Potential collaboration with the private sector for the provision of ambulatory care in the Mekong region, Vietnam

Background

Over the past two decades, health insurance in Vietnam has expanded nationwide. Concurrently, Vietnam's private health sector has developed rapidly and become an increasingly integral part of the health system. To date, however, little is understood regarding the potential for expanding public-private partnerships to improve health care access and outcomes in Vietnam.

Objective

To explore possibilities for public-private collaboration in the provision of ambulatory care at the primary level in the Mekong region, Vietnam.

Design

We employed a mixed methods research approach. Qualitative methods included focus group discussions with health officials and in-depth interviews with managers of private health facilities. Quantitative methods encompassed facility assessments, and exit surveys of clients at the same private facilities.

Results

Discussions with health officials indicated generally favorable attitudes towards partnerships with private providers. Concerns were also voiced, regarding the over- and irrational use of antibiotics, and in terms of limited capacity for regulation, monitoring, and quality assurance. Private facility managers expressed a willingness to collaborate in the provision of ambulatory care, and private providers facilites were relatively well staffed and equipped. The client surveys indicated that 80% of clients first sought treatment at a private facility, even though most lived closer to a public provider. This choice was motivated mainly by perceptions of quality of care. Clients who reported seeking care at both a public and private facility were more satisfied with the latter.

Conclusions

Public-private collaboration in the provision of ambulatory care at the primary level in Vietnam has substantial potential for improving access to quality services. We recommend that such collaboration be explored by Vietnamese policy-makers. If implemented, we strongly urge attention to effectively managing such partnerships, establishing a quality assurance system, and strengthening regulatory mechanisms.

• public-private partnership
• primary care
• health care access
• health care quality
• Mekong
• Vietnam
• regulation
• quality assurance

Acknowledgements

The authors would like thank Dr. Forsberg, Program Coordinator of the Private Sector Program in Health at Karolinska Institute, for sharing survey tools of the survey in Zambia. The views expressed in this paper are solely the responsibility of the named authors and do not necessarily reflect the decisions or stated policy of the organizations they work for and the funding organization.