KHAO SAT ^ THAI DO, KIEN THLfC, HANH VI VE VE SINH...

SO Y TE OUANG NAM

IRLNG 1 AM IRUYEN I H 6 N G GIAO DUC SI ( KHOE

w.m'ki

DE TAI

KHAO SAT

^ THAI DO, KIEN THLfC, HANH VI

VE VE SINH AN TOAN THlTC PHAM

CIA NGirOl DAN TAI TINH QUANG NAM

MA SO KX.0309 ' • - \ ; A - \

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NAM 2010

DANH SACH NHOM NGHIEN CtTU

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HQTEN

BsCKI. Trinh Van Truyen

Ths. Nguyen Thi Lien

Ths. Thai Ngpc Huynh Van

BsCKI. Nguyin Van Scm

Bs. Nguyen Minh Thu

Bs. Nguyen Thi Kim Van

KS. Vo Quang Lpi

Bs. CKI. Trin Thanh Tam

Lp Van Himg

Phan Thanh Tiing

Nguyin Thj Thu Trang

Nguyen Thi Hoang Viet

DON VI C 6 N G T A C

Sdytg

Trung tam Truyen thdng

Giao due Stic khoe

SoYte

SdYte

Trung tam Truyen thong

Giao dttc Siic khoe


Giao due Siic khoe

Tinmg tam Y ti du phdng tinh

Trung tam Y te dir phdng tinh

SdYte

Tnmg tam Truyen thong

Giao due Stic khoe

Tnmg tam truyen thong

Giao due stic khoe tinh

Tmng tam TruySn thong

GHI CHIJ

Ban chu

nhiem

Chu nhiem

Thuky

Thanh vien

nhdm

nghien ciiu

Thanh vien

nhdm

nghien ciiu

Thanh vien

nhdm

nghien ciiu

Thanh vien

nhdm

nghien ciiu

Thanh vien

nhdm

nghien ciiu

Cpng sir

Cpng sir

Cpng sit

Cpng su

s

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CN. Hd thi Thanh Giang

CN. Nguyen Trudmg Hoa

CN. Hoang thj Minh Hiin

Phan Cdng Duan

Tran Cong Tuan

Bs. Dang Van Hai

BsCKII. Nguyin Cam

Bs. Nguyen Day

Bs. Nguyen Thai Tho

Bs. Dd Trudng Lim

Bs. Nguyen Van Cam

Ho Van An

Huynh Van Hoang

Le Ngoc Quang

Tnromg Van Thanh

Biti Van Hai

Tran Thi Chi

Tran Thi Mai

Vo Thi Chm

Giao due Stic khoe


Giao due Siic khoe


Giao due Stic khoe

Trung tam Truyin thong

Giao due Stic khoe


Giao due Stic khoe


Giao diic Siic khoe

Trung tam Y te Dir Phdng

tinh

Chi cue An toan Ve sinh

Thuc pham

Chi cue An toan Ve sinh

Thuc pham

Trung tam y te Nam Tra My



Trung tam y te Hiep Dtic

Trung tam y te Hiep Diic



Tram y te Binh Lam Hiep Dtic

Tram y te Tan An Hiep Dtic

Tr^im y te Tan An Hiep Diic

Tram y te Tan An Hiep Dtic

Cdng sir

Cpng sir

Cpng su

Cong sir

Cpng su

Cpng su

Cpng sir

Cong su

Cpng sir

Cong sir

Cpng sir

Cpng sir

Cpng sir

Cpng sir

Cpng sir

Cong su

Cpng su

Cpng sir

Cpng sir

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Pham Thi Ha

Trinh Ky Lo

Nguyen Hiiu Ky

Nguyen 'Nhu

Nguyen Ho Quang Huy

Le Thanh Chien

Hoang Tieu Anh

Le Thi Nil

Luong Van Thdng

Tran Diic Thinh

Truong Thi Chung

Nguyen Dtic Thai

Chau Thi Duong

H6 Thi T6 Nga

Vii Thi Kim Hucmg

BCii Quoc Xet

Nguyen Thi Biit

Thai Thi Hau

Lam Thi Dieu Ngpc

Doan Xuan Viet

Chi Thi Viet Hoa

Nguyen Thai

Ngo Cong Binh

Tram y te Binh Lam Hiep Diic

Tram y te Que Thp Hiep Diic

Tram y te Que Thp Hiep Dire

Tram y te Que Binh Hiep Dtic

Tram y te Que Binh Hiep Diic

Tram y te xa Tam Xuan I Niii Thanh

Tram y te xa Tam Xuan I Nlii Thanh

Tram y te xa Tam Hiep Nlii Thanh

Tram y te xa Tam Hiep Nlii Thanh

Tram y te xa Tam Xuan 11 Nlii Thanh

Tram y te xa Tam Xuan 11 Nlii Thanh

Tram y te xa Tam Xuan II Niii Thanh

Tram y te Thi tran Nlii Thanh



Tram y te Tam Tien Nlii Thanh

Tram y te Tam Tien Nlii Thanh

Trung tam y te Ntii Thanh

Trung tam y te Niii Thanh

Trung tam y te Nlii Thanh

Tnmg tam y te Niii Thanh



Cdng su

Cong su

Cong su

Cong sir

Cong sir

Cong su

Cpng su

Cong sir

Cong sir

Cpng su

Cpng sir

Cgng su

Cong sir

Cpng su

Cong SIT

Cong sir

Cong sir

Cpng su

Cpng sir

Cpng sir

Cpng su

Cpng su

Cpng su

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Trin TSn Thinh

Phan Thi An

Truong Thi Suong

Nguyen Thi Phuong Thao

Nguyen Thi Phi Anh

Nguyin Vo Duy Trung

Nguyen Thi Van

Nguyen Thi Thu Ba

Hoang Thi Nhi

Phan Thi Tuyet Mai

Bill Thi Bpt

Bui Hoang Himg

Trung tam y te Nili Thanh

Tnmg tam y te Tam Ky

Trung tam y te Tam Ky

Trung tam y te Tam Ky Tram y te An My

Tam Ky Tram y te An My

Tam Ky Tram y te Phudc Hoa

TamKy Tram y te Phudc Hoa

TamKy Tram y te An Xuan

TamKy Tram y te An Xuan

TamKy Tram y te Tan Thanh

TamKy Tram y te Tan Thanh

TamKy

Cong su

Cpng sir

Cpng sir

Cong su

Cong su

Cpng sir

Cpng sir

Cong su

Cpng sir

Cpng su

Cpng su

Cong sir

MUC LUC

TT NOl DUNG TRANG

B$t van de 1 I Mof dau 3 1 Tong quan tinh hinh nghien ciiu 3 1.1 Tdng quan 3 1.1.1 Khai niem vi thuc phim va ve sinh an toan thuc pham 3 1.1.2 Vai trd cua VSATTP ddi vdi siic khoe va kinh ti, xa hdi 3 1.1.3 Hau qua cua TP khdng dim bao v? sinh an toan den siic 4

kho6 va nen kinh te xa hoi 1.1.4 Phan loai 6 nhilm thuc phSm 7 1.1.5 Nhiing dieu cdn lam di cd btta in ngon va dam bao 9

VSATTP 1.1.6 Mot sd qui dinh lien quan din ngudi kinh doanh, che biin 9

TP 1.1.7 Thirc an dudng phd 11 1.1.8 He thdng hoat dpng va luat phap vi VSATTP 13 1.2 Tinh hinh nghien ciiu 14 1.2.1 Tinh hinh ngo doc TP tren the gidi va trong nude 14 1.2.2 Mot sd van di v i T A D P 19

1.2.3 Nhimg hieu biet ctia cpng ddng vi VSATTP 21

2 Muc tieu, doi tirong, noi dung, phirong phap nghien 24 cmi

2.1 Muc tieu nghien ciiu 24 2.2 Ddi tugfng nghien ciiu 24 2.3 Ndi dung nghien ciru 24 2.3.1 Tim hieu sir hiiu biit kiin thirc vi an toan ve sinh TP va 24

each quan ly VSATTP cua cac cdp chinh quyen, ban nganh, doan the vdi cong tac VSATTP

2.3.2 Danh gia thuc trang kiin thiic, thai dp, hanh vi ve 24 VSATTP cila ngudi kinh doanh TP

2.3.3 Danh gia nhOng hieu biet vi chfa lupng VSATTP cua 25 ngudi ban rong

2.3.4 Tim hiiu mdt s6 vto de ve TADP 25 2.3.5 Tim hiiu kiin thilc, thuc hanh ciia ngudi san xuat che 25

biin TP 2.3.6 Danh gia thuc trang van di dam bao VSATTP tai hep an 26

tap thi 2.3.7 Tim hiiu thai dp, kiin thiic cua ngudi tieu dung ve 26

VSATTP 2.3.8 Thuc trang cong tac myen tmyen giao due siic khde ve 26

VSATTP tai tinh Quang Nam 2.4 Phuong phap nghien cum 27 2.4.1 Thiit k i nghien ciiu 27 2.4.2 Cd miu 27

2.4.3 2.4.4

2.5 2.6 2.7 2.8

[I 1 1.1 1.2 1.3 1.4 1.5 1.6 1.7

Cach chpn ddi tupng vao miu nghien ciiu Cac budc tiin hanh Xir ly sd lieu nghien cim

Khdi lupng cdng viec dS hoan thanh Nhan luc Diiu phdi

Ket qua nghien ciiu va ban lufln Bac diem chung Phan bd theo dp tuoi va gidi tinh Phan bd theo dia du Phan bd theo ddi tupng Trinh dp hpc van Thdi gian dam nhan cdng viec Kham siic khoi dinh ky Dupe tham gia tap huin kiin thirc VSATTP

27 29 29 29 29 29

30 30 30 31 31 32 33 34 35

2 Thye trang cong tic quan ly vf sinh an toan thuc 36 pham ciia chinh quyen, sir ph6i hgp cua cac ban nganh, doan the tai dja phirong

2.1 Dia phuong cd thanh lap Ban chi dap VSATTP 36

2.2 Xay dung ke hoach, ban hanh van ban chi dao ve 36 VSATTP

2.3 Td chlic hpi nghi trien khai va tdng ket vi cdng tac 37 VSATTP

2.4 Phuong phap chi dao khi cd vu ngd dpe TP xay ra tai dia 38 phuang

2.5 Vai trd cua ban nganh, doan the trong cdng tac VSATTP 38 2.6 Cdng tac quan ly VSATTP d ngudi ban rpng 39 2.7 Cong tac truyen thdng qua he thong loa huyen/xa 40 2.8 Y kiin ve cdng tac quan ly VSATTP 41 2.8.1 Cac cdng doan (khau) can luu y de dam bao VSATTP 41 2.8.2 NhOng heat dong can thuc Men de lam tdt cdng tac 42

VSATTP 2.8.3 Quan ly ve VSATTP ddi vdi ngudi ban hang rong tai dia 43

phuang 2.8.4 Ngudn cung cip thong tin vi VSATTP 44 2.8.5 Hinh thiic myen trayin cd hieu qua tai dia phuang 44 2.8.6 Nhu ciu tap huln kiin thiic VSATTP 45 2.8.7 Cac cdng viec cin thuc hien di nang cao kien thiic 46

VSATTP cho ngudi dan

3 Kien thiic, thai d6, hanh vi vl VSATTP 3.1 Kiin thiic, thai dp, hanh vi ve VSATTP cua ngudi SX, 47

CBTP 3.1.1 Kiin thiic cua ngudi SX, CBTP 47

3.1.2 Thai dd, hanh v iv i VSATTP ciia ngudi SX, CBTP 52 3.2 Kiin thiic, thai dp, hanh vi vi VATTTP cua ngudi kinh 56

doanh TP 3.2.1 Kiin thiic v i VATTTP cua ngudi kinh doanh TP 56 3.2.2 Thai dp hanh vi v i VSATTP ciia ngudi kinh doanh TP 59

3.3 Kiin thiic, thai do, hanh vi vi VSATTP ciia ngudi tieu 65 diing

3.3.1 Kiin thirc vi VSATTP cita ngudi tieu dting 65 3.3.2 'Thai dp, hanh vi v i VSATTP cua ngudi tieu dimg 72

3.4 Y kien ciia ngudi dan 77 3.4.1 Ngudn cung d p thdng tin VSATTP 77 3.4.2 Mong mudn nang cao kiin thirc VSATTP 77

4 Thv'c tr^ng hoat d$ng truyin thong giio dye sue khoe 78 ve VSATTP

4.1 Cdng tic xay dung ki hojch hoat dpng TTGDSK vi 78 VSATTP

4.1.1 Tinh hinh thuc hien cdng tac xay dyng ki hoach 78 4.1.2 Ca sa xay dung ki hoach hoat dpng TTGDSK 79 4.1.3 Nhihig ngudi tham gia xay dung ki hoach 79 4.1.4 Ke hoach dupe thdng qua cac d p chinh quyin dja 80

phucmg 4.2 Cac hinh thiic tmyen thdng dupe thuc hien 81 4.3 Tinh hinh thanh lap ban tin, diim tayen tmyen bing 82

Video vi VSATTP 4.4 Tilth hinh san xuat cac phuang tien trayen thdng cua cac 83

td TTGDSK

5 Tim hieu nguySn nhan dva den tinh trang kien thiic, 84 thai dg, hanh vi ve vg sinh an toan thirc pham cua ngirdi dan con thap

5.1 Cdng tic quan ly chua ddng bp 84 5.2 If thirc trach nhiem vi vige bao dam ATVSTP ctia ngudi 85

san xuit, che bien, kinh doanh TP ehua cao: 5.3 Nhjn thiic cua ngudi dan vi vg sinh ATTP cdn rat thap 85

m Ket luan vk de xuat giai phap can thif p 86 1 K^tlu^n 86 1.1 Thuc t r ^ g kiin thiic, thai dp, hanh vi vi VSATTP ctia 86

ngudi dan 1.1.1 Thvrc trang cdng tac quan ly VSATTP cua chinh quyin, 86

su phdi hop cua cac ban, nganh, dean thi t^i dia phuang cdn nhiiu bit cap

1.1.2 Ngudi SX, CBTP cdn thiiu kiin thiic va cd thai dp, hanh 86 vi v i VSATTP

1.1.3 Kien thiic cua ngudi kinh doanh TP cdn yeu va hp cd 87 nhiiu bit cap trpng thirc hanh vi VATTTP

1.1.4 Ban than ngudi tiSu dimg cDng cdn thieu kien thirc va 87 chua cd thai dp, hanh vi dam bao vi VSATTP

1.1.5 Thuc trang hoat ddng TTGDSK vi VSATTP 87 1.2 NguySn nhan cua tinh traing thieu kiin thirc, chua cd thai 87

dp, hanh vi tdt cua ngudi dan 1.2.1 Cdng tac quan ly chua ddng bp 87 1.2.2 'Y thiic trach nhigm vi vigc bao ddm ATVSTP ciia ngudi 87

SX. CBTP, kinh doanh TP chua cao 1.2.3 Nhan thiic ciia ngudi dan vi ve sinh ATTP cdn rat thap 88

2 s i xu^t giai phap can thigp 88 2.1 Ddi vdi cac cap chinh quyin, ban, nganh, doan thi 88 2.1.1 Can hoan thign hg thdng van ban chi dao, van ban phap 88

luat vi quan ly chit lupng an toin vg sinh TP 2.1.2 Ciing cd he thdng to chirc quan ly chat lupng VSATTP 88

2.2 Vdi nganh y ti 98 2.3 Ngudi lam SX, CBTP; kinh doanh TP 90 2.4 Ngudi dan 90

Ldi kit 90

N H I T N G C H C VIET TAT

VSATTP Ve sinh an toan thirc pham

TP Thirc pham

SK Stic khoe

•WTO World Trade Organization: Td chiic Thuong mai t h i gidi

W H O World Health OrganizationiTd chirc y te The gidi

T A D P thirc Sn dudng phd

TTGDSK Truyen thdng giao due sir khde

D S , S K S S / K H H G D Dan sd, sue khde sinh san/ke hoach hda gia dinh

DAT VAN DE

Chat lupng ve sinh an toan thuc phim (VSATTP) la vin di cd tim quan trpng djc bigt, khdng nhiing anh hudng true tiip va thudng xuyen den sire khde nhan dan, deii sir phat trien gidng ndi, ma cdn anh hudng true tiep din qua trinh san xuit, xuit khau hang hda, phat triin du lich va uy tin quoc gia. Dam bao VSATTP se tang cudng ngudn lire, thuc diy phat triin kinh te - xa hpi va md rpng quan hg quoc te.

Theo thdng ke cua To chirc Y ti The gidi (WHO), hdng nSm cd khoang 1,3 ty lupt ngudi hi ia ehay thi 70% trong sd do do sir dung thuc phim (TP) che biin khdng hpp vg sinh, TP nhiem vi khuln hpSc tdn du ho4 chit qui Idn. Cac trudng hpp ngp ddc do d nhiSm vi khuan thudng bieu hien cap tinh, nguyen nhan chii yen do thieu vg sinh trong qua trinh che bien va bao quan TP [82].

(3 nude ta, vin de dam bao chit lupng VSATTP da dupe Nha nude cpi trpng. Thil tudng Chinh phii da cd Chi thi ve tang cudng chat lupng VSATTP; nam 2003, Uy ban Thudng vu Qude hdi da thdng qua Phap lenh VSATTP; Bd Y te la ca quan quan ly nha nude ve chat lupng VSATTP da phdi hpp vdi cac Bd, Nganh xay dung kS hoach hanh dpng den nam 2010 ve quan ly chat lugng VSATTP... Cong tac trayen thdng giap due sire khde (TTGDSK) nham nang cao kien thirc ve VSATTP cho ngudi san xuat, che bien thuc pham (SX, CBTP), kinli doanh dich vy Sn udng va ngudi tieu dimg da dupe thuc hien rpng rai. Nhieu tieu chuIn, quy chuIn, quy pham ky thuat ve van de nay da duac thuc thi. Cdng tac phdi hpp lien nganh kiim tra, thanh tra da gdp phan ngan chan nhieu sai pham trong san xuat va kinh doanh thuc pham (TP).

Tai tinh ta, qua han 8 nam triin khai chuang trinh muc tieu VSATTP da tao dupe su chuyin biin tich cue ve nhan thiic, nang cao trach nhiem eua lanh djio cac d p , cac nganh, cac to chile xa hdi, da gdp phan dieu chinh vi nhsn thiic va hanh vi cda ddng dao quan chiing nhan dan ve VSATTP. Sd vu ngd dde TP va tir vong do ngd dde TP da giam di hang nam, nam 2007 giam 72% s6 vu va giam gan 90% so tradng hpp mic so vdi nam 2006. Da lap lai trat tu ky cucmg trong san xuit, che bien, kinh doanh TP va giam dang ki cac benh trayen qua TP.

Tuy nhien, nhiing thach thirc trong cdng tac dam bao chit luoDg VSATTP teong ca nude ciing nhu tai tinh ta cdn rat Idn. Dd la he thdng to chile quan ly cdn chua du manh. Cac van ban phap quy, cac quy trinh, quy pham, tiSu cliuin ky thuat vfi chat lupng VSATTP ban hanh cdn chSm va chua dap ling vdi yeu ciu hOi nhjp nhu hien nay. Su quan tam cia cac d p , cac nganh, cac td chiic xa hpi va ctia nhan dan cdn han chi, he thing thanh tra chuyen nganh, kiim nghifim TP cdn yiu. Dac biet, cdng tac quan 1 hoat ddng VSATTP tai cac tuyin co sd cdn dang gap nhieu khd khan thach thirc, trong do nhan lire thiiu, nang luc quan ly va ky nang quan ly cdn rSt h^n che; tmh hmh ngd dde TP cd diln biin philc tap han, cac vu ngd dpe TP t^p the van khd kiimsoat

Trong nhOng nam vira qua, tinh ta phai ddi mat vdi nhieu bien ddng lien quan din VSATTP nhu dich cum gia elm, Ipn tai xanh, bao liit...Ban chi dao lien nganh VSATTP ciia tinh da triin khai nhiiu hoat dpng nhu: td chirc hdi nghi triin khai hoat ddng VSATTP hang nam, td chirc li phat dpng thang hanh dpng vi chit lupng VSATTP, tjp huln, tuyen trayin... Nhung chua cd mdt khao sat nao danh gia thue ttang kiin thiic, thai dp, hanh vi cua ngudi dan (bao gdm cac nha lanh dzio, ngudi san

xuat, kinh doanh TP, ngudi tiSu dimg) trong tinh. Tren co sd do di xuat mOt sd giai phap can thiep nhim nang cao nhan thiic, thai dp hanh vi cua ngudi dan ve VSATTP. Chinh vi v^y chiing tdi tiin hanh thuc hien di tai: Khao sat kiin thirc, thai dp, hanh vi v i VSATTP cua ngudi dan tinh Quang Nam vdi 2 muc tieu: danh gia thuc tr^ng kien thiic, thai dd, hanh vi v i VSATTP cua ngudi dan tinh Quang Nam va di xuit mpt sd giai phap thich hpp nhim nang cao nh^n thiic ciia ngudi dan ve VSATTP.

I. MO DAU

1. TONG QUAN TINH HINH NGHIEN CUU

1.1. TONG QUAN

1.1.1. Khai nigm vi TP \k vg sinh an toin TP

TP la tat ea mpi dd an, thirc udng d dang chi bien hojc khdng chi biin ma con ngudi sir dyng hang ngay di an, udng nhim cung d p cac chit dinh dudng d n thiit cho CO thi di con ngudi cd thi sdng, phat teiin va hoat dpng [53].

VSATTP la cae dieu kign va Ijign phdp d n thiit di dam bao TP khdng gay hai eho siic khde, tinh mang con ngudi [48].

Phai gia VSATTP vi TP rit di bj d nhilm bdi cac tac nhan sinh hpc, hca hpc va ly hoc nen niu khdng tuan thu cac quy dinh vi VSATTP trong ca aua trinh san xuit, ehi bien, bao quan, phan phdi, v|in chuyin va sil dung thi TP cd the trd nen nguy hai cho siic kho^ con ngudi va la nguyen nhan cua cac vu ngp dpe TP.

Nhu v?y, VSATTP la cdng vigc ddi hdi su tham gia cua nhiiu khau, nhiiu nganh. each tdt nhat de ty bao vg sire kho^ cho ban than va gia dinh la mpi ngudi d n phai cd kiin thiic co ban vi TP va VSATTP [53].

1.1.2. Vai trd cua VSATTP doi voi siic khoe va kinh te, xS hî

1.1.2.1. Vai tro cua VSATTP idi v&i sue khoe va kinh ti, xS hî

- Vai tro ciia VSATTP ddi vai sue khoe Tat ca chiing ta deu nhan thay tam quan trpng cua vi$c an udng, dd la nhu d u

hang ngay rat cap bach va phai dap irng. Ngay tir trade cdng nguyen, cac nha y hpc da cho rang an udng la mpt phuang tien di chOa berth va giii gin siic khde. An udng sach se hap vg sinh rat quan trpng cua dinh dudng hpp ly. Quan sat each an trayen thdng cua ngudi Viet Nam chiing ta thay khi an cac thirc an ddng vat thudng dung kem theo mdt sd rau, gia vi, mdt mat giiip an ngon mieng, mat khac cilng la each phdng rdi loan tieu hoa.

TP eung cap cac chat dinh dudng dam bao siic khde cho con ngudi, ddng thdi ttong nhiing diiu kien khdng an toan TP cung cd the la ngudn gay bSnh, tham chi cdn din din tir vong. Khdng mpt thirc an nao dupe coi la cd gia tri dinh dudng niu nhu nd khdng bap dam VSATTP. Theo Hai Thuong Lan (Dng, thiic an phai la cac chit bd duSng eho ca thi chit khdng dupe la ngudn gay benh. Vigc bao quan TP phdng ttanh radi nhang, Im mdc, di thiu va gitt v^ sinh ngudn nude cung dupe Ong khuyen day. HiSn nay, khai niSm an toan TP khdng cdn ddng khung trong van de an, luong thuc ma cdn phai dam bao biia an da dang gdm nhieu loai TP. Cac TP nay khdng nhiing dam bao cho con ngudi phat triin tdt vi the luc, tri luc, tang eudng siie lao dpng sang tao ma cdn phai dam bao vg smh an toan, khdng dupe la ngudn gay bgnh, tiic la tien tdi dam bao an ninh dinh dudng [3], [35].

- Vai tro cua VSATTP ddi v&i kinh tixa /igi TP dam bao chit lupng vS sinh an toan Ididng nhiing lam giam ty Ig benh tat,

tang cudng kha nang lao ddng ma cdn gdp phan phat teien kinh te, van hoa, xa hdi va thi hi§n nep s6ng vSn mmh ciia mdt dan t§c. Hdi nghi Chau A lln thii 3 vi an toan TP (ATTP) va dinh dudng td ehiic tî Bic Kinh thang 10/2000 da thao lu?n nhiiu din biSn phap day manh cdng tac VSATTP, danh gia nguy co 6 nhiim TP va diin biin cua

tinh hinh dinh dudng lien quan den TP trong nhung nam diu budc vao thiSn nien ky mdi [71].

TP CO vai trd quan ttpng trong nhiiu nganh kinh ti. Chit lupng VSATTP la chia khpa tiep thi cua san phim. Tang cudng chit lupng VSATTP dem lai uy tin cimg vdi lpi nhuan Idn cha nganh san xuit ndng nghiep, cdng nghiSp chi biin TP ciing nhu dich vu du lich thuong mai. TP la mpt loai hang hoa chien lupc, TP dam bao chat luong VSATTP sS tang ngudn thu xuat khiu san phim, co tinh canh ttanh lanh manh va thu hut thi tradng the gidi. Hien nay, kim ngaoh xuit nhap khIu tren thi gidi dang ngay mdt tang len nhimg TP lai dang dirng trudc nguy co d nhiim nghiem trpng. Nhiiu vu ngp ddc do TP gay nen da lam chin dpng du luan thi gidi.

Nude ta da ttd thanh thanh vien cua To chirc Thuong mai thi gidi (WTO) vao nam 2007. Ngoai nhung no luc chung tren lat ca cac mSt, cdng tac VSATTP cung dupe quan tam mdt each tieh eye va dong bo nham thuc hign diy dii cae yeu d u de tuong ddng vdi cac nude ve ky thuat, chi tieu chat lupng, luat Ig, he thing quan ly ehlt luong tien tien... Vi vay, Viet Nam khdng nhirng phai thiic diy san xuit teong nude phat trien ma cdn phai tang cudng qudn ly chiil lupng VSATTP di xuat khIu dupe san phim (ndng san, thiiy san...) dat ehlt lupng va ngan chan dugc TP khdng dam bao chSt lupng, an toan vg sinh nhap vao Vigt Nam nham bao vg sire khde ngudi tieu dimg.

1.1.3. Hau qua cua TP khong dam biio ve sinh den sHc khoe va nen kinh te xa hpi

TP dupe cei la san phim dac biSt, cd anh hudng true tiep den sire khde va tmh mang con ngudi. Viec cung cap TP va nude udng an toan, dam bao chat luong la rat d n thiit. TP khdng nhttng cd tac dpng thudng xuyen ddi vdi siic khde mdi ngudi ma cdn anh hudng lau dai den ndi gidng ciia dan toe. Hign nay van de dang quan tam la de phdng va khic phuc hau qua cda TP d nhilm, khdng dam bao vg sinh an toan gay ngd doc nguy hiem cho con ngudi [2].

H^u qua ctia ngg dge TP co the tdm tat theo so do

Tieu ehay, suy dinh duong,

cac benh khac c> Anh hudng den kinh te xa hdi

Ca thi Cdng ddng

So do 1.1. H?u qua cia ngi dge TP

1.1.3.1. Anh hu&ng iin site khde

Chat lupng VSATTP khdng dam bao se anh hudng trye tiip va thudng xuyen dSn siic khde, gay nen nhihig bgnh tat, rii loan chuc nang ca thi, hiiu hign qua ngd dpe TP cap tinh, ngd doc man tinh, ngi dOc tich luy ciing nhu cac b^nh trayen qua TP. Dge hist, chit lupng VSATTP cdn anh hudng den vin di tap hinh va vin di diiu hoa gen ma true tiip hay gian tiep anh hudng den gidng ndi [39, [42].

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Sir do 1.2. Chat luyng VSATTP va sire khde

- Ngp dOe TP d p tuih; Chit lupng VSATTP khdng dam bao gay h?u qua diu tien la cac ngO dOe TP d p tmh. HiSn nay, do nhung biin dpng vi mdi teudng, nhttng thay ddi v i giao luu quoe ti , su phat teien ciia cong nghigp, teong dd ed cdng nghifip che biin TP, cac thay ddi ttong cdng ngh$ chan nudi, teong ttpt, ttong dd ed edng nghe gen... lam xuat hifin nhiiu nguy co mdi gay ngd dpe TP [43].

-I- Tai My, mdi nam cd 5% dan sd hi ngd doe TP va chit 5.000 ngudi. -I- T ii Anh, mSi nam cd 190 ca ngO dpe TP/lOOOdan. -I- Nhjt Bin cii 100.000 dan ed 40 ea ngp dpe TP mdi nam. + T?i Oc, mdi nam cd 4,2 ttieu lupt ngudi ngp dde TP. -I- 0 Vigt Nam do edng tac kiim soat VSATTP mdi dupe thiit IJp, cdn nhiiu hgn

chi v i hg tiling giam sat, thdng kS, bao cao, n6n sd lupng ngd dOc TP thu thap chua

dupe day du. Tuy nhien con sd ngd ddc TP a Viet Nam nhttng nam gin day cung cho thay day la van de d n dupe quan tam va can lliiep.

Ngp dpe TP man tinh: Neu chat lupng VSATTP khdng dam bao cdn gay ton thuong man tinh nhu:

-I- cac b$nh man tinh: Dai thao dudng, tim mach, huyet ap tang, loang xuong, ung tiiu, beo phi....[73].

+ Cae tdn thuong m ^ tinh: tdn thuong gun. than, da va cac eo quan hg thing khac. -1- Rdi loan cac chtic nang co the: cac ciu'ic nang tieu hoa, hd hap, tim mach, than

kinh, sinh due, tao mau, thj giac... cung bj linli hudng neu chat lupng VSATTP khdng dam bao [44].

1.1.3.2. Anh hudng Sen kinh te - xa Iiiii cac b^nh lien guan din ngp dpe TP da gay thiet hai Idn eho nganh kinh te, xa

hpi va cac ehi phi y te khac. Theo To chirc y ic The gidi (WHO), hing nam d My ed khoang 3,3 - 12 ttigu ca bi nhilm dpe TP va ihict hai 6,5 - 35 ty USD (chi phi 1.531 USD/ca). d Anh 190 ca nhiim dpe TP/l.OOOdan (chi phi 789 bang Anh/ca). d Uc tnmg binh hing nam cd khoan 11.500 ca nhiOm dpe TP, chi phi vao khoan 2,6 ty USD tjc/nam (1.679 USD/ca), Canada hing nam co 33 ttigu ca, chi phi hit 7,7 ty USD. Cac bgnh do an phai TP hi d nhiem dang la mpl \ fin de siic khde idn d cae nude phat trien cung nhu cae nude dang phat triin. 6 cac mu'ic dang phat triin cd khoang 10% hi ngp dpe TP. Nhu vgy, ngp dpe TP dang la mdi &: dga sire khoe ciia mpi ngudi dan.

6 Vigt Nam, Cyc An toan vg sinh thuc pliam (ATVSTP) udc tinh moi nam cd khoang 9 ttigu ca bi ngO d0c TP va cac bcnli truyin qua TP. Theo tinh toan ctia cae nuac dang phat ttiin, ehi phi khic phyc hau qua cho mot tradng hpp nhilm ddc TP la 100 USD tiic la khoang 1.900.000 dong (ban gdm ttr ngudn ngan sach nha nude, gja dmh nan nhSn phai chi tta va doanh nghiep nui xay ra ngd ddc TP phai chi tra di khac phuc hau qua). Nhu vgy, mdi nam d nuiic Ui phai mit 17.000 ty ddng di chi cho viSc khie phyc hau qua do ngp dpe TP va cac bC Ji iruyen qua ' p ' [45].

TP b} d nhiim da gay thiet hai nghiem Irpng din nin kmh te. Vu dich ta xay ra d Peru nam 1991 dS gay tin thit 700 trieu USD trong viec xuit khlu ca va cac san phim tir ea, ngay nhu d My dang phai ddi dau vdi vd sd nguy co xay ra nhu thit b) nhiim vi khuln, chiia cac ehlt tang tnione. ihudc khang sinh hoge 'TP sir dyng cong nghg gen. Vln di thit bd diSn d Anh nh.iiii \ lio cac nude khdi Bac Au, TP hi nhiim digoxm d Bi da lam eho nganh cdng nghiC;) xuat khlu TP nude naylamvao khing hoang ttlm ttpng. Ri6ng van de kiem tra doe chat digoxin ttong TP d6 khSng djnh dd an toan cua cac TP dd cung da ehi phi l5ii l;em dang ki (khoang 20 ttigu dong ViSt Nam/mlu x6t nghigm). Mpt chuyen gia hang banh kgo Corana-Loms d Bi cho biSt lpi nhuan eua hp bj giam 47% sau vu digPNin nay. San phim thit ipn ddng hpp, xdng khdi d Phap bi nhiim Listeria diu nam 2000 d;1 gay du luan Idn va din tdi viee dinh ttg tieu thu TP nay d thi trudng chau A.u.

Ngoai cac anh hudng ttlm trpng tdi sue klipe cung nhu ehi phi cia timg ea the, ngO dpe TP cdn gay inh hudng Idn doi vi'n nin cdng nghiep TP va nen kinh t& cac qude gia, khu vue.

Bang 1.1. Ng6 d0c TP anh hu-ong din chi phi

Ddi vdi ca thl

. Cac chi phi y te

. That thoat thu nhap • Dau don va chiu dung • Khong con thi gia rdi rai • Chi phi cham soc nguoi benh • Su xao tron trong sinh hoat gia dinh . Cac chi phi boi duong phuc hoi - Cac chi phi hgrp phap

Doi voi c6ng nghiep TP

- Thu hoi san pham . Dong cua nha may . Don ve sinh • M^t thj truong • Mat tinh than tugng • Gia tang chi phi bao hiem • Cac chi phi hop phap

dnh te xa hoi

Doi voi Nha nyo'c

. Chi phi giam sat

. Dieu tra nghien cuu sir bung no cua benh

Ton that lao dpng quoc gia a nhiing vung ngp doc . Giam xuat khau • Chi phi cham soc y le va an toan xa hpi

That nghiep Thiet hai ve du lich

- Thiet hai v^ ngu6n nhan luc

GMgudn: Food safety for nutritionist. ICD/SEAMEO/GTZ/WHO)

Ching ta nhgn thay anh hudng cia ngp ddc TP cd thi xay ra tren 3 pham vi. Chi phi cia ngp dpe TP cho ea the cd the chiem uu the khac nhau tuy thupc vao timg khu vue tten the gidi. 6 cac nude dang phat ttiin thieu he thdng bao hiim xa hdi nen mat thu nhip ttong thdi ky dau dm cd anh hudng Idn ban so vdi cac nude phat trien. Ddi vdi nen ndng nghiep, ngd doe TP dan den su nghi viec, mat mat sire lao ddng va cd the dan den that nghigp. Ddi vdi cdng nghiep TP, ttong tradng hop cd san pham gay ngd ddc TP thi nha may phai ngimg san xuit va cd the gay hau qua tai hai hon den cpng ddng. Sy tang trudng cia kinh te cac nude dang phat triin cd thi bi anh hudng bdi ngp dpe TP do khdng dap img dupe yeu d u cia sy phat teien ludn ddi hdi sic lao ddng khoe manh.

Van de TP khdng dam bao chat luong VSATTP la nguyen nhan chi yeu dan den nhimg thiet hai khdng chi tinh mang, sic khoe ciing nhu kinh te cia timg ngudi hoac timg gia dinh, ma cdn anh hudng den sic lao ddng cia toan xa hdi, anh hudng den uy tin hang hoa va lam giam kha nang tieu thy TP che bien tu ngudn nguyen lieu trong nude, cac cd gang nang cao chit lupng VSATTP, phdng ngua ngp ddc do TP gay nen da gdp phan thue diy sit phat triin kinh te, phic lpi xa hdi, sic khde cdng ddng va cai thien chat lupng eupe sdng. Thdng ke cac vy ngd ddc TP la 1 chi tieu nhay ben ve sic khde, vg sinh va an udng hign nay.

1.1.4. PhSn lo^i 6 nhiem TP Tuy theo tac nhan gay d nhiim TP ngudi ta ehia ra 3 loai d nhilm TP ehinh.

1.1.4.1. O nhiim sinh hpc

u. Cdc con ducmg gay 6 nhiim TP do sinh hoc

TAC NHAN SINH HQC

: ^ ^ T Sue vat bj

benh

Mo thit

Sinh vat co doc to

Che bien TP

IMo quan TP

Doc to

nam mdc

Th\rc vgt c6

doc

Dong vat CO

doc

V^ sinh c^ nhan (tay ngirai lanh

mang trung, ho..

I O'Au kign

ini t v? sinh, klidng che day, ruoi. chuOt...)

THy'c PHAM

So do 1.3. C4c con dirdng gay 6 nhiem sinh hgc vao TP.

b. Cdc tdc nhdn sinh hoc gdy 6 nhiem TP

- Vi khuan: Cac vi khuln cd ttong TP cd the gay bgnh nhilm khuln ho|o gdy ngd dde cho ngudi an. Cac bgnh nhilm khuln la do an phai vi khuan gay bgnh, ching phat trien teong co the ngudi, thudng la trong dudng rapt Ngp ddc TP do an phai chit ddc hinh thanh t i trudc (chat ddc do vi kliuin sinh ra teong TP t i trade khi Sn). Thudng ngudi ta chia ra: vi khuln hkih thanh bao t i va vi khuan khdng hinh thanh bio ni:

+ cac loai vi khuan hinh thanh bao t i : Closteidium botalmum, Clostridium perfringens. Bacillus cereus.

+ cac loai vi khuan khdng hinh thanh bao t i : Vibrio cholerae. Vibrio parahaemolyticus. Salmonella, Shigella, Campylobacter, Listeria, Staphylococcus, aureus, Stteptoeoccus, Escherichia coll. Yersinia enterocolitica, Proteus.

- Cac vhus: Virus viem gan A, Vhus viem gan E, Rota viius, Norwalkvirus, Vims bai liet

- Cac i y sinh tring: Ky sinh tring don bao: Entamoeba histolytica; Giim dua; Giun tdc; Giim mdc; Giun xoin; San la gan nhd; San la phdi; San day Ipn; San day bd.

- Cac vi sinh vat cd ddc td: Ddc td nim ddc; -H Aflatoxin: La ddc td cia nam Aspergillus flavus va Aspergillus parasiticus,

hay cd ttong ngd, dau, ciii dia khd... la ddc td gay ung thu gan, giam nang xuit sia, tring.

+ Ochratoxin: La ddc td c ia nim Aspergillus ochraccus va Penicllltum virdieatum, hay ed ttong ngd, lua mi, lia mjch, bdt dgu, hat ea ph6. Ddc td Hay cing cd kha nang gay ung thu. Qua kit qua Idem tra Aflatoxin Bl Ihay rang ty If d nhiim d m.pt sd loai TP nhu sau: lac nhan: 17%; xi diu: 33%; tuong: 42%; ca phi: 30%; ddu phdng: 68%. Ddng v^t cd chit ddc: cdc; ea ndc; dde td teong nhuyin thi: DSP (Diarrhetie Shellfish Poisonmg): gay tieu ehay, NSP (Neurotoxic Shellfish Poisoning): gay het thin kinh, ASP (Amnesic Shellfish Poisoning); gay dSng tri, PSP (Paralytic

Shellfish Poisoning): gdy liet ca; cac loai ca ddc khac. Thuc vat cd chat ddc (Pyrrolizidine, Alkaloids, Lipin alkaloids): nim ddc; mang, sin doc; la ng6n...fl9]

1.1.4.2. O nhiem hod hpc: u. Nhitng chdt hod hoc cho them vao TP Iheoy mudn - De bao quan TP: + Chat sat khuln: Mudi Nitrat, mudi Nitrit, axh benzoic, Natri benzoat, Natri

borat (han the)... + cac chat khang sinh: Chloramphenicol, Tetracycllin, Streptomycin,

Penicillin... -I- Cac chat kich thich tang trpng. + cac chat chdn^ dxy hoa: axit aseobic, axit xltic, axit lactic, a - Tocopherol... + Chat chdng mde: Natri diaxetae, diphenyl... -I- De tang tinh hip din cia thic Sn: Chat ngpt ting hpp: Saccarin; cac phim

mau: phim mau vd co, pham mau hfln co, phim mau tong hpp. -I- cac hpa chit cho them vao di che bien dac biet: cac chit lam tring hot: khi

Cio, Oxyt nita...; cac ehlt lam tang kha nang thanh banh dai. gion cia bpt: Rroinat. . Han the...; cac chat lam eung TP: Canxi CIrua, canxi citrat, canxi photphas... (ding canxi photphas lam cimg dau phy).

-I- Tang khlu vi: mi ehinh...

b. Nhitng hod chdt lan vdo TP: - cac hoa chat cdng nghiep, cac hoa chat trong dat: dioxin, PCBs, vinyl

chloride, aeryloniteile, benzopyrene, styrene... - cac kim loai nang: thuy ngan, chi, cadimi, kem, arsen, ddng, sat. - Chat d nhiem trong nau nudng, che bien: acrylamide, chloropropanols.

c. Hod chdt bdo ve Ihuc vdi: O nhiem TP do hoa chat bao vf thuc vat d nude ta ngay cang gia tang. Nguyen

nhan do ehua kiem soat dupe tinh teang nhap lau, budn ban cae loai hoa chat bao vg thye vat cam qua bien gidi, chua hudng dan ve each ding hoa chat bao ve thire vat den noi den chdn eho ngudi dan, chinh quyin cac d p , nhit la eo sd eung nhu cac nganh chuc nang chua thue su cd bien phap quan ly nghiem ngat. Chinh vi vay, tinh teang rau qua ke ca che xanh hi nhilm hoa chat bao vg thue vat edn kha phd bien.

1.1.4.3. 6 nhiim TP do cac yiu td vgt Iy

- cac di vat: Cac manh thuy tinh, san, dat, sdi, manh cac vat dyng khac ISn vao TP.

- cac manh kim logi, chit deo... - cac yiu td phdng xa: Do sy cd n i cac Id nguyen t i , cac nha may dien nguyen

hi, rd ri phdng xa t i cac Trang tam nghifin ciu phdng xa, t i cac md phdng xg. - Cac thuc vat, ddng vgt ttong vung mdi trudng hi d nhiim phdng xa ki ea nude

udng hi nhilm cae ehlt phdng xg se gay hai cho ngudi s i dung khi an udng phai ching.

1.1.5. Nhung dieu cin lam d l co bira iin ngon va dam bao VSATTP [S4]: Phu lyc 10

1.1.6. Mot s8 qui djnh lien quan din ngvdi kinh doanh, che bien TP

Ca sd kinh doanh TP: la cae ca sd td ehie budn ban TP de thu ldi lai, bao gdm:

- Co sd ban TP la cac ea sd trung bay TP di ban cho khach hang. - Co sd dich vy an udng la cac co sd kinh doanh dich vu an udng. - Co sd vgn chuySn TP la cac co sd van chuyen TP, nguyen lieu TP t i noi nay

den noi khac.

1.1.6.1. Quy Oinh yeu ciu kien thAc vi VSA TTP - Ca nhan true tiip san xuat, kinh doanh TP phai cd Giiy ching nhan da duac

tgp huan kien thuc ve VSATTP phu hpp vdi timg nganh nghi san xuit, kinh doanh. - NhOngngudi cd bang tdt nghigp dai hpc, cao ding y, dupe chuyen khoa ve

sinh TP, dich ti , dinh dudng; bing tit nghigp Dai hpc hoac Cao ding - khoa Cdng nghg TP khi \xnc tiip tham gia san xuit, kinh doanh TP khong d n cd Gily chimg nhan da dupe tap huln kien thic vi VSATTP.

- Cap nhat cac kien thic chuyen nganh

Ngudi cd Giay ching nhgn da dupe tap huln kiin thic vi VSATTP, hang nam, phai tham gia tap huan de cap nhat cac kien thic chuyen nganh, cy the cho timg nganh nghe san xuat, kinh doanh TP [8].

Chi CO sd san xuat, kinh doanh TP cd trach nhiem tao dieu kien cho ngudi true tiep san xuat, kinh doanh tham gia tap huan hang nam; ddng thdi phai ed sd theo doi viec tap huan ndi teen. Sd theo doi phai cd su xac nhan cia co quan giang day.

- cac kien thic co ban la diiu kien di duac cap giay ching nhan: -I- cac mdi nguy co gay mit VSATTP. -I- Diiu kien VSATTP. -1- Phuang phap bao dam VSATTP (trong san xuat, che bien, bao quan, luu tri,

van chuyin, tiiu ding ...) -I- Thye hanh tdt VSATTP. -I- cac quy djnh phap luat ve VSATTP. -I- cac kiin thic: thue hanh san xuit tdt (GMP - Good Manufacture Practice),

thue hanh vg sinh tdt (GHP - Good Hygiene Practice), phan tich mdi nguy ca va kiim soat diim tdi han (HACCP - Hazard Analysis and Critical Conttol Point).

- Cac kien thic chuyen nganh: cu thS cho timg nganh nghe san xuat, kinh doanh TP.

1.1.6.2. Quidinh dieu kiin v&i cff sd chi biin TP

Thuc hien theo Quyit dinh si 4428/2001/QD-BYT ngay 3/10/2001"Qui dinh xi diiu kien bao dam an toan TP tai cac nha an, hep an tap the va co sd kinh doanh che biin suit an sSn", eua Bd y t i [14] (phy lyc 9)

1.1.6.3. Biiu hien sAc khoe cOa ngu&i lao ifng

Thuc hign theo Quyit dinh sd 4428/2001/QD-BYT ngay 3/10/2001"Qui dinh vi diiu kign bao dam an toan TP tgi cac nha an, bep an tap thi va co sd kinh doanh che biin suit an sin ", cua Bd y t i [14] (phy lyc 9)

1.1.7. Thirc an dunng ph6 Hien nay, cimg vdi cac loai TP chi biin sin, dich vu T A D P ngay cang phat

trign. cac dich vu nay thugn tien eho ngudi tieu ding nhung cung tiim In nhiiu nguy CO gay ngd dpe TP.

Theo khai nigm cua Td chic Y t i thi gidi, TADP la nhung dd an, thic udng dupe larn sSn hoac che biin, nau nudng tai ehd, cd thi an ngay va dupe bay ban tren dudng phd, nhiing nai edng cdng. Cd 3 loai TADP: ban ttong cia hang cd dinh, ban teen he phd va ban rong. Hien nay, ea 3 loai hinh nay dang phat teiin rit manh d nhiiu dd thj Idn ttong nude. Vigc phat ttiin cae loai hmh T A D P teen la mdt nhu d u tit yiu cia xa hdi, vdi vigc dem Igi nhiiu thugn tien cho ngudi tieu dung. Tuy nhien song hanh cung sir thuan tien nay la nhttng mdi nguy tdi sic khde, tinh mang ngudi su dyng, thgm chi la tdi ca cpng ding.

1.1.7.1. Nhiing Igi Ich va nhufc Mem cua TABP - Left ich: + Thugn tign cho ngudi tieu dung. + Re tien, thich hpp eho quang dai quin ehung. -I- Ngudn thic an da dang, hip din, ddng vai ttd quan ttpng ttpng viec cung cip

thic an eho xa hpi. + Ngudn thu nhap va tao cdng an vigc lam cho nhieu ngudi, nhit la phy nii,

nhimg ngudi di cu t i ndng thdn ra do thi, it vdn, khdng d n nhiiu eo sd va ttang thiit hi [15].

- Nhwac diem: + Thiiu ha ting co sd va dich vy ve smh mdi tradng (cung d p nude sach, xu ly

rac, chit thai, cdng trinh ve smh...) -I- JChd kiim soat do su da dgng, co ddng, tam thdi, mia vy... -I- Ngudi ban T A D P thudng thieu kien thuc vi VSATTP, diiu kien kmh t i han

hep. -I- Viec quan ly, tiianh tta, kiim tra T A D P cdn rit khd khan do thieu nhan luc,

ttang thiit bi va phan cdng ttach nhiem. -I- La mdi nguy co Idn cho sic khoe cdng ddng (ngd dpe TP, eae hfnh lay

trayen qua TP), anh hudng tdi canh quan va van minh dd thj |49].

1.1.7.2. Yiu can vg sinh doi vdi TADP De T A D P that sir giip cho moi ngudi, khdng gay ngd ddc can thuc hien cac yeu

cau sau: - NguySn lifu tuai sdng, cd ngudn gdc r5 rang, dang tm cay, an toan khdng d

nhiim ktd bao quan, van chuyin. - Nude, nude da: Nude diing chi biin, lam da phai la

nude sach, nude dung di udng tryc tiip phai la nude dun sdi. - Noi chi biin: Khu vue chi biin, dyng cu chi biin phai

sach, v i sinh. TP sdng, chin phai dupe chi irien hang dyng cu rieng, nia sgch, nlu chin. Khdng s i dung pham mau, phu gia, hoa chit ddc hai trong chi biin.

- Van chuyin, bao quan: Hgn chi vgn chuyen xa, dun^ ey v|n ehuyin phai sach, duac die day kin, phai ed hi lanh m bao quan A i c an.

- Noi bin hang, dung cy niu nudng: Cd ban, t i kinh, gia cao tten 60 cm cdch ly ngudn d nhiim (khu vi smh, cdng

Hinh 1.6. Canh ban

hang rong

ranh,...). Dyng cy tiep xic TP phai sach sg, r ia sgch thudng xuyen. S i dyng bao bi sach, an toan khi bao gdi TP.

- Ngudi che bien, ban hang: Ria tay va giu ban tay sach trong sudt qua ttinh che bien, ban hang. S i dung trang thiet hi chuyen dung (quin, ao, mu, tap de, khlu trang...) khi ban hang. Cd benh truyin nhiim khdng dupe ban hang. Dupe tap huln kiin thic vi VSATTP.

Ddi vdi dich vu TADP ban rong ein thye hign. - Chi ban thic an ed thi dam bao dupe VSATTP khi dem di ban reng. - Cd phuong tien dam bao VSATTP (xe day, xe dap, ganh hang, lan hang,

thing hang, mgt hang...). Cy the phai: + Kin, tranh dupe mua ning, byi, gid, rudi, mudi, cdn trung... -I- Giu dupe thic an sach, khdng d nhilm. Ngudi ban hang khdng cd bgnh trayen nhiem, cd dieu kien vg sinh ca nhan tdt,

dupe tap huan vi kiin thic VSATTP. Cd cam kit vdi chinh quyin co sd va y ti vi vigc dam bao chat lupng

VSATTP. - Dung eu dung thic an, bao gdi thic Sn phai sach, khdng ding lai trong cing

mpt lln. - Gitt ding thdi gian an toan cia thic an, khdng dupe ban thic an cd diu hieu

hu hdng, di thiu, d nhilm. - Nguyen lieu lam thuc an phai dupe chpn Ipc, che bien dam bao yeu cau vg

sinh. - Khdng ding tay tryc tiep bdc, nam thuc an de ban [51].

1.1.7.3. Nguyen tac bao dim an toan TABP - Chinh quyin phudng la ngudi chi tti, kit hpp bio dam VSATTP vdi xay

dung phong ttao van minh dd thi. - Y te la tham muu. - Huy dpng cac td chic quin ching va cac nganh tham gia: Cdng an, quan ly thj

tradng, y ti , chtt thap dd, cuu chiin binh, van hoa thdng tin...) - Duy tri chi dp kiim tra ddn ddc, chan chinh thudng xuyen (td thanh tta nhan

dan) - Thudng xuyen myen trayen nhIc nhd tren loa dai, thuc hign cam k& gitta ca

sd kinh doanh T A D P vdi chinh quyin dia phuang. - So kit, tdng kit, danh gia.

1.1.7.4. Tieu chudn ve sinh dSi v&i TABP - Bao dam d i nude sgch. - Cd dung cy rieng gip thiie an chin. Khdng di lin thic an chin vdi thic an

sdng. - Nai chi biin TP phai sach, each biet ngudn d nhilm (edng, ranh, rac thai,

cdng ttinh ve sinh, noi bay ban gia sic, §ia cam...). - Ngudi true tiip lam djeh vy ehi biin, kmh doanh thic an phai dupe tap huan

kiin thic va kham sic khoe dinh kJ'. - Nhan vif n phai cd tap di, khlu ttang, mu khi b&i hang. - S i dung nguySn lieu chi biin TP cd ngudn gdc tin c$y. Khdng s i dung eae

chit phy gia, pham mau khdng dupe phSp s i dyng ttong ehi biin TP. - Thic an phai dupe bay ban tten gia cao tten 60 cm.

12

- Thie an chin phai dupe bay ban ttong t i kinh. - Thic an phai dupe bap gdi hpp ve sinh. - Cd dyng cy chia dyng rac thai tai npi kinh doanh dich vu T A D P [7].

1.1.8. Hg thong hoat dpng v4 lu^t phap ve VSATTP

1.1.5.1. Trin thigi&i:

Hau hit cac qude gia tren the gidi deu rat quan tam den cdng tac dam bao chat lupng VSATTP, nhat la nhihig qude gia cd nen kinh te phdt triin nhu Bac My, Chau Au... luat phap lien quan den cdng tac nay da dupe ban hanh t i rat lau, each day ca tram nam nhu My, Uc,... Vifc diu tu ban hanh cac vSn ban phap quy, thanh lap cac don vj chuyin nganh nghien cim, kiim spat hpat dpng nay cing nhu cac quy dinh ve dieu kign vg sinh, tieu chuan chat lugng... ngay cang nghiem ngat hon; chang ban nhu Tmng tam kiem soat TP va dupe phim Hoa Ky (FDA) ra ddi chuyen nghien eiu vi Hnh vue TP va dupe phim, Uy ban tieu chuIn hda TP Qude ti (CODEX); Hdi ddng chung FAO/WHO vi phy gia TP (JECFA), Co quan an toan TP Chau Au (EFSA) da ky hiep djnh vdi Co quan kiim soat TP va dupe pham Hoa Ky (FDA) trong ITnh vue danh gia nguy co an toan TP,... [73].

cae nude d gan ching ta nhu Trung Qude, nam 1995 da ban hanh lugt ve sinh TP, CO quan quan ly nha nude ve VSATTP thupc Qude vu vien; Indonesia ban hanh phap ifnh ve thye pham, san pham cia trdi cho nam 1996; Malaysia ciing da ban hanh phap lenh TP tir nam 1983 [52].

1.1.8.2. Tai Viet Nam

Dang va Nha nude dae bift quan tam din cdng tac cham sde va bao vf sue khde nhan dan, diiu nay dupe thi hifn ttong tit ca nghj quyit, van kign Dgi hdi Dang cac cap, cac ky Dai hpi. Quan diim nhit quan nay dupe khing djnh cy thi trong Nghi quyit sd 46/NQ-TW ngay 23/2/2005 cia Bp Chinh tti ve cong tac bao vf, cham soc va nang cao sic khde nhan dan ttong tinh hinh mdi. Bao dam an toan TP la mpt ndi dimg quan ttpng teong edng tac bao vg sic khde nhan dan, nen cung da dupe Dang, Nha nude quan tam sau sac, dieu nay da dupe thi hifn cy thi bing hanh dpng cu thi: thanh lap Cue quan ly chat lupng, vf sinh, an toan TP (tien than cia Cue ATVSTP ngay nay) nam 1999. Ngay teong nam nay, Chinh phi da ban hanh Chi thj sd 08 ve viec tang cudng cac bifn phap bao dam chit lupng VSATTP; nam 2000 da phe duyet ehuang trinh bao dam VSATTP la mpt teong 10 chuong trinh mye tieu quoc gia cia Bd Y te; nam 2003 da ban hanh Phap ifnh vg sinh an toan TP ; nam 2004 ban hanh Nghj djnh sd 163/2004/ND-CP hudng din chi tiit thi hanh mpt sd diiu cia Phip Ifnh VSATTP; nam 2006 phe duy ft chuong trinh hanh dpng bao dam VSATTP giai doan 2006-2010 theo hudng ted thanh chuang trinh mye tieu qude gia doc lap; nam 2007, phe duyft 6 du an nim teong chuang tthih muc tiiu qude gia bao dam VSATTP giai doan den 2010 vdi tdng kinh phi khoang 1300 ty ddng. Nam 2008, ban hanh Nghj djnh sd 79/2008/ND-CP vi hf thdng td chic quan ly va kiim nghifm vf sinh an toan TP [17].

Bin cgnh dd, Chinh phi cung chi dao, giam sat chat che cdng tac bao dam VSATTP; da td chic Hdi nghj toan qude lln th i nhit v i cdng tac bao dam VSATTP vao thang 01/2007 va lln 2 vao thang 3/2008; ban hanh Chi thj sd 06/2007/CT-TTg vi vifc triin khai cac biin phap cap bach bao dam vf sinh an toan TP; chi dao eae bp nganh Hen quan di xuit xay dung du an luat an tpan TP di trinh Qude hpi vao nam 2009. Cac Bp, nganh Uin quan cung da ban hanh hang loat cae Quyit djnh, Thdng tu, Thdng tu lien tjch ... d i hudng din chi tiit thi hanh cae nhif m vu quan ly nha nude vi

13

ATTP, tgo hanh lang phap ly kha day d i cho linh vye quan ly mdi, dac bift quan trpng nay.

l.l.S.3. Tai tinh QuingNam

Nhiing nam qua cdng tac nay da dupe UBND tinh ban hanh nhieu van ban chi dgo thuc hien: Chi thi sd 12/CT-UBND ngay 27/3/2006 cia UBND tinh, Ki hoach so 3960/KH-UBND vi Phe duyet ki lioach hanh ddng vf sinh an toan TP giai doan 2006 - 2010 cia tinh Quang Nam va nhiiu van ban chuySn mdn khac cia cac Sd Y te, Khoa hpc - Cdng nghg, Ndng nghiep - Phat trien ndng thdn, Cdng thuong,...mot each thudng xuySn va kip thdi di teiin khai ede hoat dpng vf sinh TP mpt each cd hifu qua.

1.2. TINH HINH NGHIEN CXSV

1.2.1. Tinh hinh ng§ dge TP tren the gidi vi trong nnde

1.2.1.1. Tren thi gi&i: Theo udc tinh cia WHO, tren thi gidi hang nam cd khoang 1,3 ty ngudi bj tieu ehay, teong dd 70% nguyen nhan do s i dyng TP khdng an toan, TP nhiem ban gay ra va lam ehet 2,2 trieu ngudi [19]. Ci My theo thdng ke cua Trimg tam kiem soat va phdng ngua benh tat (CDC) thi cd Idioang 5% dan sd bj nhiem doc TP teong nam, nhu vay moi nam cd khoang tren 13 trifu ngudi bj ngp ddc va phai chi vai ty dd la cho cdng tac ciu ehtta. Thuc te, nude My dang phai ddi dau vdi vd sd cac nguy eo ngd dde nhu thjt bj nhilm khuln, TP cd nhilm hormon tang tradng, cac chit khang sinh, TP cdng nghf gen.

d Ha Lan, ngd dpe TP hang nam len tdi 9-15 tradng hgp/1000 dan, trong do ty If ngp ddc do Salmonella la 5% va do Campylobacter chiem tdi 15% [70]. Gan day, sd tradng hpp ngd ddc do Salmonella chiem 1,5% dan sd va do Campylobacter chiim tdi 4,5%i dan sd. Vdi sd dan Ha Lan la 15,2 teifu, nhu vay udc tinh hang nam cd tdi 100.000 tradng hop do Salmonella va 300.000 ca bgnh do Campylobacter [70].

