Local Health System Sustainability Project

The Government of Vietnam is in the process of transitioning its national responses to HIV and tuberculosis (TB) from donor to domestic funding, with Social Health Insurance (SHI)—the country’s national health insurance system—as the primary financing mechanism. This complex process involves transferring financial management authorities, rebuilding commodity procurement supply chains, revising legal documents, and much more. The U.S. Agency for International Development (USAID) supports the Government of Vietnam (GVN) in this endeavor through USAID’s Local Health System Sustainability (LHSS) project.

SUPPORTING DOMESTIC RESOURCE MOBILIZATION 

The project supports the GVN to find cost-savings in health expenditures and mobilize more domestic resources for the national HIV and TB responses. This includes strengthening public financial management systems, identifying opportunities to increase revenue from excise taxes on products harmful to health, and supporting Vietnam Social Security to improve SHI management for more efficient and effective budgeting, payment, and accounting of expenditures. 

IMPROVING SUPPLY CHAIN MANAGEMENT

The project supports GVN efforts to address gaps in locally-led supply chain management to ensure the public health system has an uninterrupted supply of commodities. This includes providing technical assistance and training to provincial government officials to improve their ability to accurately quantify and forecast demand and continually evaluate inventory. 

UPDATING THE LEGAL FRAMEWORK

The project works with health policymakers to review and revise existing policies and legal documents to enhance local ownership of the national HIV and TB responses through SHI and other domestic financial resources.

IMPACT

Thanks to this project, the GVN is well on its way to integrating TB and HIV health services into the domestically led and financed Social Health Insurance system. In July of 2022, the first TB patients received medications through SHI. As of 2023, 90% of Vietnam’s needed antiretroviral therapy (ARV) drugs for HIV-positive patients are procured domestically by the Government of Vietnam as opposed to donors and available to patients via SHI. Making these life-saving treatment options available via SHI makes them more affordable and accessible for those who need them.

TARGETED LOCALITIES

The project works mainly at the national level with the Ministry of Health, Vietnam Social Security, the Ministry of Finance, and partners closely with national and provincial HIV and TB program managers and health policymakers.