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Health Policy and Planning Advance Access originally published online on April 19, 2008
Health Policy and Planning 2008 23(4):252-263; doi:10.1093/heapol/czn009
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Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2008; all rights reserved.

Health insurance reform in Vietnam: a review of recent developments and future challenges

Björn Ekman1,*, Nguyen Thanh Liem2, Ha Anh Duc3 and Henrik Axelson1,4

1 Health Economics Program (HEP), Lund University, Sweden.
2 Institute of Sociology, Hanoi, Vietnam.
3 Boston University, School of Public Health, MA, USA.
4 Partnership for Maternal, Newborn, and Child Health (PMNCH), Geneva, Switzerland.

* Corresponding author. Health Economics Program (HEP), Department of Clinical Sciences, Lund University, Malmö SE-205 02, Sweden. E-mail: bjorn.ekman{at}med.lu.se

Vietnam is undertaking health financing reform with a view to achieve universal coverage of health insurance within the coming years. To date, around half of the population is covered with some type of health insurance or prepayment. This review applies a conceptual framework of health financing to provide a coherent assessment of the reforms to date with respect to a set of key policy objectives of health financing, including financial sustainability, efficiency in service provision, and equity in health financing. Based on the assessment, the review discusses the main implications of the reforms focusing on achievements and remaining challenges, the nature of the Vietnamese reforms in an international perspective, and the role of the government. The main lessons from the Vietnamese experiences, from which other reforming countries may draw, are the need for sustained resource mobilization, comprehensive reform involving all functions of the health financing system, and to adopt a long-term view of health insurance reform. Future analysis should include continued evaluation of the reforms in terms of impacts on key outcomes and the political dimensions of health reform.

Key Words: Health financing, health insurance, reform, Vietnam, review

Accepted for publication 11 March 2008.


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