Universal coverage challenges: Determinants of enrolment in family-based social health insurance

ABSTRACT

Background: With the aim of achieving universal coverage, the Family-based health insurance was introduced for informal sector workers and their families in Vietnam in 2015.

Objective: The objective of the study is to identify the factors influencing enrolment in Family-based health insurance.

Methods: Data were collected from a cross-sectional in-house survey in Soc Son district from April to June 2016. A total of 469 household heads were interviewed with information on 2,071 residents. A logistic regression model was used to estimate the probability of uptake in Family-based health insurance in relation to socio-economic factors.

Results: The results indicate a low coverage of Family-based health insurance schemes (16.6%) compared with relatively high rates of willingness to join (71.9%). The significant influential factors were: knowledge of health insurance; historical use of health services; and place of residence.

Conclusion: To increase the Family-based health insurance enrolment it is necessary of strengthening communication and education about health insurance scheme at the local level and improvement of the quality of primary health care.

KEYWORDS:

• Health insurance
• informal sector
• family health insurance
• universal health coverage
• Vietnam

Acknowledgement

We would like to express our special thanks to the Soc Son district Social Security branch, Health center and Commune People’s committee for their support and coordination with us on conducting this research. Also, we would like to extend our appreciation to the household heads in the study areas for their participation in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Nguyen Thi Thuy Nga

Nguyen Thi Thuy Nga, MPH, PHD. Lecturer, Hospital Quality Management, Health Financing, Health Management and Planning Department of Hospital Management, Hanoi University of Public Health. Address: 1A Duc Thang, Bac Tu Liem, Hanoi. Tel: [phone]; e-mail: [email protected]. I am a senior lecturer at Hanoi University of Public Health with substantial experience in doing research and giving lecturer on hospital quality management, health financing and health management and planning for almost 15 years. My recent research projects are of mixed-methods and more focus on health insurance and health universal coverage, hospital management, health financing funded by both national and international funders. Key current interests and expertise include: health system, hospital management, health insurance and health universal coverage. I also have over 15 years of experience of teaching these subjects at the Hanoi University of Public Health.

Chu Huyen Xiem

Chu Huyen Xiem, MPH. Lecturer, Health Services Management, Monitoring and Evaluation, Hospital Quality Management, Department of Hospital Quality Management, Hanoi University of Public Health. Address: 1A Duc Thang, Bac Tu Liem, Hanoi, Vietnam 10000; Tel: [phone]; e-mail: [email protected]. I am now a lecturer at the Hanoi University of Public Health with experience in coordinating, doing research and giving lectures on health services management, monitoring and evaluation (M&E), hospital quality management for almost 10 years. My recent projects are focus on the health system (according to the WHO's six-blocks building framework). Key current interests and expertise including the health system, health universal coverage (UHC), hospital quality management.

Bui Thi My Anh

Bui Thi My Anh, MPH, Lecturer of Department of Hospital Quality Management, Hanoi University of Public Health. Address: 1A Duc Thang, Bac Tu Liem, Hanoi, Vietnam 10000 Tel: [phone]; email: [email protected]. I am now a lecturer at the Hanoi University of Public Health with substantial experience in coordinating, doing research and giving lectures on health management and planning, monitoring and evaluation (M&E), hospital quality management for almost 10 years. My recent projects are mixed-methods and implementation researches focus on health system (according to the WHO’s six-blocks building framework), non-communicable diseases (NCD) and quality management which funded by the national and international funds. Key current interests and expertise include: health system, health universal coverage (UHC), NCD, hospital quality management, Evidence-Informed policy-making.