Healthcare System In Vietnam.pptx

Healthcare system in Vietnam Public Health, Policy and Practice Tran Thuy Ngan Hoang Gia Linh

Introduction About the country • Vietnam is a South-East Asian country • Population: 90 million • Lower middle-income country with GDP US$ 2,000 per capita per year

Health indicators • Life expectancy at birth increased: from 69 in 2000 to 73 in 2013 • Maternal mortality decreased: from 170 per 100,000 live births in 1990 to 65 per 100,000 live births in 2013 • The under 5 mortality decreased: from 34 per 1,000 live births in 2000 to 23 per 1,000 live births in 2013 • Polio-free status achieved in 1997 • Elimination of neonatal tetanus achieved in 2005 • Shift from communicable diseases to non-communicable diseases: proportion of communicable diseases decreased from 38% in 1996 to 25% in 2013. In 2013, proportion of non-communicable diseases was 62%

Healthcare system At present, the public health care sector widely covers from central to grassroots levels Central level (Ministry of Health)

Provincial level

District level

Commune level

• Issuing law and other legal documents, making long-term plans and strategies • Managing national hospitals, research institutes, universities and colleges • State-level department of health • General and specialized hospitals (maternity, obstetric, paediatric, traditional medicine, tuberculosis and lung disease hospitals) • Specialized medical centers (reproductive health, preventive medicine, HIV/AIDS, communication and health education, food safety and population agencies)

• General hospitals and preventive medicine centers at district level • Other district agencies engaged in health: population, food safety management • Provide basic services:mother and child health care, family planning, treatment for acute respiratory infections, immunization and treatment of common illnesses

Healthcare system Private health facilities • • • • •

Late 1990s and early 2000s Including private hospitals, medical and maternity clinics Mainly developed in highly populated urban areas Licensed by the Ministry of Health 2013: 155 private hospitals and more than 30,000 private clinics

Health information management system • Reports are mostly paper-based and manually created → difficult to obtain the accurate data and analyze • Health workers in lower level report monthly to higher levels → takes time

Need of a computerized, universal and comprehensive health information management system

Health equity Quality of healthcare between cities vs rural location • Most patients prefer to go to better provisioned public hospitals in major cities (Hanoi, Ho Chi Minh) • Not only serve the needs of citizens residing in the cities but also people travelling from the surrounding countryside • Some hospitals in central level are always overcrowded: reaching 120-160% bed occupancy [3]

• What are the reasons? • High quality, advanced and well-equipped hospitals and clinics: clustered around major urban areas • In rural areas, accessing quality healthcare is more challenging: lack the diagnostic equipment and training to carry out some treatments [3]

Health equity Quality of healthcare between cities vs rural location • Most critical issue Disintegration of health facilities at the primary care level

 Government efforts • Project 1816: Satellite Hospital Program • Rotate experts from central-level hospitals through local hospitals to train their colleagues on the procedures and devices necessary to provide more treatment options locally

Health insurance • In 1989, health insurance was introduced in Vietnam and began to be implemented in 1992 • In 2014, the Law of Health Insurance was revised with the aim of Universal Health Insurance Coverage • Health insurance provided by the government includes 3 types: medical insurance, accident insurance and a part of social insurance • For employees • Who are in contract with an organization for more than 3 months • Total cost for medical insurance is 4.5 of salary (3% paid by employers)

• Use of government insurance • Most people use government insurance for major surgery and treatments: long process, high cost (for example: orthopedic surgery, cancer treatment…). • For minor cases such as health check-up, patients often disregard of the insurance because of the complicate procedure

Health insurance • Health insurance coverage over the years [4]

References 1.

World Health Organization (2016). Human resources for health country profiles – Vietnam.

2.

Le DC, Kubo T, Fujino Y, Pham TM, Matsuda S. Health Care System in Vietnam: Current Situation and Challenges. Asian Pacific Journal of Disease Management. 2010. 4. 23-30. 10.7223/apjdm.4.23.

3. Hoang, C. K., Hill, P., & Nguyen, H. T. (2018). Universal Health Insurance Coverage in Vietnam: A Stakeholder Analysis From Policy Proposal (1989) to Implementation (2014). Journal of Public Health Management and Practice, 24, S52-S59. 4. Ministry of Health. Annual Report on Healthcare Activities 2011-2018 Vietnam. Hanoi, Vietnam: Ministry of Health; 2011-2018