Theo thdng ke cia Mayer trong 50 nam gan day, ty If t i vong do ngd ddc Botalism chiim tdi 34,2%, d My ty If nay la 63,7%). Stta chua cia cdng ty Acor Dairies nude Anh nam 1989 nhiim Closteidium botolinum lam 27 ngudi mac va cd 1 ca t i vong. Nam 1993, vy ngd ddc do Closteidium botulinum typ B cd lien quan den mdn ca chiSn ttong dau tai "Y eung da dupe bao cao [4].

Cae thic an bd sung bj d nhiim do cae vi khuln nhdm Escherichia coli dang la nguyen nhan ehinh cia tieu ehay d tee nhd [46]. Vy djeh d My (1998) lam 32 tee em hi viem rapt kit ehay mau cd lien quan tdi vifc tieu thy thjt vien nhd che bien chua chin nhilm Escherichia coli 0157:H7 thudc la smh dde td dudng rapt (ETEC). Nam 1999 ed 804 tradng hap mle bgnh do nude udng nhiem vi khuln nay, do la hau qua cia thye hanh vf sinh kem, gay lay nhilm t i ngudi nay sang ngudi khac.

Nhat Ban la nude cd nin cdng nghifp phat teiin mgnh ddng thdi cung la nude ma sy d nhilm mdi te^udng da lam cho hang ngan ngudi chit vi an phai ca bj nhiem thuy ngan [64]. Theo sd lieu (1991-2000) d Nhgt cd 14.549 vy ngp doc TP vdi 368.313 ngudi mic va 72 ngudi chit, ttung bhih 20-40 ca/lOO.OOOdan. (3 Uc cd khoang 4,2 nieu ngudi mle hing nam. 6 Canada c i 11 ngudi mic benh thi cd 1 ngudi bi ngd ddc TP, nhu vay cd khoang 2 ttieu ngudi mic/nam vdi chi phi 1.100 do Canada/ea. Trong nhung ttudng hap ngd dde tten cd 85% la do bj nhilm khuln thic an. Tai Osaka-Nhat Ban (6/2000), cd 14.700 ngudi bj ngd dde do udng stta tuoi loai beo ddng hop gily SNO'W, do khdng dam bao cac quy trinh, chi dp vf sinh san xuit mdt each nghidm ngat.

Khu vue Thai Lan, An Dd, Philipin cd khoang 100 ngudi vao vifn hing ngay do s i dung TP khdng an toan. Theo thing ke cia Manila (Philipin) thi tieu ehay la mpt ttong 10 nguydn nhan gay hfnh tat chinh vdi tong so 19.498 ca (1997) va 19.598 ca (1998). Tgi Trang Qude, teong 6 thang diu nam 2004 cd 3.634 ngudi bj ngp ddc TP va 89 hfnh nhSn t i vong. Tgi miin Bic Thai Lan (3/2006), 161 ngudi d tinh Nan da phat hifn sau khi an mSng tre mudi chua d mdt ll hpi do bao quan mang tre khdng tdt da tao ra vi khuan Clostridium botulinum. Theo udc tinh cua td chic y te the gidi, cd khoang 1/100 sd ea n^p ddc TP dupe ghi nhan tren bao cao cia cac nude cd he thdng bao eao ngd ddc TP bat budc (it hon rit nhiiu sp vdi thuc ti). Thue te hang nSm tai cac nude phat triin cd khoang 10% dan sd bj ngp dpe TP, cac nude kem phat triin con sd nay eao hon nhiiu, chiim khoang 1/3 dan sd bj ngp ddc TP/nam [29].

Ngp ddc do an phai TP cd chua sin chat dpe tuy it xay ra nhtmg ty If t i vong lai cao hon ngd ddc do d nhiem vi sinh vat.

Nhiiu bao eao gan day cho thiy cac bfnh lien quan den TP ngay cang tang. Cd tdi 30% dan sd d cac nude phat triin ehju anh hudng bfnh tgt do TP gay nen. Vy ngp ddc tai 19 tinh nude Phap (1/2000), do thjt Ipn ddng hpp bj nhiim Listeria gay nhieu lo ling cho ngudi tieu ding Chau Au.

Nghien ciu d cac nude dang phat triin cung cho thay tinh trgng bfnh tat do TP d nhilm dang cd chiiu hudng gia tang. Ngp dpe TP gay ra bdi phly khuln ta (Vibrie cholerae) dupe biit t i thiin niin ky trade, thudng xay ra d eae cdng ddng ngheo nhu An Dp, Ddng Nam A va Chau Phi. Dau nam 1991, benh xuit hifn d Pera da lan rdng tdi M5' La tinh va Trang My, tdng sd len tdi 506.798 ngudi mac do su lan trayen qua nude vaTP [64].

1.2.1.2. TaiVi^lNam

Tai nude ta, teong nhung nam qua, cdng tac VSATTP dang ding trade nhieu thic thach. Nhieu vu ngd ddc cap tinh xay ra gay ehet ngudi rit dang tiic d cac btta an tap thi. Theo thing ke cia Bd Y ti, t i nam 1999 din 13/8/2004, tren toan qude da xay ra 1.245 vy ngp ddc TP vdi 28.014 ngudi mac, trong dd 333 ttudng hop t i vong. Dien hmh la vy ngd dde TP ngay 11/6/2003 tgi bip an tap thi cia Cdng ty TNHH P&G sin xuit hda my phim cia tinh Binh Duong vdi 350 nan nhan; hoac vy ngp ddc tai bSp an tap thi cua Cdng ty May Nghia Tung (Thanh phd Hd Chi Minh) vdi 59 ngudi. Phan tieh nguyen nhan xay ra ngd ddc teong thdi gian tren cho thay ty If sd vu ngd ddc do vi sinh vgt vln cao nhit ( t i 32.8-51.3%), sau dd la ngp ddc hda ehlt (11-25%) va TP ed ddc (6.4-31.8%), cdn lai la cac trudng hpp ngp dpe chua xac djnh dupe nguyen nhan. RiSng teong nam 2007, sd vy ngp dpe TP cua ca nude da tang gin 39.0% so vdi nam 2006 [6].

Nhiing dot kiim tra VSATTP cia Cyc An toan vf sinh TP cho thay, nhiiu doanh nghifp chua quan tam ding mic ddi vdi quy djnh vi VSATTP, thudng gap nhung vi phgm nhu dung cy phue vy an udng, chi biin, tin trtt, bao quan TP sai quy djnh; nhan viSn tryc tiip san xuit ehua dupe teang bj kiin thie ea ban ve bao dam an toan TP va vf smh ca nhan. Hiu hit cac bip an tgp thi, noi cung cap suat an eho cdng nhan mua hang tedi nil, kem chit lupng, mit vf sinh, t r i sd it cong ty Ion mdi mua d siSu thj. Nguy ca gay ngd d^c Idn nhit la ngudn nguySn Ufu, nhimg hiu hit nguyen lifu diu vao khdng qua kiim djnh. Dang lo nggi hien nay la vigc nh$n thic vi phdng dich benh ciia cac ca sd nau an edn chi quan, coi nhe.

VSATTP la vln di dang dupe quan tam d nhiiu nude ttSn thS gidi, nhat la teong hoan canh hinh thanh cac khu vye mau djeh ty do, toan ciu hoa kinh t i hifn nay. 6

nude ta, VSATTP cung dang la vln di cd tinh thdi su d p bach. Nhung nam qua, ehlt lupng VSATTP khdng dn djnh, mac du ed nhiiu tiin bd khoa hpc ky thuat trong cdng tac dam bao A T V S T P , cac blfn phap ve quan ly, giao dye cung nhu ban hanh cac van ban quy pham phap lugt... v i vf sinh TP, nhung cae bfnh do chit lupng TP va thii-c an khdng an toan vln cdn chiSm ty If kha cao, nhiiu vy ngd dpe do an udng xay ra, nhiiu teudng hpp gay chit ngudi.

Khi nghien eiru du lupng hoa ehlt bao vf thuc vat trong mpt sd rau qua d Thai Nguyen, Bic Ninh, Ha Nam, Ha Npi, Quang Binh, Ninh Thuan cho thiy, cd mdt ty If Idn rau nhiim hoa ehlt bao vf thuc vat (bang 1.4) [19].

Bang 1.4. Rau qua bj d nhiim hoa chat bao vg thurc vat

STT 1 2 3 4 5 6 7 8 9

Ten rau qua Rau mudng Rau ngdt Rau cai Bap cai Dau dua Dua chudt Nho npi Tap Trang Qude Li Tnmg Qude

Ty Ig 6 nhiim hoa chat bao ve thuc vat (%) 83,00 68,00 91,00 30,00 50,00 100,00 50,00 50,00 50,00

Tuy nhiSn da sd vy ngd dpe cd nhiSu ngudi mac thudng lien quan den TP bj d nhilm vi sinh vat gay thift hai Idn din sic lao dpng va cae chi phi phuc hdi sue khde. Mdt sd ddng ngudi hi mac tai bip an tap the nha may, tradng hpc... Tai cdng ty CHIN-LI khu cdng nghifp Vift Huong tinh Binh Duong, 3 nam lien xay ra ngp dpe TP, nam 1998 cd 148 ngudi mac, nam 1999 cd 79 ngudi mac, nam 2000 cd 30 ngudi mac do dat suat an eho edng nhan tu mdt nha thiu d thanh phd Hd Chi Minh van ehuyin len Bmh Duong [6].

Dieu tea cia Pham Thj Ngpc (2001) tgi Yen Bai cho thay: ty If mac ngd ddc TP 0,06%, ngudi Idn bj mac ngp dpe TP nhieu han tre em, ty le ehet do ngp ddc TP la 5,3%. Nguyen nhan gay ngd ddc TP do vi sinh vat 41%, hoa chat bao ve thuc vat la 30%, TP chia ddc td ty nhiSn (nim doe, tring ede... ) la 22,6%, rau qua rimg dpe 2%, ehua ro nguyen nhan la 4,2%. Hoan canh xay ra ngd doe ehu yeu la btta an gia dinh 58%, xay ra btta an ddng ngudi 24%i. Cae vy ngp dpe TP xay ra quanh nam nhung cao diim nhit la cac thang 4, 5, 6, 7. Sd ngudi bj ngp dde TP cd lien quan din vifc s i dung TP khdng dam bae VSATTP la 67%, diiu kign ve sinh mdi trudng, nha bSp la 20% [51].

Tai Nam Djnh, Hoang Tiin Cudng (2003), nghien cim tinh hinh ngd ddc TP t i nam 2000-2002 cho thiy: da xay ra 37 vy ngp dpe TP vdi si mic 524 ngudi, t i vong 6, ngoai ra ghi nhan 745 ea ngd dpe le te. Nguyen nhan cia cac vy ngd ddc TP: vi sinh vat 45,9%, yiu td hoa hpc la 5,4%, TP cd ehia chat dde tu nhien la 27%, khdng rd nguySn nhan la 21,2%>. Hoan canh xay ra ngd ddc TP chi ySu xay ra tai btta an gia dhih 35,1%, btta an ddng ngudi chiim 27%, btta an tap thi 8,1%, an hang rong 2,7%. Thdi gian xay ra ngd dpe TP chi yiu la mia he thang 4-6 chiim 45 sd vy, dja ban ndng tiidn xay ra chi yiu, teong dd chi yiu ggp tgi cac huyfn ven biin. Ket qua xet nghiem do vi khuln Salmonella chiim 55% sd miu xet nghifm [18].

16

Theo Nguyin Sy Hao (2003), tinh hinh ngd ddc TP tai thanh phd Hd Chi Minh (1995-2002) la 105 vu vdi 4.237 ngudi mic, t i vong 4, trong 105 vu ngp ddc TP cd 54 vu xay ra tgi bip an tap thi (51%), ngp ddc tai hd gia dinh chiim 33%. Nguyen nhan ngd ddc TP chi yiu do vi sinh vat 60,37%, hoa chit dpe (hoa chit bao vf thuc vat) 20,7%o, eae nguyen nhan khac: do ca ndc 3,7%, dj ing 4,7%, tring cdc mdt vu 0,9%, khdng rd nguyen nhan khoang 6%i. Khao sat T A D P cung cho thiy ty If miu khdng dat chi tiSu vi sinh vat rit cao 88%), khdng dat chi tieu ly hoa 31% [40].

Bao cao tinh hinh ngp ddc tgi Tiin Giang (2005) cho biit t i nam 2000-2004 xay ra 69 vy ngp dpe TP, 784 ngudi mle va t i vong 6. Cac vu ngd dpe cd chiiu hudng gia tang qua cae nam. NguySn nhan ngf dpe TP do vi sinh vat 57,97%, hoa chit 15,94%, TP ddc 24,63%), khdng ro nguyen nhan l,44%i. Hoan ednh xdy ra ngp doc TP cao nhit la btta an gia dinh 72,46%, btta an ddng ngudi (tiee cudi 17,39%), dam gid 5,79%), bip an tap thi 1,44%, T A D P 1,44% [55].

Theo bao cao cia Le Minh Uy (2005) trong thdi gian ngin 6-29/3/2005 tai An Giang xay ra lien tiip 11 ea ngd dde, tu vong 10, nguyin nhan do ruou cd ham lupng methanol vupt qia tieu chuIn cho phSp. Khi kiim tea 310 miu rapu ed tdi 97,9%i miu khong dgt tieu ehuin Vift Nam 5013-89 va tieu chuIn rupu theo quy dinh 867/1998/BYT [47].

Bao cao tinh hinh ngp dpe tai Binh ThuSn ghi nhan: xay ra 60 vu ngd ddc TP (2000-2004) sd mac 376 ngudi, t i vong 21. Nguyen nhan do vi sinh vat 24,2%o, chit hoa hpc va hda chat bao ve thye vat 0,02%., ngp dpe khac (khdng ro nguyen nhan) 0,2%, hoa chit ddc tu nhiSn (TP bien: ca ndc, mye bgch mdc, cua la): 52,65% [1].

Nhan xet 173 tradng hop ngd ddc TP tai Khanh Hoa (2005), Nguyin Van Hai cho biet: teong 27 vu ngd dde TP xay ra t i nam 2001-2004 thi cd tdi 22 vy xay ra tai gia dinh (81,48%), vdi sd mac la 109 ngudi chiSm ty If 63%, t i vong 4 ngudi, ngd ddc TP do an hang rong (11,11%). NguySn nhan ngp dpe TP do vi khuln 37%, ddc td tu nhien 40% (ca ndc, nim dai, mim khoai lay, sin ddc, bach mdc dam xanh), khong xac djnh nguyen nhan la 9%, ntt mic ngd ddc TP (35,26%i) cao ban nam (27,74%i), ngp ddc xay ra cao nhat d Iia mdi 16-60. Phan chia ngd ddc TP theo khu vye dja ly cho thiy: miin nii 51,84%, ndng thdn 23,5%, thanh thj 16,76%, ven biin 8,67% [41].

Khi phan tich cac mdi nguy gay ngd ddc TP va cae bfnh trayin qua TP tgi bip an tap the. Tran Van Ky (2005), nhan dinh cd 3 nguy co cd the xay ra tai cac bep an tap the la: Ngudi tham gia che biSn TP khdng thuc hifn ding, du cac quy dinh hudng dan VSATTP (mac d i da hiSu biet cac quy djnh nay), ngudi true tiep che biSn kinh doanh TP khong hiiu biit v i VSATTP nSn vd tinh gay cae nguy ca, eae co quan chic nang chua thong tin kjp thdi cac nguy ea ngoai tim hiiu biit cia ngudi chi bien va cac nguy CO khach quan khac ngoai tim kiim soat cia ngudi che bien [47].

Theo cue ATVSTP, trong thang hanh ddng vi chit lupng VSATTP nam 2006, ca nude da xay ra 22 vy ngd dde "TP vdi sd mac 534 ngudi, t i vong 14, nguyen nhan ngp doc do vi sinh vat la 31,8%, hoa chat 22,7%, TP cd doc to tu nhiSn 18,2% va khdng xac djnh dupe nguyen nhan la 27,3%i.

Ngay 30-11- 2008, Sd Y t i tinh 'Vinh Long cho biit, qua kiim tra tdng si 214 bip an tap thi tren dia ban tinh, chi cd 141 bSp an dat ySu eau va 73 bSp an khdng dam bao cac diiu kign vf sinh, khong thue hifn kham sic khde, nhan vien khdng mac trang phyc chuySn dung va khdng thuc Men luu miu TP theo ding quy dinh [37].

Qua thdng tin t i Trung tam Y t i du phdng tinh Ben Tre ve ket qua thanh tea dot 1 nam 2007, ttong sd 8 tradng tiiu hpc dupe thanh tra thi cd din 6 tradng khdng dat ve VSATTP hoac vf sinh dinh dudng TP. Trong 57 tradng, nhdm tre, Idp mim non thi sd

trudng dgt ca 2 tieii ehuin chi dim trSn diu ngdn tay. Vi pham thudng la nha vf sinh dat gan khu ehS biin thuc an; giao viSn, can bp khdng kiim tra s ic khde djnh ky theo quy djnh; bep an dinh dirdng xay ehua ding quy each (mot chiiu), dyng cy ehi biin cdn ehung cha gitta TP sdng va chin; phdng an Im thip, chat chdi, mdi nhang.. .[57].

KSt qua thanh tta eua Sd Y t i Ha Npi eho thiy, gin mdt nia sd bip an tap thi d eae trudng tieu hpc ban tri chua dat tieu chuin vi vf sinh TP. CJ cac trudng trung hpc co sd ban tru v i cae ea quan xi nghifp, ty If nay lin lupt la 40%) va 30%o I Ui I Nhu vay, dam bao chat lupng VSATTP tai cac bip an tap thi dang la vin di hire xic d tat ca cac tinh, thanh ttong ca nude. Di giai quyit d n cd nhiiu giai phap vdi sy Iham gia cia nhieu cap chinh quySn trong dd quan tepng nhit vln la ngudi lam tai cac bip an tap thi phai cd kiin thic ding vi VSATTP, phai chuyin t i kiin thie dung dd thanh hanh vi ding thi edn^ tac dam bao VSATTP tgi eae bip an tap thi mdi eai thifn dupe.

Theo sd lieu thong kS cia cyc ATVSTP, tinh hinh ngd ddc TP d nude ta t i nam 2000-2009 nhu sau:

Bing 1.5. Tinh hinh ngg dge TP it Vift Nam tir nam 2000-2009

Nam 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Tong cgng

So vg 213 245 218 179 145 141 139 248 205 152 1.885

So mac 4.233 3.901 4.233 5.437 3.584 4.291 5.564 7329 7.828 5.212

7.373.283

So chit 59 63 71 35 41 50 49 55 61 35 519

Bang 1.6. NguySn nhan gay ngo doc TP 6* Viet Nam

Nam

2000 2001 2002 2003 2004 2005

11/2006 2007 2008 2009

Nguyen nhan gay ngg doc TP (%) Vi sinh vat

32.8 37.4 42.2 49.2 55.86 51.8 38.1 36.3 7.8 40.8

Hoa chat

17.4 17.2 25.2 19.3 13.1 9.9 11.5 7.7 0.5 2.6

TP CO chat doc tu-nhiSn khac

24.9 32.6 25.2 21.4 22.76 25.5 23.7 27 25.4 27

Chira ro nguyen nhSn

24.9 12.8 7.4 lO.I 8.28 12.8 26.7 29 66.3 29.6

Khu VUC miin trung hing nam cd tren 100.000 ca nhiem tring dudng tieu hoa, t i nam 2002-2009 ed 433 vy ngd ddc TP xay ra vdi 3.499.172 ngudi mle va tu vong 61 ea (bang 1.7) [2], [21], [22].

Bang 1.7. Tinh hinh ngg dge TP d mien Trung (2002-2009)

Nam 2002

2003

2004

2005

2006

2007

2008

2009

Tong egng

Sovu

84 62 48 43 38 46 60 52 •

433

So mic

808 501 446 460 1.281

1.579

1.312

1.280

3.499.172

So ehet

21 10 4 6 6 7 4 3 61

Tgi Quang Nam, theo bao cao cia Trang tam Y te Du Phdng tinh, trong 4 nam (2006 - 2009), tinh hinh ngd dde TP nhu sau:

Biing 1.8. Tinh hinh ngg dge TP d Quang Nam (2006-2009)

Nam 2006

2007

2008

2009

Tong cgng

Sovu

7 2 3 3 15

So mac

378 37 39 43 497

SS ehSt

0 0 0 0 0

Tuy nliiSn, sd thdng ke ve ngd ddc TP cdn it ban rat nhieu so vdi thye te. Theo edng bd eua Td chic Y t i thi gidi ("WHO) vi tinh hinh ngd ddc TP tai Vift Nam trang bmh mdt nam cd 8.000 ngudi ngd dde TP. Tuy nhien sd ngudi dupe thdng kS, phat hifn, bang l%i sd ngudi ngd ddc TP trSn thye ti. Vi vay, di cd sd liSu tin cay phan aiih tinh hmh ngp ddc xay ra hang nam, cung eip cho cac nha hoach djnh ehinh sach qude gia, vigc xay dung mdt hg thdng giam sat ngd ddc TP theo chuan muc qude t i dang la ySu d u cip bach d nude ta [32], [33].

1.2.2. M5t so van d i vS TADP

T A D P hifn dang ddng vai ttd rat quan trpng ttong ddi sdng, sinh boat eua cdng ddng. Tuy nhiSn, vdi thye trgng trSn thi ching cung dang tiSm In nhieu nguy co de dpa din s ic khde va gay nSn eae vy ngp df c. Nam 2002 da cd 83 vy ngp dpe TP do T A D P dupe bao eao, cd nhiiu vy si ngudi mic len din hang ttam ngudi nhu d Ddng Nai, Hal Phdng, Thanh Hda... [42]

Theo thdng ke chua diy du eua Bd Y t i t i nam 1999 den nam 2004, ca nude ed 1.386 vu ngd ddc TP, trong dd cd tdi 1.056 vy ngo ddc la do T A D P va bip an tap thi

gay ra. NguySn nhan cia tinh ttang tten, trudc hit la do nhiiu dja phuong chua thuc su quan tam din cdng tae bao dam vf sinh, an toan T A D P , ehua cd quy hoach eho loai hinh djeh vy nay; cdng tac thdng tm, giao dye, tenyin thdng chua dupe diy manh. Ngudi budn ban va ngudi tiiu ding cdn thiSu kiin thic ve VSATTP; sy phdi hpp liSn nganh ehua ddng bO; edng tac thanh tta, kiim tta chua thudng xuySn va vifc x i Iy cac

19

hanh vi vi pham ehua nghiem; chua huy ddng dupe su tham gia cia cae td chic xa hdi vao cdng tac giam sat ve sinh, an toan T A D P [7].

Cung vdi su dd thj hda va cdng nghiep hda, T A D P la mdt logi hinh djeh vy phat ttiSn rat nhanh d cac nude phat triin, T A D P thudng da dang, cd thS che bien san. mua d nai khac ve ban hoac cd phuong tien ehi biin tgi ehd. d nude ta, tinh teang d nhiim TADP da gay ra nhiSu vy ngf dpe TP dang tiee va thudng chiim t i 10 den 20% sd vu ngp dde TP xay ra mdi nam. Day la van dS dupe du luan xa hpi quan tam.

Thdng ke cia cyc An toan vf sinh TP trong bao cao tdng kit 3 nam dam bao ve sinh an toan T A D P cho thay, nguyen nhan ngp dpe dp mdt sd yiu t i chi ySu sau:

- Mua TP tiy tien, khong rd xuit xi : 88% - Nude da s i dyng eho djeh vy T A D P cd nhilm E.coli: 35.6%o d cac co sd ndi

thanh va 64,7% d cac ca sd ngoai thanh - Khdng dam bao VSATTP ttong qua trinh chi biin 49,1 - 91,6% - van ehuyin, bao quan khdng bao dam ATVS: 85.9 -99,2% - Noi ban hang, ttang thiit bj va dyng cy nau nudng khdng dam bao vS sinh: 37-

88% - Ngudi kinh doanh, chS bien TP khdng chip hanh cac qui dinh VSATTP 43,8 -

88% Theo dng Trin Dang, Cyc trudng Cyc An toan vf sinh TP, qua dieu tra moi day

cia Bd Y te vi T A D P tai 11 dja phuang cho thay, hau het ban tay cia ngudi kinh doanh, che biSn T A D P deu bj nhilm vi khuln E.coli nhu Ha Ndi la 43,42%, TPHCM 67,5%, Da Ning 70,7% .

Nguy hiim hon, cae TP, thic an cho du da dupe nau chin nhung qua kiim tra van phat hifn ra tihiSu vi khuan gay bfnh nguy hai. Tai Nam Djnh, 100% mau cac logi gid, cha, nem ehua, Idng heo chin cd vi khuan E.coli, cdn tai TPHCM la 90%i bj nhiim E.Coli; ngoai ra mat hang kem ban tgi cac cdng tradng hpc d day cing nhiem tdi 96% cd vi khuan gay benh tiSu hda.

Nguyen Thj HiSn va cac cdng sir ttong nghiSn ciu "Tinh hinh d nhiSm vi khuan va nhan thic VSATTP d ngudi kinh doanh T A D P " , cho thay 46,7%> chi yeu do nhilm Conforms. TP d nhiem cao: Pate, thjt him khdi, banh phu the, kem, xic xich, thjt quay. Ngudi kinh doanh TP cd nhan thic tdt vS VSATTP, nhung mpt sd hanh vi thieu ve sinh ttong lie ban thic an ehi biin sSn vln edn phd bien [39].

Chfaih tim quan ttong cia TADP ddi vdi sic khdc edng ding ma nam 2003, thang hanh ddng vi ehlt lupng VSATTP dupe td chic trin tean qude vdi chi de " T A D P va ddi sing van hda - sue khde" nham nang eao nhan thic, teach nhiem cac cap chinh quyin, cae nganh va toan thi xa hpi vi vigc diy manh cdng tac bao dam VSATTP •TADP. Di dam bao an toan ve sinh TP T A D P , trude hit mdi ngudi chu kinh doanh T A D P phai y thic duge ttach nhiem cia minh vdi sic khde edng ddng di diiu chinh hanh vi va thay ddi diiu kiSn kinh doanh sao eho dat ySu cau vf sinh. Cae cap chinh quyin, djc bift la xa, phudng phai la ngudi ehu tri, y t i eae cap tham mtm thgt tit cho chinh quyin di huy ddng ddng dao lyc lupng xS hdi tham gia ed hieu qua eae heat ddng bao dam VSATTP tren dja ban minh. Can day manh cdng tac truyen thong giao due di nang cao nhan thic cia cdng ding vi edng tac nay, mdi ngudi phai tu bao ve minh trude eae nguy co ddi vdi sic khde, ehi s i dyng cac thic an khi biit chic la an toan, quan sat ky trade khi budc vao quan an, kien quyit khdng an d nhimg ca sd khdng dam bao vf sinh va diu ttanh vdi nhiing sai ttai ttong vifc bao dam VSATTP.

20

1.2.3. Nhfl-ng hilu biit cua cgng dong vl VSATTP

1.2.3.1. Trin thi gi&i

Nhieu edng ttinh nghien ciu tai mdt sd nude khi tim hiiu thai dp, kien thuc, hanh vi v i VSATTP.

Tureoni G va cpng su (cs) khao sat tai 'Y vao nam 2008 vi kiin thic, thdi quen, hanh vi ail udng cia 132 hpc sinh nam, tuii 15.4 +/- 0.7, nhan thiy chi 37% cd thdi quen an udng ding, 18.5%) cd ldi sdng tich cue, chi 8.6%i cd kiin thuc dinh duong tit, chi 2.4%) cd kiin thic an toan TP ding, mSc diu cd tdi 43.7%) thye hanh vf sinh tit. Cac nha nghiSn ciu cho ring kit qua nghien ciu nay phai dupe xem x6t di hoan Ihifn nhtmg chuang trinh dinh dudng chi tiet nham cai thien nhan thic cia thanh thiiu nien di cd mdt Idi sdng lanh manh [72].

Howells AD va cs tiSn hanh nghien ciu tai Mp nJm 2008 danh gia nhan thie cia 159 nhan viSn nha hang vi nhttng rio ein ddi vdi vifc thuc hifn day di 3 thuc hanh an toan TP la r ia tay, s i dung nhift ki va lain sach be mat noi lam vifc. Nhttng rao can da dupe xac djnh la: thieu khdng gian, nhttng cdng vifc khac da chiem mat thdi gian chii sgch noi lam vifc, vj tri bat tifn cua nhttng bdn chau va lam khd da sau khi r ia tay, thiSu nhiet ke, khdng cd dpng cp thye hifn, ngudi quan iy khdng theo doi lifu nhan viSn cia minh cd thue hifn khong.Nhttng kSt qua nay se dupe s i dung de phat teiin nhung can thifp nham khac phyc nhiing rac can trSn. Nhan thie vi nhung rao can ed thi hd tro chuySn vien TP va dinh dudng ttong vifc giip do nhan vien nha hang vupt qua nhiing rao can, va cudi cing cai thifn vifc tuan thi thuc hanh an loan TP[65].

Clayton DA va cs nghien eiru tai Anh nam 2008 vS nhung yeu td anh hudng dSn thuc hanh vf sinh ban tay eua 115 nhan vien TP tu 29 nha hang khach san bang each quan sat nhimg hoat dpng che bien TP cia hp, sau dd, ddi tupng phai hoan thanh mdt quy teinh vf sinh ban tay. Kit qua, cd 34%> thye hanh vf sinh ban tay sai (p<0.05). Nghien ciru da xac djnh dupe 5 ySu td du doan thye hanh vf sinh ban tay sai la: thai dp, tiSu chuan chi quan, tiSu chuan md ta, sy chi y vi kiem soat hanh ddng. KSt qua nay ching minh khdng the cai thifn thue hanh vf sinh ban tay chi thdng qua vifc cung d p thdng tin cho ddi tupng. Chuong trinh can thifp hieu qua can tap trung vao vifc thay doi van hda an toan TP cd to chic [63].

Roseman M va cs phan tich nhiing dtt lifu cia co quan quan ly thudc va TP cia My (FDA) tu cudc khao sat 728 ngudi tieu ding d Kentucky ve cac van de: su tin mdng vao su an loan cia TP cung cip, nhgn thic ve nguy co bi bfnh do TP, nhan thic vi nai ma nhiing vln dS an toan TP cd the xay ra nhat. KSt qua, cd sy khac nhau cd y nghia vi nhto thic va hanh vi an toan TP gitta 2 gidi, mic tudi, thu nhap, teinh dp van hda va nghi nghiep. Cd mdi lien quan cd y nghia gitta nhan thic va hanh vi. Nhin chung, ngudi cd nhan thic cao hon se cd hanh vi an toan TP tdt hon. Cd the noi. mpt sy hiiu biit t i t hon vi nhto thic va hanh vi an toan TP cia ngudi tiSu dimg se giip ching ta cd mpt chuang teinh giao due an toan TP hieu qua [70].

Garayoa R, va cs nghiSn ciu mdi liSn quan gitta kiSn thic an toan TP vdi hanh vi cia 562 sinh viSn tai Tay Ban Nha (ehi yiu din t i eae bd mdn khoa hpc sic khde) nhgn thiy ed hon 2/3 s6 sinh viSn cd kiin thie dung ye 8 bfnh nguyen dudng TP theo nhu yeu ciu, nhung chi cd 5,2% cd thi nhan biit tu d u vang la nguySn nhan gay bfnh. Cd su khac bift cd y nghia gitta mic dd kiin thic sic khde dupe hpc vdi ket qua tea ldi. Ddi vdi s i dyng TP, ed tdi 60%i cd kiin thic ding vS che bien, bao quan TP thich hop, r ia tay va vat dyng di ttanh nhilm khuln cheo. Tuy nhiSn, ngoai tei nhttng cau

21

hdi liSn quan den nhift dp bao quan, thi dSu ed sy khac biet dang ke gitta kien thic \a hanh vi. Mac dau cd 98,6%i so sinh vien thia nhan tim quan trpng cia r ia tay trade va teong khi chi biSn thic an, nhtmg chi 24,4% xac nhgn da ria tay vdi nude va xa phdng. Vdi nhung eau hdi lien quan din thye hanh, sinh viSn Idp tren tra Idi chinh xac hon sinh viSn Idp dudi. Nhin chung, sinh vien cd kiin thic tdt ban se cd thye hanh tdt hon. Nhung ket qua nay xac nhan sy cin thiit phai cai tiin chuang trinh giao dye [66].

Ngudi ban thic an ddng mpt vai trd quan trpng trong vifc bao dam an toan TP bat dau t i khau san xuat, gia edng, bao quan va chS biSn. Vi vay, neu ngudi ban thic an cd nhan thic va hanh vi vf sinh kem se la nguyen nhan dan dSn bfnh do TP. Okojie OH va cs thye hien mdt eupe khao sat vS nhan thic va hanh vi cia nhttng ngudi ban thic an hogt dpng d khu vue tradng dai hpc Nigeria. Kit qua, 90/102 ngudi (88,2%) tham gia tea Idi la phu ntt, hp ed kiin thie vf sinh TP rit kSm. Chi cd 15 ngudi (14,7%)) thye hifn bao quan va ham ndng thie an thia; tan suat rua tay rat thap. Tinh ttang vf sinh ca nhan cia hp d muc thip. Chi 31 (30,4%i) ngudi da dupe kiim tra sic khde trade khi hanh nghe, va chi 49 (48%)) ngudi ed gily chimg nhan da tham gia Idp giao due sic khde [63].

Trong gia dinh, ky nang chuan bj TP kSin cd thS la nguySn nhan gay viSm da day-rapt. Mitakakis TZ va cs (2004) khac sdt thanh vien ngudi Idn cia hen 1000 hd gia dinh d Melbourne, Australia nhan thiy gin nhu mpi gia dinh diu cd khiSm khuySt theo mdt each nao dd lam cho TP dS bj nhilm khuln. Tong quat, 99%i ngudi dupe phdng vin ed sai sdt ttong ehuin bj TP, ttong dd, 46,6%) khdng nia tay ding, 41,7% x i ly thie an sdng khong tdt, va 70,l%i x i ly thic an da niu chin khdng tit [68].

Bermidez-Milian A va cpng su khao sat kien thuc, thai dp, hanh vi an toan TP cia nhiing ngudi cd ngudn gie Latinh tai My lam edng vifc cham soc tre nhan thay: mac dau 97% ngudi dupe phdng van chp rang hp da r ia tay vdi nude va xa phdng, nhung quan sat thye tS chi cd 1/10 ngudi lam vifc dd; 89%) qua quySt hp da ria mat ban bSp bang nude va xa phdng, nhung thuc te con sd nay la 60%); 5% cho rang hp biet y nghia cia nhiSm khuln chee, nhtmg lai cd dSn 71%) ding chung mdt mat ban bip eho ca thjt va rau qua. Nhttng ngudi gitt tre chuySn nghifp va ngudi ed mie giao dye eao ban cd kiSn thie, thai dp va hanh vi tot hon. KSt qua cia nghien ciru nay chirng minh sy cin thiit phai cd mdt chuang trinh giao dye an loan TP thich hop eho cdng dong nay [62].

Ngudi ban TP ddng mpt vai ttd quan trpng ttong vifc bao dam an toan TP thdng qua chudi qua ttinh san xuat, gia cong, dy trtt, chS biSn. Zain MM, Naing NN phdng vin 430 ngudi ban TP d quto Kota Bhara (Malaysia, 2002); mdi trang binh la 42±12, 69.5% la phy ntt, 81.4% da lap gia dinh, 64,2% lam viec d quiy ban, 54.2% khdng cd gily phep, 10.5%) khdng dupe di hpc, 31.9%o cd bing tiSu hpc, 57% cd bang trung hpc, 57.2%) khdng cd gily ching nhan da tham gia chuang trinh tap huan, 61.9% dupe kham sic khde thudng quy, 48.4%i ed kiin thuc kem vS an toan TP. Phan tich cho thiy teinh dp giao dye, tinh ttgng nghi nghifp cia ngudi ban hang anh hudng cd y nghia din mic dp kiin thic an toan TP (p=0.003 va 0.0031, lin lupt). Khdng cd su khac biit cd y nghia vi thai dp va hanh vi gitta ngudi dupe tgp huan va khdng tap huan

[69]-Ban T A D P dang thjnh hanh d eae nude dang phat ttiSn, nhung tinh an toan TP

cia nd bj nghi ngd. Mdt phuong phap phd biin di theo ddi thi tradng nay la kham sic khde cho ngudi ban hang. Musa 01, Akande TM tgi Nigeria, thue hiin mdt nghiSn eiu 185 ngudi ban hang d 58 tiirdng trang hpc bing bang cau hdi va checklist, nhan

22

thiy 76.2% dupe kham sic khde trade khi hanh nghi, va 21.3% kham sic khoe dinh ky [67].

1.2.3.2. Tgi Viet Nam

Nhgn thic va thye hanh ve an toan ve sinh TP cia cac nhdm ddi tugng d nude ta cdn rat ban chS, kit qua nghien eiu nam 2006 cho thay sd ngudi cd nhan thic ding ve an toan vf sinh TP cia ngudi quan ly, lanh dgo an loan vf sinh TP tuyin huyfn mdi dat 82%), tuyen xa 40%), tnmg binh cpng ca hai tuySn chua nhgn thue ding vS VSATTP 39%>; edn ddi vdi ngudi san xuit, ehi biin TP cd 52.2%) ngudi cdn thiiu kiin thic vi VSATTP, ngudi kinh doanh TP la 61.4% va ngudi tiSu ding thiiu kiin thic chiim ty If 61.7%) [37]. Nhu vay, vin di nhan thic vi bao dam chit lupng VSATTP cia ngudi Vift Nam cin dupe quan tam.

Bang 1.9. Kit qua xdt nghifm ban tay ngu'di \km dich vu TP tai mgt sd tinh

TT 1

2 3 4 5 6 7 8 9 10 11

Dia phirong Ha Npi

Tp Hd Chi Minh Nam Dinh Hai Duong Thai Binh Thanh Hoa Hui Phi Tho Bmh Duong Long An Da Nang

Ty Ig nhilm E.coli (%) - TADP: 43,42 - Khach san, nha hang: 62,5 - Bip an tap thi: 40,0

67,5 31,8 64,7 92,0 66,6 37,0 19,3 56,5 60,0 70,7

Kit qua tten cho thay cd ty If ban tay nhilm E.coli (nhiem ban) cdn rat cao d ngudi ehi biin va kinh doanh TP. Diiu nay dang lo ngai hon khi kit qua nghien ciu ty If bdc thic an bing tay edn rit cao 67,3%); ty If khdng r ia tay la 46,l%i; ty IS mdng tay dai la 22,5%); ty if nhd nude bpt, xi mui la 26,7%); van hpa den trang hpc co sd la 64,6%; t i ndng thdn l i 57,8%; khdng deo khiu ttang la 95,3% [25].

1.2.3.3. Tgi linh QuingNam

Cho din nay, cae co quan chuyen mon vS an toan vf sinh TP eua tinh chua cd cdng trinh nghien c iu quy md ve nhan thic cia can bp lanh dgo ciing nhu cae doi tupng san xuit, kinh doanh TP va ngudi tieu ding. Tuy nhiSn, qua qua trinh triin khai hogt ddng, giam sat va dua ttSn bao cao cia cac co quan chuySn mon tai cac dja phuang va cpng ddng eho thiy vln df nhan thie cia can bp va nhan dan ttong cdng ddng ndi chimg cdn d mic thap.

2. MUC Tifiu, D 6 I TlTOfNG, N p i DUNG, PHlTONG PHAP NGHIEN CUtJ

2.1. MUC TIEU NGHIEN CUtJ 1. Danh gia thye trgng kiin thic, thai do, hanh vi vi VSATTP cua ngudi dan tai

tinh Quang Nam.

2. De xuat mdt sd giai phap can thifp nhim nang cao nhan thuc cua ngudi dan vi

VSATTP.

2.2. D 6 I TirOfNG NGHIEN CtTU + Cac nha lanh dao cac cap chinh quyen t i huyen, xa, thdn;

-I- Ngudi san xuit; chi biin TP, ngudi lam tgi cdc bip an tap thi;

-I- Ngudi kinh doanh TP; ngudi ban hing rong;

+ Ngudi tieu ding.

Dang sdng d 1 s i dja phuong tinh Quang Nam.

2.3. N Q I DUNG NGHIEN CUtJ

DS dat dupe 2 mue tieu di ra, chung tdi tien hanh nghien cuu cac npi dung sau:

2.3.1. Tim hieu sir hieu bilt kien th ic ve an toan ve sinh TP va each quan ly VSA'TTP cua cae d p ehinh quyen, ban nganh, doan thl vdi cong tac VSATTP

DS thuc hien ndi dung nay, ching tdi thanh lap 1 nhdm nghien ciu khoang 6 - 1 0 ngudi tham gia vdi eae hogt ddng eu thi sau:

DiSu tra thuc dia tgi 4 huyfn dupe chpn gdm: -I- Lam vifc trade vdi timg huyfn di xay dung kS hogch diSu tta. -I- Phdng vln sau 355 can bd lanh dgo cae d p chinh quySn t i huyen, xa, thdn theo

miu (phu lyc 1). Tdng hpp sd lieu. Phan tich danh gia kSt qua, viet bao cao va du kiSn cac giai phap can thiep. Td chic hpi thao lay y kiSn gdp y cac giai phap. Viit bao eao ehinh thuc va xay dung giai phap can thiep

Day la npi dung mdi, chua cd tac gia nae nghiSn eiu, dii tupng dupe diSu tra la can bp cae ban, nganh, doan thi tai co sd, do vay cd nhieu kha nang khd tiep can v i lip ban nhiSu cdng viec, thdi gian diSu tta cd thS keo dai han dy kiSn. Chinh vi vay phai cd mdi quan hf tdt vdi dja phuong, ed kS hoach that chi tiet va kha thi mdi cd the thuc hien dupe.

2.3.2. Danh gia thye trgng kiln thirc, thai dg, hanh vi vl VSATTP eua nguoi kinh doanh TP

Di thuc hifn ndi dimg nay, ehung tdi thanh lap 1 nhdm nghien ciu khoang 6 - 1 0 ngudi tham gia vdi cae boat ddng cy thS sau:

- Diiu tra thue dja tai 4 huyfn dupe chpn gim: -1- Lam viec trade vdi ting huyfn dS xay dyng kS hoach diSu tra, chpn ddi mong

diSu tea -I- Phdng vln sdu, kit hop quan sat thye te khpang 170 ngudi lam tai cac co sd ban

TP theo miu (phu lyc 2).

24

Tdng hop sd lifu. Phan tieh danh gia ket qua, viit bao eao va du kiin cac giai phap can thiep. To chic hdi thao lay y kiSn gdp y cac giai phap.

- Viet bao cao chinh thic va xdy dung giai phap can thifp

Day la ndi dung mdi, chua cd tac gia ndo nghien ciu, ddi topng dupe diiu tra la nhan vien tai cae ea sd kinh doanh TP, do vay vifc thu thap thdng tin se khd khan bdi hp it mudn tta Idi hoac tra Idi khdng chinh xdc (dnh hudng din cdng vifc kinh doanh).

DS khac phyc van de nay can: phdi hap vdi dpi kiem tra liSn nganh cua sd y ti di thye hifn; can bp diiu tra phai kheo ISo, mem mdng trong khi hdi, kit hpp vdi quan sal thuc ti.

2.3.3. Danh gii nhirng hilu bilt vl chat lupng VSATTP cua ngudi ban rong. Di thye hifn ndi dung nay, ching tdi thanh lap 1 nhdm nghiSn cim khoang 6 -10

ngudi tham gia vdi cac hogt ddng cy thi sau: Dieu tta thye dja tgi 4 huyfn dupe chpn gdm:

-I- Lam vifc trade vdi timg huyfn di xay dyng ki hoach diiu tra, chpn ddi topng diiu tta.

-I- Phdng vin sau, kSt hpp quan sat thye t i khoang 170 ngudi ban rong theo miu (phy lue 4).

Tdng hop ket qua. Phan tich danh gia ket qua, viet bao cao va du kien cac giai phap can Ihicp, Td chic hpi thao lay y kiSn gdp y cac giai phap. Viet bao cao chinh thic va xay dyng giai phap can thifp

Trd ngai nhat cia ndi dung nay la trong qua trinh diSu tra ddi lupng il hop lac vi hg dang ban hang it cd thdi gian tea ldi, hp e ngai tta Idi se anh hudng den ban hang va thu nhap cia ban than, nSn hp khdng mudn tra ldi hoac tra Idi qua loa, thieu chinh xac. Chfaih vi vay ddi hdi phai ed ke hoach chpn ddi topng dS hpp tac, diSu tra vien phai cd kinh nghiem va mSm deo ttong qua trinh phdng vin.

2.3.4. Tim hieu mgt so van de ve T A D P . Di thue hifn ndi dung nay, ching tdi thanh lap 1 nhdm nghien ciu khoang 6 - 1 0

ngudi tham gia vdi cac boat dpng ey thi sau: Diiu tra thuc dia tai 4 huyen dupe chpn gom:

+ Lam viee trade vdi ting huyfn di xay dung ki hogch diiu tta, chpn ddi topng dieu tta.

+ Quan sat thuc t i khoang 170 -180 ca sd ban rong tren dudng phi theo mau (phu lyc 5).

Tdng hop kit qua; phan tich danh gia kSt qua, viet bao cao va dy kien cac giai phap can thifp; td chic hdi thao liy y kiin gdp y cac giai phap

Viit bao cao chmh thic va xay dyng giai phap can thifp v i n ik TADP dang la vln di ndng bdi thye t i nd cd nhttng thuan lpi cho ngudi

tieu ding, nhung nd cung dang la noi cd nguy ca lay benh nhiiu nhat. Vifc diSu tta ed khd khan nhit la khdng ed hop tac gitta diiu tta vien va nhttng ngudi ban hang, do vay d n kit hpp vdi dja phuang chat che mdi ed thi thuc hien dupe ndi dung de ra.

2.3.5. Tim hilu kiln thiic, thye hanh eua ngvoi san xuit che biln TP Di thye hiin ndi dung nay, ching tdi thanh Igp 1 nhdm nghien ciu khoang 6 - 1 0

ngudi tham gia vdi eae hogt ddng cu the sau: Diiu tta thuc dia tgi 4 huyfn dupe chpn gdm:

_ -I- Lam viec trudc vdi ttmg huyen. di xay dyng ki hoach diiu tra, chpn ddi tupng diiu tta

+ Phdng van sau, kit hpp quan sat thye t i khoang 170 ngudi lam tai cac ca sd san xuit TP theo miu (phy lye 6).

Tdng hpp sd lifu, phan tich danh gia kit qua, viit bao cao va dy kiin cac giai phap can thifp.

Td chic hOi thao liy y kiSn gdp y cac giai phap. Viet bao cao ehinh thic va xay dyng giai phap can thifp

Day la npi dung mdi, chua ed tac gia nao nghien eira, ddi topng dupe diiu tra la nhan yiSn tgi cae co sd san xuit TP, do vay viec thu thap thdng tin se khd khan bdi hp it tnudn tta ldi hoac tra ldi khdng chinh xac (anh hudng din cdng viec kinh doanh). De khac phyc van dS nay cin: phdi hpp vdi dpi kiim tta liSn nganh cia sd y ti di thye hien; can bp diiu tta phai khSo ISo, mim mdng teong khi hdi, kit hop vdi quan sat thye ti.

2.3.6. Dinh gia thye trgng vin dl dim bao VSATTP tai blp an tap thl

DS thye hifn nfi dung nay, ching tdi thanh lap 1 nhdm nghiSn ciu khoang 6-10 ngudi tham gia vdi cac boat dfng cy thi sau:

Dieu tea thye dja tai 4 huyfn dupe chpn gdm: Lam viee trade vdi timg huyfn di xay dyng kS hogch dieu tea, chpn ddi tupng diiu tea; quan sat thuc te cac bip an theo miu (phy lyc 7).

TSng hop kSt qua; Phan tieh danh gia ket qua; ViSt bao cao va dy kiin cac giai phap can thiep; td chic hpi thao lay y kien gdp

y cac giai phap

2.3.7. Tim hilu thai dg, kiln th ie eua nguoi tieu dung vl VSATTP Di thuc hien ndi dimg nay, ching tdi thanh lap 1 nhdm nghiSn ciu khoang 6 - 1 0

ngudi tham gia vdi cac hogt ddng cy the sau: Diiu tea thue dja tgi 4 huyfn dupe chpn gom:

+ Lam vifc trade vdi timg huyfn di xay dyng kS hoach diSu tea, chpn ddi topng diSu tta.

+ Phdng van sau, kit hpp quan sat thuc t i khoang 355 ngudi tiSu dung tgi theo miu (phu lyc 3).

Tdng hpp kSt qua Phan tich danh gia kit qua, viit bap cap va du kiin cae giai phap can thifp. Td chic hdi thap liy y kiin gdp y cae giai phap. ViSt bao eao chinh thic va xay dung giai phap can thiep

Trd ngai nhat cia ndi dung nay la trong qua trinh diiu tra ddi topng it hop tac vi nhitng vin di te nhi ttong sinh hoat, hp khdng mudn tta ldi hoac tra Idi qua loa, thiiu chinh xac. Chinh vi v|y ddi hdi phai ed ki hogch chpn dii topng di hap tac, dieu tra vien phai cd kinh nghifm va mim deo ttong qua trinh phdng van

2.3.8. Thye trang edng tac tuyin truyin giao due s ic khde ve VSATTP tai tinh Quing Nam

Di thuc hifn ndi dung nay, ehiing tdi thanh lap I nhdm nghiSn eiu khoang 6 - 1 0 ngudi tham gia vdi cac boat dpng cu thi sau:

26

- DiSu tta thye dia tai Trung tam y t i (hoac phdng/ td TTGDSK) tai 4 huyfn duac chpn gdm:

-I- Lam vifc trade vdi timg huyfn de xay dung ki hoach, ndi dung diiu Ira + Phdng van sau kSt hop tim hiiu qua bao cao, ki hoach... cua tung don vi Iheo

mau (phy lyc 8). Tdng hop kSt qua; phan tieh danh gia kit qua, viit bao cao va dy kiin cac giai

phap can thiep; to chic hdi thao liy y kiin gdp y eae giai phap. - ViSt bao eao chinh thic va xay dyng giai phap can thifp Hoat dpng nay khdng cd ttd ngai Idn, song npi dung thu thap thdng tin nhiiu, cin

thdi gian di ttanh thiiu sdt teong qua trinh thu thap thdng tin.

2.4. PHlTONG PHAP NGHIEN ClTU

2.4.1. Thiet kl nghien eiu: Phuang phap md ta vdi thiit ki cit ngang.

2.4.2. Co' mau: Cd miu dupe tinh cho nghien eiu theo cdng thic sau:

p-q

—¥-

Trong dd: n: cd miu nghiSn eiu;

Z^(i-a/2): He sd tin cay d mue xac xuit 95%i.

p: 0,3 (p d day gia djnh ia ty If ngudi dan cd kiin thic VSATTP).

q: 1-p.

d: 0,05 (Dp chinh xac mong mudn). n = 1,96^ X 0,3 X 0,7/ 0,0025 = 322 ngudi.

C9 mau dupe tinh cho nghien cin nay n = 322 ngudi, thSm 10% du phdng cac tradng hop bd cudc ta cd n = 355 ngudi X 4 huyfn/thanh phd = 1.420 ngudi.

2.4.3. Cach chgn doi tirong vao man nghien ciru: Ap dyng phuang phap phan tang d nhiSu giai doan.

Bu&c 1: Chpn huyin: lift ke danh sach cac huyen, thj xa, thanh pho cd 5 huyen ddng bang chpn 1 huyfn Nii Thanh; ed 3 huyfn trang du chpn 1 huyfn Hifp Die; ed 7 huyfn miSn nii chpn 1 huyen Nam Tra My; cd 2 dd thj chpn thanh phd Tam Ky.

Bu&c 2: Chpn xS: - Lgp danh sach cac xa thee timg ving sinh thai tgi cac huyfn dupe chpn, 30%o sd

xa ttong mdi ving sinh thai dupe chpn ty If vdi sd xa trong mdi viing. - Sd xa tai mSi ving dupe chpn nhu sau:

Bang 1.10. S6 xS dirgre chgn theo viing sinh thai

Viing sinh thai Miin nui (Nam Tri My) Miin trung du (Hiep Die) Dong bang (Nii Thanh) Thanh pho Tam Ky

Tong so

Tong so xa/phirdng 10 12 18 14 54

So xa/phirdng diroc chgn | 3 4 5 4 16

27

- each chpn xa: Lap danh sach cac xa trong mdi ving sinh thai, chpn ngau nhien mpt xa va sau dd chpn eae xa lan can trong mdi ving sinh thai cho di 16 xa bao gdm:

-I- Huyfn Nam Tra My chpn 3 xa la Tra Don, Tra Tap va Tra Nam. -I- Huyfn Hiep Die chpn 4 xa la Qui Thp, Binh Lam, Qui Binh va Tan An. + Huyfn Nii Thinh chpn 5 xa la Tam Xuan I, Tam Xuan II, Tam Hiep, Tam

TiSn va thj trin Nii Thanh. -i- Thanh phd Tam Ky chon 4 phudng la Tan Thanh, Phudc Hoa, An Xuan va An

My. Bu&c 3: Chpn ddi tupng diiu Ira cda lirng huyln/thanh phd nhu sau:

* Cdn bg lanh dgo: chon 355 ngudi gdm

- Lanh dao huyfn: Ban chi dao VSATTP, Trung tam y te huyfn, can bd quan ly thj

tradng, can bd thi y, cdng an, cin bp phy ntt huyfn, mat tran huyfn, Hdi ndng dan,

phdng giao dye, phdng van hda thdng tin, dai phat thanh phat lai cia huyfn... khoang

115 ngudi

- Lanh dgo xa: Phd chu tjch vin xa, doan thanh niSn, phy ntt, phdng van hda thdng

tin, cdng an, ttgm y te xa, mjt ttan, ban cham sde sic khde...: mdi xS: 15 ngudi X 16

xa = 240 ngudi

* Ngudi sdn xudt, che bien TP: khoang 355 ngu&i, chia lam hai nhdm:

- Nhdm san xuat, chS biSn TP tai cac co sd san xuat. che bien TP: chon ngau

nhien 1 co sd san xuat, che biSn TP theo danh sach dS bat dau dieu ira, cac co sd khac

dupe dieu tta tiSp theo la cac ca sd lien ki. Diiu tra het cac co sd nay den cac ca sd

khac cho dSn khi d i mau.

- Nhdm lam tai cae bep an tap thi: Chpn ngau nhiSn 1 bip an tap thi thee danh sach dS bat dau diiu tra, eae eo sd khac dupe diiu tta tiip theo la cac co sd liSn kS. Diiu tta hit cae eo sd nay den cac ca sd khac eho den khi d i mau

* Ngu&i kinh doanh TP khoang 355 ngu&i, chia lam hai nhdm:

- Nhdm ban hang tgi cac ca sd ban TP va djeh vu an udng: Chpn ngiu nhien I

CP sd ban TP va djeh vu an udng theo danh sach di bat dau diiu tra, cac co sd khac

duac diiu tra tiip theo la cac ca sd liin kS. Diiu tra hit cac co sd nay den cac co sd

khac eho den khi du mau . - Ngudi ban rong: Chpn ngiu nhien 1 quan ban rong theo danh sach di bit dau

diiu tra, cac quan khac dupe dieu tra tiep theo la cac co sd lien kS. Diiu tra bet cac co sd nay din cac co sd khac eho den khi d i miu.

* Ngu&i tieu dimg: chpn 360 ngudi nhu sau

Chpn ngiu nhien 1 hp thee danh sach di bit diu diiu tta, cae hd khac dupe diiu tta tiip theo la cic hd liin ki. Diiu tta hit cac hp nay dSn cae hd khac cho dSn khi d i miu (uu tien chpn ngudi ndi ttp ttong gia dinh).

* Cdn bp ldm cdng tdc TTGDSK: chpn 20 ngudi, gdm mdi huyfn 1 can bd tgi phdng TTGDSK thupc TTYT huyfn, 16 xa: mdi xa I can bO phu ttach TTGDSK thudc team y tS xa

28

2.4.4, C4e bwdc tiln hanh

- Thiit k i 8 bd cau hdi; - Sau do tiSn hanh phdng van thi va chinh sia bd cau hdi cho phi hop di thu thgp

thdng tin day du va hgn chi tii da sy sai Ifch; - Tap huan can bp tham gia dieu tra vi each hdi va each ghi vap phiiu diiu tra; - TiSn hanh thu thap dtt lifu thdng qua phdng vln true tiip; -1- Chpn can bd tham gia diiu tra la nhttng can bd y t i cd kinh nghiem trong triin

khai cdng tac y tS cpng ddng, ed tinh than nhift tinh va trach nhif m cao; -I- Phan nhdm diiu tra tgi cac xa; - Tdng hpp dtt lifu diiu tta

2.5. x C LY SO LI$U NGHIEN ClTU Sd lifu dupe thu thap va x i ly bang phuong phap thdng ke Y lipc. ung duMg

phin mim SPSS 10.0 vi Excel 2000.

2.6. KHOI LUQiNG CONG Vlf C DA H O A N THANH: trong thdi gian qua, ching tdi da thye hifn eae edng vifc nhu sau:

TT

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

Cae ngi dung, cong vige chii yeu

Xay dung dS cuong nghiSn ciu va thdng qua dS cuong.

Lap cac mau phieu diSu tra

Thanh lap va tap huin nhdm nghien ciu va diSu tea vien

DiSu tra cac ddi tuong da chpn va viet 8 chuyen dS.

Bao cao kSt qua thuc hien de tai. Kiem tra tiSn dd lan 1. Hpi thap danh gia thye trang cdng tac dam bao chat lugng VSATTP Hpi thap xay dyng cac giai phap nang cao nhgn thic cia ngudi dan vi VSATTP Viit bao eao de tai.

Hdi thao gdp y ket qua dS tai

Bao eao ket qua thye hifn di tai. Kiim tta tiSn dp lan 2 Nghiem thu co sd

Nghifm thu chinh thic

Thoi gian

5/2008- 1/2009

1/2009

6/2009

7-12/2009

10/2009

1 '20 H)

2/2010

3/2010

4/2010

4/2009

5/2010

5/2010

2.7. NHAN L V C : 66 can bd trye tiip tham gia dieu tta gdm: Sd y ti: 4 bac si; Trang tam y te Dy phdng tinh: 3 bac s i ; Chi cue An loan vf

sfaih tinh: 2 bac sT; Trang tam Truyen thdng Giao dye Sic khoe tinh: 3 bac si, 8 dieu tta vien; 4 huyfn/Thanh phd dupe chpn: 7 bac sT, 39 can bd y te xa/phudng.

