HUYN EAKAR, K LKBO CO TM TTKt Qu Tham Vn Ngi Dn V Dch V Cng
TiBQL Chng trnh h tr Pht trinhuyn EAKARGII
THIUThng5nm2009,BanQunldnEakarvtchcActionAid Vit Nam (AAV) phi hp
cng cc ban ngnh huyn v x t chc ly kin ngi dn v 03 loi dch v cng gm:
Y t, Gio dc, v dch v hnh chnh cp x. Qu trnh ly kin c cc c quan a
phng vngidnnghvthamgiatchcc.Ktqunhgic
trnhbyviccngnhgiodc,yt,nivcahuynv03x.Cc bn cng tho lun cam kt ci
thin dch v v ngh tip tc cthmthamvnvonhngnmtiptheocthmthngtint ngi
dn. tip tc c thm cc kin ca ngi dn v cc dch v thit yu, Ban Qun l DA9
- Eakar, vi s h tr k thut ca t chc AAV cng
cccquanaphngvngidntchctnhgiln2.y cng l hot ng quan trng thuc khun
kh d n Tng cng s tham gia ca ngi dn vo qu trnh ci cch hnh chnh cng
Vit Nam do DANIDA ti tr.MC TIUGip ngi dn, vi t cch l ngi s dng dch
v, nhn xt v by t mc hi lng v cc dch v cng ti a
phng;Htrcccquanqunlvmtsnvcungngdchvnhn
nhnlichtlng,cchthccungngdchvcamnhtquan im ca ngi dn;Da trn kt qu
tham vn v thng qua qu trnh i thoi, chia s thng tin, cc bn s cng a
ra gii php v cam kt ci thin dch v cng c nh gi;Kt qu nh gi cng l c s
theo di v i chiu vi cc nh gi sau ny.PHNG PHP NGHIN CUp dng phng php
Th bo co cng dn;Cn b a phng v nhm nghin cu cng thit k bng
hi;Phngvntheobnghicutrc379hdnclachnngu nhin ti 3 x C Ni, C Hu, v
Eaar;X l s liu thu thp c bng phn mm thng k SPSS;Bng 1: Cc thng tin
c bn v mu iu traTiu chS lng T l (%)S x3 19S thn/bun20 42S h c tham
vn379 -Nhm dn tcNgi Kinh258 68,3Ngi 114 30,2Ngi dn tc khc 7 1,5Loi
hH ngho85 22,5H trung bnh278 73,5H kh15 4,0PHNG PHP NGHIN CUCC PHT
HIN CHNHDCH V Y TMC TIP CN Trong nm va qua, trn 2/3 (68,3%) s h i
khm cha bnh ti cc c s y t x/huyn. Phn ln cc h c th khm cha bnh, th
bo him y t, t l c th l:- Trn 3/4 h ngi Kinh- Gn 98,6% h ngi H ngho
(81,8%) v h ngi (87,1%) thng khm cha bnh ti trm y t x hn so vi h kh
(40%) v h ngi Kinh (46,3%).IU KIN VT CHT, TRANG THIT B
Nhnchungngidnchorngiukincsvtcht trmytxcnnghonnvthiuthncham bo cht
lng khm cha bnh vi t l ngi dn phn nh khong 30% tt c cc kha cnh. c
bit, hn mt na cho rng trang thit b khm cha bnh va thiu li va lc hu.
