PRESS RELEASE: Policy Round-table “The Journey to health equality for older people in Vietnam”

Hanoi, September 6, 2019 - Global population aging trends and the impact of population aging on universal health care goals, published research report “Vietnam Perspective: Right to health care and universal health care access for the older people ”, the real situation of health care for the older people in the perspective of community and policy perspective and health care orientation for the older people with a vision to 2030 were the main contents presented and discussed this morning at the policy round-table "The journey to health equality for the older people in Vietnam" held at the General Office for Population and Family Planning of the Ministry of Health. This is an activity organized under the cooperation of HelpAge International in Vietnam, Vietnam Association of the Elderly and General Office for Population and Family Planning of the Ministry of Health. As of August 2018, the whole country had 11,313,200 older people, accounting for 11.95% of the population. According to the global population aging trend, it is expected that by 2050, the proportion of the older people in Vietnam and many other countries of China, Russia, Korea, Chile, Thailand ... will exceed 30%. Therefore, to achieve the World Health Organization's goal of “Universal Health Coverage”, as well as the UN's “No one is left behind” goal, ensuring the right to care Health care and universal access to health care for the older people are essential. Universal Health Care coverage, as defined by the World Health Organization, is a guarantee that every citizen and community receive the quality healthcare services they need, protected from Health risk factors at an affordable cost. The World Health Organization believes that to achieve Universal Health Coverage, it is necessary to address issues related to population aging and healthy aging as an approach to respond to population aging, to ensure human rights, sustainable development, and economic benefits. Another message from the World Health Organization is that the implementation of healthy aging must be started early in life with personal efforts; and continued in the following years with support from the health sector, long-term care system and an older people-friendly environment. The report "Vietnam Perspective: The right to health care and universal health access for the older people" by HelpAge International based on the technical report of Assoc. Hoang Van Minh, Hanoi School of Public Health and Assoc. Kim Bao Giang, Hanoi Medical University, shows the difference in health insurance coverage among groups of older people of different ages, and older people with different levels of education and income. Although the coverage of health insurance among the older population has increased rapidly in Vietnam, from 54% in 2006 to 96% in 2018 among those aged 60 and older, coverage Health insurance among the older people under the age of 80 is much lower than that of the 80s and older, the older people have tertiary education (94%) and live in high-income families (80%) ) is significantly higher than that of the older people with only primary education (66%) and the second-lowest income group (65%).
  The report also shows that access to health services related to non-communicable diseases in older people is low, up to 68% of people with non-communicable diseases between 50 and 69 years old. Survey participants said they were not treated at any medical facility. Access to preventive and treatment services is different for each type of non-communicable disease, for example, among older people with diabetes, only 42% were screened, compared to 80% screened in the older people group with hypertension. In the qualitative results of the survey, health service providers affirmed that the older people's difficulty in accessing non-communicable disease screening, diagnosis and treatment services is partly due to the patchwork in providing health services, medicine and expertise at health facilities at all levels. Also, access to services depends on the list of health services covered by Social Insurance. This is one of the reasons that make it difficult for older people in Vietnam to access non-communicable care services.
In addition to the research result, the presentation presented by the Vietnam Association of the Elderly and the General Office for Population and Family Planning also pointed out difficulties in health care for the older people. Although the average life expectancy is high (73.5 years), the number of healthy years of life for the older people in Vietnam is only about 64 years old. The older people in Vietnam are faced with the burden of double illness, with an average of 3-4 illness per older population with the rate of non-communicable diseases increasing rapidly, while the healthcare system Health is still not able to meet the increasing needs of the older people. The ability to provide health services for older people is limited, there is a shortage of manpower trained in geriatrics, geriatric nursing, and a shortage of human resources to care for older people. The database system related to the older people is lacking, there is no national data on older people. Besides, the social security system does not meet the needs of the older people, does not have a long-term care system and employment supply system for older people. At the same time, older people have limited access to health care services, especially the older people in remote and disadvantaged areas. At the event, the representatives of older people in the community also contributed their voice about the practical needs of the older people in the community, in which the need for advice and guidance on self-improvement of health, provide health promotion equipment in each community, as well as local health promotion models such as club models, including Intergeneration Self-Help Club. to be replicated under the Prime Minister's Decision 1533, underlined. 

“What older people need most is health advice. Because for the older people the disease is going to progress very quickly once it occurs and can lead to mortality only in a few hours, but if we are instructed on how to handle it, we will be able to also handle it ourselves in those situations… Best is to invest in each community the training kits to encourage people to practice. This is more effective than investing in the hospital. I find everything that makes people healthy and does not have to go to the hospital is the best because this is not only beneficial for older people but young people could also improve their health. Older people also wish to have geriatric hospitals at the district level, because it is close to where we live. There are many policies for older people, but many have not been implemented. ”- Ms. Nguyen Thi Diem - Manager of Intergeneration Self-help Club,Phung Town, Dan Phuong district, Hanoi.
We were afraid to access health care services because of the distance, but the government now has free buses for older people, so I find it very practical. Besides, we hope that hospital at the city level will accept the examination results at the health facilities at district, commune, and ward levels, thus saving labor, travel costs as well as reduce hospital overcrowding. – Deputy Manager of Intergeneration Self-help Club, Khuong Dinh Ward, Thanh Xuan District, Hanoi.
 Besides, Vietnam needs to improve policies on solutions, long-term care services and care for the older people in the community. Promote the close cooperation between domestic and foreign units and agencies in the care of older people. Also, it is necessary to include the older people in health policies and create conditions for the older people to participate in monitoring, evaluating and reporting on the implementation progress of these policies. For older people, the Report recommends a communication campaign to raise awareness about the right to health care as well as knowledge about the prevention and self-management of non-communicable diseases in the community. At the same time, the development of education programs on geriatric care for health workers, as well as the improvement of the health information system to collect sufficient data on the older people are also concerned and given in the event. The figures are given in the research paper "Vietnam Perspectives: The right to health care and universal health care for the older people" as well as from the presentations of agencies and the results. The discussion results of today's Workshop provide the basis for initiatives and recommendations to ensure the right to health care and the implementation of universal health care for the older people in Vietnam.