Vietnam’s shift from a centrally planned to a market economy has transformed the country from one of the poorest in the world into a lower middle-income country. Vietnam now is one of the most dynamic emerging countries in East Asia region.
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Hanoi, September 17, 2014 – Vietnam has made great strides in expanding social health insurance, now covering more than half of its population, but reforms, such as providing premium subsidies, ... Show More +greater family enrollment and introducing catastrophic cost coverage can help the country reach universal coverage, according to a new report the World Bank released today.“Vietnam has made significant progress toward achieving universal coverage for its population, and the government has made ambitious plans toward reaching that goal.” said Victoria Kwakwa, the World Bank Country Director for Vietnam. “This study shows us how Vietnam can speed up this process in order to ensure a healthy Vietnamese population while reducing the health financial burden on the poor.” The report, Moving Toward Universal Health Coverage of Social Health Insurance in Vietnam: Assessment and Options, offers a comprehensive assessment of Vietnam’s implementation of its social health insurance program, as well as recommendations on key reforms that the country can undertake to achieve universal coverage. During its preparation stage, it already contributed to the dialogue on the revision of Vietnam’s Health Insurance Law. Propelled by higher government spending in health care, the insurance program, which was piloted in 1989, has greatly boosted the number of people with health coverage. In 2010, nearly 60 percent of Vietnamese had health insurance, up from 10 percent in the early 1990s. The Master Plan for Universal Coverage, which was approved in 2012 by the Prime Minister, aims to expand coverage even further, to at least 70 percent of the population by 2015 and 80 percent by 2020. It also sets the goal of reducing patients’ out-of-pocket costs to less than 40 percent of total health care spending by 2015.But challenges remain. Despite large increases in subsidies for the near-poor, low enrollment rates persist, even among those in the formal sector, where enrollment is mandatory. Meanwhile, out-of-pocket costs still made up nearly 60 percent of health care costs in 2010, leaving households vulnerable to financial shocks. To reach the goals set out in the Master Plan, the report recommends reforms in several areas: (1) Further increasing coverage through premium subsidies, greater family enrollment and enforcement of enrollment compliance.(2) Improving equity and financial protection by cutting down on extra charges outside of policy and introducing catastrophic cost coverage(3) Strengthening health financing arrangements by ensuring money is spent more effectively and efficiently on drugs, providers etc.(4) Strengthening accountability by strengthening the organization, management and governance of social health insurance. For more information, please visit www.worldbank.org/vn Show Less -
Challenges- Enrollment rates remain low even amongst those enrollment is compulsory, such as the formal sector, and despite large increases in the partial subsidy extended to the near-poor. - In ... Show More +2010, when nearly 60% of the population was already enrolled, their out-of-pocket (OOP) share in health expenses was still almost 60%. High OOP payments leave households exposed to financial risk. Road map of reforms- Expanding the breadth of coverage: • Substantially increase general revenue financing to subsidize enrollment for the near poor and/or informal sector; • Enhance information, education and communication about health insurance to both providers and beneficiaries; • Encourage family enrollment; and • Enforce enrollment compliance in the mandatory enrollment group, particularly formal sector workers.- Improving equity and financial protection • Strengthen implementation of the co-payment policy, including grievance mechanisms; • Further reduce or waive co-payments for the poor and vulnerable groups such as ethnic minorities; and • Introduce catastrophic cost coverage.- Strengthening health financing arrangements for Social Health Insurance (SHI) • Generate additional revenues by raising tobacco taxes and gradually increasing the premium contribution rate; • Rationalize and cost out the benefits package; • Reduce inefficiencies arising from the current mix of provider payment mechanisms; and • De-fragment the procurement of and payment for pharmaceuticals.- Strengthening Organization, Management and Governance of SHI • Define the objectives of UC more clearly, and revise and define the roles and mandates of key agencies; • Strengthen the organization of SHI by putting in place a specialized SHI Division and eventually SHI Agency; • Strengthen SHI management arrangements • Strengthen SHI governance and accountability by clearly specifying financial accounting arrangements, conflict resolution arrangements and penalties. Show Less -
