Introducing health information systems to aged care in Vietnam

Similar to many other countries worldwide, Vietnam is facing a challenge of an ageing population. This challenge is even more difficult to overcome because Vietnam is a developing country lacking an established aged care infrastructure and system. Many aspects of aged care have largely been relied on families of aged people due to a strong influence of Confucian philosophy. Looking after aged parents has always been seen as a responsibility and filial piety of children and their extended families. Therefore, providing healthcare for aged people in their family and community context is important. The paper offers a rich description and an analysis of the current situation of the health state of and healthcare for aged people in Vietnam. The paper also suggests directions for integrating information communication technology into aged care in Vietnam.<br /

Asia in the ageing century: part III - healthcare

With total health spending in the region worth over a trillion dollars in 2010 and demand for healthcare continuing to grow, Asian governments will have a tremendous challenge meeting and funding this demand.Summary• This is the third research brief in a three-part series that looks at Asia in the ageing century, with a particular focus on the countries of East and South-East Asia.• The context is outlined in the first brief, which describes population, urbanisation and social trends in the region. Specifically, it notes that population ageing in East and South-East Asia is happening faster and at a lower level of economic development than in the West. Many Asian countries now have a decade or so to prepare for the final stages of demographic transition. Parts II and III of the series focus on two areas of economic activity which are both pertinent to population ageing and have enormous scale: provision of retirement income (covered in Part II) and of healthcare (outlined in the present brief).• As Asian societies become wealthier and older they will demand more of their health systems. This translates to extending health insurance coverage to a broader cross- section of the population, and offering reimbursement for a greater proportion of costs on a larger package of benefits. China has enrolled 1.2 billion people into the health insurance system within the last decade but in some provinces benefit packages are lacking. Malaysia achieved universal health coverage in the 1980s, but in 2004 key medicines were only available in a quarter of public health facilities.• East and South-East Asian governments currently have the fiscal capacity to keep expanding health systems, but to avoid the excessive cost growth seen in the West they will need to employ various micro, macro and demand-side measures – heeding the successes and failures of reforms within the region and elsewhere.• An important area for healthcare is the epidemiological transition that comes with ageing societies, where the relative prevalence of non-communicable diseases increases. Health packages in Asia are yet to take a full account of this change.• Health spending in the region was worth over US$1 trillion in 2010. On the financing side, private health insurance is still a niche market making up US$50 billion of spending, but recent growth has been high (e.g. 100% p.a. in China). On the provider side, the size and growth of the market will result in opportunities for pharmaceutical, medical device manufacturing and consumer health companies, as well as for operators of hospitals and specialised facilities. Some of that demand will spill over into the growing medical tourism market.• At the level of the macro-economy, stronger welfare provision offers an opportunity to rebalance growth in the region by reducing excessive precautionary savings. So far, East and South-East Asian countries have been taking this opportunity but much remains to be done for healthcare systems to be fully ready for an ageing population.&nbsp

Rights, social policy and reproductive wellbeing: the Vietnam situation

Wellbeing Rights and Reproduction Research Paper I

Socioeconomic inequalities in access to health care: Examining the case of Burkina Faso

Copyright @ 2011 Johns Hopkins University PressThe past decade has recorded remarkable interest in socioeconomic inequalities in health care. A multivariate analysis of the World Health Survey data for Burkina Faso was conducted using STATA. This included questions on household economic factors, perceived need, and access to health care. Poverty was defined using Principal Components Analysis. There was no significant difference in perceived need on the basis of poverty or gender. The less poor accessed health care more than the poor, but this difference was significant only among males. Respondents who lived in urban areas accessed health care more than those in rural areas, but this difference was significant only among females. We argue that health care financing arrangements affect self-reported need and access to health care. Even when they perceive need, the poor do not access care, probably because of cost, exacerbated by non-availability of readily accessible health care facilities

Economic evaluation of HBV vaccination: a systematic review of recent publications (2000-2013).

Aim: To conduct a systematic review of the economic evaluations (EE) of HBV vaccination, taking also into account the studies published in the new millennium. Methods: An extensive scientific literature review was conducted using two electronic medical journal databases: Scopus and PubMed engines for published studies on EE of HBV vaccination. Results: 22 articles were reviewed, 9, 5 and 8 cost-effectiveness, cost-benefit and cost-utility analysis, respectively. Studies were mainly concerning EE of universal vaccination (UV), mostly with regards to low or low-medium income countries. For high income countries, EE were focused on the possible implementation of HBV vaccination in particular settings, such as diabetic, renal and other chronic conditions care, as well as infectious diseasesUV has usually a very good cost-effectiveness ratio (80%), ranging from cost-saving (China) or few Euro per LY/QALY gained (in Thailand, and Vietnam) to 630.00$/ QALY in USA (Asian and Pacific Islands) Moreover, EE of HBV vaccination are favorable in the infectious diseases field as well as for chronic conditions. In relation to diabetes the studies gave controversial results. Conclusion: This systematic review highlighted the importance of introducing HBV vaccination not only for infant UV program but also for other settings in which patients are people affected by communicable and non-communicable diseases

