Background: Health insurance card dispensation and free-charge health care service for children under 6 years old is a great policy implemented by the Government of Viet Nam, but up to now there were little studies to evaluate this problem. Objectives: 1) To discover the situation of the health insurance card dispensation and free-charge health care service provided for children under 6 years of age at communal level. 2) To analyze the advantages/disadvantages and opportunities/challenges of these works to propose several measures for improvement. Subjects and method: The semi-quantity cross-sectional study was conducted at 3 provinces, which includes Bac Giang, Ha Noi and Quang Tri. One district was selected randomly from each province and 2 communes were selected from each district. Total of 6 communes were involved in the study. Results. Procedures for card dispensation and drug supply were complicated. The number of children under-6, that had no health insurance card was highest in Quang Tri (12.5%-26.2%), followed by Ha Noi (3.0%-4.3%). Some 15% of children had not visited the communal health centers for illness. The insurance-covered drug list in communal health centers has been limited to 36 kinds of drug, not enough for the proper treatment of diseases. Communal health centers in Quang Tri have a lack of doctors and essential equipment. The health insurance cards were not used in 44.7% of health facility visits of children under 6. Conclusion: The policy of free-charge health insurance for under 6 children can be strengthened by improvements in insurance card and drug dispensation procedures, increase the number of drugs in the insurance-covered drugs list, assign doctors to the communal level and strengthen the medical equipment for CHCs.
Health insurance ; Under-6 children