Quality healthcare access for Vietnam

H E A LT H C A R EQ u a l i t y H e a l t h c a reA c c e s s Fo r V i et n a mS O C I A L I N N O VAT I O N P L AY B O O K S E R I E Seden strategy institute SOCIAL INNOVATION PLAYBOOK SERIES

Vietnam’s healthcare system is broad in coverage … 1 MINISTRY OF HEALTH 3 CENTRAL HOSPITALS 10 TEACHING HOSPITALS 34 CENTRAL HOSPITALS 63 PROVINCIAL HOSPITALS 200 PROVINCIAL SPECIALTY HOSPITALS 682 DISTRICT HOSPITALS 11,699 COMMUNE STATIONSedenstrategyinstitute.com 2

… due to a multi-prong government strategyedenstrategyinstitute.com eden strategy institute 3

1. Strengthen quality of doctors in rural areas Health workers Equipment Investment Policies Equip hospitals with Invest / grants for Strengthen quality of Regulate healthcare adequate devices in hospital equipment doctor in rural areas system rural areas & infrastructure M A N D AT O R Y R O TAT I O N of 425 doctors in 85 rural districts under Decision 1816 PREREQUISITE 2-year rural practice for entry to specialist training INCENTIVE SCHEMES VND 3 mil for doctors to work in remote areas for 2 years TRAIN the TRAINER program to strengthen quality of doctors in rural areas MANAGEMENT TRAINING program offered by the Hanoi School of Public Health TA R G E T 80% of doctors at grassroots commune level by 2015edenstrategyinstitute.com 4

2. Equip hospitals with adequate devices in rural areas Health workers Equipment Investment Policies Equip hospitals with Invest / grants for Strengthen quality of Regulate healthcare adequate devices in hospital equipment doctor in rural areas system rural areas & infrastructure M O H ’s F O C U S last 5 years to equip district hospitals with proper medical devices M O H ’s TA R G E T focus this year onwards to upgrade / replace X-rays, CTs and Ultrasounds in Provincial & Central DECISION 950 to outfit Commune health stations with Ultrasounds for basic checksedenstrategyinstitute.com 5

3. Invest / grants for hospital equipment & infrastructure Health workers Equipment Investment Policies Equip hospitals with Invest / grants for Strengthen quality of Regulate healthcare adequate devices in hospital equipment doctor in rural areas system rural areas & infrastructure MOH has been managing 62 ODA projects (KOICA, Finland, Germany, France, etc.) and over 100 NGO projects for a value of over USD 1 bil JICA biggest ODA in Vietnam placing USD 1.9 bil. in 2010 in the form of loans, grants and technical assistance, with about 10% of that going into Healthcareedenstrategyinstitute.com 6

4. Regulate healthcare system Health workers Equipment Investment Policies Equip hospitals with Invest / grants for Strengthen quality of Regulate healthcare adequate devices in hospital equipment doctor in rural areas system rural areas & infrastructure DECISION 1816 Tier 1 Central hospitals oversee monthly progress, share findings ,and consult medical cases with lower tier hospitals INSURANCE 50% less reimbursement for skipping referral pathways PRICING differentiated pricing across hospital tiers MOH to standardize brands and technical standards of devices in Vietnamedenstrategyinstitute.com 7

Yet, the Patient Experience suffers from quality inconsistencies 3 to 1 Patient to bed ratio 2 day Waiting for critical surgery 20X More X-ray test in urban than rural hospitals 15-20 year Old medical devices 70% Communes without doctorsedenstrategyinstitute.com 8

… and funding is expected to be cut by 15-20% in coming years PHARMACEUTICAL Training ODA Central IMMUNIZATION Provincial NGO HOSPITALS Devices District NATIONAL INSURANCE Commune BUDGET Facilities ETC.edenstrategyinstitute.com 9

Social innovations are needed to break through healthcare constraints SOCIAL INNOVATIONS IN Lack of skills Local HEALTH WORKFORCE Challenges Lack of EQUIPMENT funding INVESTMENT Lack of quality Lack of equipment POLICIESedenstrategyinstitute.com 10

… and the private sector needs to play an integral role Strengthen quality of Equip hospitals Regulate doctors in rural with adequate Invest / grants healthcare areas devices in rural for hospital system areas equipment & infrastructure  Partnerships with  Infrastructure planning  Joint Public-Private  Hospital workflow universities Partnership  Equipment leasing  Reimbursement &  Local online support programs  Government grants insurance coverage  Sponsorships  Equipment maintenance  Corporate sponsorships  e-Health packages of equipment  m-Health  International gold  Facility audits &  Hybrid financing from standards  Re-skilling accreditation international Socially Responsible Investor  Generic drugsedenstrategyinstitute.com 11

Questions to consider 1. How do the industry structure or local market conditions affect our sources of sustainable advantage? 2. Where are the rural challenges in this country that we can help to solve? 3. How can we break through our own underlying constraints and mental models? 4. What might be some ways we can improve the quality of healthcare? 5. Can we change our business models or products to make healthcare more accessible? 6. Who can we build partnerships with, to bring down the cost of healthcare? 7. Which are risks and investments that these could lead to?edenstrategyinstitute.com 12

Eden Strategy Institute. Asia’s leader in Social Innovation Consulting What we do. Eden Strategy Institute approaches the global issues of disease, poverty, illiteracy, and exploitation head-on, by formulating strategies, models, processes, products, and designs that help our clients create, realize, and sustain quantum profit in addressing these issues. We focus exclusively on empowering business strategies with Social Innovations that create enduring financial impact, such as Silver Hair Marketing, identifying Bottom-of-Pyramid segments, creating Ethical Supply Chains, Microfinancing, Energy Efficiency, Socially Responsible Investing, Policy Planning and Advocacy, and so on. Eden’s Healthcare Practice. Eden has experience spanning the entire healthcare system, from R&D at medical technology firms, pharmaceutical companies, and biotechnology institutions, to commercialization, manufacturing, downstream distribution, hospital installation and management. We have an extensive network of contacts with the entire healthcare ecosystem across Asia-Pacific. Sustainability in healthcare. Eden brings sustainability to the Healthcare sector by supporting governments with policy and infrastructure development, helping research institutions go-to-market while protecting and managing their innovation pipelines, planning the market entry of medtech firms, hospitals, and pharma companies, supporting healthcare education to raise patient awareness, facilitating the flow of medical tourists, assisting in API manufacturing and vaccine distribution, assessing treatment efficacy, and working with health insurers and reimbursement systems to improve treatment quality while reducing costs. Our philosophy. We believe in the power of ideas to positively shape our world, one client at a time. Our focus is unparalleled in bringing to bear our entire senior management team, as well as the world’s foremost experts, on our clients’ most pressing sustainability issues. In turn, we elect to only collaborate with clients who are seriously committed to creating value together.edenstrategyinstitute.com 13

Thank youeden strategy institute Enquiries: Mark Lee, Partner E: mark@edenstrategyinstitute.com T: +65 9228 5305 Level 25, North Tower One Raffles Quay Singapore 048583 www.edenstrategyinstitute.com

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Quality healthcare access for Vietnam

by Eden Strategy Institute LLP

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