Vietnam’s healthcare: Achievements and challenges

After the country’s reunification in 1975, Vietnam’s healthcare had to face a lot of difficulties and challenges as well as the economic underdevelopment. These difficulties became worse because of the consequences of years in war, which resulted in the environment and sanitation degradation together with spreading social diseases such as venereal disease, leprosy, tuberculosis and drug addiction, etc.

However, Vietnamese government recognized these problems and quickly had positive measures to adjust and overcome them. The government set up a comprehensive healthcare program of high application. The government established national programs, key projects on sanitation, epidemic prevention, reproductive and primary health, medical examination and treatment, physical rehabilitation, medical and forensic verification, and also directed and supervised the implementation of these programs and projects.

Up to now, a healthcare network of policlinic and specialized hospitals in 61 provinces and cities has been set up in the whole country. The public healthcare network has reached many communes, especially rural and mountainous areas. The present ratio of medical staff on every 100,000 people stands at 4.5 doctors, 12.2 nurses, 0.8 pharmacists.

The national healthcare program has obtained considerable achievements, especially in the prevention of major epidemics such as malaria, goiter, dysentery, typhoid, dengue fever, Japanese encephalitis B, meningitis, bubonic plague, trachoma, etc. The government also shows particular concerns about the mothers and children healthcare. A nationwide vaccination campaign has been launched twice a year. Under 12-month-old babies are vaccinated against six child-killing diseases including: tuberculosis, diphtheria, whooping cough, tetanus, polio and measles, which has considerably decreasing the mortality rate of children in this age group. 

At the central level, specialized hospitals such as pediatrics, obstetrics, gynecology, gerontology, ophthalmology and dermatology, etc. are operating effectively contributing to reducing newborn death rate and increasing life expectancy. Besides, traditional medicine is also combined with modern medicine to improve medical treatment quality.

Acupuncture, massage, cup massage and point massage are widely applied, which not only takes advantage of the domestic diverse medicinal herbs but also contribute to solving the shortage of medicine and medical equipment shortage. 

However, there are still many adequacies in healthcare sector. The healthcare spending per capita remains very low (about $3 per capita per year). Since the early 1990s, Vietnam’s healthcare has been under great pressure such as rapid population growth, increasing demands for healthcare while the state budget for healthcare has been limited. There has been a shortage of fund in hospitals and clinics; infrastructure and medical equipment are seriously degraded. The lack of electricity and water is very common in hospitals. The low salary of medical staff and the high cost of living have decreased the qualifications and responsibility of some healthcare staff. There has a lack of both quality and quantity of medical staff failing to meet the new demand for healthcare and prevent spreading epidemics.

To overcome these challenges above and achieve the set targets, the health sector should exploit  and effectively use the state budget for healthcare services, at the same time fully exploit  other resources such as health insurance, hospital fees, aid and credit to support health activities.

Some missions and solutions:

1.Raise the efficiency of using medical infrastructure; stabilize the domestic medicine market; intensify the production of domestic medicine and medical equipment.

2.Intensify programs of disease prevention in the country:

-Open vaccination for children, eradicate polio and tetanus for new-born babies.

-Eradicate leprosy, conquer tuberculosis, prevent HIV/AIDS prevention.

-Minimize diseases in the developed countries: cancer, cardiovascular, mental illness, occupational accidents.

-Eradicate cholera, typhoid, bubonic plague, hepatitis B, Japanese encephalitis B, rabies, malaria.

3.Enhance the healthcare services for the poor.

4.Diversify forms of investment in healthcare, maximize available resources, encourage private healthcare services, reinforce state healthcare institutions.

5.In 2005, popularize the fact that hospital fees are paid via health insurance system in various forms conducted by the cooperation of healthcare sector and insurance companies.

6.Synchronously implement incentive policies for healthcare staff, especially those volunteering to work in rural and mountainous areas.