Health System and EPI Program
Administratively, the health system is divided into fourlevels: central Ministry of Health (MOH); provincial health departments, district level health offices and communal. The service delivery network is quite well organized and has wide coverage. There are health facilitiesat all four levels.
The MOH carries out the state’s public health functions. These include health protection and promotion, curative care, rehabilitation, traditional medicine, pharmaceutical supplies, food safety and medical equipment. The administrative apparatus of the MOH includes the Ministry’s Cabinet, departments and inspectorate. In addition, the MOH has 70 subordinate institutions in three major areas: (1) hospitals; (2) preventive medicine and professional institutes; and (3) medical colleges and universities.
The primary care network covers all districts and communes. By the end of 2006, Vietnam had 671 districts and 10,876 communes/wards serving a population of more than 83 million people.
Vietnam has been decentralizing its health care delivery system for several years. This has led to an increasing share of government health spending at the local level (provincial level and below).
Over the period 2006-2011, Gross National Income (GNI) in Vietnam increased from $700 to $1260 per capita. According to the WHO/UNICEF-Joint Reporting Form (JRF) Database, government expenditures on routine immunization increased from 2006-2009 and declined in 2010. On average, the Vietnamese government spent $6 per infant on routine immunization. In 2011, the government spent $10.6 million on routine immunization, a $4 million increase from reported expenditures for 2006. Although government expenditures have increased, the contributions over the total budget have decreased from 39% in 2010 to 33% in 2011.
The State Budget Law, effective from January 2004, gives increased budget autonomy to provinces by providing recurrent funding on two block grants, one for “wages and salaries” and the other for “all other operations and maintenance”. The size of these block grants depends on the provinces’ population size, disease patterns and differential resource needs.
The Socialist Republic of Vietnam has a single-party socialist governance system.The president is the head of state and the prime minister is the head of government. The leading political party is the Communist Party of Vietnam. Legislative power is vested in the National Assembly of Vietnam (Vietnamese: Quoc hoi), and the judiciary powers remain independent of the executive.
The president (Chủ tịch nước Cộng hoà xã hội chủ nghĩa) is elected by the National Assembly for a five-year term. The president is the commander-in-chief of the Vietnam People's Armed Forces and Chairman of the Council for Defence and Security. The prime minister has several deputy prime ministers and several ministers in charge of particular activities. The executive branch is responsible for the implementation of political, economic, cultural, social, national defence, security and external activities of the state. The National Assembly is a unicameral legislative body. with 500 members, elected by popular vote to serve four-year terms. The legislature is, according to the constitution, the highest organ of the state. Its powers include the enactment and amendment of the constitution and laws; the adoption of the government budget; supervising the Government of Vietnam and other holders of public powers responsible to the National Assembly; and appointing members of the judiciary.
The Constitution of Vietnam, Chapter III, article 39 states: “The state shall invest in, develop, and exercise its unified management over health care activities for the people. It shall mobilize and organize all social forces to build and develop Vietnamese medicine, especially preventive medicine; combine disease prevention with medical treatment; develop and combine modern and traditional medicine and pharmaceutical practices; combine the development of state health care with folk medicine; offer health insurance; and create conditions for citizens’ access to medical care”.
The Constitution, chapter V, article 61, paragraphs 1– 3 further states: “Citizens have the right to health care. The State shall devise systems for hospital charges, and for exemption and reduction of hospital charges. Citizens have the obligation to comply with all regulations on disease control and public sanitation.”
Showcasing Vietnam's Progress in 2013
Right click to view full-sized image in new tab
- October 2012: First mission to Vietnam was held by SIF Program Director Mike McQuestion and SPO Khongorzul Dari.
- January 2013: SPO Khongorzul Dari carried out a visit to Vietnam where she met with counterparts from the Ministry of Health and Parliament.
- May 2013: Vietnam held its first national briefing in the city of Da Nang. This was the fisrt time that central and provincial representatives from the Ministry of Health and the immunization program, the Ministry of Finance and the Parliament came together to discuss sustainable immunization financing.