The assignment investigates several published articles from multiple sources, such as the New York Times, the Wall Street Journal, and other scholarly journals/articles found in the California State University, Long Beach (CSULB) Library database. The sources are used to assess Vietnam's healthcare challenges. Vietnam's healthcare system, like that of other developing countries, faces numerous issues, including accessibility, affordability, and quality. Another issue is the nation's growing expenditure burden from residents diagnosed with long-term chronic ailments such as heart disease and diabetes. These are problems relating to development of the international arena since the improvement of the healthcare system in Vietnam is faced many challenges including accessibility, affordability, as well as quality. Another issue is the growing expenditure burden that the nation experiences from the citizens diagnosed with long-term chronic diseases like heart diseases and diabetes. These are problems relating to development of the international arena since the improvement of the healthcare system in Vietnam as one of the developing nations has the effect of reducing maternal mortality rates, infant mortality rates, and enhancing life expectancy.
Introduction: Health care in Vietnam
The current health state in Vietnam is such that it is trying to alleviate the financial weight it has placed on its citizens. The health facilities that they rely on were the ones built in the '80sand the upgrade of the system has been substantially slow. At the moment, life expectancy is 76 years but owing to the Vietnam war that occurred in the '60s, people are still experiencing some negative impacts. Some of the common negative impact is the high records of miscarriage or children born with disability. It is quite unfortunate that the government at the moment only chirps in 0.9 % of the country's GDP of the health financial contribution and this leaves the citizens with the burden of catering for their health by paying during each medical visit. With the reforms placed in 2014 that are yet to be initiated, the government of Vietnam will shoulder the whole medical burden and in order to reduce the health care provision gap that is between the rural and the urban areas of Vietnam. If a comparison of the health care set up in the rural and the Urban is done, on will notice that the health care services vary dramatically. While comparing the health care provision in Vietnam with the larger Australia, statistics show that the health situation is the worst case scenario in the whole of Asia and this is majorly due to lack of government participation in the health care sector (Pigg, 1992).
There is a very big difference in the health care that is provided in the towns when compared to the rural areas. The case is so severe such that it is very hard to get a specialist or health care providers in rural areas. Hygiene standards in the rural areas are also not equal to the standards in the city. The reforms made that are yet to be implemented incorporate the need to bridge the health care gap that lies between the city and the rural areas. However, this cannot be implemented unless funding is improved. The major cause of problem in the health care provision in Vietnam is lack of government contribution. However, the main challenge in the Vietnam case is the poverty levels. With high poverty levels, the government is not in a position to cater for their health duties and therefore forego it. Vietnam is a developing country which heavily depends on the out of pocket payments in the health care sector. Statistics show that I the year 2005, the government had improved their health care contribution to 5% which when compared to the latter 0.9 % the growth in the economic sector over the years is very slow. Majority of the citizen operate below the set living standard and only a handful of people living within the living standards or slightly above the living standards. With low living standards and poor living conditions, the overall contribution to the GDP is very minimal since the citizens cannot cater for themselves and contribute to the total government income. There have however been strategies that have been set to overcome the poverty situation in Vietnam which are taking a while to become operational, however, with such reforms, the living standard of the normal Vietnam Citizen will improve and as a result the GDP increase likewise (Glewwe, et al., 2004).
Below is a table showing poverty incident in Vietnam over the periods 1993- 2004
If a comparison between Vietnam and Indonesia is done, the results yielded show that both these nations are majorly affected by high poverty levels. Indonesia is a country that is best characterized by poverty and violence. The poverty levels in this country can be gauged on the structure of infrastructure they have, the health care services provided, the living standards of the people and management of national disasters on occurrences. In countries majorly faced by high levels of poverty, corruption is a common case scenario and in most cases, plans implemented to cause an improvement in the country's economy and overall financial may not necessarily be effective. The poverty characteristics in these two countries are almost similar and they have been the major setback in health care provision in the public sector. Despite the corruption levels, some of the strategies that have been placed to ensure the improvement in the economic sectors are actually functional. In the case of Indonesia, some of the key practices that have been placed to improve the poverty situation are first identification of the deficiencies that need to be rectified and then application of the technical practices that will cause the improvement- technical rendering which is the domain that applies an intelligible field that offers specific limits and the particular characteristics that contribute to the development (Frewer, 2013). Population improvement is also a way of the government setting the right manner of disposing poverty issues. In Vietnam, plans that have been put to ensure that poverty is alleviated include assessing the national poverty situation with regards to its limits and its weaknesses. The considerations in the strategy involve upholding the democracy and provoking collective national strength in the process, then next attaching special importance to the effectiveness of the development goals and providing macroeconomic stability before ensuring the national independence and maintenance of social- political stability.
