
Ch s thu
nhp cn
bng gii
0.636
0.643
0.642
0.647
0.648
0.650
0.650
0.652
0.651
0.650
0.655
0.654
0.665
0.667
0.669
0.670
0.669
0.670
0.672
0.672
0.675
0.675
0.678
0.677
0.677
0.676
0.683
0.681
GDI
60
62
63
61
62
63
Ha Bnh
Lai Chu
H Giang
Kon Tum
in Bin
Gia Lai
Sn La
Cao Bng
Lo Cai
Yn Bi
Bc Cn
c Lc
c Nng
61.90
57.99
56.39
63.40
61.00
64.97
61.47
64.72
65.96
65.37
64.70
64.20
65.96
67.72
Tui th
(nam)
188
Ph lc
Ngun: tinh toan cua VASS va TCTK cho NHDR 2011
59
61
59
58
58
60
56
57
56
55
55
57
52
54
53
54
50
51
51
52
53
50
Ninh Thun
Xp
hng Tnh
GDI
Xp
hng
HDI
68.00
64.80
63.20
69.90
67.52
71.12
68.14
71.17
71.63
71.52
70.50
70.00
71.73
73.23
71.64
78.98
89.67
86.89
90.23
90.87
84.77
87.17
88.70
94.31
91.28
95.29
95.25
88.35
46.59
60.55
73.68
56.41
74.83
66.28
76.45
73.07
81.21
86.48
85.42
86.18
92.47
83.07
(nam)
(n)
51.07
64.67
71.35
73.05
57.55
64.19
66.98
65.95
65.25
66.09
68.42
66.66
57.26
54.36
T l nhp
hc chung
(nam)
(%)
40.16
54.47
71.77
51.08
57.58
50.76
64.00
57.17
61.93
66.45
68.15
59.08
56.37
65.99
T l nhp
hc chung
(n)
(%)
522.6
584.8
991.8
689.6
943.0
703.0
801.1
889.1
795.6
579.7
888.8
972.6
773.2
1,053.4
499.9
633.3
788.8
1,066.0
739.6
755.5
1,038.0
963.2
867.2
809.1
825.4
881.2
793.2
683.4
GDP
GDP
trn u
trn u
ngi(nam) ngi(n)
(PPP US$) (PPP US$)
49.76
50.49
49.77
49.80
49.11
49.72
50.91
50.22
50.18
49.91
49.56
50.40
50.30
50.54
0.67
0.61
0.58
0.69
0.65
0.72
0.66
0.72
0.73
0.72
0.71
0.70
0.73
0.76
Ch s tui
T l dn s
th cn bng
(n)
gii
0.53
0.65
0.78
0.66
0.74
0.70
0.75
0.73
0.78
0.82
0.82
0.81
0.81
0.77
Ch s gio
dc cn
bng gii
0.27
0.30
0.36
0.35
0.35
0.33
0.37
0.37
0.35
0.32
0.36
0.37
0.34
0.35
Ch s thu
nhp cn
bng gii
0.489
0.520
0.574
0.569
0.582
0.583
0.595
0.607
0.620
0.622
0.628
0.628
0.630
0.628
GDI
74.90
77.08
70.20
73.91
76.29
71.35
92.56
96.19
92.21
95.38
97.62
92.28
90.37
95.52
82.75
92.34
95.62
83.15
(nam)
(n)
69.41
ng bng
sng Cu Long
Bc Trung B v
duyn hi min
Trung
64.05
68.35
ng bng
sng Hng
71.78
70.68
Trung du v
min ni pha
Bc
ng Nam B
65.25
Vng
Ty nguyn
Tui th
(nam)
54.43
60.53
65.64
67.61
62.01
64.23
T l nhp
hc chung
(nam)
(%)
51.26
57.54
64.14
66.78
64.02
58.12
T l nhp
hc chung
(n)
(%)
1970.3
4673.6
1000.8
1268.5
2030.7
826.3
1112.7
2864.8
826.9
1086.4
1718.3
926.6
GDP trn u GDP trn u