2.8. DIEU PHOI - Bs CKI. Trinh Van Trayin - phd Giam ddc sd y ti , thanh viSn ban chi nhiem dS

tai, chiu trach nhif m chi dao toan bd nghiSn ciu. - Ths.Bs. NguySn thi LiSn - Giam die Trung tam TTGDSK ehi nhifm dS tai,

ehju ttach nhifm td ehic, ttiin khai va true tiip tham gia nghiSn eiu. - 07 thanh viSn nhdm nghiSn ciu trac tiip tham gia nghiSn ciu.

29

II. KET QUA NGHIEN ClTU VA BAN LUAN

1. DAC DIEM CHUNG

Nghien e iubao gdm 1.430 doi topng, trong do, 957 (66.9%) ntt va 473 (33.1%) nam, todi nhd nhit la 19, tudi Idn nhat la 75. Phan bd nhu sau (biiu dd 2.1):

1.1. PhSn bi theo dg tuoi va gidi tinh

PHAN BO THEO TUOI VA GlOl TINH

TY LE % 70

60

50

40

30

20

10

66.9

8.9 7.i

23.3 24.3

5.5 8.2 1.3 2.2

<20 21-30 31-40 41-50 51-60 > 60 Chung

Bilu do 2.1. Phan bi theo d^ tuii va gidi tinh

Nhin xet:

Ddi vdi nO, nhdm todi 41-50 chiim ty If eao nhit 24.3%), tiip din la nhdm todi 31-40 (23.3%), nhdm todi 21-30 (8.9%), nhdm 51- 60 todi (8.2%), > 60 todi chi chiim ty IS 2.2%, thip nhit la nhdm < 20 mdi chi chiim 0.1%.

0 nam, toy it hon ntt nhung nhdm todi 41-50 chiim ty If cao nhit 13.2%, tiep din la nhdm todi 31- 40 (7.5%), nhdm 51- 60 todi (6.5%), nhdm todi 21-30 (4.1%).

Nhu vay, ddi topng nghiSn eiu da sd t i 31-50 tudi, chiim ty If 68.3% (bieu dd 2.1).

30

1.2. Phan bi theo dia du-

P H A N B O M A U N G H I E N CU'U T H E O D j A D U '

T Y L E % ^ j j

35

30

25

15

10 L

"in.i

" • • 1 ."

n \} 3

Tam Ky Nui IMnli 1 lii;p Due Nam I r i My

Bieu do 2.2. Phan bd mau nghien cun theo dia du

Nhan xet: Sd luong ddi topng dupe diiu tta phan bi ddng dSu d cac xa/phudng, tieu bieu

cho nhiing khu dan cu dac ttung nhu thanh phi, ddng bing ven biin, ving trung du va miin nii eao vdi ty If lln lupt la 33.3%, 30.1% ,24.5%, 12.0% (biiu dd 2.2). Diiu nay phan anh tinh chat da dang va tinh dgi dien cia quan the nghien ciru lien quan den khia canh dja du d mdt dia phuang cd dac diSm dja ly phic tap nhu tinh Quang Nam.

1.3. Phan bo theo doi tngng Bang 2.1. Phan bo man nghien ciiu theo doi tirgmg

T T

1

2

3

4

5

^ B i a diem

Noi dun^v

Can bo quan Iv Nguoi kinh doanh TF Ngudi ban TP Ngudi ban rong NgffM SXCBTP Ngudi lam tai ca sd SX,CBTP Ngudi lam tai bep an tap the Ngirci ti§li diing Can bd lam TTGDSK

Cgng

Tam Ky

n

S6

129

64

65

128

68

60

128

5

476

Tyle % 6.0

9.0

4.5

4.5

9.0

4.8

4.2

9.0

0.3

3 3 J

Nui Thanh

.. 105

105

55

50

105

55

50

110

6

431

Tyle % 73

7.3

3.8

3.5

7.3

3.8

3.5

7.7

0.4

30.1

Hiep Birc

n

90

84

44

40

84

44

40

88

5

351

Ty le %

6.3

5.9

3.1

2.8

5.9

3.1

2.8

6.2

0.3

24.5

Nam Tra IWy

n

75

30

15

15

30

15

15

33

4

172

Ty le%

5.2

2.0

1.0

1.0

2.0

1.0

1.0

2.3

0.3

12.0

Chung

n =1430

356

348

178

170

347

182

165

359

20

1430

Tyle %

24.9

24.3

12.4

11.9

24.2

12.7

11.5

25.1

1.4

100.0

Nhan xet: Ty If timg doi topng (can bd quan ly, ngudi kinh doanh TP. ngudi san xuat. che

biin TP, ngudi tiiu ding) tuong duong nhau (24.9%, 24.3%; 24.2% va 25,1%), ngoai ra cd 1.4% ngudi lam cdng tac TTGDSK tai cac tuyin (Bang 2.1). Su phan bo doi topng nay phi hpp vdi phuong phap chpn mau cia dS tai.

1.4. Trinh do hge van

Bang 2.2. Trinh df hgc van

T T

1

2

3

\ H g c van

Ngi dun^v

Ngirdi kinh doanh TP Ngudi ban TP Ngudi ban rong Ngn*i SX, CBTP Ngudi lam tai CO sd SX,CBTP Nguoi lam t^i b8p an t4p the Nguoi tieu dung

Cgng

Tieu hgc

n

45

20

25

23

15

8

37

105

Tyl f

% 4.3

1.9

2.4

2.2

1.4

0.8

3.5

10.0

Trung hgc ctysit

n

212

104

108

184

100

84

181

577

Tylf %,

20.1

9.9

10.2

17.5

9.5

8.0

17.2

54.7

Pho thong trung hgc

n

88

51

37

131

65

66

123

342

Tyle

% 8.3

4.8

3.5

12.4

6.2

6.3

11.7

32.4

> Trung cap

n

3

3

0

9

2

7

18

30

Tyl f Vo

0.3

0.3

0.0

0.9

0.2

0.7

1.7

2.8

Chung

n =1054

348

178

170

347

182

165

359

1.054

Tylg

% 33.0

16.9

16.1

32.9

17.3

15.7

34. T

too

Nhan xet: Nhdm nghiSn ciru cd trinh dp van hoa cap 2 chiem da sd (54.7%), sau do den cap

3 (32.4%), cip I chi cd 10%, thip nhit la t i trung cip ttd len (2.8%), (bang 2.2). Vdi trinh dp hpc vin niy di diiu kien tiip thu cac kien thic dim bap VSATTP.

32

1.5. Thoi gian dAm nh$n cfing viec

Bang 2.3. Thdi gian dam nhdn cong vifc

T T

1

2

^ ^ ^ T h o i gian

Nf i dung ^""^^

Ngiroi kinh doanh TP Ngudi ban TP Ngudi ban rong Ngvoi san xuat, che bien TP Ngudi lam tai ca sd SX,CBTP Ngirai lam t^i bep an tap th^ Cgng

< 1

n

32

8 24

49

17

32

81

nam Tyle

% 4.7

1.2 3.5

7

2.4

4.6

11.7

I - < 5uam

n

109

50 59

130

58

72

239

Ty lg%,

15.7

7.2 8.5

18.7

8.3

10.4

34.4

5-<10

n

84

50 34

79

49

30

163

nam

Ty If %.

12.1

7.2 4.9

11.4

7.1

4.3

23.5

> 1 0

n

123

70 53

89

58

31

212

nam

Ty If %

17.7

10.1 7.6

12.8

8.3

4.5

30.5

Chung

n = 695

348

178 170

347

182

165

595

ry 16 "A.

50.1

25.6 24.5

49.9

26.2

23.7

IUU

Nhan xet: Su liSn quan gitta kinh nghifm, ky nang va tham nien lam vifc da dupe ching

minh ttong thuc tiin, thdi gian lam vifc cang Mu thi cang nhieu kinh nghifm va cang cd ky nang tit. Trong edng tac kinh doanh, san xuit va chS bien TP ciing vay, nhung ngudi lam cang lau cang cd mdi quen biit ttong mua TP cd chit lugng va ngudn gdc rd rang, cang cd ky thuat trong kinh doanh, san xuit, chi bien TP va dge biet cflng biSt bao quan TP.

Qua nghiSn ciu ching tdi thiy thdi gian dam nhan cdng vifc cia ngudi kinh doanh TP va ngudi SX, CBTP toong duong nhau. Thdi gian lam viee eua ca hai nhdm tu 1- <5 nam chiim eao nhit (34.4%)); ki din la > 10 nam (30.5%)); nhdm cd thdi giaii to 5 - < 10 nam 23.5%) va nhdm cd thdi gian < 1 nam 11.7%o (bang 2.3), day la yiu td thuan Ipi che vifc dam bao VSATTP cua ngudi kinh doanh va SX, CBTP tgi tinh ta.

1.6. Kh^m su-c khoe djnh ky

Bang 2.4. Kham swc khoe dinh ky

T T

1

2

\ K h a m SK

Ngi d u n g X

NguM kinh doanh TP

Ngudi ban TP

Ngudi ban rong

Ngiroi san xuat, CBTP Ngudi lam tgi ca sd SX,CBTP Ngudi lam tai bep an tap the

Cgng

C6 kham

< 1 2

"

119

72

47

184

85

99

303

thang

Ty l f

%

17.2

10.4

6.8

26.4

12.2

14.2

43.6

>12 thang

n

81

52

29

100

55

45

181

Ty If %

11.7

7.5

4.2

14.4

7.9

6.5

26.1

Khong kham

n

148

54

94

63

42

21

211

Ty If %

21.3

7.8

13.5

9.0

6

3

30.3

Chung

n = 695

348

178

170

347

182

165

695

Ty le %'

50.1

25.6

24.5

49.9

26.2

23.7

100

Nhgn xet: Theo Quyit djnh sd 21/QD-BYT ngay 12 thang 3 nam 2007 cia Bp trudng Bp y

te ve qui djnh dieu kifn s ic khoe ddi vdi nhirng ngudi tiip xuc true tiip trong qua ttmh chi biin TP gdi sin va kinh doanh TP an ngay, diSu 4 ve yeu eau kham sic khoe ddi vdi ngudi lao ddng ghi rd "Ngudi lao ddng phai dupe kham sic khoe trade khi toyin dung, khim sic khoe dinh ky..."[12]. Trong 695 ngudi dupe dieu tra chi cd 43.6%) kham sic khde ding qui djnh (mdi kham <12 thang); 181 ngudi (26.1%) ed kham nhung da >12 thang; dae biet cd den 211 ngudi (30.4%)) khong kham sic khoe djnh ky (bang 2.4). Nhu vay, so ngudi ehua dupe kham sic khoe ding theo qui dinh chiim den 56.5% cao ban kSt qua nghien eiru cia Okojie OH va cs chi ed 30,4% ngudi da duac kiim tta s ic khde trade khi hanh nghe [63].

Qua thong tin to Trang tam Y tS du phdng tinh Ben Tre vS kSt qua thanh tta dpt mpt diu nam 2007. Trong 57 tradng, nhdm trS, Idp mim non thi trudng dgt ca 2 tiiu ehuin (VSATTP hoac vf sinh dinh dudng TP) chi dem tren dau ngdn Ui). Vi pluiiii thudng la khdng kiSm tra s ic khde djnh ky theo quy djnh [57].

Tai tinh Vinh Long, qua kiim tta tdng sd 214 bip an tap thi tren dja ban tinh, chi cd 66%) bip an dat yeu elu va 34%> bip an khong thuc hifn kham sic khdc [38].

Vifc khdng kham sic khoe dung theo qui djnh khdng nhttng vi pham qui djnh cia nha nude ma cdn la tiem an nguy ca gay ngd ddc TP.

1.7. Dugc tham gia tap huan kien thic VSATTP

Bang 2.5. Tham gia tap huan kien thie VSATTP

TT

1

2

"—-—Iham gia tap huln Huyfn/Thanh pho ~ - _ Ngffdi kinh doanh TP Ngudi ban TP Ngudi ban rong Ngirdi san xuit, ehi biin TP Ngudi lam tai co sd SXCBTP Ngudi lam tai bep an tap the

COng

Cd n = 695

203 118 85

277 142 135 480

Ty Ig % 29.2 17.0 12.2 39.9 20.4 19.4 69.1

Khong n = 695

145 60 85 70 40 30 215

Ty If % 20.9 8.6 12.2 10.1 5.8 4.3 30.9

Nhgn xet: Nhung ngudi kinh doanh TP, dae bift nhttng ngudi true tiSp SX, CBTP can cd

hiiu biit tdi thiiu vi VSATTP va th\rc hanh tdt cac ^ui trinh, qui pham VSATTP. DS cd kien thic, thuc hanh tdt hp phai dupe tap huan vS dam bap VSATTP. Thong qua cac dpt tgp huln nay can bd y t i se cung cap cae van ban qui djnh phap luat, eae ky nang thuc hanh va ban than nhihig ngudi lam tai eae co sd khac nhau se chia se kinh nghifm cho nhau.

Hon ntta, theo Quyit djnh sd 43/2005/QD-BYT ngay 2(3 thang 12 nam 2005 cia Bd tradng Bp y t i eung qui djnh rd "Ca nhan true tiSp san xuit, kinh doanh TP phai cd giiy ching nhan da dupe tap huln kiin thic vi VSATTP phi hap vdi tong nganh nghS san xuat, kinh doanh" [10].

Bang 2.5 cho thiy chi cd 69.1%) dupe tap huln kiin thic vi VSATTP, sd cdn Iai 30.9% ehua dupe tap huin. Kit qua nay phi hpp vdi kit qua nhung dpt kiim tta VSATTP cia Cue An tpan ve sinh TP cho thiy, nhiiu doanh nghiep chua quan lam ding muc ddi vdi quy djnh vi VSATTP, thudng gap nhimg vi pham nhu dung cu phuc vu an udng, ehi biin, t in trtt, bao quan TP sai quy djnh; nhan viin true tiSp san xuat chua dupe ttang bj kiin thic co ban vi bao dam an toan TP va ve sinh ca nhan [19].

Ngay 30-11- 2008, Sd Y t i tinh Vinh Long cho biit, qua kiim tra ting si 214 bip an tgp thi tten dja ban tinh, chi cd 141 bip an dgt ySu cau va 73 bep an khdng dam bao cac diiu kien vf sinh, khdng thirc hifn kham sic khde, nhan viSn khong mac ttang phuc chuySn dung va khdng thuc hifn luu miu TP theo ding quy dinh [37].

35

2. THlTC TR^NG CONG TAC QUAN LY VE SINH AN TOAN THUC PHAM CUA CHINH QUYEN, SU PHOI HOT CUA CAC BAN NGANH, DOAN THE TAI DIA PHUONG

