CHAPTER 1
Vietnam’s Health System Since DOI MOI
Vietnam’s successes in the health sector are legendary and were rightly emphasized in Growing Healthy (World Bank 2001), the 2001 report produced jointly by the World Bank, Sida, AusAid, and the Dutch Embassy. Vietnam’s rates of infant and under-five mortality are comparable to those of countries with substantially higher per capita incomes, and it has brought down child mortality far faster than a country with its per capita income might have been expected to do. Maternal mortality has also fallen dramatically, as have deaths from communicable diseases. It is true that Vietnam has done less well than some neighboring countries in some areas—tuberculosis, for example, has fallen faster in many neighboring countries—and there are concerns over new and re-emerging communicable diseases such as HIV/AIDS, Avian flu, Japanese encephalitis, and SARS. It is also true that, like other growing economies, Vietnam has seen a growth of noncommunicable diseases such as cancer, cardiovascular disease, and diabetes. But as this report shows, Vietnam’s legendary performance continues. Vietnam saw reductions in age-specific mortality rates between 2000 and 2005 for all ages, while some of its neighbors saw increased rates for some ages, or little change. By 2005, Vietnam’s age-specific death rates compared favorably with those of Malaysia—a far richer country—across all ages. And for people below the age of 55, Vietnam’s age-specific mortality rates were a good deal better than those of Thailand. Why then the need for a further World Bank study on Vietnam’s health system? The answer is that while Vietnam has done and 25