Developing health insurance system with functioning provider payment mechanism: The financing for the community health stations (CHS) has been increased as health insurance has been introduced at this level. About 50% of the population is covered by health insurances. The project provided incentives to the Vietnam Social Security Administration (VSS) to identify and enrol the near-poor and the rest of the eligible population into the social health insurance scheme. The project piloting new payment mechanisms starting with capitation in the CHS, and a mixed system with 50% capitation and 50% fee for services, in the district hospitals.
Developing a functioning primary curative care: Primary curative care facilities at commune level have been upgraded with running water, improved sanitation and rooms, as well as being equipped with furniture and basic medical equipment. The technical skills of the medical doctors have been improved by developing clinical and therapeutic guidelines, together with on job training for better diagnostic and treatment procedures. Assistant doctors (42 people) received support to attend medical university and receive medical degrees. Village health workers (150 people) received three months certified training. They also received training on planning and management of health education programs at the village level.
Improving quality secondary curative care hospitals: Support has been given to improve hospital management. Water and sanitation, emergency electricity and good standard pharmacies have been assured.
The project also organized better referral and counter referral system between commune and district levels to secure a better use of the two levels, developed chronic disease management programs for the local levels for diabetes and hypertension (focusing on early detection, evidence-based treatment, monitoring for controlling the disease, self care for the patient, and a coordinated health service) and providing health education to local people about their health insurance rights, the improved function of the CHS and the care for chronic ill.