The Vietnam’s health system is oriented as a health insurance based system with the aim of enabling people to access to quality health care services when needed and at the same time create equity in health financing contribution. The Health Insurance Law has identified the goal of universal health insurance by 2014. With more than 70% of population living in rural areas, the expansion of health insurance (HI) in rural areas is key to reach to goal of universal health insurance. The project titled “Bringing health care to the vulnerable: Development of equitable and sustainable rural health insurance in Vietnam” is implemented to provide evidence for developing HI policies for rural areas. Within this project, a number of interventions have been piloted in two districts of Hai Duong and Bac Giang provinces in 18 months. These interventions need evaluation to serve as grounds for making recommendations and providing information for policies makers in developing health insurance policies for rural areas.
The project on health care for Central Highlands people (Central Highlands Healthcare Project) is implemented in 5 Central Highlands provinces in 6 years, from 2004-2009 with the overall objective of improving health status and increasing accessibility to quality health care services, especially for the poor and ethnic minorities. One of the key outputs of the project is the Health care Fund for the Poor (HFP), which has been comprehensively and effectively supported. Costs analysis and impact assessment of project support components is essential to project assessment, in general and providing scientific evidence for managers and policy makers in expanding health care model for the poor in the future.
Tobacco smoking is the leading cause of mortality in the world and Vietnam. Smoking related morbidity and mortality cause severe losses to the health and economy to individuals and the whole society. The Government of Vietnam has issued the “National policy on tobacco control” in 2000-2010 period and drafted the Tobacco Control Law with the aim to reduce smoking rate and related losses to each individual, family and whole society. Which measure to select, which level of intervention and effectiveness are important questions that need highly reliable answers to help the Government develop effective tobacco control policies.
Hypertension is among the leading causes of disability and mortality globally, and has become a major public health problem in Vietnam and the world. Hypertension control is part of efforts to combat non-communicable diseases in Vietnam. Given the current resources constraints, valid evidence is needed on the cost-effectiveness of antihypertensive interventions to inform policymakers in effectively prioritizing resources allocation. This study was conducted under the auspices of the Health Strategy and Policy Institute, Queensland University, Australia and the National target program for Hypertension control, Vietnam Cardiovascular Hospital, Bach Mai Hospital.
Health insurance (HI) in Vietnam is a vital health financing source contributing to equity in health. After more than 15 years the HI policy is in place, the rights and interests of the health insured have been expanded and guaranteed over time. Patients now have access to HI-related medical services right at the commune level, which contributes to medical cost saving. The HI-related medical service delivery process, however, is not flawless. In respect of service providers, especially commune health, the lack of consistency of the district level health system in different areas raises numerous barriers to HI-related medical care at commune health stations (CHSs). Added to that, the limitations of capacity, human resources and facilities of commune health centers are a major challenge to delivery of HI-related health services at the centers. On the users’ side, the need for medical care of HI card holders at the commune level is colossal. Yet, HI-related medical care at the commune level is still limited to outpatient consultation, prescription and drug dispensing. To incrementally improve the policy system in this regard to provide the regulatory platform for health financing reform through health insurance and canvass a roadmap toward universal HI by 2014, this study aims to seek answers to the following questions.
To undertake the direction of the Minister of Health as regards reviewing the enforcement of Decree No. 43 in the public hospital system in order to see achievements made as well as weaknesses and unexpected impacts on healthcare and recommend pertinent revisions/variations, the Health Strategy and Policy Institute (HSPI) in collaboration with the Department of Planning and Finance (DPF) and some other departments within the Ministry of Health (MoH) conducted a survey on reviewing the implementation of Decree No. 43 in 18 hospitals at all levels (7 at the central, 5 at the provincial/municipal and 6 at the district level).
At present the private health sector is developing quickly and plays an important role in the health system. The Vietnam’s health system has been oriented to be a health insurance based system with the goal of universal health insurance (HI) by 2014. Mobilizing private health sector to participate in providing examination and treatment for the insured is one of the effective measures to carry out the above-mentioned goal. However to date there are only about 120 private health facilities signing HI examination and treatment contract. Meanwhile, overcrowding at public hospital remains a great challenge to the health sector, which is directly linked to HI examination and treatment. Health Strategy and Policy Institute (HSPI) conducts assessment on current situation of private health facilities’ participation in health services delivery for HI card holders to learn about its difficulties and obstacles to recommend policy and organization options to stepwise expand participation of private health facilities in HI examination and treatment contracting.
Given the existing scarcity of literature on the private health care system, this study looks to give an overview of the current status of the management of private health system. The study also provides recommendations for improvement of governance on private health to promote strong development of the sector while meeting the indicated targets in health care of equity, efficiency and development.