ngi(nam)
ngi(n)
(PPP US$)
(PPP US$)
51.01
51.17
49.64
50.86
51.01
50.31
T l dn s
(n)
0.79
0.82
0.70
0.77
0.81
0.72
0.79
0.84
0.80
0.85
0.85
0.78
Ch s gio
Ch s tui th
dc cn bng
cn bng gii
gii
0.44
0.58
0.37
0.40
0.46
0.36
Ch s thu
nhp cn
bng gii
0.671
0.746
0.622
0.674
0.707
0.621
GDI
190
19
22
23
20
21
22
Ph lc
18
20
18
16
17
19
15
17
15
14
14
16
13
12
12
13
11
11
Vnh Phc
10
10
Qung Ninh
Tin Giang
Vnh Long
Thi Bnh
Bnh Thun
Bnh Phc
Ninh Bnh
Khnh Ha
Long An
Lm ng
Hng Yn
Bc Ninh
Hi Dng
Ty Ninh
71.07
70.48
69.97
70.30
70.83
70.94
69.94
66.01
70.58
70.90
70.08
68.28
70.01
73.27
71.57
68.25
71.93
ng Nai
72.07
72.77
74.22
H Ni (bao
gm c H
Ty)
Hi Phng
Nng
Bnh Dng
76.77
TP H Ch
Minh
B Ra-Vng
Tu
72.89
C nc
66.50
Tnh
Tui th
(nam)
Xp hng
GDI
Xp hng
HDI
74.00
73.53
73.81
74.30
74.42
73.50
69.66
74.11
74.38
73.65
71.89
73.57
76.46
74.99
71.68
74.23
75.29
75.41
76.05
77.31
79.44
76.13
70.12
Tui th
(n)
94.13
93.47
98.17
91.34
91.01
97.49
94.71
94.79
93.56
97.83
97.73
98.09
91.54
97.39
95.53
98.24
94.98
98.09
97.25
95.31
96.38
94.97
93.89
T l bit
ch ca
ngi ln
(nam)
87.63
87.81
91.98
85.72
83.13
90.91
88.57
88.32
86.12
90.31
90.39
91.03
86.53
90.76
89.11
92.51
90.43
92.20
90.90
90.52
92.66
90.52
86.89
T l bit
ch ca
ngi ln
(n)
54.42
60.81
63.13
59.78
62.43
69.93
54.89
51.99
65.90
66.76
66.89
67.42
54.91
69.23
61.03
62.92
61.98
65.13
74.72
59.62
53.78
59.70
62.55
T l nhp
hc chung
(nam)
(%)
49.64
52.52
59.55
56.43
58.25
67.25
65.10
51.80
66.24
61.89
60.23
61.17
51.33
62.83
65.19
58.61
59.59
64.97
66.37
54.83
47.66
66.01
58.06
T l nhp
hc chung
(n)
(%)
734.3
789.5
1,037.2
1,001.1
631.5
723.5
795.7
627.6
960.1
882.4
757.9
854.6
885.1
886.7
1,017.0
880.7
1,315.6
2,072.8
1,500.5
1,374.8
1,397.1
2,112.0
2,654.9
3,633.9
1,113.1
GDP
trn u
ngi(n)
(PPP US$)
696.6
1,053.3
1,035.8
681.0
1,728.2
1,174.5
911.7
898.0
1,332.6
925.6
1,387.0
1,281.6
2,117.6
2,304.4
1,965.8
1,557.2
2,355.2
2,945.2
3,934.6
4,858.7
1,527.5
GDP
trn u
ngi(nam)
(PPP US$)
51.56
51.46
52.20
50.08
48.40
51.49
50.52
50.97
49.53
51.69
51.60
51.42
50.87
51.26
48.97
50.71
50.06
50.66
50.88
51.62
51.84
49.97
50.83
T l dn s
(n)
0.79
0.78
0.78
0.79
0.79
0.78
0.71
0.79
0.79
0.78
0.75
0.78
0.83
0.80
0.75
0.79
0.81
0.81
0.82
0.85
0.88
0.82
0.72
Ch s tui
th cn
bng gii
0.78
0.79
0.84
0.78
0.78
0.86
0.81
0.78
0.82
0.84
0.84
0.84
0.77
0.85
0.83
0.84
0.82
0.85
0.86
0.81
0.80
0.83
0.80
Ch s gio
dc cn
bng gii
0.36
0.36
0.32
0.36
0.37
0.31
0.42
0.39
0.35
0.36
0.39
0.37
0.41
0.39
0.47
0.47
0.47
0.45
0.48
0.53
0.58
0.62
0.43
Ch s thu
nhp cn
bng gii
0.642
0.643
0.645
0.645
0.648
0.649
0.648
0.652
0.655
0.661
0.660
0.663
0.670
0.680
0.681
0.700
0.701
0.703
0.721
0.729
0.753
0.759
0.650
GDI
49
50
50
51
Lng Sn
Qung Ngi
ng Thp
c Lc
Qung Tr
Tr Vinh
Thanh Ha
48
49
Bc Cn
47
46
46
51
45
45
47
44
44
48
Ninh Thun
42
43
Bn Tre
Ph Yn
43
41
Qung Bnh
41
39
40
Sc Trng
An Giang
Bc Giang
Bnh nh
Tuyn Quang
Ph Th
58.41
61.62
63.76
60.48
65.44
68.36
62.36
66.39
64.96
65.24
64.57
63.85
66.16
67.90
68.60
65.58
68.11
67.35
65.93
68.51
Tha
Thin-Hu
Bc Liu
65.72
66.27
67.30
65.18
68.42
68.31
70.01
68.39
70.05
Tui th
(nam)
Cn Th
Kin Giang
Qung Nam
C Mau
H Tnh
Thi Nguyn
Nam nh
Ngh An
H Nam
Tnh
42
38
40
38
37
37
39
35
36
35
36
33
34
33
32
32
34
31
30
30
29
29
31
26
28
27
27
26
28
25
24
24
21
23
25
Xp hng
GDI
Xp hng
HDI
62.14
65.34
67.46
64.24
69.11
71.96
66.07
70.02
68.63
68.91
68.24
67.52
69.79
71.52
72.19
69.24
71.72
70.95
69.60
72.12
69.40
69.92
70.92
68.85
72.02
71.92
73.57
71.99
73.61
Tui th
(n)
93.74
92.49
89.15
91.14
89.39
86.49
93.27
87.93
95.47
93.57
93.77
95.57
89.03
88.12
96.73
96.26
93.01
97.48
91.02
92.44
92.00
90.80
95.07
94.18
97.36
97.20
98.20
96.05
97.70
T l bit
ch ca
ngi ln
(nam)
85.26
82.89
82.51
82.98
80.72
77.12
81.20
77.94
88.48
87.33
86.52
88.48
81.91
81.47
90.03
88.78
84.73
92.00
86.63
79.74
86.70
84.74
86.34
90.96
91.85
92.21
91.50
90.03
90.73
T l bit
ch ca
ngi ln
(n)
69.39
68.98
51.73
68.77
71.85
62.07
47.53
60.83
67.67
54.00
64.22
70.43
58.78
50.51
64.41
62.26
72.66
64.13
57.64
69.02
52.84
57.89
69.75
60.61
73.06
60.80
61.89
72.79
63.05
T l nhp
hc chung
(nam)
(%)
65.62
61.07
46.76
64.70
67.59
59.65
96.31
47.79
66.03
51.66
61.20
63.94
48.66
42.92
54.50
60.95
66.65
58.68
49.17
65.21
46.82
50.02
62.65
49.35
74.35
59.52
61.71
66.58
64.00
T l nhp
hc chung
(n)
(%)
921.2
740.8
871.1
893.9
555.2
681.2
808.8
878.7
679.1
972.2
922.2
766.5
1,094.8
1,260.4
658.1
916.6
744.6
744.0
1,359.5
894.6
1,481.6
1,397.1
979.4
1,413.7
638.0
939.5
663.7
753.6
671.6
GDP
trn u
ngi(nam)
(PPP US$)
50.13
574.4
500.4
627.3
489.8
352.3
507.5
50.38
51.24
50.93
49.16
50.04
50.67
50.77
748.6
619.5
51.11
51.60
50.46
50.54
51.26
50.79
50.56
51.44
50.54
50.88
51.02
50.66
50.89
50.78
51.61
50.65
50.92
50.16
51.32
50.74
51.38
T l dn s
(n)
519.4
689.7
560.8
587.9
762.6
825.6
434.4
599.5
468.7
512.8
983.5
669.2
1,125.7
1,036.6
626.2
909.0
516.0
583.8
601.2
613.8
619.1
GDP
trn u
ngi(n)
(PPP US$)
0.59
0.64
0.68
0.62
0.70
0.75
0.65
0.72
0.70
0.70
0.69
0.68
0.72
0.74
0.76
0.71
0.75
0.74
0.71
0.75
0.71
0.72
0.73
0.70
0.75
0.75
0.78
0.75
0.78
Ch s tui
th cn
bng gii
0.82
0.80
0.73
0.80
0.80
0.75
0.82
0.73
0.83
0.78
0.81
0.84
0.75
0.72
0.82
0.82
0.82
0.83
0.77
0.79
0.76
0.76
0.82
0.80
0.88
0.83
0.84
0.85
0.84
Ch s gio
dc cn
bng gii
0.33
0.30
0.33
0.31
0.24
0.29
0.32
0.35
0.30
0.35
0.32
0.32
0.37
0.38
0.28
0.33
0.29
0.30
0.41
0.34
0.43
0.41
0.34
0.40
0.29
0.33
0.31
0.32
0.31
Ch s thu
nhp cn
bng gii
0.578
0.579
0.581
0.578
0.582
0.597
0.599
0.599
0.609
0.609
0.607
0.610
0.609
0.616
0.617
0.619
0.621
0.624
0.629
0.629
0.632
0.631
0.632
0.633
0.640
0.637
0.641
0.641
0.643
GDI
55
57
56
58
59
60
61
62
63
Ph lc
56
57
58
59
60
61
62
63
192
54
54
55
53
52
52
Xp hng
GDI
53
Xp hng
HDI
Hu Giang
c Nng
in Bin
Lai Chu
H Giang
Gia Lai
Sn La
Lo Cai
Kon Tum
Cao Bng
Ha Bnh
Yn Bi
Tnh
58.55
58.21
56.25
61.59
61.52
54.01
59.17
60.41
64.96
Tui th
(nam)
62.31
61.94
59.98
65.31
65.25
57.70
62.91
64.16
68.63
Tui th
(n)
66.13
72.35
80.78
81.71
73.89
83.73
81.16
95.34
88.86
T l bit
ch ca
ngi ln
(nam)
40.65
50.03
64.34
56.73
56.31
67.53
69.23
88.68
77.77
T l bit
ch ca
ngi ln
(n)
58.81
70.70
70.33
64.28
66.02
82.97
71.10
61.37
65.32
T l nhp
hc chung
(nam)
(%)
39.09
51.10
49.34
51.35
52.82
75.71
64.05
68.80
57.08
T l nhp
hc chung
(n)
(%)
629.9
519.2
855.0
603.4
782.6
863.1
740.1
577.1
669.5
GDP
trn u
ngi(nam)
(PPP US$)
531.4
317.2
515.3
504.9
493.9
522.9
457.1
482.9
430.7
GDP
trn u
ngi(n)
(PPP US$)
49.44
50.49
49.49
49.64
50.08
49.65
51.51
50.35
50.10
T l dn s
(n)
0.59
0.58
0.55
0.64
0.64
0.51
0.60
0.62
0.70
Ch s tui
th cn
bng gii
0.49
0.59
0.67
0.64
0.62
0.76
0.72
0.83
0.76
Ch s gio
dc cn
bng gii
0.29
0.23
0.31
0.28
0.30
0.31
0.29
0.28
0.28
Ch s thu
nhp cn
bng gii
0.459
0.467
0.512
0.521
0.520
0.530
0.536
0.576
0.576
GDI
70.62
77.61
65.20
70.22
73.85
67.68
Tui th
(n)
67.00
ng bng sng
Cu Long
Bc Trung B v
duyn hi min
Trung
61.52
66.60
ng bng sng
Hng
74.63
70.44
Trung du v
min ni pha
Bc
ng Nam B
64.01
Vng
Ty nguyn
Tui th
(nam)
91.42
95.11
88.68
94.75
97.88
88.89
T l bit ch
ca ngi ln
(nam)
85.21
90.71
78.09
87.25
91.48
77.41
T l bit ch
ca ngi ln
(n)
55.25
56.93
69.54
67.00
64.53
65.40
T l nhp
hc chung
(nam)
(%)
48.52
52.98
62.25
65.54
61.44
57.74
T l nhp
hc chung
(n)
(%)
1,170.48
3,123.8
886.6
910.0
1,410.6
710.9
GDP trn u
ngi(nam)
(PPP US$)
847.77
2,192.6
564.2
633.9
1,210.2
482.5
51.01
51.01
49.37
50.91
51.09
50.35
0.73
0.85
0.64
0.72
0.79
0.68
0.76
0.80
0.77
0.83
0.84
0.75
0.38
0.53
0.32
0.33
0.40
0.29
Ch s thu
GDP trn u
T l dn s Ch s tui th Ch s gio dc
nhp cn bng
ngi(n)
(n)
cn bng gii cn bng gii
gii
(PPP US$)
0.623
0.727
0.577
0.626
0.673
0.574
GDI
194
Ph lc
Bnh nh
Ninh Bnh
Hng Yn
H Tnh
Bc Liu
23
24
25
26
27
C Mau
20
Thi Bnh
Ty Ninh
19
Tin Giang
Kin Giang
18
22
Bnh Dng
17
21
Hi Dng
Bn Tre
14
Lm ng
Vnh Long
13
16
Long An
12
15
Khnh Ha
11
0.744
Bc Ninh
ng Nai
Hi Phng
Cn Th
Vnh Phc
Qung Ninh
0.744
Nng
10
0.770
H Ni (bao gm c H
Ty)
0.714
0.717
0.718
0.718
0.718
0.719
0.719
0.720
0.720
0.722
0.723
0.723
0.723
0.728
0.729
0.732
0.735
0.742
0.745
0.750
0.755
0.760
0.771
0.803
B Ra-Vng Tu
TP H Ch Minh
0.728
GDI 2008
C nc
Tnh
Xp hng GDI 2008
Thay i GDI 1999-2008
0.676
0.678
0.691
0.672
0.677
0.681
0.683
0.682
0.675
0.684
0.716
0.669
0.705
0.677
0.689
0.686
0.710
0.694
0.730
0.722
0.697
0.695
0.721
0.758
0.730
0.779
0.790
0.701
GDI 2004
0.629
0.640
0.661
0.649
0.619
0.642
0.645
0.633
0.670
0.631
0.729
0.655
0.663
0.609
0.643
0.652
0.648
0.680
0.703
0.701
0.660
0.632
0.681
0.721
0.700
0.753
0.759
0.650
GDI 1999
7.43%
5.97%
4.59%
3.51%
9.49%
5.99%
5.84%
7.60%
0.64%
8.25%
-1.89%
2.13%
6.35%
11.28%
7.20%
5.17%
9.57%
1.99%
3.76%
2.94%
5.56%
10.08%
5.93%
5.12%
4.26%
3.42%
4.12%
7.87%
5.66%
5.80%
3.92%
6.93%
6.03%
5.68%
5.40%
5.64%
6.78%
5.70%
0.97%
8.05%
2.55%
7.42%
5.84%
6.79%
3.44%
7.01%
1.93%
3.08%
6.89%
7.87%
4.68%
0.32%
5.49%
-1.04%
1.63%
3.78%
Thay i 1999-2004 (%) Thay i 2004-2008 (%)
13.51%
12.11%
8.69%
10.68%
16.09%
12.01%
11.55%
13.66%
7.45%
14.42%
-0.94%
10.35%
9.06%
19.55%
13.46%
12.31%
13.34%
9.14%
5.76%
6.11%
12.83%
18.74%
10.88%
5.46%
9.98%
2.35%
5.82%
11.95%
Thay i 1999-2008
(%)
Lo Cai
57
Tr Vinh
54
Cao Bng
Bc Cn
53
Ninh Thun
Gia Lai
52
56
Sc Trng
51
55
c Nng
Tuyn Quang
48
Ha Bnh
Qung Tr
47
50
Ph Th
46
49
Bc Giang
Ph Yn
42
45
Tha Thin-Hu
41
ng Thp
c Lc
40
Qung Ngi
Hu Giang
39
44
Ngh An
38
43
Bnh Phc
37
Thanh Ha
34
Lng Sn
An Giang
33
Qung Bnh
Nam nh
32
36
H Nam
31
35
Qung Nam
Thi Nguyn
30
Tnh
29
Bnh Thun
28
Xp hng GDI 2008
0.643
0.654
0.658
0.665
0.666
0.667
0.680
0.681
0.683
0.684
0.686
0.687
0.688
0.689
0.690
0.693
0.694
0.694
0.700
0.701
0.702
0.702
0.702
0.704
0.705
0.706
0.709
0.709
0.710
0.712
GDI 2008
0.607
0.628
0.595
0.651
0.622
0.582
0.642
0.630
0.628
0.650
0.636
0.670
0.643
0.647
0.654
0.648
0.670
0.628
0.650
0.675
0.652
0.665
0.650
0.667
0.655
0.684
0.685
0.669
0.686
0.672
GDI 2004
0.520
0.597
0.536
0.599
0.582
0.512
0.609
0.576
0.621
0.599
0.624
0.617
0.579
0.581
0.607
0.629
0.578
0.641
0.648
0.610
0.578
0.609
0.616
0.641
0.643
0.637
0.632
0.645
GDI 1999
16.62%
5.08%
10.97%
8.60%
6.93%
13.81%
5.39%
9.32%
4.77%
6.14%
7.53%
4.34%
11.77%
12.65%
6.71%
6.47%
8.76%
5.34%
0.64%
9.10%
12.42%
9.53%
6.34%
6.68%
6.44%
4.88%
8.64%
4.22%
5.98%
4.24%
10.56%
2.15%
7.11%
14.59%
5.99%
8.16%
8.73%
5.17%
7.91%
2.42%
6.89%
6.50%
5.52%
6.90%
3.49%
10.46%
7.60%
3.87%
7.64%
5.52%
8.08%
5.62%
7.66%
3.20%
3.55%
6.06%
3.45%
5.98%
Thay i 1999-2004 (%) Thay i 2004-2008 (%)
23.59%
9.54%
22.69%
10.93%
14.54%
30.41%
11.70%
18.24%
10.18%
14.54%
10.13%
11.53%
19.04%
18.87%
14.08%
10.18%
20.13%
9.42%
8.33%
15.12%
21.51%
15.68%
14.48%
10.10%
10.22%
11.23%
12.39%
10.46%
Thay i 1999-2008
(%)
GDI 2008
0.746
0.76
0.71
ng Nam B
ng bng sng Cu Long
196
Ph lc
0.622
0.69
Ty nguyn
0.707
0.671
0.674
0.74
0.71
0.621
GDI 2004
0.531
0.566
0.594
0.630
0.637
0.641
GDI 2008
ng bng sng Hng
0.66
Lai Chu
63
Tnh
Vng
in Bin
H Giang
62
60
61
Sn La
Yn Bi
59
Kon Tum
58
Xp hng GDI 2008
0.489
0.520
0.569
0.620
0.583
0.574
GDI 2004
0.623
0.727
0.577
0.626
0.673
0.574
GDI 1999
0.459
0.467
0.576
0.521
0.530
GDI 1999
7.70%
2.67%
7.81%
7.68%
5.03%
8.20%
Thay i 1999-2004 (%)
6.47%
11.40%
7.64%
11.90%
8.30%
6.17%
1.15%
10.73%
4.93%
4.77%
6.23%
Thay i 2004-2008 (%)
8.74%
8.84%
4.40%
1.68%
9.27%
11.67%
15.78%
21.25%
9.45%
22.28%
20.94%
Thay i 1999-2008
(%)
14.35%
3.85%
19.38%
12.99%
10.04%
14.93%
Thay i 1999-2008 (%)
Thay i 1999-2004 (%) Thay i 2004-2008 (%)
0.830
0.558
0.728
Ch s thu nhp
GDI
0.794
0.443
0.663
Ch s thu nhp
GDI
0.852
0.568
0.746
Ch s thu nhp
GDI
0.717
0.488
0.854
0.809
0.624
0.362
0.788
0.722
0.702
0.495
0.826
0.784
2004
0.857
0.491
0.709
Ch s thu nhp
GDI
0.825
0.487
0.690
Ch s thu nhp
GDI
0.623
0.369
0.800
0.702
0.677
0.411
0.850
0.770
0.757
Ch s tui th
Ch s gio dc
Ty nguyn
0.778
Ch s tui th
Ch s gio dc
0.819
Ch s tui th
Ch s gio dc
ng bng sng Hng
0.750
Ch s tui th
Ch s gio dc
0.796
Ch s tui th
Ch s gio dc
C nc
2008
58.1%
32.7%
77.6%
63.9%
63.0%
33.8%
82.7%
72.4%
68.5%
42.9%
84.1%
78.6%
57.8%
29.5%
75.9%
68.1%
65.1%
42.8%
80.3%
72.2%
1999
7.3%
12.7%
3.0%
9.8%
7.5%
21.6%
2.7%
6.3%
4.7%
13.9%
1.6%
2.9%
7.9%
22.8%
3.9%
6.0%
7.8%
15.6%
2.8%
8.6%
10.6%
32.2%
3.2%
7.8%
4.8%
19.6%
0.9%
1.1%
4.0%
16.2%
-0.2%
1.2%
6.1%
22.3%
0.8%
3.9%
3.7%
12.7%
0.5%
1.5%
18.7%
49.0%
6.3%
18.4%
12.6%
45.4%
3.6%
7.5%
8.9%
32.4%
1.4%
4.1%
14.6%
50.2%
4.6%
10.2%
11.8%
30.3%
3.4%
10.2%
Thay i
Thay i
Thay i
1999-2004 (%) 2004-2008 (%) 1999-2008 (%)
Thay i GDI v ng gp ca tng ch tiu vo GDI 1999-2008
7.3%
2.4%
1.4%
3.6%
7.5%
3.9%
1.2%
2.4%
4.7%
2.9%
0.7%
1.1%
7.9%
3.9%
1.7%
2.4%
7.8%
3.4%
1.2%
3.2%
ng gp vo
thay i
(im %)
1999-2004
10.6%
6.3%
1.4%
2.9%
4.8%
4.0%
0.4%
0.4%
4.0%
3.7%
-0.1%
0.4%
6.1%
4.3%
0.3%
1.5%
3.7%
3.0%
0.2%
0.6%
ng gp vo
thay i
(im %)
2004-2008
18.7%
9.2%
2.8%
6.7%
12.6%
8.1%
1.6%
2.9%
8.9%
6.8%
0.6%
1.6%
14.6%
8.5%
2.0%
4.0%
11.8%
6.6%
1.4%
3.8%
ng gp vo
thay i
(im %)
1999-2008
100.0%
32.5%
18.4%
49.0%
100.0%
51.8%
15.9%
32.3%
100.0%
62.2%
14.1%
23.6%
100.0%
48.9%
21.3%
29.8%
100.0%
44.2%
15.0%
40.8%
ng gp (%)
1999-2004
100.0%
59.7%
12.7%
27.6%
100.0%
83.2%
7.9%
8.9%
100.0%
91.0%
-2.0%
11.0%
100.0%
70.1%
5.2%
24.7%
100.0%
79.6%
5.7%
14.7%
ng gp (%)
2004-2008
100.0%
49.1%
15.0%
36.0%
100.0%
64.5%
12.6%
22.8%
100.0%
75.9%
6.4%
17.6%
100.0%
58.6%
13.9%
27.5%
100.0%
56.3%
11.8%
31.9%
ng gp (%)
1999-2008
0.821
0.620
0.759
Ch s thu nhp
GDI
0.800
0.536
0.715
Ch s thu nhp
GDI
0.674
0.449
0.786
0.787
0.753
0.600
0.836
0.825
2004
62.5%
38.3%
76.1%
73.1%
73.3%
54.4%
80.2%
85.3%
1999
198
Ph lc
0.808
Ch s tui th
Ch s gio dc
ng bng sng Cu Long
0.836
Ch s tui th
Ch s gio dc
ng Nam B
2008
1.4%
19.5%
6.1%
7.8%
1.8%
2.7%
0.7%
3.3%
-1.8%
17.2%
3.2%
7.7%
2.8%
10.2%
4.2%
-3.2%
14.4%
40.0%
5.1%
10.6%
3.5%
13.9%
2.3%
-1.9%
Thay i
Thay i
Thay i
1999-2004 (%) 2004-2008 (%) 1999-2008 (%)
7.8%
3.5%
1.3%
3.0%
2.8%
2.5%
1.5%
-1.3%
ng gp vo
thay i
(im %)
1999-2004
6.1%
4.3%
0.7%
1.1%
0.7%
0.9%
-0.7%
0.5%
ng gp vo
thay i
(im %)
2004-2008
14.4%
8.2%
2.1%
4.1%
3.5%
3.4%
0.8%
-0.7%
ng gp vo
thay i
(im %)
1999-2008
100.0%
44.9%
16.8%
38.3%
100.0%
90.4%
54.5%
-44.9%
ng gp (%)
1999-2004
100.0%
71.0%
11.5%
17.5%
100.0%
122.6%
-93.0%
70.4%
ng gp (%)
2004-2008
100.0%
56.9%
14.4%
28.8%
100.0%
97.1%
23.7%
-20.8%
ng gp (%)
1999-2008
30
29
Tnh
Qung Nam
Bnh Thun
H Tnh
Bc Liu
Ninh Bnh
Hng Yn
Bnh nh
Thi Bnh
Ty Ninh
Tin Giang
Hi Dng
Lm ng
Bnh Dng
Kin Giang
C Mau
Bn Tre
Vnh Long
Long An
Khnh Ha
Vnh Phc
ng Nai
Hi Phng
Bc Ninh
Cn Th
Qung Ninh
Nng
H Ni
TP H Ch Minh
B Ra-Vng Tu
C nc
32
28
27
28
12
26
24
23
13
19
20
21
22
24
17
20
25
23
16
18
17
19
10
27
15
16
61
41
13
15
12
14
18
21
10
11
43
25
Xp hng HPI
Xp hng HDI
Ch s ngho i con ngi (HPI) 2008
7.34
5.32
6.41
5.00
5.62
4.73
6.50
4.25
5.00
4.32
4.61
5.19
3.54
5.32
5.32
4.65
4.32
3.98
5.84
4.61
3.54
4.25
4.73
3.46
5.68
3.98
3.89
3.24
3.59
5.66
T l ngi khng k vng

sng n 40 tui (%)
4.40
7.13
2.57
5.04
3.40
4.16
4.64
3.52
7.57
7.22
3.61
7.09
3.54
9.91
3.37
5.77
4.96
5.92
4.47
3.60
3.95
3.34
3.86
5.41
4.17
3.00
2.87
2.77
4.66
6.40
T l ngi ln bit ch
(% s ngi t 15 tui
tr ln)
8.53
6.15
5.88
0.04
1.00
0.19
4.06
0.00
1.68
3.19
2.95
6.44
0.64
5.87
0.12
17.25
64.91
3.63
7.12
1.46
3.97
0.18
0.46
19.10
7.64
2.62
0.27
0.18
0.53
10.38
20.40
21.70
23.90
19.20
22.30
19.70
22.40
19.80
19.90
18.20
19.70
18.90
15.40
19.60
19.40
18.80
21.60
16.90
17.50
21.80
14.90
14.10
18.90
17.70
20.00
11.20
8.20
4.60
14.10
19.90
T l ngi khng c tip T l tr em di 5 tui b

