How the Rockefeller Foundation is Approaching Universal Healthcare in Vietnam

The Rockefeller Foundation recently awarded the Health and Strategy Policy Institute a $900,000 grant in support of policy strengthening and implementation of Vietnam’s Universal Health Coverage. This grant marks Rockefeller’s second to the Vietnamese organization.

Its first grant to the Health Strategy Policy Institute was a $550,700 award in 2011 to establish a new research center focusing on Vietnam’s private health sector. Both grants were awarded out of Rockfeller’s Transforming Health Systems Program.

In the late 1980s and early 1990s, Vietnam went through Doi Moi—an economic reform process that had the goal of “creating a socialist-oriented market economy.” In 2011, it appeared that Vietnam’s Social Health Insurance Program was an overwhelming success—after all, an estimated 97 percent of the country’s poor population had enrolled in the program (although let’s not forget that enrollment was compulsory). But as they go, appearances can be deceiving.

Doi Moi impacted the country’s economy in many ways, but for the health sector it meant privatization with state payment assistance. It turned out that the previous high universal healthcare enrollment levels did not translate into effective healthcare coverage for poor people. What ended up happening was that the poor enrollees were subsidizing the rich and overall, the poor provinces were subsidizing the affluent ones.

The resulting out-of-pocket costs for healthcare, especially for Vietnam's poor and near poor populations, made the country’s socialized health insurance program ineffectual, and successfully integrating poor people into the system remains a major issue.

For a number of years, new healthcare laws and regulations were established, enacted, repealed and otherwise changed. The back and forth of new healthcare laws and regulations culminated in 2012 with its Master Plan for Universal Health Insurance.

Vietnam’s Health Strategy and Policy Institute is working to balance UHI inequities and the recent $900,000 financial bump from the Rockefeller Foundation will help the Institute carry out its mission.

So why Vietnam? In 2011, Rockefeller’s former Vice President of Foundation Initiatives, Heather Grady, shared a few thoughts:

The question of equity in health care access is a major issue in Vietnam. Many of the poor are covered by one or another safety net, but some of the poor and a majority of the near-poor such as rural farmers are not. Moreover, the people who live in remote mountainous regions are triply disadvantaged due to their poverty, remoteness, and often ethnic backgrounds. The health services in such areas are minimal.

The Rockefeller Foundation has also been working closely with Vietnam’s Ministry of Health for the past few years addressing disparities in healthcare. The organizations have been working together toward education, capacity building, hospital management, and provincial staff training.