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n t n t: t s k n m v dn s v t . n t a : quan qua l a dn s v t . n t ba: t s p p n m m n s p t tr n dn s v t . l mt vn tu k n cn m tu n n tron qu trn t o lun n m k n tr n k n n t u s t v c c c n cn c n n vn c n n n cu t o lun t m. C n t mon n n c k n n p t p tc b sun , o n t n l b t o lun n m ca mn . PHN H NH S KHI NI V DN S V Y I.DN S. Dn s c l n quan n n u o t n , n u k a c n k c n au ca sn k n t x . v c n u mn c n n cu dn s. Dn s t eo n a t n t n l s l n dn s tr n mt vn ln t , mt a p n n t n . B v dn s c t co l s l n dn s ca c tr t a mt p n ca n , ca mt quc a a mt vn a l n o . t n n tr n quan n m dn s c t dn s ca mt n c c n a cc k quan trn . Dn s t eo n a rn c u l mt tp p n . p p n k n c l s l n m c c cu v c t l n . p p n bao m n u c n n p l , n k n c n m t n xu n b n n . a b n t n m c n n cn t n xu n b n n : s n ra, ln l n, tr n t n , qu v t von . Tron dn s c, t ut n dn s k n c u t eo n a t n t n , m cn u t eo n a rn ca n . n n cu c tr n t tn v tr n t n cn n n u t n n s b n n . II.Y Sc k o l mt u t quan trn m b o n p c c o m con n . Sc k o tt l c s lao n c n n sut cao, c t n t n tr c n m, tm n l n m n , tron s n v l mc t u quan trn tron s p t tr n. Sc k o l k n m k x c n . eo n n a ca t c c t t , sc k o l tr n t t o m v t c t, t n t n v x , n k n c b p tron n a l k n c b n

tt oc k n b t n tt. Y c l n n k oa c c n m v n n cu d p n , c a k oc m bt t c n ca c c b u n r lo n, b n tt n n t sc k o. Yt l t n t c c c c b n p p c t , c b t l c c b n p p d p n , c a b n , c m s c sc k o c o n n dn. v n n n trc t p n mc s n v mc c t, tc l n qu trn t s n xut dn s. Y c v t l a mt o t n b o v , c m s c sc k o n n dn. Y c su v o vn n n cu l t u t, t su v o c c b n p p t c c, c o, t c n c t p n c a b n tron cuc sn . quan a dn s v t c tn c t t n . t mt n na t t c n t to n b qu trn t s n xut dn s, mt k c s bn n dn s cn an t o sc p m n m v n n t . D s l c c m quan .

PHN H HAI I QUAN H GIA DN S V Y I. C NG CA DN S I VI H HNG Y . a) Q m l n n n n n n m v ca t n t l k m c a b n v c m s c sc k o c o n n dn. v qu m dn s qu t n s l n b c s v s l n c s t . u ta H l s l n k m v c a b n ca m n dn tron mt n m c u v dc v t ca m n dn . D l tn s l t n k m v c a b n tron n m tn c u v dc v t ca mt n c tron mt n m . a c D= .H R r n n u H k n t tn c u D t l t un v s dn v t n t eo t l a t n ca qu m dn s. Dn s t n qu n an s dn n s l n k m c a b n ca mt n H t n l n v do l m c o tn c u D t n l n. p n n u c u n t qu m n n t cn p t n . C n a l cun v c m s c t p t n . Qu m n n t c u l : - C c c s k m, c a b n , p n b n v p c c c n n . - C n b cn n n v n n n t b c s, t , l - C c p n t n p c v c o v c k m b n , c a b n , p n b n v p c c c n n . - u t c o n n t : n na n c ta u t c o t mc ct n p nl n n c ,t n n v c c t c c x k c.