2.1. Dia phu-ffng co thanh lap Ban chi dao VSATTP

Bang 2.6. Dja phuong c6 thanh lap Ban chi dao VSATTP

~~~~~~—~ Ban chi dao H u y g n / T P ~ ~ ~ — ~ - ^ TamKy Nii Thanh Hifp Die Nam Tra My

Chung

Tong so

86 105 90 75

356

Cd n 86 105 90 50

331

Ty If % 100 100 100 66.7 93.0

Khong n 0 0 0 25 25

Ty If % 0.0 0.0 0.0 33.3 7.0

Nhgnxit : Vifc thanh lap Ban chi dgo la yeu cau bit budc trong he thdng quan ly chat

lupng VSATTP tu trung uong den co sd. Ban chi dao VSATTP co vai trd rat Idn trong viec chi dgo xay dung va triin khai thue hifn kS hoach vS VSATTP, cac boat dpng chuyen mdn, edng tae thanh kiSm tta, giam sat, danh gia cac mat hogt ddng... nham thuc hifn tdt edng tae dam bao chit lupng VSATTP tai dia phuang. Tren bang 2.6 cho thiy tai cae dia phuong da thanh lap Ban chi dao VSATTP chiem ty If kha cao 93.0%) chi ySu tai cac huyfn ddng bang, trang du, van cdn 7.0%o dja phuang chua thanh lap Ban chi dao tap trang tai huyfn miSn nii. Day la van de ma ching ta can quan tam nhiiu ban cho cic dia phuang miin nii, bdi mot each dl hiiu vi cac dja phuong miin nii edn gap nhieu khd khan hon nhu ve dja hinh, sd lupng va nang luc can bd, thieu su quan tam den cdng tac nay.

2.2. Xay dnng ki hoach, ban hanh van ban ehi dao ve VSATTP

Bang 2.7. Xay dung ke hogch hoat dgng VSATTP tai dia phirong

\ \ Hoat dgng

Dja diMK

TamKy Nui Thanh Hiep Die Nam Tra My

Chung

Tong n

so

86 105 90 75

356

Xay dung ke hoach

Co

n

83 103 90 37

313

Ty If %

96.5 98.1 lOO.O 49.3 87.9

Khong

n

3 2 0

38 43

Ty If %

3.49 1.90 0.00 50.67 12.1

Ban hanh van ban

Co

n

85 104 87 47 323

Tyle %

98.84 99.05 96.67 62.67 90.73

Khong

n= 356

1 1 3

28 33

Tylf %

1.16 0.95 3.33 37.33 9.27

Nh^n xet: Xay dung ki hpgch boat dpng va ban hanh cae van ban chi dao la cin thiit, k i hoach xay dimg cu thi, chi tiit va kha thi tai dja phuong se giip cho vifc triin khai thtrc hifn ni nip, xuySn suit nhim thue hien cd hifu qua cdng tac dam bao chit lupng VSATTP. Vi vgy, muin lam tit cdng tac dam bao chat lupng VSATTP

mdt ttong nhung edng vifc dja phuong cin lam dd la xay dung ki hoach hoat ddng va ban hanh van ban chi dao vi VSATTP. Ty IS dja phuang da xay dung ki lioaeh hoat dpng va ban hanh cac van ban chi dgo chiim ty If kha cao (87.9%) va 90.7%)), chi yiu cac dja phuang ving ddng bing, ttung du, khong xay dung ki hoach hoat ddng va ban hanh van ban (12.1% va 9.3%) (bang 2.7). Ket qua nay tuong duong vdi kit qua nghiSn ciu co sd khoa hpc di di xuit qui hoach phat triin mang ludi quan ly VSATTP ttong nganh y t i cia tae gia Tran Dang (88.1%) [32].

Day eung la van di cin quan tam, do viec thieu thanh lap ban chi dao nen thiiu su quan tam chi dao di xay dung ki hoach boat dpng va ban hanh van ban.

2.3. To chuc hgi nghi trien khai vin ting kit ve cong tac VSATTP

Bang 2.8. T6 chic hgi nghj trien khai va tong kit ve cong tac VSATTP

^^^-TQ.chie hf i nghj Huyfn/TP ^ ^ ^ ^ ^ ^

TamKy Nii Thanh Hifp Die Nam Tra My

Chung

Tong so

86 105 90 75

356

C6

••

76 94 84 23 277

Tylf %

88.37 89.52 93.33 30.67 77.8

Khong

••

10 11 6 52 79

Tyle Vo

11.63 10.48 6.67

69.33 22.2

Nhgn xet: Hpi nghj ttiin khai, tdng kit cdng tac VSATTP nham muc dich danh gia kit

qua boat ddng, nSu ra nhiing thuan loi, tim dupe cac khd khan de to do dua ra giai phap phi hop nham ttiin khai tdt cac hpat ddng. Theo kSt qua nghiSn ciu cho thiy cac dja phuong da quan tam din vln di nay, cd den 77.8%) can bp lanh dap biit va tta ldi ed td chic cac hogt ddng nay va nhtmg cdn 122% lanh dao tta Idi khong ed hpi nghi triin khai va ting kit v i cong tac VSATTP (tap trung nhiiu nhit tai huyfn mien nii Nam Tra My) (bang 2.8). Day la npi dung ein thiit ma cac dja phuang can phai quan tam ldng ghep di td chic cac cupc hdi nghj, ting ket dS danh gia, ddng gdp y kiSn, rut kmh nghiem dua ra giai phap phi hpp nham triin khai cac hoat dpng ngay cang hieu qua hon.

2.4. Phu'ofng phap chi dgo khi c6 vy ngg dge TP xay ra tai dja phu-ong

PHlTONG PHAP CHI BAG TVLg%

90

80

lr\rclicp V.lnbmi Hhh Ihirc kliic

Bieu do 2.3. Phinmg phip ehi dao khi e6 vg ngf dge TP

Nhgn xit:

Khi cd vu ngp ddc TP xay ra, vifc chi dao kjp thdi khdng nhung giai quyit nhiing hau qua do ngd ddc TP gay ra ma cdn tun nguyen nhan di x i ly ttift di ngan chan ngd ddc TP tai diSn, van dS chi dao true tiip thudng dupe ap dung va do ca quan chuySn mdn la co quan thudng true cia Ban ehi dao tien hanh. Theo kit qua nghiSn ciu, phuong thue ehi dao khi cd xiy ra vu ngp ddc TP theo each: chi dgo true tiip chiem ty If cao 85.7%, tiip theo la bang van ban 71.9% va cuii eung la nhung phuang thic khac 8.4% (hpp, difn thoai) (biSu dd 2.3). Dieu nay ehirng td eae dia phuong da the hifn cdng tae quan ly ehi dao khi cd ngp dpe TP la kha thuan nhit va hpp ly. Day la cac ndi dtmg cin phat huy di ehi dao thuc hifn khi cd ngd ddc xay ra nhim dam bao ding thudng quy vi diiu tta x i ly cac vu ngp die TP cia BS Y tS.

2.5. Vai trd ciia ban nganh, doan the trong cdng tac VSATTP

Bang 2.9. Vai tro cua ban nganh, doan the trong eong tic VSATTP

^^luyln /TP

Ngi dung ^ ^ ^ ^

Hoi ndng dSn Doan thanh nien Hoi phu ntt Van hda thong tin Hoi chu thap dd Hdi cmi chien binh Nganh giao due Khac

TamKy

a

42 49 79 53 27 25 48 15

Tylf %

11.8 13.8 22.2 14.9 7.6 7.0 13.5 4.2

Nui Thanh

n

61 46 96 75 38 33 64 0

Ty If %

17.1 12.9 27.0 21.1 10.7 9.3 18.0 0.0

Hifp Due

n

60 48 77 57 18 19 58 28

Ty le%

16.9 13.5 21.6 16.0 5.1 5.3 16.3 7.9

Nam Tri My

n

57 29 63 57 5 30

55 5

Tylf %

16.0 8.1 17.7 16.0 1.4 8.4 15.4 1.4

Chung

n=356

220 172 315 242 88 107 225 48

Tyle %

61.8 48.3 88.5 68.0 24.7 3a.i 63.2 13.5

38

Nh|n xet: Mudn dam bao chit lupng vi VSATTP thi trong boat ddng cin su huy ddng

cia toan xa hdi, dac bift phai ed su phdi hpp ban nganh, doan thi. Niu thiiu su phii hop nay thi vifc triin khai rit ban chi va it hifu qua. Vi v^y, vai trd cia ban nganh, doan the l i rat quan trpng, khdng thi thiiu ttpng cdng tac nay. Khi danh gia vS vai ttd cia ban nginh, doan thi nao quan trpng nhit ddi vdi edng tae VSATTP, bang 2.9 cho thay chiSm ty If cao nhit la Hoi phy ntt (88.5%), ki din la Van hda thdng tin (68.0%), Nganh giao due (63.2%), Hpi ndng dan (61.8%), Doan thanh niSn (48.3%), Hpi cuu chiSn binh (30.1%), thip nhit Hpi chtt thap dd (24.7%), khac (13.5%). Ching td vai ttd cia hdi phu ntt la vd cing quan trpng trong hpat ddng nay, vin di btta an gia dinh hoac bep an tap the thudng liSn quan din ngudi phu ntt hon, do dd cdng tae VSA T TP gan bd vdi edng vifc cua ngudi phg ntt nhiiu hon. Mat khac, cung nhu Hpi phu nu, cac ban nganh doan thi khac nhu Van hda thdng tin, Hpi ndng dan da khing djnh duac vai frd cia minh thdng qua each to chic va trien khai cac boat ddng truyin thdng, van ddng. Ddi vdi Nganh giao due cd vai trd quan trpng ttPng vifc chi dao va triin khai taySn ttuyin hudng din VSATTP eho hpc sinh.

2.6. Cing tic quan ly VSATTP d uguoi ban rong

Bang 2.10. Quan ly VSATTP d ngu-di ban rong

TT 1

2

3

4

5

6

7

8

9

10

Ngi dung

Thanh lap dpi liSn nganh kiim tra, giam sat

Chi dao cac ban nganh, doan the phdi hpp tuyen traySn, van ddng hp thuc hien qui djnh vS VSATTP

Lap danh sach theo ddi, quan Iy

Hudng din ngudi ban rong dang ky de theo ddi

Cam kit

Td ehic va van ddng kham sic khde djnh ky

Quy hoach tap trung dja diSm ban

Td chic cic Idp tap huln vi VSATTP

Van ban chi dao

Khdng tta ldi

So ngirdi tra loi

90

34

32

10

9

9

8

7

1

192

Ty If %

25.3

9.6

9.0

2.8

2.5

2.5

2.2

2.0

0.3

53.8

Nhgn xet: Thuc ttang ban hang rong kha phi biin d cae dia phuang bdi tinh tien lpi cua

nd. Tuy nhiin, thic an to ganh han^ rong nay ludii tiim in nguy co gay ngp ddc TP, ttong khi dd cdng tac quan ly cdn rit khd khan. Bing cau phdng van sau kit qua thu dupe tgi bang 2.10 eho ta thiy ed 192 ngudi khdng tta ldi (53.8%), nhu vay chi ed 46.2% ngudi eho y kiin nhto xet vi cac hinh thie quto ly ngudi ban rong tgi dja phuong; ttong dd ed nhiiu ndi dung di quan 1 nhimg thuc t i each quan ly dupe nSu ra la thanh lap d$i liSn nganh kiim tta, giam sat 25.3%, taySn trayin, vto dpng hp thue hifn qui djnh vi VSATTP 9.6%, lap danh sach thep ddi, ^uan ly 9.0%o, cho ngudi ban rong dang ky di theo ddi 2.8%i hogc lam earn kit 2.5%, td ehic kham sic khde 2.5%,

39

tjp trung dia diSm ban 2.2%, td chic tap tgp huin 2.0%), lam van ban ehi dao 0.3%. Chung tdi cho rang thuc te each quto ly do la phi hop vdi cdng tac quan ly TP tgi nude ta hien nay chi yiu la vifc toySn trayen hudng din ngudi bto rong tai dja phuang thyre hifn dam bao chit lupng VSATTP, ddng thdi thudng xuySn giam sat, kiim tta de giip do hp thuc hifn tdt cflng nhu x i ly kjp thdi nhttng sai pham, nhttng diSu dd se gdp phto rat Idn frpng vifc quan ly co sd san xuat, che bien, kinh doanh TP.

Tuy nhiSn, cd 53.8%) ngudi khdng tta Idi ttong vifc quto ly ngudi ban rong, nguySn nhto cd thS do chua quan tam din vin di nay, hoac khdng quan ly hay quan ly ldng leo, thiiu hieu biit doi vdi linh vue nay va mat khac cd thS la hp cho vifc tra ldi phdng vln la khdng cin thiit.

Theo thing kS chua diy d i cia Bp Y ti to nam 1999 din nam 2004, ca ntrde cd 1.386 vu ngd dde TP, ttong dd cd tdi 1.056 vu ngp dpe la do T A D P va bip to tap thS

gay ra. NguySn nhto cia tinh ttgng tren, ttudc het la do nhiSu dja phuang chua thuc su quan tam dSn edng tac bao dam vf sinh, an toan TADP, chua cd quy hoach cho loai hinh djeh vu nay; cdng tac thdng tin, giao dge, traySn thdng chua dupe day manh; su phdi hpp lien nganh chua ddng bp; cdng tac thanh tra, kiSm tta chua thudng xuySn va vifc xu ly cae hanh vi vi phgm chua nghiem; chua huy dpng dupe sir tham gia cia cac td chic xa hdi vao edng tac giam sat vf sinh, an toto TADP [7].

2.7. Cong tac truyen thong qua hf thong loa truyen thanh

HE THONG LOA TRUYEN THANH

^ ^

I Khong

Bilu d i 2.4. Hf thing loa truyin thanh tren dja ban huyfn

Nhgn xet: Hf thing loa truyin thanh ttin dia bto huyen/xa rit cd y nghia ttong vifc phd

biin thdng tin, kiin thic va phi hop diiu kifn thuc tiSn eae dja phuang. Qua biiu dd 2.4 cho ta thiy cac dja phuong cd hf thing loa trayin thanh ttin dia bto huyf n/xa la kha cao (85.7%); diiu nay tao diiu kifn thuan lpi cho vifc trayin thdng giao due tgi dia phuong; vin edn 14.3% dja phuong khdng ed hf thing loa ttuyin thanh nay, dac bift la cac dja phuang ving trung du v i miin nui. Day la vin di ma cae cap lanh dao

40

cto phai quan tam dau to dung mic dS ngudi cdng dong tiSp cto thdng tin vi VSATTP.

Bang 2.11. So lln tuyen tuyen ve VSATTP hang thang

^~'~~- ^o lan/thang

Huyfn/TP ^ ^ ^ ~ \ TamKy Nii Thtoh Hifp Die Nam Tri My

Chung (n=356)

I lin

n

17 15 36 20 88

Tylf % 4.8 4.2 10.1 5.6 24.7

2 - 3 Ito

n

47 49 30 01 127

Ty le% 13.2 13.8 8.4 0.3 35.7

4 - 6 lln

n

13 24 18 01 56

Ty IS% 3.7 6.7 5.1 0.3 15.7

>6ian

n

7 17 4 01 29

Tylf % 2.0 4.8 1.1 0.3 8.1

Khdng cd

n

2 0 2 52 56

Tylf % 0.6 0.0 0.6 14.6 15.7

Nh^n xit: Trayen thdng vS VSATTP qua hf thdng loa thudng xuyen htog thtog se giip

ngudi dto nhan thie tit hon di phdng ngia, ngto chto ngd dpe TP. Qua bang 2.11 cho ta thiy 84.3%) hf thing loa traySn thanh tai cic dja pliuong dupe phat huy htog thtog, gin 60%) dupe t i ehic toySn traySn trSn 2 lln/thtog; dae bift ed 8.1%o toyen trayin ttSn 6 lln/thang, mpt lln ntta khing djnh van di toySn trayin bing hf thong loa tmyin thanh tai dja phuang la cin thiit, hifu qua va dupe quan tam thuc hien. Tuy nhiSn vin cdn 15.7%) khong cd lln nao, nguySn nhto do khdng td chic toyen trayin qua hf thing loa va khdng cd hf thing loa nay ttong dd chi ySu l i Nam Tra My (chiem 14.6%) ttong ty If chung). Day cung la vin di ma cac cap lanh dao dae bift miin nii cin phii quan tam hon ntta ttong vifc chi dao, ttiSn khai thue hifn.

2.8. Y kien ve eong tac quan ly VSATTP

2.8.1. Cdc cong dogn (khau) cin luuy didam bao VSATTP

CAC KHAU CAN LUU 'V DE DAM BAG VE SINH ATTP

88.2 Ty 1? %

30.3

Sdn)aiat Chi bien Bao quan Phan phdi Van Sii dyng Du>4n9i chuyen dung

Bilu d6 2.5. Cic khSu cin Inn y de dam bao VSATTP

Nhgn xet: Trong qua ttinh to sto xuat din tiSu ding ttai qua 6 cdng doan cin thiit di dam

bao chat lupng VSATTP. Vi vay, ngudi quto ly cin biit cac npi dung nay. Theo qui djnh cia Cue Y t i Du phdng, ngudi dupe diiu tra tta Idi d i to 4 khau trd ISn thi duac xem nhu la thue s\i hiiu biit vi cdng tac VSATTP. Kit qua nghiSn ciu cua ching tdi sd ngudi tta ld|i d i to 4 khau ttd len chiim ty If 48.3%) (biiu do 2.5). Diiu nay cung chiing td su hiiu biit chung cia nhdm nghien eiu vi cdng tic VSATTP la ehua tit. Ty If nay thip ban so vdi nghiSn cum cua Bp Y ti - Cue VSATTP nam 2007 (tra ldi ding to 4 khau ttd len 82.7%) [7].

2.8.2. NhOmg hogt dpng can thfrc hi^n di ldm lot cdng tdc VSATTP

HOAT DONG CAN THV'C Hlf.N Oft LAM T 6 T C 6 N C TAC Vf. SINH AN T O A N T i i y c P H A M

MM Xay dyrig ll)ining I o thirc Hhh kyi.1, Du 4 !ii>yl

KH sal Ihili; \iiyen GS. nhl^u hhih kcL long ket dOajJ kKDi Ua ihirc iiiyiln

Bieu do 2.6. Nhirng hogt dgng can thire hifn d i lam tot eong tae VSATTP

Nhgn xet: Di dam bao ehlt lupng VSATTP, ttpng cdng tac quto ly VSATTP cd 4 npi

dtmg hogt ddng quan ttpng cin phai thuc hifn ddng bd mdi ntog eao chit lugng boat dpng. Qua nghiSn eiiu chiing toi nhto thiy tta ldi diing timg phin kha ding nhit tai cac dja phuong va chiim ty If cao ito lupt: Vifc thudng xuySn kiim tta, giam sat (93.5%), td chuc nhiiu hmh thic toySn trayin cho ngudi dto (86.8%)), xay dung ki hoach boat dpng ehp Ban chi dao sat thuc (79.2%)), djnh ky td chic so kSt tdng kSt cdng tac dam bao ehlt lupng VSATTP (64.9%)). Tuy nhiSn, tta Idi dtag va du 4 npi dung cin boat dpng ttSn chi chiem ty If khiSm tin 53.4%o (biiu dd 2.6).

42

2,8.3. Qudn iy vi VSATTP doi v&i ngu&i bdn hdng rong tai dia pliuong

Bang 2.12. C^c hoat dong 6.1 lam t6t cong tac quan Iy ngu'O'i ban rong

TT

I

2

3

4

5

6

7

8

9

10

11

12

Ngi dung

TuySn traySn bing nhiiu hinh thic

Phdi hpp liSn nganh thanh, kiim tra, giam sat

Td chic cho ngudi bto rong dang ky mua ban

Tgp tmng dja diim bto rong

Lap danh sach theo ddi

Ngudi bto rong thue hifn cam kSt dam bao VSATTP

cap giay phep eho ngudi ban rong

Chuyen ddi nghS

Thtoh lap td tu quto

Lap Ban chi dao

Vto bto hudng dto

Cam bto rong

So ngiroi de xuit

159

101

76

61

30

18

12

8

6

5

5

4

Ty If %

44.7

28.4

21.3

17.1

8.4

5,1

3.4 -) -> 1.7

1.4

1.4

1.1

Nhan x^t: Bto htog rong la phd biSn d cac dja phuong, trong khi dd cdng tac quto ly cdn

rit khd khto. Can bd lanh dgo d cac dja phuang da cd kinh nghifm trong quto ly ddi toong nay va hp de xuat cac vifc cin lam di lam tdt cdng tae quan ly ngudi bto hang rong ty If lin lupt nhu sau: Ban nganh, doan the phii lipp toyen traySn bang nhiiu hinh thic 44.7%); phdi hpp lien nganh thanh, kiim tra, giam sat 28.4%); to chic cho ngudi ban rong dang ky mua bto 21.3%); tap trang dja diim ban 17.1%; lap danh sach theo doi 8.4%); thuc hifn cam kit dam bao VSATTP 5.1%); cap giay phep cho ngudi bto rong 3.4%); chuyin dii nghi 2.2%); td tu quan 1.7%; lap Ban chi dao. co van ban hudng din (diu 1.4%i) va cim ban rong la 1.1%). (Bang 2.12) Nhu vay, hoat dpng dupe di xuit nhiiu nhit va cd kha thi vdi tinh hinh thuc te hien nay la td chic truySn thdng bing nhiiu hinh thic; thanh, kiim tra, giam sat; t i chic cho ngudi bto rong dtog ky mua ban.

43

2.8.4. Ngudn cung cdp thdng tin vi VSATTP

- —

Ty le %

90

80

70

60

50

40

30

20

10

0

— - - — NGUON CUNG CAp THONG TIN

8 7 9 848

1 40.4

1

1 I

^ ^ B 6.7

IP ^ ' Tiiong tin dai Can bp y Ic Ban cham soc Khac

chinig siic khoe

Biiu do 2.7. Nguon thong tin vi VSATTP

Nhfn xit: De cimg cip thdng tin vi VSATTP ed nhiiu kSnh thdng tin khac nhau nhu qua

cac phuang tifn thdng tin dai ching, qua tap huin, hdi thao, tai lifu.... Qua biiu dd 2.7 cho ta thiy ngudn thdng tm vi VSATTP ma cto bp lanh dao dupe nhto ehi yiu to cac phuang tiin thong tin dai ching (87.9%)), qua cto bd y tS (84.8%)); ban cham sde sic khde (40.4%), ngudn khac rit it (6.7%). Diiu do chiing td thdng qua cac phuang tifn trayin thdng dai ehung va cto bd y ti rat cd y ngliia ttong vifc cung eip thdng tm vi VSATTP din lanh dao cae cip tai cac dja phuong va cin dupe duy tri, md rdng.

2.8.5. Hinh thuc tuyen truyin co hifu qua tgi dia phuang

HINHTHLCTUYI

Tyl? 8(1

70 1

60

50

4 0 -

3 0 -

20-j

10-i

79 2

-

'''•

Qua loa Quad^ pMt thanh truydn xa. Wnh

N TRUYEN CO HI$U QUA

.10.1

r\ 1 J

55.6

^ ^ 8

f=^ n -LU Qua h&a Qua cdc lo Truyen

chi roi, tranh thong tivc anh tiep

Biiu di 2.8. Hlnh thuc tuyin truyin c6 hifu qua tgi dia phumig

44

Nh§n xet: Hmh thie toyen tmyin ed hieu qua thdng thudng la ttuyin thong true tiip nhu

to vto, thao Into nhdm, ttinh diin, ndi chuyfn chuyen di... toy nhiSn ddi hdi ngudi dto phai cd nhu cau va muin tham gia, chi phi cao ban nhiiu so vdi trayin thdng gian tiSp qua loa. Tuy nhiSn, kit gua cho ta thiy hmh thic toyen trayin lanh dao dja phuong eho la hieu qua cao nhat tai dja phuong vin la he thing ttuyin thanh xa chiim 79.2%); trayin hinh (61.5%)); roi din tranh anh, td roi, qua bao chi va thip nhit la trayin thdng tr\rc tiip 25.8% (biiu dd 2.8). Diiu nay phi hop vdi diiu kifn hifn nay, khi m i ngudi dto it danh thdi gian di den du hpp, nghe traySn thong true tiip va dpe tai lieu, bao ehi. MJe khac, ngudn kinh phi danh cho cdng tac trayin thong cdn ban hep nin vifc trayen thong qua loa di kha thi ban. Do dd, vifc ed chuih sach diu to, ntog cap, phat huy cd hifu qua hf thing trayin thdng tgi xa la vd cing cin thiit ttong cing tac dam bao VSATTP tgi cac dja phuong.

2.8.6. Nhu ciu tgp huan kiin thuc VSATTP

NHU CAU TAP H U A N KIEN THifC VSATTP

140%

^^^^^PI ffi ^B^ I ^Bl K'' y

89.60%

a Co

• Khong

Biiu do 2.9. Nhu eau can tap huin kien thiic VSATTP

Nhan xet: Tap huln kiin thic VSATTP nhim cung d p thdng tm cho lanh dao giip cho

vifc quto ly chit lupng VSATTP di dap inig eho cdng tac chi dao triin khai va thuc hien ngay etog hifu qua tai dja phuang. Day cung la nhu ciu va mong mudn cia cac nha lanh dao, qua diiu tta chung tdi 98.6% nha lanh dao diu mong mudn dupe tap huin (biiu dd 2.9).

2.8.7. Cdc cdng viic cin thifc hiin di ndng cao kiin thirc VSA TTP

Bang 2.13. Cae edng viee can thge hifn de nang eao kiin th ic vi VSATTP cho ngirdi dan

Ngi dung cong vifc

Td ehic traySn thdng, vto dpng true tiep nhan dan thuc hifn nham dam bao VSATTP bing nhiSu hinh thie Tuyen tmyin ttin phuong tien thdng tin dai ching cae npi dung ve VSATTP, tinh hinh ngp dpe TP... Lam td rai cung cap chp cdng ddng Lam pane, htog rdn Cung cap tai lifu, sach Tap huto cho nhiing ngudi tham gia trong cac co sd san xuat, chi bien, kinh doanh TP, djeh vu to udng... Cung cap vto bto ve VSATTP

So ngudi de nghi

273

83

15 12 7

92

2

Ty If %)

76.7

23.3

4.2 3.4 2.0

25.8

0.6

Nhgn xet: cae cto bp lanh dgo dja phuang la ngudi gan dan, thudng xujcn Id chiic cac

boat ddng xa hpi ndi chung va boat dpng dam bao chat lupng VSATTP ndi riSng, chinh vi vay, hp cd kmh nghifm trong vifc lua chpn cac hoat ddng kha thi va co hifu qua di ntog cao kiin thie VSATTP cho ngudi dto. Qua phdng van ching tdi thiy hau hit eae nha lanh dgo diu thing nhit hogt dpng trayen thdng GDSK bao gdm traySn thong, van dpng true tiip 76.7%); toyen trayin tten cae phuang tifn thdng tin dai ching 23.3%), k i din la tap huln cho nhing ngudi tham gia ttong cac co sd sanxuit, chi biin, kinh doanh TP, dich vu to udng... chiim ty If 25.8%, nhu vay eho thiy vai ttd cia edng tie trayin thdng la rit quan ttpng trong viec ntog eao kien thie ngudi dto. Cae hmh thie trayin thong khac nhu qua td roi, pa nd/btog rdn, tai lifu, sach cto bd lanh dap dua ra rit it (htog 2.13).

46

3. KIEN THi rc , THAI BQ, HANH VI VE VSATTP 3.1. Kiin thiic, thai dp, hanh vi ve VSATTP eua ngwdi SX, CBTP

3.1.1. Kiin thuc cua ngu&i SX, CBTP

3.1.1.1. Kien Ihiic ve cdc benh khdng duac Iham gia vdo qud trinh sdn xudi hay che biin TP

Bang 2.14. Kien th ic ve eie bfnh khong dugc tham gia vao qua trinh san xuat hay ehc biin TP

^ ^ ^ Doi tirgng

Mle eae b e n h ^ ^ ^

Lao tiin ttiin chua duoe dieu tti Bfnh dudng tieu hoa (Ta, ly, thuong bto...) Viem gan vi rit (A va E) Cae bfnh ngoai da nhiSm trung ViSm dudng hd hap cap tinh cac chiing sdn dai, sdn phto Ngudi lanh mang trung Di 6 ndi dung ttSn

Ngu'di lam tgieo' sd SX, CBTP

n=182

163

90

21

110

66

12

0

0

Ty If %

89.6

49.5

11.5

60.4

36.3

6.6

0.0

0.0

Ngudi lam tai bep an tap the

n=165

141

116

78

112

105

85

4

4

Ty If %

85.5

70.3

47.3

67.9

63.6

51.5

2.4

2.4

CI

n=347

304

206

99

222

171

97

4

4

ung

Ty If %

87.6

59.4

28.5

64.0

49.3

28.0

1.2

1.2

Nhan xet: Danh mue eae benh hoae ching bfnh trayen nhiim ma ngudi lao dpng khdng

dupe tiip xic ttong qua trinh chi biin TP bao gdi sin, kinh doanh TP ta ngay gdm cic bfnh sau:

- Lao chua dupe diSu tri; - Bfnh dudng tieu hoa (ta, ly, thuong ban...); - ViSm gan vi rit (A va E); - Cae bfnh ngoai da nhiem trung; - ViSm dudng hd hap d p tinh; - cae ehirng sdn dai, sdn phto; - Ngudi lanh mang trung [12]. Bang phuang phap phdng vin ching tdi thu dupe kit qua nhing ngudi tta Idi

ding nhu sau (htog 2.14): lao chua dupe diiu trj 87.6%; bfnh dudng tiiu hoa (ta, Iy, thuong hto...) 59.4%; viem gan vi nit (A va E) 28.5%); cae bfnh ngoai da nhilm tring 64%; viem dudng hd hip d p tinh 49.3%); eae chiing sdn dai, sdn phto 28%); ngudi lanh mang triing 1.2%).

Dac bift ty If ngudi SX, CBTP tta Idi diy d i danh muc 6 benh trayin nhilm khi mic khdng dupe tham gia san xuit hay ehi biin TP chi cd 1.2%. Nhu vgy, hiiu biit

47

cia ngudi SX, CBTP vi cac bfnh va ching bfnh trayin nhilm edn qua thip. Kit qua nay thap hon nghiSn ciu nam cia T.T. Htog 2006 cho thiy cd 52.2% ngudi sto xuit, chS bien TP con thiiu kiin thic vi VSATTP [38]. Cac kit qui trSn phi hpp vdi thing ki cia Bp Y ts to nam 1999 din nam 2004, ca nude cd 1.386 vy ngd dpe TP, trpng dd cd tdi 1.056 vu ngp dpe la do TADP va bip an tap thi gay ra. Mpt ttong nhiing nguyen nhto chmh cia thih ttang tten la do ngudi budn ban va ngudi tiSu dung cdn thiiu kiin thic ve VSATTP; sir phdi hpp lien nganh chua ddng bd; cong tae thanh tta, kiim tta chua thudng xuySn va viec xi ly cic hanh vi vi phgm ehua nghiSm; chua huy ddng dupe sir tham gia cua cac ti chic xa hpi vio cdng tac giam sat vf smh, an toto TADP Ul

Nhu vgy, vln di nhto thue vi bao dam ehlt lupng VSATTP cia ngudi Vift Nam cto dupe quan tam.

5. /. 1.2. Kien Ihiic ve bdo qudn Idl TP

KIEN THLTC BAO QUAN TOT TP

- Nguoi lami tai CO so SXCBTP,

- Nguoi lam tai bep an tap the

Chung

Biin ab 2.10. Kiin thic ve bio quan tit TP

Nhgn xet: Vi Idiuin nhilm vao TP thudng to 4 ngudn chu yiu: - Do mdi trudng khdng dam bao ve sinh, vi khuto to dit, nude bto, khdng khi,

dung eg, vgt dgng khic nliilm vao TP. - Do thiiu vS smh ttong qua trinh ehi bien, vf sinh ca nhto khdng dam bao, tiip

xuc vdi TP ttong qua ttinh dang mac cac bfnh nhilm tring dp tinh. Thic to dupe niu khong chin ky, to thic to sdng.

- Do bao quto TP khdng ve smh, khong che day di edn tring, vat nudi... tiip xic vao thic an, mang theo vi khuln gay bfnh.

48

- Do bto thto TP, gia sic, gia cim bj benh trude khi giit mi vi vay thit cua ching mang cae vi khuln hoae do ban thto TP, gia sic giit mi hoan loan khoe manh, khdng _chia vi khuto gay bfnh nhung trong qua trinh giit mi, van chuyin, bao quan, chS biSn TP da bi nhilm vi khuln va cac ehlt dpe hai khac [56].

^ DS TP khdng bj hu hdng vifc bap quan TP la idiau quan trpng, trpng dd nam vin de chi ySu la phai luu giu ttong khu vue, dung eg, trang bj chuySn ding; dd dung bao gdi khdng thing, khdng nhilm bin, ri rSt... cd nip dgy; bao quan d nhift dp an toan; bao dam thdi gian bao quto, khong dung chit bao quan ngoai qui djnh [54], [59].

Bieu dd 2.10 eho thiy ty If ngudi lam SX, CBTP cd kiin thic bao quan tit TP day d i chi ed 13.5%, sd edn lai chi biit ting npi dung nhu sau:

- Do dung bao gdi khdng thing, khdng nhiim bin, ri ret...cd nip day 76.7%; - Luu giu trong khu vue, dung eu, trang hi chuySn diing 66.3%; - Bio dam thdi gian bao quto 53.3%); - Bao quto d nhiet dp an tpan 47%i; - BChong dung chat bao quto ngoai qui djnh 36%); Diiu nay cd nghia la cd din 86.5% ngudi SX, CBTP chua cd kien thic diy du vS

bao quto TP di dam bao an toto vf sinh TP. Thuc trgng nay la hii ehudng bao dpng vdi nhimg nha quto ly edng tae nay.

3.1.1.3. Kien thiic ve thifC hdnh Idt vi sinh cd nhdn

Bang 2.15. Kien th ie vi thirc hanh t i t ve sinh ea nhSn

^^~^^^ Doi tirgnag

Ngi dung ^ " ' ^ ^ ^

Djnh ky htog nam kham sic khde va d y phto Tam ria, gdi dau trade va sau khi di lam Giu mdng tay ngan va sgch se Ria tay diing qui djnh Cd quto ao sgch, mu chup tdc khi tiSp xic vdi TP Btog vSt thuong tay htog gae khdng tham nude Khdng tiSp x ic vdi TP khi bj bfnh Thao dd ttang sic d tay khi tiip xic vdi TP Khdng ding tay tiep xic true tiip vdi TP Khdng ho, hit hoi, nhai keo,.. .tgi khu chi biin Tra ldi dung toto bd

Ngirdi lam tgi cff SO"

SX,CBTP n

=182

142

150

158 139

107

140

142

120

119

119

0

Tylf %

78.0

82.4

86.8 76.4

58.8

76.9

78.0

65.9

65.4

65.4

0.0

Ngu'di lam tai bep an tgp the

n =165

133

104

117 92

93

70

105

88

83

93

23

Tylf %

80.6

63.0

70.9 55.8

56.4

42.4

63.6

53.3

50.3

56.4

13.9

Chung

n =347

275

254

275 231

200

210

247

208

202

212

23

Ty If %

79.3

73.2

79.3 66.6

57.6

60.5

71.2

59.9

58.2

61.1

6.6

49

Nhgn xet: Chat lupng VSATTP ludn la vln di quan tam cia toto xa hdi vi nd gin liin va

anh hudng true tiip din sic khde cia tit ea mpi ngudi. Di ed TP an toto d n thuc hifn 8 thuc hanh tit VSATTP [53], [54]:

- Thue hanh tdt sto xuat rau an toto; - Thtjc hanh tit chto nudi, giit mi; - Thire hanh 10 nguyin tie vtog chi biin TP an toto; - Thuc hanh bao quto TP tdt; - Thuc hanh tdt luu tiidng TP; - Thue hanh tdt nhto mac TP; - Thvrc hanh tdt bto tay; - Thirc hanh tdt vf sinh ca nhto. Ngudn gde chinh gay nhiSm khuln TP xuit phat to hanh vi con ngudi nhu thiiu

ve smh ea nhto, elm bdc thie to, ho, khgc nhd... niu thiiu kiin thic vi thuc hanh tit vf sinh ca nhto se cd nguy co cao gay ngp dpe TP.

Qua n^hiSn eiu, ching tdi thiy khdng cd ngudi SX, CBTP tta Idi dtog, di vi th\ic hanh tdt vf smh ca nhto (btog 2.15). Kit qua nay phi hpp vdi nhung dot kiim tta VSATTP cua Cyc An toto vf sinh TP cho thay, nhieu doanh nghifp chua quan tam ding mie ddi vdi quy djnh vS VSATTP, vi pham thudng gap la nhto viSn true tiip sto xuit chua dupe ttang bj kiin thie. Nhu vay, thiSu kiin thic co bto vi bao dam an toto vf sinh TP va vf sinh ea nhto sS din nguy co ngp dpe TP.

3.1.1.4. Kiin thirc vi Thuc hdnh lot luu thdng TP

100 . 90 J

s? 80 ' •» 70 .> 60 H 50

40 30 20 10 0

41.9^

V37

Diing trang

thiit bj chuyen dimg

THLTC H A N H TOT LlTU THONG

A88.6

•^ ^ k 5 9 > 5 5 39.42 45

Che day, Giu nhiet Bao dam Khong Thuc an bao gdi do an dung Ihdi iam thay va dung TP an toan cho gian van doi tinh cu de toan, tungTP chuyen chit cua trong vat

tranh lay TP lieu nhiem sach..

them vao TP

TP

Tra ldi dung

loan bo

—•—Casd SX,CB TP

-•—Bep an tap the

- i ^ Chung

i

Bilu dd 2.11. Thye hinh t6t luu thing TF

Nh|n xet: _ , . , DS dam bao thtrc hanh tit Itm thdng phan phdi TP cto dung ttang IhiSt hi

chuyen ding di v|n chuyin, ttanh giy di nhilm; che day, bao gdi TP an toan, ttanh 50

gay d nhilm thSm vao TP; gift nhift dp an toto cho ttmg loai TP ttong qua tthih vto chiiyin; khdng lam biin tinh, thay dii tinh chit cia TP trong qua ttinh luu thdng, phan phdi; khi van chuyen thic to va dung cu eho khach htog d n di trong cac vat lifu sach se, khdng ddc, chac chin, che day km khdng di hu hdng; bao dam dtog thdi gian vgn chuySn. Dam bao thirc hanh tit lim thong phto phdi TP cung la khau quan ttpng di dam bao VSATTP, nhung qua diiu tta ching tdi thiy khdng cd ngudi SX, CBTP cd kien thic vi thuc hanh luu thdng TP ding va di, hp ehi ed kiin thic timg ndi dung nhu sau: cao nhit la biit che day bao gdi an toan: 88.6%o; tiip din la gii nhift dp an tPto: 56.85%), thic to va dgng eg di ttpng vat dgng sach 45%); cd ttang thiit bj chuyen dtog 41.96%; bao dam dtog thdi gian van chuyin 39.42%); thip nhit la khdng Ito thay ddi tinh chit TP: 26.38%) (biiu dd 2.11).

Nhu vay, nhttag ngudi SX, CBTP gin nhu chua cd kiin thic vi thuc hanh tdt luu thdng TP, cto phai cd ki hoach di tap huan cho hp vi vln di nay.

3.1.1.5. Kien thiic ve th&i diem cdn nia lay de ddm bdo VSA TTP

i 1 H "

100 90 80 -70 -60 -50 -40

30 20 -10 -0 -

THliil DIIZM CAN Rll'A TAY

')5.1

69.2 61-1

^^^f^'^^^^pC^^ ,1.5

Sau khi Truoc Sau khi Sau khi Sau khi Tnrac Tra Kri

dive khi tiep savao dung hut khi che diing 6

sinh xiic voi toe. tai vao thuoc la bien then

ihirc miii hay rac, do ihirc diem

p h ^ cac bo ban, pham can nia

song phan quan tay

khac ao

ciia CO

thl

—•—Nguoi lam • tai bep an tap the

- •— Nguoi lam j tai CO so SX,' CBTP

Chung

Bilu dS 2.12. Kien thic vi thdi dilm can rira tay dl dam bio VSATTP

Nhgn xet: Trong sudt qua tthih tt chuin bj, chi biin din phto chia thic to lie nio cung cin

bto tay cia ngudi SX, CBTP, cM cin bto tay cia hp khdng sach se la ngudn dua vi smh vat vao thue to, dae bift thie to ngay. Chfaih vi vay, ttong nam chia khda de cd TP an toto thi chia khda diu tien do la gill vf smh cia ngudi chi hiin va phuc vu to udng. Trong dd biit each r ia tay sach la vin di miu chdt Nhtmg qua dieu tta ching tdi thiy ty If tta Idi ding 6 thdi diim d n r ia tay di dim bao VSATTP chi chiim 11.5%, tta ldi ding riSng timg thdi diim theo th i tt hi eao din thip nhu sau: Sau khi di vf smh 95.1%; trade khi chi biin TP 69.2%); sau khi dung vao rac, dd bin, quin ao 61.1%; tiude khi tiip xic vdi TP sdng 49.9%; sau khi sd vao tdc, tai, mfli hay cac bd phjn khic cua eo thS 26.8%; sau khi hit thudc la 16.7% (biiu dd 2.12).

51

Nhu vgy, khdng ed thdi diim nao tit ca ngudi SX, CBTP diu r ia lay; chi cd 3 thdi diim sau khi di vf sinh, trudc khi chi bien TP, sau khi dgng vao rac, dd ban, quin ao la cd >50%) ngudi r ia tay. Day qua la con sd cto quan tam, cto ed giai phap de chin chinh ttong thdi gian din.

3.1.2. Thdi 0$, hdnh vi ve VSA TTP cda ngu&i SX, CBTP

3.1.2.1. Mac trang phuc rieng khi che bien TP

MAC TRANG PHUC RIENG KHI CHE BIEN TP

Ty If %

100

• Klidng!

nCo

Ngudi lam Iai Ngirdi lam tai CO sd SX, bep an tap the

CBTP

Chung

Bilu d i 2.13. IMgc trang phyc rieng khi ehf bien TP

Nh^n xet: Di ttanh nhilm khuln tt ttang phue, tdc va hoi thd cia ngudi SX, CBTP sang

thic an, ddi hdi phai ed ttang phuc riSng sach se, mu chup toe khi tiSp xic vdi TP. Niu chi d n vd y di tay cham vao quin ao cd nhilm khuto, di tdc rdt vao thie to thi vd sd vi smh vat se tin cong vao thie to, nguy co ngd ddc khdng tranh khdi.

Ngay 30-i 1-2008, Sd Y t i tmh Vihh Long cho biit, qua kiim tta ting si 214 bip to tap flii ttSn dja bto tinh, chi cd 141 (65.9%) bip to dgt ySu elu va 73 (43.1%) bip to khdng m|ic ttang phue chuyen dvmg theo dtag quy dinh [40]. Kit qua nay etog ttcmg tii nhu kit qua nghien ciiu cua chtag tdi, khi SX, CBTP, ed 72% ngudi dupe mjc trang phuc riSng, cdn 28% vin mac quin ao ca nhto (biSu di 2.13).

52

3.1.2.2. Mdng tay ciia ngu&i SX, CBTP

MONG TAY CUA NGU'DI CHE BIEN TP

Ty le %

100

80

60

20

0

n Khong cat ngan

Ngudi lam Ngudi lam Chung tgi ca sd Iai bep an

SX CBTP lap the

Bilu do 2.14. M6ng tay eua ngirdi che bien TF

NhSn xet: IVIdng tay di dai chmh la noi to nau cua vi khuln, do vay mpt ttpng cac yeu cau ctia bto tay sach la mdng tay phai d t ngin. Khi kiim tta mdng tay cia nhiing ngudi SX, CBTP chtag tdi thay cd 91.1% duac cat ngto nhung cdn 8.9% chua dupe cat ngto (biSu dd 2.14). Mac du 8.9% la sd nhd nhung ctag cto quan tam bdi viee d t ngin mdng tay la mdt thao tac dan gito nhung mang lai hifu qua, cd thi ngto chto nhiing vu ngd ddc TP do chinh mdng tay cia ngudi SX, CBTP gay ra.

Khi phto tieh cac mdi nguy gay ngd ddc TP va cac bfnh truyen qua TP tgi bip to tap thi, Trin Vto Ky Ctag da nhto djnh cd 3 nguy co cd the xay ra tgi cac bip to tap till la: ngudi tham gia chi biin TP khdng thuc hifn dtag, d i cic quy djnh hudng din VSATTP (mac du dS hiiu biit cac quy djnh nay), ngudi true tiip chi biin kmh doanh TP khdng hiiu biit v i VSATTP nSn vd tmh gay cac nguy co, eae co quan chic ntog chua thdng tm kip thdi cac nguy co ngoai tim hiiu biit cia ngudi chS biin va eae nguy CO khach quan khac ngoai tim kiim soat cia ngudi che biSn [47].

3.1.2.3. Deo trang sire & tay khi chi biin/liep xiic v&i TP dn ngay

Bhih thudng, ttang sic (vdng deo tay, nhin) lam cho ngudi phy nO ttd ISn duySn dtog horn, do vay chtag dupe dep thudng xuySn khi di lam, di choi, di chp... Nhung ttang sic d tay ctag ehinh la noi smh sdng cia vd sd vi khuln, neu khi tiSp xic vdi thie to ngay vin deo ttang sic thi chtag ctag la ngudn dua vi khuto vao thie to. Chinh vi vay, theo qui djnh, phii thao bd ttang sic khi tiip xic vdi TP.

Qua quan sat nhung ngudi dang chi biin TP, chtag tdi thiy cd 73.2%i ngudi khdng deo dd ttang sic nhtmg vin ed 26.8% ngudi edn deo ttang sic (biiu dd 2.15).

Kit qua thanh tta cua Sd Y t i Ha Ndi cho thiy, gin mdt nia sd bip to tap thi d cac Oirdng tiiu hpc bto tru chua dat tieu chuin vi vf smh TP. O cac tradng trung hpc ca sd bto ttii vacac CO quan xi nghifp, ty If nay lln lupt la 40% va 30% ...[36].

53

DEO TRANG SLTC KHI CHE BIEN TP

Ty le %

120

100

80

60

40

20

n 0M n LP ""^

LP Ngudi lam Iai Ngudi liim lat Chung

ca sd SX bep an lap the CBTP

• Co n Khong

Bieu do 2.15. Beo trang s ie khi ehi biln TP

3.1.2.4. Thuc hdnh nia tay

Trong sudt qua ttmh hi ehuto bj, ehi biin din cip phat thic to, khau nao eiing s i dung ddi bto tay. Nhung neu bto tay khdng sach thi chinh nd cd thi gdp phin lam lan truySn cac bfnh traySn qua TP. Thuc hanh tit r ia tay la mdt tieu ehuin quan ttpng cila nhing ngudi true tiip tham gia chS biin, cip phat thic to. Trong dd, vifc thuc hanh ding qui ttinh r ia tay, phii r ia ky btog nude sgch va xa phdng; phai lau khd tay bing giay lau mdt Ito hoac khto sach la nhiing khau quan ttpng.

PGS -TS Trto Dtog, cue tradng Cue An tpto vf sinh TP cho biSt: 70% vu d nhiem TP cd liSn quan dSn bto tay bto. NSu khdng gi i sgch, tay la noi vto chuySn vao ca ths vi khuto, hda chat ddc hai tt mdi tradng va cae chat bto khac do tiep xuc thong thudng [17].

Bang 2.16. Th\rc hanh rira tay bing

"^^-..-..^^ Rira tay bing

Ddi tirgmg ~~'~~---.> Ngudi lam tgi ea sd SX,CBTP Ngudi lam tgi bip to tap thi Chung (n =347)

Xa phong, BU6IC sgch

n

168

160

328

Ty If %

48.4

46.1

94.5

Nir6'c sgch

n

13

5

18

Tylf%

3.7

1.4

5.2

Niric da dung (rua ly, rira chen. ) D

I

0

1

Tylf%

0.3

0.0

0.3

54

TYLE%

90

80

70

60

50

40

30

20

10

V A T DUNG DE LAU KHO TAY

87

43.5 1 rw^

43.5 1 ' f^Oyi

f 1

»7 1 Wb^ Ngudi lam uii c(T Nguiii lamlai

so SXCBTP bip an lap thl Chung

D Giay lau I lln

I Khan sach

O Chili vao tap

n Lau vao quan ao dang mac

Bilu dS 2.16. Vft dgng lau khd tay sau khi rira

Bing phuong phap di nghj ngudi SX, CBTP thuc Men ria tay trade khi ehS biin TP, qua quan sat ehtog tdi thiy:

- Cd 94.5%) ngudi dtog xa phdng va nude sach r ia tay, cdn 5.2% chi r ia tay bing nude sach khdng ding xa phdng, cd 0.3%) ngudi ding nude da d i i ^ di r ia tay (btog 2.16).

- Chi cd 2 vat dung dupe ngudi SX, CBTP ding di lau khd tay sau khi nia tay la lau btog klmn sach (87%) va 13.3% s i dimg gily lau 1 lln, cd 0.9%) chii tay vao tgp di, khdng cd tradng hop nao lau tay vao quin ao dang mac (biiu dd 2.16).

Theo cac nghiSn ciru y ti , vifc r ia tay vdi xa phdng trade khi to, sau khi dive smh hay din nhttng noi khdng dam bao vf smh se giam 50% cac bfnh trayen nhilm, ddng thdi ban chi ty If tt vong, cac chi phi tiim In vi y t i va xa hfi nhu ngudi Idn bfnh tat, khdng thi di lam din din tmh ttang thit nghifp va tte em thit hpc do bfnh tat ma khdng thi din tradng. Tuy nhien, cdng vifc ttdng chiing nhu qua don gito nay lai chua dupe nhiiu ngudi quan tam dtag mic. Kit qui dieu tta "Thuc ttgng vf sinh mdi tradng ndng thdn Vift Nam" thtog 6-2006 cua Cue Y t i du phdng va Mdi budng Vift Nam (Bd Y ti) ctag eho thiy ty If khdng r ia tay thudng xuySn cia ngudi dto ci nude kha cao, d i tay la noi tiim In cua hon bdn ttifu mim bfnh. Chtog ban, ty If khdng r ia tay hudc khi to chiim 69,7%, sau khi tiiu tifn la '79,6% va sau khi dai tifn la 68,1%). Ty If r i a tay Ihudng xuyin vdi xa phdng rit thip, chi chiim 12,8% trade khi an, 15,5% sau khi tiiu tien va 16,9%) sau khi dgi tifn. Da phin ngudi dto quan niem ehi d n r ia khi tay cd mui hdi hoac hi bto [15].

Garayoa R, va cs nghien ciiu mdi liSn quan gitta kiin thic an toto TP vdi hanh vi cia 562 smh vien (chi y iu din tt eae h i mdn khoa hpc sie khde) nhto thay cd

55

98,6% sd sinh vien thia nhan tim quan trpng cia ria tay trude va trong khi chi biin thic to, nhung ehi 24,4% xac nhto da r ia tay vdi nude va xa phdng [66].

Clayton DA va cs trong nghien ciu nhttng yiu td anh hudng din thuc hanh vc sinh ban tay cua 115 nhan viSn TP tu 29 nha hang khach san bing each quan .siil nhirng hogt dpng che bien TP cia hp, sau dd, dii tupng phai hoan thanh mpt quy trinh ve sinh bto tay. KSt qua, cd 34% tiig-c hanh vf sinh bto tay sai (p<0.05).

KSt qua nay chimg minh khdng thi cai thifn thuc hanh vf sinh ban tay chi thdng qua vifc cung cap thong tin cho dii tupng. Chuang trinh can thifp hieu qua d n tap tiung vao vifc thay ddi vto hda an loan TP cd td chic [63].

Nhu vgy, dam bao ehlt lupng VSATTP tgi eae co sd SX, CBTP dang la vln di bic xic d tat ea cac tinh, thtoh ttong ca nude. Di giai quyit ein ed nhiiu giai phap vdi su tham gia cia nhiiu cip chinh quyen trong dd quan trpng nhit vln la ngudi lam tai cac bSp ta tap tiii phai cd kiin thic dtag vi VSATTP, phai chuyin to kiin thie dtag dd thtoh hanh vi dtag thi cdng tac dam bao VSATTP tgi cae bep an tap thi mdi eai thien dupe.

3.2. Kien thic, thi i dg, hanh vi vl VATTTP cua ngudi kinh doanh TP

3.2.1. Kiin thUc vi VATTTP cua ngu&i kinh doanh TP

3.2.1.1. Kien thiic ve thuc hdnh tdt ve sinh cd nhan

Bang 2.17. Kiln thire vl thuc hanh t i t ve sinh ea nhan

^ ~ ^ ^ ^ Doi tugng

Vf sinh ca nhan ^ ^ ^ ^ Dinh ky htog nam kham sie khde va cay phto Tam ria, gdi dau trudc va sau khi di lam Giu mdng tay ngan va sgch se

Ria tay dtag qui djnh Cd quto io sgch, mu chup tdc khi tiSp xic vdi TP Btog vit thuong tay bing gac khong thim nude Khdng tiip xic vdi TP khi bibSnh Thao do trang sie d tay khi tiip xic vdi TP Khdng ding tay tiip xic hue tiep vdi TP Khdng ho, hit hoi, nhai keo,.. .tai khu ehi bien. Tra Idi du cac ndi dung

Ngirdi

n

104

131

142

76

51

41

54

54

51

60

0

banTP

Ty l f%

29.9

37.6

40.8

21.8

14.7

11.8

15.5

15.5

14.7

17.2

0.0

Ngirdi ban rong

n

83

93

87

52

28

28

70

26

63

63

0

Tylf %

23.9

26.7

25.0

14.9

8.0

8.0

20.1

7.5

I8.I

18.1

0.0

Chung

n =348

187

224

229

128

79

69

124

80

114

123

0

Ty If %

53.7

64.4

65.8

36.8

22.7

19.8

35.6

23.0

32.8

35.3

0.0

56

Nhjn xet: Chat lupng VSATTP ludn la vln di quan tam cia loan xa hpi vi nd gin liin va

anh hudng tirirc tiSp dSn sic khde cua tit ea mpi ngudi. Di cd TP an toan cto thuc hien 8 thuc hanh tdt VSATTP [53], [54].

- Thue htoh tdt sto xuat rau an toan; - Thuc hanh tdt chan nuoi, giit md; - Thuc htoh 10 nguyen tic vang chi biin TP an toan; - Thue htoh bao quto TP tit; - Thue htoh tit luu thong TP; - Thue hanh tit nhan mie TP; - Thue hanh tdt bto tay; - Thye hanh tdt vf sinli ea nhto. Nguon gde ehinh gay nhiSm khuln TP xuit phat t i hanh vi con ngudi nhu thiiu

vf sinh ca nhto, cam bic thie an, ho, khgc nhd... niu thiiu kiin thic vi thue hanh tit vf sinh ca nhto se cd nguy co eao gay ngp dpe TP.

Khi hdi sir hiiu biit vi thuc hanh tdt vf sinh ca nhan khong cd ngudi kinh doanh TP nao tta ldi ding toto bd cac npi dung, tra Idi ding tung phin thee thi tu to cae din thap nhu sau:

- Giu mdng tay ngin va sgch se 65.8%); - Tim ria, gii diu tiude va sau khi di lam 64.4%o; - Djnh ky htog nam kham sic khde va eiy phan 53.7%o; - Ria tay ding qui dinh 36.8%); - Khdng tiip xic vdi TP khi bj bfnh 35.6%; - Khong ho, hat hoi, nhai keo,... tai khu ehi biin 35.3%). - Khdng dung tay tiip xic true tiip vdi TP 32.8%); - Thio dd ttang sic d tay khi tiip xic vdi TP 23%o; - Cd quto ao sgch, mu chup tdc khi tiep xic vdi TP 22.7%); - Btog vet thuong tay bang ggc khdng tham nude 19.8%).

Nhu vgy, kiin thie ve thuc hanh tit ve sinh ca nhan cdn nhiSu ban che, chi cd 3 ndi dimg gitt mdng tay ngan va sgch se, cto djnh ky kham sic khoe va cay phto; cto tam ria, gdi dau trudc va sau khi lam dgt tt 50% trd lin (btog 2.17).

Theo thdng ke chua day d i cia Bp Y tS tt nam 1999 din nam 2004, ea nude cd 1.386 vu ngp dpe TP, trpng dd cd tdi 1.056 vu ngp dde la do TADP va bip an tap the gay ra. Nguyen nhto cia tinh trgng ttSn, trudc hSt li do nhiSu dia phuang chua thuc su quan tam din cdng tac bao dam vf sinh, an toan T A D P , chua cd quy hogch cho loai hinh djeh vu nay; cdng tac thdng tin, giao due, traySn thong ehua dupe day manh. Ngudi budn bto va ngudi tiSu ding cdn thiiu kiin thic ve VSATTP; su phdi hpp lien nganh ehua ddng bd; cdng tac thanh tta, kiem tra chua thudng xuySn va viec x i ly cac hanh vi vi pham chua nghiSm; chua huy dpng dupe su tham gia cia cic td chic xa hpi vap cdng tac giam sat vf sinh, an toto TADP [7].

Okojie OH va cs thue hien mft cufc khao sat vi nhto thie va hanh vi cia nhitng ngudi bto thic to hogt d^ng d khu vue tradng dgi hpc Nigeria. Ket qua, 90/102 ngudi (88,2%) tham gia tra ldi la phu nO, hp cd kiin thic ve sinh TP rat kem [63].

Zain MM, Naing NN phdng vln 430 ngudi bto TP d quto Kota Bhara (Malaysia, 2020) flily 48.4% ed kiin thic kem vi an toan TP [69].

57

3.2.1.2. Kiin thiic vi nhan mdc cua TP

Bang 2.18. Kiln thic vi nhan mac eua TP

^ ^ ^ ^ ^ Dii tirgng

Nhan mac T P ^ ^ ^ ^ TSnTP Ten, dja ehi eo sd sto xuit TI"

Djnh lupng cua TP Chi tieu chit lupng chi ySu cia TP Ngay sto xuat, hgn s i dgng va bap quto TP Hudng din bao quto va s i dung TP Xuat x i cia TP

Dtog cac npi dung

Ngudi ban TP

n

135

99

26

33

119

78

113 1

Ty If %

38.8

28.4

7.5

9.5

34.2

22.4

32.5 0.3

Ngudi ban rong

n

122

70

32

27

111

50

61 0

Ty If %

35.1

20.1

9.2

7.8

31.9

14.4

17.5 0.0

Chung

n=348

257

169

58

60

230

128

174 1

Ty If %

73.9

48.6

16.7

17.2

66.1

36.8

50.0 0.3

NhSn x^t: Theo diiu 35 tai phap Ifnh VSATTP, nhan TP phai cd cac noi dung co ban sau

day: TSn htog hda, tSn va dja chi cia thuong nhto ehju trach nhiem ve hang hoa, dinh luong htog, thanh phin d u tao, ehi tieu chit lupng chu yiu, ngay san xuit, thdi gian s i dung va bao quan, xuat x i cua TP [20].

Kit qua nghien eiu cia ching toi chi cd 1 ngudi kinh doanh TP (0.6%) tra ldi dtag toto bp cac qui djnh ghi tren nhto, mac cac TP bao gdi sin va cd 3 npi dung: ten TP; ngay sto xuit, thdi hgn s i dung; xuit x i cua TP cd ty if ngudi kinh doanh TP tra ldi dtag >50%) (bang 2.18). Nhu vay kiin thie qui djnh vS nhto mac cia ngudi kinh doanh TP cdn han che.

3.2.1.3. Biiu kiin TP duac bdn

Mpi ngudi diu cd quyin ttdng dpi TP ma minh to udng phai duac an toto va phi hop. Benh tat v i tin thuong mang din tt TP la khd ehju nhit, tham chi edn cd thS gay tt vong. TP ma bj hu hdng cdn gay Itog phi, tin hao, va ed thi anh hudng xau tdi vifc budn bto va tin nhiem cia ngudi kinh doanh TP.

Di TP din tay ngudi tiSu dung dam bao chit lupng VSATTP thi nhung ngudi kinh doanh TP phai biit eae diiu kifn TP cd thi ban dupe tii thiiu la edn ban s i dung; khdng mic, hu hdng; biit rd ngudn gie; ed nhto mac.

Kit qua cia chtag tdi ehi ed 25%) s i ngudi tta ldi ding 4 tiSu chuan tren (biSu dd 2.17). Bay la con sd kha khiim tdn, ein dugc ctag ci ttong thdi gian dSn di ngudi kinh doanh TP cd thSm kiin thic vi vin di nay.

58

-1

->•

90

80

70

60

50

40

30

20

10

^ 1 . 9

42

C6nhan

diuig

DIEU KIEN TP DU'OC BAN

^ ^ . 4

^~~~^ ^ ) . 4

^ ^ . 1

Khong CO nhan Biet r6 Ehi cac npi

n'wc iTHc iigiion goc dung

1 —•— NgifCfj \

ban TPII

-•—Ngirai ban rong 1

Chung

Bieu do 2.17. Bieu kifn TP duge ban

3.2.2. Thai df hanh vi vl VSATTP cua nguoi kinh doanh TP

3.2.2. 1. Chieu cao bdy hdng de bdn

1 CHIEU CAO BAY HANG DE B A N

TY LE %

lOOi

80-|

i f\ '' M. l\ 20 ^ [_J

56.61 1

• '

Ngirai ban Ngircri ban Chung thirc pham rong

• Cach mat dat >60cm

D Cach mat dat <60ciTi

-

Bieu d^ 2.18. Cbilu cao biy bang d l b i n

Nb|fl xet: Theo quy djnh cia Bd Y tS, kinh doanh TP jihai bto dam 10 tiSu chuto, dd la:

d i nude sgch, cd dvmg cu gip thie to chin, khdng di lin thie to chin va sdng; nai ehS

59

bien TP phai sach, each bift ngudn d nhiSm nhu edng ranh, rac thai, cdng ttmh vS sinh, noi bay bto gia sic, gia cim; ngudi lam dich vu chi biin thic to phai dupe tap huto kien thic va kham sic khde djnh ky, nhto viSn deo tap di, khiu ttang, m i khi bto htog; khdng s i dung phu gia va mau TP; thic to phai dupe bay bto ttSn gia cao han 60cm, phai dupe bay bto ttong tt kinh va bao gdi hpp vS sinh; cd dgng cu dung chlttiiai... [10].

Khi tiSn hanh diiu tta chtag tdi thiy chi cd 43.4%) ngudi kinh doanh bay thic to ttSn eao > 60cm, sd cdn Igi (56.6%) khdng tiiuc hifn dupe nhu tren (biiu di 2.18).

3.2.2.2. Thuc hdnh nia tay Bing 2.19. Thdi dilm rua tay

^~~^~--^^ Doi tugng

Thai dilm ri« tay ^ ^ ~ ^ ~ - ~ , ^ ^

Sau khi di vf sinh Trade khi tiip xic vdi TP Sau khi dd rac hay tiip xic vdi TP bi d nhiSm Sau khi xi miii Sau khi sd vao tdc, tai... Sau khi hit thuoc li Toto bd thdi diim ttSn

Ngudi ban TP

n

166 98

117

98 48 28 0

TJlf %

47.7 28.2

33.6

28.2 13.8 8.0 0.0

Ngudi ban rong

n

152 115

84

46 33 17 0

Tylf %

43.7 33.0

24.1

13.2 9.5 4.9 0.0

Chung

n =348 318 213

201

144 81 45 0

T^If %

91.4 61.2

57.8

41.4 23.3 12.9 0.0

RtTA TAY BANG TYLE%

91.4

D Ngudi bto TP

• Ngudi ban rong

D Chung

Xa phdng, nude sach Nude da dung

nude sach

Bien d5 Z19. Thip: banh rua tay bing

60

TY LE % VAT DUNG LAU ICHO TAY

91.4

D Ngirai bati TP

• Ngiroi ban rong

n Chung 1

Bilu do 2.20. V$t dgng dl lau kho tay

Nhgn xet: cac chuyen gia y tS khtog dinh bto tay la mdt "diSm trung chuyin" quan ttpng

eua cac vuus gay bfnh bdi nd la cong eg lam vifc, giao tiip. MSi cm^ da ngudi ed din 40.000 vi khuln va eon sd nay cao hon rat nhiiu d bto tay. Chinh vi vgy r ia tay sach la mpt each phdng ngia quan ttpng ddi vdi cae bfnh traySn nhiim. Theo tiin sT Trinh Quang Huto, ddng tac nay lam giam 35% nguy ca My traySn bfnh tieu ehay, 17-45%) nguy CO nhiim khuln dudng hd hap. Ngay ca vdi nhirng cto bfnh nguy hiem gay chit ngudi htog logt nhu H5N1, SARS, r ia tay ctag dupe cpi la loai "vacxin" re tiin mang Igi hifu qua eao [16].

Khi kinh doanh TP, dac bift TP to sto, ttong suot qua trinh tt chuto bj, chS biSn dSn phto chia thic to lie nao ctag cto bto tay cia ngudi bto TP, ehi cto bto tay cia hp khdng sgch se i i ngudn dua vi sinh vat vao thic to, dac bift thic to ngay. Chinh vi vay, ttong tam thuc hanh tdt VSATTP thi cd thgre hanh tdt bto tay, ttong do ein luu y:

- Thdi diim r ia tay: phii nia tay sau khi di vf smh, trude khi tiip xuc vdi TP; sau khi dd rac hay sau khi tiip xic vdi TP d nhiSm; sau khi xi mui; sau khi hit thudc la, sau khi dd ric hoto tiip xic TP d nhiim [53]. Nhtmg qua diiu tia chtag toi thiy khdng cd mpt ngudi kmh doanh TP nao thuc hifn r ia tay ca 6 thdi diem theo qui djnh (bang 2.19), day cung chmh la nguySn nhto gay nhiSm khuto thic to, ma hgu qua la gay cac vu ngd dpe dtog tiic xay ra.

- Khi r i a tay d n phai r i a 1^ tay bing xa phdng va nude sgch, diSu nay da duac ngudi kinh doanh TP thirc hifn tdt (cd 91.4% ngudi thvrc hifn dtag); nhung ctag cdn 8%) chi r ia tay vdi nude sgch, 0.6%i r ia tay vdi nude da dtag rdi (biiu dd 2.19).