The Mekong Delta is the food bowl of Vietnam, producing 50 percent of the country’s rice and 70 percent of its aquaculture produce. Almost 20 percent of the country’s poorest people live in the delta,... Show More + home to about 18 million people who are feeling the impact of climate change. The population is growing and the land sinking while the sea level rises. This is leading to more frequent flooding.Upstream hydropower and irrigation are affecting water flows, natural sedimentation patterns, and fish migration. The change in fresh water flows affects the delta’s ability to flush the ever intruding saline. The delta’s balance is tipping.These mounting pressures are unlikely be reversed any time soon. Studies indicate climate change is set to exacerbate these land and water use challenges. Sea water levels are set to rise, storms to become more severe, and farmers’ rice yields are expected to decline up to 12 percent due to salinity intrusion. Aquaculture production will also be affected. The costs of adaptation for aquaculture alone could reach $130 million - $190 million per year.Government agencies and communities must now decide how to defend the delta, when to make room for the river, where to let the salt water stay, and why it might need to adjust the communities livelihoods and agriculture or aquaculture practices in response to a new reality. To address these challenges, the World Bank Group is working closely with other development partners to help design and deliver knowledge and financing for addressing challenges in provinces of the Mekong Delta in a long-term program. The bid to support resilient planning in provinces like Bến Tre province is founded on a decision support framework which will overlay existing data and analysis commissioned by different government agencies and development partners together with GIS maps, sectoral master plans, local expert experience, and available climate modeling.With this, lower cost solutions can be identified. These may include decisions to build dikes, create sluice gates, or plant mangroves. Mapping which farmland or homes are likely to flood when, or which rice fields would be subject to salt water intrusion, would help guide investments and planning processes.The decision support framework will enable government officials and community leaders to better understand the impact of the choices they make, weigh the options they have, and collectively assess the inevitable trade-offs that result. “A long-term development strategy for this region will require a sustained effort in adaptive delta management based on sound science and bringing different sectors and provinces together to think, plan, prioritize, and implement resilient investments,” says Anjali Acharya, a World Bank senior environmental specialist who is leading a multisectoral team on this work.Leadership in the Mekong Delta will provide lessons for Vietnam’s neighbors, as well as for the Ganges, the Okavango, the Mississippi and other complex delta systems.Mr. Dung will be attending the September Climate Summit. He hopes to share his experience and help mobilize global action and inspire others to step up to the climate challenge. Show Less -
Hanoi, August 25, 2014 – The World Bank today congratulated Vietnam on the high-level attention to building resilience of vulnerable areas like the Mekong Delta – which are especially impacted by clim... Show More +ate change and disaster risks, as well as Vietnam’s green growth strategy and action plan, and urged the country to forge ahead on a low carbon and resilient growth path.The statements were made during meetings between the World Bank Group Vice President & Special Envoy in charge of Climate Change, Rachel Kyte, and Vietnam State President Truong Tan Sang, and Prime Minister Nguyen Tan Dung."Climate change is a fact. It is intensifying threats to development and growth and there is no benefit in delaying action. Vietnam's leadership in climate action, green growth and building resilience is widely recognized," said Rachel Kyte. "Moreover, Vietnam recognizes the need to coordinate climate action at the highest level and we look forward to continuing to work together to tackle the climate challenge.”During these meetings, the participants discussed several areas of mutual interest, including building resilience in vulnerable areas and sectors. They also discussed bilateral relationship on Climate Change and Green Growth, in which the World Bank official reaffirmed the Bank’s willingness to continue its support to Vietnam, by bringing in both global knowledge and financing.The meetings were part of her visit to Vietnam on August 24-25, 2014 at the invitation of Vietnam’s Minister of Natural Resources and Environment. During this visit, Ms. Kyte attended a High-level Meeting on Climate Change with Deputy Prime Minister Hoang Trung Hai and other high ranking officials. She also participated in a Mekong Delta Roundtable on collaboration amongst development partners, and a dialog with private sector companies on investments opportunities relating to climate changeIn a field trip to Ben Tre Province, she learnt first- hand about the impacts that salinity intrusion and coastal erosion are already having on local economic development, people’s livelihoods, and gained an understanding of the adaptation strategies and coping mechanisms of local communities. Show Less -