The State of Healthcare in Vietnam: Challenges and Opportunities

Vietnam, a country with a rich history and vibrant culture, has made significant strides in its healthcare system over the past few decades. 

The country’s life expectancy has increased from 72.91 in 2000 to 75.91 in 2024, indicative of improvements in the population’s health. This progress is a testament to Vietnam’s efforts in enhancing healthcare services and infrastructure.

However, like many developing nations, it faces a complex web of challenges and opportunities.

Mekong Plus, our non-profit organization working in Vietnam and Cambodia, is dedicated to improving healthcare access and education, particularly in the Mekong Delta region. 

Through initiatives like health education programs in schools and infrastructure improvements in rural areas, Mekong Plus is actively working to bridge these healthcare gaps.

In this comprehensive article, we delve into the state of healthcare in Vietnam, examining its achievements, persistent gaps, and the role of NGOs like Mekong Plus in bridging those gaps. 

Your contribution can make a difference. Consider donating to Mekong Plus and support their vital healthcare initiatives in Vietnam.

 

I. The State of Healthcare in Vietnam

1. Strides Towards Universal Coverage

The Vietnamese government’s commitment to achieving universal health coverage (UHC) has led to expanded access to medical services, improved infrastructure, and increased funding for healthcare. The goal is to ensure that every citizen can access essential healthcare without financial hardship.

The journey towards UHC has been marked by several key government initiatives:

  • Health Insurance: The implementation of mandatory health insurance has been a game-changer, substantially increasing the number of people covered, reaching 93.35% of the country’s population. It provides subsidized healthcare aid to Vietnamese prioritized groups, including the poor, ethnic minorities, children under 6, and elderly individuals over 80 years old. 
  • Healthcare Facilities: There has been a notable increase in investments in healthcare infrastructure. New hospitals, clinics, and community health centers have sprung up (such as VinMec), enhancing healthcare accessibility in both urban and rural settings. Vietnam has promised to upgrade six hospitals to international standards in 2024, to tackle the increase in citizens seeking medical care overseas. 
  • Human Resources: According to data from the Ministry of Health (MoH) in 2023, Vietnam had 12.5 doctors per 10000 people. This places Vietnam on par with India and ahead of Indonesia, but far from the USA with 26 per 10000 and 32 per 10000 in France. Recognizing the importance of skilled healthcare professionals, the government has prioritized the training and deployment of medical staff, particularly in underserved regions. All provincial governmental bodies have enacted policies to attract medical staff to the rural and mountainous areas to bridge the talent gap between regions and to serve the needs of Vietnamese in such areas.

With continued support and dedication, the vision of accessible and affordable healthcare for all Vietnamese citizens is within reach.

 

2. Uneven Landscape: Disparities in Access

Vietnam has made significant improvements in its healthcare system, yet disparities in access to healthcare services persist, particularly between urban and rural areas.

Urban centers, with their better-equipped hospitals and higher concentration of healthcare professionals, offer specialized care that is often out of reach for those living in rural regions. These areas need more infrastructure, more transportation options, and more skilled healthcare workers.

The socioeconomic divide further worsens the issue. Individuals with higher income levels can afford private healthcare services, while those with lower incomes must depend on overburdened public services.

Moreover, ethnic minorities and marginalized communities face additional obstacles in accessing healthcare due to cultural, linguistic, and geographical barriers.

Compounding these challenges is the issue of corruption within the health sector. Vietnamese citizens have reported instances of having to pay bribes, sometimes up to 30% of the total cost of care, to access medical services or receive preferential treatment. This not only creates a financial burden but also erodes trust in the healthcare system and disproportionately affects low-income individuals who are unable to afford these unofficial fees.

rural doctor vietnam
A doctor from Binh Liêu District Health Centre in the northern province of Quảng Ninh examines a child on a roadside. Source: baodantoc.vn

Addressing these disparities is crucial for achieving social justice and ensuring equitable healthcare for all Vietnamese citizens. Efforts to improve healthcare access in rural areas include investing in infrastructure, enhancing transportation systems, and training more healthcare professionals to serve these communities. Additionally, policies aimed at reducing income inequality and providing support to ethnic minorities and marginalized groups can help bridge the gap in healthcare access.

