The effect of a poverty reduction policy and service quality standards on commune-level primary health care utilization in Thai Nguyen Province, Vietnam

Dados Bibliográficos

ID11492004
AutoresP Nguyen (0000-0002-8155-6152), Phan-Kien Nguyen (Emory University, autor correspondente), D Bich Hanh (Institute of Population, Health and Development), M Ruth Lavergne (Institute of Population, Health and Development), Tam Mai (0009-0002-9336-8439, Institute of Population, Health and Development), Quan Dong Nguyen (0000-0002-6024-8441, Institute of Population, Health and Development), Q Nguyen (0000-0001-9170-6751), Jonathan F Phillips (0000-0002-6720-7204, Institute of Population, Health and Development), Joanne Hughes (0000-0003-2791-4817, Institute of Population, Health and Development), H Van Thuc (Institute of Population, Health and Development)
Ano2010
Volume25
Fascículo4
Páginas262-271
Data de publicação2010-07-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoHealth Policy and Planning (JOURNAL)
Identificadores do periódicoISSN: 0268-1080 • E-ISSN: 1460-2237
EditoraOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czp064
PMID20038572
OpenAlexW2101946814
IdiomaEN
Citações recebidas2
Referências citadas20

Although universal access to quality health services is a primary policy goal of the Government of Vietnam (GOVN), economic restructuring and privatization of health services have been associated with emerging inequities in access to care. A GOVN programme for socio-economic development known as Program 135 (P135) designates communes known to be relatively poor as priority localities for development resources. Under this programme, basic curative and preventive health services, including some prescription drugs, are provided free of charge at commune health centres (CHCs). In an effort to improve the quality of care provided at CHCs, the national Ministry of Health (MOH) has implemented a set of national benchmarks for commune health care, which defines a minimum configuration of equipment, staff, training and other elements of service provision. This research examines the impact of P135 poverty reduction policy, achievement of MOH benchmark indicators and commune socio-economic characteristics on CHC utilization rates in Thai Nguyen Province, Vietnam. The analysis uses administrative data reported from 178 CHCs in Thai Nguyen Province for nine quarters, including 2004, 2005 and the first quarter of 2006. Mixed linear regression models are used to estimate the main and interaction effects on utilization rates of exposure to the P135 policies, achievement of MOH benchmarks, poverty, distance to the district hospital and ethnic composition. Communes that are poor and remote have comparatively high CHC utilization rates. Multivariate regression results suggest that communes exposed to the P135 policy have higher utilization rates, but these effects are conditional upon achievement of benchmark standards, thus perceived quality care enhances CHC utilization. Combining Program P135 with benchmark investment reduced the gap between primary health care utilization in poor communes versus those that are less poor. These commune-level findings suggest that CHC policies differentially benefit poor communities and reduce inequality in use of health care services.

Business · Economic growth · Economics · Government (linguistics) · Health care · Poverty · Quality (philosophy) · Restructuring · Finance · Global Maternal and Child Health · Healthcare Policy and Management · Healthcare Systems and Reforms · Health Policy