These plans for reducing and eventually eliminate poverty levels in the countries follow the millennium development goals. The WHO MDGs on poverty have the target of reducing the poverty rates by 50 percent and in most countries; the target was met before its maturity time. The schemes that have been put in place to ensure this is the way they work with developing countries and ensure the workability of their development goals and strengthen the delivery of essential services, build standard assessment goals, conducting surveys on development and also develop policies and plan that will enhance poverty elimination. The development goals in health after poverty elimination is the fact that child health is also given a high priority and the child health strategies have been complemented by interventions for maternal health care. The WHO strategies for reducing the child mortality rate incorporates provision of appropriate home care and quick care given to children born with complications, increased involvement in provision of immunization, and ensuring proper feeding of both infants and young children. To combat diseases such as malaria and others that occur frequently, further innovation in disease prevention, diagnosis and treatment has been developed, improvement in health information provision and formation of stronger links between the disease and the outcomes of the disease have been established. One of the countries that were successful in embracing the millennium development goals is Rwanda, however, the implementation of the policies contributed greatly to internal conflicts due to diverging opinions concerning the strategies used. However, the analysis in the different strategies promoted by the outside organizations -the multilateral development agencies, provided room for economic structural adjustment, they also provided for peace promotion and democracy. These were the initiates of the donors that offered a resulting impact that contributes to the social and the economic development (Andersen, 2000).
Rural and urban health situation in Vietnam
The quality and the availability of health services in Vietnam differ greatly in the urban and the rural areas. The overall health situation in Vietnam is such that the health care facilities in Vietnam are the worst when compared to the health facilities in the surrounding nations and it is majorly caused by lack of government participation in provision of the health finances. The government contribution in the health sector is so minimal such that the impact cannot be totally felt. The citizens are therefore lest with the burden of catering for their own health issues and medical provision is on the basis of out of pocket payment scheme. The current statistics show that most health institutions and health care professionals are situated in the urban areas of Vietnam. Large cities in Vietnam such as Hanoi, Ho Chi Minh City and Hai Phong have the most hospitals and clinics. The availability of health practitioners in these institutions is considerate, but the counterparts, the rural areas of the country, are faced with even larger challenges. The probability of getting a health specialist or health care services in the rural areas is close to zero. It is almost impossible to get a doctor or other health practitioners such as nurses to go to the rural areas and attend to the health situations of the citizens there. One of the major challenges in health provision in the rural areas is the hygiene level. The government has put no initiates to cater for the hygiene conditions in the suburbs. Waste disposal, water provision and other necessary amenities that would ensure a good hygiene standard have not been incorporated which contribute to even deteriorating health standards in the rural areas and an increased outbreak of diseases.
The table below shows the Health expenditure in Vietnam, by poverty status, Rural/ Urban, with the total household spending.