cn nc sch (%)
suy dinh dng (%)
10.53
10.23
10.61
7.25
8.43
7.29
9.64
7.14
8.46
8.24
8.11
9.45
5.86
10.21
7.20
12.70
30.02
7.67
8.95
8.30
6.81
5.42
7.09
12.89
9.88
5.19
3.75
2.84
5.64
10.93
HPI
58
56
53
57
59
50
56
58
55
57
54
54
53
55
45
37
51
47
50
52
42
48
48
39
47
49
26
22
45
40
44
46
29
59
42
46
41
43
33
35
39
36
38
40
34
44
36
49
35
37
11
38
33
34
14
52
31
32
Ph lc
31
30
200
Xp hng HPI
Xp hng HDI
Sn La
Kon Tum
Lo Cai
Ninh Thun
Cao Bng
Bc Cn
Gia Lai
Tr Vinh
Ha Bnh
c Nng
Tuyn Quang
Sc Trng
Qung Tr
Ph Th
Bc Giang
Qung Ngi
ng Thp
Ph Yn
c Lc
Tha Thin-Hu
Ngh An
Bnh Phc
Qung Bnh
Hu Giang
Lng Sn
Thanh Ha
Nam nh
An Giang
H Nam
Thi Nguyn
Tnh
9.51
13.02
12.23
7.86
9.92
6.96
8.97
5.99
6.96
9.30
6.96
5.99
12.97
6.60
6.08
7.01
5.64
7.34
7.69
8.03
6.50
6.67
7.31
4.32
6.92
5.99
4.83
5.99
5.60
5.24
T l ngi khng k vng

sng n 40 tui (%)
18.81
16.62
19.40
14.32
16.19
8.68
12.00
13.58
6.33
10.67
5.55
16.37
7.81
4.40
3.76
10.47
10.58
5.87
9.22
8.88
5.74
6.76
3.89
8.22
7.00
5.22
4.25
9.39
4.53
3.66
T l ngi ln bit ch
(% s ngi t 15 tui
tr ln)
27.14
34.75
41.28
20.13
47.27
38.07
33.96
4.43
16.00
13.13
22.10
3.03
7.26
3.73
5.56
10.11
59.42
6.39
11.35
9.74
6.28
10.32
11.52
11.77
24.58
8.22
0.16
38.90
0.37
9.40
25.60
30.20
28.40
25.50
23.90
28.30
28.40
21.90
25.00
30.50
24.00
20.60
21.40
21.60
22.50
22.60
20.30
21.30
29.10
18.60
23.50
22.30
28.30
18.30
23.10
26.00
19.40
18.20
19.00
20.60

cn nc sch (%)
suy dinh dng (%)
20.50
23.92
25.78
17.21
25.59
23.22
22.19
11.86
14.53
16.05
16.20
12.77
12.31
9.29
10.04
12.51
27.83
10.27
14.69
11.06
10.79
11.81
14.06
11.04
16.80
12.14
7.21
20.09
7.32
10.60
HPI
3.82
8.02
3.7
5.02
Ty nguyn
ng Nam B
ng bng sng Cu Long
10.17
6.68
8.33
5.86
3.5
4.49
min Trung
11.97
67.95
47.89
60.58
27.85
28.50
27.50
24.40
24.70

cn nc sch (%)
suy dinh dng (%)
19.31
1.68
17.94
7.61
0.99
24.43
19.18
10.52
26.77
22.38
15.56
24.12
T l ngi khng c tip cn T l tr em di 5 tui b suy dinh

nc sch (%)
dng (%)
38.41
26.90
28.45
16.56
T l ngi ln bit ch
(% s ngi t 15 tui
tr ln)
T l ngi ln bit ch
(% s ngi t 15 tui tr ln)
16.12
ng bng sng Hng
T l ngi khng k vng sng

n 40 tui (%)
Lai Chu
12.82
13.51
9.92
T l ngi khng k vng

sng n 40 tui (%)
8.46
63
63
H Giang
in Bin
Yn Bi
Tnh
Vng
62
60
61
51
60
62
Xp hng HPI
Xp hng HDI
14.28
5.05
16.23
11.00
6.25
17.98
HPI
38.63
29.26
32.42
19.90
HPI
202
36
32
26
27
Ph lc
13
47
24
10
23
25
28
21
20
22
16
38
18
34
17
19
57
12
15
16
14
51
11
11
18
23
10
12
Khnh Ha
19
17
13
Bnh Dng
H Tnh
Bnh nh
Bn Tre
Bc Liu
Thi Bnh
Tin Giang
Nam nh
H Nam
Qung Nam
Long An
Kin Giang
Hng Yn
Vnh Long
C Mau
Vnh Phc
Bc Ninh
Cn Th
Hi Dng
Qung Ninh
ng Nai
H Ni (bao gm c H Ty)
Hi Phng
Nng
B Ra-Vng Tu
Tnh
TP H Ch Minh
31
C nc
Xp hng HPI
Xp hng HDI
7.10
7.10
7.10
7.40
5.50
5.10
5.70
3.90
6.20
5.30
5.40
5.50
4.40
6.20
5.30
5.90
6.00
4.20
5.30
5.60
6.20
5.80
4.89
4.40
3.00
2.90
3.70
6.30
T l ngi khng k vng

sng n 40 tui (%)
3.34
5.23
5.27
6.13
3.28
6.58
3.56
4.23
6.55
5.45
10.72
4.42
4.72
4.05
3.28
3.82
6.18
3.31
5.79
3.62
4.08
4.17
3.00
3.26
3.20
3.16
4.71
6.70
T l ngi ln bit ch
(% s ngi t 15 tui
tr ln)
10.20
14.90
33.10
2.80
0.60
15.40
0.30
1.80
17.40
8.90
16.70
0.80
65.60
0.80
3.30
0.30
45.10
0.70
10.70
9.40
8.00
5.50
0.66
0.50
0.70
2.30
21.00
15.90
32.6
29.0
25.1
24.3
26.2
23.4
25.9
25.0
27.9
22.0
24.7
26.9
27.4
24.0
29.0
27.0
24.1
26.2
23.8
22.2
25.0
19.3
18.3
19.7
21.4
10.9
21.2
26.6

cn nc sch (%)
suy dinh dng (%)
15.03
15.46
20.31
10.14
9.54
13.70
9.38
9.46
15.94
11.01
15.07
9.90
32.26
9.03
11.36
9.78
24.08
9.46
12.22
11.16
11.69
8.98
6.96
7.26
7.77
4.86
14.71
15.01
HPI
59
57
Tnh
Cao Bng
Lo Cai
Yn Bi
Bc Cn
c Lc
c Nng
Ha Bnh
Ninh Thun
Qung Tr
Bc Giang
Sc Trng
Qung Ngi
Ph Yn
Lng Sn
Tuyn Quang
Bnh Phc
Tr Vinh
Hu Giang
An Giang
ng Thp
Qung Bnh
Thanh Ha
Thi Nguyn
Ph Th
Lm ng
Tha Thin-Hu
Ninh Bnh
Bnh Thun
Ngh An
Ty Ninh
49
56
55
55
54
56
44
45
52
48
51
53
41
43
49
27
48
50
33
29
46
24
45
47
39
52
43
30
42
44
46
35
40
41
61
54
38
40
37
39
26
37
35
15
34
36
22
25
32
14
31
33
42
21
29
20
28
30
Xp hng HPI
Xp hng HDI
14.40
10.60
9.60
10.00
11.00
11.50
9.50
7.80
12.80
9.40
7.50
7.30
10.60
11.60
10.00
7.40
7.10
7.20
7.30
5.70
8.90
7.60
7.40
6.30
6.40
7.00
5.90
6.60
7.10
6.90
T l ngi khng k vng

sng n 40 tui (%)
19.47
19.91
15.06
9.60
11.63
9.30
6.15
14.32
9.36
3.63
13.98
10.49
5.18
6.92
5.26
6.17
15.23
9.65
11.65
9.43
4.94
4.80
3.93
3.96
7.89
9.11
3.13
6.49
5.69
8.22
T l ngi ln bit ch
(% s ngi t 15 tui
tr ln)
61.60
54.00
27.00
52.70
19.50
16.90
28.10
18.90
18.60
6.90
9.00
10.10
3.50
39.00
14.80
12.60
10.80
32.30
58.90
76.00
11.80
10.60
8.50
3.10
9.00
4.80
1.20
5.90
19.40
7.30
30.2
34.6
31.9
35.6
36.4
36.6
32.2
30.8
27.7
29.8
26.7
31.0
29.2
29.8
31.3
28.5
27.0
25.0
26.7
25.6
35.7
33.8
28.3
27.7
25.3
27.9
28.1
28.0
30.3
25.2

cn nc sch (%)
suy dinh dng (%)
32.92
31.75
21.51
30.83
20.20
19.27
21.18
18.42
17.22
13.30
14.34
15.05
12.39
24.22
16.47
14.59
15.25
20.22
29.92
35.31
16.80
15.65
13.07
10.97
12.46
12.22
10.41
12.19
17.43
11.99
HPI
4.13
11.76
4.37
6.23
Ty nguyn
ng Nam B
ng bng sng Cu Long
204
Ph lc
12.48
7.26
8.56
6.17
3.40
5.12
min Trung
12.29
92.60
58.50
32.30
86.40
28.30
58.90
31.15
6.04
19.98
11.97
1.25
32.65
25.07
16.59
33.36
29.95
23.38
30.83
T l tr em di 5 tui b suy
dinh dng (%)
36.2
33.4
35.3
29.1
35.0
31.6

cn nc sch (%)
suy dinh dng (%)
T l ngi khng c tip cn

nc sch (%)
40.82
30.33
18.29
28.28
17.33
21.35
T l ngi ln bit ch
(% s ngi t 15 tui
tr ln)
T l ngi ln bit ch
14.20
ng bng sng Hng

n 40 tui (%)
Lai Chu
18.80
20.90
12.10
15.10
10.50
T l ngi khng k vng

sng n 40 tui (%)
10.30
63
63
H Giang
Kon Tum
in Bin
Gia Lai
Sn La
Tnh
Vng
53
60
61
62
50
62
59
58
58
60
Xp hng HPI
Xp hng HDI
20.02
8.16
19.65
14.94
8.83
22.93
HPI
48.30
35.26
26.18
41.67
23.78
32.56
HPI
12
27
26
27
B Ra-Vng Tu
H Tnh
Thi Nguyn
Nam nh
Ngh An
H Nam
Tin Giang
Vnh Long
Thi Bnh
Bnh Thun
Bnh Phc
Ninh Bnh
Khnh Ha
Long An
Lm ng
Hng Yn
Bc Ninh
Hi Dng
Ty Ninh
Vnh Phc
8.65
9.00
5.00
11.65
6.45
9.30
8.05
6.35
7.74
9.47
10.71
10.48
7.85
8.80
6.75
6.25
7.38
5.69
7.57
10.00
5.97
H Ni (bao gm c
H Ty)
Qung Ninh
7.24
6.54
5.49
6.29
5.00
8.60
9.70
T l ngi khng k vng

sng n 40 tui (%)
ng Nai
Hi Phng
Nng
Bnh Dng
TP H Ch Minh
31
15
24
19
23
25
57
44
21
20
22
28
26
18
19
21
23
16
33
15
17
14
20
13
14
10
12
13
16
11
10
11
C nc
Xp hng HPI Tnh
Xp hng HDI
5.53
5.33
5.34
7.09
5.99
9.31
9.51
5.16
11.53
12.87
5.95
8.46
8.58
10.17
6.18
6.15
5.66
11.07
6.10
7.62
4.73
7.34
4.95
6.05
7.22
5.59
7.30
9.75
T l ngi ln bit ch
(% s ngi t 15 tui
tr ln)
9.49
5.78
8.36
12.71
13.61
48.18
83.52
9.97
13.47
10.26
11.84
11.10
33.38
12.85
6.43
7.18
8.66
8.50
3.62
12.97
5.66
6.04
7.35
4.81
6.81
1.22
6.09
22.90
44.20
37.80
39.30
45.10
34.90
31.50
33.70
32.20
39.10
41.50
36.50
36.40
29.90
34.40
39.80
36.70
35.10
34.90
37.70
33.30
27.42
32.20
33.90
27.60
34.50
18.10
34.00
36.70
T l ngi khng c tip T l tr em di 5 tui b suy

cn nc sch (%)
dinh dng (%)
18.87
15.52
16.64
20.56
17.01
27.86
40.73
14.82
18.87
18.92
17.31
17.16
22.19
17.07
16.26
15.44
15.45
15.77
14.67
16.64
11.73
13.73
14.52
11.57
14.65
7.37
14.47
21.13
HPI
206
56
57
Ph lc
47
53
55
54
54
56
42
41
52
48
51
53
58
38
49
35
48
50
46
51
46
34
45
47
29
45
43
55
42
44
43
37
40
36
39
41
24
52
37
22
36
38
17
39
34
30
33
35
50
18
31
32
25
40
29
30
32
Sn La
Lo Cai
Kon Tum
Cao Bng
Ha Bnh
Yn Bi
Lng Sn
Qung Ngi
ng Thp
c Lc
Bc Cn
Ninh Thun
Qung Tr
Tr Vinh
Thanh Ha
Bn Tre
Ph Yn
Qung Bnh
Sc Trng
An Giang
Bc Giang
Bnh nh
Tuyn Quang
Ph Th
Bc Liu
Tha Thin-Hu
Cn Th
Kin Giang
Qung Nam
C Mau
Xp hng HPI Tnh
28
Xp hng HDI
16.94
13.89
28.60
18.46
9.28
12.95
14.53
15.69
8.87
19.19
10.57
11.18
12.20
10.82
9.71
10.22
26.45
13.07
7.62
8.42
11.80
9.66
8.55
10.78
13.03
9.05
11.01
10.21
8.98
13.50
T l ngi khng k vng

sng n 40 tui (%)
30.86
34.99
24.44
25.02
8.08
16.78
10.58
12.60
14.31
12.90
14.99
18.36
13.04
17.36
8.20
9.72
9.98
8.09
14.72
15.35
6.72
7.72
11.22
5.37
11.29
14.17
10.76
12.35
9.58
7.49
T l ngi ln bit ch
(% s ngi t 15 tui
tr ln)
68.66
54.23
30.80
65.99
28.33
31.30
50.58
19.84
86.57
8.23
59.39
41.99
22.75
47.00
12.03
79.95
12.09
27.00
30.29
73.00
6.04
8.14
26.77
7.03
23.98
9.61
66.89
37.91
10.83
23.87
39.40
45.50
44.20
41.50
43.30
40.60
42.50
45.10
31.80
51.10
43.20
39.80
39.20
31.80
41.30
33.70
41.30
51.50
33.90
32.80
42.30
39.90
40.90
39.80
31.90
34.70
32.50
30.60
39.00
33.50

cn nc sch (%)
dinh dng (%)
40.00
38.37
31.16
38.94
25.07
26.10
32.72
23.73
41.28
22.75
35.96
29.37
22.41
28.25
18.95
39.54
23.42
27.62
23.04
37.02
17.49
17.18
23.86
16.81
20.40
16.89
34.70
24.32
17.85
20.67
HPI
7.17
18.22
6.16
9.73
ng Nam B
ng bng sng Cu Long
16.61
11.00
11.83
9.17
5.47
16.95
T l ngi ln bit ch (% s
ngi t 15 tui tr ln)
T l ngi khng k vng

