English - CEDAW Southeast Asia

A Gendered and Rights-Based Review of Vietnamese Legal Documents through the Lens of CEDAW
those relating to access to health, maternity and pregnancy, HIV/AIDS and other STIs, sexual and
reproductive health-care services and education, birth control and family planning methods, abortions,
and the privatization of the health-care services. In view of these, the selected indicators
focus on these areas.
GUARANTEES OF NON-DISCRIMINATION AND EQUAL ACCESS TO HEALTH CARE
There are numerous laws, plans and strategies in Viet Nam that address the equal right to access
health-care services, including the Law on Health, Plan of Action for the Advancement of Women
and Strategy for Protection and Care of People’s Health. There is a need to supplement legal and
policy documents through: (a) building or strengthening centres that specifically focus on healthcare
concerns of women, including diseases and infections that disproportionately affect them; (b)
putting in place measures relating to GBV, establishing women’s protection units in hospitals; (c)
introducing targets for women’s participation in leadership positions in the health sector; (d) ensuring
that mobile teams that cater to women have a substantial proportion of female staff, are gender-sensitive,
and are trained to address gender and women’s health needs and concerns; (e)
mandatory training on gender aspects of health care for health professionals; and (f) strengthening
the institutionalization of professional social work in health care. In all these recommendations,
special attention and mention must be made to prioritizing ethnic minority women, and women
from remote and mountainous regions, who have been clearly disadvantaged in their right to
access health care. Legal provisions should also be in place relating to gender budgeting.
ASSISTANCE TO POOR AND DISADVANTAGED WOMEN
User fees remain a major source of health financing and, in many ways, undermine equality of
access to health care. To reduce the inequalities caused by user fees, the Government introduced
a policy of exempting or privileging certain individuals from or in treatment fees, including
war veterans, people with disabilities, orphans, ethnic minorities, the poor, children aged less
than 6 years and individuals with particular illnesses. These exemptions may be found in relevant
legal documents, such as the Decision on Health Insurance, Law on Children, Ordinance on
Elderly People, Ordinance on Disabled Persons and Resolution on Socialization. They should be
viewed in the context of Decree on Financial Regime, which reflects the Governments policy to
spend less on public services and shift the burden to the consumer. The impact of these legal
documents - and, in particular, the Decree on Financial Regime - must be further looked into,
especially their effects on the disadvantaged sectors of society. Data must be sex-disaggregated
to enable an analysis of the gender issues and impacts. To ensure that the appropriate standard
of care is given to patients regardless of their gender and economic status, protocols on
appropriate treatment and handling of patients must be drafted. Legal provisions that clearly prohibit
and penalize direct and indirect forms of discrimination against disadvantaged groups in the
field of access to health care, including those with health insurance cards, must be stipulated.
These forms include: (a) patient skimming; (b) unnecessary referrals when treatment and care
can be reasonably provided by the health-care establishment; (c) refusal of treatment when able
to do so; and (d) providing less than the minimum standard of care.
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PREGNANCY AND MATERNITY
There are a substantial number of laws, plans and strategies in place relating to pregnancy and
maternity. A degree of progress has also been achieved in maternal health care. Nevertheless,
women from remote and mountainous areas still receive inadequate maternal health care, due to
cost, distance to health centres and traditional birth practices. Hence, it is suggested that a legal
Executive summary