Vietnam has emphasized equity in health through a series of pro-poor policies, especially for the disadvantaged in The Northern Midlands and Mountain Areas, and the Central Highlands.

 

II. Healthcare Risks in Vietnam

1. Maternal Care

The reduction in maternal mortality is a testament to Vietnam’s dedication to achieving the Millennium Development Goals (MDG5), with a notable decline from 103 deaths per 1,000 live births in 1955 to 17 deaths per 1,000 live births in 2020. However these numbers are still far from Western standards, with the USA sitting at 3,3 deaths per 1,000 live births in 2020, and France at 4 per 1000.

This progress continued with innovative interventions, especially in ethnic minority regions, where projects funded by organizations like the “Leaving no one behind” project by UNFPA and MSD for Mothers which aims to stop preventable maternal deaths through targeted support.

Despite these achievements, Vietnam faces ongoing challenges. The disparity in healthcare access is a significant concern, particularly in remote areas. These regions still suffer from a lack of skilled healthcare professionals, which can lead to preventable maternal deaths.

The Northern Midlands and Mountain Areas, as well as the Central Highlands, are among the most affected, with maternal mortality ratios as high as 100-150 per 100,000 live births in these mountainous and ethnic minority regions.

midwife
A midwife takes care of a newborn at home in Cang Tang village, Lung Cu commune, Dong Van district, Ha Giang province. Source: VNA.

The postpartum period, a critical phase for new mothers, demands greater attention. It is during this time that most maternal and infant deaths occur, yet it remains the most neglected phase in the provision of quality maternal and newborn care. Ensuring comprehensive care during this period is crucial for the well-being of both mother and child.

Vietnam’s journey to improve maternal health is ongoing. While the country has made impressive advancements, the work is far from over. With continued support and innovative solutions, Vietnam can overcome these challenges and set a standard for maternal health care in the region.

 

2. Common Diseases

Vietnam, with its tropical climate, is a breeding ground for various infectious diseases, especially dengue fever and tuberculosis (TB).

The warm and humid conditions favor the proliferation of the Aedes mosquitoes, which are the primary vectors for dengue virus transmission. The country has witnessed fluctuating cases of dengue fever, with peaks typically occurring from June to October annually. Despite the challenges, Vietnam has been successful in controlling dengue fever mortality since 2005, with mortality rates less than 1 per 1,000 cases.

Vector control measures, such as eliminating mosquito breeding sites and using insecticides, are crucial in preventing dengue outbreaks. Public awareness campaigns play a significant role in educating the population about preventive measures and the importance of early medical intervention.

anti mosquito
A government staff sprays chemicals to kill mosquitoes that transmit the dengue virus in Buon Ma Thuot. Source: Báo Đắk Lắk.

Tuberculosis remains another significant public health issue in Vietnam, with the emergence of multidrug-resistant TB (MDR-TB) posing a serious challenge. The country ranks 11th among the 30 with the highest burden of TB globally, and efforts to improve treatment outcomes for MDR-TB are ongoing.

Vietnam has established a national TB program and a national TB commission to mobilize resources and coordinate healthcare support across multiple sectors to end TB by 2030. Training healthcare workers, improving diagnostic capabilities and ensuring the availability of effective treatment regimens are part of these sustained efforts.

The fight against these diseases is a continuous one, requiring the commitment of the government, healthcare providers, and the community. The success of these initiatives is critical not only for the health of the Vietnamese population but also for setting a precedent in infectious disease control for other tropical countries.

 

3. Non-Communicable Diseases (NCDs)

Vietnam is facing a significant health challenge with the rise of non-communicable diseases (NCDs). These diseases, which are not passed from person to person, are becoming increasingly prevalent due to various factors, including lifestyle changes and an aging population.

Diabetes is one such NCD that is on the rise, with urbanization and lifestyle changes contributing to its increasing prevalence. In 2021, the diabetes prevalence in Vietnam was reported at 6.1% among the population aged 20 to 79. This growing burden of diabetes is a cause for concern, as it can lead to severe complications and a high economic burden on individuals and society.

