Poverty as a Barrier to Women's Health Status and Care in Two Rural Vietnamese Provinces

The Vietnamese government has invested a greater proportion of public resources in improving primary health care for rural poor and minority populations than any other developing country. Yet, many among the poor and near poor, especially women, remain less healthy and face more difficulties in meeting their health care needs than non-poor. This paper examines the relationship between poverty and health with particular reference to rural women and shows how poverty constitutes a barrier to health and health care accessibility in rural Vietnam. The analysis uses qualitative data collected in Thua Thien Hue (central Vietnam) and Vinh Long (southern Vietnam) provinces in partnership with Provincial Health Services and local medical colleges. Results demonstrate a strong inter-relationship between poverty and health. In particular, poor women, relative to less poor women, are more seriously affected when illness arises, face greater difficulties in financing the travel and opportunity costs of referral to district and provincial hospital facilities, and are more likely to delay seeking care. Findings suggest that the Vietnamese government should improve outreach services, reduce paperwork and procedural difficulties, and train service workers in methods of improving rapport with minorities. Since poor and minority women tend to rely upon the clinical services of Commune Health Centers (CHCs), public investment in poverty reduction should be targeted on upgrading service quality at CHCs.