Health insurance

Viet Nam’s female factory workers empowered with knowledge on health protection entitlements

A series of awareness raising activities have been put in place as an ILO study points out knowledge gaps related to health insurance, sickness and maternity benefits amongst female factory workers.

News | 23 March 2020
Women and girls must be at the helm of decisions that affect their health, rights and wellbeing.
HANOI (ILO News) – Efforts are underway in Viet Nam to tackle access barriers to health care and strengthen female workers’ awareness on health related social security benefits, with assistance from the ILO’s Luxembourg-funded project Support to the Extension of Social Health Protection in South East Asia (ILO-Lux).

The project is working with the Viet Nam General Confederation of Labour (VGCL), with support from the Viet Nam Social Security (VSS), to develop effective communication tools including a training manual, complimented by a Training of Trainers to be organized in April 2020, and a number of communication outreach events at industrial zones to assist union officials to better communicate health related benefits and procedures to workers.

A booklet on health insurance, maternity, employment injury and sickness benefits is also being developed and will be distributed in three forums discussing health insurance and health related protection in Bac Ninh and Binh Duong provinces.

The activities are part of a communications plan to address knowledge gaps identified by a rapid assessment conducted by the project in November 2019 among female factory workers in industrial zones, who have been identified as a project’s priority target group.

Findings from the assessment, undertaken in the provinces of Bac Ninh and Binh Duong, revealed that although general knowledge on basic social health insurance (SHI) benefits was strong with four in every five participants able to identify key entitlements, limited understanding of the details and conditions for access, was an issue.

Only 57 per cent of workers were aware of the level of payment provided for maternity leave and only one third of participants knew how many paid sick leave days they are entitled to. Participants also lacked clarity regarding the process of co-payments, and around 40 per cent of respondents were unaware of the value of their contributions to SHI.

Over half of health insurance card-holders participating in the study reported using health facilities that they are not registered with, preventing them from fully utilizing their SHI entitlements. The most commonly cited reason for this was the distance of the registered health care centre from workers’ homes, followed by inconvenient opening hours, long waiting times and dissatisfaction with services.

The report also pointed out that very few workers called VSS hotline or referred to its official website for information despite their existence.

Women and universal health coverage

Sixty per cent of workers in industrial zones in the country are women. Consistent with global trends, in Viet Nam, women account for a significant proportion of the working poor and are more likely to be confined to lower paid sectors and affected by precarious working conditions, than their male counterparts.

“To achieve universal health coverage, gender equality is critical and countries must ensure that girls and women are at the helm of decisions that affect their health, rights and wellbeing. As such, it is crucial that female workers in Viet Nam are fully aware of their rights to social health protection, and that their entitlements are upheld and fully utilized,” Marielle Phe Goursat, manager of ILO-Lux project.

Promoting universal health coverage is the central pillar of this project. It implies non-discriminatory access to essential health care without the burden of financial hardship.

Viet Nam has made remarkable progress towards universal health coverage following the pilot implementation of a social health insurance scheme in 1992. Overseen by the Ministry of Health (MoH) and implemented by VSS since 1995, the scheme provides mandatory and comprehensive health insurance for the entire population. For vulnerable groups, including those identified as poor or near poor, ethnic minorities, the elderly and young children, social health insurance enrolment is subsidized through tax revenues.

In accordance with the first Law on Health Insurance in 2008 and its revision in 2014, health protection coverage increased from 60 per cent of the population in 2010 to 90 per cent in 2019. This year, it aims for 90.7 per cent of the overall population and 100 percent of vulnerable groups to be covered.

“But clearly, enrollment alone is not enough to ensure effective coverage for vulnerable groups. They must have a thorough understanding of their rights to health benefits and the means to fully utilize those rights, so that they can speak out when their entitlements are not upheld and avoid unecessary out of pocket healthcare payments,” said the ILO specialist.

“By addressing this important need and working to ensure gender responsive, equitable and efficient coverage, Viet Nam is rapidly nearing universal health coverage, placing it in a prime position to serve as a model for other countries working towards the same goal.”

In that context, ILO-Lux project is working in partnership with the MoH, VSS, employers and workers organizations to strengthen national capacity on social health protection, support evidence-based policy reforms and enhance coverage for vulnerable groups.