sng n 40 tui (%)
Ty nguyn
Hu Giang
c Nng
6.73
63
63
46.65
38.99
27.45
13.06
62
62
in Bin
19.01
20.59
22.77
T l ngi ln bit ch
(% s ngi t 15 tui
tr ln)
61
61
Lai Chu
H Giang
Gia Lai
T l ngi khng k vng

sng n 40 tui (%)
ng bng sng Hng
Vng
59
60
59
60
49
Xp hng HPI Tnh
58
Xp hng HDI
55.61
4.22
19.13
13.52
7.89
34.36
T l ngi khng c tip

cn nc sch (%)
76.75
63.46
41.73
32.26
26.37
45.41
41.10
33.45
41.41
T l tr em di 5 tui b suy
dinh dng (%)
43.20
43.00
46.70

cn nc sch (%)
dinh dng (%)
30.88
11.23
24.72
19.76
14.60
27.83
HPI
47.63
41.78
34.10
HPI
208
Bc Giang
Kin Giang
Bnh Thun
Ph Yn
26
27
28
29
Ph lc
Qung Ninh
25
Ph Th
22
Lm ng
Khnh Ha
21
Bnh nh
Ty Ninh
20
24
Ninh Bnh
19
23
Tin Giang
Hi Dng
16
Vnh Phc
Long An
15
18
H Nam
14
17
Hng Yn
10
13
C Mau
Nam nh
Thi Bnh
Bc Liu
Bc Ninh
12
ng Nai
11
B Ra-Vng Tu
Bnh Dng
Nng
Hi Phng
10.27
10.23
10.21
10.04
9.88
9.64
9.45
9.29
8.95
8.46
8.43
8.30
8.24
8.11
7.67
7.32
7.29
7.25
7.21
7.20
7.14
7.09
6.81
5.86
5.64
5.42
5.19
3.75
H Ni (bao gm c
H Ty)
2.84
10.93
HPI 2008
TP H Ch Minh
C nc
Tnh
Xp hng HPI 2008
Thay i HPI 1999-2008
12.39
12.19
15.07
13.30
11.69
15.46
12.46
10.97
12.22
11.99
10.41
11.36
13.70
9.46
11.01
9.46
9.90
10.14
9.38
9.03
9.54
9.78
8.98
11.16
14.71
7.26
7.77
6.96
4.86
15.01
HPI 2004
23.42
18.87
24.32
17.49
16.64
17.18
17.07
16.81
17.16
15.77
17.31
14.67
27.86
15.45
22.19
17.01
16.26
20.40
16.64
20.67
14.82
15.44
13.73
14.65
14.47
14.52
11.57
11.73
7.37
21.13
HPI 1999
-47.11%
-35.42%
-38.04%
-23.98%
-29.72%
-10.05%
-27.02%
-34.71%
-28.76%
-23.94%
-39.89%
-22.59%
-50.81%
-38.73%
-50.41%
-44.36%
-39.12%
-50.31%
-43.60%
-56.29%
-35.61%
-36.66%
-34.58%
-23.86%
1.69%
-49.96%
-32.80%
-40.70%
-34.12%
-28.96%
Thay i 1999-2004 (%)
-17.07%
-16.05%
-32.25%
-24.48%
-15.50%
-37.61%
-24.14%
-15.36%
-26.74%
-29.50%
-18.98%
-26.89%
-39.84%
-14.36%
-30.33%
-22.63%
-26.37%
-28.48%
-23.14%
-20.33%
-25.21%
-27.47%
-24.23%
-47.46%
-61.64%
-25.35%
-33.20%
-46.06%
-41.45%
-27.21%
Thay i 2004-2008 (%)
-56.14%
-45.78%
-58.02%
-42.59%
-40.61%
-43.88%
-44.64%
-44.74%
-47.81%
-46.37%
-51.29%
-43.41%
-70.41%
-47.53%
-65.45%
-56.95%
-55.18%
-64.46%
-56.65%
-65.18%
-51.84%
-54.06%
-50.43%
-59.99%
-60.99%
-62.65%
-55.11%
-68.01%
-61.42%
-48.29%
Thay i 1999-2008 (%)
Tnh
H Giang
Vnh Long
60
61
ng Thp
59
Kon Tum
56
Cao Bng
Bc Cn
55
Lo Cai
Gia Lai
54
58
Sn La
53
57
Yn Bi
An Giang
Ninh Thun
50
52
Lng Sn
49
51
Tuyn Quang
48
Qung Bnh
44
c Nng
Cn Th
43
47
Sc Trng
42
Ha Bnh
Bn Tre
41
c Lc
Qung Ngi
40
46
Qung Tri
39
45
Tr Vinh
Bnh Phc
36
Thanh Ha
Tha Thin-Hu
38
11.04
Hu Giang
34
35
37
10.79
Ngh An
33
10.60
30.02
29.26
27.83
25.78
25.59
23.92
23.22
22.19
20.50
20.09
19.90
17.21
16.80
16.20
16.05
14.69
14.53
14.06
12.89
12.77
12.70
12.51
12.31
12.14
11.86
11.81
11.06
10.61
Thi Nguyn
H Tnh
32
10.53
HPI 2008
31
Qung Nam
30
Xp hng HPI 2008
32.26
35.26
35.31
31.75
32.92
26.18
30.83
23.78
32.56
29.92
21.51
18.42
24.22
16.47
19.27
20.20
21.18
16.80
24.08
14.34
20.31
15.05
17.22
15.65
15.25
14.59
12.22
20.22
17.43
15.03
13.07
15.94
HPI 2004
40.73
41.78
41.28
38.37
38.94
31.16
35.96
34.10
40.00
37.02
26.10
29.37
32.72
23.86
22.75
25.07
27.62
34.70
23.04
39.54
23.73
22.41
18.95
28.25
18.92
16.89
20.56
18.87
15.52
17.85
HPI 1999
-20.80%
-15.60%
-14.44%
-17.26%
-15.46%
-15.95%
-14.26%
-30.25%
-18.60%
-19.18%
-17.61%
-37.27%
-25.99%
-31.00%
-11.19%
-15.53%
-39.18%
-30.60%
-37.78%
-48.63%
-36.59%
-23.14%
-17.45%
-46.03%
-22.87%
-27.68%
-15.24%
-20.33%
-15.82%
-10.75%
Thay i 1999-2004 (%)
-6.96%
-17.04%
-21.18%
-18.80%
-22.27%
-8.66%
-24.71%
-6.71%
-37.03%
-32.87%
-7.46%
-6.57%
-30.63%
-1.61%
-16.71%
-27.29%
-31.38%
-16.29%
-46.45%
-10.90%
-37.47%
-16.90%
-28.51%
-22.42%
-22.25%
-19.04%
-9.42%
-45.41%
-38.12%
-29.44%
-18.92%
-33.90%
Thay i 2004-2008 (%)
-26.31%
-29.98%
-32.56%
-32.81%
-34.29%
-23.23%
-35.44%
-34.93%
-48.74%
-45.75%
-23.75%
-41.39%
-48.65%
-32.11%
-35.42%
-42.04%
-49.09%
-62.84%
-44.56%
-67.88%
-47.31%
-45.05%
-35.96%
-58.04%
-37.56%
-34.50%
-47.55%
-43.78%
-31.75%
-41.00%
Thay i 1999-2008 (%)
5.05
14.28
ng bng sng Cu Long
210
Ph lc
16.23
ng Nam B
11
Bc Trung B v duyn hi min

Trung
Ty nguyn
6.25
ng bng sng Hng
38.63
32.42
HPI 2008
HPI 2008
17.98
Lai Chu
63
Tnh
Vng
in Bin
62
Xp hng HPI 2008
20.02
8.16
19.65
14.94
8.83
22.93
HPI 2004
48.30
41.67
HPI 2004
30.88
11.23
24.72
19.76
14.60
27.83
HPI 1999
47.63
HPI 1999
-35.18%
-27.29%
-20.53%
-24.38%
-39.55%
-17.62%
Thay i 1999-2004 (%)
1.41%
Thay i 1999-2004 (%)
-28.67%
-38.14%
-17.39%
-26.39%
-29.19%
-21.58%
Thay i 2004-2008 (%)
-20.01%
-22.19%
Thay i 2004-2008 (%)
-53.76%
-55.02%
-34.35%
-44.33%
-57.19%
-35.40%
Thay i 1999-2008 (%)
-18.88%
Thay i 1999-2008 (%)
6.40
15.14
10.93
T l ngi ln bit ch

nc sch (%)
HPI
11.97
24.28
17.70
T l ngi ln bit ch (% s
ngi t 15 tui tr ln)

nc sch (%)
HPI
3.50
8.28
6.16
T l ngi ln bit ch

nc sch (%)
HPI
6.68

n 40 tui (%)
4.49

n 40 tui (%)
ng bng sng Hng
8.46

n 40 tui (%)
5.66

n 40 tui (%)
C nc
HPI
2008
7.26
8.79
12.32
3.40
5.12
22.66
31.74
12.29
10.30
15.01
21.25
6.30
6.30
HPI
2004
11.00
14.58
20.67
5.47
6.73
27.36
37.88
16.95
13.06
21.13
29.80
9.75
9.70
HPI
1999
-34.0%
-39.7%
-40.4%
-37.9%
-24.0%
-17.2%
-16.2%
-27.5%
-21.1%
-29.0%
-28.7%
-35.4%
-35.1%
Thay i
1999-2004
(%)
-8.0%
-30.0%
-32.8%
3.1%
-12.2%
-21.9%
-23.5%
-2.6%
-17.9%
-27.2%
-28.8%
1.5%
-10.2%
Thay i
2004-2008
(%)
-39.3%
-57.8%
-60.0%
-36.0%
-33.3%
-35.3%
-35.9%
-29.4%
-35.2%
-48.3%
-49.2%
-34.4%
-41.7%
Thay i
1999-2008
(%)
Thay i HPI v ng gp ca tng ch tiu vo HPI 1999-2008
-6.9%
-39.7%
-27.5%
-6.8%
-5.3%
-17.2%
-7.8%
-5.9%
-3.5%
-29.0%
-16.1%
-6.5%
-6.4%
ng gp
vo thay i
(im %)
1999-2004
-2.3%
-30.0%
-26.6%
0.7%
-4.1%
-21.9%
-17.0%
-0.7%
-4.2%
-27.2%
-25.0%
0.4%
-2.6%
ng gp
vo thay i
(im %)
2004-2008
-9.6%
-57.8%
-43.1%
-6.9%
-7.8%
-35.3%
-20.7%
-7.6%
-7.0%
-48.3%
-32.1%
-7.3%
-8.8%
28.6%
100.0%
69.4%
17.2%
13.4%
100.0%
45.3%
34.3%
20.3%
100.0%
55.5%
22.4%
22.1%
8.5%
100.0%
88.5%
-2.3%
13.7%
100.0%
77.5%
3.3%
19.1%
100.0%
91.8%
-1.5%
9.6%
21.7%
100.0%
74.6%
11.9%
13.5%
100.0%
58.7%
21.5%
19.8%
100.0%
66.5%
15.2%
18.3%
ng gp vo
thay i
(im %)
1999-2004
2004-2008
1999-2008
1999-2008
15.00
10.89

nc sch (%)
HPI
10.17
22.36
16.19
T l ngi ln bit ch

nc sch (%)
HPI
3.82
6.10
4.81
T l ngi ln bit ch

nc sch (%)
HPI
8.33
19.25
13.77
T l ngi ln bit ch

nc sch (%)
HPI
43.93
30.77
19.74
212
Ph lc
11.83
9.73
11.17
15.29
7.17
6.16
24.52
32.27
16.61
18.22
19.57
27.31
9.17
HPI
1999
28.11
8.56
6.23
8.11
11.31
4.13
4.37
19.58
26.67
12.48
11.76
14.85
20.96
6.17
HPI
2004
5.02

n 40 tui (%)
ng bng sng Cu Long
3.70

n 40 tui (%)
ng Nam B
8.02

n 40 tui (%)
Ty nguyn
5.86
T l ngi ln bit ch
HPI
2008
-35.8%
-36.0%
-27.7%
-36.0%
-27.4%
-26.0%
-42.4%
-29.2%
-20.1%
-17.4%
-24.9%
-35.5%
-24.1%
-23.3%
-32.8%
Thay i
1999-2004
(%)
-30.2%
-31.5%
-2.6%
-19.4%
-40.7%
-46.1%
-7.6%
-15.3%
-17.3%
-16.2%
-18.5%
-31.8%
-26.7%
-28.5%
-5.0%
Thay i
2004-2008
(%)
-55.2%
-56.2%
-29.6%
-48.4%
-57.0%
-60.1%
-46.7%
-40.0%
-34.0%
-30.7%
-38.8%
-56.0%
-44.4%
-45.1%
-36.1%
Thay i
1999-2008
(%)
-35.8%
-25.1%
-5.2%
-5.6%
-27.4%
-12.4%
-9.4%
-5.6%
-20.1%
-7.0%
-5.1%
-8.0%
-24.1%
-11.7%
-5.5%
ng gp
vo thay i
(im %)
1999-2004
-30.2%
-26.0%
-0.7%
-3.6%
-40.7%
-34.3%
-2.1%
-4.4%
-17.3%
-7.2%
-3.9%
-6.2%
-26.7%
-23.2%
-1.2%
ng gp
vo thay i
(im %)
2004-2008
-55.2%
-41.5%
-5.9%
-7.9%
-57.0%
-34.9%
-12.7%
-9.4%
-34.0%
-12.7%
-8.2%
-13.0%
-44.4%
-27.4%
-7.4%
100.0%
70.0%
14.5%
15.5%
100.0%
45.1%
34.5%
20.4%
100.0%
34.6%
25.5%
39.9%
100.0%
48.5%
23.0%
100.0%
86.1%
2.2%
11.7%
100.0%
84.2%
5.1%
10.8%
100.0%
41.6%
22.3%
36.1%
100.0%
87.1%
4.5%
100.0%
75.0%
10.6%
14.3%
100.0%
61.3%
22.3%
16.4%
100.0%
37.3%
24.2%
38.4%
100.0%
61.7%
16.6%
ng gp vo
thay i
(im %)
1999-2004
2004-2008
1999-2008
1999-2008
10
11
12
13
14
15
16
17
18
19
20
22
33
31
17
10
25
45
27
39
46
23
H Ni
Lm ng
Qung Bnh
Thanh Ha
Bnh nh
Ph Tho
Ngh An
H Tnh
Bc Giang
Ninh Bnh
Qung Ninh
Vnh Phc
Bnh Dng
H Nam
0.0658
0.0599
0.0570
0.0552
0.0549
0.0534
0.0441
0.0392
0.0324
0.0299
0.0244
0.0211
0.0197
0.0185
0.0151
B Ra-Vng
Tu
Nam nh
0.0137
0.0110
0.0108
0.0100
0.0091
0.0087
0.0071
0.0053
0.0936
H*A
Thi Bnh
Hng Yn
TP H Ch Mnh
23
18
21
Nng
24
22
Hi Phng
19
34
Bc Ninh
37
Hi Dng
C nc
Tnh
Xp hng
MPI
Xp hng
HDI
MPI
17.4
16.1
15.0
15.4
14.8
12.8
11.7
10.5
9.2
6.8
7.0
5.9
5.5
5.0
4.2
3.9
3.0
3.0
2.8
2.7
2.5
2.1
1.5
23.3
(H) (%)
T l
37.9
37.2
38.0
35.8
37.1
41.6
37.8
37.4
35.3
43.9
34.8
35.8
36.1
36.7
36.1
35.1
36.3
35.8
35.0
34.0
35.0
34.1
34.9
40.2
(A) (%)
Mc thiu
ht
T l ngho a chiu
23.8
26.6
23.5
36.3
24.2
23.7
23.3
22.4
31.8
10.3
28.7
17.4
22.6
16.7
13.4
16.7
5.0
10.8
11.2
10.9
11.4
4.6
7.5
20.2
(%)
T l ngi st
mc ngho a
chiu*
1.8
1.4
2.1
1.0
2.1
2.2
4.6
1.0
4.0
0.5
2.0
1.4
1.2
2.1
0.8
1.1
0.9
1.7
1.1
1.7
1.6
1.0
0.4
1.6
(%)
Gio dc
19.3
12.3
14.0
20.6
11.2
13.8
12.8
15.3
13.9
11.1
13.9
20.1
12.9
12.2
15.7
11.0
12.2
10.2
12.7
14.1
10.7
13.4
8.7
20.0
(%)
Y t
9.3
12.9
9.5
4.3
11.3
8.6
6.9
7.4
1.8
4.9
2.0
2.1
1.5
1.8
2.0
1.3
1.9
0.8
0.4
0.4
0.9
1.0
0.6
17.5
(%)
Mc sng
T l ngi b thiu ht **
30.6
51.8
57.4
34.1
43.4
53.2
57.4
45.7
42.5
16.8
31.3
2.2
41.5
30.6
19.1
36.3
11.0
19.9
31.0
24.8
25.4
0.8
4.9
32.9
(%)
2 $/ngy
(PPP)
14.4
22.8
26.0
13.3
16.3
25.0
28.0
16.6
11.7
6.6
10.1
0.1
8.2
7.0
5.3
8.6
2.0
4.1
7.2
4.7
8.0
0.3
0.8
13.2
(%)
18.3
23.6
26.3
13.3
17.4
24.9
28.2
17.5
12.9
7.2
11.3
0.5
8.4
7.7
7.0
8.5
3.0
4.9
7.1
5.9
8.9
0.5
1.7
14.6
(%)
T l ngho theo chun ngho

