Challenges remain in Vietnam’s childcare system
Positive changes
After one year of implementing the circular on providing free medical check-ups for children under six, there have been notable changes. According to the National Committee for Population, Family and Children, as of March 31, 2006, the government granted free medical cards to 6.629 million out of a total of 7.711 million children under six across the country. Many provinces have a high proportion of granting the cards to local children, for example, Ninh Binh (93 percent), Dak Nong (nearly 100 percent), and Vinh Long (98.24 percent).
Since the implementation of free outpatient and inpatient treatment, the number of children going for medical check-ups has increased considerably. In 2005, the number of children going for medical check-ups in Vinh Long province’s polyclinic rose to more than 41 percent against 2004 while the number of children seeking treatment increased by 33 percent. The percentage also increased in polyclinics in Dong Thap and Ninh Binh provinces. Besides, many children who needed special treatment were transferred to higher-level hospitals for treatment. Hospitals at the communal and district levels also offered active and timely treatment for sick children. The problem of overcrowded hospitals, especially central hospitals, has been gradually solved with doctors spending more time doing scientific research.
Head of the Committee for Population, Family and Children in Central Highlands Dak Lak province Nguyen Quy Ba said the province has now completed the granting of free medical cards for children under six (achieving 95 percent). “We are fully aware of the problem of overcrowded hospitals, so measures have been taken to make local residents become aware of their responsibility,” he said. “In 2005, most children under six were provided with free health care services in the province. only two cases of heart operation were transferred to
Deputy director of the Central Pediatrics Hospital Nguyen Van Loc said the number of patients going to higher-level hospitals has been reduced in recent times.
Shortcomings remain
However, there remain certain difficulties in providing medical check-ups for children under six.
Poor and obsolete facilities and equipment still exist at many medical establishments in the country. Besides, the State has not offered reward policies to encourage doctors specialised in pediatrics at public health establishments and they have not yet enjoyed high incomes like other doctors.
A nurse from the Central Pediatrics Hospital Nguyen Thi Hanh said formerly, when each health worker examined patients under the heath care insurance service, they received around VND300,000-500,000 payment. “However, since the implementation of free health care service programme for children under six, our incomes have remained the same because we do not get any bonuses,” she said. As prices are escalating these days, we find it difficult to cover our family expenditure. Although we fulfill our jobs, I feel unhappy.”
There are also difficulties in separating patients with medical cards from patients with health insurance cards. Many hospitals have to increase their health workers to solve problems related to formalities and documents. Mr Loc said due to the cumbersome formalities, consulting rooms are always crowded and this problem needs to be solved as soon as possible.
Providing free medical check-ups for children under six is a major policy of the Party and State, which aims to create favourable conditions for children, especially children in remote areas and poor children, to enjoy good health care services. To implement the policy effectively, it is necessary to have concrete regulations on providing free medical check-ups for children under six and make proper policies for health workers specialised in pediatrics.
