Asia Pacific Journal of Health Management (Feb 2021)

Vietnam’s Healthcare System Decentralization: how well does it respond to global health crises such as covid-19 pandemic?

  • Huy Van Nguyen,
  • Joseph Debattista,
  • Minh Duc Pham,
  • An Thi Minh Dao,
  • Stuart Gilmour,
  • Hoa Lan Nguyen,
  • Tien Van Nguyen,
  • Phuong Mai Le,
  • Phuong The Nguyen,
  • Anh Thi Ngoc Tran,
  • Kien Duy Vu,
  • Son Thai Dinh,
  • Minh Van Hoang

Journal volume & issue
Vol. 16, no. 1


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This article discussed Vietnam’s ongoing efforts to decentralize the health system and its fitness to respond to global health crises as presented through the Covid-19 pandemic. We used a general review and expert’s perspective to explore the topic. We found that the healthcare system in Vietnam continued to decentralize from a pyramid to a wheel model. This system shifts away from a stratified technical hierarchy of higher- and lower-level health units (pyramid model) to a system in which quality healthcare is equally expected among all health units (wheel model). This decentralization has delivered more quality healthcare facilities, greater freedom for patients to choose services at any level, a more competitive environment among hospitals to improve quality, and reductions in excess capacity burden at higher levels. It has also enabled the transformation from a patient-based traditional healthcare model into a patient-centered care system. However, this decentralization takes time and requires long-term political, financial commitment, and a working partnership among key stakeholders. This perspective provides Vietnam’s experience of the decentralization of the healthcare system that may be considered as a useful example for other countries to strategically think of and to shape their future system within their own socio-political context.