Healthcare Choices in the Context of Reform: Perspectives of Young Lives Caregivers in Vietnam

Abstract

Since the late 1980s, Vietnam has implemented market-based economic and healthcare reforms, destabilizing the publicly funded healthcare that had gained international renown. These reforms initiated substantial changes in healthcare provision and financing, which involved the introduction of user fees, legalization of private practices, and liberalization of pharmaceutical companies. In response to the impact of user fees on equity of healthcare access, the government has introduced compensating measures that aim to assist poor households and young children overcome new barriers to access. Using existing qualitative data of caregivers within a sub-sample of Young Lives Project participants, this study investigates the experiences and perceptions of caregivers as they seek care in this mixed healthcare system of public and private providers. Emphasis is placed on issues of quality and accessibility. Where do caregivers take their children when they are sick? What are the important determinants of health seeking behaviour within this sub-sample? This study finds that households, regardless of poverty status, perceive quality and accessibility of care to be highest in the private sector. Caregivers suggest that improvements in resources and quality of care offered by the commune health clinic would influence their choice of care, if quality could be guaranteed. This study also confirms gaps and inconsistencies in the existing compensation measures, such as free care for the poor and for young children, in their implementation and coverage