Financial Burden of Household Out-of-Pocket Payment for Reproductive Health Care in Vietnam: A Study from 3 Northern Provinces in Vietnam

Minh Van Hoang, Giang Kim Bao, Minh Hung Tran, Trang Thu Quach


Introduction: This paper aims to describe the pattern of out-of-pocket payment (OOP) for reproductive health care among women who had a child of less than 12 months of age in three Northern provinces Vietnam and examine its financial burden to households of the study subjects. Methods: This study was conducted in 3 Northern provinces. 2000 women having a child of less than 12 months of age were interviewed. Results: 13.6% of the households were pushed into poverty due to the out-of-pocket payment for reproductive health care in the last 12 months. Ethnic minority and near-poor households had higher risk of being impoverished due to the out-of-pocket payment for reproductive health care. Health insurance was shown to have financial protection impacts for reproductive health. Conclusion: Household out-of-pocket payment for reproductive health care is considered as a major impediment to achieving poverty reduction and the Universal Coverage of reproductive health care in Vietnam.


Burden; out-of-pocket payment; reproductive health; Vietnam

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The International Conference on Population and Development, Cairo Egypt, September 5-13, 1994. Pathways. 1994;8(2):1-2.

World Health Organization. Reproductive health: 2013.

Ouchtati M, Mezhoud S, Rahmoun FC. [MDG5 and maternal mortality: disastrous combination of inequalities]. Sante. 2009;19(3):167-170.

World Health Organization. The World Health Report: Health systems financing: The path to universal coverage. 2010.

Goverment of Vietnam. Vietnam's national strategy on reproductive health care for the 2010-2020. 2009.

UNDP VietNam. United Nations Millennium Development Goals. 2010.

Ministry of Health of Vietnam. Joint Annual Health Review: Towards Univesral Health Coverage. 2013.

Xu K, Evans DB, Carrin G, et al. Protecting households from catastrophic health spending. Health affairs. 2007;26(4):972-983.

Van Minh H, Kim Phuong NT, Saksena P, et al. Financial burden of household out-of pocket health expenditure in Viet Nam: findings from the National Living Standard Survey 2002-2010. Social science & medicine. 2013;96:258-263.

Van Minh H, Xuan Tran B. Assessing the household financial burden associated with the chronic non-communicable diseases in a rural district of Vietnam. Global health action. 2012;5:1-7.

Goverment of Vietnam. Decison 9/2011/QD-TTG on poor and non-poor household for period 2011 - 2015. 2011.

Bonu S, Bhushan I, Rani M, et al. Incidence and correlates of 'catastrophic' maternal health care expenditure in India. Health policy and planning. 2009;24(6):445-456.

Afsana K. The tremendous cost of seeking hospital obstetric care in Bangladesh. Reproductive health matters. 2004;12(24):171-180.

Mahesh Puri, Ronald Horstman, Zoë Matthews, et al. Examining Out-of-Pocket Expenditures on Reproductive and Sexual Health among the Urban Population of Nepal. Population Review 2008;47(2).

Vietnam NAo. Law on Health Insurance. 2008.

Sanneving L, Trygg N, Saxena D, et al. Inequity in India: the case of maternal and reproductive health. Global health action. 2013;6:19145.

Patel V, Chisholm D, Kirkwood BR, et al. Prioritizing health problems in women in developing countries: comparing the financial burden of reproductive tract infections, anaemia and depressive disorders in a community survey in India. Tropical Medicine & International Health. 2007;12(1):130-139.

Jing F. Health sector reform and reproductive health services in poor rural China. Health policy and planning. 2004;19 Suppl 1:i40-i49.