Within the last twenty years a large-scale bottom-up privatization has taken place in Vietnam, changing and dismantling the public health care system. This process has led to severe tensions inherent in the transitional society of Vietnam between equity and access to health care support - especially for the poor, elderly, migrants, and ethnic minorities - on the one hand, and its efficiency on the other hand. The book traces the reform efforts to modernize the health care system by the Communist Party of Vietnam and the Vietnamese government. The author bases her findings on little known primary literature and interviews with key stakeholders of the policy network involved in the reform of the health care system, thereby painting an authentic atmospheric picture of the profound changes in the health care system in Vietnam.
Vietnam's successes in the health sector are legendary. Its rates of infant and under-five mortality are comparable to those of countries with substantially higher per capita incomes. However, challenges remain in how to further expand coverage, increase quality of care, and contain the rapidly increasing health care costs.
Vietnam's Health Care Fund for the Poor (HCFP) uses government revenues to finance health care for the poor, ethnic minorities living in selected mountainous provinces designated as difficult, and all households living in communes officially designated as highly disadvantaged. The program, which started in 2003, did not as of 2004 include all these groups, but those who were included (about 15 percent of the population) were disproportionately poor. Estimates of the program's impact-obtained using single differences and propensity score matching on a trimmed sample-suggest that HCFP has substantially increased service utilization, especially in-patient care, and has reduced the risk of catastrophic spending. It has not, however, reduced average out-of-pocket spending, and appears to have had negligible impacts on utilization among the poorest decile.
This book describes the nature of public-private partnerships (PPPs) in the health sector in Vietnam. It defines health-related PPPs, describes their key characteristics, and develops a taxonomy of the different types of PPPs that exist in practice, illustrated by international examples. It also assesses the regulatory and institutional framework for the health PPP program in Vietnam, as well as financing and accountability mechanisms for PPPs at its national and subnational levels. It provides an overview of the PPP project pipeline in Vietnam and analyzes important issues in the health PPPs’ design, preparation, and implementation, using eight case studies involving projects in different phases of the project cycle. This book also examines barriers that have hampered the successful design and implementation of health care PPPs in Vietnam. These barriers may be broadly categorized as barriers in the PPP policy and regulatory framework, in the public sector, in the private sector, and in the financial sector. It proposes feasible and actionable recommendations so that the government can consider tackling the identified barriers and advance the successful design and implementation of health PPPs.
Mixed Methods in Health Sciences Research: A Practical Primer, by Leslie Curry and Marcella Nunez-Smith, presents key theories, concepts, and approaches in an accessible way. Packed with illustrations from the health sciences literature, this ready-to-use guidebook shows readers how to design, conduct, review, and use mixed methods research findings. Helpful checklists, figures, tables, templates, and much more give readers examples that will elevate the quality of their research, facilitate communication about their methods, and improve efficiency over the course of their projects. Real-world examples and insights from mixed methods researchers provide unique perspectives on every aspect of mixed methods research. This book successfully pulls together foundational mixed methods principles, synthesizes the knowledge base in the field, and translates it for a health science researcher audience. “The content is highly applicable to real life research teams in the areas of clinical research, health services research, and implementation science, providing sound content and practical advice. The authors have synthesized and pull key concepts from a variety of sources to provide a concise resource.” —Linda M. Herrick, South Dakota State University “Everything from the references, to the topics, checklists, conceptual graphic representations, and organizers, interviews, and resources, all contribute to the content and aid with understanding and/or application. … It addresses specific MM research as it pertains to health sciences in a way that other texts just do not even attempt.” —Denise L. Winsor, University of Memphis “[This text is] a very pragmatic approach to mixed methods research; excellent resources, tables, and figures [are] provided, along with cases and examples of value to researchers and grant reviewers. Its relevance to practice, education, and research, as well as to potential policy implications, is a strong focus that would make this a valued textbook for any researcher!” ? —Karen Devereaux Melillo, University of Massachusetts Lowell “The text is cutting edge. It leads the way with its focus on team dynamics. [The authors] succeed in making the book relevant and practical. They also articulate a number of key insights in the area of mixed methods that rarely get addressed, such as teams and conflict. Great read with a lot of good, practical information for mixed methods researchers at all levels. The practical approach of this text makes it an innovative and valuable resource.” —John G. Schumacher, University of Maryland
There is now strong evidence that the earth's climate is changing rapidly, due mainly to human activities. Increasing temperatures, sea-level rises, changes in precipitation patterns and extreme events are expected to increase a range of health risks, from the direct effects of heat-waves, floods and storms, to more suitable conditions for the transmission of important infectious diseases, to impacts on the natural systems and socioeconomic sectors that ultimately underpin human health. Much of the potential health impact of climate change can, however, be avoided through a combination of strengthening key health system functions and improved management of the risks presented by a changing climate. The critical first step in this process is to carry out a vulnerability and adaptation assessment. This allows countries to assess which populations are most vulnerable to different kinds of health effects, to identify weaknesses in the systems that should protect them, and to specify interventions to respond. Assessments can also improve evidence and understanding of the linkages between climate and health within the assessment area, serve as a baseline analysis against which changes in disease risk and protective measures can be monitored, provide the opportunity for building capacity, and strengthen the case for investment in health protection. WHO has responded to this global demand by building on past guidance and technical tools to outline a flexible process for vulnerability and adaptation assessment. In 2009, the WHO Regional Office for the Americas and WHO prepared draft guidance for this process, which was pilot-tested in studies across all WHO Regions. In July 2010, representatives of ministries of health from 15 countries came together in Costa Rica with WHO and subject area experts to share their experiences and provide feedback on how to improve the guidance for the conduct of vulnerability assessments. This document is the result of this process. It is intended not as a final, definitive guide but as an important part of an evolving set of resources that will support effective and evidence-based action to protect health from climate change.
