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Vượt qua nút thắt cổ chai trên đường tiến tới bao phủ y tế toàn dân ở việt nam

Sang Minh Le's picture
Also available in: English
Một bác sĩ trẻ tình nguyện đang tư vấn cho người phụ nữ dân tộc thiểu số ở huyện nghèo Bắc Hà, tỉnh Lào Cai. Ảnh: Nguyễn Huy Hoàn/Vụ Tổ chức cán bộ, Bộ Y tế

Năm 1977, khi tôi sinh ra, tôi chỉ nặng 2.5 kg như phần lớn trẻ em sinh ra trong thời kỳ kiệt quệ sau chiến tranh. Một người họ hàng của tôi chết ở tuổi 40 vì bệnh lao. Ông tôi, một lang y, rất buồn vì không thể dùng thảo dược để chữa trị căn bệnh thuộc tứ chứng nan y này, trong khi bác sĩ và thuốc chống lao lại không sẵn có ở tuyến xã. Bố mẹ tôi quyết định rời nông thôn ra thành phố để mong chúng tôi có thể tiếp cận hệ thống giáo dục và y tế tốt hơn.

Năm 1997, khi tôi hai mươi, cùng các bạn sinh viên y, tôi háo hức đi thực tập tại một trạm y tế xã ở vùng nông thôn. Các giáo sư nói rằng chúng tôi là thế hệ bác sĩ đầu tiên của Việt Nam được đào tạo để tăng cường cho y tế cơ sở. Thời kỳ này, Việt Nam có ít hơn 5 bác sĩ trên 1 vạn dân và hơn 75% số xã không có bác sĩ phục vụ. Nhưng thành thực mà nói thì không có nhiều sinh viên tốt nghiệp trường y lựa chọn công việc chăm sóc sức khỏe ban đầu, vì thế, những khó khăn về nhân lực cho y tế cơ sở còn tồn tại dai dẳng.

Хятад улсын махны эрэлт Монголд ямар нөлөөтэй вэ

Miles McKenna's picture

Also available in English

Tsetsen-Uul soum, Zavkhan province, Mongolia. Photo: Miles McKenna/World Bank

Хүнсний аюулгүй байдлын зарчмын хувьд хүнсий сүлжээнд фермээс хоолны ширээ рүү хүрэх тухай ойлголт мах, махан бүтээгдэхүүний хувьд тийм ч амаргүй байдаг. Таны ширээн дээрх шинэ мах хажуугийн фермээс эсвэл бүр дэлхийн нөгөө өнцгөөс онгоцоор 10,000 км-ийн зайг туулан ирсэн байх боломжтой.  Хүйтэн тээвэрлэлтийн гинжин хэлхээ, логистик сайжирснаар махыг тээвэрлэхэд зарим тохиолдолд хэдэн долоо хоног шаардагддаг байсныг хэдэн цаг, эсвэл хэдхэн өдрийн дотор тээвэрлэх боломжтой болгосон. Бага болон дундаж орлоготой цөөн хэдэн орнуудын хувьд махны экспорт томоохон бизнес болоод байгаа билээ.  

Монголын бэлчээрийн мал аж ахуйн баялаг түүх, малын тоо толгойн өсөлт, мөн дэлхийн томоохон зах зээлтэй газар зүйн хувьд ойрхон зэрэг нь Монголд малын махны экспортод чиглэсэн үнэ цэнийн сүлжээг хөгжүүлэх томоохон боломж байгааг илтгэдэг.

Өнөөгийн байдлаар мал аж ахуйн салбар 150,000 орчим малчин айл өрхүүдийн амьжиргааг залгуулж байна. Эдгээр өрхийн ихэнх нь нэн ядуу бүлэгт хамаарагдах бөгөөд өрийн дарамттай, ядуурлын онц нөлөөллүүдэд эмзэг байдаг. Монгол улс малын махны дэлхийн үнэ цэнийн сүлжээнд нэгдэснээр эдийн засгаа өсгөх, ажлын байр бий болгох, ялангуяа хөдөө орон нутагт ядуурлыг бууруулах шинэ боломжуудыг нээх бололцоотой.

Competitive Cities: A Game Changer for Malaysia

Judy Baker's picture
Photo: mozakim/bigstock


As an upper-middle income country with a majority of its population living in cities, Malaysia is situated among the countries that prove urbanization is key to achieving high-income status. Asking “How can we benefit further from urbanization?” Malaysian policymakers have identified competitive cities as a game changer in the 11th Malaysia Plan. To this end, the World Bank has worked with the government to better understand issues of urbanization and formulate strategies for strengthening the role of cities through the report, “Achieving a System of Competitive Cities in Malaysia.”

While Malaysia’s cities feature strong growth, low poverty rates, and wide coverage of basic services and amenities, challenges still remain. 

Its larger cities are characterized by urban sprawl, particularly in Kuala Lumpur, where population density is low for an Asian metropolis. This inefficient urban form results in high transport costs and negative environmental impacts. This is matched by low economic density, indicating Malaysia’s cities can do better in maximizing the economic benefits from urban agglomeration.  



A second challenge hampering Malaysia’s cities is the highly centralized approach to urban management and service delivery, a system that impedes the local level, and obstructs service delivery and effective implementation of urban and spatial plans.

Third is a growing recognition of the importance of promoting social inclusion to ensure that the benefits of urbanization are widely shared.