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d, n c ta tron t k bao cp, t s n n c m n n. n t k c c c dc v c m s c sc k o, a n n c m cn c s t am a ca n n c n o v c c t c c t t n

- Qu m dn s t n n an cn n

H n na c c n c an p t tr n c tc t n dn s cao n c c n c p t tr n. ron mt quc a tc t n dn s nn t n cao n t n t , do v v c c m s c sc k e n n vn n p rt n u k k n. + Dn s t n n an tron u k n v k n t x an cn km p t tr n, t u n p ca n dn cn t p, ao t n l k k n, p n t n p c v c o k m c a b n , p n b n v p c c c n n cn t u t n, t u c n b c trn c u n mn , dc b n x ra tr n m n do m tr n b n m , c c c s c m s c t s qu t . + Dn s t n n an l tp trun c c n c n o , k n n d n d n b n c , t l mc b n t n l n, tr c t l b n su d n d n . n m 1980-1990 c k o n 50 tr em d 5 tu n u n c an p t tr n k u vc C u b su d n d n . G n , t eo ICEF 2009 tr n t c 129 tr u tr em d 5

tu c c n c an p t tr n b su d n d n t n cn, 195 tr u tr em d 5 tu b su d n d n t t p c , tron 90 sn k u vc c u v c u .

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t qu t p t n l n c trn v n a t t p n n rt k k n tron v c vn n dn c n n p v s n , p n c a b n t eo k oa c t qu cao t n l c c t n p ln, mc n m m tr n cao t c n xu n sc k e con n . vn c k u k c n au,qu m v c cu dn s, trn v c cu p t tr n k n t x . n n c c cu b n tt k c n au. Do c n c c n b v c cu b c s c u n k oa, p n t n t p p p v n u c u v c cu b n tt d : vn n bn ,ven b n n Bc t am b n v n t u a, b n v p rt p b n cn vn cao t b n st rt, b n ba c c n quan tm p n c n . C c b n x n u m v a l lan n an ma , IDS t n tp trun c c t n p ln c mt dn s cao. d. Mc c t n n nc ms c t m d n v t p n t tu 10-15 tu

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Cc t sut cht tui th u trong 5 nm trc iu tra

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Phn b mc cht ca tr s sinh Vit Nam S liu cho thy mc cht (trong 10 nm trc iu tra) ca tr s sinh cao nht l Min ni Trung du Bc B v thp nht l ng Nam B.

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Nhng nhn t lin quan n nguy c t vong cao Tr em vo tnh trng c nguy c cht cao nu: - Ngi m qu tr hoc qu gi (Di 18 hoc trn 35 tui) - Khong cch t ln sinh trc qu ngn - sinh con qu sm (di 24 thng sau ln sinh trc ) - S lng con (qu nhiu con: 4 con tr ln) T sut cht s sinh v t sut cht di 5 tui chia theo tui ca ngi m S cht trn 1000 trng hp sinh sng

T trng tr em cht di 1 thng tui so vi tng s tr em s sinh, Vit Nam, 2003

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2. Gim t l sinh: a. Cc bin php k hoch ha gia nh ( s dng cc bin php trnh thai, tuyn truyn cc bin php trnh thai gp phn hn ch sinh ).

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trn 3% vo nhng nm 1960 ca th k 20 gim xung cn 1,2% nm 2009. S ngi tng thm mi nm mc di 1 triu ngi. Mi gia nh thnh th trung bnh khong 2 con.

- Hn Ch : + Vng nng thn cha c ph bin nhiu v cng tc k hoch ha gia nh, tuyn truyn cc bin php trnh thai.

+Nhiu bn tr cha hiu bit v cc cch trnh thai, t l no ph thai con xy ra nhiu. + Cc trng hc cha ph bin , dy hc sinh cc vn sinh sn, gii tnh nhiu. Hu qu:
Trung bnh mi nm c nc c khong 300.000 ca no ph thai i tui v thnh nin t 15 -19 tui, trong 60 -70 % l hc sinh, sinh vin. c tnh trung bnh mi ngy c trn 20 ca no ph thai.Vit Nam tr thnh nc c t l no ph thai tui v thnh nin cao nht ng Nam v ng th 5 trn th gii. ( nm 2010).

b. Y t pht trin lm gim t l sinh: -Gip cu cha c nhiu tr s sinh hn, b m yn tm hn khng cn nhiu d phng. - Gp phn to iu kin chm sc ngi gi ->ko ph thuc nhiu vo con ->khng cn nhiu -> gip gim t l gia tng dn s.

B. Tc ng n mc cht. ( p dng cho mi la tui). - Hn ch c dch bnh (gim t l ngi cht, gia tng dn s). - Tng cng cng tac phng bnh ( vc xin cho tr em, vac xin cho dch bnh, H5N1,vv). - Gip cha tr ,hn ch bnh tt, gim t l cht mi la tui c bit la tui gi (to iu kin gia tng dn s).