quc gia***
1.25$/ngy
Ngho
(PPP)
tin t*
Ch s ngho i a chiu v Ngho i tin t 2008
214
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
42
30
47
28
40
29
44
38
50
51
21
12
41
56
20
49
35
26
15
54
32
53
16
60
14
Ph lc
24
11
Bn Tre
Yn Bi
Kin Giang
Gia Lai
An Giang
Bc Cn
C Mau
Bc Liu
Lng Sn
Cn Th
Tuyn Quang
Tin Giang
Ninh Thun
c Lc
Long An
Ty Ninh
Ha Bnh
c Nng
Bnh Phc
Qung Ngi
Qung Nam
Tha Thin-Hu
Bnh Thun
Qung Tri
Thi Nguyn
Ph Yn
Khnh Ha
ng Nai
0.2006
0.1997
0.1987
0.1916
0.1899
0.1817
0.1806
0.1773
0.1716
0.1676
0.1577
0.1449
0.1373
0.1341
0.1309
0.1210
0.1160
0.1009
0.0928
0.0881
0.0822
0.0814
0.0784
0.0783
0.0751
0.0694
0.0685
0.0662
MPI
51.0
45.4
49.2
46.3
45.0
45.2
46.2
46.1
45.0
39.3
41.2
38.3
33.5
36.0
35.0
31.9
31.2
27.0
23.2
23.4
21.3
20.3
20.2
20.4
19.7
19.2
17.4
16.8
T l
39.3
44.0
40.4
41.4
42.2
40.2
39.1
38.4
38.1
42.6
38.2
37.8
41.0
37.3
37.4
37.9
37.2
37.4
40.1
37.6
38.6
40.0
38.8
38.5
38.1
36.0
39.4
39.5
Mc thiu
ht
T l ngho a chiu
29.2
22.4
23.8
24.9
23.1
28.4
26.2
24.2
34.1
19.5
29.0
32.3
21.2
28.7
31.5
26.1
36.0
36.4
25.9
27.2
25.3
23.2
21.1
30.6
22.6
33.1
18.9
18.4
T l ngi st
mc ngho a
chiu*
1.4
2.2
2.1
1.5
1.8
0.7
2.0
0.9
0.8
1.0
2.6
1.7
3.1
2.5
1.5
1.4
2.4
2.2
1.5
1.2
2.0
1.6
0.7
2.2
2.2
1.2
2.1
1.5
Gio dc
29.4
21.4
32.6
32.6
36.5
18.0
30.0
28.7
19.7
31.2
18.9
31.5
37.5
20.4
27.2
27.9
16.0
14.8
21.2
22.1
18.7
26.0
31.0
17.9
14.3
24.1
19.8
17.3
Y t
39.4
40.6
38.4
34.8
34.4
40.1
35.6
38.4
36.0
31.8
33.7
25.6
23.6
27.0
24.6
22.1
22.2
19.1
15.7
14.9
14.3
14.4
11.1
13.8
14.4
7.4
11.7
13.8
Mc sng
31.6
53.0
33.5
48.9
19.1
64.2
27.0
33.5
49.8
20.7
53.9
30.9
52.4
44.3
28.1
18.8
60.1
49.5
19.2
44.9
43.8
37.5
31.6
47.8
45.1
39.1
29.8
11.2
2 $/ngy
(PPP)
14.9
24.6
8.7
26.6
8.3
38.9
13.3
11.9
20.5
5.7
23.1
9.7
14.5
19.9
7.2
3.8
31.2
25.8
7.3
21.7
20.3
13.7
4.9
26.9
16.5
16.7
10.3
2.3
15.5
24.6
9.5
29.1
8.5
39.9
13.7
12.4
21.2
6.9
23.3
10.7
21.2
24.6
7.6
5.6
32.3
26.7
10.1
21.7
20.7
15.7
9.3
27.6
17.5
17.6
10.7
4.3

quc gia***
1.25$/ngy
Ngho
(PPP)
tin t*
53
54
55
56
57
58
59
60
61
62
63
52
48
36
59
57
43
55
13
62
61
63
Thnh th
0.0232
0.2004
ng bng sng Cu Long
Nng thn/Thnh th
0.1350
0.0346
0.0647
min Trung
ng Nam B
0.0132
ng bng sng Hng
Ty nguyn
0.1684
H*A
MPI
Lai Chu
in Bin
H Giang
Vnh Long
Cao Bng
ng Thp
Lo Cai
Sn La
Hu Giang
Sc Trng
Tr Vinh
Kon Tum
Trung du v min ni pha

Bc
Vng
52
58
82.3
75.0
73.0
71.3
60.9
65.6
57.0
60.1
60.6
57.7
55.0
50.1
T l
5.9
49.7
9.0
34.5
16.8
3.6
39.5
(H) (%)
T l
39.1
40.3
38.2
39.2
38.6
36.3
42.6
(A) (%)
Mc thiu
ht
7.3
24.7
12.0
26.8
24.5
13.6
23.5
(%)
T l ngi st
mc ngho a
chiu*
50.0
48.3
45.6
40.7
46.3
42.7
45.4
41.8
39.3
41.0
38.9
41.4
Mc thiu
ht
T l ngho a chiu
T l ngho a chiu
0.4119
0.3622
0.3325
0.2898
0.2819
0.2800
0.2591
0.2513
0.2379
0.2363
0.2143
0.2074
MPI
1.1
1.8
1.2
2.0
1.9
1.3
1.6
(%)
1.9
1.5
0.6
1.4
1.4
1.5
0.7
1.2
2.7
2.9
2.5
2.1
Gio dc
43.0
37.5
35.7
25.5
27.0
35.3
32.6
35.0
34.1
38.9
34.4
26.9
Y t
12.6
32.3
16.5
23.2
18.5
11.0
22.2
(%)
Y t
4.0
39.8
6.2
25.3
10.3
1.2
33.4
(%)
Mc sng
80.8
73.6
74.4
28.2
62.4
38.7
64.6
66.9
37.5
52.1
49.1
51.6
2 $/ngy
(PPP)
60.1
48.5
41.4
9.4
41.9
11.1
37.1
41.8
13.1
18.0
19.6
25.1
61.3
49.0
43.0
10.0
42.0
10.3
37.7
42.4
13.8
19.2
20.7
32.0

quc gia***
1.25$/ngy
Ngho
(PPP)
tin t*
11.3
32.0
6.9
43.1
45.3
21.9
56.1
(%)
3.8
11.1
1.8
21.1
19.5
5.4
28.4
(%)
6.7
11.7
2.8
24.9
20.4
6.8
29.2
(%)
T l ngho theo chun ngho quc

gia***
Ngho
2 $/ngy (PPP) 1.25$/ngy (PPP)
tin t*
77.7
71.0
68.6
67.2
57.2
58.8
50.0
46.0
48.6
46.7
43.7
42.1
Mc sng
Gio dc
7.8
11.3
11.4
14.8
22.0
19.4
19.4
25.3
26.9
21.0
25.6
23.2
T l ngi st
mc ngho a
chiu*
0.2638
0.0676
Dn tc thiu s
Dn tc Kinh v Hoa
0.0846
0.0479
0.0206
Trung bnh
Kh
Giu nht
0.0978
24.3
22.3
5.7
12.8
21.9
30.9
48.8
17.4
61.9
29.9
T l
40.3
40.0
36.5
37.6
38.6
39.6
42.4
38.8
42.6
40.3
Mc thiu
ht
T l ngho a chiu
20.2
20.3
10.1
17.3
24.6
25.8
24.9
19.5
25.2
25.1
T l ngi st
mc ngho a
chiu*
216
Ph lc
Ngun: Tnh ton ca TCTK cho NHDR 2011

* Ngi st mc ngho a chiu: l nhng ngi thiu ht 2 trong s 9 ch tiu s dng trong tnh ton
(tr ch tiu gio dc v y t tng hp)
** T l ngi b thiu ht
1. mt hoc hai ch tiu gio dc
2. ch tiu y t
3. ba trong s 6 ch tiu mc sng tr ln
***Ch tiu ngho tin t c da trn cc ng ngho sau:
1. 2 USD/ngy (PPP), tng ng vi 515.722,5 VND/ngi/thng nm 2008.
2. 1,25 USD/ngy (PPP), tng ng vi 322.312,8 VND/ngi/thng nm 2008.
3. Chun ngho quc gia nm 2008 l 290.000 VND/ngi/thng vng nng thn.
0.0891
Nam
Gii
0.2069
0.1224
Ngho nht
Ngho
Ng phn v thu nhp
0.1205
Nng thn
in
MPI
1.7
1.6
0.4
1.1
1.4
2.1
3.1
1.6
1.8
1.8
Gio dc
23.8
16.1
9.7
15.6
20.6
24.3
31.3
17.9
33.9
22.9
Y t
17.5
17.5
3.7
8.8
15.5
23.0
39.1
12.3
51.4
22.6
Mc sng
33.6
32.1
0.0
0.0
0.0
70.6
100.0
26.9
71.8
41.1
13.8
12.7
0.0
0.0
0.0
0.0
68.0
9.0
41.0
16.9
15.2
14.0
0.0
0.0
0.0
1.8
70.8
10.2
42.6
17.7
T l ngho theo chun ngho quc

gia***
Ngho
2 $/ngy (PPP) 1.25$/ngy (PPP)
tin t*
10 Nam nh
11 H Nam
12 Bnh Dng
13 Vnh Phc
14 Qung Ninh
15 Ninh Bnh
16 Bc Giang
17 H Tnh
18 Ngh An
19 Ph Th
20 Bnh nh
21 Thanh Ha
22 Qung Bnh
23 Lm ng
24 ng Nai
25 Khnh Ha
19
24
22
33
31
17
10
25
45
27
39
46
23
34
37
18
11
16.5
7.5
B Ra-Vng
Tu
7.7
5.6
6.0
5.7
7.7
4.6
8.7
8.1
20.3
4.3
27.5
1.4
14.3
10.5
10.3
15.5
7.3
5.0
14.9
13.3
20.0
Thi Bnh
Nng
Hi Phng
Hung Yn
Bc Ninh
24.9
6.6
4.5
TP H Ch
Minh
Hi Dng
Gio dc
61.3
42.2
59.8
31.9
41.9
77.4
30.4
50.5
49.7
51.8
58.7
51.8
60.3
69.6
72.3
69.0
64.7
65.6
58.6
68.6
75.4
76.2
59.1
65.7
64.7
54.8
45.5
29.8
61.3
39.1
56.3
79.0
44.5
49.9
49.7
44.2
83.2
40.2
71.8
85.4
94.1
78.4
58.7
79.8
39.0
95.7
91.9
78.8
73.3
59.0
80.3
43.9
1.7
24.9
9.9
0.2
6.8
2.5
1.8
22.1
1.6
2.2
2.1
38.2
0.0
4.1
0.0
0.5
5.4
3.6
0.0
0.0
2.9
2.4
0.0
1.9
2.7
11.3
in
34.5
21.9
21.7
53.9
46.7
13.9
20.1
36.0
28.0
35.8
8.1
74.0
13.4
6.1
5.8
0.0
4.0
0.0
41.1
7.7
0.0
2.4
44.5
5.5
7.0
38.5
96.4
99.4
99.2
98.4
99.8
99.6
98.4
97.3
98.9
98.8
97.1
99.1
97.5
93.7
97.7
92.9
96.7
95.8
95.0
91.3
91.0
85.7
71.7
70.2
87.2
98.9
91.4
80.9
94.1
94.7
93.3
91.6
87.3
91.9
79.3
88.8
92.2
87.3
91.6
79.3
78.5
78.1
79.2
84.3
75.8
66.6
53.8
79.8
54.7
68.1
80.0
93.7
Nc sinh Tip cn v Nh v
hot
sinh
sinh
T l ngi va ngho va thiu ht *

Mc sng
Khng c Hon thnh Con ci c

tip cn
tiu hc
i hc
H Ni
C nc
Tnh
Xp
hng
MPI
Xp
hng
HDI
Y t
42.9
66.0
34.9
21.8
20.3
9.4
72.5
33.2
32.6
46.0
12.9
9.9
12.2
31.8
8.5
24.0
55.1
24.4
31.2
24.7
8.8
12.0
27.8
71.3
30.7
47.4
Nh
19.2
14.2
7.1
23.3
17.3
13.9
9.9
32.6
25.5
7.5
5.8
30.4
11.3
6.9
34.4
40.7
10.9
26.5
22.3
32.2
56.3
20.1
23.6
6.9
22.1
12.8
Ti sn
2.17
1.58
1.75
1.71
2.26
1.44
2.60
2.16
5.95
1.28
8.65
0.36
4.55
3.25
3.16
4.70
2.31
2.32
1.53
4.62
4.21
6.55
7.89
5.39
2.10
1.24
13.47
9.40
14.06
7.00
10.28
22.07
7.37
10.47
12.51
12.57
16.64
9.95
17.03
20.18
21.10
19.46
14.95
18.89
14.67
20.24
23.26
23.06
16.40
18.96
18.76
11.82
3.78
2.65
5.85
4.00
4.36
4.73
3.17
3.83
3.39
3.34
5.98
3.88
6.30
7.75
6.55
4.40
5.45
4.44
2.48
6.05
5.04
4.28
5.15
2.69
5.98
3.25
Khng c
Hon thnh Con ci c
tip cn y t
tiu hc
i hc
0.47
6.99
2.92
0.07
1.98
0.77
0.54
5.90
0.48
0.67
0.65
9.66
0.00
1.27
0.00
0.15
1.66
1.15
0.00
0.00
0.91
0.79
0.00
0.63
0.86
3.13
in
9.73
6.15
6.37
16.09
13.66
4.32
6.02
9.59
8.24
10.63
2.54
18.74
4.28
1.89
1.77
0.00
1.23
0.00
12.59
2.39
0.00
0.79
14.12
1.80
2.22
10.66
27.15
27.95
29.11
29.38
29.19
30.96
29.46
25.96
29.05
29.31
30.61
25.10
31.12
29.07
30.06
28.09
29.75
30.35
29.12
28.34
28.87
27.99
22.76
22.86
27.78
27.35
25.73
22.74
27.60
28.28
27.28
28.47
26.15
24.52
23.30
26.34
29.04
22.11
29.21
24.59
24.15
23.61
24.35
26.73
23.22
20.68
17.06
26.07
17.35
22.19
25.47
25.91
hot
sinh
sinh
ng gp ca thiu ht tng ch tiu vo MPI (%)