Hiu hit nhing ngudi kmh doanh TP lau tay bing khto saeh sau khi r ia (91.4%)), lau bang giiy lau I lin chi ed 12.1%, riSng cac thdi quen khdng tdt nhu lau khd vdi tap di hoac ao quin dang mjc thi vSn cdn nhung thip (diu 2.3%)) (bieu dd 2.20).

Theo ong Trin Dtog, Cgc tradng Cyc An toto vf smh TP, ttong vdng 3 nam ttd day da cd ttSn 55 vu ngp ddc TP do T A D P gay ra lam hon 1.300 ngudi tt vong. Dieu tra mdi day cia Bp Y t i v i TADP tgi 11 dja phuang cho thiy, hiu hit bto tay cia ngudi kinh doanh, chi biin T A D P diu bj nhiSm vi khuto E.coli nhu Ha Npi la 43,42%, TPHCM 67,5%, Da Ning 70,7%. [39].

Nhu vay, dam bap cd bto tay sach ttong chi biin, ban TP etog la diiu can thiit ma ngudi kinh doanh TP cto phai dupe trang bi.

3.2.2.3. Logi vdt dung gdi TP cho khdch hdng

Bang 2.20. Logi v^t dgng gdi TP eho khach bang

^^561 tugng Nguyen lifu —^^^ Giiy bao

Blngia

Bao ny ldng sgch

Dvmg eg saeh

Ngudi bin TP n 29 12

154

46

Ty If % 8.3 3.4

44.3

13.2

Ngudi n 15 12

147

22

ban rong Ty If %

4.3 3.4

4.0

6.3

Ting n=348

44 24

310

68

Tj- If % 12.6 6.9

86.5

19.5

Nbfn xet: Trong thuc t i hifn nay, cac dimg cu gdi TP nhu bao nylon, hop xdp... bto vdi gia

re, ttong khi kiin thie cia khach htog ctag dupe ntog cao, do vay phto ddng cac quto htog rong diu thtrc hien dupe. Qua quan sat chtag tdi nhto thiy hifn tai da sd dtog bao nyldng di gdi TP cho kMeh htog (86.5%), dgng cu sgch la 19J%; giiy bao la 12.6%, thip nhit dtag la 6.9% (btog 2.20). Nhung kit qua nay chi qua quan sat, thire t i cac dung eu dimg thic to cd nhiim khuln hay khdng edn phii thvrc hifn xet nghifm mdi khing dinh dupe.

3.2.2.4. Nai mua TP

NOl MUA THUC PHAM

60 n

50 1

^ 40

•>- 30 i-

10 H

0

-Ngiroi cung cap thirong xuyen

Nguoi ban TP ngu6i ban rong Chung

Biiu ad 2.21. Ncri mua TP

62

Nhgn xit: De TP khdng gay ngp dde cin mua nguySn lifu ttoi sdng, cd ngudn gdc rd

rtog, dtog tm cfy, an toto, khdng d nhiim khi bao quto, vgn chuyin. Mudn vgy, ngudi mua htog phai chpn dupe nai bto htog tin cay di biit rd ngudn gie TP dd tt dau? chat lupng TP nhu thi nao..., mpt ttong nhing bien phap tit phai mua htog tt nhung ngudi eung cap TP thudng xuySn, cd uy tin. Qua diiu tta chtag tdi thiy nhing not ngtrdi kmh doanh TP fliudng mua n^uySn lifu vi chi biin chi yiu mua tt ngudi cung cap tiiudng xuyen (56.9%); tiip dSn mua d siSu thj (41.4%), thip nhit mua d ehp (23.6%)) (bieu dd 2.21). Nhu vay cdn 23.6% TP dupe ngudi kinh doanh TP mua tgi cho, day la noi khd kiim soat dupe nguon goc, nguy eo khdng dam bao ATVSTP rat eao.

3.2.2.5. Ndi dung kiem tra khi mua nguyin lieu

1

90

80

70

5^60

- 50

•^ 40

30

20

10

0

L_.

NOI DUNG KIEM TRA KHI MUA TP

. .42

^ ~ ^ ^ 1 . 8

- ^^^N. ^^^^^^1*

' ' T).o Han dimg Nguon goc Hinh dang ben Du cac noi

ngoai dung tren

—•—Nguai' ban TP;,

! —•— Ngirai |

ban rong

—«i—Chung

Bieu do 2.22. N$i dung kiem tra kbi mua nguyin lifu

Nhfnxet: Vifc chpn mua nguydn lifu vi chi biin TP ctag la khto quan ttpng, khi biit

chpn TP edn hgn dtag, ed ngudn gde rd rtog, via ed gia trj dmh dudng via dam bao VSATTP thl via cd btta to ngon, via dam bao an toto VSTP. Chtah vi vjy, ngudi mua TP phai biit tdi thiiu ba ndi dung ein kiim tta trade khi mua nguyen lifu la han dtog, ngudn gde TP va hhih dgng bin ngoai cia TP. Qua diiu tra chtag tdi thiy ty If nguoi tra ldi ^ y di cac npi dung chi cd 4.6%, day la tin tgi dn phai hudng din di ngudi kinh doanh TP cd them kiin thic va ky ntog ttong qud trinh chpn mua TP.

63

3.2.2.6. Diiu kien nai kinh doanh TP L

E%

)

H

i 1 1

90

80

70

60

50

40

30

20

10

0

DIEU KIEN NOl KINH DOANH TP

>78.4

/ / / ^ '

^--^/||-

Ngudi ban TP ngudi bto Chung rong

• Cao rao thoang unit

B Sach .se

Khong CO ruoi, nhang, con triing

Bieu do 2.23. Dieu kifn noi kinh doanh TP

Nhgn xet: Di giam nguy co nhiSm khuto TP ddi hdi nai kinh daanh TP phai sach se,

khdng ed eon trtag, noi bay htog phai eao rao, each bift ngudn 6 nhiim nhu cdng, ranh, rac thai, cdng trinh vf smh, noi bay bto gia sic, gia cam...Nhung thuc te, nhtog ngudi kinh doanh TP thudng bto d via he, ben xe, nha ga, gde phd, chp hay bit e i noi dau cd ngudi qua Igi. Do vay, nguy co vi khuto phat tto tt ngudn d nhiem vao TP la khdng ttanh khdi.

Nghien eiu cia Bii Ngpc Lto " T A D P va cac nguy co cho s i c khde" cho thiy ttSn 40%) sd co sd djeh vu TADP khdng dam bao ySu ciu vf smh.

Kit qua ciia chtag toi hiu hit nhiing ngudi kinh doanh TP diu bay htog noi cao rto, tiiotog mat (78.4%), noi saeh se (70.1%), noi khdng cd cin trtag (56.3%)

Thing ke cia cue An toto vf smh TP ttong bio cao ting kit 3 nam dam bao ve sinh an toto TADP cho thiy, nguySn nhto ngp dpe do noi bto htog, ttang thiit bi va dvmg cu niu nudng khdng ffim bao vf sinh chiSm 37- 88%

64

3.3. Kiin th ic , thai do, hanh vi vi VSATTP eua ngudi tieu dung

3.3.1. Kiin Ihiic vi VSATTP cda ngu&i tiiu dung

3.3.1.1. Hieu duffc ly do gdy ngd dpe TP

Bang 2.21. Hiiu dngc ly do gay ngg dge TP \„^^ Huyfn,

Ngi dung ^ \

Sur dyng chdt bao quan, phy gia TP khong cho phep hoac qua HSu lu^ng quy dinh B% TP tidp xuc true tiep hoac gan noi 6 nhiem Khong rua tay truac khi chu5n bi TP, thiic M De thiic an qua dem, nhiet dO thucmg qua 3 gia, khong che day thiic an, cac lo^ con trung gam nhSm, ruoi nhang va cac dong vat khac tiep xiic gay 6 nhiem. Dung chung dao, that dd iSn TP s6ng voi thiic an chin Riia TP, dung cu an uong biing nuac nhidm ban NSu TP chua chin hoSc khong dun soi truac khi &n. Dung khSn bSn de lau dung cu an uong Nguoi che bien TP mac cac b$nh truydn nhiem, ia chdy, nhiem trung a da... Dii 9 tidu chi

Tai

n =128

39

35

76

93

63

44

27

31

22

1

nKy

Tyl? %

30.5

27.3

59.4

72.7

49.2

34.4

21.1

24.2

17.2

0.8

Nii Thanh

n =110

59

92

68

81

54

32

27

17

16

Tylf %

53.6

83.6

61.8

73.6

49.1

29.1

24.5

15.5

14.5

1 0.3

Hifp Die

n =88

63

55

46

75

13

10

7

8

12

4

Ty if %.

71.6

62.5

52.3

85.2

14.8

11.4

8.0

9.1

13.6

4.5

Nam Tra Mv

n=33

17

24

20

20

16

14

21

10

17

Tylf %,

51.5

72.7

60.6

60.6

48.5

42.4

63.6

30.3

51.5

I 1 3.0 1

n=359

178

2U6

210

269

146

100

82

66

67

Tylf %

49.6

1 57.4

58.5

74.9

40.7

27.9

22.8

18.4

18.7 !

7 1 1.9

65

Nhan xet:

. _ Ngd ddc TP la mpt tinh ttang benh ly xay ra do an hay udng phai cac thuc an bi o nhiSm cac chat ddc hgi ddi vdi sue khoe con ngudi. DS phdng tranh ngd doc cto phai biet nguySn nhto nao dua din tinh ttgng ngp ddc do, nhung qua kit qua nghiSn ciu Chung tdi thay chi cd 1.9% ngudi tieu ding biit diy du cac nguyen nhan gay ngd ddc (bang 2.21), tuy nhiSn hiSu ting ly do gay ngp doc TP la khd tdt: cd din 74,9% ngudi cho rtog dS thic an d nhift dp thudng ttSn 3 gid, khong che day va dS cae loai edn ming tiep xic; khdng r ia tay ttudc khi chuin bi TP, thic an la 58,5%; di TP tiip xic ttirc tiSp hoac gan noi d nhiSm chiim 57,4%; s i dung chit bao quan, phu gia TP khdtig cho phep hoac qua liiu lupng quy djnh chiim 49,6%); dung chung dao, thdt va dS l_to TP sdng vdi thie to^ chin la 40,7%; va nhttng y kiin khac nhu dung nude bj nhiSm bto, dung khto lau bin, khdng dun sdi thic an ttirde khi an...

Trong nghiSn eiu cia Roseman M va cdng su (cs) phan tich nhing dtt lieu cia CO quan quto ly thudc va TP cua My (FDA) tt cupc khae sat 728 ngudi tieu dung d Kenttcky vi nhgn thic vS nguy co bj bfnh do TP. Kit qud, cd mdi lien quan cd y nghTa gitta nhan thic va htoh vi. Nhin chung, ngudi cd nhan thiic cao hon se cd hanh vi an toto TP tdt ban.

Garayoa R, va cs nghiSn ciu mdi lien quan giua kiin thic an toan TP vdi hanh vi cia 562 sinh viSn tgi 'Tay Ban Nha (chu yiu din t i cac bp mon khoa hpc sic khde) nhto thay cd ban 2/3 sd sinh viSn cd kiin thie dung vi 8 nguySn nhan gay bfnh dudng TP theo nhu yeu elu [70].

DS ntog cao hon nua kiin thic cho ngudi tiSu ding, chung ta d n quan tam ttog eudng eong tac ttuyin thdng vi VSATTP tai cac dja phuang. Cd thi ndi, mdt su hiSu biSt tdt ban vi nhto thie va hanh vi an toan TP cia ngudi tieu dung se giip chtog ta cd mdt chuong trinh giao due an toan TP hifu qua.

3.3.1.2. Kien thuc chpn cdc logi rau qud

Bang 2.22. Kien thic chgn eae loai rau qua

• Huyf n, TP

Ngi dung ^X.^

Tuoi

Khong bj dap nat Khong cd mau sac la Khdng cd miii vjla Bu 4 tieu chi

TamKy

n =128

125

72

30

13 7

Tylf %

97.7

56.3

23.4

10.2 5.5

Nui Thanh

n =110

108

70

36

14 54

Tyle %)

98.2

63.6

32.7

12.7 49.1

Hifp Die

n =88

88

60

8

7 4

Tylf %

100. 0

68.2

9.1

8.0 4.5

Nam Tra My

n= 33 31

24

4

8

0

Tyle %.'

93.9

72.7

12.1

24.2 0.0

C h u n g '

n=359

352

226

78

42 16

T>lc %

98.1

63.0

21.7

11.7 4.5

66

NhSn xet: Trong btta to gia dinh Vift Nam khdng thi thiiu rau, cu, qua. T i xa xua, ong

ba ta da ndi "Com khdng rau nhu dau khdng thudc" di thiy dupe tim quan trpng cua rau xanh trong cac btta to. Rau cung d p cac loai vitamin va chit xo. TrSn btog 2.22 cho ta thay ngudi tiSu ding da chpn cac Ipgi rau, ci, qua dam bao du 4 tiSu chi VSATTP chi cd 4.5%).

3.3.1.3. Chpn thit luai

Bang 2.23. Chgn thjt tuoi

\ Huyf n, TP

Nfi dung \.^

Mang ngoai khd

Mui va mau sic binh thudng

Khoi thit rto chac Da khong cd nhung not xuat huyet mau do tim Ngon tay an vao thit tao thanh vet 16m nhung khdng de lai diu vet khi nhac ngon tay ra Thit khong dupe CO au triing sto mau ttIng nho bang hat gao

Du 6 tieu chuto

TamKy

n =128

15

109

61

38

22

26

1

Tylf Vo

11.7

85.2

47.7

29.7

17.2

20.3

0.8

Nui Thanh

n =11

0

24

102

63

56

18

15

1

Tylf Vo

21.8

92.7

57.3

50.9

16.4

13.6

0.9

Hifp Dire

n =88

14

67

52

41

9

11

3

Tylf %

15.9

76.1

59.1

46.6

10.2

12.5

3.4

Nam Tra My

n= 33

3

23

15

7

3

18

0

Tylf %

9.1

69.7

45.5

21.2

9.1

54.5

0.0

Chung

n=359

56

301

191

142

52

70

5

Tylf %

15.6

83.8

53.2

39.6

14.5

19.5

1.4

Nh^n xet: Thjt bd sung chit dam va nhiiu chit dinh duong giip co the phat irien. 1 ii>

nhiSn eae loai thvrc phim nay chi dem Igi tae dung tdt khi ching ta lua chpn dam bao tmh an toto nhu ttoi, khdng cd mii, vj Ig..., kit qua diiu tta cia ching tdi eho ta thay ngudi tiSu ding da chpn thit dim bao d i 6 tiSu chi VSATTP chi cd 1,4% (btog 2.23).

67

3.3.1.4. ChQn cd tuai

Bang 2.24. Chpn ca tiroi

\ H u y f n, T P

Nf i dung \s.^^

Thto ca chic, khi de len b to tay thto ca khdng thong xudng

Mat trong suot, giac mgc dto hoi Mifng ngam cing

Mang do tuoi

Vay ong anh, dinh chat thto

Bung binh thudng, hgu mon thut sau va mau trang nhat. Khi cit thiy thit ca r to chac, d to hoi, dinh chat vao xuong song

Du 7 tieu chuto

T a m K y

n =12

8

61

103

23

no 68

9

37

3

T y l f

%

47.7

80.5

18.0

85.9

53.1

7.0

28.9

2.3

Nlii Thanh

n =110

71

100

36

80

29

13

26

1

Tyl f %

64.5

90.9

32.7

72.7

26.4

11.8

23.6

0.9

Hifp D i e

n =88

67

72

22

56

19

11

16

3

Ty l f %

76.1

81.8

25.0

63.6

21.6

12.5

18.2

3.4

Nam Tra My

n= 33

10

1 1

11

20

1

6

10

0

Tyl f Vo

30.3

33 3

33.3

60.6

3.0

18.2

30.3

0.0

Chung

n=359

209

2S(.

92

266

117

39

89

7

Ty l f

%

58.2

7M.7

25.6

74.1

32.6

10.9

24.8

1.9

NhSn xet:

ca la logi TP thdng dung dupe ngudi dto dung trong cac btta to bi sung protide, canxi cho co thi eon ngudi. Nhtmg niu ching ta ding ca uon di ehS bien thie to thi nd s8 la nguyen nhto gay ngd ddc. Vi vgy biit each chpn ca ttoi la kiSn thie d n thiit eho mdi ngudi npi trp. Nhung khi hdi each chpn ca ngudi tiSu dung nSu du 7 tiSu chi v i VSATTP chi ed 1.9% (btog 2.24).

Viec khdng biit chpn ea dam bao VSATTP se la nguySn nhto gay ra cac vu ngd die dtog tiie xay ra. Tgi Nhat Ban la nude cd nin edng nghiep phat teiSn mgnh ddng thdi eOng la nude ma su d nhilm moi ttudng da lam eho hang ngto ngudi chSt vi to phai ca hi nhilm thuy ngto [64]. Nam 1994, xay ra vu ngp ddc gay tieu ehay cd 16/25 ngudi mic do to mvic, va 40 trudng hop khae do to hai sto bi nhiem khuan chua nlu chin ky tgi Hai Phdng.

Tit ca cac diiu nay da ching td ngudi dto ed hiiu biit v i each chpn cae leai TP

rau qua, thit, ea dam bao VSATTP cdn chua dam bao.

68

3.3.1.5. Cdch chpn TP bao gdi sdn

Bang 2.2S. Chgn TP bao goi sin

\ Huyf n, TP

Nf i d u n g \ ^

TenTP

Ten, dja chi co sd sto xuit TP Dinh luang cua TP Chi tieu chat lupng chu yiu cuaTP Ngay SX, thdi han SD, thdi hgn bao quto Hudng dto bao quto, s i dung

Xuat x i cua TP

Du 7 tieu chi

TamKy

n =128

94

14

21

48

41

17

116

2

Tylf %

73.4

10.9

16.4

37.5

32.0

13.3

90.6

1.6

Nui Thinh

n =11

0

78

32

25

48

55

7

95

1

Tylf %

70.9

29.1

22.7

43.6

50.0

6.4

86.4

0.9

Hifp Die

n =88

54

18

21

19

43

8

75

1

Tylf %

61.4

20.5

23.9

21.6

48.9

9.1

85.2

1.1

Nam Tra My

n= 33

22

0

0

12

16

0

31

0

Tylf %

66.7

0.0

0.0

36.4

48.5

0.0

93.9

0.0

Chung

n=359

248

64

67

127

155

32

317

4

Tylf %

69.1

17.8

18.7

35.4

• 43.2

8.9

88.3

1.1

Nhan xet:

Trong cupe sdng hifn dai, TP chi biSn sto la nhttng sto pham di lien vdi ddi sing htog ngay cua mdi gia dinh. Diiu lo nggi duy nhat la chat lupng cua TP che bien sin vi ham lupng chit bao quan va phu gia TP. NSu la ngudi tieu dung thong thai, moi ngudi dto cin tt bao vf chinh bto than bang each tim den nhttng san pham ciia cac nha sto xuit uy tm. Vdi hp, chi nhttng nguyen lifu, phu gia dgt tiSu chuan chat lupng va ed ngudn gdc xuit x i rd rtog mdi dupe phep s i dung vao qua ttinh ehS biSn. Thtoh phim ehi biin cia nhttng nha san xuit cd uy tin dSu phai ttai qua nhung dpt kiem tta ehlt lupng trudc khi dupe dua ra tiSu thvi ttSn thi ttudng.

Tai btog 2.25 eho ta thiy ngudi tiiu dtag biit duoe each chpn TP bap gdi sin d i 7 tiiu chi VSATTP chi cd 1,1%. Phin Idn ngudi tieu dung chi quan tSm xuit xu eua TP chiim 88,3%; tSn TP chiim 69,1%; ngay sto xuit, thdi hgn s i dung, bao quto la 43,2%; chi tiSu chit lupng chi yiu cia TP la 35,4%; djnh lupng cia TP 18,7%; tSn, dja chi ca sd sto xuit TP 17,8%; hudng din bao quan, s i dung la 8,9%.

Tgi Osaka-Nhat Bto (6/2000), cd 14.700 ngudi bj ngp doe do udng stta tuoi

logi beo ddng hop giiy SNOW, do khdng dam bao eae quy ttinh, che d i ve sinh sto

xuit mdt each nghiSm nggt.

69

3.3.1.6. Nhiing ddu hieu ciia TP khdng nin su dung

Bang 2.26. Din hifu cua TP khdng uen s i dung XHuyf n, TP

Ngi d u n g \

Da bi hu hong, mic, nim... Co chat bao quto, phim mau cua cac co sd khdng dtog ky chat luong Cac TP con nghi ngd, chua biet rd ng. gie Du 3 tieu chuto

Tam Ky

n =128

120

40

50

17

Tylf %

93.8

31.3

39.1

13.3

Nui Thinh

n =110

108

76

86

64

Tylf %

98.2

69.1

78.2

58.2

Hifp Dire

n =8 8

86

53

80

51

Tylf %

97.7

60.2

90.9

58.0

Nam Tra My

n=3 3

32

8

12

2

Tyle Vo

97.0

24.2

36.4

6.1

Chung

n=359

346

177

228

134

Tyle %

96.4

49.3

63.5

37.3

Nhan xet:

TP la ngudn dinh dudng cho co thS con ngudi de duy tri cudc sdng, cung cap ntog lupng CO bto va ntog lupng cin thiit che mpi hoat ddng ehic eua eo thi, cung cap protein, vitamin nhim tao te bao mdi, cac hormone... nham phat trien eo the. Nhtmg niu thic to bj bien ddi thanh nhttng chit khac, khdng mang lai lpi ich cho co thi ve ntog lupng va tao tS bao, ngupe Igi tgo ra cac chat dde hgi eho co thS, dto den xuit hifn nhihig trieu chirng va dau hifu cia ngp ddc sau khi to, udng nhurng thuc to do.

Kit qua nghiSn ciu cia ching tdi thiy cd 37,3%) ngudi tieu ding chua biet du 3 diu hifu cia TP khdng nSn dtag. Nhttng ngudi tiSu dung khac chi biit ttoig diu hieu nhu 96,4%) khdng s i dung TP hi hu hdng, mdc, nim...; 63,5% khing s i dung TP cdn nghi ngd, chua biit rd ngudn gdc; 49,3%) khdng s i dung TP cd chat bao quan. pham mau cia cac co sd khong dtog ky chit lupng (btog 2.26). Kit qua nay cho thay kiin thic vi cac diu hieu eua TP khdng nSn ding eua ngudi tieu dung cdn thiiu. trong do ngudi tiSu dtag cdn it quan tam nhit la TP cd chit bao quto, phim mau cua cac co sd khing dtog ky ehlt lupng.

Theo sd Ufu thing kS cia Cue ATVSTP trong nam 2007 ctag cho thiy ty If ngudi tiSu dtog cd kiin thic va thvic hanh ding vi VSATTP cia ca nude la 46,2% [16]. Byrd-Bredbenner C va es thvrc hien mpt cu^c khap sat true ttySn tPto quoc tai My nam 2007 vdi 4343 thanh nien. Kit qua, chi cd 60% tta Idi ding nhung cau hdi vi kiin thie an toto TP [61].

70

3.3.1.7. Cdch bdo qudn thuc dn

Bang 2.27. Cach bao qu^n thi^c Sn

^ H u y f n, TP

N$i d u n g ^ ^

Che day btog vung, ldng bto

Tikinh

Khdng che day

TamKy

n =128

118

71

5

Tylf % 92.2

55.5

3.9

Nui Thanh

n =110

98

45

0

Ty If %>

89.1

40.9

0.0

Hifp D ie

n =88

81

35

1

Tylf Vo

92.0

39.8

1.1

Nam Tra My

n=3 3

31

2

0

Tylf %

93.9

6.1

0.0

Chung

n=359

328

153

6

Tylf %

91.4

42.6

1.7

Nhfn %it:

Cic loai TP mudn di lai khdng bj hu, thii, biin chit ctag d n mdt svr hiiu biit nhit djnh vi ky thuat bao quto. Tgi btog 2.27 eho ta thiy ngudi tieu dtag nhgn biit dupe cae eieh di bap quto thic to la phi hpp nhu: Che dgy bing vung, long bto chiim 91,2%; di ttong tt khih chiim 42,6% va cd 1,7% cho ring khdng d n che dgy.

3.3.1. 8. Rira sgch rau qua tnr&c ichi nau, dn

RITA RAU TRT/OC KHI N A U , AN

80

701

60

50

40

30

20

10

0 2lto

Biiu do 2.24. R i a sgch ran qua trude khi nau, an

Nh$n xet:

Rau qua la nguin cung eip vitamm va chit xo cho eo thi eon ngudi, nd edn

giip phdng ngia ri i logn lipide mau, nguySn nhto quan ttpng gay eae bfnh 1; tim

mach Tuy nhiSn, hiSn nay rau qua bi S nhilm hpa chit bao vf thvic vat kha ttSm ttpfig,

ttong bao cao Hdi nghi Khoa hpc VSATTP nam 200Iehp thiy:

TT

I 2 3 4 5 b

'/ 8 9

Tfn rau qua Kau mudng Rau ngdt Rau cai Blp cai Dfu dua Dua chupt Nhpndi Tao Trung Qude LS Trung Qude

Ty If 0 nhilm hoa chat bao vf thue vat (%) 83,00 68,00 91,00 30,00 50,00 100,00 50,00 50,00 50,00

Do vay, khi s i dyng rau qua d n phai biit lua chpn dung va vln di quan trpng la phai r ia sgch ttudc khi chi biin hojc to.

DS ria rau qua sach cin phai qua cae budc: loai bd cdc chit bin, cac vgt la lln vao TP nhu sgn, ldng tdc... va cae phin rau qua bim dap, hu hdng. Sau dd phai ria ky dudi vdi nude ehay hoae thay nude ria 3-4 lan, eae logi qua d n gpt sach vd.

Khi tien hanh phdng vin ngudi tieu dtog vi vln di nay thiy 75.5%) ngudi tiSu dtag r ia rau tten 3 lln trude khi to, 19.2%) ria rau 2 lin va ehi cd 5%) ngudi tieu ding r ia rau 1 lln (biiu dd 2.24). Day ehinh la ly do gay ngp doe TP thudng xay ra tai cac bua to gia dinh thiiu vf sinh. Tai Nha Trang, theo Bui Trpng Chiin, Vien Quang Mai diSu tta 153 ttudng hpp mic benh trong vu dich 1994 cho thiy 35,8%) si mle do dtog giai khat cd da va 41,9%) dtag cac thic to tuoi sing. Do vay, cin cd nhttng nd luc lien tuc vS s i dung an toto thie to gia dinh di giip bao ve sic khde. Ddng thdi ngudi tieu dtog ctag cin nhto dupe nhieu thdng tm ban ve su dung TP d gia dinh hp va co hiiu biet tdt ban vS tam quan ttpng cia viec s i dung thic to thich hop di du phdng benh doTP.

3.3.2. Thai dp, hdnh vi vi VSATTP cda ngu&i tiiu diing

3.3.2.1. Di riing TP sdng vd chin

Bang 2.28. B i rif ng TP sing va chin

^-.-^^^ Noi dung

Huyen/TP ^ ^ ^ ^ ^ TamKy(n=128) Nui Thinh (n =110) H i i p D i c ( n = 8 8 ) Nam Tra My (n=33) Chung (n=359)

DS rieng TP sdng v4 chin

n 125 110 84 33

352

Ty If % 97.7 100 95.4 100 98.1

SS ehung hai loai TP song va chin

n 3 0 4 0 7

Ty If % 0.3 0.0 4.6 0.0 1.9

Nh$n xet: Niu di chung thic to chin vdi thic to sdng sS gay ra tinh ttgng nhiim khuto

chio to thie to sdng sang thic to chto. Do dd, cae logi thjt sdng khdng dS lln vdi cac TP chm. Tgi btog 2.28 eho ta thiy ngudi tiSu dtag da ed thvrc hanh khi chS biin va bao quto TP rit tdt; cd 98,I%i ngudi tiSu dtog biit di riing TP sing va chin. Day la

yiu eau bat budc dii vdi mpi ngudi khi tham gia chi biin hoae bao quto TP; diiu dd da cho ta thay ngudi tieu dtag da thvrc hanh rat tdt vi vln di nay. Tuy nhien, vto cdn 7 ngudi (1,9%) khdng thvtc hanh ding yeu cau nay la cdn di chung ca hai logi TP song va chm vdi nhau ttong chi biin va bao quto; chtog ta cin tiip tue trayen thdng di hp thire hanh dung ban. Cd thS ndi, mot su hiiu biit tdt ban vi nhto thic va hanh vi an toto TP cia ngudi tiSu dtag se giip chtag ta ed mpt chuong ttinh giio due an loan TP hieu qua

3.3.2.2. Diing dao th&l chung cho TP sdng vd chin

DUNG CHUNG DAO THOIT

16.70",, ^

c ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^

83.30%

DCV,

• Khung

Biiu di 2.25. Dung dao thdt chung cho TP sing va chin

Nhgn xet: Theo eae ehuySn gia VSATTP, nguy ca lay nhiim vi khuto tt TP song sang TP

chm la mpt ttong nhing mii nguy hiim htog diu d nha bip. Trong TP sdng cd chia rit nhiiu vi khuln nguy hiim nhu E.coli, sahnonella, camplylobacter. Vibrio vuhiieulus... gay ra benh tiSu ehay, rdi loan tiSu hoa... tham chi cd thS din dSn tt vong. NhCmg loai vi kliuin nay cd thi lay nhilm do dtag chung dao, thdt... cho ea hai loai thic to sdng, ehm hoac di lln lOn thie to sing, chm vdi nhau.

Qua diiu tta chtag tdi thiy ngudi tiSu dtag da khdng dtag dao thdt chung cho TP sing va chm kha cao chiim 83,3%, diiu nay chtag td ngudi tiSu ding ed thuc hanh kha tdt khi ehi biin 'TP; toy nhien vln cdn 16,7%) ngudi tieu dtag cd dtag dao thdt ehung cho TP sdng va chm (biiu dd 2.25); day la vln di chtag ta cto quan tam dS ed nhiing hd ttp nhim thay dii hanh vi cia nhdm ngudi niy.

73

3.3.2.3. Ve sinh dung cu dn udng

VE SINH DUNG CU AN UONG

Ty 1? %

90 80 7(1 60 50 40 30 20 Ul

^')7.«

, ^ ^ ^itmr y Rua bang xii Chi rua bang Rua bang niroc

phong vi iiirac nuoc nong sach

Bieu do 2.26. Vf sinh dgng cu an u6ng

Nhgn xit: Ong ba ta thudng ndi: "Nha sgch thi mat, bat saeh ngon cam" nSn vifc vf smh ehSn, dia, dung evi to udng sgch se, hpp vS smh chtoh la gdp phin tgo nSn svr ngon mien^ va ehlt luong btta to.

BiSu dd 2.26 cho ta thay ngudi tiSu dtag da cd thuc hanh khi r ia dimg cu to udng la kha dam bao, dd la r ia btog xa phdng hoac nude r ia chen va nude sgch chiim ty If rit cao (97,8%,); r ia bing nude thdng thudng la 1,9%) va nude ndng la 6,3%). Day la nguyin tie bit bupe ddi vdi mpi ngudi khi ve sinh dyng cvi to udng.

3.3.2.4. Thuc hdnh rira tay

Bang 2.29. Thuc hanh riia tay

^ ^ a diem

Nfi dung X^

Ria btog nude sach Ria btog xa phdng vdi nude sach Ria dual vdi

nude sgch, ehay hen tyc Lau btog khto khd, sgch hogc gily lau 1 lan

TamKy

n =128

10

108

10

0

Tylf % 7.8

84.4

7.8

0.0

Nlii Thanh

n =110

4

101

5

0

Tylf % 3.6

91.8

4.5

0.0

Hifp Die

n =88

9

77

2

0

Tylf %

10.2

87.5

2.3

0.0

Nam Tra My

n= 33

3

30

0

0

Tylf % 9.1

90.9

0.0

0.0

Chung

n= 359

26

316

17

0

Tylf

7.2

88.0

4.7

0.0

74

NhSn xet:

Ngudi ta ude tinh 70%) cac vu nhiim ddc TP cd liSn quan din ban tay ban. NSu khdng giu sgch, tay la noi van ehuyin vao co thi vi khuln, hda chit ddc hai tu mdi trudng va cac chit bin khac do tiip xic thdng thudng. Do do, ria tay bing xa phdng va nude sgch la each tit nhit di di phdng ngd dpe TP.

Tai bang 2.29 da eho thay ring ngudi tieu dung da thuc hanh kha tdt trong each rua tay; dd la r ia tay bing xa phdng vdi nude saeh chiim ty IS cao 88,0%); cdn lai la ria bing nude sgch dudi vdi nude ehay liSn tuc (12%)). Day la dieu ching td ngudi tieu ding cd thuc htoh tit khi r ia tay. Tuy nhiSn, khdng cd ngudi tiSu dung nao dupe lau tay sau khi ria. Dieu nay ching ta cin phai quan tam ban.

3.3.2.5. Tli&i gian chudn bi Ihirc dn truac ichi dn

Bang 2.30. Thdi gian ehuin bj th ic an trudc khi an

\ ^ ^ Dia diim

Nii dun^v

<2gid

2 - 4 gid >4g id

TamKy

n =128

107

10 11

Ty le%

83. 6

7.8 8.6

Nil Thanh

n =110

81

20 9

Tyle %

73.6

18.2 8.2

Hifp Due

n =88

80

2 6

Tyle %

90.9

2.3 6.8

Nam Tra My

n= 33

2

23 8

Tyle % 6.1

69.7 24.2

Chung

n-359

270

55 34

Tyle %

75.2

15.3 9.5

Nhan xet;

Thuc to da nlu chin chi an toan 2 gid sau khi niu. Sau khoang thdi gian nay, bao quto ndng hay Ignh khdng ding diu tao diiu kien cho vi khuin xam nhap va phat triin. Khi s i dung thic an da chi biin dupe 2 tiing, nSn dun soi Iai d nhiet dp tt 70°C ttd ISn ttirde khi dung. Trudng hop di thic an trong thdi gian lau hon, tuy ttag ttudng hpp, tty logi thic to mi cd thi nlu lai di ding hay hiy bd di dam bao an toan. Nen nlu via du to trong 2 - 3 btta di ttinh ham di ham Igi qua 2 lin, via mit nhieu chat dmh dudng via tgo cac chit cd hgi eho sie khde.

Kit qua nghien ciu cua ching toi eho thiy nhiiu ngudi tieu ding da danh thdi gian chuin bi thic ta cho din khi an ding vdi ySu elu vi diiu kifn VSATTP; dd la tu khi chuin bj thic an din khi an tdt nhit la trudc 2 gid chiim 75,2%; t i 2 dSn 4 gid chiim 15,3% va cd 9,5% ngudi chpn ttSn 4 gid (bang 2.30), cao hon nghiSn ciu cia Almanza BA va es ty IS nay chi cd 63% [60].

75

3.3.2.6. Nai che bien thuc dn, tude chen, dia, phong dn

Bang 2.31. NO'i che bien thirc an, tu de chen, dia, phdng an

" ^ y f n, TP

Nf i d u n g x ^ Saeh, hop vS sinh Khdng hpp vS sinh Cgnh cdng ranh i dpng Canh nai hui bto, d nhilm

TamKy

n =128

126

2

0

0

Tylf % 98.4

1.6

0.0

0.0

Nui Thanh

n =110

103

7

0

0

Tyle %

93.6

6.4

0.0

0.0

Hifp Bue

n =88

88

0

0

0

Tyle %

100.0

0.0

0.0

0.0

Nam Tra My

n=33

33

0

0

0

Tyle %

100.0

0.0

0.0

0.0

Chung

n= 359

350

9

0

0

Tyle %

97.5

2.5

0.0

0.0

Nhgn xet:

Bip la noi chi biin thic to, tai day thudng xuyen cd nhiiu loai TP chua che biin, la mdi trudng rit thuto tifn cho cac logi vi khuin doe hai tap trung va phat trien. cae dgng eu, dd dge trong bip, phdng to cung phai sip xip gpn gang, ngan nap, cd khotog each, khdng nen di chdng cheo ISn nhau di dam bao vf sinh. Tgi bang 2.31 da thi hifn tai noi chi biin thuc an; tt di chen, dTa; phdng an cia ngudi tiSu dung sach, hop vf sinh chiim ty If rit cao 97,5%. Diiu dd chtag td ngudi tieu ding da cd thuc hanh tdt vi ndi dung nay. Mae d i vay, vln edn 2,5%o tai noi chi biin thic an; tt de chen, dia; phdng an cia ngudi tieu dtag khdng hpp ve sinh nhung hpto toto khdng ed d canh edng ranh i dpng hay d nhilm; vin di nay chtag ta d n phat huy ddi vdi ngudi tiSu dtag.

3.3.2.7. Thiing dtfng rac thdi bo

Bang 2.32. Thing dyng r ie thai bo

XDja diim

Ngi dung!

Sach, kin, cd nip

Sgch kin, khdng ed

Rach, bto.

Khdng cd thtog dtmg rac

TamKy

n =128

124

4

0

0

Ty If %

96.9

3.1

0.0

0.0

Nii Thanh

n =110

80

II

0

19

Tyle %

72.7

10.0

0.0

17.3

Hifp Bue

n =8 8

70

8

0

10

Tyif %

79.5

9.1

0.0

II.4

Nam Tra My

n=3 3

5

2

0

26

Ty le %

15.2

6.1

0.0

78.8

Chung

n-359

279

25

0

55

Ty le %

77.7

7.0

0.0

15.3

76

Nh^n xet:

Thing ehia rac la noi tap tmng rit nhiiu vi khuln gay benh. Do dd, thing chia rac tai moi gia dinh phai cd nap day kin di xa noi che biin, phdng an va chuyen di htog ngay. Tgi bang 2.32 cho ta thiy ngudi tiSu dung da cd s i dung thing dung rac thai bd sgch, kin, cd nip day chiim ty IS cao (77,7%); ngudi tieu diing cd Ihiing dirng rac thai bd nhung khdng cd nip day la 7,0%; khdng cd thing dung rac chiim 15,3%. Vifc s i dung thu gom rie la vd cing cin thiet, vin de nay ta d n quan tam thSm.

3.4. Y kien cua ngudi dan

3.4.1. Nguin cung cap thong tin VSATTP

Bang 2.33. Nguon eung cap thong tin VSATTP

^ ^ ^ D j a diim Nguon ^ ^ ^ ^

Tivi saeh bao Ban be

Dai phat thanh Cto bp y te

Ngudi SXCBTP n

=347 334 203 128 177 272

Tylf % 96.3 58.5 36.9 51.0 78.4

Ngudi kinh doanh TP

n= 348 308 127 70 99 208

Tylf % 88.5 36.5 20.1 28.4 59.8

Ngudi tieu dung

n = 359 309 144 91 153 260

Tylf % 86.1 40.1 25.3 42.6 72.4

Chung

n =1.054

951 474 289 429 740

Tylf %

90.2 45 0 27.4 40.7 70.2

Nhgn xet: Khi hdi v i ngudn cung cip thdng tin vi VSATTP cho ngudi dto ehi yeu qua tivi

95Ingudi (90.2%), sau dd din cto bd y t i 740 ngudi (70.2%,), ba ngudn cdn Igi la qua saeh bao, dai phat thanh, ban be lln lupt (45%; 40.7%; 27.4%) (btog 2.33). Nhu vgy tmyin thdng qua cac phuang tifn thdng tin dgi chtag nhat la qua bao hinh da phat huy dupe thi mgnh la pho biin rpng rai din nhiiu ngudi, cac kenh ttuySn thdng khac nhu sach bao, dai phat thanh cdn thip.

3.4.2. Mong muin nang eao kiin thie VSATTP

Bang 2.34. Mong muon nSng cao kien thuc VSATTP

^ ^ ^ ^ Ykien Huyfn/TP ^ ^ ^ ^

Ngudi SXCBTP (n =347) Ngudi kmh doanh TP (n =348)

Ngudi tiiu ding (359) Chung fn =1.054)

BvK/c nghe noi chuyfn ve VSATTP

n 320 320 318 958

Ty If % 91.95 91.95 88.6 91

Dug c cung cap tai lifu

n 258 258 225 741

Ty If % 71.1 74.1 62.3 70

Co 1

VSA tivi n

271 271 250 792

ehuang rinh FTP tren daiPT Ty If %

78.1 77.9 69.6 75

77

NhSn xit: Cd nhieu hhih thic di ttang bj cho mpi ngudi kiin thic vi VSATTP nhu truyin

thong gian tiSp qua dai phat thanh, tmyin hinh, qua saeh bao, tai lieu, qua mitting...; hay truyen thdng true tiSp nhu tap huln, ndi chuySn, thao luan nhdm, tt vto... Khi hdi mong mudn dupe ntog cao kiin thie VSATTP cia nhttng ngudi dto thdng qua cic kSnh thdng tm nao thu hit hp nhit thi nhiiu nhit qua ndi chuyen vi VSATTP (91%), bdi bang hinh thic nay khong nhihig cung eip dupe nhiiu thdng tm ma cdn ed su phto hdi cia ngudi du tap huln, chinh qua su ttao ddi dd se giip cho ngudi duoe tap huto nhd lau ban kiin thic dupe nhto. Day la hmh thic d n dupe s i dung nhieu trong thdi gian dSn; 75%, ding y cd chuang ttinh hudng dto VSATTP ttSn tivi; dupe cip tai lieu (70%) (btog 2.34).

4 THVC TRANG HOAT D Q N G TRUYEN T H 6 N G GIAO D^C SlTC KHOt VE VSATTP

4.1. Cong t ic xay dvmg k i hogch hogt dgng TTGDSK ve VSATTP

4.1.1. Tinh hinh thftc hi^n cdng tdc xdy dipig ke hogch

TINH HINH XAY D V'NG KE HOACH HOAT DONG TTGDSK

TYLE% mo_ 100_ I00_

100

100

TamKy Nui Thanh Hiep Die Nam Tra My

Bieu do 2.27. Xay dgng k i hogeh hogt dgng TTGDSK

Nhgn xet: , , Di lam tit bit c i hogt ddng nao, vto dS quan ttpng nhat la phai xay dvmg dupe

ki hoach hoat ddng eg thi, phi hop vdi diiu kifn thuc tiin tgi dja phuang. Qua nghiSn eiu chtag tdi thiy 100% cic t i TTGDSK dSu xay dung ki hoach hogt ddng nay (biSu di 2.27). Day la kit qua rit kha quan, cho thiy cdng tae xay dtmg kS hogch hoat dpng ttuySn thdng da dupe chi ttpng tai ttySn ca sd.

4.1.2. Cas&x&y dftng ki hogch hogt dpng TTGDSK

Bang 2.35. Cas&xay dipig ki hogch hogl dpng TTGDSK

\ ^ ^ ^ ^ Do

Dja d i i m ^ ^

TamKy Nui Thanh Hifp Die Nam Tra My Chung

Cap trin dua xuong

n=20 I 0 2 3 6

Ty If % 5 0 10 15 30

Tvr xay dung

n=20 3 6 2 0 11

Ty If % 15 20 10 0 55

Kit hgp ca cap tren dua xuong va

tu xay dung n=20

1 0 1 1 3

Ty If % 5 0 5 5 15

Nhgn xSt: Cto ci dS xay dvmg ki hogch boat dpng y ti ndi ehung va hpgt dpng TTGDSK

ndi riSng phai dya ttSn cae ea sd phto tieh thye trang tgi dja phuang va cac diiu kifn vi nhto Ivrc, v$t Ivic va tii Ivic di dua ra cac giai phap va hogt dpng phi hpp vdi thye tiln. Nhu vgy, ki hpgch phii dupe chinh nhihig ngudi tgi co sd dd xay dvmg lin hogc phai kit hpp gitta ki hogch cia dp ttSn dua xudng vi cia don vi thi mdi kha thi. Qua btog 2.35 chtag tdi thiy ki hogch cia eae td TTGDDSK dupe thvrc hifn do ban thto cae ti xay dvmg len chiem ty If eao nhit 55%,; sau dd din ki hogch dupe xay dvmg do dp ttin dua xuing chiim 30%, cdn kS hoach dupe xay dimg do kSt hap ea ke hoach tt ttin dua xuing va tt xay dvmg rit thip chiim 15%. Nhu vay vln cdn 30% sd td TTGDSK khi xay dtmg ki hogch edn phg thudc hoto toto vao ki hogch cia cip ttSn,

Di giai thich cho thuc ttang ttin chtag tdi thiy, muin xay dvmg dupe kS hpgch hogt dpng, diiu khong thi khdng tmh din la kmh phi d dau di thvrc hifn hogt dpng nay. Hifn nay, mac du tgi eie huyen da hmh thanh cae phdng TTGDSK dudi dgng ldng ghSp, nhimg phin Idn cto bd lam kiSm nhiem, khong cd rieng nguon kinh phi ma phu thudc vao chuong ttmh qude gia vi VSATTP, cac boat ddng phai phu thuf c vao hoat dpng cia ehuang ttmh. _ ^

Tuy nhiSn, di ki hoach kha thi va cd hifu qim eao, cto phai ket hgp giOa ySu du cia chuang ttmh VSATTP qude gia vi thuc tiin dja phuang.

4.1.3. Nhung ngu&i Iham gia x&y dttng ke hogch NHUNG NGUOI THAM GlAXAVDlTNG KE HO.^CH

TamKy NUi HitpOiic NamT,4 Thinh My

Biiu di 2.28. Nhihig nguoi tham gia xay dung kS hogch

79

Nhgn xit:

Di eong tac TTGDSK vi VSATTP thirc hien tdt, vln di quan ttong la phai huy dpng dupe cOng ding tham gia, mudn vgy cac ki hoach hoat dpng di thuc hiSn dupe tPt thi bto thto hp phai dupe ctag tham gia xay dung. Nhu vay, mpt bto ki hoach hogt dOng TTGDSK tdtphai dupe cto bp y ti, ban cham sde sic khoe va ngudi dto eung xay dirng. Thvrc tiSn, qua kit qua nghiSn eiu cua chung tdi, ki hoach hoat dong TTGDSK vS VSATTP dupe xay dimg chi yiu bdi can bp y ti d tit ca cac td TTGDSK cua 4 huyfn (chiim 100%), ngoai ra Ban cham sde sic khoS cd tham gia xay dvmg ke hogch hoat dOng TTGDSK vi VSATTP nhiiu nhit tai Nii Thanh (66.7%), sau dd dSn Tam Ky va Hifp Die (diu la 40%). Khdng ed td TTGDSK nao d ca 4 huyfn cd ngudi dto tham gia vao hogt df ng ttSn (biiu dd 2.28). Day la vln de cin diipe quan tam ttong thdi gian din bdi ngudi dto via la ddi ttpng tac dpng via la ehi thi dS giai quyit cto vin di sic kheS do v^y ngudi dto phii la nhtag tac gia chinh -la ddi ttpng chi yiu thyrc hifn vifc thu thap va phto tich thong tin, lgp ki hogch. Su tham gia cia ngudi dto vao mpi khau cia qui ttinh l$p ki hogch dam bao tinh phi hop va phto inh dtag nguyf n vpng cia eOng ddng ctag nhu sur ehi dpng, tich cue cia hp ttpng cac hogt dpng can thifp nhim giai quyit cae vln dl sic khpS cia chinh cpng ddng, bio dam cho tmh tiip Ufc vi vifc duy tti bin vtag cia cic hogt dpng do chmh cpng ddng xay dvmg nin.

4.1.4. Ke hogch dupic Ihdng qua cac cdp chinh quyin dja phuang

Biiu do 2.29. Ke hoach dug'c thdng qua e^c cap chinh quyin dia phuong

Nhgn xit: Ki hoach hogt ddng TTGDSK vi VSATTP cin phai thing nhit ttudc vdi lanh

dao dja phuong di thuyit phyc cac d p lanh dao tgo dilu kifn thvrc hifn; ttanh thu Sv* giip da ddng thih, hudng ing cia mpi ngudi; ddng viin dupe quin chtag tich evie tham gia hoat ddn^ ngay tt diu va duy tri phong ttto dupe lau bin. Kit qua cia ching tdi cho thiy eie td TTGDSK khi xSy dvmg ki hoach xong dupe cae cip chmh quyin phi diQfft chiim da sd (85%), nhung vin cd 15 %, khdng dupe phS duyft (biSu 66 2.29). Can luu y hogt dOng nay ttong thdi gian din

80

4.2. Cic hinh thue truyin thong dugrc th^c hifn

CAC HINHTHU'C TtCDSK

100 101

D Xc liiyen Iruyen

• Milling

D N6i Chuyen sue khoe

n Ptial Ihanh

• I njycn hinh

n IMm ho gia dinh

• ITiao luan Nhom

P Tu van

• Bao SKQN

liep Due Nam Trd My

Biiu di 2.30. Cic hinh thie truyin thSng dugre thvrc hifn Nhan xit: De cdng tac TTGDSK cd hifu qua ngudi lam cdng tac nay phai biet tta chpn

cae hinh thie TTGDSK phi hgp nhat vdi ndi dung, diSu kifn vl phuang tifn cia mmh. Hifn nay ngudi ta thudng si dvmg eie hmh thie TTGDSK sau:

- Truyin thing gito tiip: qua cac phuong tifn thong tm dgi chtag (dai phat thanh, truyin hinh, bao, tap ehi...), qua ttanh anh, pand, td roi, hdi thi, xe ttyfn tmyin...

- Truyin thdng tnic tiip: ndi chuySn sie khoS, thao Into nhdm, lam miu, W vln, tham hd gia dmh...

Dilu quan ttpng la ngudi lam cdng tac truyin thdng phM tta chpn sap chp phi hpp vdi phong ttic tap quto va diiu kien cua dja phuang. Thdng thudng cto bp y ti ca sd hay s i dvmg nhit li phuong phap tmyin thdng trvre tiip. Ket qua nghiSn ciu cia chtag tdi thiy (biSu dd 2.30):

- Ndi chuyfn sic khoe la hhih thie dupe tit ei eae td TTGDSK si dgng, ttong dd eao nhit la huyen Hifp Die va Nam Tra My (100%), Thanh phi Tam Ky cd 80% va huyfn Nil Thanh chi cd 60% to si dvmg hmh thic nay.

- Thao luan nhdm ctag la hinh thie dupe cae huyen ding di taySn truyin vl cdng tac VSATTP, nai dtag nhilu nhit la huyfn Nii Thanh (chiim 66.7%), thanh phi Tam K.^ va huyfn Hifp Die cd 40% sd td si dvmg hhih thic nay va Nam Tra My chi cd 25% si dvmg hmh thic nay.

Trong nghiSn ciu cia Huynh Vto NSn vl "Hifu qui boat ding traySn thong giao dvie sic khde vl vf smh mdi trudng tgi 5 diim trudng tiiu hpc huyfn Phi Tto tmh An Giang" ctag ip dimg cac hmh thie TTGDSK hire tiip cho thiy: Hiiu biit cia hoe smh vi x i 1; phto, nude, rae da ttog ISn dtog ki. Thay ddi dupe mdt sd hanh vi vi ve sinh mii tradng cd lpi cho sic khde ca nhto vi sie khde cdng dong [50].

Tai BIC Nmh, teong Chuang trinh hanh dOng thvrc hien chlin lupc ttuySn thdng gito dvic, chuyin ddi hanh vi vl dto sd, sic khoe smh san/ki hogch hoa gia dmh (DS, SKSS/KHHGD), sau gin 2 nam thvic hien, dupe svr quan tam cia cae cap uy Dtog, cWnh quyin vi svi phoi kit hpp chJt che cia cac ban nganh, doto thi, cong tac ttuyin

thdng^giao dvic thay dii hanh vi vi DS, SKSS/KHHGD da tgo dupe su thay dii mgnh me ve nh^ thie va hanh dOng cia toto xa hdi tten phgm vi loan tinh. Kit qua vifc thvic hien KHHGD va cham sde SKSS da gdp phin quan ttpng vao muc tiSu giam suih va ntog eao chit lupng dto si. Qui ino gia dmh it eon ngay etog dupe nhto dto chip nh^ rpng rai, tdc dp gia ttog dto sd dupe kiim soat; si cap vp chdng chip nhto si dung bifn phap ttanh thai hien dgi ngay etog ttog. DJe biet thdng qua cac dpt td chic chien dich ttuyin thdng ling ghep dich vu d ving cd mic sinh cao va khd khto, si ngudi dupe hudng lpi tt cac djeh vg cham sde SKSS/KHHGD ngay etog cao.

Vifc chpn cae htoh thie truyin thdng nay ed uu diim giip ttao ddi fruc tiip giOa ngudi cto bd y ti va ngudi dto, tao svr phan hoi ngay trong buoi tmyin thdng. Tuy nhiSn, hinh thic nay chi tac ddng din si it ngudi ttuc tiip tham gia. Trong khi kinh phi danh eho hogt dpng nay gin nhu khdng cd nSn khd dpng viSn ngudi cto bp y ti thvrc hiin tdt cong tac nay.

Hmh thic phit thanh ttySn truyin vi VSATTP ctag dupe cac huyfn/thanh phd si dgng, ttong dd si dvmg nhiiu nhit tai Thanh phi Tam Ky va Huyfn Nii Thanh (100%), Hifp Die chi cd 60% va Nam Tra My cd 25% td TTGDSK si dgng hmh thic niy (biiu dd 2.30). Qua cac budi phat thanh cd thl cung dp thdng tm din nhiiu n^di, svr lan rOng nhanh chdng, thuto V' eho cac vtag cd diiu kifn dja ly khd khto. De thvrc hifn hogt dpng nay ein cd diu tt tt Nha nude vS ttang thiit bj, dudng trayin va con ngudi... Tuy phai diu tt nhiiu nhung niu ehtog ta lam thi khdng chi cd lai cho cdng tac cham sde sie khoe mi cdn cd Ipi cho ca kmh te, an ninh, qude phdng va vto hoa nia.

Tuyen trayin VSATTP btog hinh thie dtog tii ttSn bao khong dupe huyfn/thanh phd nao si dvmg (tit ca 0%,) (biSu dd 2.30). Day etog la kSnh truyin thdng gito tiip ed thi din vdi nhiiu ngudi, hon nua nganh y ti cd riSng "Thdng tm y dupe" va "Sic khoe Qutog Nam", viec dtog tii cac bai, tm phto anh boat ding vi dam bao ehlt luang VSATTP la cto thiet khdng chi chia se nhing kinh nghiSm ttong triin khai cac hogt ddng ma cdn la phuang tifn giip cho cac trayen thdng viSn cd tii lifu di thuc hifn nhifm vu cia minh tgi co sd dupe tdt hon. Chinh vi vay, dn cd khuyln cao ik ttog eudng hogt dpng nay.

4.3. Tinh hlnh thanh ISp ban tin, diim tuyen truyin bing Video vl VSATTP

20

-Co -KhongI

TamKy Niii Thanh Hiep Dire Nam Tra My Chung

Biiu di 2.31. Tinh hinh thanh lgp ban tin tuyin truyen ve VSATTP 82

Bieu do 2.32. Tinh hinh tbifc hifn diem tuySn truyen bang Video Nh^n xit: Be ldng ghSp cdng tac kham ehtta bfnh vdi cdng tac TTGDSK cho ngudi dto

mdt each don gito va dl dtog khdng ddi hdi kmh nghiSm va kinh phi Idn dd la chtog ta thvic hien trayin thong gito tiip qua bto tm, diim mySn trayin bing Video vi VSATTP tgi eae eo sd y ti , cac diim edng edng thudng tap trung ddng ngudi... Qua dilu tra chtag tdi thiy cac td TTGDSK thanh lap bto tm vi cdng tac VSATTP thip (chiim 30%,), s i edn lai khdng thvrc hifn dupe hinh thic nay (chiim 70%) (bilu do 2.31) va chi cd 25% s i td TTGDSK thaiih lap diim tuyen trayin bing videp tgp trang d Tam Ky va Ni i Thanh, 75%, sd cdn lai khdng thvic hien dupe boat dpng niy (biiu di 2-32).

Nhu vay, d n Iuu y xay dvmg bto tm, diim toyen trayin bing video vi VSATTP eho cac ca sd y t i bdi day la hogt ddng dan gito dl lam va cho hifu qua eao bdi khdng chi tac ddng vao bfnh nhto ma cdn tac ddng dSn ca ngudi nha cia hp va thdng qua hp cd the dua thdng tin dSn cpng ddng

4.4. Tmh hmh san xuat cic phuong tifn truyin thong cua cic t i TTGDSK

Tyl?

!

XAY DV^iG TAI LI$U TRUYEN THONG

80 f

70

60

50

40

30

20

10 /I

35

1 75

3(

20 20 r

IdLi-Chung TamKy Nui Hi^p Nam

Thinh Diic Tii My

n Pano

• T^roi

a Khau hi^u

Biiu ah 2.33. Tmh hmh sin xuit cac phuong tifn truyen thong

83

Nh|n xet: ^™^^" * ° " S qua tai lifu nhu khlu hieu, pand, td roi... la phuang phap truyin

thong gito tiSp mang hieu qua cao, eung d p thdng tin ehinh xac, dS dang thu duac phan hot, tao dupe dieu kifn eho su thay doi hanh vi... Chinh vi vay, khi thuc hien cic boat dOng TTGDSK cto phdi kit hpp nhiiu phuang phap trong dd khdng thi thiiu dupe do la cung cap tai lifu eho dii tupng dupe tmyen thong. Qua nghien eiu cia ching tdi, cdng tie xay dimg cac loai tai lieu trayin thdng dupe cae t i TTGDSK thuc hifn nhiSu nhat la lam khlu hifu (chiim 75%), sau dd la san xuit pano (chiim 35%) va sto xuat td roi chi cd 30%, (bilu do 2.33). Day qua la con sd khiem tin, ein duac ttog cudng trong thdi gian din.

5. TIM HIEU NGUYEN NHAN D U A DEN TINH TRANG KIEN THUC, THAI DO, HANH VI VE Vf SINH AN T O A N THyC PHAM CUA NGU6l DAN CON THAP

Vdi kit qua nghiSn ciu ttSn, qua phto tich nhttng dac diim ehung cia cac ddi Wong nghiSn ciu ching toi thiy nhttng nguySn nhan cia tinh trang thiiu kiin thic, chua ed thai dp, hanh vi tdt ttong SX, CBTP, kinh doanh TP va ngay ca ngudi tieu dtag la do cae nguySn nhto sau:

5.1. Cing tae quin ly chua dong bg Quto ly chit lupng VSATTP la mdt hogt dpng ting hop va phic tap ddi hdi

phai thdng nhat va lien nganh. Nhung thue t i cing tac quto ly diiu hlnh cdn nhiiu bit cap, cu thS:

-VS td chic bp miy quto ly chit lupng VSATTP: hf thing t i chic quan ly chua thdng nhat va ehua d i manh t i tnmg uong tdi co sd, cung vdi dd, cac van ban quy pham phap luat cdn thiSu chi tiSt trong hutag dan x i ly vi pham. Luc lupng thanh tta chuyen nginh, hf thdng kiSm tta xet nghiSm via ySu v ia thiSu vS nhto lue va ttang thiSt hi. Tai Qutog Nam qua nghiSn ciu ching tdi thay vto cdn 7.0% dja phuong chua thanh lap Ban chi dgo tfp trung tai huyfn miln nii (btog 2.6).

Ve chic ntog quto ly: ba chic ntog co bto cia edng tae quto ly chat lupng VSATTP la lap ki hpgch, td chic, phto cdng thvrc hien kS hoach va giam sat, kiSm tra cdng tac thgre hien ki hoach. TrSn thvrc ti ca ba ehic nang nay chua dupe friSn khai mpt each khoa hpc, day d i v i chua xuat phat tt diiu kifn thtrc te. Qua nghien ciu ching toi thiy cd 12.1%, dja phuang khdng xay dimg ki hoach boat ddng va 9.3% khdng ban hanh vto ban chi dgo vl VSATTP (btog 2.7); 22.2%, lanh dgo tta Idi khong cd hdi nghj triin khai va tdng kit v l cing tac VSATTP (tfp trung nhilu nhit tgi huyfn miln nii Nam Tra My) (btog 2.8)

Di dam bao chit lupng VSATTP, ttong cdng tac quto ly VSATTP ed 6 npi dung hpgt ddng quan trpng cin phai thuc hifn ding hi mdi nang cao chit lupng hogt ddng. Qua nghiSn eiu chtag tdi nhto thiy tta ldi ding ttmg phin kha ding nhit tai cae dia phuang va chiim ty IS cao lln lupt: Vifc thutag xuyen kilm tta, giam sat (93.5%), td chic nhiiu hinh thic ttySn trayin eho ngudi dto (86.8%), xay dung ke hoach hoat ddng cho Ban chi dao sat thvrc (79.2%), djnh ky td chic so kit tdng kit cdng tie dam bao chit lupng VSATTP (64.9%) (bilu dd 2.6).

Trong cdng tac quto Iy ehlt lupng VSATTP, cac dja phuang cto phai t i chic cho cac ca sd SX, CBTP, kmh doanh TP hpc tfp kiin thic vi VSATTP va thutag xuyin td chic kham s ic khde cho hp. Nhung ttong thuc t i chi cd 43.6% kham sic

84

khde dung qui djnh (Bang 2.4) va chi cd 69.1% dupe tap huln kiin thiic vi VSATTP (Btog 2.5).

Ve thiic hien cdng tac tuySn trayin giao due cho ngudi dan vi VSATTP chua dupe quan tam ding mie:

+P'teu kien co sd vat chit ehua dam bao nhu vin edn 14.3% dja phuang khong cd he thdng loa trayin thanh, dge bift la cac dja phuang ving trang du va miin nui.

+ DS cdng tie TTGDSK cd hieu qua ngudi lam cong tae nay phai biit lua chpn cac hinh thic TTGDSK phi hpp nhit vdi npi dung, diiu kien, phuang tien va phi hpp vdi phong tuc tap quan, diiu kifn cia dja phuang; phai da dang hda cac hinh thic tniySn thing di tao sir hip din giip ngudi dan dS tiSp thu eie kiin thic co bto. Qua dieu tta chtag tdi thiy cac td TTGDSK cdn chi trpng vao hinh thic ndi chuyfn, thao luan tadin va xe tuySn trayin, chua quan tam nhilu din cac hinh thic nhu thata lap bto tin vS cdng tac VSATTP, diim ttySn trayin bing video, dang tai npi dung taySn trayen qua bao, dai...

- Dau tt cho cdng tac quto ly ATTP cdn rit thip. Kinh phi diu tu cho edng tac quto ly ATTP giai dogn 5 nam (ti 2004-2008) la 329 ty ding, tinh binh quan diu ngudi cia ea nude chi dgt 780 ddng/ngudi/nam - chi bing 1/19 mic diu tu cua Thai Lan vi btog 1/136 so vdi diu tu cia co quan quan ly TP va thudc (FDA) cia My [16].

5.2. Y thuc trach nhifm biin, Idnh doanh TP chua cao:

Trong CO chS thj tratag, nhieu ngudi sto xuat, kinh doanh chgy theo Ipi nhuan trade mat, coi thudng tinh mang, sic khde cia ngudi tieu dtag. Cu thS:

Khdng chap hanh cac qui djnh cia nha nude nhu khdng tham gia tap huin, khong kham sic khde dinh ky.

Khdng thuc hien cic qui djta vS dilu kien eo sd vat chit, dieu kifn ve smh. Khdng cd y thic trong vifc dim bao ve sinh ttong qua trita san xuat, chi biin

va kinh doanh TP... Bin cgnh do, mo hinh sto xuat, ehi biin TP cia nhieu co sd, doanh nghiep

ttong nude vln manh min va thd so, nhieu khi chi vi ehay theo Ipi tauto ma quen di ttach nhifm sic khde edng ddng.

5.3. Nhan thfre eua ngudi dan ve vf sinh ATTP con rat thap: - Do thdi quen sinh hogt, Im thuc lau ddi, khd thay dii. - Do chua dupe eung d p kiin thie VSATTP thudng xuySn.

85

III. KET LUAN VA DE XUAx GIAI PHAP CAN THIEP

1. KET LU^N Mue tieu cua nghien ciu nay nhim danh gia thuc trang kiin thic, thai dd, hanh

vi ye VSATTP cia ngudi dto tita Quing Nam va di xuit mdt sd giai phap thich hop nham ntog cap nhto thic cia ngudi dan vl VSATTP. Nghien eiu tiin hanh t i tbJng 6 nam 2009 din thtog 5 nam 2010, dupe thiit ki thep phuong phap chpn miu ngiu nhiin nhiSu giai dogn, cae ddi tupng dupe phdng vin bing bd cau hdi sogn sin kit hop vdi quan sat thuc t i . TSng ddi ttpng nghiSn ciu d 16 xa / phutag eua 3 huyfn (Nam Tra My, Nui Thtoh, Hifp Die) va thtoh phi Tam Ky la 1.430 ngudi, trong dd, 957 (66.9%) ntt va 473 (33.1%) nam, tuoi nhd nhit la 19, tudi Idn nhit la 75. Ty If ting ddi ttpng (cto bp quto ly, ngudi kinh doanh TP, ngudi sto xuit, chi biin TP, ngudi tieu dtag) Wong duong nhau (24.9%, 24.3%; 24.2% va 25,1%), ngoai ra cd 1.4% ngudi lam cdng tac TTGDSK tgi eae tuyen. Nhdm nghien cuu cd trinh dp van hoa chii yiu la d p 2 va eip 3 (87.1%). Nhtag ngudi SX, CBTP, kinh doanh TP cd 43.6% kham sie khde ding qui djnh (mdi kham <I2 thtog); 26.1%, ed kham nhimg da >12 thtog; cd dSn 30.4%, khdng kham sie khoS djnh ky. Dge bift ttong si hp ed 69.1%, dupe tgp huto kiin thie ve VSATTP, si cdn Igi 30.9%, chua dupe tap huin. Qua phto tieh, chtag tdi rit ra mdt sd kit luto sau:

1.1. THV'C TR^NG KIEN THtTC, THAI B p , HANH VI VE VSATTP CUA NGUCn DAN

l . I . l . Cong tac quan ly VSATTP cua chinh quyin, sg' phoi hgp cua cac ban, nganh, doan the tgi dia phuong eon nhiiu b i t e|ip:

- Cdn 7.0%o dja phuang chua thinh lap Ban chi dgo tap ttung tgi huyin mien nii. - Cd 9.3%) dja phuang khdng xay dtmg ki hoach boat ddng va ban hanh vto bto - Cdn 22.2% lanh dgo tta ldi khong cd hdi nghj triin khai va tong kit v i cdng tac

VSATTP. - Phuang thic ehi dgo khi cd xiy ra vu ngp ddc TP theo each: chi dao irte tiSp

chiim ty If cao 85.7%, tiip theo la bing vto bto 71.9% va cudi ctag la nhung phuang thic khie 8.4% (hpp, difn thoai).

- v l n cdn 14.3%, dja phuang khdng ed he thing loa trayin thanh nay, dge bift la eae dja phuang ving tmng du va miSn nil

