ArticleHealth research policy and systems2024
Towards universal health coverage in Vietnam: a mixed-method case study of enrolling people with tuberculosis into social health insurance.
Article in Health research policy and systems, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06916962 (Understanding Psycho-socioeconomic Linkages Through an Intervention Providing Enhanced Financial and Social Support During Tuberculosis Treatment), which is not on this map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Understanding Psycho-socioeconomic Linkages Through an Intervention Providing Enhanced Financial and Social Support During Tuberculosis Treatment
Who cites it
8 citing papers in PubMed, 9 citations in OpenAlex.
- Engaging tuberculosis-affected people in investment decisions: applying a people-centered design approach in Viet Nam.BMC public health · 2026Article
- Why condition cash transfers? A multimethod pilot study evaluating the conditioning of cash transfers for tuberculosis treatment.BMC health services research · 2026Article
- Perceived stigma among hospitalized pulmonary tuberculosis patients in Hue Central Hospital: A 2024 mixed method study in Vietnam.PLOS global public health · 2026Article
- Achieving Universal Health Coverage in Cambodia: Barriers, Strategies, and Policy Recommendations.Health science reports · 2025Article
- The influence of provider payment mechanisms on TB service provider behavior in Indonesia: insights from National Health Insurance data and provider perspectives.Frontiers in public health · 2025Article
- Non-medical costs incurred by critically ill patients with dengue, sepsis and tetanus within a major referral hospital in Southern Vietnam: a cost of illness study.BMJ public health · 2025Article
- Medical insurance and its impact on tourism: evidence from Vietnam.Frontiers in public health · 2025Article
- Article
Corrections and comments
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Authors and funding
16 authors at 3 institutions in 4 countries.
Funding
Abstract
backgroundVietnam's primary mechanism of achieving sustainable funding for universal health coverage (UHC) and financial protection has been through its social health insurance (SHI) scheme. Steady progress towards access has been made and by 2020, over 90% of the population were enrolled in SHI. In 2022, as part of a larger transition towards the increased domestic financing of healthcare, tuberculosis (TB) services were integrated into SHI. This change required people with TB to use SHI for treatment at district-level facilities or to pay out of pocket for services. This study was conducted in preparation for this transition. It aimed to understand more about uninsured people with TB, assess the feasibility of enrolling them into SHI, and identify the barriers they faced in this process.
methodsA mixed-method case study was conducted using a convergent parallel design between November 2018 and January 2022 in ten districts of Hanoi and Ho Chi Minh City, Vietnam. Quantitative data were collected through a pilot intervention that aimed to facilitate SHI enrollment for uninsured individuals with TB. Descriptive statistics were calculated. Qualitative interviews were conducted with 34 participants, who were purposively sampled for maximum variation. Qualitative data were analyzed through an inductive approach and themes were identified through framework analysis. Quantitative and qualitative data sources were triangulated.
resultsWe attempted to enroll 115 uninsured people with TB into SHI; 76.5% were able to enroll. On average, it took 34.5 days to obtain a SHI card and it cost USD 66 per household. The themes indicated that a lack of knowledge, high costs for annual premiums, and the household-based registration requirement were barriers to SHI enrollment. Participants indicated that alternative enrolment mechanisms and greater procedural flexibility, particularly for undocumented people, is required to achieve full population coverage with SHI in urban centers.
conclusionsSignificant addressable barriers to SHI enrolment for people affected by TB were identified. A quarter of individuals remained unable to enroll after receiving enhanced support due to lack of required documentation. The experience gained during this health financing transition is relevant for other middle-income countries as they address the provision of financial protection for the treatment of infectious diseases.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.