Retrieved from: World Bank, urban poverty in the East Asian region
In the cases where there is a health institution in the rural area, it is very likely to no professional health care giver or the ration of the professional health care provider to the number of people who need medical attention would be overwhelming. In such situations, the health facilities are characterized by overcrowding. This is not to say that the health care situation in the city is better, a research in the health care standards that were done in Ho Chi Minh City provided results that showed the overall health situation in Vietnam was terrible. Medical data obtained in the year 2000 showed that Vietnam as a country had 250,000 hospital beds, which when analyzed against the population in the country was about 14.8 beds to be shared by 10000 people. The health facility equipment was also not sustainable and up to standard to ensure the health providers was secure. Some of the doctors and the nurses and the other health provides worked in both public and private health institutions at the same time owing to the overwhelming number of patients and the minimal number of health professionals. In the case where a patient is critically ill and is in the rural areas, the family members and the close relatives had to find a means of getting the patient to the city for treatment purposes and this was only possible for the people who lived within the set living standard since medical provision was on the basis of out of pocket and not insurance plans (Thuan, et al., 2008). Due to this, the death rate in the rural areas was high since most people could not afford medical care. The current situation, however has improved slightly due to programs such as the Vietnam National Tuberculosis Control program which have been developed over the years to provide treatment for the disease which was widespread.
The medical institutions in both rural and the urban areas in Vietnam were characterized as follows before the implementation of the MDGs that have sought to improve the health state in the country and the poverty eradication schemes that have been successful. However, this is not to say that the improvement in the Vietnam health sector has changed completely: most of the hospitals were constructed log ago and a little improvement has been done concerning the buildings and the internal structure of the hospitals. Hospitals such as those located in the Ho Chi Minh and Hanoi are overcrowded since they serve the local patients and the patients in the other provinces. The medical equipment is outdated and a replacement should be done especially for the surgery and the intensive care departments. The dependency of the public hospitals on the government to upgrade their facilities, equipment and services is not too positive since the rate at which the development is being established, is slow and can't be able to exactly meet the increasing demands of the citizens and the shortage of medical staff in many hospitals is common and the medical personnel work in tight conditions with very minimal wages that does not motivate medical provision.
References
Glewwe, P., Nisha, A., and Dollar, D. (2004). Economic growth, poverty, and household welfare in Vietnam. Washington, DC: World Bank.
Andersen, R. (2000). How multilateral development assistance triggered the conflict in Rwanda
Pigg, S. (1992). Inventing Social Categories Through Place: Social Representations and Development in Nepal. Cambridge University Press.Taylor & Francis, Ltd.
Thuan, N., Curt, L., Lindholm, L., & Nguyen T. (2008). Choice of healthcare provider following reform in Vietnam. BMC Health Services Research.
Frewer, T. (2013). Doing NGO Work: the politics of being 'civil society' and promoting 'good governance' in Cambodia, Australian Geographer, 44:1, 97-114, DOI: 10.1080/00049182.2013.765350
www.worldhealthorganisation.com
Bibliography
Glewwe, Paul, Nisha Agrawal, and David Dollar. Economic growth, poverty, and household welfare in Vietnam. Washington, DC: World Bank, 2004.
I will use this scholarly book to present information regarding the economic growth, poverty, and household welfare in Vietnam. This book provides high-quality data obtained through the Vietnam Living Standards Survey to help understand Vietnam's historical struggle with poverty and economic growth, as well as to provide policy recommendations for other low-income countries. This information is important because it explains the historical background of economic and social development in Vietnam.
Shobert, Benjamin. (2014). "Healthcare in Vietnam -- Part 1." Forbes.
I will use this article to present the background information on Vietnam's healthcare issues. This article provides an overview of the healthcare environment in Vietnam, specific challenges within Vietnam's healthcare economy, and finally, opportunities for investors and multinational pharmaceutical and device companies. This information is critical to my country project because it helps explain the issues of access, affordability, and quality regarding the healthcare system in Vietnam and how infrastructural improvement and aid can contribute to this ongoing problem.
Thuan, Nguyen Thi Bich, Curt Lofgren, Lars Lindholm, and Nguyen Thi Kim Chuc. (2008). "Choice of healthcare provider following reform in Vietnam." BMC Health Services Research. 2008.
I will use this experimental study to examine the choice of medical provider and household healthcare expenditures for various providers in a rural district of Vietnam. This study provides data to the differences in access and quality of health providers in Vietnam. This information is important because the results from this study are useful for policy makers and healthcare professionals to formulate new effective healthcare policies, as well as provide information for future short and long-term health service strategies.