- Vln cdn 15.7% dja phuong khdng td chic tuyen trayin lln nao.

1.1.2. Ngudi SX, CBTP: - Cdn thiiu kiin thie: Chi cd 1.2% ngudi sto xuat, chS biSn TP tta Id; day d i danh

muc 6 benh ttuyin nhilm khi mic khdng dupe tham gia siti xuat hay ehS biSn TP; chi cd 13.5% ngudi SX, CBTP cd kiin thic bao quto tit TP diy di; khdng cd ngudi SX, CBTP tta Idi dtog, d i v i thue hanh tit vf sinh ea nhto; khdng ed ngudi SX, CBTP cd kiin thic vi thirc hanh luu thing TP ding va di; chi cd 11.5% tta Idi ding, d i 6 thdi diim cin r ia tay di dam bao VSATTP.

- Thai do hanh vi v i VSATTP cdn nhiSu batcap: khdng mgc ttang phuc rieng (28%); Cd 8.9% ngudi chua cit ngin mdng tay; vln cd 26.8% ngudi cdn deo trang sic; cdn 5.2% chi r i a tay bing nude sach khing dung xi phdng, cd 0.3% ngudi ding nude da dtag di r i a tay.

86

1.1.3. NguM kinh doanh TP - KiSn thie cdn yeu; khdng cd ngudi kinh doanh TP nao tra Idi ding toan bp

oac nOi dung vS thvrc hanh tdt ve sinh ea nhto; ehi cd 0.6% ngudi kinh doanh TP tra ldi ding toto bp cic qui djnh ghi ttSn nhan, mac cac TP bao gdi sin; chi ed 25% sd ngudi tta Idi ding 4 diiu kifn TP cd thi bin dupe.

- Cdn nhilu bit cap trong thuc hanh nhu cd din 56.6% ngudi kinh doanh khdng bay thic to ttSn eao > 60cm; khdng cd mpt ngudi kinh doanh TP nao thuc hien rua tay ca 6 thdi diSm theo qui djnh; ctag cdn 8% chi ria tay vdi nude sgch, 0.6% ria tay vdi nude da dung rdi; chi cd 4.6%, ngudi kinh doanh TP tra Idi diy du cac npi dung kiim tta khi mua nguySn lifu.

1.1.4. Ngudi tieu dung

- KiSn thic vS VSATTP rat thiiu: khong biit cac nguySn nhto gay ngp ddc TP (91,9%); Chi cd < 5%, ngudi tiSu ding biit chpn cae logi rau, ei, qua; thjt; ca; TP bao gdi sin dam bao VSATTP; cd 37,3% ngudi tiSu dung biit du 3 diu hifu cia TP khdng nSn dtog.

- Thai dp, hanh vi ve VSATTP ehua dam bap: cd 98,1%, ngudi tiSu ding biit dl rieng TP sdng v i chin; cdn 16.7%, ngudi tiSu ding da dtag dao thdt chung cho TP sdng va chin; cCd 24.8%, ngudi tiSu ding chuin bj thic to trade 2 gid; cd 7,0% ngudi tiSu dtag ding thing dvmg rac thai bd nhung khdng cd nip day va khdng cd thing dimg rac chiem 15,3%.

1.1.5. Thu-e trang hoat dgng TTGDSK vi VSATTP Cong tac xay dimg kS hogch hogt dpng TTGDSK vl VSATTP da thuc hifn

nhtag chua dtag qui ttita, chua dupe cac cap chinh quySn phe duyet Ba hinh thic dupe cic td TTGDSK thuc hifn la: ndi chuySn sic khoe, thio luto

nhdm, phat thanh. Chi cd 30% t i TTGDSK thanh lap ban tin vl cdng tae VSATTP.

1.2. NGUYEN NHAN CUA TINH TRANG THIEU KIEN THtTC, CHUA CO THAI BO, HANH VI TOT CUA NGUCji DAN

1.2.1. Cong tac quan Iy chua ding bg - v i t i chic bp miy quto ly chit lupng VSATTP; hf thdng td chic quto ly

chua thing nhit va chua du manh tt ttung uong tdi co sd, cung vdi dd, cac vto bto quy phgm phap luat cdn thiiu chi tiit trong hutag din x i ly vi pham. Luc lupng thanh tta ehuySn nganh, he thing kilm tra xet nghifm via ySu, via thiiu ve nhto luc va teang thiSt bj.

- v i chic ntog quan Iy: ca ba chic nang co bto cia cdng tie quto ly chat lupng VSATTP la lap ki hogch, t i chic, phto edng thue hiin ki hogch va giam sat, kiim tta cdng tac thuc hien ki hogch ehua dupe teiin khai mit each khoa hpc, day di va ehua xuit phat tt dilu kiin thuc t l

- Cdng tac ttyin trayin giao dge eho ngudi dto vS VSATTP ehua dupe quan

tam ding mic. • , j < - Diu tt cho cdng tac quto Ij? an toto vi sinh thvrc pham cdn rat thap.

1.2.2. 'V thfrc trach nhifm ve vife bao dam an toan vf sinh thyre pham cua ngudi SX, CBTP; kinh doanh TP ehua eao

- Khdng chip hanh cae qui djnh eua nha nude nhu khdng tham gia tgp huto, khdng kham sic khde djnh ky.

87

- Khdng thvrc hien cic qui djnh vi diiu kifn co sd vat chit, diiu kien ve sita. - Khdng cd y thic trong vifc dam bao vS sinh trong qua trinh san xuit, chi biin

va kinh doanh TP...

- BSn canh dd, md hinh sto xuit, chi biin TP cia nhiiu eo sd, doanh nghiSp ttong nude vto manh min va thd so, nhiiu khi chi vi ehay theo loi nhuan ma quen di ttach nhiem sie khde cpng ddng.

1.2.3. Nhan thfre cua ngudi dan ve vf sinh ATTP cdn rat thip - Do thdi quen sinh hogt, Im thvrc lau ddi, khd thay dii. - Do chua dupe eung cip kiin thic VSATTP thutag xuyen.

2. BE XUAT GIAI PHAP CAN THIf P

Qua kSt qua nghien ciu thai dp, kiin thic, htoh vi vi VSATTP cia ngudi dan tinh Qutog Nam chtag tdi thiy hp thiiu ca kiin thic va khing chip hanh cac quy djnh vi vf sita ca nhto dam bao VSATTP theo tieu chuin cia Bd y ti. DS nang cao kiSn thie, hinh thtoh cic hanh vi tot talm dam bao ehlt lupng VSATTP chung tdi di xuat mf t sd giai phap sau:

2.1. Dii vdi cac cap chinh quyen, ban, nganh, doin the 2.1.1. CSn hodn Ihifn hf thing van bin chi dgo, vdn bin phap lugt vi quin ly

chit lupng an lodn vf sinh TP - Be nghj Ban Chap htoh Trang uong Dtog cd nghi quyit chuyen di v i

VSATTP. - Ban hanh Lu$t VSATTP thay cho Phap ISta VSATTP da khong cdn phi hpp va

khdng d i mgnh. - Hoto thien hf thdng vto bto tieu chuin va quy ehuin ve chit lupng, ve sinh, an

toto TP. 2.1.2. Cdng cd he Ihdng to chuc qudn ly chat luang VSATTP

- Cing cd v i doi mdi phuang thie boat ddng cia Ban chi dao Lien nganh vi VSATTP eae cap tt Tnmg uong dSn xa, phutag, thj trin. Phto rd trach taiem eu thi cia cic nganh liin quan, nhu sau:

+ Ngata y ti: Chju ttach nhifm ehinh ttong vife phdi hpp vdi cac ngata, cac td ehic chinh trj, xa hdi, cae Co quan thdng tin dgi ching, chi dgo ttiin khai thvrc hien v i duy tti cac kit qua hogt dpng cia "Thtog hi ta dpng vi chat lupng VSATTP". Hutag din xay dvmg ki hpgch hata ding, td chic KiSm tta va ttySn traySn, giao due vi chit lupng VSATTP, tdng kit, danh gia va bap cao kit qua eho UBND tinh va Bd Y ti . Phdi hpp vdi cac ban nganh lien quan xay dvmg kS hoach cong tac htog nam vl bao dam chit lupng VSATTP.

+ Sd Thdng tin va trayin thdng va eae co quan trayin thong dai chtog: cd ttaeh nhiem phd biin, giao dvic phap luat va kiin thic liSn quan den chat lupng VSATTP, nSu guong cae diin hinh tiSn tiin va phS phto cac tradng hop vi phgm vS sto xuit, chi biin va kinh doata eae mgt htog TP va dich vu an udng.

t- Cdng an Tmh: ehi dgo ivrc lupng cong an cac cap thutag xuySn phoi hpp vdi nganh y t i va eae nganh ehic ntog khae teong vifc kilm tta va x i Iy nghiem eae ehi eo sd sto xuit kmh doata TP v i djeh vvi to uong vi phgm cac quy djnh vl chit luong VSATTP.

+ Sd Cdng thuong: Chi dgo co quan quto ly thi tmtag chi dOng va phoi hop vdi nganh y t i kiim tta, x i ly nghifm vifc buon ban, luu thdng cac TP gia, TP khdng

dam bao chit luong, VSATTP, khdng thuc hifn hogc thuc hien khdng dung eae qui dmh ve bao bi, taan hifu TP. ' '

+ Sd Ndng nghifp va Phat triin Ndng thdn, Sd Thuy san va Sd Khoa hoc & Cong nghe, Sd Tai nguySn va Mdi tratag: TS chuc phdi hap sau rdng yeu ciu cac quy ttinh s i dung hda chat bio ve thue vat, thuie chuyen ngata, phan bdn hoa hoc, hoa chat kich thich ttog tratag... tdi ngudi s i dgng di bio dam an loan sic khoe cho ngudi tiiu ding.

^ + Cac ngtoh, eae don vi ed eo quan y ti phai ehi dao co quan y ti true thupc phoi hpp vdi to chuc y tS dja phuang trong vifc kiim tra, giam sat cac co sd san xuit chS bien, kita doanh TP ya djeh vg to uing trong cac don vj true thudc, ddng thdi hutag ing va tham gia triln khai "Thang htoh dpng vi chit lupng VSATTP".

_- Cto phai xay dung co chi phii hpp hogt dfng chat che, phto cdng trach nhiem eu thi cho ting nganh, cd su dan xen gitta cae edng doan di bao dam quan ly chit lupng VSATTP theo chudi TP nhu di xuit cua Uy ban Thutag vu Qude hSi. Cac co quan quto ly taa nude cin xay dgmg chuin quic gia vi xa, phutag dam bao VSATTP vdi nhttng tieu ehi eg thi, coi day la mpt tieu chuan di edng nhan la khu phi van hda. Chinh quySn co sd, cae to ehic ehinh ttj-xa hpi cd trich nhifm to chic thuc hien vdi svr hutag dto cia cic cp quan chuySn mdn.

Day taata tien dp thtoh l^p va tang cutag ntog luc hpat dpng cia Chi cue ATVSTP cac tinh thata phd.

- Thata lap va dua vao hogt ddng hf thing thanh tra ehuySn ngata vi VSATTP den cap quto, huyin.

Xay dvmg va chuin hda cac phdng kiim nghifm vi VSATTP dat chuin qude gia, khu vue va dan dat din tiSu chuin quic ti.

cae ban ngata ttong vai ttd, ttach taiem eua mita cto tham muu xay dvmg tatag chita sach thich hpp di dau tt, ap dung dupe taung each thic quto ly tien tiin tau GAP, HACCP ttong sto xuat, chi biin nong lam, thiy sto va TP.

Cto cd tattng che tai va sir giam sat chat che dS budc ngudi lam tai cac bip an tap thS phai tuto thi cic quy djta ve VSATTP. Trong khi lue lupng chuySn ngata cdn rat mdng thi chita quySn dja phuang can van dimg, quan tam huy ddng mpi luc luong hien cd de kiim tra. Idem soat boat dpng VSATTP ttSn dja bto mita quan ly.

Tang kita phi boat ding eho chuong ttinh muc tiSu quoc gia VSATTP vi kinh phi hifn nay cdn qua ban hep, hau nhu chua cd kinh phi cho tuyen co sd hoat dpng nen hifu qua.

Chi dao kjp thdi va thuc hifn xay dimg kl hogch hogt dpng cd su tham gia cia edng ding dl phi hpp vdi dilu kifn vi thuc trgng eua dja phuang

2.2. Vdi nganh y t i - c i n diy manh ban ntta cdng tac ttuyin thong giao due true tiip nhim ntog cao

tagn thic, ky ntog thvrc hata va ^ thic ttieh taiem cia cac co quan, td chic, ci tato vl VSATTP; ttog cudng ttySn trayin ttSn cac phuang tifn thong tin dai ehtog, cac thong tin phai hit s ic chinh xac dim bao dp tin cgy cao. Cin quy djnh chat che ttong viec qutog eao cac sto phim ttin cae phuang tifn thdng tm dai chung vi day la k i t a ttySn ttuyin cd tim ata hutag Ita, niu thong tin thiSu ehinh xac se khd khae phue.

Tham muu cho ban chi dao VSATTP cia tinh tang cutag edng tac giam sat, ttiin khai md hita diim vi VSATTP. Qua cic dpt thata tra, kiim tra cin cong khai kit qua thata tta, kiim tta di v ia giao dge, bilu duong, hoac cata bao cho ngudi tieu dtag va taa sto xuat.

89

- Tang cuong cdng tac quto ly chat lupng VSATTP, nang cao ty IS d p gily Chung nhgn d i diSu kien VSATTP dii vdi cic doanh nghiSp ed liSn quan din TP khuyen khich cae doanh nghifp eong bd tieu chuin sto phim TP theo quy dinh

- Ttog cutag cdng tac thanh tra vl VSATTP, qua dd phat hiSn x i ' ly cac sai pham, dua hogt dpng san xuat kinh doanh TP vao khudn khd phap luat.

- Quto ly tdt cac yiu td nguy eo TP gdp phin giam sd vu, sd'ngudi mle va s i ngudi t i vong do ngp dpe TP

2.3. Ngudi lam SX, CBTP; kinh doanh TP - Cto phii ttto thi cac quy djta cia tai nude di dam bap VSATTP. - Chju ttach iihifm vi san phim cia mita trade ngudi tieu ding va xa hpi.

Tham gia day d i cae buei tgp huin, trayin thing vi VSATTP. - Thuc hifn cae tiSu ehuin an tpan vf sita TP.

2.4. Ngudi dan

- De an toto, trade tien, mdi ngudi phai tir y thic dupe vifc bao vf sic khoe cua bto thto, nghiSm tie hon va xem lai each to udng cia mita.

- Thutag xuySn cap tagt kiin thic VSATTP thdng qua cac budi hutag din cia cto bp y ti , cic chuang ttinh hutag din VSATTP trSn eae phuang tiSn thdng tin dai ehtog, tai lifu, td roi, ip phich..

- Hgn che s i dung cic thie to bay bto tai dudng phd, chi mua d tattng noi dam bao vf smb.

LOU KET

Vto dS TP khong dam bao chat lupng VSATTP la nguySn taan ehi yiu din

den tattng thiet hgi khdng chi tita mang, sic khoe cung tau kita te cia ttag ngudi

hoac timg gia dita, ma cdn ata hutag dSn sic lao dpng cia toto xa hdi, i t a hutag

dSn uy tin htog hoa va lam giam kha ntog tiSu thu TP che bien t i ngudn nguyen lieu

ttong nude. Ching ta dilu biit, cic ci ging ntog cao chit lupng VSATTP, phdng

ngia ngd ddc do TP gay nSn da gdp phin thic diy sur phat triin kita ti, phic Ipi xa

hdi, s ic khde cpng ddng va cai thifn ehlt lupng cupc sdng. Chita vi vay, khi tien htoh

dl tai nay, khdng tattng giip ching tdi ttau ddi thim kiSn thie, kita nghifm khi tien

hanh dl tai nghiSn eiu khoa hpc trSn qui md toto tita, mi cdn giup chung tdi biet phat

huy hon cdng tae huy ddng su tham gia cia edng ddng ttong cac boat ddng nghien cuu

khoa hpc. Chtag tdi hy vpng kit qua nghien cim se giip cho taung taa hogch djta

chinh saeh cd ca sd khoa hpc trpng cdng tac xay dvmg kl hegch phi hpp vdi diiu kifn

thvrc tiln

Chu nhiSm de tai

/ • iVqcujwi Cth! O tm VaO

NHtnVG HINH ANH KHI THlTC HIEN DE TAI

XET DUYET DE CU'ONG

TAP H U A N THU T H ^ THONG TIN

MOT HI ()[ I'HONG VAN NGUOI TIEU DUNG

HOI THAO DANH GIA THV'C TRANG CONG TAC VSATTP

HOI THAO GOP V DE TAI

NGHIf M THU C A P CO SO

Phu luc 1

BANG CAU HOI PHONG VAN LANH DAO

Hp va ten: Tuii B t a v j : Chic i Dja diem: Ngiy phdng vin : Ngudi phdng vln :

Xin Ong (Ba) vui Idng cho biet mgt so thing tin sau:

TT

1.

2.

3.

4.

5.

6.

7.

8.

9.

Can hdi

Dja phuang ed ban ehi dao VSATTP

Dja phuang nam qua cd quyit djta, chi thi hoac cdng van ve VSATTP Cd hpi nghj ttiin khai va ting kSt vS eong tac VSATTP

Khi ed vu ngp die TP xay ra, dja phuang thutag chi dgo cdng tac dd bing (Cd thl chon taiSu cau). Cd kS hogch boat dpng VSATTP tai dia phuang khdng? Ong (ba) eho biSt hlta thic myen traySn nio cd hieu qua tai dja phuong mita? (Cd thi chon taiiu cau).

Theo a ta cac ban ngata ddan the nao da ddng vai trd quan trpng taiiu tail trong cdng tac VSATTP? (Cd thi chpn taieu cau).

Theo Ong (Ba) di thvrc hifn tdt cdng tae VSATTP dja phuong cin lam gi? (Cd thi chpn taiiu cau).

Theo Ong (Ba) di dam bao

Ma so cua cau tra ldi

l:Cd 2: Khdng

l:Cd 2: Khdng

l:Cd 2: Khong

1. Vto bto 2. True tiSp 3. Hita thic khac l.Cd 2. Khong

1 .Qua loa phit thanh xa. 2. Qua dai trayen hita 3. Qua bao ehi 4. Qua cac td roi, ttata ata 5. Hita thic khae 1. Hpi ndng dan 2. Doto thata nien 3. Hpi phu ntt 4. van hda thong tin 5. Hpi eho thap dd 6. Hpi evm chiin bita 7. Ngata giao due 9. Khac... 1. xay dvmg kS hogch hogt dpng cho ban chi dgo sat thuc 2. Thutag xuyin kilm tta, giam sat 3. TS chic taiiu hita thic tuyen trayen cho ngudi dan 4. Djta ky td chic so kit, tdng kit cing tac dam bao chit luong VSATTP 5. Khac

I. san xuit 2. Chi biin

Tra IM

10.

II .

12.

13.

VSATTP cto Iuu y t i khau nao? (Cd the chpn taieu eau).

Tren dja bto huyfn/xa ed he thdng loa truyin thata khdng? Vgy tuyen tuyin vl VSATTP eho nhto dto bao nhiSu lln/thtog?

Theo Ong ba ed cto tham gia tfp huin kiin thic VSATTP? cac thdng tin ve VSATTP ong ba

thutag tagn dupe tu nguon nao?

(Cd thl chpn nhiiu eau).

3. Bao quan, 4. Phan phii 5. Vto chuySn 6. S i dung 7. Khac 1. Cd 2. Khdng

1. llto 2. 2 - 3 lin 3. 4 - 6 lln 4. > 6 lin 5. Khdng cd lan nao 1. Cd 2. Khdng

1. Cac phuang tien thdng tin 2. Cto bp y te 3. Ban cham sde sie khoe 4. Khac (ghi rd)

14. Tgi dja phuang Ong Ba ed taiiu ngudi bto hang rong khdng? Dja phuong quto ly hp tau thS nao?

15. Theo Ong (ba) di lam tit cdng tac quto ly ngudi bto hang rong cto lam gi?

16. Theo Ong (ba) dl lam tit edng tac quan Iy chit luong VSA'TTP tai dja phuang d n phai lam gi? (cae gpi y khi cin: vl cac co sd san xuit, chi biin, kita daata TP, djeh vu to udng?; thata, kiim tta?; phdi hop ban ngata?)

17. Theo Ong (ba) di ntog cao kiin thic cho ngudi dto vi VSATTP eto lam gi?

cam on Ong (Ba) da eung cip cho ching tii tattng thdng tin tten.

Ngirtridirffc phong van Di4u tra viin

Xac nhSn cua ea quan chii tri de tai

BANGCAUHOI DANH CHO NGlTcn BAN THl/C PHAM

Phu luc so 2

HgvatSn: Tu6i.. Dia chi:

T T 1

2

3

4

5

7

8

9

10

11

Cau hoi

Trinh dp hpc vto

Thdi gian lam vifc tai ca sd

Co giay chtog nhto kham sic khoe djta ky cbo ngudi che bien. Bao nhieu lau dupe kham sic khoe dinh ky 1 lln. C6 gily chtog nhto da tham gia tfp huin kiin fliic VSATTP Di dam bao VSATTP cin ria tay khi nao. (C6 the chpn nhieu cau)

Ria tay btog

Lau khd tay sau khi ria btog

Thuc hata tit vf sita ca nhto (Co thl chpn nhieu cau)

cac thvic phim bao goi sto phai cd nhSii day di npi dung theo quy djnh. (C6 thS chpn nhif u cau)

Ma so ciia cau tra loi

l .Capl. 2. d p 2. 3. d p 3 4. Khac 1. < 1 nam 2. 1 - < 5 ntoi 3.5-<10ntoi 4. > 10 nam l.<12 thtog 2. > 12 thtog 3. Khong 1. 6 thtog 2. 1 nam 3. > 2 nam 4. Khong cto 1.C6 2. Khdng

1. Sau khi di ve sinh 2. Trudc khi tiip xuc vdi thuc phtoi 3. Sau khi sd vao toe, tai, mii hay cac bo phto

khac cua co the. 4. Sau khi xi mui 5. Sau khi hut thuoc la 6. Sau khi di rac hay tiep xuc vdi TP bi 6

nhiem. 1. Xa phong, nude sach 2. Nude sach 3. Nude da dtog (ria ly, ria chen....) 1. Gily lau 1 Ito 2. Khto sach 3. May thii kho 4. Chui vao tap dl 5. Lau vao quto ao dang mac 6. Khac: 1. Djnh ky htog nam kham sic khoe va cay phto 2. Tim ria, gpi diu trudc va sau khi di lam 3. Gitt mong tay ngin va sach se. 4. Ria tay dtog qui dinh 5. Co quin ao sach, mu chup toe khi tiep xiic

vdi TP 6. Btog vlt thuong tay bing gac khong tham

nude 7. BOidng tilp xuc vdi TP khi bj bfnh 8. Thao di trang sic khi tiip xuc vol TP 9. Khong dtog tay tiip xic true tiip vol TP 10. BChong ho, hit hoi, nhai keo,...tai khu che

bien. 1. Ten thitc phim 2. Ten, dia chi co sd sto xuat TP 3. Dinh lupng cua thue phirn 4. Chl tieu chit lupng chi yiu cua TP 5. Ngay SX, thdi hgn s i dung va bao quto TP

tra lii

12

13

14

15

16

17

18

19

20

21

22

23

24

Chi bto thuc pham

Di goi thuc phtoi cho khach dtog

Tnmg bay thge phim hoSc chia d kho tau bata kgo, mi ta liin d kf, gia, tu... phai Di thuc pham khong qud han s i dung cto phai

Nhung sto pham cdn hgn s i dung nhung bj hu hdng, bien chat thi C6 nen dtog hoa chat dl bao quto thgc phim khong Nguyen lifu thuc pham lay tu

Khi mua nguyen lifu eo kiem tra

Noi bto htog phai

Khi bay bto thit phai de tten bto cao bao taiSu cm Khi bto cac thic to chin co dung cu gap thic to cho khach htog Thutag nghe thong tin VSATTP d B^ ntog cao kiin thic VSATTP cto

6. Hudng dan bao quto, si dung TP 7. Xuat xu cua thuc phim 1. C6n han s i dgng 2. Khong mic, hu hong 3. Co nhto mac 4. Biet ro nguin goc 1. Giay bao 2. Bang la 3. Bao nylon sgch 4. Dung cu sach 5.Khac 1. Ching bui 2. Chong mua, 3. Chong ning 4. Ching con trmg 5.Cachtutog20cm 6. Cach nin 20 cm 1. Kiem tra han ding djnh l<y 2. sap xep thgc pham theo han diing 3 1. Be bto 2. Huy bo 3. Khong de y nhung van de do. 1.C6 2. Khong

l.Chp 2. Sieu thj 3. Ngudi cung cap thudng xuyen 1. Hgn dtog 2. Nguon goc 3. Hinh dang ben ngoai 4. Khac 1. Cao rao, thotog mat 2. Sach se 3. Khong CO moi, nhtog, con trtog... 1. Cach mat dat < 60cm 2. Cach mat dat > 60cm 1.C6 2. Khong

l.TiVi 2. Sach bao 3. Ban be 4. Dai phat thanh 5.Ctobpyte 1. Duac tap huto 2. Duac cung cap tai Heu 3. Co chuong trinh VSATTP tren tivi, dai phat thanh

Ngudi dug'c phong van DiSu tra vien

Co quan ehu tri de til

BANG CAU HOI DANH C H O NGir6l TIEU DUNG

Hp va ten: Tuoi. Dia chi:

..Nam .

TT

1.

2.

3.

4. 5.

6.

7.

8.

cau hoi

Trinh dp hpc vto

Nghe nghifp chita (taieu cau tta ldi deu dupe) Hoto canh gia dinh

Dto tpc Thuc pham co the gay ngp doc vi (Co thl chpn nhieu cau)

Chpn cac loai rau qua cto (Co thl chon nhilu cau) cac tieu chuto thjt ttoi (Co thl chpn taiiu cau)

Chpn ca phai (Cd thl chpn nhiSu cau)

Ma so cua cSu tra 151

i . d p i . 2. d p 2. 3. d p 3 4 Khac 1. Nong nghifp, lam ray 2. Cong nhan 3. Nhto vien vto phong 4. Buon bto 5. Thit nghifp 6. Khac (cu thl) 1. Ngh^o 2. Khong thuoc dien ngheo 3. D i t a 4. Khac (ghi ro) 1 Kinh 2 Khac (ghi ro) 1. Si dgng cac chat bao quto, phu gia thuc pham

khong cho phep hoac qua lieu luang quy dinh. 2. B^ thuc pham tilp xuc true tiep hoac gan noi 6

taiem. 3. De thic ta qua dem hoac qua 3 gid 6 nhiet dp

thutag, khong che day thic to de bui bto, cac loai con trtog gtoi nham, moi nhang va cac dpng vat khac tilp xuc gay 6 nhiem.

4. Khong ria tay trade khi chuin hi thuc phim, thic to. . ^ . .

5. Dtog chung dao, that hoac dl lln thuc phim song voi thuc ta chin.

6. Ria thuc phim, dung cu ta uing bing nude tailm bto.

7. Nlu thuc phim chua chin hoac khong dun soi lai tmdc khi ta. _

8. Dtog khto bin dl lau dgng cu an uing. 9. Ngudi chl biln thuc phim bi mac cac benh trayen

nhilm, ia ehay, nhilm trung d da... 1 Tuoi, 2. Khong bj dgp nat, 3. BOidng CO mau sic la 4. Khong co mui vi la

1. Mtog ngoai kho, 2. Mui va mau sSc binh thudng,

3. Khii thit rin chic, 4. Da khong c6 nhtog nit xuit huylt mau do tim 5. Ngon tay In vao thit tao thtoh vlt 15m nhung khdng de Igi diu vlt khi nhic ngon tay ra. 6. Thjt khdng dupe co lu trtog sto mau tetog nhd bing hat gao. l.Thto ca chic, khi dS len bto tay thto ca Ko thong xuing. ,

2. Mat ttong suit, giac mac dto hdi. 3. Mifng ngtoi ctag. 4 Mang mau dd tuai.

Tra 161

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

Chpn trtag (Cd the chon taiiu cau)

cac thuc pham dong hpp, dong goi sin phai CO tato ghi day di ndi dung: (Cd the chpn taiiu cau)

Khong s i dgng cac logi thge phim (C6 the chpn taiiu cau)

Thdi gian chuto bj trudc thic to

Bao quto thic to

Ria sach rau qua trudc khi nau, to Sau khi ria co cto ngam rau, qua khdng Cd dtog tt lata bao quto thuc phim Khi che bien va bao quto thuc phim thi Cach ria tay

Ve sita dgng cu ta uong

Dtog dao thdt chung cho TP sing va chin.

Noi ehi biln thie to, Ti dl chen, dia, phdng to

Thtog dvmg ric, thai bd

Ngudn nude dtog cho gia dita

5. vay ttai ong ata, dita chat vao thto. 6. Bgng binh thutag, hau mon thut sau va mau tring taat.

7. Kbi cat thiy thjt ca rin chic, dto hii, dinh chat vao xuong sing. 1. Vo trtog stog, Ichong c6 nhOng vfl xdm den, 2. Khong hi giap, vd. 3. Qua trtog c6 mau hong trong suit khi soi qua anh stog

1. Ten sto phtoi, 2. Trpng lupng, 3. cac thtoli phto chinli, 4. Cach bao quan, su dung, 5. Nai sto xuat chl biln, 6. Co si dtog ky san xuit 7. Cdn thdi gian s i dgng 1. Da bj hu hong, mic, nim... 2. C6 chat bao quto, pham mau cua tatog co sd khong dtog ky chit lupng. 3._ Cac thgc pham con nghi ngd, chua biet ro nguon gie.

l.<2gid 2. 2-4 gid 3. >4 gid

1. Che dfy btog vung, long bto 2. Tu kinh 3. Khong che day 1.1 lto 2. 2 lto 3. > 3 Ian

l.Cd 2. Khong

1.C6 2. Khong

1. De rieng TP sing va chin 2. De chung ca hai loai TP song va chin 1. Ria btog nude sach 2. Ria bing xa phong vdi nude sach 3. Ria dudi vol nude sgch, ehay liSn tuc 4. Lau bing khta kho, sgch hoac btog giay lau 1 lto 1. Ria btag xa phong (nude ria chen) va nuac sach 2. Chi ria btag nude 3. Chi ria btag nude ndng l.Cd 2. Khong

1. Sach, hpp ve sinh 2. KhSng hpp vf sinh 3. Cgta cong rata idpng 3.Catanaibuiban,o nhilm 1. Sach, km, c6 nSp dfy 2. Sach kin, khing eo nap 3. Rach, bin, rd ri 4. Khong ed thtog dvmg rdc 1. Nude may 2. Nude mua 3. Nude giing khota 4. Nude Gilng khoi

24.

25.

26.

C6 tham gia nghe noi chuyen vl VSATTP Thutag nghe thdng tin VSATTP d dau

De ntog cao kiln thic VSATTP cin

5. He thdng tu ehay

1. Tham gia 2. Khdng c6 thdi gian

l.TiVi 2. Sach bao 3. Ban be 4. Dai phat thanh 5. Ctobpyte 1. Cto dupe nghe n6i chuyfn ve VSATTP. 2. Dupe cung cap tai lifu 3. Co chuang trinh VSATTP tten tivi, dai phat thanh 4..Kh4c...

Ngu6i dugic phong van Dieu tra vien

Xac nhan cua CO quan chu tri de tai

Phu lue sd 4

BANG CAU HOI DANH CHO NGirOd B A N T H V C P H A M B A N RONG

Hp vaten: Xuii Dja chi;

T T 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

Can hoi

Trita dp hpc vto

Thdi gian di bto thirc pham

Cd giay ehtog tato kham sie khoe djta ky Bao taieu lau dupe kham sic khde dita ky 1 Ito. C6 gily chtog tato da tham gia tgp huan kiln thic VSATTP De dam bao VSATTP cto ria tay khi nao? (Cd thS chpn taieu cau)

Ria tay btog

Lau khd tay sau khi ria btog

Sau khi dta tien cho khach htog hoSe di chuyin phuang tifn vto chuyen thic ta (xe diy, xe dap, gata htog...) rdi lai bto diie to cho khach htog co ria lai tay khdng? Thuc hata tit vf sita ea tato (Cd thi chpn nhilu eSu)

Chi bto thvrc pham fC6 thi chon nhilu cau)

Ma so cua cau tra loi

l .Capl. 2. Cdp 2. 3. d p 3 4. Khac l .< lnam 2. l -<5nam 3. 5-<10nam 4. > 10 nam 1.<I2 thtog 2. > 12 thang 3. Khong 1. 6 thtog 2. 1 nam 3. > 2 ndm 4. Khong can 1.C6 2. Khong

1. Sau khi di ve sita 2. Tmdc khi tiep xuc vdi thuc pham 3. Sau khi sd vao toe, tai, mii hay cac bp phto khac cua co the. 4. Sau khi xi mui 5. Sau khi hut thuoc Id 6. Sau khi di rdc hay tiep xuc vdi TP bj 6 nhilm. 1. Xa phdng, nude sach 2. Nude sach 3. Nude da dtog (ria ly, ria chen....) 1. Gily lau 1 lln 2. Khta sach 3. Chui vao tap dl 4. Lau vao quto do dang mac 5.Khdc:

1.C6 2. Khong

1. Djta ky htog nam khdm sic khoe vd cay phto 2. Tim ria, gpi diu trade va sau khi di lam 3. Gitt mdng tay ngin va sach se. 4. Ria tay dtog qui djnh 5. Co quin ao sach, mu chup toe khi tiep xuc vdi

TP , 6. Btog vlt thuong tay bing gac khong tham

nude 7. Khong tilp xuc voi TP khi bi beta 8. Thao di tttag sic d tay khi tiep xic vdi TP 9. Khdng dtog tay tilp xuc ttuc tilp vdi TP 10. Khong ho, hit hoi, taai keo,...tai khu chi bien. 1. Cdn han s i dung 2. Khdng moc, hu hong 3. Co tato mac 4. Bilt ro nguin goc

Tra IM

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

Phuang ti?n v ^ chuydn thuc an (xe day, xe dap, ganh hang...) phM Rua dyng cu an, uong nhu (bat, chen, dua, thia...) nhu thd nao? Lau dyng cu dung thiic an bang De lay thiic an cho khach diing 0e goi thye pham cho khach diong

NguySn lifu thuc pham muatu Khi mua nguyen lieu can kiem tra nh&ng gi? (C6 the chpn nhieu cau) Cdc thye phSm bao g6i sSn phai CO nhan day du npi dung theo quy dinh. (Co thl chpn nhi^u cau)

Noi ban thiic an phai

Ncfi ban thiic an phai xa ngu6n 6 nhilm. (Co the chon nhieu cau) Co dung cu dyng chat thai khong Dung cy dung chat thai

Thuong nghe thong tin VSATTP Cf DS nang cao kiSn thiic VSATTP c k (Co the chon nhiSu cSu) Khi duoe moi di nghe noi chuydn (tap huan) vd VSATTP, Ong (Ba) c6 di khong?

1. Kin 2. Tranh dupfc con trung, ru6i... 3. Tranh dupe mua, nang 4. Tranh dupe bui

1. Riia bang nuoc sach 1 lin 2. Riia bang nuoc sach 2 lan 3. Riia bang nuoc sach 3 lin l.Khan 2. Giay sach 3. Giay bao 4. Khong lau 1. Tay true tiep 2.Tay co bao tay 3.Dyngcy de gap 1. Giay bao 2. La 3. Bao nylon sach 4. Dung cu sach 5.Khac l.Chp 2. Sieu thi 3. Nguoi cung cap thuong xuyen I.Han dimg 2. Nguon goc 3. Hinh dang ben ngoai 4.Khac... 1. Ten thye pham 2. Ten, dia chi co so san ximt TP 3. Dinh lupng cua thuc pham 4. Chi tieu chat luong chu yeu ciia TP 5. Ngay SX, thai han SD, thai han bao quan TP 6. Huong dan bao quan, huong din su dung TP 7. Xuat xu cua thuc pham 1. Cao rao > 60cm 2. Cao < 60cm 3. S ch se 4. Khong CO ruoi, nhang, con trimg... 1. C6ng ranh 2. Rac thai 3. C6ng trinh ve sinh 4. Noi bay ban gia cam, gia sue con song 1.C6 2. Khong

l.Kin 2. Co nap day 3. D6 di sau m6i lan ban hang rong. 1. Ti vi 2. Sach bao 3. Ban be 4. Dai phat thanh 5, Nhan vien Y te 1. Dupe nghe noi chuyen \k VSATTP. 2. Duoe cung cap tai lieu 3. Dupe tap huan 4 Co chuane trinh VSATTP tren tivi, dai PT 1.C6 2. Khong

Nguiri dupe didu tra Dieu tra vien

Cff quan chu tri de tai

Phu luc so 5

BANG QUAN SAT THlTC HIEN VE SINH VOl THlTC AN DITONG PHO

Hpvatto: Tuii.. Dja chi:

T T 1

2

3

4

5

6

7

8

9

10

11

HOAT BONG

Bao dam du nude sgch

Co dung cu ritog de gip thie ta chin, sing

Cd de lto thie to chin vdi thic ta sing

Ve sito nai chl bien thuc phim sach

Nai che biin thye pham cd each bift nguin 6 nhiem (cing, ranh, rac thai, cong trinh ve sinh, nai bay bto gia sue, gia ctoi...) Nhto vien c6 tap de, khau trang, mu khi bto htog Thic ta dupe bay bto tten gid cao tten 60 cm

Thic ta chin c6 dupe bdy bto ttong tu kinh

Thic ta CO dupe bao goi hop ve sinh

Ria tay va giS bto tay saeh ttong suit qua trinh chi bito, bto htog Co dung cu chia dung rac thai

CO KHONG GHI CHU

Bieu tra viSn

Xic nh^n cua co* quan chu tri de tai

Phu luc so 6

BANG CAU HOI DANH CHO NGlTcn SAN XUAT, CHE BIEN THU C PHAM

Hp vaten: Tuii.. Dja chi:

TT 1.

2.

3.

4.

5.

6.

8.

9.

10.

11.

12.

13.

14.

15.

16.

Cau hoi Trinh do hpc vto

Thoi gian lam vife tgi co si

Co giay ching toto khdm sic khoe djnh ky cho nguii Itoi djeh vu che bien. Bao nhieu lau dupe kham sic khoe dito ky 1 Ito. C6 giay chtog nhto da tham gia tap huan kiin thic VSATTP Nhung nguoi bj mdc cdc bfnh ndo khong dupe tham gia vao qud ttinh sto xuat hay che bien thuc phdm (Co the chpn nhieu cau)

Co dupe mac ttang ph\ic rieng khong khi chi sto xuat TP Mong tay cua nguoi sto xudt, che bien thuc pham cto Co dupe deo di ttang sire khi tiip xic true tiip vol thuc phdm. Co but thuie, hat hoi, nhai keo, khac nhi...khi tiip xuc vol thuc pham Cto ria tay khi nao (Co thl chpn nhieu cau)

Ria tay btog

Lau kho tay sau khi ria btog

Khi CO vit xuic 6 bto tay, ngon tay eto

Ca so sto xuit c6 nhd vf suih

Ma si cua eau tra 161 l.Capl. 2, Cap 2. 3. Cdp 3 4. Khdc l .<lnam 2. l -<5nam 3. 5-<10nam 4. > 10 ndm l.<12 thtog 2. > 12 thtog 3. Khdng

1. 6 thtog 2. 1 nam 3. > 2 nam 4. Khong cto 1.C6 2. Khong

1. Lao tien triin chua dupe dieu tri 2. Bfnh duong tieu hoa (Td, Ly, Th/hto...) 3. Viem gan vi nit (A va E) 4. Cdc benh ngoai da nhiem trtog 5. Viem duong ho hap cap tinh 6. Cdc chtog son ddi, son phto 7. Khdc 1.C6 2. Khong

1. Cat ngto, gitt sach 2. Khong cdn quan tam 1.C6 2. Khong

1.C6 2. Khong

1. Sau khi dive sinh 2. Tiep xuc voi thuc pham sing 3. Khi gai ngia, ngody tai 4. Khi dung vdo rdc, quto do 5. Khi hut thuoc 6. Truic khi chi biin thuc phim l.Xdphong, nuicsach 2. Nuac sgch 3. Nude da dtog (ria rau, ria chen....) 1. Giiy lau l l to 2. Khan 3. Chui vao tap di 4. Lau vdo quto do dang mac

1. Btog bo btog gac sach 2. Btog bo btog gac sach vd di gfag tay 3. Khong cin lam gl 1.C6 2. Khong

Trd lii

17.

20.

21.

22.

23.

'24.

Co s i sto xuat c6 phuong tifn ria tay vd khi trtog tay Bdo quto TP tit can (Co thi chpn nhiiu cdu)

Thuc hdnh tot luu thSng TP Id (Co thi chpn nhiiu cau)

Thuc hdnh tot vf sito ca nhto (C6 thi chpn nhiiu cdu)

1.C6 2. Khong

1. Luu gia trong khu vue, dung cu, trang bj chuyfn dtog (tu lanh, kho lanh,...) 2. pa dung bao goi khong thing, khong nhiem ban, ri ret...c6 nSp day 3. Bdo quto d nhiet dp an todn 4. Bdo ddm thM gian bdo qudn. 5. Khong dtog chat bao quto ngoai qui djnh 1. Dung trang thiet bj chuyen ding 2. Che dfy, bao gii TP an toto, trdnh lay

nhilm them vdo TP 3. Gitt nhift df an toto cho ting TP 4. Bao dam dtog thai gian vto chuyin. 5. Khong lam thay doi tinh chat cua TP

Co sa sto xuat CO giay chtog nhto "Thuc hanh ve sinh tit" Nhiing he thong quto ly chdt lupng VSATTP nao dang dupe dp dung tgi cac co so sto xuat, che bien thuc phdm hien nay' Htog nam co dupe tap huto ve VSATTP

1. Djnh ky htog nSm khdm sic khoe vd cay phto 2. Tdm ria, gpi ddu truoc vd sau khi Idm 3. Gitt m6ng tay ngta yd sach se. 4. Ria tay dtog qui djnh 5. C6 qudn do sgch, mu chup toe khi tiip xuc vai TP 6. Btog yit thuong tay bang gac khong thdm nuoc 7. Khong tiip xuc vol TP khi bi benh 8. Thdo do ttang sic khi tiip xuc vai TP 9. Khong dtog tay t. xuc true tiip voi TP 10. Khong ho, toai keo... tai khu ch. biin 1.C6 2. Khong 1. HACCP 3. GHP

2. GMP 4. Khac .

1.C6 2. Khong

Thuong nghe thong tin VSATTP a (Co the chpn nhieu eau)

l.Tivi 2. Sach bdo 3. Ban be 4. Ddi phdt thanh 5. Ctabpyti

De ntog eao kito thic VSATTP cto (Cd the chpn nhieu cau)

1. Dupe tgp huto 2. Cung cap tdi lifu 3. Co chuang tiinh VSATTP tiSn tivi, ddi phat thanh

NgvM dwffc dieu tra Dieu tra vien

Ctf quan chu tri de tai

Phu luc so 7

BANG CAU HOI DANH CHO NGirtn CHE BitN THl/C PHAM TAI BfiP AN TAP THE

Hp va tto: Tuii Dja chi eo quan: s i lupng nguoi to tii da/btta to:

TT 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

Cau hoi Trinh dp hpc vto

Thii gian lam vifc tai co si

Co giay chtog nhto khdm SK djnh ky cho nguoi che bien TP Bao nhieu Idu dupe khdm sic khie dinh ky 1 lan Htog ndm co dupe tap huto lai ve VSATTP Co so da dupe cap "Giiy chtog nhto CO so di dieu kifn ATVSTP" Co gidy chtog nhto da tham gia tap huin kien thic VSATTP Khi bi cam cum, tieu ehay co tham gia chi biin thuc phdm khong Nhtog nguoi bi mdc cdc benh ndo khong duac tham gia vao qud trinh sto xudt hay chi biin thuc phim (Co thi chpn nhieu cau)

Co mac ttang phuc rieng kbi cbS biin TP khong? Mong tay cia nguoi sto xuat thuc

Co deo do trtag sic 6 tay khi chi biin hogc tiip xuc vai tiiuc pham

Cto ria tay khi tmo (Co thi chpn nhiiu cdu)

Lau kho tay sau khi ria btog

Ria tay btog

Ma so cua cau tra loi l.Cdpl 2. Cap 2 3. Cap 3 4. Khdc l .<lnam 2. l -<5nam 3. 5-< 10 nam 4. > 10 nam l.<12 thtog 2. > 12 thtog 3. Khong 1. 6 thtag 2. 1 ndm 3. > 2 nam 4. Khong can 1.C6 2. Khong

1.C6 2. Khong 3.Khon|Jbiet 1.C6 2. Khong

1.C6 2. Khong

1. Lao chua dupe diiu trj. 2. Benh duong tieu hod (Td, Ly, Thuong hto...) 3. Viem gan vi rut (A vd E) 4. Cdc bfnh ngodi da nhiim tiing 5. Viem duong ho hdp cap tinh 6. Cdc chtog son ddi, s6n phto.

1.C6 2. Khong

1. cat ngto, giu sach 2. EChong cdn quan tdm 1.C6 2. Khong

1. Sau khi dive sinh 2. Tiip xuc vol thuc phdm s6ng 3. Khi gai ngia, ngody tai 4. Khi dung vdo rdc, di bdn, quto do 5. Khi hut thuie 6 Trucrc khi chi biin thuc phdm 1. Gidy lau Hto 2. Khta sach 3. Chui vao tap di 4. Lau vao quto ao dang mac

1. xa phdng, nucrc sgch 2. Nude sgch 3 Nude da dtog (riia rau, ria chen....)

Trd loi

16.

17.

18.

19.

20.

21. 22. 23.

24.

25.

Khi ria tay cto ria i vj tti ndo? (Co the chpn nhiiu eau)

Co so chi bien TP c6 nha vf sinh

Bdo quto TP tit eto phdi ldm gi? (Co the chpn nhieu cau)

Nguyen lieu thye phtoi mua t i

Khi mua nguyto lifu cto luu y nhttng gi? (Co the chpn toieu cdu)

C6 luu mau thuc pham khong? Mdu dupe luu ttong bao Idu? Thuc hdnh tit vf sinh ca nhto (Co the chpn nhieu cau)

Thuong nghe thdng tin VSATTP a (Co thi chon nhiiu cdu) Di ntog cao kito thic VSATTP cto (Co tiii chpn nhiiu cdu)

1. Gan bto tay 2. Mu ban tay 3. Ci tay 4. Khe ngon tay 5. Mong tay 6. Chi ria nhtog nai bto tten tay 1.C6 2. Khong

1. Luu giu trong khu vue, dung cu, ttang bi chuyen dtog (tu lanh, kho Ignh,...) 2. Do dung bao goi khong thtog, khong nhiem bta, ri ret.. .co nap day 3. Bdo quto a nhiet dp an toto 4. Bao dam thoi gian bdo quto 5. Khong dung chdt bdo quto ngodi qui djnh l.Chp 2. Sieu thj 3. Nguoi cung cap thuong xuyen 1. Han dtog 2. Nguon goc 3. Hinh dang ben ngoai 4. Khac 1.C6 2. Khong 1.4 gia 2. 12 gia 3. 24 gicr 1. Dinh ky htog nam kham sic khoe vd cay phto 2. Tdm ria, goi ddu truac vd sau khi di lam 3. Gitt m6ng tay ngto vd sach se. 4. Ria tay dtog qui dinh 5. Co qudn do sach, mu chup toe khi tiSp xuc voi TP 6. Btag yit thuong tay btog gac khong tham nuoc 7. Khong tiip xuc voi TP khi bi benh 8. Thdo di trang sic khi tiip xuc voi Tp 9. Khong dtog tay tiep xuc true tiip voiTP 10. Khong ho, hat hoi, nhai keo,... tgi khu che bi8n. l.Tivi 2. Sdeh bdo 3. Bail be 4. Ddi phdt tiianh 5. Ctabpyt i 1. Dupe tap huto 2. Dupe cung cdp tdi lieu 3. Co chuong tiinh VSATTP tten tivi, ddi phat thanh

Ngiroi Smfc dieu tra Di€u tra vien

Phu luc si 8

BANG THU THAP KET QUA HOAT DONG TTGDSK VE VE SINH AN TOAN THUC PHAM

Dorn vi: Huyfn: Nguoi eung cap thong tin: Dieu tra vien:

1. Xdy dung ki hoach hoat dpng TTGDSK ve VSATTP: Co CD Khong CD

2. Ki hoach do: cdp ttto dua xuing I I Tu xdy dung I 1

3. Nhtog ai tham gia xdy dung ke hogch hoat dpng TTGDSK vi VSATTP tai dia phuong:

Cto bp y ti CD Ban ehdm s6c sic khoe CD Nguoi dto CD

Nguoi khic (ghi cy the) 4. Ke hogch boat dpng TTGDSK ve VSATTP tgi dja phucmg dupe thong qua cac cap chinh quyen dia phuang

Co CZI Khong CZl Si Idn thong qua: lan/nam 5. Cdc hinh thic thuc hien truyin thong ttong nam qua

Noi chuyfn vi VSATTP EH Thdo luan nhom •

Qua loa phdt tiianh CD Qua tiuyin hinh CD Tuvin CD Bdo SKQN-TTYD CD

Khdc CD

6. Thdnh lap btag tin (si lupng): btog;

Tgi:

7. Diim tuyen tiuyin btog Video diem;

Tgi:

S.Sto xudt cdc phuang tien ti^yen thong:

Sit imptao tam. Si to-rai to. Si khdu hieu (btag

ron): cau.

9. Nhto bto cde tai lifu VSATTP: hto.

10. Phii hpp phat tiianh, tmyin hinh va cdc phuang phdp khac di TTGDSK ve VSATTP:

- Si lto phat tiianh: lin; Uie si nguoi nghe: nguoi

- Si lin ttuyin binh: lto; Uie si nguoi xem: nguoi

A Di u tra vien Nguin diTflfc phong van

Xac nh^n cua ca quan ehu tri d% tai

Phu luc s6 9

MOT s o QUI DINH LIEN QUAN DEN

VE SINH AN TOAN THUC P H A M

l."Qui dinh vi diiu kifn bao dim an toan thuc phim tai eae nha an, bip

^^^oVfnn?!"" '"• '* '^"'' ^'"'"^ '•'^ l*''" ^"^^ *» ««""' •''•'10 Quyit dinh si 4428/2001/QD-BYT ngiy 3/10/2001euaB9yti.

£)/•« (?ie/«, mdi Iru&ng

_ Chpn vj tri xay dung ca so sto xuit, chi biin thue pham ein xem xet cac nguon 6 nhiem tiem an anh hudng tii sto phim thuc phim. Khong dat co so tai noi ma sau khi xem xet cac bifn phap bao ve vto thiy con mii de doa dii vii ve sinh an toto thue pham.

a) Co so sto xuit thirc phim phai b i tri each xa

- Khu VUC c6 moittuong o nhiim va cac hoat dpng cpng nghiep, sinh hoat eo nhito kha ntog gay 6 nhiim thgre phdm.

- Khu vue di bj u nuie, ngap lut, t r i khi co bifn phap bao vf, phong ngia mpt cich huu hifu.

- Khu vue de bj sinh vat gay hai pha hoai; khu vue eo cac chit thai rto hay long ma khong the loai bo ching mit cich eo hiiu qua.

- Duong npi bp ttong eo so tiiuc phim phai dupe xay dung bap dam tieu ehuin vf sinh, CO cing ranh thoat nuac tit, khep kin, khong gay 6 nhiim, bao dam vf sinh.

Vj tri eo so cin bao dam c6 di nguon nuac sach, thuto tien vi giao thing.

b) Yiu eau thiit ke, bo tri nha xuong

- Khu vue sto xuat, che bien thuc pham phai dupe thiet ke theo quy tac mpt chiiu t i nguyto lieu dau vap cho dto san phim cuii cing di tranh 6 nhiim.

- Co su cich bift giia khu san xuat va khong sto xuat, giia cac khu tiep nhto nguyen lifu, sa chi, che bito, bao goi, kho hang, khu vf sinh, khu thay ttang phuc, khu nha to di ttanh 5 nhiim cheo.

- Kho ehia dung va bao quan thuc phim cia co so sto xuit, kinh doanh thue phim phai dupe thiit k i phi hpp vii ydu eau cia ting leal thuc pham va tranh su xam nhap cia con trtag, dpng vat gay hai.

- Thiit ki, b i tri nha xuong phai phi hpp voi eong nghf va chtog loai sto phim, phong ngia dupe su 6 nhiim cheo thuc phim gitta cic cong doan sto xuit etog nhu khi thao tac, ehi biin va x i ly thuc phim.

c) Kit ciu nha xuong

- Kho, xuong, thiit bi cin b i tti phi hpp va thuto Ipi chp qua trinh sto xuit, chi biin tiiire phim di ap dung cac bifn phap x i Iy ve sinh.

- Trin nha: stog miu, lam btog cae vgt lifu khong thim nuoc, khong ran nit, ttanh moc, dpng nuac va cac chat bto.

- Sto nha: stog mau, lam btog cac vjt lieu khong fliam nuac, di ep ria, khong tton, khong gay doc dii vii thvtc phim, di lau chii, khi tiling va thoat nuoc tit.

, u." ^"^S ^^ &°^ ' " , ^ g nha: tuang phai phlng, cac goc nha phai lam Iron, stog mau, khong gay 6 nhiem doi vol thue phim, khong thim nuac, di cp r ia va khi tring.

^ - Cia ra vio: nhto, khong thim nuic, tit nhit la ty dpng dpng, m i va dong kin. Doi vdn eae ea so san xuat thue phim bao goi sin, thue phim dong hop phai thiit ki chi di nuoc sat tiring dtag ngam ing truac khi vio va ra.

- Cia so: phai de lau chii, dupe thiit ki sap ehp ban ehi bdm bui tii mie thip nhat. 0 nhing nai cto fliiit phai cp luai bao vf trtoh su xam nhap cia eon tring va dpng vat; luoi phai thuto tien cho vife lam vf sinh thuong xuyen.

- cae bi mat tiip xic true tiip vii tiiue phim: phai bin ving, di lau ehii, di duy til, bao duOng va tay trtag. Phai dupe lam btog cdc vat lifu nhto, khong thim nuoc, khing 6 nhiim ra thuc phim, khong hi bao min bii cae chit tly ria, tly trung trong nhiing diiu kifn binh thuong.

d) Hf thong thong gii:

- Hf tiling thing gi6 phi hpp vii dac thi sto xuit, kinh doanh cia co si , di phong ngia, ban chi den mic toi thiiu nguy eo 6 nhiim thue phim do khong khi hay nude ngung tu.

_ - Huong cia hf thong thong gii phii bao dam gio khong dupe thii t i khu vue nhiim bto sang khu vue sach.

- Hf thong thong gio phii dupe thiit ki an toto, di bao duong va kiim tta, eo ludi bao vi btog cae vat lifu khong gi, de thao roi de lam ve sinh.

e) Hf thong chiiu sang:

- Cto cung cap d i inh stog (khong dual 200 lux) tu nhien hay nhto tao de co the tien hanh thao tae dupe di dang. Cupng dp anh sang phai phi hop vii tinh chat thao tic.

- Nguin stog ein dupe che chto an toto di ttanh bj v8 va bao dam trong trudng hpp vo, cac manh vo khong rai vao thvrc pham.

g) Dung cu ehia chit thai va v$t phim khong ta dupe:

- Phai dupe lam btog vft lieu It bj hu hpng, bao dam kin, co nip ddy, tranh sur xam nhap cia dpng vat va dugc dpn ria thudng xuyin.

- D6 chia cic chit nguy hiim phai dupe thiit ki dac bift, de phto biet de ttanh nhim lin khi dtag, khi ein c6 thi khoa di ttanh su taiim bin thirc phim do ci y hay voy.

h) Hf thing cung d p nuae

- Hf thing cung eip nude phai diy d i va eo eae phuang tien di luu tru, phaii phii nuac, kiim soat nhift dp di bap dam tinh an toto va phi hop ttong sto xuit, chi biin thvre phim.

- Nuac s i dimg cho chi biin thvrc phim phai sach va khong chia cac chit o nhilm khac, bao dam tito ehuin vf smh an toto nuoc di uong va sinh boat theo quy djnh cia BO Y ti .

- Co sif sto xuat phai co day di nuac s^ch, du ip luc cung cap cho qua trinh lam sach, chi biin thuc phim. Thiit bj chia nuic phai dupe thiit ki phi hop cho vifc du hU va s i dung hpp ve sinh.

- Neu s i dving nuae hii luu, phdi x i ly vd duy tri sao cho bdo dam an loan, khong gay 6 nhiem thuc phim. Qua ttinh x i ly phdi dupe kiim spat bing cae bifn phip huu hifu.

i) Hf thing eung cip nuoc da

Nuac da ding cho to uing vi bao quto thyre pham phai dupe sto xuat t i nguon nuac sach va phai dupe bap quto, van chuyen hpp vf sinh theo quy djnh cia Bp Y ti.

k) Hf thing x i ly chit thai

- Hf thong thoat nuae va phuang tifn do chat thai phai dupe thiet ke vd bi tri hpp ly de ttdnh dupe moi nguy gay nhiem ban cho thye pham hay lam o nhiem nguon cung cap nuic sach dung d^ chi bien thue pham.

-Thiit ke c ia rieng biet de liy cac chdt thai, rac.

m) Phong thay bao hp lao dpng

Co phong riing bift, thiit ki hpp ly di nhan vito thay trang phue bae ho lao dpng truae khi vao lam vifc.

n) Nha vi sinh

- He thing nha ve sinh phai diy di, dupe b i tti cr eie vj tri thuan tien cho tit ca mpi nguoi trong ea s i va co diy di thiit bj bao dam vf sinh. Trung binh tii thieu 25 nguoi phai c6 01 nha ve sinh.

- Khu VUC vf sinh phai co he thing chiiu sang va hf thing th6ng gio, he thong tiioat nuoc di dtog loai bo chit tiiai va Mo dam ve sinh. Nha vf sinh phai dupe xay dvmg sao cho huong gio ehinh khong thii t i khu virc nha vf sita sang khu virc che biin, bio quan va bay bto thuc pham.

- Khu vue ve sinh phai each ly hoto toto va ma cia khong dupe huong vao khu VUC ehi biin, bio quan thuc phim va phai eo bin r ia tiiy; cd bang chi dto "Riatay sau khi ra khdi nhi ve sinh" dat d vj tri di nhin ngay sau khi md cia ra khoi cho ve sinh.

2. Dieu kifn trang thiit bj, dung cu:

- Trang thiit bi, dung cu tiip xuc vdi thuc phim phii dupe tiiiit ke va chi tao an tPto, phi hgp vdi yeu elu cia san phim, di lam sach, tly tiding va bap duong.

- Phai dupe lam bang vat lieu khong gay dpe hay gay 6 taiim sto phim. Trong ttudng hgp ein thiit phai bin, di di ehuyin, tiiao lap de bao dudng, lam sach, lay tttag, giam sat cac mdi nguy vi vf sita an toan thuc pham.

Phuang tifn r ia v i khi trung tay

Cd diy d i eie tiiiit bi r ia tay vi khi trtag tay d cic vj tri tiiuto tien ttong

khu vvrc chi biin thvtc pham.

Nai r i a tay phai cung eip diy di nude saeh, x i phdng, khan lau tay s i dung

mit lln hay may sly khd tay.

Trung binh toi thiiu 50 edng tato phai cd mdt bin r ia tay va it talt 1 phto xudng phai cd mpt bin r ia tay.

- Nude sit tring

• cac chat ding di tly r ia vi sat tring dung cu chia dung thuc phim phdi dupe dvmg trong bao bi dl tato biit vi cd hutag din s i dung phi hpp vdi dac diim ky thuat.

• cac chit tly r ia phii di each bift vdi noi chi biin, bao quan thuc phim.

. Chi s i dyng chit tly rua dyng ey chia dvmg thue phim va ehlt tly tring dupe Bp Y t i cho phip.

- Thiit bj phdng chdng con tiling, dpng vft gay hai

Phai s i dving eie v^t lifu khong gi, dl thdo rdi di lam vf sinh, thiit ki phu hpp bap dam phdng chdng hiiu qui cin tiling va df ng vat gay hai.

- Thiit bj, dvmg cu giam sat ehlt lupng

Ngoai nhttng y6u eau chung, thiit bj dung di dun, x i ly nhift, lim ngupi, luu gitt hay lam ddng l mh thue phim phai dupe thiit ki di lam sap nhata chdng dat dupe nhift dp theo yeu cau cia thvrc pham taam bao dam tita an toan va phi hop cia thue pham va de duy tti taif t dp dd.

- Thiet bj phai dupe thiit k i di cd thi giam sat, kiem soat dupe nhift dp. 6 nhung noi cto thiit, phai ed phuong tifn de kiim soat, giam sat dp am khdng khi, ddng khi va bit kp thong so nao khac toh hudng tdi tita an todn, phu hpp cia thuc phim.

- Thiit bj, dvmg eu ehi biin, bae gdi, bdp quto, van ehuyin

. Phai dupe lam t i nguyen lifu khdng dde, khdng gay mii vj la so vdi mii vj cia thuc phim ban diu, khdng hip thu, khdng i nhilm vio thue pham, khdng bj to mdn, tttah bui, edn tring vi cae nguon o taiim khde.

- Vifc s i dung cdc vat lifu bao gdi mdi diu phai dupe Bp Y te thdm djta va cho phep.

. Nghi6m elm vife ddng gdi thuc phim btog cac bao gdi ed nguy ca gay ngp ddc, gay hai, khdng bao dam chit lupng va an toto fliue pham.

. Bao quto va vto chuyin fliuc phim phai bao ddm an toto, phi hgp vdi dae diim cia timg logi thvre pham.

3. Diiu kifn con ngiroi

Theo Quyit dmh sd 2I/2007/Qe-BYT ngdy 12/3/2007 ban hata "Qui djta v i diiu kiin s ic khoe dii vdi taOng ngudi tiip xic ttvic tiip ttong (jui tiita chi biin tiiire phim bao gdi sin v i kita doata thvrc pham to ngay" cia B i Y t i [12]

- Kiin thic vi vf sita an toto thvrc phim cia ngudi sto xuit, kita doata tiiutc

phim Ngudi tham gia true tiip vio sto xuit, chi biin, kita doata flivrc phim phai hpc

tap kiin thic v i vf sita an toto thue phim theo quy djta va ed Giay ching tafn da

tham dir tap huto kiin thic vi vf sita an toin thue phim do ea quan ed thim quyin cap, htog nam phai hpc tap bd sung va efp taat kiin thic.

- Sic khp^ cia ngudi sdn xuit, kinh dpanh thvrc phim

. Ngudi tham gia trac tiip vio sdn xuit, kinh doata thuc phim phai cd Gily ching tato d i dito kifn s ie khoi theo quy djta cia Bp Y ti.

. Kham sic khoe va cay phto tim ngudi Itoh mang tring trudc khi tuyin dung vi djta ky it taat 1 nam/lln.

. Nhttng ngudi dang bj mic cac bfnh taiim tring thudc danh muc da dupe Bd Y tS guy djta khong dupe tham gia true tiip vao qua trinh san xuit hay ehi biin thvrc pham (Lao, Kiit Iy, Thuong hto, ia ehay, Td, Myn tapt, Sdn dai, Sdn phdn, Viem gan siiu vi tiiing, Viem mui, Viem hpng mi, eie bfnh ngoai da, cac bfnh da lilu, tathig ngudi Itoh mang vi khuln gay bfnh dudng nipt).

. Viec kham sie khde phai dugc thye hifn d cac co quan y t i t i eip quto> huyen ttd Ien.

- Thye htoh vf sinh cia ngudi sto xuat, kinh doata thye phim

• Nhihig ngudi tham gia true tiep vdo sto xudt, chi biin va kita doata thye pham phai thye hifn eae yeu cau sau:

• Mac ttang phyc ritog khi ehi biin hoae ban thye phim. Ngoai ra, tattng trudng hpp eto thiit phai dpi mu va di gtog tay hay dep khlu ttang saeh.

. Giu mdng tay ngin, saeh se va khing deo di ttang sie khi tiep xuc true tiep vdi thye pham to ngay.

. Khdng to udng ttong khu vye sto xuat thye pham.

. Khong hit thuie, khac tai, hat hai hay ho, nhai keo, cudi ndi to, deo di trang sic, ddng hd hay cic vat khac khi tiep xic vdi thye phim chua dupe bde vf an toto.

. Ngudi true tiip sto xuit thue phim diu phdi chip hata "thue hata vi sita bto tay tdt":

Ria tay sau khi: Di vf sita, tiip xic vdi thye phim song, xi mui, dyng lay vao rac, gai ngia, ngoiy tai, ngoay mui hoac dung tay vao cac bp phto cia co the, quto ap, hut thuie, dung tay vao sic vat sau mdi Ito nghi.

Ria tay trudc khi chi biin, tiip xic vdi thye pham.

Lau khd tay sau khi r ia bing khto gily dtog mdt lln, khto bdng sach hoac may flidi khd, khdng chii vio quin ao, vay, tgp di.

R ia tay ky btog xa phdng va nude sach (ca gan bto tay, mu tay, ed tay, ede khe ngdn tay va cac nip mdng tay).