Heart disease is another major NCD affecting the Vietnamese population. Unhealthy lifestyles and poor diets are primary drivers of cardiovascular diseases, which were responsible for 31% of all deaths in the country in 2016. The age-adjusted death rate for coronary heart disease in Vietnam was 86.67 per 100,000 of the population, ranking the country 125th in the world.

Cancer rates in Vietnam are also on the rise, necessitating better prevention, early detection, and treatment. In 2020, Vietnam reported 182,563 new cases of cancer, with liver cancer being the most common. The age-standardized rate of cancer mortality in Vietnam is 104 per 100,000 population, ranking 57th globally.

Addressing these NCDs requires a multifaceted approach, including improving public health surveillance, promoting healthier lifestyles, and enhancing healthcare services. The Vietnam Non-communicable Diseases Prevention and Control Alliance (NCDs-VN) is one such initiative that aims to advocate and support the achievement of NCD prevention objectives by 2025 in accordance with WHO’s recommendations.

The challenge of NCDs in Vietnam is significant, but with joined efforts from the government, healthcare organizations, and the community, progress can be made in managing and reducing the impact of these diseases on the population.

 

4. Sexually Transmitted Diseases (STDs)

Vietnam faces challenges in dealing with sexually transmitted diseases (STDs) prevention and treatment, most prevalently HIV/AIDS, with over 200,000 Vietnamese affected. (around 0,2% of the population). 

The social judgement of STDs can stop individuals from seeking necessary medical care, thus undermining the progress made in combating these infections. This is particularly evident in the lives of sex workers and other marginalized groups, who often face discrimination and limited access to resources.

To counteract these challenges, comprehensive sexual health education is essential. It empowers individuals with the knowledge to make informed decisions about their sexual health, promotes respectful and safe relationships, and fosters an environment where seeking help is not met with judgment but with support. Education plays a pivotal role in dismantling misconceptions and fostering a more empathetic society that supports those affected by STDs.

For example, WeGrow Edu is a Vietnamese NGO which provides comprehensive sex education lessons to students from grade 1 to 12 and focuses on healthy relationships, self-identity, and gender equality while challenging the traditional abstinence-based approach prevalent in Vietnam.

kids
An activity during WeGrow Edu’s sex education summer camp. Source: WeGrow Edu Việt Nam.

As Vietnam continues to navigate the complexities of public health, the integration of sex education into the broader strategy will be crucial. It’s not only about treating infections but also about nurturing an informed and compassionate community that upholds social justice and the dignity of every individuals. The journey towards eradicating STI stigma is ongoing, and education is the beacon that will guide the way forward.

 

5. Mental Health

In Vietnam, mental health has long been a subject hidden in silence and stereotypes. However, the tide is slowly turning as awareness grows and more individuals seek the support they need.

The country faces significant challenges in this area, with limited mental health services available to its population. This has created a silent crisis that demands immediate and sustained attention.

The statistics are sobering: a report by the WHO highlights that in Vietnam, the prevalence of common mental disorders was 14.2% in 2014, with depressive disorders accounting for 2.45% of this figure. Despite these numbers, the conversation around mental health is often muted, and many suffer in silence due to fear of judgement or lack of resources.

Efforts are being made to change this narrative. A variety of organisations and platforms now offer mental health services in both Vietnamese and English, catering to the diverse needs of the population. These include counselling platforms like Psychologist Vietnam, which connect individuals with therapists and counsellors specialising in a range of mental health services. Additionally, initiatives like the National Target Programme for Mental Health (a government charity) are working towards integrating mental health into general healthcare, focusing on primary care settings.

The path forward involves not only increasing the availability of mental health services but also continuing to destigmatize mental health issues. Education and open dialogue are key components in this process, allowing individuals to understand that mental health is a critical aspect of overall well-being and that seeking help is a sign of strength, not weakness.

As Vietnam continues to develop its mental health infrastructure, the hope is that more individuals will have access to the care they need, and mental health will no longer be a silent crisis but a recognized and supported part of the healthcare system.

 

6. Physical Disabilities

In Vietnam, the challenges faced by individuals with physical disabilities are multifaceted and deeply rooted in the country’s history.

