As Vietnam has grown and developed over the last two to three decades, so has its health care system. There is a decrease in the number of deaths due to health issues and an increased rate of vaccination through Universal Health Coverage (UHC). With much success for the UHC implementation, Vietnam’s health system has become a model to other countries. However, there is still a difference in the level of care between the rich and poor in Vietnam’s health care system.
Health Care and Hospital Systems
Business Monitor International (BMI) stated that health care spending in Vietnam in 2017 increased to 7.5 percent of gross domestic production, which is $16.1 billion. Meanwhile, experts forecasted it to grow 12.5 percent annually during a four-year period from 2017-2021, which would be approximately $20 billion according to KPMG. Public health care spending is expanding with social health insurance programs that projections determine will 58.1 percent of all health care spending.
Vietnam’s health care system is decentralized with the Ministry of Health at the central level. Meanwhile, the provinces, cities, districts and communities connect to the Ministry of Health. The four groups implement their own health policies and manage their own health care system and facilities. The Ministry of Health (central level) manages the health care system for the government as well as hospitals, medical education and research. Provinces and cities run hospitals, other health care facilities and health care-education programs with central oversight. Finally, health care facilities at the district and commune-level provide basic medical care with preventative services.
Universal Health Coverage (UHC)
Vietnam is a leader in implementing universal health coverage. This would cover medical and dental services as well as medicine and vaccines. The Global Monitoring Report on UHC by both the World Health Organization and the World Bank states that almost 88 percent of people in Vietnam have health coverage and 97 percent of the children received vaccinations. There is also a 75 percent decrease in the death of mothers through universal health coverage. Vietnam has reached health care goals (as recommended by the United Nations’ Sustainable Development Goals) earlier as compared to other countries due to its strategy on using all that is available, including staffing and administration.
Public View and Poverty Gap
Vietnamese’s traditional viewpoint on health care services affects health care delivery. It is a common belief that larger health care facilities in big cities would provide better health care services through more specialized staffing and more robust technology and equipment. Therefore, people tend to overlook smaller local facilities in the countryside or in rural areas. This, in turn, is impeding faster and necessary care while incurring unnecessary, unknowing or avoidable high costs. Such a barrier would ultimately contradict the proposed health care strategy above.
Vietnam’s health governance body is working to change the public viewpoint on local community health by educating the public about the programs and charging local health offices to provide excellent care in order to build trust. Wealthy patients have better access and higher quality health care. As wealthy patients tend to live in big cities, they are closer to big health care facilities that are well equipped. Meanwhile, poorer patients often have to travel hundreds of miles from rural areas to reach better care. While private insurance gives patients primary and preventative medicine that would avoid high health care expenditures due to medical emergencies, wealthy patients have more opportunity to purchase private insurance for better care. Health care inequity leaves the poor at a disadvantage with higher chances for illness and a lower quality of care.
Support and Challenges for UHC
Vietnam’s universal health care is receiving support from the Working Group for Primary Healthcare Transformation. The group works to present and emphasize primary care services in provinces around Vietnam, as well as improve and expand those services moving forward. Harvard Medical School, a member of the group, helps with primary care structuring and management. Another member, Novartis, provides rural community health education outreach as well as technology and rural medicine education for health care professionals. For instance, Novartis’ Cung Song Khoe Program has provided treatment for many conditions such as diabetes, hypertension and respiratory disease, as well as education for local rural communities and health care professionals, totaling 570,000 people served in 16 provinces. However, there are still challenges that are holding back Vietnam’s health care system including a high number of smokers and adults with alcohol usage, as well as extreme air pollution and aging populations.
Despite drawbacks from public views, health challenges and the environment, Vietnam’s universal health coverage is holding strong and progressing with ongoing program evaluations, strategic planning, improved care quality and partnerships. Therefore, Vietnam’s health care system has also been growing and is standing tall among that of other well-mentioned countries. With that said, eliminating health inequity is the focus to improve Vietnam’s health care.
– Hung Le