Health, Nutrition & Population in Vietnam

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Country Overview

Vietnam has achieved levels in basic health indicators that are remarkably better than other developing countries with similar or even higher per capita incomes. Much of this achievement has been the result of widespread practices of promoting social solidarity and a relatively egalitarian distribution of wealth and income.

Another factor that has contributed to good levels of health status by such a poor country is a health system that has wide population coverage with many modem and cost-effective disease control interventions and primary health care services delivered through an extensive grassroots health services network. Public investments and recurrent budget support for the grassroots health network are being given priority attention.

These efforts are expected to yield gains in terms of further reductions in morbidity and mortality from preventable causes through more effective disease prevention, health promotion, and appropriate early treatment at the household, village, commune and district levels. Even as large health gains are expected from anticipated improvements in community health, large numbers of sick patients still require higher level clinical care for which public hospitals remains the almost exclusive provider. 

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• Project P082672 - Northern Upland Health Support Project
  Approval Date:  13 March 2008, Closing Date:  31 August 2014
  Estimated Project Cost: US$60 Million
  The development objective of the Northern Uplands Health Support Project in Vietnam is to increase utilization of district health services especially among Decision 139 beneficiaries in the Northern Upland Provinces through: (i) strengthening of district hospitals, and (ii) reducing financial constraints to accessing health services. The first project component will strengtheni district-level health services. The second project component will increase financial access to healthcare services for decision 139 beneficiaries. The third project component is monitoring, evaluation, and project management.  
   
• Project: P073305 - Regional Blood Transfusion Centers Project
  Approval Date: 16 Apr. 2002, Closing Date: 31 March 2008
  Estimated Project Cost: US$47.5 Million
  The Regional Blood Transfusion Centers Project aims at securing the health benefits of safe blood transfusions (BT) in Vietnam. The subcomponents include: A voluntary donation recruitment program, based on public education campaigns, and organizing blood collection sessions, focused on retaining donors that meet screening standards. Counseling services for blood donors and management and administrative services are also financed; a blood bank operations program including the activities of transporting, testing, processing, and storing collected blood to be used at area hospitals. Records management, and information systems will be established, as will quality-assurance management; an effective clinical use of blood program; a quality management program will prepare a five year plan (2002-06) to develop BT services, monitor BT operations, conduct epidemiological and clinical studies related to BT medicine, and develop annual assessments of BT services. A Regional Blood Transfusion Center staff development program that will recruit, train, and retain core staff, and, the facility and logistics management program that will plan and improve regional blood transfusion center physical facilities.  

• Project: P082604 – HIV/AIDS Prevention Project
  Approval Date: 29 March 2005, Closing Date: 31 Dec. 2011
  Estimated Project Cost: US$38.5 Million
  The HIV/AIDS Prevention project for Vietnam aims at reducing transmission of HIV/AIDS and ensuring that HIV prevalence remains below .3 percent - the key objective of the Government of Vietnam's National HIV/AIDS Strategy. The project has the following three components: Component 1 will provide sub-grants to 18 provinces (An Giang, Bac Giang, Ben Tre, Cao Bang, Dong Nai, Hau Giang, Khanh Hoa, Kien Giang, Lai Chau, Nam Dinh, Nghe An, Son La, Thai Binh, Thai Nguyen, Thanh Hoa, Tien Giang, Vinh Long, and Yen Bai) and two cities (Hai Phong and Ho Chi Minh City) to support the design and implementation of Annual Provincial Action Plans (PAPS). Component 2 will strengthen capacity at national and provincial levels and promote the development of innovative, effective prevention and treatment approaches and models among vulnerable groups through (a) demonstration sites that will explore a community-based treatment model to integrate harm reduction with comprehensive HIV treatment and care; (b) policy studies and research; (c) knowledge sharing and training; and (iv) other innovations. Component 3 will provide support to the set up and management of the Central Project Management Unit as well as the Provincial Project Management Units located in the 18 provinces and two cities.
   
• Project: P079663 – Mekong Regional Health Support Project
  Approval Date: 30 March 2006, Closing Date: 30 June 2012
  Estimated Project Cost: US$80 Million
  The Mekong Regional Health Support Project's objective is to improve health services in the Mekong region and to enhance access to and coverage of these services, especially for the poor. The project consists of five components: 1) Protecting the poor and near-poor - support government efforts to ensure access to health care services for poor and near-poor households. 2) Curative care quality and capacity - improve the quality and capacity of hospital services in the Mekong region. 3) Preventive health - build the capacity of the region's preventive health system to address long-standing and emerging infectious disease threats as well as new health challenges. 4) Human resources development - improve the capacity of the health workforce to deliver quality health services, especially for the poor and near-poor. 5) Project management, monitoring and evaluation - the establishment and operation of the Central Project Management Unit, Local Project Management Units, and Regional Advisory Committee.

