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Workshop on: "Health equity: The issues of ethnic minorities in Vietnam Wednesday, 13/04/2016

Workshop on: "Health equity: The issues of ethnic minorities in Vietnam The Partnership for Action in Health Equity (PAHE) organized its annual workshop on 7 April 11, 2016. The third Vietnam Health Watch Report titled “Health equity – The issue of ethnic minorities in Vietnam” was also introduced on this event.

Inequity in health status and assess in health services of ethnic minorities

The Health Watch report revealed important inequity in health status and assess in health services of ethnic minorities. The maternal mortality rate, child mortality rate and average life expectancy at birth among ethnic minorities were significant lower than in Kinh group. There were no difference in utilization of health services between the Kinh and ethnic minority people, except pregnancy examination. The rate of receiving prenatal care among ethnic minorities were notable lower than the Kinh and the quality of pregnancy care is generally poorer than the Kinh.

However, research on utilization of health services showed that despite the similar frequency between the two groups, most minorities utilized health services at grass root level (commune health stations) while the Kinh made use of services at higher levels (provincial and national levels), which offered more qualified medical examination and better equipment for testing and treatment.

Ms. Nguyen Thi Mai Huong presented the third Vietnam Health Watch report

The proportion of minorities with health insurance was even higher than that of the Kinh but their average health insurance payments were lower since they mostly used health services at grass root levels, which required smaller expenditure. Despite having health insurance, the ethnic minorities still have more limited access to the up-line health care services than Kinh people since the indirect costs such as transportation and food were one of big challenges for them. For example: One mother had spent millions dong for her child, who was treated in the district hospital but the payment for medical examination fee was less than 100,000VND and covered by the health insurance. The rest was the indirect cost, which was her out-of-pocket payment.

Harmful traditional practices are big challenges for access in health services among ethnic minorities

In addition to the difference in quality of infrastructure, capacity of health workers, living conditions, harmful traditional practices are also ones of the most important intermediary factors influencing health inequities.

Some health officers shared their thoughts that many minorities did not go to health facilities due to their traditional practices, such as home deliveries although this practice put them at high risk of maternal death and other complications.

Picture in the workshop

Discussion from participants

The report has gained a great attention from participants. The representative of PLAN raised an issue: Instead of bring the local people to the health facilities, why don’t we bring the health services to the local people? If their traditional practices and indirect costs prevent them accessing health facilities, it is better for the health system to be more closer/available to the local people. Similarity, there were 23 children who were raped recently. While all stakeholders tried to persuade children and their parents to go back to schools after this scandal, no any protection solutions were mentioned. One question about the protection mechanism was raised for the dean of this school and he reaffirmed that all parents were asked to sign the commitment to send their children back to the school with no other comments.

 “This report is very comprehensive. However, the detail recommendations for each organizations should be mentioned to reduce health inequalities between the Kinh/Hoa and ethnic minorities”, said the director of the Center for Health Communication and Education (Ministry of Health). He also appreciated the establishment of PAHE and believed that PAHE would have many helpful contributions for the government. Other organizations were encouraged to join PAHE to have more useful research and reliable advocacy activities. Currently, there were 70 people in the Center for Health Communication and Education and they hoped to have opportunity to collaborate with PAHE. One meeting between the two parties was expected to organize to discussion about the collaboration.

Agreed with the research results, the representative of LIGHT organization clarified the pregnancy examination in mountainous areas. In addition to the difference in the amount of this service, its quality was also worthy of paying attention.

Furthermore, the representatives from General Office of Population and. Family Planning, Childfund Australia in Vietnam and other participants also gave comments and contributions to the report as well as sharing their experiences on implementation of health programs for ethnic minorities in general.

Other activities, implementing by PAHE

Equally important to note, some other activities implementing by members of PAHE were presented at the workshop. The most notable presentation was “Policy on socio-economic development for ethnic minorities” by Ms. Be Hong Van – vice director of the department of ethnic policies (Committee for ethnic minority affairs). She also shared that the committee hoped to get research reports from civil society organizations, which were not influenced by the political factors.

Additionally, the one other activity by PAHE titled “enhancing the access in resources to ensure health equity”, in collaboration with Oxfam and dissemination of research result on quality of hospitals were presented at the workshop.

 


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