From the economic reforms of the late 1980s, Vietnam's health care system has been transformed into a mix of public and private systems with the introduction of user fees, legalized private clinics, and a commercialized pharmaceutical sector. These reform policies have led to many changes to health access of Vietnamese people and has negatively affected the nation's most vulnerable population, the rural community.
While the country has performed well in health indicators when compared to other countries in the same developmental bracket, there is a skewed proportion of malnutrition and other health disparities that affect the rural populations of Vietnam. Though the introduction of user fees to all medical services has helped finance the Vietnamese health care system and health insurance scheme, it has also created barriers for the poor to access medical care in the preventive stages. Thus, a majority of the rural population and a large part of the nation in general forego medical visits and professional medical advice, opting for quick fixes and self-medication practices.
The practice of self-medication is dangerous not only on the individual but also on the Vietnamese community as a whole. According to news reports, Vietnam currently is ranked second in the world for taking non-prescription drugs. It is reported that 45% of Vietnamese tend to buy drugs over the counter without seeking medical advice from a registered physician for minor illnesses. The process of obtaining a doctor's prescription, combined with the costs of user fees, are often too expensive for Vietnamese, therefore the individual may commonly resort to the advice of friends and unlicensed professionals to obtain antibiotics Taking too little, too much, or the wrong medication can not only have no effect on the individual, but it could also potentially damage the individual's health in the long run if used incorrectly. Not only so, drug resistance can occur and reduce the whole community's immunity to disease in the future.
According to the WHO, Vietnam has already reported a 10-15% prevalence of transmitted HIV drug resistance to antiviral medicines. Drug resistance to other infectious diseases are on the rise in the country.
This issue of self-medication and drug resistance is brought about in part by the Vietnamese government's lack of regulation and enforcement of policies. Many have called for a stronger national surveillance network to better monitor infectious disease outbreaks and resistance to antibiotics. Training of medical professionals to stress the importance of proper allocation of medication could prove beneficial. Changing the payment scheme as to how medications are obtained could encourage less leniency to over the counter options.
This summer, I hope to engage in children's health rights and this issue of over-prescription/self-medication through creating and providing informational materials to parents and community members to encourage proper medication practices. My PE focuses on increasing patient knowledge about this issues and how others can take preventative measures to reduce the spread/contraction of infectious diseases.
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