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This study examines health inequality in Vietnam using data on health services delivery and outcomes. The analysis highlights disparities and recommends priority actions for improving health equity in the country.
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Objective • To describe and analyze inequality in some aspects of health in Vietnam: • Health services delivery: family planning, MCH, EPI • Health outcomes: IMR, U5MR
Methods • Data sources: DHS (1997, 2002), MICS (2006, 2010) • Process: • Descriptive data in Excel files to see the differences between groups and trend • Used HDCal software to estimate specific inequality measures, both absolute (range difference) and relative measures (Theil index and its % change/ RCI) • Did not include some indicators because small sample size (care seeking for pneumonia, ORS) or only one survey (malnutrition), or data may not be accurate (NMR) • Discussed to give priority for HE actions by also looking at current coverage and national targets
IMR Slope Index : -31.3 -34.1 Theil index: 0.04-0.078 Policy: In 2002, Vietnam launched decision 139 about health care fund for the poor, decision 135 to support health care for people in the remote areas
IMR Policy: Vietnam gave more priorities to central highland and northern uplands, red river delta and southeast regions are more developed. North central received less priority
U5MR Policy: Similar impact to all groups. Success of EPI, nutrition, CDD, ARI programs and socioeconomic development in VN could help to the improvement
Conclusion • Low priority for health equality regarding FP, contraceptive use, measles immunization, initial breastfeeding, skilled birth attendance. • Medium priority should be given to ANC, DPT3 • High priority should be given to improve mortality among infant and U5 children • Inequality is more likely among wealth, education and regional groups • National coverage was good but inequality remained among wealth, and educational groups (ANC, birth attendance) • Improvement in health equality between wealth, educational and regional groups was not as good as that between sexes, areas • Vietnam is among countries with medium level of health inequality