Khdng di mdng tay dai, niu cd vit xude d bto tay va ngdn tay thi ein dupe btog bd bang gac khdng thim nude va di gtog tay khi tiip xic vdi fliue pham.

Cac ca sd sto xuit thuc phim tiiyc hifn du cae diiu kifn niu tai quy djta nay ttong hai nam lifn tac ttd Iin cd flii di nghj ca quan y t i ed flilm quyin ching taan "Thye hata vf sita tdt". Gily ching tafn fliue hata vi sita tdt ed gia ttj hai nam ke t i ngay ky.

Phy lyc sd 10

N H C X G Dri:U CAM LAM DE CO Bf A AN NGON

1.1.5.1. Chpn TP bao ddm dinh du&ng, vf sinh vd an lodn * Chpn cic loai rau qua tuai, khong bj dap ndt, khdng cd mau sic, mii vj la. * Chon cic lo^ phi tgng, thjt vi thiy sto cdn tuoi: - Cae tiiu chuan thjt tuai tau: mtog ngoii khd, khdng bj tadt, mui va mau sic

bmh thudng, khdi thjt rto chle, ed df dto hoi cao, ngdn tay In vao thjt tgo fliata vit lom taung khong de lai diu vit khi taac ngdn tay ra. MO Ign mau tring, bi khdng cd taitng lam chim xuat huyit mau dd tim, ta<i xuang trong, bam ch t vao thata ing xuong va khong ed mii di. Can ehu j kiim tta phan thjt n?e va ludi khdng dugc ed lu triing sto mau ttlng tad btog h it ggo.

- Phi tgng: tim phdi ed mau hong tuoi, chle, khdng ed ehim xuat huyit d vata tun va mtog ttong tim. Gan bita thudng ed mau tim hing, bi mdt mjn, thuy gan mim, khdng cd tattng nit hogi hjr mdu tring hoae vtog. Biu dye mdu tim hong, khdng cd ndt hoid ti.

- Cd: chpn ci dang sing hay via mdi chit nhtmg van dat cdc tiiu chuin ca tuoi tau:

+ Thto ca co cing, khi di ci Ito bto tay thto ca khdng thdng xudng.

+ Mat ttong suit, giac mgc dto hii. + Mifng ngfm cirng. + Mang mau dd tuoi, dto chat xudng hoa khi. + vay tuai dng ata, dita chat vao thto. + Byng bita thudng, hf u mdn thyt sau va mau tring tagt. + Thjt rln chic, cd dto hdi, dmh chat vao xuong sing. - cac lo^ fliiy sto khac: phai cdn tuai, gitt mau sic bhih fliudng, khdng cd mii

uon hdi. * Chpn ttTJmg: vd tiling miu stog, khdng cd taung

vft xdm den, khdng bj giap. Qua tiling cd mau hdng ttong suit khi soi qua ata stog.

* cac TP ddng hpp, ddng gdi sin phai ed tato ghi diy du npi dung: ten sto phim, ttpng lupng, cac fliata phin chuih, cdch bao quto, si dyng, nai sto xuat che Win, cd so dtog ky sto xuit va cdn flidi hgn si dvmg.

* Khdng si dyng cic logi TP khd da bj mde, dac bift la ede logi ngii cdc, hgt cd dau tau dfu, Igc mde cd chia ddc td vi nam rit nguy hiem. . , , s^ - i i . -

' • Khdns si dyng cac chit bao quto, phim mau, duong hda hpc, ddng goi khong cd tato hoac gdi btog gily bto le d ehp va tattng eo sd khong dtog ky de che bien T P ' X k

' * Kh6ng su dyng cac TP con nghi ng6r, chua biet r6 nguon goc.

1.1.5.2. Diing nir&c sgch, an lodn de chi biin thUc dn do uSng vd rira dgng eg:

- Si dyng nude miy, nude giing, nude mua, sing sudi... da qua xi ly hojc ling Ipc.

- Nude pMi ttong, khdng mau, khdng mii, khdng V) Ig. Nfu ngudn nude ed nghi ngd nin di nghj ca quan y ti kiem tta.

- Dyng cy chia nude phii bao dam sgch, khdng chia cac chat gay dpe tau kim logi, phy gia, mau, mii vao nude, khdng dupe cd rto bin bdm xung quata hpjc d day, cd nip dgy kin, di eg ria vi nto cd vdi di lly nude.

Dtag nude da dun sii di u6ng hpje dtog pha ehi nude giai khat, lam kem, nude da.

- Bita dvmg nude uing phai bing vgt lifu ehuyto dtag chia dvmg TP theo quy djta cia ngata y ti, ria sgch htog ngay va trtog Igi bing nude sdi. Tuyft ddi khdng dtog cde chto muc nude hojc udng tryc tiip vio bita dimg nude udng.

1.1.5.3. sa dgng cdc dd diing n&u nu&ng vd dn uong sgch si - Si dyng cac dyng cy nlu nudng, to udng saeh va

bang vgt lifu thich hgp da dugc ngata y ti cho ph^p. Cin than vdi cac dd thuy tita pha le, sata si, sit tttog men miu sic sjc sd, ddng, tadm gia cdng, taya tai sita ed mau vi chtag cd thi ehia kim loai njng gay die tau chl... hoae phy gia ed mii la khi tiip xic vdi cic TP Idng tfaih a xit, rugu, eon, va diu md.

- Khdng di cac dyng eu bto qua d6m. - Thic to edn thia, TP tiiii bd phai dugc dung vao

flitog kui ed nip dgy va chuyin di htog ngay, ttata nidi taang.

- Bat dia phai dugc nia sach ngay sau khi to xong va ip vio gia khd rao, ttata byi bin.

- Dvmg cy tiip xic vdi TP song, chin ritog bift. ^ - Khdng si dyng cac dyng ey to uong da bj rach, xude, sit me, moc bto hoac

hoenri. , , . . • . t i • - Niu bat dia via nia xong cto dtag ngay flii tdt taat nen ttang Igi btog nuoc

sdi Khdng dtog khto am mdc, tadn md di lau khi bat dia. - Khdng dtog cae chit tly ui, chit sat tiling vf smh taa cia hoac xa phong giat

di ria dyng cy an udng. 1.1.5.4. ChuHnbiTP sgch si vd n&u chin kp - Lya chpn phin to dugc, loai bd cdc vgt Ig Ito vao TP tau sgn, xuang, mata

kim loai thuy tita, Idng tdc... , . , . , , > - i • - Rau qua phii ria ky dudi vdi nude ehay hoae fliay nude ma 3-4 lan, cac logi

qua'^^l^tj^achv .^^^^^^^_, ^^^^^^^^^^^^^^^^^^^^^^^^yjj^y

biin, nlu nudng.

- Cd taieu logi TP tuoi sdng tau thjt, ea, tiling, stta dl bj d taiim bdi vi sita vgt gay bfta. Nlu chin ky se tieu dift dupe eae mim gay bfta taimg TP phai dat taift dO sdi dong diu, tiy theo tinig logi TP mi thdi gian dun nlu khac taau.

- Chu y phan thjt gto vdi xuong (ga, vit, chto gid, ca ...) niu flily edn ed mau hdng hojc mau dd thi bit bupe phai dun lai din khi chin hpto loan.

1.1.5.5. An ngay khi Ihirc dn vita niu chin xong Thic to chin de ngufi d taift dp bmh thudng thi vi khuln di xam tagp va phat

trien. Thdi gian de etog lau, vi khuln phat ttiin etog taiiu. Di bao dam an toto nen to khi thic to cdn ndng, via nlu chin xong.

- Ddi vdi eae TP khdng cto nlu chin tau chudi, cam, dua va eae logi qua khac thi cto to ngay khi via bdc vd hay elt ra.

1.1.5.6. Bdo quin dn lh$n IhuK dn dd niu chin vd dun kf Igi tru&c khi dn - Neu phai chuan bj thic to trude hoae phii chd dgi sau han 3 gid thi phai ludn

ludn gitt ndng d taift dO t i 60°C ttd Ien hoae bao quto lata ttong diiu kifn t i I0°C ttd xuing. Doi vdi thic to cia tri dudi mft tuii phii cho dn ngay khi via ngufi md khdng dp dvmg diiu kifn bao quto nay.

- Khdng dua qua taiiu thic to cdn am hoac thic to dang ndng vio ti Igta. Khi phin giita cia TP cdn Im (tten IO°C) thi vi khuln cd thi phit ttiin din mie gay bfta.

- Phai dun Igi thic to chfa d taift df sdi ngay tiirdc khi to vi qua trita gitt Igta etog ehi lam hgn chi sy phat ttiin ma khing tiiu dif t dugc vi khuln.

- Khdng de lln TP sdng va thic to chin; + Thie to chm an toto v'a vf smh ed thi bj d taiem khi tiip xic vdi TP song. + Thic to chin etog ed flii bj d taiim qua tiip xic gito tiip vdi TP sdng tau

ttong trudng hpp dtag dao, thdt md ci, thjt sing ehua dupe ria sach di thai thjt chin. - Khdng di cde hda ehlt, thudc bao vf thye vdt hoac eae ehlt gay dOc khac d

ttong khu vye chi biin TP di phdng sy talm lln. - Thic to cin dupe che day ttata byi, rudi tatog hay sy xdm taap cia edn

tiTtog, gjm talm va eae dpng vat khae. - Bao quto tdt cac TP ddng gdi flieo ding yeu elu ghi d tato.

1.1.5.7. Gilt gin v( sinh cd nhdn lot , ^ - Ria tay bang xa phdng va nude sach (tdt taat la

ria dudi vdi nude chiy, niu ria ttong chau thi phii ed gao mie nude dfi Igi).

- Ria tay thudng xuyen: + Trude Idii to, chi bien hogc tiep xic thic to; + Sau khi di vf smh; + Sau khi tiip xic vdi cac TP tired sdng, vft nudi

ttong taa hoac dd vat gay bin tay. + Sau mdi lln dtag Igi lam vife khac tau thay ta

Idtchotte, ximuL... - Khdng dtog tay bic thic to chm hay nude di d6

pha nude uong. .is »i . - 11.- u - K-TTJ - Mac quin ao sgch se (cd flii deo tap de), dau toe gpn gang khi chuan bi TP. _ - Gitt mdng tay ngin va sgeh se. Neu ed v6t fliuang d tay flii phai btog km btog

vjt lifu khdng thim nude.

c

Hinh 1.5. Riia tay

_ - Hidng che biin TP hoac phyc vy an udng khi dang bi dau bung, ia ehay, sdt non, nhiem h ^ g ngoai da hogc cae beta lay truyen khae.

1.1.5.8. Gilt gin vf sinh nai dn uong va chi biin TP - Khu vye chi biin TP phai xa cae khu gay khdi, byi bin, nha vi sinh hoac khu

Chan nuoi gia sue, rae thai gay d nhiem mdi tiirdng vd khdng cd nude dong. Tat ca cae bi mat di ehuin bj, chi biin TP nen ed mau sang, dl'co nia vi sinh

ngay sau mdi Ito s i dung vi ludn gi i sgch se, khd rio. - Bep, phdng ta phai d i toh sang va thdng gid. - Khdng de nude r ia TP, nia dyng cy to udng i dpng lam d nhilm mdi tradng

ximg quata.

- Khdng dupe di eae chit tift tring, lay ui cdng rata khi Idm ve sinh bin vao gay d taiem TP.

- Phai d i nude sgch s i dyng ttong ehi biin TP va vf sinh khu vye to udng, ehi biin.

- De phdng sy xam ta|ip cia gito, chupt va cac dpng vat khac vap noi an udng vd che bito TP.

1.1.5.9. Su dung cdc v^l lifu bao gdi TPsgch se vd Ihlch hap - Khdng s i dyng cdc logi Id bin, gily viit eu, sach bdo, gily in, tii nilon tai sita

ed mau di gdi thic to chin. Vat lieu bao gdi TP phii bao dam sach, gitt duge tita hip din vi mil vj, miu

sic va khdng chia cic ehlt gay dfe vao TP tau chi, cadimi, chit phy gia.... - Khi mua TP, cto chi y xem tato, mde ed ddy du cac thdng tin cin thiit tau tto

san pham, ttgng lupng, ede thtoh phto chita, edeh bdo quto, s i dyng, noi san xuit ehi bito, cd sd dtog ky sto xuat va thdi ban s i dvmg.

1.1.5.10. Ngdn chgn, xu Iri kip th&i cic vu ngd ddc TP vd thifc hiin cic biln phdp vi sinh phong binh

- Khi phat hiin hogc nghi ngd bj ngd dpe TP, phai dita chi vifc s i dyng va niem gitt toto bd thie to do igi (ke ci chat ndn, phto, nude tiiu...) di xdc mita, bdo ngay eho ca quan y te gto tadt dto x i tti kjp thdi hoae dua ngudi bj ngd ddc di bfta vifn.

- Phai vf sita, tly ue khu vye ed ehlt ndn, phto, nude tiiu cia ngudi bj ngi ddc TP va thye hifn chi dp each ly nghiem nggt de phdng sy lay lan cia djeh bfta. Thye hiin cic bifn phap dift rudi, tatog, gito, chudt... va cac hutag din vf sita phdng chdng djeh bfta theo hutag eua ngata y ti.

DANH SACH DOI TU'OfNG DIEU TRA

TT

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

II.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

Hp va t in

Huynh Thj Khuong

Trto Thi Man

Doto Dung

Nguyen Hda

Nguyen Thj Tinh

Le Thj Chau

Thai Thiy Yin

Nguyin Thj Ha

Nguyen Nguyen Vu

Bii Mai

Doto Ngpc Thiit

Nguyin Bd Phutag

Nguyin Thj Thu Mai

Nguyin Ata Vu

Trin Thj Ata Lito

Nguyto Ata Tuto

Trto Thj Thao

Luu Thj Nd

Trin Thj Hoa

Trita Thj Hdng Loan

Pham Thj Ly Ca

Bui Thj Xuto Ata

Bui Thj Mto

Traang Thj Nhung

Nguyin Thi Lgi

L i Thj Hdng

Trin Thj Hi Trto Thj Thu Huong

Doto Chau

Nguyin Kim

Bii Xudn Duong

Nguyin Data

Huj-ta Ba Sita

Trin Cao Mita

Ng. Thi Vift Hoa

Tuii

Nam

59

60

48

58

63

64

47

40

74

42

43

38

40

50

Nfr 50

48

48

50

40

29

45

24

28

47

47

46

31

47

34

40

46

40

65

30

43

Nghe nghifp

SX, che bito TP

SX, che bito TP

SX, chi biin TP

SX, chi biin TP

SX, chi biin TP

SX, ehi biin TP

SX, chi biin TP

SX, chi biin TP

SX, che bito TP

SX, che bien TP

SX, che bien TP

SX, che biin TP

SX, che bien TP

SX, che bien TP

SX, che bito TP

SX, ehi bien TP

SX, che bito TP

SX, che bita TP

SX,ch6bienTP SX, che bito TP

SX, che bien TP

SX, chi bito TP SX, che biin TP

SX, chi bien TP

SX, ehi bito TP

SX, ch6 bito TP SX, chi bien TP

SX, che bito TP

SX, cha bien TP

SX, che biin TP

SX, chi biin TP

SX, chi biin TP

SX, chi bien TP

SX, chg bito TP SX, chi biin TP

Dia ehi

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Tan Thgta, Tam Ky

Tto Thgta, Tam Ky

Tto Thgta, Tam Ky Tto Thata, Tam Ky

Tto Thgta, Tam Ky

Tto Thgta, Tam Ky Tto Thanh, Tam Ky

Tto Thgta, Tam Ky

Tto Thata, Tam Ky

Tto Thgta, Tam Ky Tto Thgta, Tam Ky

Tto Thata, Tam Ky

Tto Thata, Tam Ky

Tto Thgta, Tam Ky

Tto Thgta, Tam Ky

Tto Thata, Tam Ky

Tan Thata, Tam Ky

Tto Thgta, Tam Ky An Xuto, Tam Ky

36.

37.

38.

39. 40.

41. 42.

43.

44.

45.

46.

47.

48.

49.

50.

51.

52.

53.

54.

55.

56.

57.

58.

59.

60.

61.

62.

63.

64.

65.

66.

67.

68.

69.

70.

71.

72.

73.

74.

L i Thi Thuy Thjnh

Dang Thj Nga

Ng. Thj Thu Vang

Ng. Thj Anh Tuyet Ng. Thj Ngpc Anh

Huynh Thj Ngpc Li Thj Ngpc

Ha Thi Chung

Luong T. Thanh Tto

Nguyen Kim Chung

Dd Thi Quy

Trin Dinh Hiiu

Nguyin Duy Liin

B i Trung Tin

Nguyin Thp

Ngd Da Hing

Nguyto Duy Khi ta

Li Thj Bich Ngpc

Dd Thj Tie

Li Thj Kim Ata

Nguyin Thj Lvm

Doto Thj My Tho

Nguyin Thj Nggc

Hd Thj Thu Hi

Truong Thj Ldc

Nguyin Thj Trang

Li Tin Htag Dd Thata Ngpc

Nguyin Dita Die

Nguyin Van Hpa

Trin Vto Thai

Trin Thai

Luu Vto Hoa

Truong Thj Ha

Nguyen Van Lita

Nguyen Ngpe Cdng

Nguyin Die Tri

Duong Qude Htag

Doto Thuyto

41

39

30

49

41

45

39

42

45

43

58

36

47

38

54

32

42

21

53

40

52

43

55

32

39

56

35

43

38

54

42

37

52

37

43

32

42

64

26

SX, chi biin TP

SX, ehi biin TP

SX, chi biin TP

SX, chi bien TP

SX, chi biin TP

SX, chi biin TP

SX, chi biin TP

SX, chi biin TP

SX, chi biin TP

SX, chi biin TP

SX, ehi biin TP

SX, chi biin TP

SX, ehS biin TP

SX, chi biin TP

SX, che bien TP

SX, ehi biin TP

SX, ehi bito TP

SX, chi bien TP

SX, chi biin TP

SX, che bito TP

SX, che biSn TP

SX, che bito TP

SX, che bien TP

SX, che bien TP

SX, che bito TP

SX, che bito TP

SX, chi biin TP

SX, che bito TP

SX, ehe bien TP

SX, che bito TP

SX, chi bien TP SX, che bien TP

SX, che bien TP

SX, ehi bien TP

SX, chi biin TP

SX, chi bien TP

SX, chi bien TP

SX, chi biin TP SX, che biin TP

An Xuan, Tam Ky

An Xudn, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An Xuto, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An Xudn, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky An My, Tam Ky

An My, Tam Ky

Tam Hifp, Nii Thi ta

Tam Hifp, Nii Thata

Tam Hiep, Nii Thata

Tam Hifp, Nii Thata

Tam Hifp, Nii Thata Tam Hifp, Nii Thita

75.

76.

77.

78.

79.

80.

81.

82.

83.

84.

85.

86.

87.

88.

89.

90.

91.

92.

93.

94.

95.

96.

97.

98.

99.

100.

101.

102.

103.

104.

105.

106.

107.

108.

109.

no. I I I .

112.

113.

Vo Phung

Ngd Httu Nga

Le Thanh Togi

Ng. Thj Hdng Chita

Le Tto Binh

Huyta Thj Nguyft

Ducmg T. Bieh Hieu

Mai Thj A

Trto Thj Kim Dung

Ngd Thj Hifu

Trto Thj Lam

Trin Thj Kim Tuyin

Dtog Thj My Hoa

Nguyen Httu Tuto

Phan sau

Nguyen Trgi

Nguyen Vto Tu

Nguyin Van Ata

Trin Thata Nam

Nguyen Vita X i

Nguyin Thata Ran

Nguyin Ngpe

Ng. Thj Thuy Sen

Nguyin Thi Sucmg

Le Thj Trang

Nguyin Thj Diim

Nguyin Thi Hdng

Dmh Quy Hung

Nguyin Vto Tin

Vu Vto Khoa

Nguyin Khie Thai

Nguyin van Sau

Nguyin Tan Thgo

Phan Hiiu

Nguyin Tin Phat

Thai Thj phyng

L i Thi Hudng

Nguyin Thi Ata

Hd Die Hifp

44

40

55

25

42

55

65

27

36

40

54

39

58

35

40

49

54

50

37

40

42

44

47

44

45

49

41

40

48

45

51

30

45

27

37

46

40

43

44

SX, che bien TP

SX, chi biin TP

SX, che bien TP

SX, che bien TP

SX, chi biin TP

SX, chi biin TP

SX, chi biin TP

SX, che biin TP

SX, che bien TP

SX, ehe bien TP

SX, che bien TP

SX, chi biin TP

SX, chi biin TP

SX, chi biin TP

SX, che bien TP

SX, ehe bien TP

SX, ehe bien TP

SX, chi biin TP

SX, che biin TP

SX, ehi bien TP

SX, ehi biin TP

SX, che bien TP

SX, che bien TP

SX, che bien TP

SX, che bien TP

SX, che bien TP

SX, ehe bien TP

SX, che bien TP

SX, che bien TP

SX, ehe bien TP

SX, che biin TP

SX, che biin TP

SX, ehe bien TP

SX, ehi bien TP

SX, che bien TP

SX, che bien TP

SX, che bien TP

SX, ehi bien TP

SX, che biin TP

Tam Hiep, Nii Thinh

Tam Hiep, Nii Thanh

Tam Hifp, Nii Thdnh

Tam Hifp, Nii Thanh

Tam Hifp, Nii Thinh

Thj Tran Nii Thtoh

Thj Trin Nii Thinh

Thj Trto Nii Thinh

Thj Tran Nii Thinh

Thj Trto Nii Thanh

Thi Trto Nii Thinh

Thj Tran Nii Thinh

Thj Tran Nii Thanh

Thj Trin Nii Thinh

Thj Tran Nii Thinh Thj Trto Nii Thanh

Tam Tiin, Nii Thita

Tam Tiin, Nii Thata

Tam Tien, Nii Thinh

Tam Tiin, Nil Thata

Tam Tiin, Nii Thdta

Tam Tien, Nii Thata

Tam Tien, Nii Thdta

Tam Tien, Nii Thdta

Tam Tiin, Nil Thata

Tam Tiin, Nii Thata

Tam Tien, Nut Thita

Tam Xuto 1, Nui Thtoh

Tam Xuto I, Nii Thita

Tam Xuto 1, Nii Thtoh

Tam Xuto 1, Nii Thdta

Tam Xuto 1, Nii Thata




Tam Xuto 1, Nil Thata




114.

115.

116.

117.

118.

119.

120.

121.

122.

123.

124.

125.

126.

127.

128.

129.

130.

131.

132.

133.

134.

135.

136.

137.

138.

139.

140.

141.

142.

143.

144.

145.

146.

147.

148.

149.

150.

151.

152.

Vd Vto Thdng

Trto Quang Vu

Ng. Thj Bieh Phuang

Nguyin Thj Tidn

Nguyen Thj Hdi

Le Thj Kim

Nguyin Thj Vu

Huyta Thj Ldm

Nguyin Thj Tien

Bii Thj Su

Dang Thi Sy

Trto Thj Ha

Phgm Thj Bay

Phan Thj Mai

Nguyen Thj Lata

Hd Thj Thi Tha

Phan Thj Minh

Trto Thj Lf Quyen

Dmh Thj Mudi

Le Thj Hudng

Nguyin Thj Nguyet

Huyta Thi Thutag

Ng. Thata Thata

Nguyin Dita Luang

Ho Thj Yin

Ng. Thj Phudc Ngpc

Nguyin Thj Cim

Dd Thj Huong

Phan Thj Tam

Trin Thi Du

Doto Thj Phyng

Ng. Thi Ngpe Tam

Bii Thi Thuy

Le Thi Kim Ata

L i Thj Hoa H6 Tin Phic

Dd Dhih Toto

Mai Thi Nga

Truong Thj Huang

40

42

43

46

42

49

35

42

37

37

40

41

40

35

58

50

45

48

27

43

33

23

33

46

47

53

34 45

55

48

38

39

46

38 32

46

51

45

55

SX, ehe bien TP

SX, chi biin TP

SX, chi biin TP

SX, che bien TP

SX, chi biin TP

SX, ehi biin TP

SX, chi biin TP

SX, che bien TP

SX, ehe bien TP

SX, chi biin TP

SX, che bien TP

SX, ehi biin TP

SX, chi biin TP

SX, che bien TP

SX, che bien TP

SX, chi bien TP

SX, chi bien TP

SX, che bien TP

SX, ehi bien TP

SX, che bien TP

SX, che bien TP

SX, che bien TP

SX, ehe bien TP

SX, che bien TP

SX, ehe bien TP SX, che bien TP

SX, che bidn TP

SX, che bien TP SX, ehe bien TP

SX, chi biin TP

SX, che bien TP

SX, che bien TP SX, che bien TT

SX, che bien TP

SX, che bien TP

SX, ehi bien TP

SX, che biin TP

SX, che bien TP

SX, chd bien TP

Tam Xuan 2, Nii Thdnh

Tam Xuto 2, Nii Thinh

Tam Xuan 2, Nii Thanh


Tam Xuan 2, Nui Thanh


Tam Xudn 2, Nui Thanh


Tam Xudn 2, Nii Thanh


TT Tan An, Hifp Die

TT Tan An, Hifp Die

TT Tan An, Hifp Die

TT Tin An, Hifp Die

TT Tan An, Hifp Die

TT Tan An, Hiep Die

TT Tan An, Hifp Die

TT Tin An, Hifp Die

TT Tto An, Hifp Die

TT Tto An, Hiep Die

TT Tdn An, Hifp Die

TT Tto An, Hiep Die

TT Tto An, Hifp Die

TT Tto An, Hifp Die

Qui Bita, Hifp Die Que Bita, Hifp Die

Que Bita, Hifp Die

Que Bita, Hifp Die Que Bita, Hifp Die

Quf Bita, Hifp Die

Qui Bita, Hifp Die

Qui Bita, Hifp Die Qui Bita, Hifp Die

Qui Bita, Hifp Die

Qui Bita, Hifp Die

Bita Lam, Hiep Die

Bmh Lam, Hifp Die

Bita Lam, Hifp Die

Bhih Ldm, Hifp Die

153.

154.

155.

156.

157.

158.

159.

160.

161.

162.

163.

164.

165.

166.

167.

168.

169.

170.

171.

172.

173.

174.

175.

176.

177.

178.

179.

180.

181.

182.

183.

184.

185.

186.

187.

188.

189.

190.

191.

Nguyin Thj Ble

Hd Thj Thuy

Vo Thj Sau

Nguyin Thj Chata

Nguyen Thj Lf

Ung Thj Kim Oanh

Dtog Thj Kim Anh

Nguyin Thi Hata

Le Thj Tuyit

Le Thj Ly

Dtog Ngpc Miin

Nguyen van Mupn

Pham Mai

Trto Vto Chien

Trto Vto Htag

Pham Thj Phi

Nguyin Thj Thp

Lim Thj Bieh Sen

Nguyin Thj Lan

Nguyin Thj Ha

Nguyin Thj Nu

Hd Thj Rit

Hd Thj Mita

H i Vto Tai Nguyen Van Thp

Dmh Vto Lata

Nguyen Thi Thu

Nguyin Thi Vi

Nguyin Vto Chung

Nguyin Mmh At a

Nguyen Thj Thu

Vd Thata Ddng

Trita Thi Ata

Phan Thj Xi

Vd Thi Lan

Dd Vto Tam

Li Thi Kim Ata

Le Thi Oata

Phan Thi Them

42

46

50

36

35

39

47

39

34

36

57

66

60

37

50

41

37

47

37

42

45

34

50

38

37

38

40

42

24

39

42

42

46

49

44

51

43

47

49

SX, chi biin TP

SX, ehi biin TP

SX, chi biin TP

SX, ehi biin TP

SX, ehi biin TP

SX, chi biin TP

SX, chi biin TP

SX, ehi biin TP

SX, chi biin TP

SX, chi biin TP

SX, chi biin TP

SX, ehe bien TP

SX, ehe biin TP

SX, che bien TP

SX, chi biin TP

SX, che bien TP

SX, che bien TP

SX, chi biin TP

SX, chi bien TP

SX, ehe bien TP

SX, che bien TP

SX, che bien TP

SX, che bien TP

SX, che bien TP

SX, che bien TP

SX, che bien TP

SX, ehe bien TP

SX, ehe biin TP

SX, chi biin TP

SX, chi bien TP Kita doanh TP

Kmh doanh TP

Kita doata TP

Kita doata TP

Kita doata TP

Kmh doanh TP

Kita doata TP

Kita doata TP

Kita doanh TP

Binh Lam, Hifp Die

Binh Lam, Hifp Die

Binh Lim, Hiep Die

Binh Lim, Hifp Die

Que Thp, Hiep Die

Qui Thp, Hiep Die

Que Thp, Hiep Die

Que Thp, Hifp Die

Que Thp, Hifp Due

Que Thp, Hiep Die

Que Thp, Hiep Die

Que Thp, Hiep Die

Que Thp, Hifp Die

Qui Thp, Hifp Die

Que Thp, Hifp Die

Tri Dan, Nam Trd My

Trd Dan, Nam Tra My

Trd Don, Nam Trd My

Trd Don, Nam Trd My

Trd Don, Nam Tra My

Tra Tap, Nam Tra My

Tra Tap, Nam Tra My

Tra Tap, Nam Tra My

Tra Tap, Nam Tra My

Tra Tap, Nam Tra My

Tra Nam, Nam Tra My

Trd Nam, Nam Tra My

Tra Nam, Nam Tra My

Tra Nam, Nam Tra My

Tra Nam, Nam Tra My Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

192.

193. 194.

195.

196. 197.

198.

199. 200.

201.

202.

203.

204.

205.

206.

207.

208.

209.

210.

211.

212.

213.

214.

215.

216.

217.

218.

219.

220.

221.

222.

223.

224.

225.

226.

227.

228.

229.

230.

Trg Thj Thata Thiy

Ly Khinh Vto

Tmang Thi Tu

Trto Die Mita

Traong van Nam Mai Thj Lidn

Ducmg Thi Nga

VaLpe Ng. Thj Kim Mai

Nguyen Thj Kita

Phan T. Thanh Chau

Bii Thj Bien

Do Thj Nguyen

Nguyin Thj Thanh

Trto Thj Lf Thuy

Nguyen Dita Liem

Ng. Thj Mita Chiu

Traong Thj Luto

Nguyin Thj Hdng

Phan Ata Tuto

Nguyin Thj Scm

Nguyin Tnmg Chita

Trin Thj My Hata

Nguyin Thj Lan

Nguyen Tg

Ngo Thj Hoa

Trin Thj Cic

Nguyin Thj My

Trin Thj Thata

Nguyin Thj Trang

Doto Thi Luan

Ng. Quang Khiim

Phgm Thj Ke

L i Vto Tto

Nguyin Thj Hien

Nguyin Thi Hdng

Vo Thi Phuong loan

Ng. Thi Kim Nhung

Huyta Thj Yfn

50

46

57

55

35

56

75

40

51

44

75

53

57

46

53

45

60

47

53

40

47

36

55

46

40

51

32

47

44

38

27

42

32

73

55

45

38 42

45

Kinh doanh TP

Kinh doanh TP

Kinb doanh TP

Kinh doanh TP

Kinh doanh TP

Kita doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kita doanh TP

Kita doanh TP

Kita doanh TP

Kita doata TP

Kinh doata TP

Kita doata TP

Kita doanh TP

Kita doanh TP

Kita doata TP

Kmh doata TP

Kita doata TP

Kita doata TP

Kita doata TP

Kita doata TP

Kita doata TP

Kita doanh TP Kita doata TP

Kita doata TP

Kita doata TP

Kita doata TP

Kmh doanh TP

Kita doata TP

Kita doanh TP

Kita doata TP Kita doata TP

Kita doata TP

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

Phudc Hda, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

Tan Thgta, Tam Ky

Tto Thgta, Tam Ky

Tto Thata, Tam Ky

Tto Thgta, Tam Ky

Tan Thgnh, Tam Ky

Tto Thgnh, Tam Ky Tto Thgta, Tam Ky

Tto Thata, Tam Ky

Tto Thata, Tam Ky

Tto Thata, Tam Ky

Tan Thgta, TamKy

Tto Thgta, Tam Ky

Tto Thata, Tam Ky

Tto Thgta, Tam Ky Tto Thata, Tam Ky

Tto Thgta, TamKy

231.

232.

233.

234.

235.

236.

237.

238. 239.

240.

241.

242.

243. 244.

245.

246.

247.

248.

249.

250.

251.

252.

253.

254.

255.

256.

257.

258.

259.

260.

261.

262.

263.

264.

265.

266.

267.

268.

269.

Le Thi Bieh Thuy

Phgm Thj Th. Duyen

Trto Thj Bgch Tuyet

Ng. Thj Mai Huong

Huyta Thj Minh

Le Thj Niem

Ung Thj Hoa

Nguyin Thj Li Trto Thj Ba

Nguyin Thj Anh

Bui Thj Hong Tra

Trto Thj Hg Duyen

Phgm Thj Thdi Hotog Tuan Hai

Hd Thj Ntt

Pham Thj Linh

Phan Thj Hiiu

Luang Thj Quang

Phan Thj Hotog My

Trin Thj Mai

Nguyin Thj Ly

Trto Thj Loan

Dmh Thj Cic

Hotog Thj Vto

Ngd Thj Nhung

Trin Thj Bi

Mai Thj Hdng

Li Thj Nga

Huyta Ly Sata

Huyta Thj Hien

Tieu Chau

Luang Thj Cic

Lam Thj Thu Thiy

Nguyin Thi Thu

Li Thj Tam

Nguyin thj Hgta

Mai Thj Lf

Ng. Thi Kim Ata

Lf Vto Nga

46

42

47

23

40

37

54

36

51

47

39

46 41

52

35

45

47

30

43

46

50

31

47

45

55

67

39

49

44

40

43

40

49

33

35

43

37

52

45

Kita doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kita doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kita doanh TP

Kita doanh TP

Kita doata TP

Kita doanh TP

Kita doanh TP

Kita doata TP

Kita doata TP

Kita doata TP

Kmh doata TP

Kmh doata TP

Kita doata TP

Kita doanh TP Kita doanh TP

Kita doanh TP Kita doanh TP

Kita doata TP Kita doanh TP

Kmh doanh TP

Kita doanh TP

Kita doanh TP

Kmh doata TP

Kmh doata TP

Kita doanh TP

Kmh doata TP

An Xuan, Tam Ky

An Xudn, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An Xuin, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An Xuto, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An Xuto, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

An Xuan, Tam Ky

Tam Hifp, Nii Thanh

Tam Hifp, Nii Thata

Tam Hifp, Nii Thata

Tam Hifp, Nii Thata

Tam Hifp, Nii Thita

Tam Hifp, Nii Thita

Tam Hifp, Nii Thata

Tam Hifp, Nii Thita

Tam Hiep, Nii Thita

Tam Hifp, Nii Thita

Tam Hifp, Nii Thita Thj Trto Nii Thinh

Thj Trto Nil Thtoh Thj Trto Nii Thtoh

Thj Trin Nii Thtoh Thj Trin Nii Thtoh

Thj Trto Nii Thtoh

Thj Trto Nii Thata

Thj Trin Nii Thita

Thj Trto Nii Thata

Thi Trin Nii Thita

Thi Trin Nii Thtoh


270.

271.

272.

273.

274.

275. 276.

277. 278.

279.

280.

281.

282.

283.

284.

285.

286.

287.

288.

289.

290.

291.

292.

293.

294.

295.

296.

297.

298.

299.

300.

301.

302.

303.

304.

305.

306.

307.

308.

Nguyin Thj Hudng

Do Thj Kim Khdnh

Phgm Thj Hgnh

Dtog Thi Hoa

Nguyin Thj Ny

Luong Thj P.Ly Nguyen Thj Difp

Trto Htog Trto Thj Toto

Nguyen Thj Tan

Nguyen Thj Trang

Nguyen Thj Dudng

Trto Thi Phuang

Li Thj Trinh

Trto Thj Vy

Nguyin Thj Nhto

Nguyin THj Hue

Trto Thj Huang

Nguyin Thj Nam

Nguyen Tdn Ldc

Nguyen Cdng

Nguyin Thj Lf Sam

Nguyen Thi Dung

Le Thj My Huyta Trifu Vy

Trin Ngpc Tuto

Phgm Thj Yen

Trin Nguyen Huong

Huyta Thj Nghia

Dd Thj Thu Thiy

Nguyin Tdn Cim

Trin Thj Trang

Nguyin Thi Lan

Ng. Thj Tuyet Thu

Trin Thi Chiin

Trin Thi Dudng

Trin Thj Phat

Trin Thi M. Thata Phan Thj Tuyet Vto

51

39

40

30

33

31

39

46

42

39

30

35 67

45

50

40

33

42

40

40

42

57

38

37

30

65

32

51

32

59

42

28

32 28

54

57

47

40

36

Kinh doanh TP

Kita doanh TP

Kinh doanh TP

Kita doanh TP

Kita doanh TP

Kinh doanh TP

Kinh doanh TP

Kita doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kita doanh TP

Kinh doanh TP

Kinh doanh TP

Kinh doanh TP

Kita doanh TP

Kita doata TP

Kita doata TP

Kita doata TP

Kita doata TP

Kita doata TP

Kita doata TP

Kita doanh TP

Kita doanh TP

Kita doata TP

Kita doata TP

Kita doanh TP

Kita doanh TP

Kita doata TP

Kita doata TP Kita doanh TP

Kita doanh TP Kita doata TP

Kita doata TP

Kita doata TP

Kita doata TP

Kmh doata TP

Kmh doata TP


Tam Xudn 2, Nii Thinh




Tam Xuto 2, Nii Thdnh Tam Xuto 2, Nui Thdnh

Tam Xuto 2, Nui Thanh

Tam Xuto 2, Nii Thanh


Tam Tien, Nii Thanh

Tam Tien, Nii Thata

Tam Tien, Nii Thanh

Tam Tiin, Nii Thata

Tam Tien, Nii Thata

Tam Tien, Nii Thata

Tam Tien, Nui Thdta

Tam Tiin, Nii Thdta

Tam Tien, Nii Thata

Tam Tien, Nii Thata

Tam Tien, Nui Thdnh



Tam Xuto 1, Nui Thdta


Tam Xudn 1, Nii Thata





Tam Xuto 1, Nii Thtoh Tam Xuto 1, Nii Thdta

Xa Que Thp, Hifp Die xa Que Thp, Hiep Die

Xa Que Thp, Hifp Die


Xa Qui Thp, Hifp Die

x a Qui Thp, Hifp Die

xa Qui Thp, Hifp Due

309.

310.

311.

312.

313. 314.

315.

316. 317.

318.

319.

320.

321.

322.

323.

324.

325.

326.

327.

328.

329.

330.

331.

332.

333.

334.

335.

336.

337.

338.

339.

340.

341.

342.

343.

344.

345.

346.

347.

Huyta Thj Thu

Vo Thj Thien

Hd Thj Ta

Td Thj Vi

Ng. Thj Hdng Hgnh Trto Thj Thata Hda

Huynh Thj Be

Ta Thj Dao Bui Thj Thtoh

Huyta Thj Lf

Dd Thj Cdng

Nguyin Thj Thu

Trto Thj Bao

Trto Thj Ha

Dtog Thj Lan

TrtoDd

Hd Thj Thata Thiy

Thai Thj Hue

Phan Thj Kim Vita

Phan Thj Ly

Traong Thj Huf

Trin Thi Huang

Phan Thj Hoa

Phan Thj Hdng Tan

Dita Thj Lilu

Mai Thj Toto

Duong Thj cam

va Thi sau Nguyin Thj Tien

Le Thi Trung

Phgm Thj Ha

Pham Thj Bdn

Trin Thi Phuang

Trin Thi Hata

Phgm Thi Suong

Ng. Thi Phudc Ngpc

Pham Thj Lua

Hd Thi Nggc Huyin

Nguyin Thi Dao

60

45

50

35

29

23

26

30

30

46

56

49

47

57

49

48

48

40

43

45

38

41

39

58

57

53 49

50

42

39

39

40

37

46

37

41 49

26

44

Kinh doanh TP

Kita doanh TP

Kita doanh TP

Kinh doanh TP

Kita doanh TP

Kinh doanh TP

Kita doanh TP

Kinh doanh TP

Kita doanh TP

Kita doanh TP

Kita doata TP

Kita doanh TP

Kita doata TP

Kita doata TP

Kita doanh TP

Kita doanh TP

Kita doata TP

Kita doata TP

Kita doata TP

Kita doanh TP

Kita doata TP

Kita doata TP

Kita doata TP

Kita doata TP

Kita doata TP

Kita doata TP Kmh doata TP

Kita doata TP

Kita doata TP

Kita doata TP

Kmh doata TP

Kmh doata TP

Kmh doata TP

Kita doata TP

Kmh doata TP

Kita doata TP Kita doata TP

Kita doata TP

Kmh doata TP

xa Qui Thp, Hifp Die


xa Qui Thp, Hiep Die

Xa Que Thp, Hiep Die

TT Tan An, Hiep Die

TT Tdn An, Hifp Die

TT Tan An, Hifp Die

TT Tan An, Hifp Die

TT Tan An, Hiep Die

TT Tto An, Hifp Die

TT Tto An, Hifp Die

TT Tdn An, Hifp Die

TT Tto An, Hiep Die

TT Tan An, Hiep Die

TT Tan An, Hiep Die

Xa Que Bita, Hiep Die

xa Que Bita, Hifp Die

Xa Que Bita, Hifp Die

xa Qui Bita, Hiep Die

Xa Qui Binh, Hiep Die


Xa Qui Bita, Hifp Die

xa Que Bita, Hiep Die

xa Que Bita, Hifp Die


x a Qui Bita, Hiep Die xa Bita Lam, Hifp Die

Xa Bita Lam, Hifp Die

Xa Bita Lim, Hifp Die

Xa Bmh Lam, Hifp Die

xa Bita Lam, Hifp Die

Xa Bmh Lam, Hifp Die

x a Bita Lam, Hiep Die



Xa Bita Lam, Hiep Die Xa Bita Lam, Hifp Die

Tri Dan, Nam Tra My

Tra Dan, Nam Tra My

348.

349.

350.

351.

352.

353.

354.

355.

356.

357.

358.

359.

360.

361.

362.

363.

364.

365.

366.

367.

368.

369.

370.

371.

372.

373.

374.

375.

376.

377.

378.

379.

380.

381.

382.

383.

384.

Nguyin Van Hing

Le Thata Hung

Nguyin Thi Trang

Mai Thj Yin

Nguyin Thj Lan

Dita Thj Co

Li Vto Dto

Nguyen Thj Hpat

Nguyin Thj Hdng

Nguyen Vto Xudi

Hd Thj Nu

Nguyin Vto Ldm

Nguyen Quang Duy

Nguyen Thj Thiy

Vu Thj Mita NghTa

Trto Thj Ata

Nguyin Thj Siru

Nguyin Thj lan

Nguyin Thj Nghia

v a Thj Thom

Nguyen Thj Tiin

Nguyin Thj Vita

Nguyin Thj Th. Tita

Li Thi To Nga

Ngd Thi Trto

Phan Thj Tuyet Nguyin T. Bich Luu

Nguyin Thj Hda

Nguyin Thj Dupe

Pham Thi Nhu Huf

Nguydn Thi Thiy

Li Thi My Duong Thiy Tnta

L i Thi Hda

Thai Thi My

Doto Thi Thdng

Cao Thi Xi

56

46

46

70

40

45

47

37

26

29

45

22

67

39

41

40

37

42

38

46

39

41

35

42

54

35

50 52

55

38 32

43

38 37

49

44

44

Kinh doanh TP

Kita doanh TP

Kinh doanh TP

Kita doanh TP

Kita doanh TP

Kinh doanh TP

Kita doanh TP

Kita doanh TP

Kinh doata TP

Kinh doanh TP

Kita doanh TP

Kinh doata TP

Kita doata TP

Bip to tap the

Bip to tap the

Bip to tap thi

Bep an tap the

Bip to tap the

Bep to tap the

Bep to tap the

Bep to tap the

Bip to tdp thi

Bep to tap the

Bip to tap thi

Bip to tap thi

Bip to tap thi

Bip to tgp the Bip to tap the

Bip to tgp thi

Bip to tap thi Bip to tgp the

Bip to tap thi

Bip to tap the Bip to tap thi

Bep to tap thi

Bip to tap thi Bip to tap the

Trd Don, Nam Trd My

Trd Don, Nam Tra My

Trd Don, Nam Trd My

Trd Tap, Nam Tra My

Tra Tap, Nam Trd My

Trd Tap, Nam Trd My

Tra Tap, Nam Tra My

Tra Tap, Nam Tra My

Tra Nam, Nam Tra My

Tra Nam, Nam Tra My

Trd Nam, Nam Trd My

Trd Nam, Nam Tra My

Tra Nam, Nam Tra My

Trg tieu hpc Kim Ddng

Mim npn Nhto van

Mdu gido Die Tri

Mdm non Die Tri

Trg tiiu hpc Kim Ddng

Trg tieu hpc Kim Ding


Trg tiiu hpc Kim Ding



Miu giap BC Huang

Sen

Miu giao BC Huong

Sen


Trg tiiu hpc Kim Ddng Trg tiiu hpc Kim Ding


Trg tiiu hoc Kim Ddng Mau giao Die Tri

Tr TH Trto Qude Toto

Tr TH Trin Qude Toto Tr TH Trto Quoc Toto

Tr TH Trto Qude Toto

Tr TH Trin Quic Toto TrTH Trin Qude Toto

385.

386.

387.

388.

389.

390. 391.

392.

393.

394.

395.

396.

397.

398.

399.

400.

401.

402.

403.

404.

405.

406.

407.

408.

409.

410.

411.

412.

413.

414.

415.

416.

417.

418.

Le Thj Hifp

Traang Thj Lf Thiy

Trto T. Ngpe Quynh

Nguyin Thj Xuan

Nguyin Thj T. Vto

Nguyen Thi Le Traang T. Xuto Lan

Nguyen Thj Phic

Nguyen T. Th. Thiy

Trto Thj Lien

Huynh Thj Hda

Trto thj Trifu

Nguyen Thj Th. Liin

Huynh Thj Bi

Phan Thj Thim

Nguyin Thj Dung

Mai Thj Nam

Trin T Phucmg Thap

Duong Thj Nguyet

Phan Thj Tuyet Le

Bii Thj Mii

Nguyin T. Thu Thiy

Ng Thj Th. Phuong

Nguyin Thj Luyen

Trin Thj Nguyf t

Lf Thj Bdng

Doto Thi Mmh

Bii Thj Diim

Dd Thj My Ntt Traang Cdng Hien

Nguyin Thi Huang

Nguyin Thi Tri

Nguyin T. Kiiu Lien

Nguyin Thj Mai

51

41

41

48

28

55

48

53

41

34

39

52

38

54

38

38

39

39

37

60

30

37

30

44

45

49

39

34

52

49

34

47

52

54

Bip to tap thi

Bip an tap thi

Bip an tap thi

Bep an tap thi

Bip dn tap thi

Bep to tap thi

Bep to tap the

Bep an tap thi

Bep an tap the

Bip an tap thi

Bep an tap the

Bep to tap the

Bep to tap the

Bep to tap the

Bep to tap the

Bep to tap the

Bip to tap the

Bep dn tap the

Bip to tap thi

Bep to tap thi

Bip to tap thi

Bip to tap the

Bip to tgp thi

Bip to tap thi

Bip an tap the

Bip to tap the

Bip to tap the

Bip to tdp the

Bep to tap thi

Bip to tap thi

Bip to tap the

Bep to tap thi

Bip to tip the

Bep to tap the

Tradng 24/3

Tradng 24/3

Tratag MG San Ca

Tratag 24/3

Tratag 24/3

Tradng 24/3

Tratag 24/3

Tratag 24/3

Trg TH Tran Qude Toan





Trg TH Trdn Qude Toan

Mdu giao Phudc Hda

Tr. Nguyin Thj Mita

Khai

Tr. Nguyin Thj Mita Khai

Tr. Nguyin Thj Mita Khai

Tr. Nguyin Thj Mita

BChai Miu giao Vdta Khuyen

Bep to Cdng an tita

Mam non Hoa Stta

Bep an Buu dien tmh

Trg Nguyin Vto Trdi

Bep to Cdng an tita

Trg Nguyin Vto Trdi

Trg Nguyin Vto Trdi

Trg Nguyin Vto Trdi

Mim non BC Hoa Mai

Mim non BC Hoa Mai

Tratag Nguyen Vto

Trdi

Mim non BC Hoa Mai

Mim non BC Hoa Mai

Trg Nguyin Vto Trdi

419.

420.

421.

422.

423.

424.

425.

426.

427.

428.

429.

430.

431.

432.

433.

434.

435.

436.

437.

438.

439.

440.

441.

442.

443.

444.

445.

446.

447.

448.

449.

450.

451.

452.

453.

Dtog T. Kim Chung

Huynh Thj Ngoan

Nguyin Thj San

Nguyin Thj Hoa

Trto Thj Minh Mau

Luong Thj Tto

L i Thj Binh

Do Thj Tiin

Luang Thj Ldi

Phgm T. Thiy Trang

Nguyin T. Ngpe Nhi

Trin Thi Hgta

Vo Thj Anh Dio

VuThj Ata Ngpc

Nguyin Thj Ph. Thao

Nguyen Thj Hdng

Pham Thi Vy

Hd Thj Lgi

Le Thj Nhan

Nguyin Thj Dogt

Le Thj Nham

Ung Thj sau Nguyin van Lita

Traang Thj Ha

Trin T. Thiy Duong

Traang Thj Lieu

Trin Thj Thu Dung

Trin Thi Hudng

Pham Thj Phuang

Nguyen Thj Lan

Trto Thi Ata Tuylt

Do T. Thtoh Phuong

Dtog Dita Ba Luang Thi Trie Luih

Nguyin Lf My

40

32

40

44

28

35

52

40

32

44

23

30

27

33

31

29

32

36

50

36

45

28

25 41

26

32

42

30

58 52

35

39

27

27

39

Bdp to tap thi

Bip to tap thi

Bep to tap thi

Bep to tap the

Bep to tap the

Bip dn tgp thi

Bep to tap thi

Bep an tdp thi

Bip to tap thi

Bep fa tdp thi

Bep to tap the

Bip to tap the

Bep to tap the

Bip an tdp thi

Bep to tap the

Bep to tap the Bip an tap thi

Bep to tap the

Bip to tap thi

Bip to tgp thi

Bep an tap the Bep to tgp the Bep to tap the

Bip fa tgp thi Bep to tap thi

Bip an tap the

Bep to tap thi

Bip to tap the Bep to tap the

Bip to tap the

Bep to tap the

Bip an tdp thi Bip to tdp thi

Bip to tgp thi

Bep fa tap thi

Bip fa Cdng an tinh

Trg Nguyin Van Trdi

MNTrue Dao, Tam Xuto 2

MNTric Dio, Tam Xuan 2

MNTric Dao, Tam

Xuan 2

IVlNTric Dio, Tam

Xuto 2

MNTnic Dao, T Xuan 2

MNTric Dao, T Xuan 2

MNTnle Dio, T Xuto 2

MNTnic Ddo, T Xudn 2

jVlNTriic Dao, T Xudn 2

MNTnic Dao, T Xuan 2

Mau giao Thto Tien

Mdu giao Thin Tien

Miu gido Thdo Nguyen

Cty May Thiy Trang Mdu Giao Hoa Sen

Cty May Thiy Trang

Mto Giio Hoa Sen

Mau Giao Hoa Sen

Mam non Ata Dao Mau Giao Hoa Sen CT Ggch Men T Hiep

CT Gach men, T Hifp Mau Giao Hoa Sia

Gach men Ata va Em

Miu Giao Hoa Stta

Mau Giao Huong Sen Miu Giao Vtog Ata

Miu Giao Hoa Stta

CT Nam Son

Xa Tam Hda Bip fa TT Nhu Thata

NhatteSuSu

Miu gido Mfag non

454.

455.

456.

457.

458.

459.

460.

461.

462.

463.

464.

465.

466.

467.

468.

469.

470.

471.

472.

473.

474.

475.

476.

477.

478.

479.

480.

481.

482.

483.

484.

485.

486.

487.

488.

489.

490.

491.

492.

Nguyin Thj Lpi

Vo Thj Trata

Nguyin T. Thu Ngpe

Phan Tgi Phg Thiy

Dtog Thj Kim Hue

Traong Thj Th. Tien

Bii T. Thanh Phudc

Trto Thi Nhung

Nguydn Thj Huong

Nguyin Thj Nhi

Trto Thj Ting

Nguyin T. Kim Anh

Nguyin Thj Phugng

Trin Thi Hi

Huyta Thj Duy

Nguyen Thj Xuto

Pham Thi Ph. Thiy

Trto Thi Nam

v a Thj Luong

Trin Thi My Hoa

Le Thi Tuyit Mai

Mge Thj Sdt

Hd Thj Nguyf t

Dmh Thj Mudi

Nguyen Thj Lan

Trin Thj Nam

Dd Thj Thdng

Nguyen Thi Lien

Dfag Thj Nguyet

Dd Thi Mai Ha Thi Hoa

Nguyen Thj Phucmg

Ld Thi Mita Phudc

v a Thi Ai Vto Dd Thi Mita Phuang

Pham Thi Tai

Dfag Thi Hgta

H i Thi Thu Hdng

Ho Thi Kun Hoa

52

44

39

35

38

20

25

33

46

39

41

45

35

39

42

52

36

42

30

34

44

35

48

41 42

34

34

29

37 47

43

35

35

32

29

40

36 50

56

Bdp to tap the

Bep an tgp the

Bep to tap the

Bep an tap the

Bep an tap the

Bep an tap the

Bip to tap thi

Bep an tap the

Bip to tgp the

Bep to tgp the

Bep an tap the

Bep to tap the

Bep to tap the

Bip to tap the

Bip to tap the

Bip to tap the

Bep fa tap the

Bep fa tap the

Bep fa tap the

Bip to tap the

Bep fa tap the

Bep to tap the

Bip to tap the

Bep to tap thi Bep to tap the

Bip to tap the

Bep fa tap thi

Bep fa tap the

Bip to tap thi Bip fa tap thi

Bep to tdp the

Bep to tap thi

Bip to tap thi Bip to tap thi

Bip to tdp thi

Bip to tap thi

Bip to tap the Bip fa tap thi

Bip fa tap thi

Mam non San Ca

Tratag Hoa Mai

Nha tre Nguyen Dat

Mau giao khdi 4

Nha tre Tudi tho

Mam non Sen Hdng

Miu Giao Hpa Mi

Bep an Nhu Thanh

Bdp an Nhu Thanh

Bip an Nhu Thanh

Tratag BC Son Ca

Khii 5, thj trin

Nhdm tre Gia dinh

Nhdm tre Gia dinh

Bip to Nhu Thtoh

Bip to Nhu Thdta

Khii 4, thj tran

Dutag Lao, Hifp Die

Nha tre CD Que Thp

Nha tte CD Qui Thp

MG Son Ca, Qui Thp

Nha tre CD Qui Thp

Miu gido Qui Thp

Dutag Lap, Hifp Die Bip fa Que Bita

Bep fa Qui Bita

Bep fa Que Bita

Thdn I, Que Bita

Thj ttto Tto An Thj ttto Tto An

Thj ttto Tto An

Npi tini DT Sing Tri

Ndi tm DT Sdng Tra Ndi ttiiDT Sdng Tra

Duong Ldo, Hifp Die

Ndi tiii DT Sdng Tra

Bfp to CA Bip fa CA

Bep fa Kiem Lam

493.

494.

495.

496. 497.

498.

499.

500. 501.

502.

503.

504.

505.

506.

507.

508.

509.

510.

511.

512.

513.

514.

515.

516.

517.

518.

519.

520.

521.

522.

523.

524.

525.

526.

527.

528.

529.

530.

Huyta Thj Cic

Nguyin Thj Ddng

V8 Thj Thata Tam

Trdn Thj Kim Binh

Le Thj Hdng

Phan Thj Minh

Nguyin Thj Hoa

Phgm Thj Phi Trjnh Thj Lan

Duong Thj Hudng

Phan Thj Tim

Le Thj Nhto

Nguydn T Ngpe Tdm

Nguydn Thj Cam

Dd Thj Huong

Nguyin Thj Cd

Nguyin Thj Lf

Ducmg Thj Hudng

Phgm Thj Hdng

Dita Thi Phuang

Nguydn T. Kim Ata

Hd Thj Huong

Nguyen Thj Nang

Nguyen Thj Hoa

Nguyin Thj An

Hd Thj Lan

H i Thj Hdng

Dmh Thj L i t a

Nguyin Thj Phugng

Hd Thj Kim Nhft

Dita Thi Hgta

H i Thj An

Nguyin Thj Hdng

Nguyin Thj Ha

Nguyin Thj Trita

Nguyin Thi Nhan HujmhT. Bich Ngpc

Trin Thj Hdng

55

41

29

32

43

35

38

50

40

40

35

43

38

46

40

42

35

29

41

37

25

32

27

26

34

29 27

26 36

40

29

26

24 29

40

75

27

5b

Bep an tap thi

Bep an tap thi

Bep to tap thi

Bep an tap thi

Bip an tap thi

Bep to tap thi

Bip an tgp thi

Bep an tdp thi

Bip an tap thi

Bip to tap thi

Bip to tap thi

Bip to tap the

Bep to tap the

Bep to tgp the

Bep to tap the

Bep to tap the

Bip to tap thi

Bep to tap the

Bep fa tdp the

Bep fa tap the

Bip fa tap thi

Bip fa tap the

Bep fa tap the

Bip to tap thi

Bep to tap thi

Bip to tap the Bip an tap the

Bip to tap thi Bep to tap thi

Bip an tap the

Bep to tap the

Bep fa tap thi

Bip to tap thi Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Thj trto Tan An

Thj tran Tdn An

Tratag MN Mdng Non

Trutag MN Mang Non

Nhd tre td 7, Tan An

Tratag IVIN Mdng Non Thj trto Tdn An

Binh Ldm, Hifp Die

Binh Ldm, Hifp Die

MG thdn Ngpc Lam

MG Hpa Phong Lan

Mau gido Hoa Phong Lan

Nhj Ddng, Binh Ldm

Nhj Ddng, Binh Lam

MG Hoa Phong Lan

Mau Giao Bita Lam

Thdn 6, Bita Lam

MG thdn Ngpc Lam

CT xay dyng Son Ha

UBND xa Tra Tap

Tratag cap 2 Tra Tap

Mau Gido xa Trd Tap

Tratag cdp 1 Tra Tap

Cdng ty cau dutag

UBND xa Tra Don

Tratag cap 2, Tra Don Tratag cap 1, Tra Don

Miu Giao xa Tra Don Cdng ty cau dutag

Tratag Cap 1, Tra Nam

Tratag cap 2, Tra Nam

CTXDNamTraMy

LOBNDxaTraNam Phudc Hoa, Tam Ky

Phudc Hoa, Tam Ky

Phudc Hoa, Tam Ky

Phudc Hoa, Tam Ky

Phudc Hoa, Tam Ky

531.

532.

533. 534.

535. 536.

537.

538. 539.

540.

541.

542.

543.

544.

545.

546.

547.

548.

549.

550.

551.

552.

553.

554.

555.

556.

557.

558.

559.

560.

561.

562.

563.

564.

565.

566.

567.

568.

569.

Nguyin Lan

Trto Thj Tra Huynh Thj Cic

Mai Thj thuy

Nguyen van Hoe

v a Thanh Tratag

Nguyin Thj Dung

Vo Thj Mudi Lf Thj Thuy

Trto Thj Tho

Le Thj yen Linh

Trto Thj Hdng

Trin Thj Tg

Trto Thj Nguyft

Doto Thj Liiu

Doto Thj Hoa

Hd Thj Thu Thuy

Nguyen Thj Hoa

Li Thj Minh

Bii Thj Huang

Trto Thi Bdn

Trin Thj Thata

Ng.Thata Nghifp

Trto Thi Lan

Nguyin Thj Thuy

Traang Thj Xuydn

Nguyin Thj Hoa

Dang Thj Hdng Ld

Nguyin Thj Phuong

Nguyin Thj Thata

Trin Thj My Phuong

Nguyin Thj Phudc

Doto Thj Thom

Nguyin Thi Hoa

Huyta Thi vift

Nguyin Thi Va

Dita Thj Ngpc

Nguyin Thj Thu

Trin Vfa Phung

53

42

44

50

68 42

51

53

33

34

25

26

42

73

46

69

41

42

39

52

39

40

17

44

42

40

55

42

47

38

40

48

39

32

42

39

41 42

57

Bto rong

Ban rong

Bto rong

Bto rong

Bto rong

Ban rong

Bto rong

Bto rong

Ban rong

Ban rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Ban rong Bto rong

Bto rong

Bto rong

Bto rong

Bto rong Bto rong

Bto rong Bto rong

Bto rong

Bto rong Bto rong

Bto rong

Phudc Hoa, Tam Ky

Phudc Hoa, Tam Ky

Phudc Hod, Tam Ky

Phudc Hod, Tam Ky

Phudc Hoa, Tam Ky

Phudc Hoa, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An My, Tam Ky

An Xuto, Tam Ky

An Xuto, Tam Ky

An Xuto, Tam Ky

An Xuto, Tam Ky An Xuto, Tam Ky

An Xuto, Tam Ky

An Xuto, Tam Ky

An Xuto, Tam Ky



An Xuto, Tam Ky


An Xuto, Tam Ky

570.

571.

572.

573. 574.

575.

576. 577.

578.

579.

580.

581.

582.

583.

584.

585.

586.

587.

588.

589.

590.

591.

592.

593.

594.

595.

596.

597.

598.

599.

600.

601.

602.

603.

604.

605.

606.

607.

608.

Li Thj Thanh

Nguyin THj Nhung

Nguyin Thj Anh

Ng. Thi Hdng Van

Vto Thj Hing

Le Nguyin Hoai Thu

Huyta Thj Tuyet Doto Thj Anh Nga

Dd Thj Long

Traang Thj Hdng

Vd Thj Bich Hutag

Trifu Thj Quy

Li Thj Sen

Ng. Thj Dif u Uydn

Nguyen Thj Difu

Nguyen Thj Hiiu

Nguyen Thj Ni

Nguyen Thj Kha

v a Vto Trita

Le Vto Kha

Le Vto Khai

Li thi Hdng Nghi

Phan Thj Nam

Nguyin Thj Ldc

Nguyin Thj Vto

Doto Thj Kim Dung

Nguyin Thj Lgc

Trin Thi Ldu

Trin thj Lya

Huyta Thj Do

Ngd Thj Nghifm

Trto Thj Phyng

v a Thj Liin

Nguyin Thj Ut

Phung Thj Lai

Huyta Ly Sata

Nguyin Thj Thuy

Trin Thj Dao

D 5 Thj Luyin

41

35

35

32

38

41

40

35

26

30

33

46

29

35

49

40

56

57

54

54

56

44

52

42

48 47

46

60

54

32

43

37

40

52

38

35

45

42

55

Bdn rong

Bdn rong

Ban rong

Ban rong

Bto rong

Bto rong

Ban rong

Bto rong

Ban rong

Ban rong

Bto rong

Bto rong

Bto rong

Ban rong

Ban rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Ban rong

Ban rong Bto rong

Bto rong

Bto rong

Ban rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Tto Thata, Tam Ky

Tto Thgnh, Tam Ky

Tto Thanh, Tam Ky

Tan Thanh, Tam Ky

Tto Thgnh, Tam Ky

Tto Thgnh, Tam Ky

Tto Thgta, Tam Ky

Tan Thgnh, Tam Ky

Tan Thgnh, Tam Ky

Tan Thgta, Tam Ky

Tan Thata, Tam Ky

Tto Thgta, Tam Ky

Tan Thata, Tam Ky

Tan Thata, Tam Ky

Tto Thgta, Tam Ky

Tdn Thgta, Tam Ky

Tdn Thgta, Tam Ky

Tto Thata, Tam Ky

Tan Thata, Tam Ky

Tan Thata, Tam Ky

Tto Thgta, Tam Ky

Tam Hifp, Nii Thdta

Tam Hifp, Nil Thata

Tam Hifp, Nii Thdta

Tam Hifp, Nii Thdta Tam Hiep, Nui Thdta

Tam Hifp, Nii Thdta

Tam Hifp, Nii Thdta

Tam Hifp, Nii Thita

Tam Hiep, Nil Thata

Tam Hifp, Nii Thita

Thj Trto Nii Thata

Thi Trin Nii Thita

Thj Trto Nii Thata

Thi Trto Nui Thita

Thi Trto Nii Thata

Thj Trto Nii Thata

Thj Trto Nii Thata

Thj Trin Nii Thata

609.

610.

611.

612.

613.

614.

615. 616.

617.

618.

619.

620.

621. 622.

623. 624.

625.

626.

627.

628.

629.

630.

631.

632.

633.

634.

635.

636.

637.

638.

639.

640.

641.

642.

643.

644.

645.

646.

647.

Phan Thj Thu Ba

Nguyin Thj Nga Dd Thj Huf

Trto Thj Kim Thoa

Ngd Thj Quto

Dd Thj Thu

Doan Thj Thu Linh Huyta Thj Vuong

Doto Thj Li

Bui Kidn Nghia

Nguyin Ngpe Thtoh

Le Vto Nhan

Nguyin Thj Diin

Li Thi Thudc

Td Thj Hoa Li Thj Thu Bich

Nguyin Thanh Rto

Nguyen Thj Ata

Le Thj My Dung

Nguyen Thj Huong

Phan Thj Dung

Traang Thi Cam

Nguyin Thj Cue

Phan Thj Chuang

Nguyin Thj Thoa

Nguyen Thj Thy

Nguyen Thj Mai

Bii Thj Liin

Nguyin Thj Lien

Nguyin Thj Nhon

Bui Thj Sita

Nguyin Thi Hotog

Nguyin Thj Chiin

Traang Thi Hoa

Nguyin Thj Lita

Phan Thj Thao

Nguyin Thj Nguyet

v e Thi Thuy

Vuong Thj Dung

58

57

48

50

46 45

50

61

49

27

48

39

33

50

51

32

39

30

42

43

43

28

48

55

63

42

50

50

36

38

44

47 32

48

69

40

35

40

38

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bdn rong

Bdn rong

Ban rong

Ban rong

Bto rong

Bto rong

Bto rong

Bin rong

Ban rong

Bto rong

Ban rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Ban rong

Bto rong

Bto rong

Ban rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Thj Trin Nii Thdnh

Thj Trin Nii Thdnh

Tam xudn 1, Nii Thdnh



Tam xuan 1, Nil Thanh



Tam xudn 1, Nui Thanh


Tam xuan 1, Nii Thtoh

Tam xudn 1, Nii Thinh

Tam Tien, Nii Thata

Tam Tien, Nii Thita

Tam Tien, Nii Thinh

Tam Tien, Nii Thita

Tam Tien, Nii Thanh

Tam Tien, Nii Thdta

Tam Tien, Nii Thdta

Tam Tien, Nii Thata

Tam Tien, Nii Thdta

Tam Tien, Nii Thdta


Tam Xuto 2, Nii Thita






Tam Xuan 2, Nii Thita


Tam Xuan 2, Nii Thtoh Que Bita, Hifp Die

Que Bita, Hifp Die

Qui Bita, Hifp Die

Qui Bita, Hifp Die

Qui Bita, Hifp Die

Qui Bita, Hifp Die

Qui Bmh, Hiep Die

648.

649.

650.

651.

652.

653.

654.

655.

656.

657.

658.

659.

660.

661.

662.

663.

664.

665.

666.

667.

668.

669.

670.

671.

672.

673.

674.

675.

676.

677.

678.

679.

680.

681.

682.

683.

684.

685.

686.

Trdn Thj Liin

Nguyin Thj Ntog

Ng. Thj Gitog Ngpc

Vuong Thj Xuto

Nguyin Thj Ngpc

Hotog Thj Vinh

Le Thj Chita

Nguyen Thi Thanh

Phan Thj Phg Dung

Vuong Thj e l m

Le Thj Lpc

Doto Thj Thanh

Doto Thj Thata

Trto Thj Khtog

Nguyin Thj Vto

Phgm Thj Yen

Dgng Thj Lam

Trin Thj Kim Phudc

Phan Thj Thata

Phan Thj Thu Suong

v a Thj Ngpe

Trin Thj Ly

Vo Thj Ata

Huyta Thi Tam

Phgm Thj Cic

Trin Thj Thu Trang

Nguyin Thj Chin

Nguyin Thj Ata

Nguyin Thj Vto

Phan Thj Tuyit Hgta

Hd Thj Ta Phan Thi Kim Loan

Dtog Thi Tita Nguyin Thj Nhan

Hd Thj Phi

Nguyin Thi Lien

L i Thi Quynh

Dmh Thi Thuy

Nguyin Thata Dita 48

40

40

37

47

53

31

35

45

23

62

30

33

33

52

54

52

38

47

32

32

39

43

30

38

46

29

34

39

51

44

35

41 34

36

36

39

30

29

Bto rong

Ban rong

Bto rong

Bto rong

Ban rong

Bto rong

Bto rong

Ban rong

Ban rong

Bto rong

Ban rong

Bdn rong

Bdn rong

Ban rong

Bto rong

Bto rong

Bto rong

Ban rong

Bto rong

Bto rong Bto rong

Bto rong

Bto rong

Ban rong

Bto rong Ban rong

Ban rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Bto rong

Que Binh, Hifp Die

Que Binh, Hifp Die

Que Binh, Hiep Die

