Vietnam Health Insurance: Use of Health Care Services by the Poor Efficiency and Equity Issues in the Province of Kon Tum

Castel, Paulette

doi:10.2139/ssrn.1461327

Cited by 7 publications

(9 citation statements)

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“…Toan et al show that ethnic minorities use public health services to a lesser extent and attribute this to the failure of fee exemption and long distances to health services (35). There is also evidence for discrimination based on ethnicity within the health system (36), and there are few health workers from ethnic minority groups (37). Evidence for differential treatment of ethnic minorities is supported by findings even if ethnic minority mothers delivered at a health facility they were still subject to an increased risk of neonatal death (6).…”

Section: Resultsmentioning

confidence: 99%

“…It has also been suggested that there are financial barriers, such as informal fees, transportation costs, and expenditure on drugs, causing inequities between ethnic minorities and the majority Kinh (36). Wagstaff further points out that the HCFP does not remove many of the non-price constraints, such as geographical inaccessibility of facilities, that the targeted groups are faced with.…”

Section: Resultsmentioning

confidence: 99%

“…Internally, traditions and norms within a group that strengthen group belonging may affect health-seeking behavior or the introduction of evidence-based medicine as described above (42). Externally, the group can be subject to discrimination and adverse attitudes from the hegemonic outsiders, resulting in lower quality of care and inferior access to health services (36). When these horizontal inequalities result in differing health outcomes, it becomes a case of horizontal inequity, since the difference in health outcome is derived from social position and is therefore unjust (91).…”

Section: Discussionmentioning

confidence: 99%

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Ethnic minority health in Vietnam: a review exposing horizontal inequity

Målqvist

Hoa

Liêm

et al. 2013

Global Health Action

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BackgroundEquity in health is a pressing concern and reaching disadvantaged populations is necessary to close the inequity gap. To date, the discourse has predominately focussed on reaching the poor. At the same time and in addition to wealth, other structural determinants that influence health outcomes exist, one of which is ethnicity. Inequities based on group belongings are recognised as ‘horizontal’, as opposed to the more commonly used notion of ‘vertical’ inequity based on individual characteristics.ObjectiveThe aim of the present review is to highlight ethnicity as a source of horizontal inequity in health and to expose mechanisms that cause and maintain this inequity in Vietnam.DesignThrough a systematic search of available academic and grey literature, 49 publications were selected for review. Information was extracted on: a) quantitative measures of health inequities based on ethnicity and b) qualitative descriptions explaining potential reasons for ethnicity-based health inequities.ResultsFive main areas were identified: health-care-seeking and utilization, maternal and child health, nutrition, infectious diseases, and oral health and hygiene. Evidence suggests the presence of severe health inequity in health along ethnic lines in all these areas. Research evidence also offers explanations derived from both external and internal group dynamics to this inequity. It is reported that government policies and programs appear to be lacking in culturally adaptation and sensitivity, and examples of bad attitudes and discrimination from health staff toward minority persons were identified. In addition, traditions and patriarchal structures within ethnic minority groups were seen to contribute to the maintenance of harmful health behaviors within these groups.ConclusionBetter understandings of the scope and pathways of horizontal inequities are required to address ethnic inequities in health. Awareness of ethnicity as a determinant of health, not only as a covariate of poverty or living area, needs to be improved, and research needs to be designed with this in mind.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ethnic minority health in Vietnam: a review exposing horizontal inequity

Målqvist

Hoa

Liêm

et al. 2013

Global Health Action

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“…This inequality in quality of care is as important as inequality in the quantity of care. Castel (2009) showed that in the Kom Tum province ethnic minorities and informal sector workers received less expensive services than nonpoor patients with the same disease. The study also showed that financial barriers imposed by hospitals were cited as the most prominent barriers to access by the poor and ethnic minorities, rather than culture or distance.…”

Section: H a P T E R 3 Implications Of High Out-of-pocket Payments mentioning

confidence: 99%

Moving toward Universal Coverage of Social Health Insurance in Vietnam: Assessment and Options

Somanathan¹,

Tandon²,

Dao³

et al. 2014

153

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“…40,41 Ethnic minority women say they are mistreated by health staff and there are language as well as cultural barriers that contribute to the inequities. 42,43 "Proportionate universalism" as a solution…”

Section: Viet Nammentioning

confidence: 99%

Promoting equity to achieve maternal and child health

Thomsen,

Hoa,

Målqvist

et al. 2011

Reproductive Health Matters

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Vietnam Health Insurance: Use of Health Care Services by the Poor Efficiency and Equity Issues in the Province of Kon Tum

Cited by 7 publications

References 0 publications

Ethnic minority health in Vietnam: a review exposing horizontal inequity

Ethnic minority health in Vietnam: a review exposing horizontal inequity

Moving toward Universal Coverage of Social Health Insurance in Vietnam: Assessment and Options

Promoting equity to achieve maternal and child health

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