This book presents the health emergency and disaster risk management (H-EDRM) research landscape, with examples from Asia. In recent years, the intersection of health and disaster risk reduction (DRR) has emerged as an important interdisciplinary field. In several landmark UN agreements adopted in 2015–2016, including the Sendai Framework for Disaster Risk Reduction 2015–2030, the 2030 Sustainable Development Goals (SDGs), the Paris climate agreement, and the New Urban Agenda (Habitat III), health is acknowledged as an inevitable outcome and a natural goal of disaster risk reduction, and the cross-over of the two fields is essential for the successful implementation of the Sendai Framework. H-EDRM has emerged as an umbrella field that encompasses emergency and disaster medicine, DRR, humanitarian response, community health resilience, and health system resilience. However, this fragmented, nascent field has yet to be developed into a coherent discipline. Key challenges include redundant research, lack of a strategic research agenda, limited development of multisectoral and interdisciplinary approaches, deficiencies in the science–policy–practice nexus, absence of standardized terminology, and insufficient coordination among stakeholders. This book provides a timely and invaluable resource for undergraduate and postgraduate students, researchers, scholars, and frontline practitioners as well as policymakers from across the component domains of H-EDRM.
Over the course of several weeks in June and July of 2014, Rubicon Strategy Group conducted close to forty interviews with country managers of pharmaceutical and device companies, director level administrators in public and private hospitals, successful pharmacy and medical device shop owners, and entrepreneurs at the forefront of the cutting edge in the Vietnam healthcare market. In addition the team went out and conducted a validated survey questionnaire of consumers to judge their preference for particular products, and their preference for healthcare access options in the public and the private sector. The goal of this paper revealed itself in the course of compiling the data: to bring out insights from the front lines of the sales channels and the business models that make up the pharmaceutical and medical device markets in Vietnam. It is the hope of the authors that the information presented in this way can help inform sales strategies and the development of value add services for companies involved in the marketing and/or distribution of drug and medical device products in Vietnam. On the eve of a pair of large negotiations, - a free trade agreement negotiation between the EU and Vietnam, set to be finalized in October 2014, and the negotiation of the Trans Pacific Asean partnership – it was found that much of the conversation with healthcare system company representatives and sales channel participants turned to the issue of the public tender system as well as some of the hardships brought on by Vietnam’s ongoing healthcare market reform. Consequently, one section of this report is geared towards exploring how the policy and regulatory level challenges of the current tender process. However, in constructing this section it became clear that the value of the research conducted during this study is not simply in explaining the tender process as it is supposed to function at the policy level and the attendant issues that stem from that design, but also highlighting how the tender process impacts the decision making of pharmaceutical and medical device executives in-country, in real time, as well as how it impacts the various operators across sales channels. In other words, a core value of the study is necessarily attendant to its exploration of the strategies currently being employed by executives active in Vietnam’s healthcare market. In trying to present a picture of the ground-level impacts of policies and regulatory structures impacting Vietnam’s healthcare space, it is of course important to present a clear outline of the issues that the research revealed. At the same time, it became apparent to fully communicate the ground-level happenings as they related to the tender process, it was also helpful to present a series of case studies that would help add color and nuance to the issues clearly presented.
Over the past two decades Vietnam has made enormous progress to expand health insurance coverage to its population. Further progress will require significant additional public financing, as well as efforts improve efficiency and strengthen insurance organization and management. It contains recommendations and next steps for Vietnam to follow.
This book is a must-read for any specialist in the history of colonial and post-colonial psychiatry, as well as a fantastic case study for those interested in the social history of European colonialism more generally.― Choice Claire Edington's fascinating look at psychiatric care in French colonial Vietnam challenges our notion of the colonial asylum as a closed setting, run by experts with unchallenged authority, from which patients rarely left. She shows instead a society in which Vietnamese communities and families actively participated in psychiatric decision-making in ways that strengthened the power of the colonial state, even as they also forced French experts to engage with local understandings of, and practices around, insanity. Beyond the Asylum reveals how psychiatrists, colonial authorities, and the Vietnamese public debated both what it meant to be abnormal, as well as normal enough to return to social life, throughout the early twentieth century. Straddling the fields of colonial history, Southeast Asian studies and the history of medicine, Beyond the Asylum shifts our perspective from the institution itself to its relationship with the world beyond its walls. This world included not only psychiatrists and their patients, but also prosecutors and parents, neighbors and spirit mediums, as well as the police and local press. How each group interacted with the mentally ill, with each other, and sometimes in opposition to each other, helped decide the fate of those both in and outside the colonial asylum.
