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Policy processes underpinning universal health insurance in Vietnam
BACKGROUND: In almost 30 years since economic reforms or ‘renovation’ (Doimoi) were launched, Vietnam has achieved remarkably good health results, in many cases matching those in much higher income countries. This study explores the contribution made by Universal Health Insurance (UHI) policies, foc...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Co-Action Publishing
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4179319/ https://www.ncbi.nlm.nih.gov/pubmed/25262793 http://dx.doi.org/10.3402/gha.v7.24928 |
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author | Ha, Bui T. T. Frizen, Scott Thi, Le M. Duong, Doan T. T. Duc, Duong M. |
author_facet | Ha, Bui T. T. Frizen, Scott Thi, Le M. Duong, Doan T. T. Duc, Duong M. |
author_sort | Ha, Bui T. T. |
collection | PubMed |
description | BACKGROUND: In almost 30 years since economic reforms or ‘renovation’ (Doimoi) were launched, Vietnam has achieved remarkably good health results, in many cases matching those in much higher income countries. This study explores the contribution made by Universal Health Insurance (UHI) policies, focusing on the past 15 years. We conducted a mixed method study to describe and assess the policy process relating to health insurance, from agenda setting through implementation and evaluation. DESIGN: The qualitative research methods implemented in this study were 30 in-depth interviews, 4 focus group discussions, expert consultancy, and 420 secondary data review. The data were analyzed by NVivo 7.0. RESULTS: Health insurance in Vietnam was introduced in 1992 and has been elaborated over a 20-year time frame. These processes relate to moving from a contingent to a gradually expanded target population, expanding the scope of the benefit package, and reducing the financial contribution from the insured. The target groups expanded to include 66.8% of the population by 2012. We characterized the policy process relating to UHI as incremental with a learning-by-doing approach, with an emphasis on increasing coverage rather than ensuring a basic service package and financial protection. There was limited involvement of civil society organizations and users in all policy processes. Intertwined political economy factors influenced the policy processes. CONCLUSIONS: Incremental policy processes, characterized by a learning-by-doing approach, is appropriate for countries attempting to introduce new health institutions, such as health insurance in Vietnam. Vietnam should continue to mobilize resources in sustainable and viable ways to support the target groups. The country should also adopt a multi-pronged approach to achieving universal access to health services, beyond health insurance. |
format | Online Article Text |
id | pubmed-4179319 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Co-Action Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-41793192014-10-14 Policy processes underpinning universal health insurance in Vietnam Ha, Bui T. T. Frizen, Scott Thi, Le M. Duong, Doan T. T. Duc, Duong M. Glob Health Action Asean Integration and Its Health Implications BACKGROUND: In almost 30 years since economic reforms or ‘renovation’ (Doimoi) were launched, Vietnam has achieved remarkably good health results, in many cases matching those in much higher income countries. This study explores the contribution made by Universal Health Insurance (UHI) policies, focusing on the past 15 years. We conducted a mixed method study to describe and assess the policy process relating to health insurance, from agenda setting through implementation and evaluation. DESIGN: The qualitative research methods implemented in this study were 30 in-depth interviews, 4 focus group discussions, expert consultancy, and 420 secondary data review. The data were analyzed by NVivo 7.0. RESULTS: Health insurance in Vietnam was introduced in 1992 and has been elaborated over a 20-year time frame. These processes relate to moving from a contingent to a gradually expanded target population, expanding the scope of the benefit package, and reducing the financial contribution from the insured. The target groups expanded to include 66.8% of the population by 2012. We characterized the policy process relating to UHI as incremental with a learning-by-doing approach, with an emphasis on increasing coverage rather than ensuring a basic service package and financial protection. There was limited involvement of civil society organizations and users in all policy processes. Intertwined political economy factors influenced the policy processes. CONCLUSIONS: Incremental policy processes, characterized by a learning-by-doing approach, is appropriate for countries attempting to introduce new health institutions, such as health insurance in Vietnam. Vietnam should continue to mobilize resources in sustainable and viable ways to support the target groups. The country should also adopt a multi-pronged approach to achieving universal access to health services, beyond health insurance. Co-Action Publishing 2014-09-26 /pmc/articles/PMC4179319/ /pubmed/25262793 http://dx.doi.org/10.3402/gha.v7.24928 Text en © 2014 Bui T. T. Ha et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Asean Integration and Its Health Implications Ha, Bui T. T. Frizen, Scott Thi, Le M. Duong, Doan T. T. Duc, Duong M. Policy processes underpinning universal health insurance in Vietnam |
title | Policy processes underpinning universal health insurance in Vietnam |
title_full | Policy processes underpinning universal health insurance in Vietnam |
title_fullStr | Policy processes underpinning universal health insurance in Vietnam |
title_full_unstemmed | Policy processes underpinning universal health insurance in Vietnam |
title_short | Policy processes underpinning universal health insurance in Vietnam |
title_sort | policy processes underpinning universal health insurance in vietnam |
topic | Asean Integration and Its Health Implications |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4179319/ https://www.ncbi.nlm.nih.gov/pubmed/25262793 http://dx.doi.org/10.3402/gha.v7.24928 |
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