An assessment of healthcare for the elderly in Vietnam
An assessment of healthcare for the elderly in Vietnam
Dam Viet Cuong, Tran Thi Mai Oanh, Duong Huy Luong,
Khuong Anh Tuan, Nguyen Thi Thang and colleagues
Like other developing countries, has experienced rapid growth of average life expectancy as well as the number of old people, resulting in a change of the disease pattern. will become an aging nation in 2014. This population shift requires due attention from the health sector and the society to provide special healthcare services for the elderly. ’s government has launched some policies for the elderly. There has not been any study that provides a comprehensive assessment of healthcare for the elderly in . This study was carried out to fulfill that gap and provide scientific evidence for policy and strategy development aiming at improving the quality of life for the elderly.
The study was carried out in 7 provinces with financial support from the Swedish International Development Cooperation Agency (SIDA), using a combination of qualitative and quantitative methods. The qualitative section was carried out in 7 selected provinces including Sơn La, Hải Dương, Hà Tĩnh, Ninh Thuận, Đắk Lắk, Bà Rịa-Vũng Tàu, and Vĩnh Long. The household survey was conducted in 3 provinces with a total of 1,132 households having elderly people.
Health status and disease pattern of the elderly
•Prevalence of morbidity among the elderly was higher than that of the other age groups and was higher among elderly women than elderly men. About 60% of the elderly had experienced sickness during 4 weeks prior to the survey. Age was a significant factor in health status as morbidity was positively associated with age.
•The pattern of acute sickness among the elderly included common diseases such as headache, dizziness, cough, arthritis, back pain, and hypertension. Around 70% of the elderly in the survey in 3 provinces reported that they had suffered some chronic symptoms and diseases. Chronic hypertension was common among the elderly (28.4%).
•Around 5% of the elderly in the survey showed some signs of depression. The depression status was closely associated with health status, loneliness, and economic status.
•Protective factors of health status among the elderly included mental comfort, family harmony, and stable economic conditions.
Utilization of healthcare services among the elderly
•Generally, the elderly had little knowledge of prevention of some common diseases such as hypertension and arthritis. More than 45% of the elderly did not know how to prevent and control hypertension. Those who were diagnosed of hypertension knew preventive measures significantly more than those free from the disease.
•With regard to acute sickness, self-care and utilization of private health services were common among the elderly. only around 40% of the elderly used public health services when sick. The hospital service utilization rate among those aged 85 or older was twice lower than those in age group 60-64 due to poorer mobility.
•Old women were more likely to use private health services than old men, whereas old men utilized more hospital services.
•Distance from home to health facilities, economic conditions, and concerns about burdening children were key factors in the elderly’s decision to use health services. Most of the elderly indicated their desire to receive healthcare services nearby including home visits, private health facilities, and commune health stations (CHS).
Healthcare for the elderly at home
•In extended families, the elderly received better care from their adult children than it used to be because of the children’s better awareness of their responsibilities for their parents and better healthcare knowledge. For those living in rural area, the current urbanization however took their children’s time. Old people received care mostly from their children when sick, and the earlier were the main care-takers of their children and grandchildren in the families.
•Self-care was the most common among the elderly. However, they generally lacked knowledge of healthcare and preventive care.
•The health sector in Vientam was rather passive in providing healthcare for the elderly. Health facilities were not active in periodical healthcare provision and detection of diseases for the elderly. Health education and communication to disseminate information on healthcare for the elderly were hardly implemented in a planned and organized manner that tood into account context-specific disease pattern. The reasons blamed for that were financialand human constraints as well as inadequate awareness of some local leaders.
Implementation of healthcare policy for the elderly
•The issuance of healthcare policy for the elderly indicated the preeminence of the Vietnamese Communist Party and Government. The elderly, especially the disabled, people without family members, and people age 90 or older received better care.
•Implementation of the “Ordinance on the Elderly” and some related policies encountered many difficulties due to several facts including the following.
-Guidelines to concerned agencies were not issued in a timely and concrete manner, causing difficulties for the grassroots level to implement these policies.
-There was a lack of intersectoral cooperation in policy implementation, especially at the grassroots level due to insufficient guidelines.
•The dissemination of policy documents at the commune level was notadequate for the concerned groups.
•There were financial and, human constraints as well as insufficient awareness of policies of some local leaders. The elderly’s rightful benefits were not guaranteed.
•There was not a close link among the elderly’s associations at various levels in policy implementation.
•Monitoring and supervising of policy implementation were absent in most of the studied locations.