Gio dc
Mc sng
Ngho i a chiu trong nhm ngi ngho v ng gp ca cc kha cnh thiu ht (%) 2008
12.10
18.55
10.25
6.52
5.94
2.92
21.72
8.86
9.59
13.64
4.06
2.50
3.89
9.87
2.62
7.27
16.93
7.73
9.55
7.68
2.79
3.92
8.84
23.23
9.79
13.10
Nh
5.40
3.98
2.09
6.94
5.05
4.31
2.95
8.71
7.48
2.22
1.82
7.69
3.62
2.14
10.58
12.31
3.36
8.39
6.84
9.99
17.86
6.56
7.49
2.25
7.03
3.54
Ti sn
29 Bnh Thun
Tha
30
Thin-Hu
31 Qung Nam
32 Qung Ngi
33 Bnh Phc
34 c Nng
35 Ha Bnh
36 Ty Ninh
37 Long An
38 c Lc
39 Ninh Thun
40 Tin Giang
41 Tuyn Quang
42 Cn Th
43 Lng Sn
44 Bc Liu
45 C Mau
46 Bc Cn
47 An Giang
48 Gia Lai
49 Kin Giang
50 Yn Bai
51 Bn Tre
52 Kon Tum
53 Tr Vinh
28
40
29
44
38
50
51
21
12
41
56
20
49
35
26
15
54
32
53
16
60
14
58
52
Ph lc
5.1
28 Qung Tri
47
218
3.1
27 Thi Nguyn
4.4
3.5
2.8
3.7
4.1
2.3
3.8
1.2
3.8
1.9
1.9
2.1
4.9
4.0
7.8
5.5
3.5
4.2
6.2
5.6
4.6
3.4
6.9
7.5
7.2
4.4
26 Ph Yn
30
58.0
60.5
53.3
42.9
56.9
73.8
64.0
35.1
52.1
48.4
37.1
62.5
33.7
62.6
74.7
44.5
53.6
59.3
36.2
42.9
58.4
66.2
53.4
61.7
68.8
57.3
38.2
65.2
41.7
31.9
33.6
34.1
45.7
52.5
43.6
28.2
59.3
44.9
36.3
50.7
39.7
45.3
48.4
38.1
37.7
54.1
46.4
35.5
56.4
40.7
36.0
40.2
71.3
32.7
49.0
75.5

tip cn
tiu hc
i hc
42
Tnh
Y t
Xp
hng
MPI
Xp
hng
HDI
3.1
1.4
3.9
46.4
9.1
4.1
10.5
15.8
14.3
2.2
21.3
4.5
1.1
0.6
4.6
13.9
2.7
4.6
3.6
11.9
6.5
4.9
3.9
3.4
3.9
1.2
6.7
2.9
in
8.1
68.0
33.2
60.3
11.4
58.6
65.9
70.0
0.3
0.1
49.4
41.1
49.2
8.1
62.8
30.7
9.8
4.7
44.3
37.8
34.9
33.4
35.6
45.0
22.3
25.4
30.0
22.6
100.0
100.0
100.0
100.0
99.0
100.0
98.1
100.0
100.0
99.8
99.6
99.2
99.8
98.7
93.9
99.9
99.5
99.9
99.7
99.9
99.8
99.9
98.8
98.4
96.6
100.0
100.0
99.8
97.2
99.3
97.9
93.3
96.5
96.2
85.3
96.2
98.5
94.9
97.8
97.1
93.0
96.4
86.1
97.9
96.1
94.4
97.2
91.8
92.6
90.6
94.2
92.4
78.0
97.3
92.0
94.6
hot
sinh
sinh

Gio dc
Mc sng
76.5
29.2
60.4
41.1
74.0
30.6
46.1
34.6
72.6
83.0
21.7
68.1
52.9
67.9
35.0
40.6
67.0
69.0
31.2
40.9
49.2
23.7
39.2
37.2
41.9
53.2
52.6
11.4
Nh
5.0
20.3
5.2
10.3
13.5
14.9
8.3
9.7
7.2
16.7
12.3
9.1
5.2
3.2
7.2
2.6
4.1
1.6
10.5
5.8
10.9
19.7
16.8
18.3
25.5
10.9
9.6
10.4
Ti sn
1.27
0.95
0.79
0.94
1.14
0.63
1.01
0.35
1.08
0.55
0.55
0.55
1.43
1.17
2.10
1.63
1.03
1.23
1.87
1.65
1.29
1.01
1.99
1.41
0.90
2.16
2.11
1.37
13.28
10.58
12.51
7.71
12.04
12.65
13.50
7.27
11.69
10.88
8.52
13.42
7.30
15.14
15.15
9.08
13.08
14.20
8.39
9.33
12.59
15.69
11.90
13.70
16.11
12.01
9.01
17.59
2.72
3.04
1.80
2.57
3.31
5.03
2.82
2.18
4.13
2.86
2.89
2.84
3.74
2.93
4.20
4.15
2.89
4.21
4.19
3.37
4.69
2.94
3.00
3.08
6.10
2.67
4.13
6.58
Khng c
Hon thnh Con ci c
tip cn y t
tiu hc
i hc
0.88
0.36
1.11
11.72
2.50
1.10
2.76
4.37
4.05
0.63
6.22
1.18
0.32
0.19
1.26
4.16
0.79
1.34
1.08
3.54
1.80
1.45
1.12
0.95
1.12
0.35
1.95
0.89
in
2.30
18.26
9.37
15.24
3.13
15.74
17.35
19.35
0.07
0.03
14.40
10.72
14.30
2.38
17.03
9.15
2.92
1.38
13.24
11.25
9.66
9.85
10.27
12.50
6.38
7.34
8.74
6.96
28.54
26.85
28.24
25.27
27.25
26.83
25.82
27.65
28.39
28.84
29.03
25.85
28.98
28.98
25.47
29.78
29.59
29.28
29.77
29.70
27.67
29.50
28.45
27.32
27.70
28.87
29.14
30.75
27.75
26.66
27.63
23.57
26.55
25.81
22.45
26.61
27.95
27.43
28.51
25.31
27.03
28.31
23.36
29.19
28.57
27.68
29.04
27.28
25.66
26.77
27.14
25.66
22.37
28.08
26.79
29.15
hot
sinh
sinh

Gio dc
Mc sng
21.83
7.84
17.06
10.39
20.37
8.22
12.12
9.56
20.60
23.98
6.31
1.43
5.45
1.48
2.60
3.70
4.00
2.18
2.67
2.04
4.81
3.58
1.52
2.37
17.76
0.95
1.95
0.76
1.22
0.46
3.12
1.72
3.01
5.81
4.84
5.07
7.32
3.16
2.81
3.20
Ti sn
15.38
19.94
9.48
12.10
19.91
20.23
9.31
12.17
13.63
6.99
11.28
10.32
12.02
15.37
15.33
3.51
Nh
56 Sn La
57 Lo Cai
58 ng Thp
59 Cao Bng
60 Vnh Long
61 H Giang
62 in Bin
63 Lai Chu
59
57
43
55
13
62
61
63
6.9
4.3
6.7
3.4
Bc Trung B v
duyn hi min
Trung
Ty nguyn
ng Nam B
ng bng
sng Cu Long
2.3
2.0
0.7
1.6
2.2
2.3
1.1
1.8
4.2
4.8
59.3
54.8
55.0
57.3
57.5
64.4
49.5
Thnh th
7.6
13.6
ng bng
sng Hng
Nng thn/Thnh th
3.0
Trung du v
min ni pha
Bc
Vng
55 Hu Giang
36
69.5
63.7
58.0
36.6
48.0
48.7
61.0
60.8
52.5
61.3
31.3
32.1
30.6
18.2
28.4
39.8
33.6
46.8
40.2
46.5
57.0
49.3
21.2
2.0
47.6
2.6
42.2
39.7
2.1
7.1
in
80.0
78.1
64.2
85.3
74.6
79.1
68.6
45.0
19.2
5.2
99.0
99.6
100.0
99.5
99.8
99.7
99.8
100.0
100.0
99.2
53.9
41.8
47.0
44.5
51.0
73.9
37.4
2.9
5.3
11.6
8.6
5.9
5.4
29.0
28.4
34.0
15.9
43.6
36.3
15.2
56.5
93.4
99.3
95.8
99.8
98.4
92.8
99.7
88.3
95.3
85.0
96.7
90.6
80.1
96.1
58.3
64.0
62.5
35.3
29.6
18.8
34.2
Nh
97.2
99.7
98.5
97.6
99.6
93.9
93.2
99.0
99.1
96.5
hot
sinh
sinh

Mc sng

tip cn
tiu hc
i hc
Gio dc

Y t
Gio dc
Mc sng
in
hot
sinh
sinh
tip cn
tiu hc
i hc
54 Sc Trng
48
Tnh
Xp
hng
MPI
Xp
hng
HDI
Y t
11.5
7.7
8.7
9.4
19.2
25.7
18.2
Ti sn
24.5
35.3
49.1
44.2
15.6
53.4
14.4
19.8
71.9
78.5
Nh
2.17
0.92
1.94
1.21
1.97
4.16
0.78
9.88
9.41
9.85
8.03
8.48
10.26
10.45
11.67
11.56
13.13
2.30
2.55
2.10
1.05
1.89
2.48
2.53
3.89
2.94
2.84
12.66
11.34
5.18
0.55
11.44
0.67
10.33
10.54
0.59
1.93
in
17.76
17.96
15.66
23.31
17.92
20.60
16.78
11.95
5.44
1.41
21.99
22.90
24.38
27.18
23.96
25.94
24.42
26.54
28.29
26.89
21.59
22.92
24.02
26.66
23.93
24.44
22.81
26.30
28.02
26.17
hot
sinh
sinh
13.71
12.12
13.01
11.09
13.38
17.72
9.39
3.73
2.69
3.79
4.47
4.02
5.26
2.91
0.82
1.45
3.38
2.45
1.70
1.67
7.55
8.06
9.37
4.61
12.36
10.46
4.66
14.71
26.54
27.40
27.85
28.31
28.32
28.41
25.97
25.10
26.28
24.71
27.41
26.08
24.53
25.03

Gio dc
Mc sng
Nc sinh Tip cn v
Hon thnh Con ci c
Nh v sinh
in
hot
sinh
tiu hc
i hc
0.50
0.45
0.18
0.44
0.54
0.60
0.28
0.48
1.17
1.30
Khng c
Hon thnh Con ci c
tip cn y t
tiu hc
i hc
Khng c
tip cn y t
35.5
18.9
27.4
2.6
33.7
4.3
36.3
12.7
5.8
18.6
Ti sn

Gio dc
Mc sng
16.58
17.64
18.17
10.02
8.53
5.74
8.90
Nh
5.43
8.12
11.97
12.06
3.75
13.89
3.52
5.26
20.35
21.28
Nh
3.28
2.12
2.54
2.67
5.54
7.86
4.75
Ti sn
7.89
4.35
6.67
0.71
8.09
1.12
8.89
3.38
1.64
5.05
Ti sn
5.4
Dn tc Kinh v
Ha
4.8
4.1
3.9
2.7
Trung bnh
Kh
Giu nht
4.7
62.0
46.2
47.4
47.9
52.0
54.5
59.5
54.0
56.4
54.4
43.0
44.7
51.2
52.2
48.4
43.8
40.0
46.6
40.0
43.2
10.9
11.8
4.9
6.4
7.4
7.6
17.5
4.8
23.3
12.0
37.2
40.1
33.2
35.3
33.9
37.2
43.2
30.9
52.6
39.3
94.9
92.6
98.8
220
Ph lc
88.3
90.6
93.1
94.3
95.1
91.6
97.5
94.1
99.0
97.8
98.1
98.8
98.9
99.3
98.3
99.9
99.3

* T l ny bao gm s ngi ngho a chiu v b thiu ht mi ch tiu trong s 9 ch tiu
Nhng ngi b thiu ht t hn 3 ch tiu khng c tnh trong t l ny.
4.3
Nam
Gii
4.8
Ngho nht
Ngho
Ng phn v thu nhp
2.8
4.3
Dn tc thiu
s
in
Nng thn
Vng

Y t
Gio dc
Mc sng
in
hot
sinh
sinh
tip cn
tiu hc
i hc
45.3
49.7
45.9
47.1
49.6
49.7
45.3
53.8
35.5
46.5
Nh
13.6
11.9
3.8
4.1
5.3
8.9
21.8
9.4
19.1
12.9
Ti sn
1.29
1.19
0.81
1.15
1.19
1.34
1.26
1.56
0.72
1.18
Khng c
tip cn y t
13.62
9.75
12.85
12.24
12.45
12.05
11.19
12.57
10.56
11.68
2.87
3.69
3.03
3.35
3.46
3.28
3.13
3.29
3.20
3.22
3.00
3.28
1.50
1.88
2.13
2.13
4.58
1.37
6.08
3.30
10.25
11.12
10.10
10.44
9.75
10.45
11.32
8.84
13.71
10.85
27.22
27.49
29.75
29.03
28.43
27.79
26.01
28.12
26.05
27.40
25.51
26.37
26.85
26.79
26.80
26.49
24.93
26.20
25.43
25.97

