Health care seeking by the poor in transitional economies: the case of Vietnam.
The background to the research in Vietnam is presented, tracing the main economic and health sectoral events that took place in that country from the planned economy period through the early transitional years to the end of the 1990s. The report then gives details of the study, the methods used, and the characteristics of the study communes and their health services. In the first of two sections, findings are presented on health care seeking by study households, both as a whole and disaggregated by income group. Findings are presented on the following: illness reporting, health care actions, rates of use of different health care providers, and health care expenditure. Household health spending is analysed as a proportion of household income and the difference is demoonstrated between the willingness and ability of the poor to pay for health care. The implications for fee exemption policy are discussed. This section documents the health care seeking behaviour of households and the influence on it of income, duration of illness and cost of health care option. The second section deals further with the determinants of household choice of ambulatory health care option, including the type of illness and characteristics of providers as seen by households. The implications are discussed of these findings for improving the quality of public primary health care and a novel form of public/private health care mix is described that was introduced to the study communes during the intervention research phase. Finally some wider implications of the research for developing transitional and market economy countries are looked at.
DFID, London, UK, 134 pp.