Kt Lun: Vy y t v dn s c mi quan h cht ch vi nhau. Cn p dng linh hot, c th c th cn bng cng nh pht trin bn vng trong tng lai to iu kin pht trin kinh t, x hi.

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2. Tng cng y t d phng, chng trnh mc tiu quc gia v y t p tc cn c, n n v u t p t tr n t n t d p n c c tu n v c s vt c t, tran t t b, o t o c n b c b t l m n l t d p n tu n u n t eo c tr n c un ca C n p . -

- Ho n t n d n x dn m run tm p n , p n HI / IDS; D n u t tran t t b p c v c o labo xt n m ca t n run tm Y t d p n n t t u c un an to n s n c cp 2 v tn b c t n t tran b c o tu n u n, t x, t n p . - m n c c o o dc n dn dc b n , c n p l n n n tron p n vt san n . t n t d p n , t n c n cn t c tru n t n , u v c n t c n c c b n p p t p n c n m s t dc t , k n dc ln x ra. n c n p n c n dc b n , c b t l c c dc b n tru n t

- r n k a u qu c c o t n sc k e m tr n , m s t, qu n l c c c t t t c n u c n m m tr n v t c n xu n sc k e con n . - X dn v tr n k a k o c p n , u tr mt s b n k n l n n : m m c , u n , n t , n u t p... m

- c c v tr n k a tt c c C n trn mc t u quc a v t ; C n trn mc t u quc a: s n an to n t c p m, Dn s - HHG , p n c n HI / IDS... - o u k n v k u n k c c c t c c, c n n n k t n lp c c c s cun cp dc v t d p n . 3. Pht trin mng li khm, cha bnh v phc hi chc nng p tc o n t n m n l k m, c a b n t eo c c tu n k t ut t t p n cao, tn b c c un a v nn n c c b n v n t eo qu o c n n t c B D n p du t, tp trun x dn c c b n v n chuyn k oa Lao, m t n, S n ...t eo n 930 ca C n p v c c d n u t , nn cp c c B n v n a k oa u n, B n v n a k oa k u vc v p n k m a k oa k u vc t eo n 47 ca C n p . n u tron qu II/2012 c n t c a B n v n S n v o o t n v tr n k a cn t c k m, c a b n c o n n dn. - n cao c t l n dc v CB: t p tc m n v c t c n C t s 06/2007/CT-BY n 07/12/2008 ca B tr n B Y t v v c nn cao c t l n k m, c a b n , tron c b t l u k n l m dn t uc, xt n m cn lm s n , dc v k t ut cao tn km k n c n t t c o n b n , t c n tt cn t c o dc nn cao c. p trun v t n c n u qu s dn n n s c n n c v c c n u n t u nn cao c t l n c c dc v k m c a b n , c c c p p s dn c u qu c s t n , tran t t

b ca c c c s t v an c u t tron t an va qua m bt v qu t v c b n tn tr n qu t . r n k a t c n n Lut m b n , c a b n . n c n k m so t c t l n t uc v B t . - m n cn t c c o tu n, x dn p n n t c n Qu t n 1816/Q -BY n 26/5/2008 ca B tr n B Y t v v c du t n C c n b c u n mn lun p n t b n v n tu n tr n v tr c c b n v n tu n d n m nn cao c t l n k m, c a b n t a p n . p tc t c n c n s c quc a v d c c c tru n, cn c, u t , nn cp c c b n v n, c s CB v c t l n CB c c tru n. t tr n c c tru n c tron t n cn lp v n o cn lp tr n c s t c n tt Qu t n s 222/Q ca t n C n p v c t s 24 ca Ban b t run n . - m c c qu n l t c n ca c c b n v n cn , n n cu xut c c p n b n n s c m c o c c b n v n. u n k c c c t n p n k n t u t p t tr n c c dc v t . C c tn , t n p c u k n k n t p t tr n p c c c p p c t k u n k c p t tr n c c b n v n n o cn lp. - m n cn t c t n c, n m n v c c trun tm trao , tr t n t n p c v c o c n o n v u tr. k oa u n n