Background. In recent years, health insurance (HI) has been chosen by many low- and middle-income countries to obtain an important health policy target—universal health coverage. Vietnam has recently introduced the Revised Health Insurance Law, and the effects of the voluntary health insurance (VHI) and heavily subsidised health insurance (HSHI) programmes have not yet been analysed. Therefore, this study is aimed at examining the impact of these HI programmes on the utilisation of health care services and out-of-pocket health expenditure (OOP) in general and across different health care providers in particular. Methods. Using the two waves of Vietnam Household Living Standard Surveys 2014 and 2016 and the difference-in-difference method, the impacts of VHI and HSHI on health care utilisation and OOP in Vietnam were estimated. Results. For both the VHI and HSHI groups, we found that HI increased the probability of seeking outpatient care, the mean number of outpatient visits, the total number of visits, and the mean number of visits at the district level of health care providers in the last 12 months. However, there was no evidence that the HSHI programmes increased the mean number of inpatient visits and the number of visits at the provincial hospital. We also found that while the VHI programme reduced OOP for both outpatient and inpatient care, the HSHI scheme did not result in a reduction in OOP for hospitalisation, although HI lowered the total OOP. Similarly, we found that for both groups, HI reduced OOP when the insured visited district and provincial hospitals. However, the statistically significant impact was not demonstrated when the enrolees of HSHI programmes visited provincial hospitals. Conclusion. The study offers evidence that the Vietnamese HI scheme increased health care service utilisation and decreased OOP for the participants of the VHI and HSHI programmes. Therefore, the government should continue to consider improving the HI system as a strategy to achieve universal health coverage.

Background: The Government of Vietnam has set the goal of achieving universal health coverage (UHC) by 2025. Health insurance (HI) is being considered a tool to achieve this goal. However, out-of-pocket spending and catastrophic health expenditure (CHE) remain high. Research evidence on how to reduce these expenditures to achieve UHC is essential. Therefore, this study examines the determinants of CHE, especially the HI factor. Method: To identify HI participation status and other factors associated with CHE, we use logistic regression on a dataset from the 2016 Vietnam Household Living Standards Survey. Results: The study finds that HI is a protective factor against CHE, although this result is not always statistically significant across different subsamples. Moreover, the household head's age and employment status, household size, share of the elderly above 60 years, income, illness status, healthcare utilisation, availability of hospitals, commune health stations with medical doctors and place of residence all correlate with household CHE. Conclusion: Although there has been a rise in HI coverage, the financial protection capacity of HI schemes in Vietnam remains inadequate, particularly for households living in rural areas. Further investigations of the causal effect of HI, other health system factors and CHE in rural settings are necessary to reduce the incidence of CHE. Additionally, policies aimed at groups vulnerable to CHE, such as those

Abstract:In Asia, there is a surge of interest in the development of Payments for Environmental Services (PES) programs. They represent a new approach that focuses directly on creating a conditional benefit transfer between providers and beneficiaries of environmental services. More specifically, in Vietnam, a Fund for the Protection and Development of Forestry has been recently established that puts in place the mechanisms for the payment of fees by downstream users of watershed services to finance forestry projects in the upper-catchments. This paper reviews the potential response of upland farming households to a PES scheme that rewards them to set aside part of land for the production of environmental services. We examine the viability of PES schemes targeted at Payments for environmental services in upper-catchments of Vietnam 65 agricultural households of the upper-catchments in Northern Vietnam. We focus our attention on households identified as the poorest in the upper-catchment areas, i.e. those with a small endowment of productive land, limited access to water for irrigation, and low access to markets. We find that farmers are unlikely to participate in a voluntary land retirement program unless they are 'compensated' for the loss in food production and a 'forced' set aside program is likely to generate an overall negative impact on both poverty and environmental protection. Development and dissemination of improved technologies that increase food yields is a complementary strategy to promote environmental protection.Keywords: Environmental services, land set-aside, modelling, poverty, shifting cultivation, Vietnam Acknowledgement: This paper presents findings from PN11 "Rice Landscape Management for Raising Water Productivity, Conserving Resources, and Improving Livelihoods in Upper Catchments of the Mekong and Red River Basins", a project of the CGIAR Challenge Program on Water and Food. Additional funds from the Theme 2 PES initiative were also used to obtain the specific results on PES impact.

The objective of the study is to find out factors that affect investment and based on that, proposing some solutions to improve the efficiency of attracting investment from non-state enterprises in Thai Nguyen province. Data sources for the study were taken from random interviews of 250 non-state enterprises to invest in Thai Nguyen province. The methods used to analyze data are descriptive statistics, numerical analysis, factor analysis and cross-analysis.

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