Gio dc
Mc sng
Nc sinh Tip cn v
Hon thnh Con ci c
Nh v sinh
in
hot
sinh
tiu hc
i hc
12.50
13.79
13.96
13.93
14.27
13.95
11.87
15.39
9.26
12.85
Nh
3.74
3.31
1.15
1.21
1.52
2.51
5.71
2.68
4.99
3.56
Ti sn
Hi Phng 0.0239
0.0386
0.0638
0.0228
0.0806
0.0522
10 Nam nh 0.0371
0.0502
Nng
11 H Nam
Bnh
12
Dng
13 Vnh Phc
Qung
14
Ninh
15 Ninh Bnh
16 Bc Giang
17 H Tnh
18 Ngh An
19 Ph Th
20 Bnh nh
Thanh
21
Ha
22
33
31
17
10
25
45
27
39
46
23
34
0.0298
B RaVng Tu
23.5
36.3
24.2
23.7
23.3
22.4
31.8
10.3
28.7
17.4
22.6
16.7
13.4
16.7
5.0
10.8
11.2
10.9
11.4
4.6
7.5
20.2
(H) (%)
Ty l ngi
ngheo a chiu
0.0537
0.0526
0.0517
0.0498
0.0707
0.0371
Thi Bnh
0.0112
0.0249
0.0241
Bc Ninh
24
Hung Yn
Hi Dng 0.0253
19
0.0103
TP H Ch
Minh
0.0167
H Ni
0.0449
H*A
C nc
Tnh
Xp Xp
hng hng
HDI MPI
MPI
2.9
0.7
2.4
3.8
9.5
2.4
3.7
2.4
2.3
2.4
1.5
4.7
2.5
3.7
1.6
7.0
4.2
5.8
6.4
6.2
0.9
1.9
Khng c
tip cn
Y t
18.0
18.3
18.1
20.9
18.8
32.2
14.1
32.9
19.5
54.4
23.4
29.3
50.7
30.6
39.2
30.4
32.9
36.1
42.5
62.8
37.4
24.0
28.0
8.6
33.5
28.0
31.0
45.9
23.3
40.2
21.8
49.6
31.5
38.6
39.7
39.9
30.7
47.0
50.9
41.8
61.6
45.4
39.4
22.4
Hon
Con ci c
thnh
i hc
tiu hc
0.0
0.0
0.0
0.1
0.4
1.2
0.9
1.1
0.0
0.0
0.0
0.5
0.0
0.0
0.0
0.0
0.0
0.6
0.3
0.0
0.0
0.7
in
Y t
4.9
4.4
3.1
6.2
11.0
8.1
0.8
24.0
1.8
1.7
0.2
0.8
1.5
0.0
16.5
1.7
0.3
3.5
12.3
3.2
3.6
6.8
98.3
99.2
97.5
95.5
97.9
97.3
94.7
95.5
96.2
95.5
96.6
91.8
95.1
91.8
92.9
95.9
86.5
84.4
93.9
76.1
87.3
96.1
68.8
77.9
59.9
64.7
44.4
42.7
78.4
24.3
77.5
36.4
68.2
62.1
31.7
65.6
33.3
52.9
51.7
59.0
17.7
22.4
56.1
61.9
1.8
1.6
11.6
2.0
12.0
7.9
2.9
5.1
0.8
3.1
2.9
1.5
15.6
1.8
10.5
1.7
4.7
1.6
7.2
28.5
7.2
6.7
1.0
0.7
2.3
2.7
1.1
1.5
0.7
10.0
0.5
3.9
3.9
4.4
2.1
1.9
4.7
3.5
9.1
2.8
7.2
2.0
4.2
1.6
1.44
0.37
1.21
1.92
4.73
1.19
1.84
1.22
1.16
1.19
0.77
2.35
1.26
1.84
0.82
3.49
2.10
2.88
3.18
3.10
0.46
1.24
7.08
6.38
7.26
7.88
7.29
12.92
5.45
13.37
7.39
23.62
9.39
12.22
19.95
12.64
16.07
12.79
14.16
14.58
19.08
26.71
15.19
11.82
4.12
1.27
4.35
4.60
4.56
6.51
3.44
5.44
2.99
4.92
3.96
4.83
5.83
4.97
4.24
5.84
7.56
6.57
8.50
4.13
5.12
3.25
0.00
0.00
0.00
0.04
0.20
0.60
0.46
0.53
0.00
0.00
0.00
0.25
0.00
0.00
0.00
0.00
0.00
0.30
0.13
0.00
0.00
3.13
2.43
2.20
1.56
3.10
5.52
4.04
0.40
12.00
0.91
0.83
0.09
0.38
0.77
0.00
8.25
0.85
0.17
1.77
6.14
1.58
1.81
10.66
49.14
49.62
48.73
47.76
48.95
48.67
47.37
47.76
48.12
47.73
48.31
45.91
47.55
45.89
46.44
47.95
43.26
42.21
46.95
38.05
43.65
27.35
2.10
3.58
34.39 0.88
38.96 0.82
29.94 5.79
32.34 1.00
22.19 6.02
21.35 3.97
39.22 1.46
12.13 2.55
38.76 0.42
18.20 1.57
34.08 1.46
31.07 0.77
15.84 7.78
32.81 0.91
16.63 5.23
26.47 0.87
25.86 2.34
29.52 0.78
8.85
0.52
0.37
1.15
1.36
0.54
0.75
0.36
5.01
0.25
1.95
1.94
2.21
1.03
0.94
2.34
1.75
4.55
1.41
3.58
11.19 14.24 1.00
28.05 3.61
25.91 13.10 3.54

Gio dc
Mc sng
Nc
Hon
Khng c
Nc sinh Tip cn Nh v
Tip cn Nh v
Con ci c
Nh Ti sn
Nh Ti sn
in
sinh
thnh
tip cn
hot
v sinh sinh
v sinh sinh
i hc
hot
tiu hc

Gio dc
Mc sng
* T l ny th hin tnh d b tn thng v ngho a chiu (khng bao gm nhng ngi b thiu ht c hai ch tiu y t v gio dc)
MPI i vi nhng ngi b thiu ht t hai kha cnh tr ln 2008
222
39
Ph lc
Ninh
Thun
38 c Lc
41
56
36 Ty Ninh
37 Long An
21
12
35 Ha Bnh
0.0472
0.0638
0.0701
0.0581
0.0800
34 c Nng 0.0809
51
0.0574
Bnh
Phc
50
0.0605
Qung
Ngi
33
0.0561
Qung
Nam
38
Tha
0.0514
Thin-Hu
28
32
0.0468
Bnh
29
Thun
47
44
25.3
0.0679
28 Qung Tri
30
31
0.0501
Thi
Nguyn
27
42
29
23.2
0.0736
26 Ph Yn
11
30
0.0421
Khnh
25
Ha
40
21.1
0.0409
24 ng Nai
21.2
28.7
31.5
26.1
36.0
36.4
25.9
27.2
30.6
22.6
33.1
18.9
18.4
23.8
23 Lm ng 0.0528
26.6
(H) (%)
18
0.0592
H*A
22
Qung
Bnh
Tnh
Ty l ngi
ngheo a chiu
37
Xp Xp
hng hng
HDI MPI
MPI
1.2
1.3
0.9
0.2
0.9
1.6
1.4
1.3
2.2
2.2
0.3
1.7
2.8
1.0
3.4
2.1
2.5
1.6
Khng c
tip cn
Y t
53.7
12.2
26.8
31.2
6.7
9.1
21.9
27.0
27.0
50.7
47.1
23.1
18.0
22.1
38.3
32.9
25.2
14.5
26.9
11.5
18.5
21.0
10.2
8.2
28.9
15.1
18.9
27.9
35.1
14.4
29.5
15.6
28.6
42.5
21.7
18.8
Hon
Con ci c
thnh
i hc
tiu hc
0.0
1.7
0.0
0.7
0.0
0.3
0.3
6.3
0.0
0.1
0.0
0.1
0.8
0.0
0.0
5.1
0.4
0.5
in
27.9
0.5
1.0
0.7
5.1
8.0
6.1
6.6
7.6
2.3
7.8
4.0
15.0
6.2
8.7
8.6
5.9
8.9
85.3
99.1
98.5
98.9
99.5
99.1
99.3
99.5
98.3
95.0
88.1
97.6
99.8
98.2
95.6
97.6
98.9
96.5
28.7
81.2
68.0
53.8
85.1
71.6
58.0
55.3
61.0
48.5
48.3
70.6
54.6
69.8
49.3
18.4
63.3
69.7
8.0
4.2
7.5
16.5
1.9
10.5
8.5
5.0
4.5
2.6
5.5
5.0
5.5
1.9
5.1
21.1
2.4
2.1
2.2
0.0
0.0
0.0
0.0
0.4
0.2
1.1
1.0
2.6
4.4
0.5
0.4
1.8
0.4
8.4
0.9
3.3
0.60
0.67
0.44
0.09
0.45
0.79
0.69
0.66
1.10
1.12
0.13
0.83
1.39
0.51
1.70
1.03
1.27
0.81
Y t
19.43
3.93
10.23
12.22
2.57
2.83
7.99
10.24
10.10
19.40
17.27
7.95
7.26
8.21
14.83
13.21
8.90
5.27
3.94
2.10
1.85
2.40
1.20
1.46
5.05
2.19
2.64
3.99
5.52
2.29
3.26
2.40
3.96
6.17
3.85
3.39
0.00
0.85
0.00
0.34
0.00
0.13
0.16
3.17
0.00
0.07
0.00
0.07
0.41
0.00
0.00
2.55
0.22
0.27
13.93
0.24
0.49
0.35
2.53
4.00
3.07
3.31
3.81
1.13
3.92
2.00
7.51
3.08
4.34
4.30
2.97
4.44
42.67
49.54
49.26
49.44
49.74
49.55
49.66
49.77
49.13
47.49
44.05
48.80
49.91
49.08
47.78
48.82
49.46
48.24
0.46
1.67
14.35 3.98
40.59 2.09
34.01 3.73
26.90 8.26
42.57 0.93
35.81 5.23
29.01 4.27
27.65 2.49
30.48 2.26
24.23 1.29
24.15 2.76
35.30 2.52
27.28 2.77
34.91 0.93
24.65 2.53
1.10
0.00
0.00
0.00
0.00
0.20
0.09
0.53
0.49
1.28
2.20
0.24
0.22
0.88
0.21
9.21 10.54 4.18
31.66 1.21
34.87 1.05

Gio dc
Mc sng
Nc
Hon
Khng c
Nc sinh Tip cn Nh v
Tip cn Nh v
Con ci c
Nh Ti sn
Nh Ti sn
in
sinh
thnh
tip cn
hot
v sinh sinh
v sinh sinh
i hc
hot
tiu hc

Gio dc
Mc sng
42 Cn Th
43 Lng Sn
44 Bc Liu
45 C Mau
46 Bc Cn
47 An Giang
48 Gia Lai
49 Kin Giang 0.0529
50 Yn Bai
51 Bn Tre
52 Kon Tum
53 Tr Vinh
35
26
15
54
32
53
16
60
14
58
52
0.0432
0.0432
57 Lo Cai
ng
58
Thp
59 Cao Bng
60 Vnh Long 0.0330
61 H Giang
62 in Bin
63 Lai Chu
57
43
55
13
62
61
63
7.8
11.3
11.4
14.8
22.0
19.4
19.4
25.3
26.9
21.0
25.6
23.2
29.2
22.4
23.8
24.9
23.1
28.4
26.2
24.2
34.1
0.0172
0.0251
0.0253
0.0490
0.0562
56 Sn La
59
0.0468
54 Sc Trng
55 Hu Giang 0.0599
48
36
0.0570
0.0515
0.0650
0.0498
0.0554
0.0513
0.0632
0.0582
0.0538
0.0758
0.0434
19.5
29.0
49
0.0644
32.3
(H) (%)
Tuyn
41
Quang
H*A
40 Tin Giang 0.0717
Tnh
Ty l ngi
ngheo a chiu
20
Xp Xp
hng hng
HDI MPI
MPI
0.3
0.5
0.0
0.7
0.0
0.0
0.0
0.3
0.6
0.5
0.3
0.4
0.0
1.6
0.4
1.3
0.2
0.3
0.8
0.0
0.0
0.8
1.3
0.3
Khng c
tip cn
Y t
7.3
6.1
7.0
9.5
3.3
13.9
13.2
8.9
15.0
25.3
14.5
6.2
14.0
10.7
17.7
15.7
32.2
8.9
15.9
24.5
5.1
22.8
8.6
22.8
4.3
4.0
7.5
11.2
3.5
13.0
14.8
1.1
6.5
10.3
5.6
3.7
6.3
13.5
10.5
11.9
18.0
10.9
14.3
22.5
6.0
18.2
13.8
14.0
Hon
Con ci c
thnh
i hc
tiu hc
24.9
0.0
0.0
0.0
0.0
0.0
4.7
0.4
0.0
0.8
0.4
0.0
0.5
1.5
3.5
0.5
0.0
0.0
1.0
0.6
0.7
0.0
0.0
0.0
in
17.0
11.0
9.0
27.7
3.2
38.2
11.1
5.6
0.5
0.2
0.0
0.8
2.9
2.1
1.8
15.2
39.1
21.7
0.0
0.0
6.9
12.3
6.2
0.3
85.3
91.7
100.0
97.4
97.5
94.6
98.1
98.1
99.0
95.5
99.4
98.3
99.0
98.3
94.8
97.3
91.8
99.6
99.3
98.5
100.0
94.7
99.4
97.2
62.9
85.0
81.3
60.3
94.0
45.1
68.4
87.5
81.3
65.7
79.1
92.8
81.1
66.6
67.6
70.4
31.4
61.8
74.6
59.5
86.5
67.2
68.1
68.3
3.8
5.9
1.4
4.0
1.1
7.1
2.0
2.1
5.8
16.3
8.5
2.7
4.3
17.8
15.5
2.0
7.9
5.6
9.2
16.0
0.7
3.5
14.7
13.4
0.0
0.0
1.1
0.2
0.9
1.3
1.8
0.0
0.0
0.0
0.0
0.0
0.1
0.0
0.7
0.0
1.1
1.1
0.0
1.1
0.0
0.3
0.0
0.2
0.16
0.26
0.00
0.36
0.00
0.00
0.00
0.15
0.28
0.25
0.15
0.22
0.00
0.81
0.18
0.65
0.11
0.17
0.41
0.00
0.00
0.40
0.65
0.17
Y t
2.13
2.23
2.36
3.62
1.25
5.23
4.65
2.83
5.69
9.37
5.38
1.72
5.30
3.96
6.41
4.39
12.39
3.61
5.95
9.43
1.85
8.60
3.42
8.72
0.72
0.63
1.24
1.19
0.46
1.63
2.25
0.18
0.74
1.20
0.79
0.78
0.74
2.04
1.42
2.29
1.84
1.33
1.58
2.74
0.78
2.03
1.73
1.40
12.43
0.00
0.00
0.00
0.00
0.00
2.37
0.20
0.00
0.38
0.19
0.00
0.23
0.77
1.75
0.26
0.00
0.00
0.52
0.29
0.34
0.00
0.00
0.00
8.50
5.52
4.50
13.83
1.58
19.08
5.56
2.78
0.23
0.08
0.00
0.40
1.46
1.05
0.89
7.60
19.55
10.85
0.00
0.00
3.43
6.13
3.10
0.13
42.67
45.87
50.00
48.71
48.74
47.32
49.07
49.07
49.50
47.74
49.68
49.16
49.52
49.16
47.42
48.65
45.92
49.78
49.65
49.25
50.00
47.37
49.70
48.61
31.47 1.91
42.52 2.96
40.63 0.70
30.17 2.00
46.98 0.56
22.53 3.56
34.18 1.02
43.73 1.07
40.66 2.90
32.83 8.15
39.56 4.26
46.38 1.33
40.56 2.13
33.28 8.92
33.79 7.77
35.19 0.99
15.69 3.94
30.92 2.78
37.30 4.59
29.74 8.01
43.24 0.37
33.59 1.74
34.03 7.36
34.15 6.72
0.00
0.00
0.57
0.10
0.43
0.65
0.90
0.00
0.00
0.00
0.00
0.00
0.06
0.00
0.36
0.00
0.56
0.55
0.00
0.54
0.00
0.13
0.00
0.11

Gio dc
Mc sng
Nc
Hon
Khng c
Nc sinh Tip cn Nh v
Tip cn Nh v
Con ci c
Nh Ti sn
Nh Ti sn
in
sinh
thnh
tip cn
hot
v sinh sinh
v sinh sinh
i hc
hot
tiu hc

Gio dc
Mc sng
26.8
12.0
24.7
0.0595
0.0266
Ty nguyn
ng Nam B
ng bng sng
0.0549
Cu Long
Nng thn
0.0432
Dn tc Kinh v
Ha
0.0223
Giu nht
0.0448
0.0449
C nc
20.2
20.2
20.3
10.1
17.3
24.6
25.8
24.9
19.5
25.2
25.1
1.9
1.7
2.1
1.1
1.9
1.5
1.9
2.7
2.2
0.5
1.8
2.7
0.4
2.5
1.5
2.6
3.5
1.3
24.0
31.7
15.7
26.6
26.1
24.1
22.2
20.9
26.3
10.6
22.7
35.2
20.8
41.6
15.3
25.5
29.3
13.8
22.4
21.1
23.6
31.1
32.9
24.6
20.9
12.8
25.9
7.6
21.7
29.7
13.0
37.3
12.7
22.9
37.4
18.3
Hon
Con ci c
Khng c
thnh tiu
i hc
tip cn
hc
Y t
224
Ph lc
0.7
0.6
0.8
1.8
0.9
0.5
0.6
0.4
0.7
0.5
0.7
0.7
0.5
1.6
0.9
0.6
0.3
0.9
in
Y t
95.7
96.1
6.5
6.8
96.6
97.2
96.0
95.8
96.1
96.7
95.5
99.5
97.4
84.8
96.7
93.4
98.6
96.7
92.3
98.4
7.2
14.0
8.5
7.2
5.6
4.1
7.2
4.9
6.7
8.4
9.9
4.4
5.8
6.9
3.3
7.5
61.9
57.5
66.4
48.0
54.1
61.3
65.6
71.0
57.9
81.7
63.2
50.0
64.0
34.1
74.7
61.9
59.7
69.5
6.7
6.4
6.9
7.5
8.2
6.9
6.0
5.5
7.4
3.2
5.7
15.2
9.4
17.4
3.9
3.7
3.4
6.4
1.6
1.7
1.4
1.3
1.2
1.6
1.7
1.7
1.8
0.3
1.4
2.9
0.4
3.4
0.2
1.7
3.6
0.7
1.24
1.29
1.19
0.81
1.15
1.19
1.34
1.26
1.56
0.72
1.18
2.17
0.92
1.94
1.21
1.97
4.16
0.78
Khng c
Nc Tip cn Nh v
Nh Ti sn
tip cn
sinh hot v sinh
sinh

