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IN VIETNAM
- May, 2018 -
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OUTLINE
I. Contry profile:
1.1 Social-economic-health indicators
1.2 Structure of health system & SHI
II. UHC status
2.1 Population coverage
2.2 Health service
2.3 Health financial protection
III. Moving forward
I. COUNTRY PROFILE
1.1 Social economic conditions Health indicators
Pop: 94.5 millions Life expectance: 75.2 years
Land area: 330,957 Km2 Fertility rate: 1.78
GDP per capita: 2,170 US$ Maternal mortality rate:
GDP growth rate: 6.2% 67/100,000 (live births)
Poverty rate: 9.8% IMR (<1): 15.5/1,000
Total health expenditure: 7.1% CMR (<5): 24/1,000
of GDP Weight malnutrition children
SHI Fund: 25% THE (3 bil USD) < 5y: 18%
OPP: 41%
1.2 Structure of health system
• Ministry of Health
• Central General and Specialised Hosp(s)
• Prov Preventive Hlth Center(s)
Nation • Medical and Phar Universities
Health
Health service: financial
- Complihensive protection
benefit package;
level: 59%
-Acess to service
Compulsory
participation
2015
50 46.1
42 41
40
30
20
10
0
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
SHI coverage
7
2.2 Health services
Comprehensive benefit package:
• Public health programmes and essential preventive
services for whole population: funded by State
budget.
• Hospital and curative care: medical examination and
treatment services for insured inpatients & outpatients
covered by Social Health Insurance.
But unequal acess:
• Most of the poor are living in under-developed health
system regions while health insurance spending in
concentrated in hospitals in big cities
2.3 Health financial protection
The government plays central roles in protecting population health: Commit to
increase budget for health
90.0%
80.0%
20.0% Other
10.0%
0.0%
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
III. Moving forward –
Increase coverage & financial protection
We need to:
Expand health insurance coverage to all population, focusing on informal
sector: About 15 mill people = 14% populationare still out of the system
Developing more favour policy for informal sector to encourage them to
participate in SHI scheme.
Mobilizing government budget for subsidy, especially increasing local
government subsidy for househole.
Increase financial protection by reducing OPP rate:
Looking for financing measures to cover co-payment for less affordable
members.
Prevent extra billing.
III. Moving forward –
Quality, Equity and Efficiency
We need to:
Improve health service Quality:
Address public demand for access to quality and safe services
Improve health infrastructure
Better train health workers.
Enhance Equity in health service access:
Upgrade service delivery system in remote areas
Re-channel spending to primary care, NCDs and ageing management.
Enhance system Efficiency:
Better Strategic purchasing
Improve performance/responsiveness of SHI system focusing on benefit
package; provider payment mechanism.