iu kin bnh vin c nh gi l y hn trm y t x. Tuy vy, khong 50% ngi dn
nhn xt rng iu kin c s bnh vin v s lng nhng cht lng th cha tt.CHT
LNG DCH V Y TCht lng dch v nhn theo kha cnh phc v ngi dn c nh gi
tng i tt. tuyn huyn, ngi dn phi ch i lu hn tuyn x. tuyn x phn ln
ngi dn c khm cha trong vng 30 pht trong khi tuyn huyn ph bin phi i
t 30 n 60 pht.Gi gic lm vic ca cn b nhn chung l m bo, nhng cng c gn
20% phn nh cn b khng m bo thi
gian.Thinhnvinnhnchungcnhgitt,trongcnb tuyn x nim n hn tuyn
huyn.Tuy vy, vn c kh nhiu kin cho rng cn b y t cha tn tnh gii
thchnhngthcmccangidn.C15,8%sbnhnhnphn
nhthcmccahkhngcgiithchthangvthmch 8,4% khng c gii thch.CHI PH KHM
CHA BNHPhn ln ngi dn s dng th khm cha bnh, th bo him y t nn gn 2/3
ngi dn khng phi tr ph khi phm cha
bnh.Vinhngngiphithanhtonthchiphivihlkhcao. Chi ph trung bnh cho ln
khm cha bnh gn nht tng i cao (250000 ng). C 15,8% nhng bnh nhn phi
tr tin cho rng chi ph cao v rt cao. Hin tng ngi dn phi tr cc khon
chi ph ngoi ha n l rt t (2,5%).MC HI LNGNhn chung ngi dn kh hi lng
vi cht lng dch v khm cha bnh c tuyn x v tuyn huyn. Tnh theo thang
im 10, s hi lng ca ngi dn vi tuyn x l 7,5 v tuyn huyn l 7,2. c bit,
ngi dn hi lng nht vi cc kha cnh lin quan n cht lng phc v nh vn th
tc giy t, thi ca cn b y t, vi trn 55% ngi dn cm thy hi lng v rt hi
lng.DCH V Y T0 10 Cht lng khm cha bnh bng BHYT Th tc khm cha bnh
bng BHYT Tnh r rng v cc chi ph Chi ph khm, cha bnh Trnh chuyn mn ca
y, bc s Thi phc v, khm v cha bnh Cht lng khm, cha bnh iu kin c s vt
cht, trang, thit b Thi gian ch i khm, cha bnh Yu cu v th tc, giy tY
t x Y t huyn20 30 40 50 60 70
80Tuyvy,ngidnvnchathamnvimtskhacnhnhiu kin c s vt cht, th tc khm
cha bnh bng th khm cha bnh, BHYT ( tuyn x), v tnh trng qu ti ( tuyn
huyn). T l ngi dn cm thy rt khng hi lng v khng hi lng vi cc kha cnh
ny l trn 20%.GI CI THIN DCH VBa gi ci thin dch v c phn ln ngi dn a
ra l: Ci thin cht lng phng, c s vt cht, trang thit b khm cha bnh
(66,7% kin); Tng cng trnh chuyn mn ca y, bc s (62,5%); Gim chi ph
khm, cha bnh (47,5% kin);DCH V GIO DCMC TIP CNMt t l kh cao h dn c
con, chu ang trong tui i hc. Trong t l h c con ang i hc l 62,1%.
Tuy nhin, c ti 17,5% h c tr em b hc; t l ny rt cao cc h ngi
(29,6%), gp trn 3 ln so vi t l h ngi Kinh.Cc chnh sch u tin v gio
dc nh min, gim hc ph v pht sch giokhoaminphcthchintt.Tlhngic hng
chnh sch l trn 90%. Vi h ngi Kinh th t l ny nh hn nhiu, ch l 17,6%,
do chnh sch ch u tin cho h ngho. th 1: Mc ngi dn hi lng vi dch v y
tCHT LNG GIO DCNgi dn cha thc s nh gi cao cht lng dch v gio dc.
Nhiu vn v cht lng c h phn nh, c bit l cc vn v ro cn ngn ng, v vn hc
ph o v khi lng hc tp.21,2% gia nh cho bit con em h gp kh khn v ngn
ng trong giao tip vi gio vin;31,6% gia nh cho bit nh trng c yu cu
hc ph o;73,9% gia nh cho con i hc ph o;Trong s gia nh cho con i hc
thm th 90,7% tin rng con khng kin thc nu ch hc chnh
kho;26,5%gianhchorngkhilnghctpcaconemhlrt nng;Tuy vy, mt s kha cnh
nh trnh chuyn mn, phng php ging dy v ng x ca gio vin c ngi dn khen
ngi. C trn 83% nh gi tt phng php, chuyn mn, v ng x ca gio vin.CHI
PH CHO GIO DCNhn chung, vi mc sng ca ngi dn a phng, chi ph gio dc
choconemlmtkhontintngiln.Mcdchng nhiu chnh sch u tin nhng chi ph
cho gio dc trung bnh trong nmcaccgianhkhcaovtngtheocphc.Bnhqunt821
nghn ng/HS cp 1 n 1,4 triu ng/HS cp 3.iu ny l do ngoi hc ph, hu ht
cc gia nh phi ng kh nhiu cc khon ph khc. Nh vy, cc gnh nng ti chnh
ca gio dc c chuyn t hc ph sang cc khon ng gp khc nh ng gp xy dng
trng, tin bo v trng, tin in, nc. Thm vo , nhiu chi ph khc ngi dn
phi ng thng qua cc loi qu nh qu ph huynh hc sinh, qu khuyn hc, qu
lp. Ngoi ra, gia nh cho con em
ihccnphichiphchotinmuangphc,tinmuaschv,v tin lao ng. DCH V GIO DCMC
HI LNG V DCH VXttrnnhiumt,ngidn tng i hi lng vi dch v gio dc c 3
cp. Th hin mc hi lngtheothangim10,ngi dn tha mn cao nht vi bc tiu
hc vi im trung bnh l 7,6 im vthpnhtvibcTHPTvi7,4 im. Kha cnh c ngi
dn hi lngnhtlmiquanhgianh trngvgianh:phngphp ging dy, trnh chuyn mn
v ngxcagiovin,cstrng lp. T l ngi dn hi lng vi cc kha cnh trn chim
gn 50%.Tuy nhin, v cc khon ng gp thtlngkngidnbyt
skhnghilng.Chckhong trn di 20% hi lng v cc khon ng gp cho nh trng.