Gio dc
Mc sng
SNgun: Tnh ton ca TCTK cho NHDR 2011

* T l ny bao gm s ngi ngho a chiu v b thiu ht mi ch tiu trong s 9 ch tiu
Nhng ngi b thiu ht t hn 3 ch tiu khng c tnh trong t l ny.
0.0450
Nam
Gii
0.0547
0.0385
Trung bnh
Kh
0.0552
0.0573
Ngho nht
Ngho
Ng phn v thu nhp
0.0559
Dn tc thiu s
in
0.0163
0.0558
Thnh th
7.3
24.5
0.0544
Bc Trung B v
duyn hi min
Trung
Nng thn/Thnh th
13.6
ng bng sng
0.0303
Hng
(H) (%)
23.5
H*A
Ty l ngi ngheo
a chiu
Trung du v min
0.0523
ni pha Bc
Vng
MPI
11.82
13.62
9.75
12.85
12.24
12.45
12.05
11.19
12.57
10.56
11.68
13.71
12.12
13.01
11.09
13.38
17.72
9.39
3.25
2.87
3.69
3.03
3.35
3.46
3.28
3.13
3.29
3.20
3.22
3.73
2.69
3.79
4.47
4.02
5.26
2.91
Hon
Con ci c
thnh
i hc
tiu hc
3.13
3.00
3.28
1.50
1.88
2.13
2.13
4.58
1.37
6.08
3.30
0.82
1.45
3.38
2.45
1.70
1.67
7.55
in
10.66
10.25
11.12
10.10
10.44
9.75
10.45
11.32
8.84
13.71
10.85
8.06
9.37
4.61
12.36
10.46
4.66
14.71
27.35
27.22
27.49
29.75
29.03
28.43
27.79
26.01
28.12
26.05
27.40
26.54
27.40
27.85
28.31
28.32
28.41
25.97
8.53
5.74
8.90
5.54
7.86
4.75
9.26
4.99
25.91 13.10 3.54
25.51 12.50 3.74
26.37 13.79 3.31
26.85 13.96 1.15
26.79 13.93 1.21
26.80 14.27 1.52
26.49 13.95 2.51
24.93 11.87 5.71
26.20 15.39 2.68
25.43
25.97 12.85 3.56
25.10 16.58 3.28
26.28 17.64 2.12
24.71 18.17 2.54
27.41 10.02 2.67
26.08
24.53
25.03
Nc Tip cn v Nh v
Nh Ti sn
sinh hot sinh
sinh

Gio dc
Mc sng
25
11
Khnh Ha
ng Nai
Lm ng
Qung Bnh
Thanh Ha
Bnh nh
Ph Th
Ngh An
H Tnh
Bc Giang
Ninh Bnh
Bnh Dng
23
24
22
37
18
20
21
23
19
46
34
17
18
27
39
16
45
Qung Ninh
14
15
25
Vnh Phc
12
13
17
10
H Nam
Nam nh
10
2.15
1.46
1.80
1.39
2.10
1.01
2.15
2.19
4.62
1.04
4.05
0.51
1.98
1.36
1.23
2.13
0.77
B Ra-Vng
Tu
11
1.09
0.86
1.73
1.06
1.67
1.62
1.03
0.44
1.61
Thi Bnh
33
22
Nng
Hi Phng
Hng Yn
Bc Ninh
Hi Dng
TP H Ch Minh
H Ni
C nc
Tnh
31
24
19
Xp hng
MPI
Xp hng
HDI
20.50
16.53
19.22
10.58
12.23
22.53
9.44
12.53
11.83
14.12
11.77
10.19
13.26
20.52
11.79
11.48
16.00
10.28
12.34
8.72
11.00
13.51
9.17
14.64
8.46
20.42
17.00
17.77
18.54
15.31
17.21
13.81
16.25
16.30
13.21
17.91
17.22
14.03
14.53
20.58
15.06
13.21
14.33
12.42
11.33
16.00
17.50
15.24
14.41
11.16
10.62
18.95
0.29
5.10
1.83
0.18
1.02
0.38
0.27
2.85
0.28
0.51
0.49
2.85
0.00
0.24
0.16
0.33
0.22
0.14
0.00
0.00
0.08
0.13
0.18
0.04
0.12
2.80
7.87
5.53
6.44
11.52
8.48
4.23
3.73
6.28
5.87
5.56
1.00
7.64
1.46
0.65
0.36
0.20
0.53
0.00
2.62
0.42
0.19
0.45
3.38
0.48
0.57
10.61
59.51
66.51
69.54
75.26
80.01
77.60
84.57
78.07
84.95
86.48
69.20
47.40
73.54
56.85
70.06
61.35
45.94
59.81
17.28
40.85
44.67
30.03
63.84
15.50
24.14
67.89
26.44
17.27
31.73
35.68
31.30
42.92
30.00
29.43
21.03
19.90
39.78
9.45
32.67
11.58
22.49
19.68
8.29
23.91
4.14
8.97
11.86
16.07
4.39
2.68
6.87
35.67
Y t
Gio dc
Mc sng
Thnh vin h c nguy Thnh vin h t 15
Khng c in Ngun nc
iu kin v Nh v sinh
c b tn thng do tui tr ln cha hon Tr em t 6 n 18 tui dng lm
khng an
sinh khng
khng t
tip cn hn ch dch
thnh gio dc tiu
hin khng i hc
ngun thp ton hoc b
m bo
tiu chun
v y t
hc
sng chnh
nhim
T l phn trm dn s b thiu ht tng kha cnh (y t, gio dc v mc sng) 2008
8.91
15.06
7.08
4.37
3.56
2.09
13.66
4.80
6.81
6.63
2.11
1.55
1.09
2.49
1.23
1.47
4.57
1.53
2.12
1.03
1.41
0.65
1.69
3.78
1.33
12.71
Nh tm
3.53
3.91
1.49
5.18
3.00
2.41
2.09
4.89
3.22
1.20
0.79
3.70
1.02
1.72
3.17
2.83
0.73
1.35
1.15
1.54
2.97
0.88
1.55
0.29
0.98
3.40
Thiu ti sn
226
51
14
Ph lc
49
50
16
48
53
60
46
47
54
45
15
32
43
44
35
42
26
40
41
20
39
56
49
37
38
12
36
21
41
34
35
50
33
38
51
31
32
29
30
40
44
28
29
47
28
26
27
42
30
Xp hng
MPI
Xp hng
HDI
1.19
Bn Tre
Yn Bai
Kin Giang
Gia Lai
An Giang
Bc Cn
C Mau
Bc Liu
Lng Sn
Cn Th
Tuyn Quang
Tin Giang
Ninh Thun
c Lc
Long An
Ty Ninh
Ha Bnh
c Nng
Bnh Phc
Qung Ngi
1.44
2.18
2.15
1.54
1.84
0.66
2.00
0.87
0.84
1.04
2.58
1.67
3.14
2.50
1.52
1.38
2.36
2.23
1.52
1.16
2.03
1.64
Tha
Thin-Hu
Qung Nam
0.74
2.23
2.21
Bnh Thun
Qung Tri
Thi Nguyn
Ph Yn
Tnh
32.55
21.59
34.55
37.43
40.20
17.97
29.49
29.94
18.95
32.00
16.08
33.75
42.82
20.83
28.83
28.80
14.04
15.98
20.42
24.12
19.84
29.06
31.32
19.46
12.28
23.17
18.53
21.30
28.02
30.69
27.79
18.78
35.06
28.23
19.86
30.22
24.65
24.79
26.70
19.85
22.08
25.29
21.62
13.30
23.05
13.65
14.54
16.22
27.66
13.60
21.48
22.12
2.13
21.41
5.42
2.03
4.71
7.14
6.85
1.14
9.83
1.78
0.45
0.25
1.55
5.51
0.93
1.63
1.13
3.31
1.59
2.87
0.83
0.72
0.79
0.29
1.51
0.55
17.78
27.85
6.03
34.05
38.90
38.06
0.12
0.05
24.58
19.11
22.09
3.19
28.93
11.35
3.75
1.68
16.27
13.13
10.32
10.11
9.65
9.89
6.16
7.26
9.42
6.39
94.21
87.05
85.12
83.20
80.57
94.17
88.63
88.11
90.02
70.94
88.56
86.85
66.27
83.21
90.78
89.31
88.18
92.46
89.80
88.22
84.64
70.12
64.04
80.73
79.27
81.22
73.83
57.86
63.70
62.74
46.78
61.27
65.17
58.55
73.92
51.42
58.41
59.29
36.04
59.14
55.45
44.37
61.24
52.12
36.64
36.69
35.90
30.90
27.98
42.32
30.82
42.31
Y t
Gio dc
Mc sng
Khng c in Ngun nc
iu kin v Nh v sinh
khng an
sinh khng
khng t
tip cn hn ch dch
thnh gio dc tiu
hin khng i hc
ngun thp ton hoc b
m bo
tiu chun
v y t
hc
sng chnh
nhim
32.42
23.44
40.52
14.89
22.66
17.66
36.26
42.84
10.01
27.64
26.53
31.86
13.54
15.92
26.24
27.11
10.39
14.86
14.06
7.01
9.49
8.27
10.41
12.37
11.80
2.81
Nh tm
2.70
4.67
6.87
6.89
4.01
4.68
3.34
7.94
5.52
3.63
2.16
1.35
2.87
0.94
1.43
0.50
3.46
1.70
2.57
4.90
3.83
5.00
6.29
2.46
2.00
2.58
Thiu ti sn
63
63
Lai Chu
in Bin
1.30
1.94
ng bng sng
Hng
Bc Trung B v
duyn hi min
Trung
1.58
Trung du v
min ni pha
Bc
Vng
62
61
H Giang
Vnh Long
Cao Bng
ng Thp
Lo Cai
Sn La
Hu Giang
Sc Trng
Tr Vinh
Kon Tum
Tnh
2.05
1.89
1.54
0.56
1.41
1.37
1.51
0.74
1.22
2.66
2.92
2.52
32.39
57.60
46.79
42.70
28.27
29.83
36.19
36.99
39.72
36.13
42.77
37.20
18.57
10.11
22.61
16.83
13.57
22.15
Y t
Gio dc
Thnh vin h
Thnh vin h t
Tr em t 6 n 18
c nguy c b tn
15 tui tr ln cha
tui hin khng
thng do tip cn hon thnh gio dc
i hc
hn ch dch v y t
tiu hc
60
61
13
62
58
59
43
57
57
55
55
56
36
54
48
59
52
53
58
52
Xp hng
MPI
Xp hng
HDI
1.13
0.31
11.70
8.11
1.16
24.23
Khng c in
Ngun nc
dng lm
khng an ton
ngun thp
hoc b nhim
sng chnh
27.07
26.77
24.65
15.99
19.88
30.87
23.87
29.95
27.40
31.13
24.48
18.39
74.97
46.22
87.31
80.91
92.12
90.00
88.86
90.49
87.96
91.53
87.19
91.56
98.85
88.60
91.18
31.55
14.56
54.99
Nh v sinh khng
t tiu chun
Mc sng
67.95
60.57
47.90
64.91
47.26
59.43
41.29
28.44
11.76
3.03
4.44
34.75
iu kin v sinh
khng m bo
49.98
36.97
15.49
1.44
29.02
1.70
25.00
23.93
1.26
4.27
1.89
0.68
6.05
1.37
15.20
Nh tm
85.10
84.48
81.12
78.61
82.12
70.37
66.55
81.96
81.89
69.49
74.00
74.62
Y t
Gio dc
Mc sng
Khng c in Ngun nc
iu kin v Nh v sinh
khng an
sinh khng
khng t
tip cn hn ch dch
thnh gio dc tiu
hin khng i hc
ngun thp ton hoc b
m bo
tiu chun
v y t
hc
sng chnh
nhim
20.76
27.50
36.37
32.23
10.04
37.13
8.69
12.43
45.12
49.40
44.56
15.60
29.23
14.17
20.09
1.89
20.71
3.08
21.38
7.64
3.52
10.74
2.75
10.17
Thiu ti sn
3.77
1.65
7.42
Thiu ti sn
Nh tm
1.17
1.80
ng Nam B
ng bng sng
Cu Long
1.82
Nng thn
1.58
2.13
1.42
1.12
0.44
Ngho
Trung bnh
Kh
Giu nht
228
Ph lc
1.55
1.67
Nam
Gii
3.14
Ngho nht
Ng phn v thu nhp
1.85
Dn tc thiu s
Dn tc Kinh v
Hoa
in
1.06
Thnh th
Nng thn/Thnh th
2.04
Ty nguyn
Vng
25.42
15.07
9.15
14.89
20.54
25.60
36.41
17.97
38.09
23.54
12.61
34.40
17.06
24.76
18.04
19.82
11.89
17.80
19.68
20.34
22.62
17.28
27.65
20.50
13.66
26.72
15.94
21.55
Y t
Gio dc
Thnh vin h
Thnh vin h t
Tr em t 6 n 18
c nguy c b tn
15 tui tr ln cha
tui hin khng
thng do tip cn hon thnh gio dc
i hc
hn ch dch v y t
tiu hc
2.78
2.81
0.54
0.98
1.74
2.53
8.64
1.00
14.56
3.75
0.30
2.77
1.25
3.22
10.57
10.66
3.60
6.34
9.44
13.21
22.20
7.06
33.87
13.60
2.78
19.42
2.18
17.72
Khng c in
Ngun nc
dng lm
khng an ton
ngun thp
hoc b nhim
sng chnh
67.54
68.26
36.23
57.56
76.51
81.77
91.36
63.53
96.46
85.12
22.80
87.49
41.41
80.47
iu kin v sinh
khng m bo
35.37
35.98
10.36
22.08
37.23
47.75
65.54
28.72
81.12
45.52
9.88
63.50
12.09
54.16
Nh v sinh khng
t tiu chun
Mc sng
12.61
12.81
3.65
8.02
12.79
17.18
23.68
11.15
22.91
15.52
5.35
34.63
8.38
13.45
Nh tm
3.75
3.04
0.50
0.79
1.68
3.30
11.11
2.10
11.91
4.25
1.18
3.94
1.28
3.33
Thiu ti sn
Ph lc 230
Copyright November 2011

25-29 Phan Bi Chu
H Ni, Vit Nam

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Dch v x hi

Bn quyn thng 11 nm 2011

Mi nm trc, Bo co pht trin con ngi u

Bo co Pht trin Con ngi 2011

Khi nim pht trin con ngi c cp

Ln u tin ti Vit Nam, Bo co cng gii thiu

cung cp mt c hi cn nhc xem lm th no

Gio s-Tin s Nguyn Xun Thng

Bo co Pht trin Con ngi 2011

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Kinh t, VASS), Nicola Jones (Vin pht trin quc

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