Disclaimer: The views expressed in this paper/presentation are the views

of the author and do not necessarily reflect the views or policies of the
Asian Development Bank (ADB), or its Board of Governors, or the
governments they represent. ADB does not guarantee the accuracy of
the data included in this paper and accepts no responsibility for any
consequence of their use. Terminology used may not necessarily be
consistent with ADB official terms.

POPULATION COVERAGE
CHALLENGES
- THE VIETNAM EXPERIENCE -

Tran Thi Mai Oanh, MD, PhD

Director, Health Strategy and Policy Institute

Population

91,703,800 millions (2015)

Per capita income

5.668 $ (PPP)

% under poverty
line

13.5% (2014) 9,79% poor HHs

% rural

74%

Life expectancy

73.2

Health expenditure

% of GDP: 6%
% of govt. expenditures: 55.7%
$113 per capita

MMR

69/100,000

U5MR

22.1 /1,000

GINI Coefficient

38.7 (2012)

Health Insurance Coverage

Compulsory Coverage Timeline for Formal and Informal

Sector: add on approach
Additional Social
Protection Groups
Civil Servants ;
GOE workers;
Workers in medium and
large private enterprises;
Pensioners;

Rural non poor

The near poor
Children under 6
Schoolchildren
Students

All salaried workers

The Poor, ethnic minorities

1992

1998

2005

2009

2010

The rest
population

2012

2014

Low health insurance coverage among some groups

Challenges in expanding health insurance coverage in

some population groups
Low compliance among formal group (50%), especially among private
enterprises.
Low coverage among informal groups due to low capacity to pay of people
and implementing individual-based but not household-based health
insurance.
Limited awareness of people on the necessity of participating in health
insurance scheme. Near poor and non poor household have low rate of
health insurance coverage and with adverse selection
Benefit package: Focus on treatment at hospitals; HI does not affect out of
pocket expenditures due to co-payment and ceiling payment for high tech
services
Quality of health services, especially at grass-root level is low; it is not
clear for the patients on what services will be covered by health insurance
services people do not trust to buy health insurance

What has been done to cope with challenges and

expand health insurance coverage in Vietnam?
Putting higher commitment from high level government leaders on expanding health
insurance coverage
Improving IEC for better awareness of HI.
Improving level of support from the government for the specific informal groups:
- Increasing the level of financial support of premium to the near poor (increase from
50%-70%), students (increase from 30-50%)
- Revising co-payment policies for the poor (100% reimbursement) and near poor (95%
reimbursement before 80% reimbursement)
Increasing trust of people on health facilities:
- Expanding basic health services package at the grass-root level to make health
services are more available and accessible at the grass-root health facilities
- Strengthening quality of services at health facilities at different levels, especially at
grass-root level to change the trust of people: putting more investment in terms of
infrastructure, applying appropriate provider payment methods, training of health
workforces