th 2: Mc ngi dn hi lng vi dch v gio dc cc cpGI CI THIN DCH V
Ngidnchorngcccithinkhthinhtvcnthitnht bao gm: H tr thm c s vt cht,
trang thit b dy v hc (68,3% kin); Tng cng quan h gia nh trng vi gia
nh (52,5%); Gim hoc b cc khon ng gp do nh trng yu cu (51,4%
kin).9080706050403020100Mi quan hgia nh trngv ph huynhChng trnh,ni
dung hc tpPhng phpgin dy vhc tpCp 1 Cp 2 Cp 3ng x cagio vin vihc
sinhC s vt cht,trang thit bdy v hcCc khonng gpDCH V TH TC HNH
CHNHCP XMC S DNG DCH V HNH CHNHMt t l cao ngi dn c s dng dch v hnh
chnh cp x v bit chc nng ca phng giao dch mt ca:69,1% ngi dn tham
gia dch v;S ln s dng trung bnh trong nm ca mt h l gn 3 ln;CHT LNG
DCH VChtlngdchv cngidnnh gicaovcsci thin ng k:Ngidnkhng mtnhiuthi
giangpc cnbgiiquyt (82,1%chdi 30pht).Cnb mbothigian lmvicvi78,5%
ngi dn cho bit lun gp c cn b ti vn phng;86,2% nh gi nng lc gii quyt
cng vic ca cn b l t yu cu v thnh tho cng vic;95,8% nh gi tt thi ca
nhn vin phng giao dch mt ca80,5% cho bit c hng dn y khi c thc
mc.Tuy nhin, nhn c kt qu trn 1/3 ngi dn phi i li nhiu ln, c bit c
10,7% phi i li t nht 4 ln. L do ch yu l do ngi dn
khngchunbgiyt,mtsthkhnggpccnbgii quyt (18,9%). th 3: Thi gian ch i
c phc v605040302010026.0Di 15phtT 15 -30 phtT 30-60phtTrn
60pht56.113.84.1DCH V HNH CHNH CP XBn cnh , ngi dn vn cha thc s cm
thy s thn thin khi n vn phng giao dch mt ca. C 15,8% cho bit h cm
thy e ngi khi n lm cc th tc hnh chnh x; t l ngi cm thy l 23,0% cao
hn gn gp i so vi t l ny ca ngi Kinh.CHI PH S DNG DCH
VCckhonlphmngidnphitrltngihplnnngi dn cng khng c thc s quan tm n mc
ph. Vi mc ph trung bnh cho mt ln giao dch l 25.000 ng, 83,1% s ngi
c hi cho rng mc ph nh vy l hp l.Ch c 58,4% ly phiu thu khi tr ph v
cng mt tl tng t phn nh h bit mc ph khi nhn kt qu.MC HI LNGNhn
chung, ngi dn kh hi lng vi dch v hnh chnh mt ca. Vi thang im 10, im
s hi lng ca ngi dn v dch v t 7,4 im.