Scaling-up Early Learning in Ethiopia: Exploring the Potential of O-Class

SDG Target 4.2 identifies ‘pre-primary education’ as a strategy to strengthen school readiness and contribute to the quality and outcomes of education, which is supported by the powerful evidence from evaluation research. The challenge faced by many countries is to deliver the proven potential of well-planned, quality programmes to scale. This working paper summarises Ethiopia’s growing commitment to pre-primary education and reports recent Young Lives engagement with the Ministry of Education in Ethiopia and other partners to support scale-up. Ethiopia’s most recent ambitious targets for early learning have been set out in the Fifth Education Sector Development Programme (ESDP V 2015), with pre-primary classes (known as O-Class) within primary schools being seen as the most rapid route to scale-up. The paper reports on the progress and the challenges in delivering ambitious targets. We report key findings from exploratory fieldwork on two key themes, namely the response of Regional Education Bureaus in planning, financing, management and ensuring human capacity for scale-up; and the potential of Ethiopia’s Colleges of Teacher Education to supply sufficient trained teachers to work with young children, especially in the rapidly expanding O- Classes. The final section draws on parallel experiences of other countries, notably Grade R in South Africa, and reports on six key challenges for scale-up; equity; age-appropriateness; cross- sectoral coordination; capacity building; and research and evidence. Other key challenges go beyond the scope of this working paper, notably the models for governance and financing that can deliver quality early education for all. While Ethiopia’s initiative to scale-up O-Class is a welcome indicator of policy commitment to SDG Target 4.2, we conclude that there is a risk that low quality pre-primary programmes will not deliver on the potential of early childhood education and that children (especially poor children) will be the losers

The Power of Primary Schools to Change and Sustain Handwashing with Soap among Children: The Cases of Vietnam and Peru

World Bank Water and Sanitation Program's Global Scaling up Handwashing Project, funded by the Bill and Melinda Gates Foundation, is an effort to expand handwashing among women and children by using innovative promotional approaches. This working paper provides case studies of the project in Vietnam and Peru. Both used entertainment education and teacher capacity building, but as a result of differences in government and education contexts, as well as child-focused research that revealed important cultural differences, programs varied substantially among the two locations. In both cases, the primary school setting was found to be an effective site for improving handwashing

Handwashing with Soap -- Two Paths to National-Scale Programs Lessons from the Field: Vietnam and Indonesia

This paper describes two Southeast Asian programs that are making handwashing a feature of everyday lives on a national scale. The program in Vietnam has concentrated on first gaining an understanding on how people actually behave and then determing how to change that behavior, while the program in Indonesia leverages the reach of the private sector and other partners to scale up handwashing initiatives previously researched and already underway

Development and validation of the Vietnamese primary care assessment tool

Objective : To adapt the consumer version of the Primary Care Assessment Tool (PCAT) for Vietnam and determine its internal consistency and validity. Design : A quantitative cross sectional study. Setting : 56 communes in 3 representative provinces of central Vietnam. Participants : Total of 3289 people who used health care services at health facility at least once over the past two years. Results : The Vietnamese adult expanded consumer version of the PCAT (VN PCAT-AE) is an instrument for evaluation of primary care in Vietnam with 70 items comprising six scales representing four core primary care domains, and three additional scales representing three derivative domains. Sixteen other items from the original tool were not included in the final instrument, due to problems with missing values, floor or ceiling effects, and item-total correlations. All the retained scales have a Cronbach’s alpha above 0.70 except for the subscale of Family Centeredness. Conclusions : The VN PCAT-AE demonstrates adequate internal consistency and validity to be used as an effective tool for measuring the quality of primary care in Vietnam from the consumer perspective. Additional work in the future to optimize valid measurement in all domains consistent with the original version of the tool may be helpful as the primary care system in Vietnam further develops

An Exploration for a Universal Non-contributory Pension Scheme in Vietnam

Briefly, some of our findings are as follows. First, the impacts of a universal NCP scheme on poverty rates and the poverty gap of the older persons would be significant, but become less potent when the eligibility age is higher. In particular, with the benefits provided, the older persons who are females; who are married; who are living in urban areas; who are working, or who are receiving social insurance benefits would be more likely to reduce their poverty rates and poverty gaps than other elderly groups. Second, the financial simulations show that the cost of the scheme, which provides a benefit equal to 50.0 per cent of the official poverty line to all the persons aged 60 and over, would be about 1.2 per cent of GDP in 2004. As population ages as in the projections of the United Nations (2007a), the cost would be higher, but only as high as about 3.0 per cent of GDP.Vietnam, non-contributory pension