The legacy of Agent Orange, a defoliant used during the Vietnamese Resistance War against the US, has left a lasting impact on the health and well-being of several generations. Between 1961 and 1971, US forces sprayed an estimated 12 million gallons or 80 million liters of Agent Orange in Vietnam. The effects remain one of the most contentious legacies of the war. According to the government of Vietnam, up to four million people in Vietnam were exposed to the defoliant, and as many as three million people have been suffering illness because of Agent Orange.

Access to healthcare is a fundamental right, yet for those with disabilities in Vietnam, it remains an exhausting issue. Many studies have highlighted the difficulties faced by people with physical disabilities, including inaccessible healthcare facilities, discrimination, and inadequate support from health insurance policies. These barriers not only hinder their ability to receive care but also affect their overall quality of life.

Efforts to improve healthcare access are underway, with initiatives focusing on policy improvement, advocacy for disability rights, and the enhancement of rehabilitation services. International assistance has played a role in addressing medical and social needs, improving disability policies, and reducing physical and social barriers.

Working in hand with the Vietnamese government, Inclusion of the Vietnamese with Disabilities (IVWD), sponsored by USAID, aims to promote the inclusion of Vietnamese people with disabilities. IVWD collaborates with local partners to develop policies, enhance employment opportunities, build capacity for disability-related programs, regain equal opportunities and social justice for the disabled.

 

III. NGOs Acting for Healthcare in Vietnam

1. Main Organizations

Vietnam’s healthcare system has seen significant contributions from various NGOs that strive to improve health outcomes and access to medical services across the country. These organisations work in diverse areas, ranging from disease prevention and control to health education and the provision of micro-credits to ensure the affordability of treatments.

One of the prominent charities is PATH, which has been operating in Vietnam for over four decades. PATH focuses on primary health care, vaccines, epidemic preparedness and response, and malaria. Their efforts have been crucial in supporting Vietnam’s COVID-19 vaccination campaign and enhancing digital systems to detect and respond to disease outbreaks. NCDs like HIV/AIDS and cancer are also one of their main focuses.

Operation Smile Vietnam is a charity that operates mainly on donations from Vietnamese. They collaborate with local partners to provide free surgeries for children with lip and palate deformities (such as cleft palate). They have been organising multiple free surgery programs across Vietnam, benefiting children in need.

operation smiles
Operation Smile organises smile surgeries for children with facial deformities. Source: Operation Smile Vietnam.

CARE International is another key player, working particularly with ethnic minority communities to increase opportunities and promote partnerships with community-based groups and national non-profit organisations. CARE’s initiatives are geared towards preventing gender-based violence, increasing economic opportunities for women and rural communities, and improving access to safe water, sanitation, and hygiene practices.

 

2. Mekong Plus

Mekong Plus plays a pivotal role in Vietnam’s healthcare landscape, with a focus on education programs and micro-credits. Mekong Plus’s initiatives are designed to raise health awareness, emphasising preventive measures and community empowerment. By providing micro-credits for medical expenses, Mekong Plus ensures that individuals can afford necessary procedures and treatments.

Their approach to healthcare is holistic, combining education, sustainable agriculture, and infrastructure projects to improve the lives of low-income households. Over the past 30 years, Mekong Plus has assisted thousands of families in escaping poverty and has established a strong presence in both Vietnam and Cambodia. Their programs have been instrumental in building resilient and dynamic communities.

For instance, Mekong Plus has been actively involved in health education programs that address childhood eyesight and dental problems. They have trained local health officials and clinics to screen children for myopia, ensuring that those in need receive proper diagnosis and eyeglasses. This initiative has reached about 50,000 primary school children in almost 100 schools, significantly improving their learning abilities and quality of life.

Mekong Plus’s commitment to healthcare extends to their support for sustainable employment and agronomy, recognizing the interconnectedness of economic stability and health. Their microcredit program has been particularly effective, providing financial assistance that enables families to invest in their health without falling into debt.

 

You can support Mekong Plus by visiting the Mekong Plus donation page and contribute securely. Your contribution makes a significant difference in the lives of vulnerable communities. Thank you for supporting Mekong Plus!

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