Cckhacnhngidnhilngnhtlcngtchngdnlmth tc, yu cu v th tc giy t v thi
gian ch i vi t l ngi dn cm thy hi lng trn mc 50%. Tuy nhin, ngi dn
cha hi lng lm vi iu kin c s thit b ti vn phng mt ca. th 4: Mc ngi
dn hi lng vi dch v HCCXGI CI THIN DCH
VCcgicithindchvchyutptrungvokhacnhkthut trong vic nng cao cht lng
ca dch v mt ca. Phn ln cc kin ngh nng cao trnh chuyn mn ca cc b v
tng cng c s vt cht trang thit b.Cng tc hng dn lm th tcV s ng hnV
thi phc vV yu cu th tc giy tV thi gian ch iV trnh chuyn mn ca nhn
vinV chi ph dch vV c s vt cht trang thit b0 10 20 30 40 50 60KT LUN
CHNHKt qu tham vn ngi dn huyn Eakar, tnh k Lk, 2010, cho thy ngi dn
kh hi lng vi cc dch v c tham vn bao gm: gio dc, y t v dch v hnh
chnh mt ca. Theo thang im 1-10, mc ngi dn hi lng vi cc dch v nm
2010 dao ng t 7,0 n 7,7, tc l cao hn khong 1 im so vi mc 5,8 n 6,7
nm 2009. Pht hin ny cho thy ngi dn ngy cng nh gi cao hn n lc ci
thin dch v ca cc nh qun l, cung cp dch v trong nm va qua (Xem ph
lc).Tuy nhin, vn cn mt s kha cnh cha c nhiu chuyn bin tt cho nn cc
nh qun l, cung cp dch v cn n lc hn na tip tc ci thin dch v. C th nh
sau:DCH V Y Tiu kin c s vt cht cn thiu thn v lc hu, thiu bc s tuyn
x v nng lc chuyn mn ca cn b y t tuyn huyn cng cha cao. Cn b y t cha
tn tm vi ngi bnh, vn c nhiu cn b y, bc s thiu trch nhim trong vic
gii thch nhng thc mc ca ngi dn. Chi ph khm cha bnh cn cao i vi nhng
ngi khng khm bng bo him y t, th khm cha bnh min ph. DCH V GIO DCVn
cn nhiu tr em b hc gia chng. C ti 17,5% h c tr em b hc c bit cc h
ngi t l ny ln n gn 30%.C s trng lp cn kh khn, c bit l cp tiu hc. C
ti gn 70% ngi dn ngh nh nc cn tng cng u t c s vt cht, trang thit b
hc tp cc cc trng.Cht lng gio dc chnh kha vn cha thc s m bo cho nn
hu ht cc gia nh u cho con em i hc thm.Ngi dn vn phi gnh rt nhiu
khon chi ph ngoi hc ph nh tin
xydngtrng,tinbov,in,ncvccloiqu.Mcchiph bnh qun t 821 nghn ng/HS cp
1 n 1,4 triu ng/HS cp 3 l kh cao i vi ngi dn y c bit l i vi nhng
gia nh nhiu tr em ang i hc.DCH V MT CA CP XCht lng phc v ca vn phng
mt ca c ci thin nhng vn cn nhiu ngi dn vn cm thy e ngi khi n giao
dch ti y.Cn 1/3 ngi dn phi i li nhiu ln gii quyt xong vic do cha
bit r v th tc hoc khng gp c cn b ph trch.Trang thit b v nng lc ca
cn b cha c nh gi cao v phn ln cc xut ci thin dch v ca ngi dn tp
trung vo cc kha cnh ny.PH LCLoi dch vim s (1-10)2009 2010Gio dcCp
tiu hc 6,6 7,6Cp THCS 6,7 7,5Cp THPT 6,3 7,4Y tY t x 5,8 7,5Y t
huyn 6,0 7,2Th tc hnh chnh cp xX C Ni 6,1 7,0X C Hu 5,8 7,3X Ea ar
6,8 7,7im s do ngi dn nh gi cho tng loi dch vMc hi lng v dch v y t,
2009 2010 (%)Mc hi lng v dch v gio dc, 2009 2010 (%)Mc hi lng v dch
v hnh chnh cp x 2009 2010 (%)Y t huyn Y t x2009 2010 2009 2010Thi
gian ch i khm, cha bnh 40 39 49 55iu kin c s vt cht, trang, thit b
30 36 22 18Cht lng khm, cha bnh 36 45 35 50Thi phc v, khm v cha bnh
40 54 52 68Trnh chuyn mn ca y, bc s 39 37 35 45Chi ph khm, cha bnh
41 37 50 50im chung 6 8 6 7Cp 1 Cp 2 Cp 32009 2010 2009 2010 2009
2010Miquanhgianhtrngv ph huynh72 83 76 69 62 68Chng trnh, ni dung
hc tp 54 53 56 42 44 33Phng php ging dy v hc tp 67 64 65 47 42 45ng
x ca gio vin vi hc sinh 77 76 72 57 51 59C s vt cht, trang thit b
dy v hc 50 44 58 50 52 63Cc khon ng gp26 22 30 21 24 27im chung 7 8
7 8 6 72009 2010V c s vt cht trang thit b31 20V chi ph dch v47 40V
trnh chuyn mn ca nhn vin45 46V thi gian ch i44 53V yu cu th tc giy
t61 59V thi phc v52 59V s ng hn56 60im chung 6 7
