Vietnam Public Health: Achievements and Orientation

 

With over 20 years of Doi Moi (Renovation), 3 years of WTO accession and deep international integration, let’s have a quick look at the achievements of public health and discuss the orientation 2015 and 2030.

In 2008, Vietnam has exceeded the GPD per capita of US$1,000, poverty households down to 12 percent. Socio-economic development has ensured achievements in public health.

 

Medical care has prevented major epidemic diseases for several years and checked in time sporadic cases including SARS, A/H5N1 and most recently A/H1N1. Progress has also been made in prevention of malaria, tuberculosis, tetanus, child polio, etc. Regarding HIV/AIDS, the cases decreased by 10 percent compared to last year. Vaccination for children under 6 years of age was over 90 percent.

 

Medical treatment has been provided to over 200 cases (2.5 times/person/year), 70 million days of hospitalized treatment (8 days/patient). High technology and regional and world standards have been applied in diagnosis and treatment of heart, brain, eye, backbone, artificial insemination. Traditional medical treatment has also been applied widely at all levels.

 

In population and family planning, the birth rate is under control reducing from 2.57 percent in 1975 to 1.2 percent in 2008. The population quality indexes have also been improved.

 

Medicare network has been spread nationwide: dispensary for each commune, 1-2 nurses for each hamlet, clinics for populated area, general hospitals for district, general and specialized hospitals for province and city, especially traditional treatment, maternity and children hospitals. In addition to public hospitals, there are 90 private hospitals with 4,500 beds, thousands of non-profit and charity medical centres. For each 10,000 people, there are 25 hospital beds (18 of public hospitals), 32.5 medical workers (excluding 6.5 doctors). Preferential treatment policy has been applied for medical workers in disadvantaged regions together with rotation of doctors to upgrade medical responsibility.

 

The clear manifestation of the public health is the life expectancy of 72.8 years and infant mortal rate of 0.15 percent (compared to the Philippines with GDP per capita four times higher than Vietnam but the life expectancy is 71 for women and 65 for men and infant mortal rate is 0.25 percent).

 

Pharmaceutical and medical equipment of high quality are imported and complemented with those made in Vietnam. So far, 50 percent of medicines are produced in Vietnam; some good brands are even exported. Vietnam can produce over 600 kinds of medical equipment. However, the total value remains far below the target of 40 percent in 2005 and 60 percent in 2010 (Decision 130/2002/QD-TTg of October 4, 2002 of the Prime Minister).

 

The above achievements are the result of the joint efforts of all medical workers at all levels guided by correct policy.

The biggest difficulties and challenges in Vietnam are poverty, unstable economic growth and impact of world economic crisis. While the demand of medicare is high and resources are limited. The big gap between rich and poor people also causes problem and medical service must give high priority to the poor and target group.

 

Natural calamities and climate change are increasingly serious in Vietnam, affecting social and economic life and spreading old and new epidemic diseases.

 

As a still poor country, Vietnam faces with diseases of both poor and rich countries, epidemic and non-epidemic diseases. In 1976, epidemic diseases made up 55.5 percent and non-epidemic diseases 44.7 percent; in 2007, they changed to respectively 23.7 and 60.7 percent. Meanwhile trauma and intoxicated cases rose from 1.8 to 13.6 percent. In 2009, Vietnam are fighting with malaria, dengue (diseases of poor country) and A/H1N1(disease started from rich countries).

 

Globalization has not only strong impact on economic life but also social life and public health. Products of poor safety have caused damage to health. Melamine contained milk from China is an example. Millions of tourists and guest workers can transmit diseases from place to place world wide.

 

Health budget was only 8.4 percent in 2006 and 8.8 percent in 2007, in which public spending made up 30 percent and the rest 70 percent from the people. Meanwhile WHO and experts recommend the share of 50-50.

 

Health insurance remains in low percentage and shortfall. Owners of health insurance cards are uncertain of the benefit. Health Insurance Fund is not adequate.

 

Another challenge is the lack of management capacity, macro and micro, from law, policy to management of hospital and unit, from over-lapping to shortage, causing both difficulty and waste, and giving way to corruption.          

Investment to public health also means to development. The State must invest 50 percent from the budget. The State and people must join efforts, attracting resources from budget, private sector, non-profit and charity institutions at home and abroad.

 

Giving high priority to preventive measures, Vietnam public health will ensure 30 percent of the resources for the prevention with network down to districts and communes and focusing on border gates, commercial centres and areas affected by pollution and climate change.

 

The health service will develop high technology to the standard of the region and the world, combining Eastern and Western medicines. By 2015, by all the provinces will have hospitals of traditional medicines and treatment will be down to districts and communes. The research will combine modern and traditional medicines to ensure most effective treatment to Vietnamese people.

 

The health service will be developed to narrow down the gap between different groups of people and minimizing the difference between rural and urban areas.

 

Health insurance law will be developed to secure balanced health insurance fund and the increasing demand of clients. The network will be expanded to rural areas and insurance will be widely used in all levels.

 

Population and family planning will maintain at low birth rate (below the replacing level), ensuring safety for birth control, maternity and child health, gender balance and population quality. The health service will coordinate with concerned authorities to solve the issues of immigrants, sales of women and children, marriage with foreigners, family and marriage among nationalities and religions.

 

Human resources development is also high in the agenda, meeting both high standard and universal need, striving to have an university among top 500 of world universities by 2015 and two universities by 2020, doctor to 80 percent of communes in 2015 and 100 percent in 2020.

 

In pharmaceutical and medical equipment production, the total production value compared to the total usage will be 70-75 percent in 2015 and 95-100 percent in 202 and with famous brands for export. The import and export will meet the demand of the people. For medical equipment production, by Decision 130/2002/QD-TTg of the Prime Minister, the percentage will be 40 percent in 2015 and 60 percent in 2020.

 

Management capacity will be upgraded both macro and micro. Law and policy will be improved ensuring the State management, smooth implementation, satisfactory to the people and preventing corruption and waste. Managers of hospitals, institutes and schools must have management standards with the targets of 50 percent of managers by 2015 and 80 percent by 2020. Management science will be developed to university standard.

 

In vision of 2030, Vietnam will reach the new height of “Prosperous people, strong nation, just, democratic and civilized society”. The environment will be kept”Green, Clean and Beautiful” with emphasis on forests and rivers. In such conditions, the health service can ensure the standard of the region and the world. The international integration will be with increased export and decreased import, eventually to balanced trade and even trade surplus with four spearheads: medical service, high pharmaceutical and medical workforce, pharmaceutical materials, and medical equipment.