Vietnam studies Malaysia’s experience with facilitating state relationships

Jana Kunicova's picture
Photo: Sasin Tipchai/bigstock



Vietnam has a vision. By 2035, it aspires to become a prosperous, creative, equitable and democratic nation. Achieving this ambitious goal has set Vietnam on a path of transformation on multiple fronts – economic, social, and political.

At the core of this transformation is the re-orientation of the state’s role in economic management.  This requires adapting Vietnam’s economic governance so that the state becomes a skilled facilitator of three types of relationships: among government agencies, between the state and market, and between the state and citizens. 

Not too long ago, Malaysia walked in Vietnam’s shoes, implementing its own wide-ranging transformation. In 2009, Malaysia embarked on the National Transformation Program (NTP) that included focus on both government and economic transformations.  Malaysia had also adopted good practices that simplified regulations, which made it easier for firms to interact with the state.

Partnerships, cornerstone to achieve Indonesia’s sustainable peatland restoration targets

Ann Jeannette Glauber's picture
Also available in: Bahasa Indonesia
Peatland. Photo: Tempo


“Peatlands are sexy!” They aren’t words you would normally associate with peatlands, but judging from the large audience that participated in the lively discussion on financing peatland restoration in Indonesia at the “Global Landscapes Forum: Peatlands Matter” conference, held May 18 in Jakarta, it seems to be true. The observation was made by Erwin Widodo, one of the speakers in the World Bank-hosted panel discussion at the event.

For me, it was a great honor to moderate a panel comprised of several of the leading voices in the space: Kindy Syahrir (Deputy Director for Climate Finance and International Policy, Finance Ministry), Agus Purnomo (Managing Director for Sustainability and Strategic Stakeholder Engagement, Golden Agri-Resources), Erwin Widodo (Regional Coordinator, Tropical Forest Alliance 2020), Christoffer Gronstad (Climate Change Counsellor, Royal Norwegian Embassy), and Ernest Bethe (Principal Operations Officer, IFC).

It was the right mix of expertise to address the formidable challenges in securing resources to finance sustainable peatland restoration in Indonesia. These include finding solutions to plug the financing gap, and identifying instruments and the regulatory framework necessary to strengthen the business case for peatland restoration. A significant amount of finance has been pledged. But one of the key issues the panel needed to address was how to redirect available finance towards more efficient and effective outcomes to reach sustainable restoration targets.

Jalinan permitraan, fondasi mencapai sasaran restorasi gambut berkesinambungan di Indonesia

Ann Jeannette Glauber's picture
Also available in: English
Lahan Gambut. Foto: Tempo

“Gambut itu seksi!” Tentu bukan rangkaian kata yang lazim dikaitkan dengan lahan gambut. Namun dari besarnya animo peserta yang berpartisipasi dalam diskusi tentang pendanaan restorasi gambut di Indonesia pada konferensi “Global Landscapes Forum: Peatlands Matter,” di Jakarta pada 18 Mei lalu, tampaknya cetusan tersebut benar. Pengamatan jitu tersebut dicetuskan Erwin Widodo, salah satu pembicara dalam sesi diskusi yang dipandu Bank Dunia.

Bagi saya, sungguh merupakan kehormatan dapat menjadi moderator bagi panel yang terdiri dari tokoh-tokoh utama dalam bidang ini: Kindy Syahrir (Wakil Direktur Pendanaan Lingkungan Hidup dan Kebijakan Internasional, Kementerian Keuangan), Agus Purnomo (Managing Director for Sustainability and Strategic Stakeholder Engagement, Golden Agri-Resources), Erwin Widodo (Koordinator Regional, Tropical Forest Alliance 2020), Christoffer Gronstad (Climate Change Counsellor, Kedutaan Besar Norwegia), dan Ernest Bethe (Principal Operations Officer, IFC).

Melihat pengalaman masing-masing, komposisi pembicara merupakan kombinasi yang tepat untuk membahas berbagai tantangan luar biasa dalam mengakses pendanaan bagi restorasi gambut berkesinambungan di Indonesia. Tantangan tersebut termasuk mencari solusi untuk menutup kesenjangan dalam pendanaan, serta mengidentifikasi instrumen dan kerangka kebijakan yang akan memperkuat dorongan dunia usaha terjun dalam restorasi gambut. Dana yang telah dijanjikan untuk restorasi gambut sesungguhnya cukup besar. Namun salah satu isu utama yang harus diurai pembicara adalah bagaimana mengarahkan pendanaan tersebut guna mencapai hasil yang lebih efisien dan tepat guna, menuju sasaran-sasaran restorasi yang berkesinambungan.

The long road to Chin state in Myanmar: A journey to build back better

Degi Young's picture

Also available in Myanmar

Chin state is the second poorest state in Myanmar, located in the mountains with poor road conditions making it difficult to travel. Photo: Kyaw Htut Aung/World Bank

My journey to Chin state in Myanmar began with a simple question from my colleague – “Where do you want to go?”

“It doesn’t matter,” I said, “Anywhere is fine.”

This was it. I had volunteered to join the World Bank Group’s Myanmar Performance Learning Review consultations, which are being held across the country this month to obtain feedback from the government, private sector and civil society on our Country Partnership Framework. Approved in 2015, the partnership is the first World Bank Group strategy for Myanmar in 30 years and consultations are being held to discuss lessons-learned, review achievements and consider adjustments.

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