In this study, we examine how governance and public administration quality can affect per capita income, income inequality, and poverty using provincial-level data in Vietnam. Governance and public administration quality are measured by the Vietnam Governance and Public Administration Performance Index (PAPI) surveys, which collect data on citizens’ experiences with and perception of provincial performance in governance and public. Using province fixed-effect regressions, we find a positive and nonlinear association between governance and public administration and per capita income. Better performance of governance and public administration also appears to improve income distribution and reduces poverty. The association between governance quality and poverty severity is larger than the association between governance quality and poverty headcount. This finding implies that, within a province, better governance and public administration are most beneficial for the poorest of the poor.

Our research examines the development of social health insurance (SHI) in Vietnam between 1992 and 2016 and SHI's role as a financial mechanism towards achieving universal health coverage (UHC). We reviewed and analysed legislation from the Government of Vietnam (GoV) and performance data from the GoV and the World Bank. Stages of development were identified from legislative change leading to change in SHI functioning as a public financing mechanism: revenue collection, pooling of risk, and purchasing. Movement towards UHC was assessed relative to: population coverage, benefit coverage, and financial protection. Vietnam has implemented SHI through five stages: Stage I (1992–1998), Stage II (1998–2005), Stage III (2005–2008), Stage IV (2008–2014), and Stage V (2014 onwards). Coverage has widened from a compulsory scheme for civil servants and pensioners and a voluntary scheme for others, to a scheme that targets the entire population. However, UHC has not been achieved with 19% of the population uninsured in 2016 and high out-of-pocket payments. The benefit package includes a wide range of services and many expensive medications and considered to be generous. It is recommended that Vietnam focus on improving population coverage rather than further expanding the benefit package to achieve UHC.

Current measures for monitoring progress towards universal health coverage (UHC) do not adequately account for populations that do not have the same level of access to quality care services and/or financial protection to cover health expenses for when care is accessed. This gap in accounting for unmet health care needs may contribute to underutilization of needed services or widening inequalities. Asking people whether or not their needs for health care have been met, as part of a household survey, is a pragmatic way of capturing this information. This analysis examined responses to self-reported questions about unmet need asked as part of 17 health, social and economic surveys conducted between 2001 and 2019, representing 83 low-, middle- and high-income countries. Noting the large variation in questions and response categories, the results point to low levels (less than 2%) of unmet need reported in adults aged 60+ years in countries like Andorra, Qatar, Republic of Korea, Slovenia, Thailand and Viet Nam to rates of over 50% in Georgia, Haiti, Morocco, Rwanda, and Zimbabwe. While unique, these estimates are likely underestimates, and do not begin to address issues of poor quality of care as a barrier or contributing to unmet need in those who were able to access care. Monitoring progress towards UHC will need to incorporate estimates of unmet need if we are to reach universality and reduce health inequalities in older populations.

Using the Vietnam Household Living Standard Survey in 2004, this article seeks to quantify the potential role and impacts of a social pension scheme for reducing elderly poverty in Vietnam. The authors simulate changes in the poverty rate, poverty gap and poverty severity of the elderly in the counterfactual situation that such a scheme had been introduced to Vietnam in the past. They consider a number of categorical targeting groups of elderly people along with various transfer parameters to assess the impacts of the scheme on social welfare. They conclude that, depending on the characteristics of the social pension, there would be beneficial poverty reductions, but also large leakages to the non‐poor people. For a variety of measures, the results suggest that targeting the elderly in rural areas might be the most effective use of limited resources. Simulations for different budgetary constraints show that, even with limited budgeting, a social pension scheme would significantly reduce poverty incidence for the elderly. Furthermore, for a given programme cost, combining lower benefits with lower eligibility requirements is more effective at reducing poverty than providing larger benefits to a more limited group of recipients.