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HOW THE NON-STATE SECTOR ENGAGE TO STEWARDSHIP OF MIXED SYSTEM IN IN VIETNAM

HOW THE NON-STATE SECTOR ENGAGE TO STEWARDSHIP OF MIXED SYSTEM IN IN VIETNAM. Health Strategy and Policy Institute - Vietnam. Content. Information on non-state sector in health in Vietnam Models of engagement of NSP in health care system

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HOW THE NON-STATE SECTOR ENGAGE TO STEWARDSHIP OF MIXED SYSTEM IN IN VIETNAM

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  1. HOW THE NON-STATE SECTOR ENGAGE TO STEWARDSHIP OF MIXED SYSTEM IN IN VIETNAM Health Strategy and Policy Institute - Vietnam

  2. Content • Information on non-state sector in health in Vietnam • Models of engagement of NSP in health care system • Regulation for engaging NSP to the health care system

  3. Information on non-state sector in Health in Vietnam (1) Non-state health practice was officially recognized in 1989 NSP legalized by Ordinance on Private Pharmaceutical and Medical practice in 1993  1998: 19.836 private health facilities (02 non-state hospitals) 2009: > 65,000 private health facilities: - about 30,000 private medical facilities and 93 private hospitals - 39,172 drug retails

  4. Public-private mix of providers - Vietnam 60% private 40% public 96% public

  5. Information on non-state sector in Health in Vietnam (2)  State sector is the main provider of hospital services Proportion of total in-patients and out-patients treated by non-state hospitals

  6. Non state sector engagement in delivering curative services (1)

  7. Engage in delivering curative services (2)

  8. Engage in delivering curative services (3)

  9. Engage in delivering curative services (4)

  10. Engage in delivering curative services (5)

  11. Current policy and regulation related to NSP engaging in health system Investment and establishment of Non state health care facilities • 1993: NSP recognized as a legal part of health care system (State ordinance 26, 1993, revised in 2003) • 1999: Social mobilization for health allowed private organization/individual participate in investment of health care activities  not-for profit (Decree 73/1999) • Incentive for NS hospital: free land or rent without fee, free taxation in first 4 years, decrease by 50% in next 5 years. (Resolution No. 46-NQ/TW & Decree No. 69/2008) • Targeting the side of non-state hospital by the year 2010: 2 beds/10,000 in 2010; 5 beds/10,000 in 2020 • The licensing requirements based on the Law on Medical Examination and Treatment of 2009 that will be applied for both state and non-state providers

  12. Current policy and regulation related to NSP engaging in health system Policy for NSP investment in state health facilities: • Hospital autonomy policy: Decree 10/2002, replaced by Decree 43/2006: • Better health services delivery, improve quality and increase hospital revenues • Social mobilization of resources for health sectors in order to reduce subsidy from government to health facilities • Social mobilization policy (Decree 73/1999, Decree No. 69/2008)  allowed public hospital to sign contract with private firms or individuals to invest in providing services (both clinical and non-clinical services)

  13. Constrain in regulation • Lack of regulation to enforce non-state sector to provide public services: • Disease surveillance, preventive cares • Policy for involving non-state sector in providing services for vulnerable group • Lack of policy instrument to mmonitoring quality of services, patient care, satisfaction, outcomes (medical errors, overuse of services).

  14. Constrain in regulation • Lack of mechanism to improve the engagement of non-state sector to public sector (PPP) • Weak role of professional/consumer organisations to oversight the performance of public facility in general, particularly for non-state sector. • Lack of health management information system for managing, monitoring and making plan for non-state sector development in the context of health system

  15. Thank you!

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