Binh Lim, Hifp Die

Binh Lam, Hifp Die

Binh Lam, Hifp Die

Bita Lim, Hifp Die

Binh Lam, Hiep Die

Binh Lam, Hifp Die

Bita Lam, Hifp Die

Binh Lam, Hifp Die

Bita Lam, Hifp Die

Bita Lim, Hifp Die

TT Tto An, Hifp Die

TT Tto An, Hifp Die

TT Tdn An, Hifp Die

TT Tto An, Hiep Die

TT Tto An, Hifp Die

TT Tan An, Hiep Die

TT Tto An, Hifp Die TT Tdn An, Hiep Die

TT Tto An, Hifp Die

Que Thp, Hifp Due

Qui Thp, Hiep Die

Que Thp, Hifp Die Qui Thp, Hifp Die

Que Thp, Hiep Die

Que Thp, Hifp Die

Que Thp, Hifp Die

Que Thp, Hifp Die

Que Thp, Hifp Die

Qui Thp, Hifp Die Qui Thp, Hiep Die

Trd Nam, Nam Tra My

Tra Nam, Nam Tra My

Tra Nam, Nam Tra My

Tra Nam, Nam Trd My

Tra Nam, Nam Tra My

Tra Don, Nam Tra My

687.

688.

689.

690.

691.

692.

693.

694.

695.

696.

697.

698.

699.

700.

701.

702.

703.

704.

705.

706.

707.

708.

709.

710.

711.

712.

713.

714.

715.

716.

717.

718.

719.

720.

721.

722.

723.

724.

725.

Traang Van Phudc

Trto Thj Sen

Nguyin Thj Sen

Truong Thj Thim

Hd Thj Difp

Hd Thj Didm

Nguyin Thj Thutag

Nguyin Thj Hdng

Nguydn Thj Hotog

Nguyen Thata Qugn

Mai Tto Cutag

Nguydn Vidt Cam

Dd Dinh Vj

Phan Vfa Nggc

Nguyin Hdng Son

Mai Tin Khoa

Nguydn Trao

Nguyen Vto Luto

Trto Vto Soan

Le Thj Thu Thdo

Vu Thj To Uyen

Nguyin Thj Difn

Trin Thj Ph. Thdo

Nguyen Thj Lan

Phan Chau Tuto

Nguyin Dita Hao

Hotog Trang Thanh

Ngjiyin Nhu Lam

Dtog Vita Hing

Traong Ngpc Hii

Nguyin Mita Hifu

Huyta Ngpc Hdng

Thai Htag Nhat

Nguyin Kh. Phuong

Dao Hdng Thiin

Trin T. Thata Thuy

Khuu Hdng Huf

Nguyin Thj Lai

31

44

25

53

40

28

49

40

48

40

52

45

51

31

88

38

32

39

60

33

46

45

Pham Thi Kim Cht |

37

44

52

35

30

30

43

23

39

40

50

31

26

31

36

36 24

Bto rong

Ban rong

Ban rong

Bdn rong

Bdn rong

Bto rong

Bdn rong

Bdn rong

Bto rong

Cto bp VP

CBVHTT

CT Mat ttan

CTUBND

Bi thu doto

BT Dfag iy

CTHDND

PCT Hdi ND

PCTUBND

CTHpiND

PCT Phy ntt

CTHLHPN

PCTUBND

CB tu phip

CBUBND

CT Mat ttto CTHDND

CB tu phap

CTHpi

CTHpi

PCTUBND

BT Dtog bd

CTCCB CBTBXH

PCT

CB dia chita

PCT

CBVPUB

CBUBND PBT Doto

Tra Don, Nam Trd My

Tra Don, Nam Trd My

Trd Don, Nam Tra My

Tra Don, Nam Tra My

Tra Tap, Nam Tra My

Tra Tap, Nam Tra My

Tra Tap, Nam Tra My

Tra Tap, Nam Tra My

Tra Tap, Nam Trd My

Phutag Tdn Thgta

Phutag Tan Thgta

Phutag Tan Thanh

Phutag Tdn Thgta

Phutag Tto Thgta

Phutag Tto Thgta

Phutag Tdn Thgta

Phutag Tan Thgta

Phutag Tan Thata

Phutag Tan Thata

Phutag Tto Thgta

Phutag Tdn Thgta

Phutag Tto Thata

Phutag Tto Thgta

Phutag Tan Thgta

Phutag An My Phutag An My

Phutag An My

Phutag An My

Phutag An My

Phutag An My

Phutag An My


Phutag An My

Phutag An My

Phutag An My

Phutag An My


726.

727. 728.

729.

730.

731.

732.

733.

734.

735.

736.

737.

738.

739.

740.

741.

742.

743.

744.

745.

746.

747.

748.

749.

750.

751.

752.

753.

754.

755.

756.

757.

758.

759.

760.

761.

762.

763.

764.

Nguyin van Thdng

Hotog Ngpc Phto

Ddng Minh Phic

Phan Vto Thjta

Nguyin Trilu Hinh

Phgm Dinh Htag

Trjta Huy Hiiu

Li Thj Thtoh Tjnh

Nguyen Thi X. Anh

Truong Thi My Linh

Ta Trto Thanh Thdo

Ng Thj Th. Doan

Nguyen Thi Hanh

Nguyen Thj Hutag

Nguyin Thj Nguyft

Vo Thata Tratag

Trto Dita Siu

Hd Thata Mita

Trto Cdng Vto

Dang Nguyin Ph. Vy

Nguydn Die Chita

Nguyen Le Sim

Le Dita Thata

Trto Ata Tuto

Li Cdng Lop

Trin Ngpc Qutog

Ng.ThjTdNga

Nguyin Thj H.Thuy Trjta T.Ngpc Thiy

Ng. Thj Td Trita

Doto Nhom

Trin Toto

Pham Cuu

Trin Qude Bio

Le Tin Vita

Lam San Hii

Nguyin Vfa Phong

Trto Vto Thu

Trin Ngpc My

49

59

45

53

55

50

24

24

36

45

28

24

45

47

45

46

62

55

48

54

52

31

45

50

50

55

47

27

27

24

28

31

34

54

45

27

33

36

27

CB tu phap

CTCCB

Chanh VP

PCT

Tuyen giao

PCT CCB

Bi thu doto

Ban kita ti

Vtofliu

PBT doto

Vto thu dtog

VP Dtog iy

PCT MTrto

Thi quy

PCTPN

Ban kita te

PCBUBND

CTHDND

CB tu phdp

CBVHTT

CTUBND

CTHpiND

PCTUBND

CTMT

CTCCB BT Dtog iy

PBT Doto

CTHLHPN

PCTHDND

CBUBND

Tr.ttgmBVTV

Tr.CA

TP.Ki ta t i BTdoto

Phd phdng GD

TP. Td ehic

PhdCA

CT Hdi ddng y Dfi phd QLTT

Phutag An Xuto

Phutag An Xudn

Phutag An Xuto

Phutag An Xuto

Phutag An Xuan

Phutag An Xuan

Phudng An Xuan

Phutag An Xudn

Phutag An Xudn

Phutag An Xudn

Phutag An Xuto

Phutag An Xuto

Phutag An Xuan

Phutag An Xuto

Phutag An Xudn Phutag Phudc Hda

Phutag Phudc Hda

Phutag Phudc Hda

Phutag Phudc Hda

Phutag Phudc Hda

Phutag Phudc Hda

Phutag Phudc Hda

Phutag Phudc Hda

Phutag Phudc Hda

Phutag Phudc Hda Phutag Phudc Hda

Phutag Phudc Hda

Phutag Phudc Hda

Phutag Phudc Hda

Phutag Phudc Hda

UBND TP. TamKy

UBND TP. TamKy

UBND TP. Tam Ky UBND TP. Tam Ky

UBND TP. TamKy

UBND TP. Tam Ky

UBND TP. Tam Ky

UBND TP. Tam Ky UBND TP. TamKy

765.

766.

767.

768.

769.

770. 771.

772.

773.

774.

775.

776.

777.

778.

779.

780.

781.

782.

783.

784.

785.

786.

787.

788.

789.

790.

791.

792.

793.

794.

795.

796.

797.

798.

799.

800.

801.

802.

803.

Nguyin Qude Vift

Nguyin HOu Dac

Nguyen Duy An

Nguyin Hull Vita

Bui Cao Nhto

Cao Quang Die Ng. Thanh Hiin

Trto Qude Phuong

Nguyin Ngpe Duy

Bii Thj If Thiy

Pham Thj Trang

Nguydn Thj Hoa

Trto Thj Bp

Dtog Thj Phi Hoa

Dtog Thj Hdng Vi

Ng. Thj H. Hata

Vu Thj Ata Suong

Trto Vfa Hda

Traang Quang Lugt

Mai Vfa Thtog Nguyin Tiin thie

Li Vfa Phu

Nguyin Hong Nhi

Nguydn Ngpe Ata

Phgm van Hifu

Mai Vto Xuan

Nguyin Vfa Bdn

Nguyin Xuto Ata

Nguyin Giip

LO Dita Vfa

Hotog Mdng Lita

Nguyin Thj Huy

Nguyin Tto Ddng

Nguyin V. Thuong

Nguyin Die Thit

Mai Hai Nam

Doto Ba Thdta

Pham Vto Cdng

Nguyin D ie Hung

30

46

40

42

46

41 57

43

45

50

49

39

29

36

32

29

31

50

46

48

36

36

55

36

41

48

51

34

51

46

55

46

52

48

47

39

27

40

33

Dpi phd CA

Dai trayin thanh

Phd TC-KH

PGD.TTYT

P.trgm thi y

Phd chi eye thud TP Npi vu

Phdng kinh ti

P. phdng VHTT

PGD. DS-GD

GD. DS - GD

Tram thi y

Phdng TB-XH

CT. HLHPN

Phdng y te

P.CVPUB

Phdng TC-KH

PCTUBND

CtobpKT-TC

CBTrayin tiiata

Tratag VHTT

PCTHDND

Tratag CA

Xa dpi tiiitag

BT Doto TN CTHND

CTM.Trto BT Dtog iy

PCT

CTUBND CT Hdi CCB

CTHpiPN

PhdCT

CAxa

Tratag TYT

BT Dpto xa

HDND

CBfliud

Tu phip

UBND TP. Tam Ky

UBND TP. Tam Ky

UBND TP. Tam Ky

UBND TP. Tam Ky

UBND TP. Tam Ky

UBND TP. Tam Ky

UBND TP. Tam Ky

UBND TP. Tam Ky

UBND TP. Tam Ky

UBND TP. Tam Ky

UBND TP. Tam Ky

UBND TP. Tam Ky

UBND TP. Tam Ky

UBND TP. TamKy

UBND TP. Tam Ky

LIBNDTP. TamKy

UBND TP. Tam Ky

Tam Tiin, Nii Thata Tam Tiin, Nii Thata

Tam Tiin, Nii Thdta

Tam Tien, Nii Thdta

Tam Tiin, Nii Thdta

Tam Tiin, Nil Thdta

Tam Tien, Nii Thita

Tam Tien, Nii Thita Tam Tiin, Nui Thdta

Tam Tien, Nii Tbita Tam Tiin, Nil Thita

Tam Tiin, Nii Thata

Tam Tiin, Nil Thdta Tam Tien, Nil Thdta

Tam Tiin, Nii Thita



Tam Xuto 2, Nil Thita


Tam Xuto 2, Nit Thdta


Tam Xuto 2, Nit Thdta

804.

loir 806.

807.

808.

809.

810.

811.

812. 813.

814.

815.

816.

817.

818.

819.

820.

821.

822.

823.

824.

825.

826.

827.

828.

829.

830.

831.

832.

833.

834.

835.

836.

837.

838.

839.

840.

841.

842.

Nguyen V i Lpng

Nguyen Tdn Nam Ngd Cdng Doto

Ve Cdng Djnh

Thai Vfa Hda

Chau Ngpe Kha

Doto Thj Thiy

Dofa Thj Hdng

Nguyen Ata Quto Nguyin Ding Tiin

Pham Die Thata

Trto Vfa Ba

Hd Vfa Lpi

Mai Kim Quoc

Nguydn Dang Nam

Nguyen Tien Dtog

Nguyen Dita Ha

Bui Vfa Ngpc

Nguyin Nguyen Vu

Trto Thj Thu Sang

Trto Thj Tien

H i Thj Nhung

Bii Thi Trie Hi

Nguyen Tam

Dmh Xuto Hung

Tra Mita The

Nguyin Van Mudn

Luong Vto Kin

Phgm Nguyin

Trin Ba Ting

Nguyin Die Ata

Nguyin Tr. Phyc

Pham Vto Thugng

Trin Yen Phuang

Ngd Thj Tidn

Le Thi NO

Tra Thi Tin

Trin Thj Lata

Nguyin Ngpc Ata

39

54 49

54

72

34

45

42

34

28

27

45

43

53

54

40

39

71

26

52

38

48

52

55

48

42

50

30

40

37

40

37

41

27

30

42

44 42

45

Chdta VP

Tratag CA

Hdi CTD

PCTMT

CT hdi CCB

Tratag VHTT

Phd HLHPN

CT Hpi PN

CTUBND

CT Hdi ND

CB ddi TT

CB dja chinh

BT Dodn

Hdi CCB

CB tu phap

xa dpi tratag

Tratag CA

PCTMT

CB Vto phdng

Tratag TYT

CTHLHPN

PCTUBND

VP Uy ban CTHpiNCT

BT Doan xa

BQL chp

CTHND Tratag ban TC

CT Hpi CTD

Tratag ban NN CT Mat tidn

PCTHDND

Tratag CA

CBVP PCTUBND

Tratag TYT CT Hdi PN

CBVHTT

CT hdi CCB

Tam Xudn 2, Nui Thanh



Tam Xuto 2, Nui Thtoh

Tam Xuto 2, Nui Thdnh

Tam Xudn 2, Nii Thtoh

Tam Xuto 2, Nii Thdnh


xa Tam Xuan 1

Xa Tam Xudn 1

Xa Tam Xuan 1

xa Tam Xuan 1

xa Tam Xuan 1

xa Tam Xuto 1

Xa Tam Xudn 1

xa Tam Xuto 1

xa Tam Xuto 1

xa Tam Xuto 1

xa Tam Xudn 1

xa Tam Xuto 1

xa Tam Xuto 1

Xa Tam Xudn 1

Xa Tam Xuan 1 Xa Tam Hifp

xa Tam Hifp

xa Tam Hifp

xa Tam Hifp xa Tam Hifp

Xa Tam Hifp

Xa Tam Hiep xa Tam Hifp

xa Tam Hifp

Xa Tam Hifp

Xa Tam Hifp xa Tam Hifp

Xa Tam Hifp xa Tam Hiep

xa Tam Hiep

T/ttIn Nii Thata

843.

844.

"iilT 846.

847. 848.

849.

850.

851.

852.

853. 854.

855.

856. 857.

858.

859.

860.

861.

862.

863.

864.

865.

866.

867.

868.

869.

870.

871.

872.

873.

874.

875.

876.

877.

878.

879.

880.

881.

Bii Vto Son

Do Minh Thata

Nguyin Van Thanh

Le Thata Hda

Pham Vfa Tran Huynh van Binh

Nguyin Van Phfa

Dd Ngpc Tam

Dang Thj T. van

Nguyin Thj Yin

Ng. Thj Ng. Lan Trto Thj Thu

v e Thj Kim Hoa

Nguyin Thj H. An Nguyen Tto Nhcm

Huynh Vto Cdng

Dita Hidn Trung

Huyta Mita Cutag

Phan Nhu Lai

Huyta Vfa oai

Nguyin Quoc Tin

Nguyin Lam

Trin Cao Khai

Nguyin Van Co

Trin Thata Nhung

Pham Cdng Vfa

TrInKhata

Le Vfa Huto

L i Viit Vita

Trto Ting

Nguyin Dutag

Vo Dfag Li Nguyin Thata Vinh

Nguyin Vfa Lu$n

Trin Vfa Huto

Nguyin Die Tri

Huyta Thi

NguySn Tto Trayin

Huyta Thi Hoa

45

32

49

34

20

55

45

32

46

40

34

35

43

45

55

41

53

50

50

50

50

45

44

46

52

47 33

53

53

71

50

49

32

32

25

40

43

47

50

PCTUBND Thj dpi tratag

PCTUB

BT Dpto TN

CB qudn Iy

PCT hpi CCB

CT Hpi ND

PCT Hpi ND

PCT Hfi PN

CT Hpi PN

C. trach DS

CB Dan van

CT Mat trdn

PCT Mat trto

Phd TC-KH

PhdCA

PBT doto

BTdoto

Phd trgm thi y

Tratag VHTT

Phd Ban VHTT

Phd VHTT

CBVHTT

CT Hdi CTD

PCT Hdi ND

GDTTYT

CVPUB

CV phdng GD

Dpi ttg QLTT

Ketoto

Phd phdng GD

PhdCA Dpi tratag CA

Phpph.TBXH

TP Ndng nghiep

CB Phdng y td

KS vien QLTT

Td ttg QLTT

CTHOiLHHPN

T/ttto Nii Thdta

T/tran Nui Thdnh T/trto Nii Thdta

T/tran Nii Thita

T/tran Nii Thata

T/ttto Nii Thata

T/tran Nii Thanh

T/trfa Nii Thinh

T/trto Nii Thita

T/trln Nii Thita

T/tran Nii Thdta

T/tran Nii Thdta

T/trto Nii Thdta

T/trdn Nii Thata

huyfn Nii Thdta

huyfn Nii Thdta

huyfn Nii Thdta

huyen Nii Thdta

huyfn Nii Thdta

huyfn Nii Thdta

huyfn Nii Thdta

huyfn Nii Thdta

huyfn Nii Thdta

huyfn Nii Thdta

huyfn Nii Thita

huyfn Nii Thata

huyfn Nii Thata

huyfn Nii Thita

huyfn Nii Thata

huyfn Nii Thita

huyfn Nii Thata

huyfn Nii Thata huyfn Nii Thita

huyfn Nii Thata

huyfn Nii Thita

huyfn Nii Thata

huyfn Nii Thata

huyfn Nii Thdta

huyfn Nii Thdta

882.

~m7 884.

885.

886.

887.

888.

889.

890.

891.

892.

893. 894.

895.

896. 897.

898.

899.

900.

901.

902.

903.

904.

905.

906.

907.

908.

909.

910.

911.

912.

913.

914.

915.

916.

917.

918.

919.

920.

Le Thj Chung

Bii Thj Xuto Thiy

Trto Thi Bich Hpp

Pham Thj Cic

Pham Thj H. Thim

Duong Bao Lpc

v e Ngpc Hiin

Luong Cdng Thai

Nguydn Vto Cdng

Huynh Quang Dtog

Duong Hotog An

Le Duy Hata Trto Vto Bd

Dtog Ngpc Son

Luu Vto Thotog Nguyin Phudc Lilu

Li Tratag Thdng

Ng Th. Ata Minh

Dfag Thj Lf T i

Doto Thj Thu Thuy

Trto Vto Lpi

Trang Vto Sang

Dd Vfa Xin

Nguyin Tratag Son

Nguyin The Ky

Phan Dita Long

Huyta Chi

Trto Vfa sy

Traong Cdng Thata

Phan Nhat Thutag

Duong Phi Ai

Trin Qude Tri

Nguyin Ldm

Dtog Thj Nam

Nguyin Thi Lupng

Nguyin Tin Hai

Trin Ngpc My

Phan Thata Ba

Trin Nggc Coi

31

55

49

24

53

53

45 55

45

46

64

52

32

60

55

45

56

43

40

53

49

67

37

29

44

48

41

40

45

32

27

50

46

30

32

31

26

37

31

Hpi phd LHPN

Hdi phd LHPN

CV phdng GD

Trutag dai

TT Hpi ND

CB VHTT

CB TPhap

Bi thu Dtog uy

PBT Doto

T.ehinh-KT

CB Dan s i

CB Dto s i

CT hpi ndng dan

Tratag CA

CT hpi CCB

CT HOi NCT

PCT Cyu CB

CBVP

CTHLHPN

Tuydn giao

CBVP

Trg BQL chp

Bi thu Dtog uy

CT hdi ndng dto

Tratag BND

Tratag CA

PCTUBND

PCTUBND

Kitoto

Tratag tai chita

Bi thu doto

PBT Doto

Bi thu ehi bp PCT HLHPN

CTHLHPN

CTUBND

PCTUBND

CAxa

PCAxa

huyfn Nui Thtoh

huyen Nii Thdnh

huyfn Nii Thtoh

huyfn Nii Thdta

huyen Nii Thinh

UBND xa Qui The

UBND xa Qui Thp

UBND xa Qui Tho

UBND xa Qui Thp

UBND xa Qui Thp

UBND xa Qui Thp

UBND xd Qui Thp

UBND xa Qui Thp

UBND xa Qui Thp

UBND xa Qui Thp

UBND xa Qui Thp

UBND xa Qui Thp

UBND xa Que Thp

UBND xa Que Thp

UBND xa Que Thp

UBND TT Tan An

UBND TT Tto An

UBND TT Tto An

UBND TT Tto An

TTTfa An

UBND TT Tto An

UBND TTTfa An

UBND TT Tto An

UBND TT Tto An

UBND TT Tto An

UBND TT Tto An

UBND TTTfa An

UBND TT Tto An UBND TT Tto An

UBND TT Tto An

UBND xa Qui Bita

UBND xa Quf Bita

UBND xa Que Bita

UBND xa Que Bita

921.

922.

923. 924.

925. "

926.

927.

928.

929.

930.

931.

932.

933.

934.

935.

936. 937.

938.

939.

940.

941.

942.

943.

944.

945.

946.

947.

948.

949.

950.

951.

952.

953.

954.

955.

956.

957.

958.

959.

Dtag Vto Tiin

Vu Trang Vto

Trto Ngpc Phim Pham Phi Thanh

Nguyin Vfa Dto Le Dinh Hdi

Dtog Thj Kim Hoa

Dtog thj Thu Nga

Phgm Thj Stog

Trto Thj Anh

Nguyin Thj Thuy

Nguyin van Difn

Lf Vto Hod

Le Tto Quto

Le Vto Lgi

Traang Vto Lilu Le Mita Chdu

Le Ata

Doto Vfa Lam

Nguydn Vfa Thdng

Nguyin Dita Chidn

Trto Oai Dung

Nguyin Mii

Trin Dodn M. Hifp

DO Vto Ba

Nguyin Thj Tu

Trto Thp

Traang Vto Thata

Nguyin Duy Hdu

Vto Thp

Trin Ngpc Thdta

Dap Bdi Thuyin

Ld van Dung

L i van Hda

Nguyin Tan Lgi

Phan Dita Nhto

Le Ngpe Quang

HdVfaAn

Huyta Vfa Hotog

50

38

48

34

63

53

32

34

45

50

46

54

45

55

50

28

42

54

32

47

46

49

56

43

51

56

44

53

47

39 47

45

40

42

32

36

30

28

35

xa dOi tratag

VHTT

CT mat Iran

BTdoto

CTNCT

PCT hpi ND

CB ndng taif p

CT hpi ndng dan

CT HLHPN

CB Ddn s i

VHTT

Bi thu Doto

CT mat trdn

PCTUBND

CB Tu phap

Tratag ban TC

Chi tjch HDND

Tratag VHTT

PCTUBND

Chu tjch UBND

CB Dja chita

CT hpi ndng dto

Bi thu Dang iy

Tratag CA

CB Dto sd

CTHLHPN

TP Kita te

Phd khoa

Phd p. tai chita

Tratag Dai

Tratag phdng

CTUBND

PCTUBND

CT mat ttto

P.phdng GD-DT

Gidm dde Gidm dde

Tratag khoa

PGD

UBND xa Qui Bita

UBND xa Qui Bita

UBND xa Qui Bita

UBND xa Qui Binh

UBND xa Qui Bita

UBND xa Qui Bita

UBISTD xa Qui Bita

UBND xa Qui Binh

UBND xa Qui Bita

UBIMD xd Qui Binh

UBND xa Qui Bita

UBND xa Bita Lam

UBND xa Bita Lam

UBND xa Bita Lam

UBND xa Bita Lam

UBND xa Bita Ldm

UBND xa Bita Ldm

UBND xa Bita Lam UBND xa Bita Lam

UBND xa Bita Lam

UBND xa Bita Lam

UBND xd Bita Lam

UBND xa Binh Lam

UBND xa Bita Lam

UBND xa Bita Ldm

UBND xa Bita Ldm

Huyfn Hifp Die

TT Y te huyfn

Huyfn Hiep Die

Ddi TH huyfn

Phdng TN-MT

Huyfn Hifp Die

Huyen Hifp Die

Huyfn Hifp Die

Huyin Hiep Die

Tr. tam DS/KHHGD TTYT huyfn

TTYT huyfn

TTYT huyfn

960.

961.

962. 963.

964.

965.

966.

967. 968.

969.

970.

971.

972.

973.

974.

975.

976.

977.

978.

979.

980.

981.

982.

983.

984.

985.

986.

987.

988.

989.

990.

991.

992.

993.

994

995.

996

997.

998.

Tran Thai Nguyen

Vu Nggc Vinh

.Trto HOu Thdng Le Trfa Huynh

Phan Thanh Trita

Le Trang Hofag

Phan Ngpc Difp

Huyta Mgt Traang Ngpe Die

Nguyin Vto Hgnh

v a Trung Vift

Nguyen Hdng Mita

Huyta Thj M. Hiin

Trto Thj Th. Thiy

Huyta Thj K. Thio

v a Thj Lan

Nguyin Thj Tiin

Nguyin van Vift

Dita Vto Ly

Hd Vfa Hiin

Hd Vfa Lam

Dita Vfa Thata

Hd Vto Nat

Hd Vto Hiiu

H i Vto Rua

Hd Vfa Giap

Nguyin HOu Giap

Hd Vto Ha

Hd Thi Hita

Trin Thj Thu Hai

Mai Thj Bich Sap

Nguyin Thj Huf

Ho Vfa Xich

Nguyin Mita Die

Khuat Duy Hit Nguyin D. Thuong

Nguyin Dgi Quang

Lf Mita Thing

H i Vto Xung

45

49

57 25

50

44

50

49 27

32

50

56

30

29

28

32

30

57

26

26

26

48

32

64

42

73

25

25

30

46

36

40

38

43

44

23 28

60

27

Q/Iy thj tradng

Phd Phdng

Dpi Phd QLTT

CA huyen

Tratag trgm

CA huyfn

PP VHTT

Tratag tram

Phdng TN - MT

PBT Doto TN

CBUBND

Tratag phdng

Phd Chata VP

CT HLHPN

Bi thu doto

Phd phdng y t i

PCT HLHPN

Thin tratag

Xa dpi phd

Xa ddi tratag

Tratag CA xa xa dpi phd

CT MTrto CT Hdi ND

PBT xa doto

BT xa doto

PCTMTxa

PCTxa

PCT Phy ntt xa CT Phy ntt

CTHpi CCB

CTxa

PCT CCB

CT MTrto

CTHpiND

PCT Hdi ND

Dja chita xa

Vto phdng BT xa doto

Huyen Hifp Die

NN&PTNT huyfn

Huyen Hifp Die

Huyfn Hiep Die

Tram thi y huyfn

Huyen Hifp Die

Huyfn Hiep Die

Tram BVTV huyen

Huyfn Hiep Die

Huyfn Hiep Die

Huyfn Hiep Die

Cdng thuong huyen

UBND huyfn

Huyfn Hifp Die

Huyfn Hiep Die

Huyfn Hiep Die

Huyfn Hifp Die

xa Tra Tap

xa Tra Tdp

xa Tra Tdp

Xa Tra Tap

Xa Tra Tgp

Xa Tra Tap

x a Tra Tdp

Xa Trd Tap

Xa Tra Tap

xa Tra Tdp

xa Tra Tfp

x a Tra Tap Xa Tra Tap

Xa Trd Tap

Xa Tra Tap

Xa Tra Dan

Xa Tra Dan

Xa Tra Don

Xa Tra Don

x a Tra Dan

x a Tra Don Xa Tra Don

999.

1000.

1001.

1002.

1003. 1004.

1005.

1006.

1007. 1008.

1009.

1010.

lOII.

1012.

1013.

1014.

1015.

1016.

1017.

1018.

1019.

1020.

1021.

1022.

1023.

1024.

1025.

1026.

1027.

1028.

1029.

1030. 1031.

1032.

1033.

1034.

1035.

1036. 1037.

Hd Vto Ha

Hd Vfa Phuang

Hi Van Liin

Nguyin Van Xu

Hd Vfa Thp Nguyin Thai Tpan

Nguyin Thj Thanh

Hd Thj Huyin

Hd Vto Quto

Dinh Vto Htog

Nguyen Ngpe Vto

Trin Ngpc Hieu

Ng. Trang Doto

Ng. Thtoh Giang

Nguyen Vu Trang

Nguyin Thata Dgt

Phan Tr. Phucmg

Hd Vto Khdi

Hd Vto Mdt

Hdng Lidm

Nguyen Vfa Hoang

Hd Vfa Duong

H i Thj Nhu Ha

Nguyin van Tutag

Nguyin van Tiin

Nguyin Dita Duy

Ng. Quang Trang

Trin Thata Bita

Nguyin van Bita

Hd Vfa Lpi

Nguyin Cdng Ta

Ld Mgta Hing

Trin Nhat Mita

Trin Vfa Ata

Trita Mita Hii Doto Vto Sogn

V5 Dtog Thugn

Nguyin That Thp

Ng. Thi ta Giang

34

36

26

52

37

29

47

36

26

27

46

43

42

37

49

22

36

56

53

47

40

46

49

32

36

37

26

45

46

28

37

31

38

45

51

44

34

26

37

Thdn phd thdn 1

PCT MT xa

Ndng nghiep xa

Hpi CCB

CB van phdng

CAxa

Hpi Phy ntt xd

Van phdng xa

CT MTrto

PBT Dtog iy

CT Hpi CCB

BT Dtog iy

Giio vien

Phd Ban VH xa

Thdn tratag

Phd CA xa

PCT MT xa

Tratag thin 5

xa dpi tratag

PCT MT xa

CB Hdi CTD

CB van phdng

CTHLHPN

CB phong NN PP kita te

Phd phdng NN

CB CA huyfn

CB VP iy ban Phd CVP iy ban

Phdng ndi vy

CB VP iy ban PhdBQLTT

CB ngto htog

CB Thi y huyen

CB VP iy ban

CBVHTT

CTCD giio due

PGD

Phd Khoa

Xa Trd Don Xa Trd Don

Xa Trd Don

Xa Trd Don

Xa Trd Don

xa Tra Don

xa Tra Dan

Xa Tra Don

xa Tra Nam

Xa Tra Nam

Xa Tra Nam

xa Tra Nam

Xa Tra Nam

xa Tra Nam

Xa Trd Nam

xa Tra Nam

Xa Tra Nam

xa Tra Nam

Xa Tra Nam

xa Tra Nam

Xa Tra Nam

Xa Tra Nam

Xa Tra Nam

huyfn Nam Tra My huyfn Nam Tra My

huyfn Nam Tra My

huyen Nam Tra My

huyfn Nam Tra My huyfn Nam Tra My

huyfn Nam Tra My

huyfn Nam Tra My huyen Nam Tra My

huyfn Nam Tra My

huyfn Nam Tra My

huyfn Nam Tra My

huyfn Nam Tra My

huyen Nam Tra My

TTYT Nam Tra My

TTYT Nam Tra My

1038.

1039. 1040.

1041.

1042.

1043.

1044.

1045.

1046.

1047.

1048.

1049.

1050.

I05I.

1052.

1053.

1054.

1055.

1056.

1057.

1058.

1059.

1060.

1061

1062

1063

1064

1065

1066

1067

1068

1069

1070

1071

1072

1073

1074

1075

1076

v a van Dgi

Huynh Van Thi

Ngd Tin Lgc

Le Vfa Die

Nguyen Van Vy

Ng. Tratag Sinh

Phgm Ngpc Hing

Le Vto Mai

Le Hifu

Nguyen Hptog Thp

Nguyin Dinh An

Ngd Thj L. Huong

Ng. Thj T. Thuy

Nguyen Thj Tutag

Nguyfn Thj Vto

Bii Thj Yen Lita

Ng. Thj Bach Yin

Trfa Vfa Tue

Mai Tto Cutag

Le Thata Chiin

Luang Vto Thdng

Nguyin Thj Bit

Vu Thj Kim Huong

Lam Difu Ngpc

Bii Thj Bdt

Trin Thj Chi

Trjta Ky L P

Pham Thj Hi

Nguyen Thj Suong

Traang Vto Thata

Hd Vto Suong

Traong Die Thi ta

Dita Thi Co

Trin Thi Nhat Thao

Nguyin Nggc Ata Hotog Vinh Lidn

Nguyin Ngpc Mita

DdTi ta Nguyin Vfa Nmh

1

28

31

38

49

30

51

41

43

43

25

44

X

X

X

X

X

X

X

X

55

64

52

50

34

32

38

38

X

X

X

X

X

X

X

X

X

X

X

X

Phd Khpa

Nhdn vidn

Giang vien

Tratag phdng

Tratag phdng

Tratag phdng

Phd Phdng

Tratag Dai

PhoGD

Phdng vidn

Giam die

Nhdn vien

Nhan vien

Nhto vien

TTGDSK

TTGDSK

TTGDSK TTGDSK

TTGDSK

TTGDSK

TTGDSK

TTGDSK

TTGDSK

TTGDSK

TTGDSK TTGDSK

TTGDSK

TTGDSK

TTGDSK TTGDSK

TTGDSK

TTGDSK

TTGDSK

TTGDSK

Nhto vien VP

Nhto vien VP

Cdng tato

Cdng tato Cdng tato

TTYT Nam Trd My

Ph. Npi vu N. Tra My

TTBD Chinh tti NTMy

GTVTdiNamTrdMy

Huyfn dpi Nam Tra My

Phdng GD Nam Tra My

Phdng GD Nam Tra My

Ddi TT Nam Tra My

TTVHTTNamTraMy

Dai TT Nam Tra My

TTBD Chinh trj NTMy

UBND huyfn NTM

Ph. Npi vuN. Trd My

Phdng GD Nam Trd My

Trgm y td Phudc Hda

Trgm y td An My

Trgm y te An Xudn

TTYT Tam Ky

TamKy Trgm y t i Tam Xudn 1

Trgm y te Tam Hiep

Trgm y t i Tam Tien

Nii Thdta

TTYT Nii Thdta

Nii Thata Trgm y te Tdn An

Trgm y ti Qui Thp

Trgm y t i Bita Ldm

Trgm y ti Que Binh TTYT Hifp Die

Nam Trd My

TTYT Nam Tra My

Nam Tra My

Nam Tra My

AnMy-TamKy

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky An My - Tam Ky

1077.

IOTS; 1079:

1080.

I08I.

1082.

1083.

1084. 1085.

1086.

1087.

1088. 1089.

1090.

1091.

1092.

1093.

1094.

1095.

1096.

1097.

1098.

1099.

1100.

1101.

1102.

1103.

1104.

1105.

1106.

1107.

1108.

1109.

II10.

n i l .

1112.

1113.

1114.

1115.

Ngd Long Giang

Nguyen Van Thjnh

Nguyin Hucmg Ng. T. Kim Sang

Le Thi Thanh Nga

Trto Th Thiy Tien

Huyta T. Difu Nga

Cto Thj Thu Stag Tdng Thj Tuydt

Traang Thj Hoa

Trto Thj Trita

Trto Thj Hien Phgm Thj Ngpe

Nguyen Thj Hda

Dtog Oata Trade

Nguyen Thj Lpi

Trto Thj Thu Thiy

Phgm Thj Ddng

Pham Trto B. Thuy

Bii Thj Yin Lita

Huyta Thu Huong

Trin Thj Kim Lita

Trin T. Thu Huang

Ng. Thj Thu An

Hd Thj Bdng

Phan Thj Ld

Pham Tr Td Trang

Ld Dita Htag

Trto Dio

v a Tin Thfag

Ly Hdng Trang

Hd Ttog Vift

Nguyin Mata Hieu

Li Mita Khata

Nguyin Vfa Phic

Nguyin van Hing

Ng. Ngpe Phong

Trin Tupng

Duomg Vto Duong

42

35

67

57

75

50

70

22

36

55

42

30

66

73

45

24

28

30

23

58

48

64

56

58

38

48

46

50

36

59

36

40

34

42

24

45

50

49

45

Cdng tain

Cdng tato

Budn ban

Nhto vidn VP

Nhto vien VP

Nhto vien VP

Budn bto

Budn ban

Budn bto

Budn ban

Budn ban

Budn ban

Budn bto

Budn bto

Budn bto

Budn bto

Budn bto

Budn ban

Budn bto

Budn bto

Nhto vien VP

Nhto vien VP

Nhto vien VP

Nhto vidn VP

Budn bfa

Budn bto

Cdng tato

Cdng tato

Budn ban Nhto vien VP

Cdng tato Budn bto

Budn bto

Budn bto

Nhto vien VP

Cdng tato

Cdng tato

Cdng tato

Cdng tato

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky



An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

An My - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky Phudc Hda - Tam Ky


Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

r~,——1 1116. 1117.

TiTsT II19.

1120.

1121.

1122.

1123.

1124.

1125.

1126.

1127.

1128.

1129.

1130.

1131. 1132.

1133.

1134.

II35.

1136.

1137.

1138.

1139.

1140.

1141.

1142.

1143.

1144.

1145.

1146.

1147.

1148.

1149.

II50.

1151.

1152.

1153. 1154.

Trto Thj Thiy Ng. Thj Td Trita

Tran Thj Tin Nguyen Thj Anh

Vo Thj Tidn

Iran Thj Tita

Le Thj Thanh Nga

Trjnh Thi Man

Trto Thi Dieu

Ng. Luu Vita Thuyen

Doto Thj Th. Tuan

Chdu Thj Cic

Trjnh Thj Ciu

Duong Thj Tuoi

Nguyin Thj A

Phan Thj Kim Cim Trto Thj Hdng

Trto Thj Vto

Phan Thj Xi

Trto Thj Vang

Nguyin Dita Tto

Cao Qude Data

Phan Thata Hdng

Dtog Thj Hue Bui Thj Ly

Huyta Thj Cdng

Hotog Thj Qua

Nguyin Thj Hiin

Trin Thj Kim Ngpe

Phan Thi Bp

Huyta Thj Nd

Ng. Thj My Thuan

Li Thj Budi

Dfag Thj Thiy

Huyta Thj Kim

Bii Thj Tuyin

Phgm Thi Thic

Pham T Kim Tuydt

Trto Thj Lilu

27

52

49

38

42

27

29

36

55

42

56

40

45

42

78

60

46

50

57

50

30

60

45

34

42

50

65

46

57

51

53

40

41

42

51

31

42

41

42

Cdng taan

Nhto vien VP

Nhin vidn VP

Budn ban

Budn bto

Budn bto

Nhan vidn VP

Budn bto

Cdng taan

Nhan vidn VP

Cdng taan

Budn bto Budn bto

Budn bdn

Cdng tato

Cdng tato

Budn bto

Nhto vien VP

Budn ban

Budn bdn

Budn bto

Ndng

Budn bto

Budn bto

Ndng

Ndng

Ndng

Ndng

Cdng tato

Cdng tato

Cdng tato

Budn bto

Ndng Ndng

Ndng

Budn bto

Ndng

Budn bto

Budn bto

Phuae Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky


Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Phudc Hda - Tam Ky

Tto Thgta - Tam Ky

Tto Thgta - Tam Ky

Tto Thgta - Tam Ky

Tan Thata - Tam Ky

Tan Thata - Tam Ky

Tto Thgta - Tam Ky

Tto Thgta - Tam Ky

Tto Thata - Tam Ky

Tto Thgta - Tam Ky

Tto Thgta - Tam Ky

Tto Thgta - Tam Ky

Tto Thgta - Tam Ky

Tto Thgta - Tam Ky Tto Thgta - Tam Ky

Tto Thgta - Tam Ky

Tto Thata-TamKy

Tto Thgta - Tam Ky

Tto Thata - Tam Ky Tto Thata - Tam Ky

r-r-

Tl56^

1157

1159.

1160.

1161.

1162

1163.

1164.

1165.

1166. 1167.

1168.

1169.

1170.

1171.

1172.

1173. 1174.

1175.

1176.

1177.

1178.

1179.

1180.

II81.

1182.

1183.

1184.

1185.

1186.

1187.

1188.

1189.

1190.

1191.

1192J 1193]

Trto Thj Ngp

NgThi Kim Phyng Huyta Thj Kim

Bui Thj Le Huynh Thj Thi

Ng Thl Ngpc Thjnh

Li Thj L i t a

Bit Thl Thu Hanh

Hotog Thj Thiy

Ly Thj Giao Linh

Pham Thi Hdng

Quyta Thj Duyen Le Thi Oanh

Nguyin Chi

Nguyin Phi Quy

v e Thj Lan

Cao Thj H. Thanh

Hd Thj My Dung

Bui Thj Thiy Mai Thj Tam

Trita Thj Lvra

Mai Thj H. Hucmg

Hd Thi Thu Trang

Trto Thi My Lf

Trg T. Cam Hotog

Ha Thj Mudi

Nguyin Thj Phat

Nguyin Thj Yen

Ng. Thj Thata Son

Vo Thj Thuto

Thai Thj Thu

Phan Thoai Cic

Ng. Thj Nggc Lan

Lf Thj Hifn

Phan Thj Ty

v a Thj Quyt

Phfa Thj Mita Tim

Nguydn Thi Mai

46

38

Mai Thi Mita |

54

43

60

47

43

40

30

40

48

46

56

36

41

40

43

36

33

28

47

26

47

47

42

42

46

45

50

52

55

56

46

63

50

46

44

51

55

Budn bto

Budn bto

Budn bto

Ndng Budn bto

Budn bto

Budn bto

Ndng

Ndng

Ndng

Budn ban

Budn bdn

Budn bto

Budn bto

Nhto vidn VP

Nhto vien VP

Budn ban

Cdng tato

Budn bdn

Budn bdn

Budn bto

Nhan vien VP

Budn bto

Budn bto

Budn bto

Budn bto

Nhto vien VP

Budn bto

Nhto viin VP

Nhto viin VP

Nhto vidn VP

Budn bto

Budn bto

Budn bto

Budn bto

Nhto vidn VP

Nhto viin VP

Nhto vien VP

Cdng tato

Tto Thata - Tam Ky

Tan Thanh - Tam Ky

Tan Thata - Tam Ky

Tan Thata - Tam Ky

Tan Thata - Tam Ky

Tan Thata - Tam Ky

Tto Thata - Tam Ky

Tan Thata - Tam Ky

Tdn Thata - Tam Ky

Tdn Thanh - Tam Ky

Tto Thgta - Tam Ky

Tan Thata - Tam Ky

Tan Thgta - Tam Ky

An Xudn - Tam Ky

An Xuto - Tam Ky An Xudn - Tam Ky

An Xudn - Tam Ky

An Xuan - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky

An Xuan - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky

An Xuto - Tam Ky An Xuto - Tam Ky

An Xuto - Tam Ky

Tigs'

1197

TT98"

1199

1200

1201

1202

1203

1204

1205 1206

1207

1208

1209.

1210.

1211.

1212. 1213.

1214.

1215.

1216.

1217.

1218.

1219.

1220.

1221.

1222.

1223.

1224.

1225.

1226.

1227.

1228.

1229.

1230.

1231.

1232.

Nguydn Thj Hutag

Ng. Thj My Nhto

Bii Thj Hing

Huyta Thj Thu Nguyin Thj Trang Huyta Thj Hda Binh

Huyta Son Tin

Nguyin Thj Kiim

Chau Thj Hdng

Vu Thj Kim Huong

Ng. Thj Thanh Nga

Le Thj Phucmg v e Thj Thanh

Duong Thj Ha

Trto Vu My Dung

Trto Thj Lf

Nguyin Thj Cic

Dita Thj Kim Huf

Phan Thj Tidu T i Nguyen Thj Huyen

Nguyen Thj Td Nhi

Duong T Bich Hidu

Hd Thj Thifn

Ng. Thi Lf Huyen

Nguyen Thj Dg Vy

Nguydn Thj Sen

Ng. Thj Thu Thao

Ng. Thj Thata Tam

Nguyin Vfa Hon

Nguyin Van Mai

Nguyin Thj Thdo

Mai Kim Phim

Phgm Thj Hda

Cao Thj Suong

Nguyin Thi Nga

Nguyin Thj Nhgn

Thai Thj Hotog Huy

L i Thj Kim Hdng

Li Thj Ngpc Giau

47

58

29

57

60

47

35

48

43

43

42

45

50

35

45

44

41

36

46

35

39

30

32

38

45

16

21

44

44

42

40

25

47

40

32

45

37

41

37

Budn bto

Budn bdn

Budn bto

Budn ban

Budn bdn

Cdng taan

Nhto vidn VP

Ndng

Budn bdn

Cdng tato

Ndng

Thdt nhifp

Thdt taiep

That nhifp

Budn bto

Nhto vidn VP

Nhto vien VP

Nhto vien VP

Nhto vien VP

Nhto vien VP

Nhto vien VP

Nhto vien VP

Nhto vien VP

Cdng tato

Thdt taifp

That taiep

Budn bto

Cdng tato

Nhto vidn VP

Ndng

Ndng

Ndng

Ning

Ndng

Budn bto

Ndng

Budn bfa

Ndng

Budn bto

An Xudn - Tam Ky

An Xudn - Tam Ky

An Xuto - Tam Ky

An Xuan - Tam Ky

An Xudn - Tam Ky

An Xudn - Tam Ky Thi trin Nii Thtoh

Thj trin Nii Thdta

Thj trin Nii Thdnh

Thj trto Nil Thdnh

Thj trdn Nii Thita

Thj trto Nii Thita

Thj trin Nii Thita

Thj tran Nii Thita

Thi trin Nii Thita

Thj trin Nii Thdta

Thj trto Nii Thata

Thj ttln Nii Thdta

Thj ttin Nii Thita

Thj ttln Nii Thita

Thj ttto Nii Thita Thj trin Nii Thita

Thj tran Nii Thita

Thj trto Nii Thita

Thj trto Nii Thdta

Thj ttto Nii Thita

Thj ttto Nii Thita

Thj trto Nii Thdta





Tam Xuto 1, Nii Thinh




Tam Xuto 1, Nii Thtoh Tam Xuto 1, Nii Thata

Tam Xuto I, Nii Thdta

T233^

T234;

I235?

1236?

1237.

1238.

1239.

1240.

I24I.

1242.

1243.

1244.

1245. 1246.

1247. 1248.

1249.

1250.

I25I.

1252.

1253.

1254.

1255.

1256.

1257.

1258.

1259.

1260.

1261.

1262.

1263.

1264.

1265.

1266.

1267.

1268.

1269.

1270.

1271.

Nguyin Thj Lan

Nguyin Thj Huong Nguyen Thj Le Trinh

Bii Thj Tiin Trdn Thj Tien Linh

Doto T Thanh Trang

Nguyin Thj My Le

Trto Thi Phupng

Vo Thj Thata

Nguyen Thj My Bien

Le Thj Tuyit

Nguyin Thj Hgt

Phgm Thj Hutag Nguyin Vfa Toto

Huyta Thj Dilm Nguyen Thj Binh

Nguyen Thj Mita

Dd Thj Hien

Bii Thj Ban

Le Thj Ba

Nguyen Thj Thata

Doto Thi Vto

Trto T. Mita Duyen

LeThiLe

Truong Thj Phupng

Nguydn Thj Lai

Dd Thj Tmh

Bui Thj Nhutag

Phfa Thj Gidi

L i Thi Bich Hdng

Trin Thj Xuto

L i Thj Hgta Nguyen Tto Thuto

Ngd Httu Nga

Huyta Thata Dung

Nguydn Die Tri

Nguydn Nguyen Vu

v e Phung

Doto Thuydn

44

46

49

52

42

47

44

40

31

31 33

40 37

30

41

41

54

40

33

44

41

44

44

31

47

47

40

38

37

25

49

30

38

67

45

60

55

57

48

Cdng tato

Ndng

Ndng

Ndng

Ndng

Nhto vien VP

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Budn bin

Budn ban

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Budn bto

Budn bto

Budn bto

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng Ndng

Ndng

Ndng

Ndng

Ndng

Budn bfa


Tam Xudn 1, Nii Thinh

Tam Xuan 1, Nii Thinh

Tam Xuan 1, Nii Thinh

Tam Xuto 1, Nii Thanh

Tam Xudn 1, Nii Thdnh






Tam Xuan 2, Nii Thtoh




Tam Xudn 2, Nii Thdta


Tam Xudn 2, Nii Thdta


Tam Xuto 2, Nii Thdnh



Tam Xuin 2, Nii Thtoh

Tam Xuto 2, Nui Thita




Tam Xuto 2, Nii Thtoh Tam Xuto 2, Nii Thita



Tam Xuan 2, Nil Thtoh

Tam Hifp, Nii Thita Tam Hifp, Nil Thita

Tam Hifp, Nil Thita

Tam Hifp, Nii Thita

Tam Hifp, Nii Thita

Tam Hifp, Nii Thita

Tam Hifp, Nii Thata

1 2 7 1 1273.

1275?

1276.

1277.

1278.

1279.

1280. 1281.

1282.

1283.

1284.

1285. 1286.

1287.

1288.

1289.

1290.

1291.

1292.

1293.

1294.

1295.

1296.

1297.

1298.

1299.

1300.

1301.

1302.

1303.

1304.

1305.

1306.

1307.

1308.

1309. 1310.

Duong Qude Hing

v e Thj Nang

Hd Thj Kiing

traong Thata Thiy Trto Thj Thu Dung

Trin Thj Huong

Phgm Thj Lan

Trto T. Thiy Duong

Huyta Thj The Huyta Thj Cu

Dio Thj Lien

Huyta Thj Cia

Nguyin Thj Tratag

Ng. Thl Hdng Vin Hd Thj Kiiu

v e Thj Ning

Nguydn Hdng Phong

Phan Mita Hucmg

Trto Ngpc Hai

Nguyin Thj Tra

Bui Thi Chung

Le Thj Minh Gidi

Huyta Thj Phupng

Huyta Thj Den

Bii Thj Van

Trin Thj Nghe

Nguyin Thj Hgnh

Thai Thj Hai Yen

Nguyen Lieu

Nguyin Thj Huang

Trin Thj Tam

Dd Thj Hoa

Lf Thj Nga

Nguyin Thj Tieu

Nguyen Thj Ntt

Bui Thj Ky

Doto Thi Cie

Nguyen Thi Hoa Trto Huu Phudc

53

47

60

29

56

40

43

46 44

30

58

44

32

40

46

60

52

49

51

54

47

54

29

45

41

49

44

41

39

43

43

60

65

40

41

65

80

49

51

Ndng

Ndng

Ndng Budn ban

Budn ban

Cdng tadn

Cdng nhan

Cdng tadn

Ndng

Ndng

Budn bdn

Ndng

Ndng

Ndng

Budn bdn

Cdng tadn

Ndng

Ndng

Ndng

Ndng

Cdng tato

Ndng

Cdng tato

Cdng tato

Buin bto

Ndng

Cdng tato

Cdng tato

Ndng

Budn bto

Budn bto

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Tam Hiep, Nii Thdta

Tam Hifp, Nii Thinh

Tam Hidp, Nii Thinh Tam Hidp, Nui Thanh

Tam Hiep, Nii Thanh

Tam Hifp, Nii Thita

Tam Hiep, Nii Thinh

Tam Hifp, Nii Thdnh

Tam Hiep, Nii Thdta

Tam Hiep, Nii Thanh

Tam Hifp, Nii Thdnh

Tam Hifp, Nii Thdnh

Tam Hiep, Nui Thdta

Tam Hiep, Nui Thata

Tam Hifp, Nii Thita

Tam Hifp, Nii Thita

Tam Hifp, Nii Thdta

Tam Hifp, Nii Thita

Tam Hifp, Nii Thdta

Tam Hiep, Nii Thdta

Tam Hifp, Nii Thdta

Tam Hiep, Nui Thdta

Tam Hifp, Nii Thdta

Tam Hiep, Nii Thita

Tam Hiep, Nii Thita

Tam Hiep, Nii Thita

Tam Hifp, Nii Thita

Tam Hiep, Nii Thdta

Tam Hifp, Nii Thdta

Tam Hiep, Nii Thdta

Tam Hifp, Nii Thita

Tam Hifp, Nii Thdta

Tam Hifp, Nii Thdta

Tam Hiep, Nui Thita

Tam Hiep, Nii Thata

Tam Hifp, Nii Thita

Tam Hifp, Nii Thita

Tam Hifp, Nii Thita


l3lT 1314

1317 1318

1319 1320

1321 1322

1323

1324

1325.

1326.

1327.

1328. 1329. 1330.

1331.

1332.

1333.

1334.

1335.

1336.

1337.

1338.

1339.

1340.

1341.

1342.

1343.

1344.

1345.

1346.

1347.

1348.

1349.

Pham Tiin

Duong Quic Cutag

Nguyen Vin Minh

Nguyin Thj Ba

Huyta Thj Tam

Le Thj Vto

Huynh Thj Hda Nguydn Thj Xuan

Dtog Thj Tita Duong Thl Phuang

Ttog Thj Hue Hd Thi Nguyft

Dtog Thj Kim Loan

Phan Thj Cam

Nguyin Thj Xy

Dtog Thj Kim Lf

Trto T. Ngpe Thuto

Trto Thj Cam Trfa Thj Suong Nguyin Thj Kiiu

Phan Thj Hien

Trto Dmh BChdi

Ld Nggc Quyt

Dd Hdng Lto Duong Hoto An

Tran Thj Hgta

Le Thj Sa

Ng. Thi Thata Thiy

Trto Thi Phugng

Bii Thj Thata

Trin Thi Lin

Truong Thj Hoa

Trin Thj Biy

Trin Thj Thata Hda

Ld Thi Nga

Phgm Thj Hifp

Nguyin Thj Tiin

Mai Thj Nam

Hd Thj Thu

31

31

42

45

37

32

53

24

42

43

38

47

30

57

42

48

49

48

34

42

32

34

45

31

36

36

47

25

29

46

77

43

38

26

40

43

41

42

47

Ndng

Ndng

Ndng

Ndng

Ndng

Cdng taan

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Budn bto

Budn ban

Cdng taan

Budn bto

Nhdn viin VP

Budn bfa

Budn bfa

Nhto vien VP

Budn bto

Budn bto

Ndng

Ndng

Ndng

Budn bto

Budn bto

Budn bto

Budn bto

Ndng

Budn bto

x a Qui Tho, Hiep Die

Xa Qui Tho, Hiep Die

xa Que Tho, Hiep Die

Xa Que Tho, Hiep Die


Xa Qui Tho, Hiep Due

xa Qui Thp, Hiep Die Xa Qui Thp, Hiep Die

Xa Que Tho, Hiep Die


xa Qui Tho, Hiep Due



Xa Que Thp, Hiep Die

Xa Qui Thp, Hifp Die xa Que Thp, Hifp Die


xa Que Thp, Hiep Die




TT Tto An, Hifp Die

TT Tto An, Hifp Die

TT Tto An, Hiep Die

TT Tan An, Hiep Die

TT Tan An, Hifp Due

TT Tto An, Hifp Die

TT Tto An, Hifp Die

TT Tto An, Hifp Due

TT Tto An, Hifp Die

TT Tto An, Hiep Due

TT Tto An, Hifp Die

TT Tto An, Hifp Die

TT Tto An, Hifp Die

TT Tto An, Hifp Die TT Tto An, Hiep Due

TT Tto An, Hifp Die

TT Tto An, Hifp Die TT Tto An, Hifp Die

lur U 5 2 :

1353.

1354 J

1355. 1356.

1357. 1358.

1359. 1360.

1361.

1362.

1363. 1364.

1365.

1366.

1367.

1368.

1369.

1370.

1371.

1372.

1373.

1374.

1375.

1376.

1377.

1378.

1379.

1380.

1381.

1382.

1383.

1384.

1385.

1386.

1387. 1388.

VaThjNhftHd

Nguyin Thj Anh

Nguyin Thj Ai

Hotog Thj Nhu Nguyen The Ky

Trto Van Anh Trjta Ky Die

Dtog Kim Cdm Trto Xuto Huy

Dd Thj Hong

Phan Thj Mdn

Dd Thj Tratag Lilu

Dtog Thj Tim

Nguydn Thj Cam Le Thj Thiy

Ngo Thj Chi

Vo Thj Lieu

Dfag Thj Lieu

Nguyen Thj Loan

Truong Thj Vin

Phan Thj Tam

Dd Thj Hucmg Ly

Ng. T. cam Thuong

Nguyin Thj Phuae

Ducmg Thj Vift

Trin Thj Phyng

Ducmg Tto Bdn

Trjta Mdt

Dii Vfa Tam

Luu Due Hanh

Nguyin Hata

Ly Thata Luang

Pham Vto Mata

Nguyin Tto Lgi

Dang Kim Cam

Huyta Mita Nudi

Nguyin Thj Phupng

Nguyin Thj Phong

Traong Thj Huong

34

49 45

26

48

43

52

42

37

40

38

40

46

26

44

31

40

32

39

46

45

26

49

46

40

35

28

41

35

35

38

48

55

45

52

32

40

46

55

Nhdn vien VP

Ndng

Budn bto

Ndng

Ndng

Ndng Ndng

Nong

Ndng

Nhdn vien VP

Ndng

Ndng

Ndng

Nhdn viin VP

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng Ndng

Ndng

Ndng

Ndng

Ndng

Cdng tato

Ndng

Budn bfa

Budn bto

Budn bfa

Budn bfa

TT Tan An, Hifp Die

TT Tdn An, Hifp Due

TT Tdn An, Hiep Die

TT Tdn An, Hiep Die

Que Binh, Hiep Die

Que Binh, Hiep Die Que Blnh, Hiep Die

Que Binh, Hiep Die

Que Bita, Hifp Die

Que Binh, Hiep Die

Que Bita, Hiep Die

Que Binh, Hifp Die

Que Binh, Hifp Die

Qui Binh, Hifp Die

Que Binh, Hifp Die

Que Bita, Hifp Die

Que Bita, Hifp Die

Que Bita, Hiep Due

Que Bita, Hiep Die

Qui Binh, Hiep Die

Que Bita, Hifp Die

Que Bita, Hifp Die

Que Bita, Hifp Die

Qui Bita, Hifp Die

Qui Bita, Hifp Die

Que Bita, Hifp Die

Bita Ldm, Hifp Die

Bita Ldm, Hifp Die Bita Ldm, Hiep Die

Bita Lim, Hifp Die

Bita Lim, Hifp Die

Binh Lam, Hiep Die

Bita Ldm, Hifp Die

Bita Lim, Hifp Die

Bita Lim, Hifp Due

Bmh Lam, Hifp Die

Bita Lam, Hifp Die

Bita Lam, Hifp Die

Bita Lam, Hiep Die

1389.

UgT 1392.

1393.

1394.

1395.

1396.

1397.

1398.

1399.

1400.

1401.

1402.

1403.

1404.

1405.

1406.

1407.

1408.

1409.

1410.

I41I.

I4I2.

1413.

1414.

1415.

1416.

I4I7.

1418.

1419.

1420.

1421.

1422.

1423.

Nguyen Thj Tien

Duong Thj cam

Phgm Thj Phi

Trjnh Thj Lan

Ng. Thi Phudc Ngpc

Trto Thj Minh Hdng

Phan Thj Mai

v a Thj Sau

Ng. Thj Nggc Tam

Hd Vto Lyc

Hd Vfa Bien

H o V t o N i c

Hd Thj Nhu Hit

Hd Thj Rfag

Hd Thj Bac

Nguydn Thj Lan

Hd Thj Ata

Nguyin Thi Nd

Hd Thi Thata

Ho Thj Hgta

Nguyin Xufa Ring

Hd Vfa Lpi

YBdy

Nguyen Vdn Quang

Mai Thi Ata Tuydt

Dmh Thj Hifp

Nguyin Thj Hdng

H i Thj Giap

Hd Thi Bita

Nguyin Thj Hai

Nguyin Thi Chita

H i Vfa Lai

H i Thj Hing

Hd Thj Giang

Hd Thi Thoa

20

25

30

39

26

32

45

30

38

49

50

40

41

31

43

50

38

35

59

69

20

17

42

39

19

26

27

25

49

20

42

24

24

27

25

That nhifp

Ndng

Ndng

Budn ban

Nhan vien VP

Budn ban

Budn bto

Budn ban

Nhan vidn VP

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ning

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Binh Lam, Hifp Die

Binh Lam, Hiep Die

Binh Lim, Hiep Die

Binh Lim, Hifp Die

Binh Lam, Hifp Die

Binh Lam, Hifp Die

Binh Lam, Hifp Due

Binh Ldm, Hifp Die

Binh Lim, Hiep Die

Thdn 2, Tri Nam, NTM

Thdn 1, Trd Nam, NTM

Thdn I, Tra Nam, NTM






Thin I, Trd Nam, NTM



Thdn 1, Trd Don, NTM

Thdn 6, Trd Don, NTM

Thdn 1 - Tra Don, NTM

Thdn 1-Tra Don, NTM

Thdn 6-TraDon,NTM





Thdn I-TrdDan,NTM

Thdn 1 - Trd Don, NTM

Thdn3-TrdTap,NTM

Thdn 1-Trd Tap, NTM

Thdn I-TrdTap,NTM

Thdn 4-Tra Tap, NTM

1424.

1425.

1426.

1427.

1428.

1429.

1430.

Nguydn Thi Hoa

Hd Thi Thdng

Hd Thj Lien

Nguyen Thj Minh

Hd Thj Sdm

Hd Thj Son

Hd Thj set

34

23

36

30

41

30

24

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Ndng

Thin 4 - Tra Tap, NTM

Thdn 2 -Tra Tap, NTM

Thdn 2 -Trd Tap, NTM


Thdn 2-Tra Tap, NTM



TAI LIEU THAM KHAO

I. TIENG VIET

1. Nguyen Thanh Binh, Nguyin Vdn Ctoh (2005), "Dtoh gid tinh hinh ngd ddc thuc phdm tinh Bita Thudn 2000-2004". Hpi nghj Khpa hpc VSATTP lln thi 3, Nxb Y hpc. Hi Npi, tt 437-442.

2. Ban chi dao lidn ngtoh vi vf sita an loan thye phim qude gia (2008), "Bao eao hpi nghj toto qude lln flii II vi cdng tic bao dam vf sinh an toto thye phim". Ha Ndi, thtog 4/2008, 157-161.

3. Bp Y te (2000), Chiin lupc hanh ddng Qude gia dita dutag 2001-2010, Ha Ndi, tt 2-5.

4. Bd Y t i - Cyc QLCLVSATTP (2002), An toan fliuc phim sic khde ddi sing vi kita t i xa hpi, Nxb Y hpc. Ha Ndi, tt 16-112.

5. Bp Y t i (2005), Ve sinh an toto thye phdm, Nxb Y hpc. Ha Ndi, tt 12-173.

6. Bd Y t i - Cyc QLCLVSATTP (2002). Bdo edo kit qud edng tac quan ly chit lupng vf smh an toto thye phim nam 1999.

7. Bd Y t i (2005), "Qui dita vd ede dieu kien ve sita chung dii vdi co sd sdn xuat

fliuc phim", Quyit djta sd 39/2005/QD - BYT ngay 28/11/2005.

8. Bp Y t i (2005), "Qui djta vi cdc diiu kifn vf sita an todn thye phim ddi vdi co sd

kmh doanh, dich vy, phyc vy an uing", Quyit djnh sd 41/2005/QD-BYT ngay

8/12/2005.

9. Bd Y t i (2005), "Qui chi vi cing bd tidu chuin sto phim thye phim", Quyit djnh

sd 42/2005/QD-BYT ngay 8/12/2005.

10. Bd Y t i (2005), "Qui djta ydu ciu kiin fliic vi vf sita an toto thye pham ddi vdi

ngudi tivc tiip sin xuit, kita doata thye phim", Quyit djnh si 43/2005/QD-BYT

ngay 20/12/2005.

II.Bf Y t i (2006), "Qui ehi eip gily chtag tagn du diiu kifn vf sita an toto fliyc

phim dii vdi co sd sto xuit, kita doata tiiuc phim cd nguy ca cao".

12. Bf Y t i (2007), "Quyit djnh s i 21/2007/QD-BYT ngay 12/3/2007 ban hanh "Qui djta vd diiu kifn s ic khod dii vdi nhttng ngudi tiip xic true tiip trong qua trita ehe bien thye phim bao gdi sin va kinh doanh thye phim an ngay"

13.Bd Y t i (2006), "Qui dinh phan cap nhifm vy quan ly va tham gia quan ly nha nude vi vf sinh an todn thye phim trong ngdnh y ti", Quyit djnh si 12/2005/QD-BYT ngay 9/3/2006.

I4.Bp Y t i (2001), "Qui djnh vi diiu kifn bao dam an todn thuc phim tai cdc nha dn,

bip to tap thi va ca sd kinh doanh chi biin suit an sin ', Quyit djnh si

4428/2001/QD-BYT ngay 3/10/2001.

15. Bp Y t i - Cyc ATVSTP (2001), Tai lifu tgp huln giam sat ngd ddc thye phim, tt 1-26.

16. Bp Y te (2008) - Tai lifu Hpi nghj ting kit chuang trinh muc tieu quic gia nam

2007 va ttiin khai ke hogeh chuong ttinh muc tieu qude gia nam 2008.

17. Chita phi (1999), "Chi thj cia Thi tutag Chinh phi vi vifc tang cutag edng tae

dam bao VSATTP"

18. Hotog Tiin Cutag (2003), " Mil sd tato xet ve tita hita ngd doc thuc phim

ttdn dja bto tita Nam Djta t i nim 2000-2004". Hdi nghj Khoa hpc VSATTP lln

tiiu 2, Nxb Y hpc. Ha Ndi, tt 379-384.

19. Cue An toto vf sita thuc phim (2005). Ky yiu Hdi nghj khoa hpc ve sinh an

toto thuc phim lln thi 3 - NXB Y hpc.

20. Cyc An toto vf sita an toin thye phim (2005). Cae vto ban quy phgm phap lugt

v i smh an toto fliye phim tap 1 va 2 - NXB Y hpc.

21. Cyc An toto vf sita an toto fliye phim (2009). "Tai lieu hdi nghj tdng kit

chuang tiita mye tidu qude gia ve sita an toto thye phim nam 2008 va trien khai

k i hoach 209", Ha Npi, tt 47-49

22 Cue An todn ve sita an todn thye phim (2010). "TM lieu hdi nghj tdng kit

chuang trinh mye tieu quie gia vf sita an toan thye phim nam 2009 va ttiin khai

k i hogch 2010", Ha Nf i, tt 64-65

23 L i Dofa Didn, Phan Qude Kita va cdng su (2002). Cac ehlt bd sung dinh dutag

. Ngata khoa hpc cdng nghe mdi eia till ky 21. Nhi xudt bfa cong nghiep.

24. Trin Dtog (2006). Vf sita an toto fliue phim. Nha xuit bto Y hpc.

25. Trin Dtog (2005). Kiim sodt vf sita an todn thue phdm thic an dutag phi -

NXB Thanh nien.

26. Trdn Ddng (2002).Cdng tdc truyin thdng va chi dao tuyen hoat dong bao dam chit lugng vf sinh an todn thye phdm - NXB - Thanh nien.

27. Tran Dtog (2005). Ca ndc vd di phdng ngp dde ca ndc - NXB Y hpc.

28. Tran Dtog (2004). Mdi nguy vf sinh an loan thye phim, chuang trinh kiim soat

GMP, GHP va hf thdng quto ly chit lupng vi sita an loan thye phim HACCP -

NXB Y hpc.

29. Trto Dtog, (2003), Tinh tat yeu cia an toin thye pham, vai trd cia nd trong ddi

sdng xa hpi. Ha Npi, tr 1-7, 13-14, 17-24.

30. Trin Dfag (2003), Tinh hinh quto ly vf sinh an toan thye pham d Viet Nam, Ha

Npi, tti, 9-16.

31. Trin Dtog, (2003), Bao cdo chuydn di thye trang cdng tdc chi dao dieu hdnh vi phdi hpp ttong quto ly taa nude vi ve sinh an toan thye phim d nude ta trong tattng nim qua (tu 1999 din nay). Kiin nghj cac giai phap. Ha Npi, tt 7-8, 16.

32. Trin Dtog va Cs (2005), "Nghien eiu eo sd khoa hpc di di xuit qui hoach phit

triin mgng ludi quto ly vf smh an loan thye phim ttong ngata y te", De tdi

nghien eihi khoa hpc d p Bd y ti, http/wwwcimsi.org.vn

33. Hd Ata Ddo, Nguyin Thj Ldm (2000), "Tinh cip bach cia cing tie vf sinh an

toan fliye phim", Mdt s i edng ttita nghien cuu Vifn Dinh Duong, Nxb Y hpc,

HaNpi,tt 51-56

34. Tu Gily (1996), Phong each to Vift Nam, Nxb Y hpc. Ha Ndi, tt 70-80

35. TO Gily (2000), "BOa an thi ky 21", Mpt sd cdng trita nghidn ciu vi dinh

duong vi vf sita an toan thye phim, Hd Npi, tt 26-27

36. Thai Ha (2008), Chua kiim spat dupe bip to tgp thi tgi ttutag hpc, bfta viin,

s ie khoe, tiin pheng onlie. Html.

37. T.T. Hing (2008), 73 bdp ta vi phgm vf sita fa toto thye phim, Y t i sue khoe,

SGGP online, html.

38 Hdi ddng vd sita Chto A (2007), "Hfi ddng ve smh Chto A keu gpi ngudi dto

fliyc hifn cic flidi quen vf sita tdt hon ttong gia dhih", BACSI.com

http://BACSI.com

39- Nguyin Thj Hiin, Phgm Thj Yin, Phan Thj Kim, Nguyin Thj Sat, Nguyin Thj Khfah Tram va cac cpng su (2006), "Tita hinh d taiim vi khuln va taan thic vf sinh an toin thue phim d ngudi kinh doanh thie an dutag phd"

40. Nguyin Sy Hio, TO My Linh (2003), "Ddnh gid tinh hinh ngp doe thuc phim tai thdnh phi Hd Chi Minh t i 1995-2002". Hpi nghi Khoa hpc VSATTP lln thu 2, Nxb Y hpc. H i Npi, tt 58-64.

41. Nguyin Vdn Hai, Le Trung Hdi (2005), "Nhdn xet 173 Irudng hpp ngo doc iliui phim tgi Khtoh Hod 2001-2004". Hdi nghi Khoa hpc VSATTP lln thu 3, Nxb Y hge. Ha Npi, tt 443-452.

42. Chu Minh Khd (2007), "Btta to cdng nhdn mit vf sinh", Vneconomy.html.

43. Phan Thj Kim, Bii Minh Die (2002). Thye phim, thye phim ehic ning an loan

va s ic khoe bin vihig - NXB Y hpc.

44. Phan Thj Kim vi cs (2001). Ve sinh an teto tbyc phim va de phdng ngd ddc thye

phim - Cdng ty in Lao ddng - Xa bpi

45. Phan Thj Kim (2003), "Bto vi quan ly an toto vf sinh thirc pham hien nay", lap

ehi Y hpc thue hata ndm 2003 si 3 tap 445, fr 38-41.

46. Phan Thj Kim, Bii Mita Die, Phgm thj Giang (1994), Bao eao tdm tit hoat ddng

ATVSTP Vifn Dita Dutag nam 1994.

47. Trin Vto Ky (2005), "Phdn tieh cdc mdi nguy gay ngd dde tiiye pham va cac

bfta tiuyin qua thye phim tgi cdc bip fa tap thi vd cac bien phap qudn ly va de

phdng cac moi nguy cia cong ty TNHH Aden services Vift Nam". Hdi nghj

Khoa hgc VSATTP lln thi 3, Nxb Y hge. Hi Npi, tt 416-419.

48. Phap Ifta vf sita an tpan fliue phim va Van ban hutag dto thi hdnh -NXB Y

hpc, 2004.

49. Thata Nhto (2007), "Cdc bip to tap tfii d Ha Npi mit vf smh", sic khoe,

vnexpress.

50 Huyta Vfa Ndn (2006), "Hifu qia hogt dgng ttuyin tiidng giio due sic khde vl

• vf sita mdi ttutag tai 5 diim tratag tiiu hgc huyfn Phi Tto tita An Giang".

51 Phgm Thi Ngpc (2003), "Dita gia tmh hmh ngd ddc fliyc phim tita Ydn Bai

• ttong 5 nam 1997-2002". Hdi nghj Khoa hpc VSATTP lln tiii 2, Nxb Y hpc, Ha

Nfi, tt 92-97.

52- Nguyin Thj Thata Qui (2006), "Nghidn ciu tag dung md hinh giam sit ngd ddc

thye phdm tgi thanh phi Nha Trang tinh Khanh Hda", http/www. Cimsi.org.vn

53. So y t i Qudng Nam (2007), "Tdi lifu tap huln VSATTP cho ngudi qudn ly vd

ngudi tryc tiep sto xuit, ehi biin, kinh doanh tgi cac co sd thuc phim", 74-75.

54. Sd y t i Qutog Nam (2007), "Nhttng dilu cin lam di cd btta in ngon" Tdi lieu tuyen tiuyin VSATTP.

55. Trto Thj Thtoh (2005), "Tinh hinh ngp dpe thuc phim tai Tiin Giang 2000-

2004", Hpi nghj Khoa hpc VSATTP lln thi 3, Nxb Y hpc. Ha Ndi, tt 403-408.

56. Tratag dgi hpc Y Ha Nfi (2004), Dita dutag vd vf sinh an tpan thuc phim, Nxb Y hpc. Ha Npi, tt 353-383.

57. Huyta Thi, (2007), "Tinh hita vf sinh an tpan thue phim treng tratag hpc d Bin Tre".

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