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• Project: P004838 - National Health Support Project
  Approval Date: 16 Jan. 1996, Closing Date: 31 March 2005
  Estimated Project Cost: US$101.2 Million
  The National Health Support Project's overall objective was to improve the health status of the rural population of Viet Nam in the poorer areas of the country. Specifically, it aimed to (a) provide high quality, reliable primary health care on a sustainable basis in sixteen of the poorer provinces; (b) reduce nationwide mortality and morbidity due to malaria, tuberculosis and acute respiratory infections, as well as the adverse socio-economic impacts associated with these diseases; and (c) strengthen the capacity of the Ministry of Health in policy-formulation, planning and management. To achieve these objectives, the project consisted of the following components: service delivery in the areas of infectious and communicable diseases; maternal and child health care; family planning; reproductive health services; and other basic health care; national program assistance for the Malaria, Tuberculosis and Acute Respiratory Infection Programs including provision of drugs, insecticides, transport, equipment and technical assistance; and strengthening institutional health planning and management.
  
  

  The project has recently closed and an Implementation Completion Report is in progress.

• Project: P004841 – Population and Family Health Project
  Approval Date: 16 Jan 1993, Closing Date: 30 Sept. 2003
  The Population and Family Health Project (PFHP) sought to facilitate economic growth and poverty alleviation, by reducing the rate of population growth and improving the health of women and children.  Between 1997 and 2002 (during the life of the project), key demographic indicators improved. The Total Fertility Rate fell from 2.67 to 1.87/ and the Infant Mortality Rate fell as well. The proportion of children fully immunized during their first year of life rose from 50.4 percent to 58.1 percent. Care at delivery improved significantly: the proportion of births taking place in a health facility rose from 62 percent to nearly 79 percent. Antenatal care improved significantly, with the percentage of women reporting receiving antenatal services rising from 71 percent to 87 percent. The source of service improved substantially, with the percentage of women reporting seeing a doctor for antenatal care rising from 25 percent to 46 percent.
    Implementation Completion Report

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• P102102: Vietnam – Health Financing Strategy Work (in progress), Economic Sector Work
  The purpose of this task is to arrive at a summary assessment of the status of health insurance and other financing arrangements in Vietnam and prospects for reforming and upgrading these into a sustainable, equitable and efficient approach. The AAA will produce various preliminary notes and other interim products leading up to a final overview paper that summarizes the analysis and provides a roadmap of arrangements and options for health financing. 

• Project: P082202 - Improving Expenditure and Financial Management by the Ministry of Health (in progress), Institutional Development Fund
  The purpose of this task is to enable the Ministry of health to participate more fully in and benefit to an increased extent from the planned Medium Term Expenditure Framework (MTEF) and other efforts (lead by the Ministry of Finance) to modernize public finance management.  The Grant is meant to be used to fund technical assistance as part of preparatory as well as post MTEF empirical and analytic work and to support some capacity building activities. Expected outputs include an invigorated partnership with the Ministries of Finance and Planning and Investment, new skills and capacities, and revised thinking along with findings and proposals relating to the focus and modalities of central government health policy. 
   
• Project: P052064 - Viet Nam - Growing Healthy: A Review of Vietnam's Health Sector (2001), Sector Report
  This reports attempt to explain some of the question raised after the Ministry of Health formulated its strategic directions for the period 1998-2000. The key objectives of the health sector, according to this strategic plan, are: improved health status, as reflected by morbidity, and mortality reductions; greater access to public health services, especially the poor; and, increased quality, and cost-effectiveness of health services. Setting these goals raises a number of policy questions, such as which priorities will likely reduce poverty? What are the emerging roles of government, donors, and nongovernmental organizations in the financing of health services? What is the level of resources, currently available to the health sector? How can public spending be oriented to meet the strategic objectives of the Ministry of Health? This report attempts to conduct an analysis of empirical trends in, and patterns of health services utilization, health outcomes, public health expenditures, and provision of health services, and, discuss the empirical findings of the analysis.
   
• Health Care Financing for the Poor in Vietnam, Vol. 1 of 1 (2003), Working Paper No. 2004-8
  This study intends to examine the equity and efficiency of existing health care financing policies, especially those targeting the poor. More specifically, this paper aims at analyzing a) the allocation of state subsidies by type of care and by type of provider; b) the impact of user fees on the poor; c) the potential for implementation of policies on health care financing for the poor; d) the use of revenues for staff salary supplements and its relationship to quality of care; d) existing policies on social health insurance and their implementation; e) potential recommendations for making health care more affordable for the poor in Vietnam.

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