WELCOME ADDRESS
DELIVERED BY MADAME RIMA SALAH, UNICEF REPRESENTATIVE TO VIETNAM
Excellency Professor Le Van Truyen, Vice-Minister of Health; Excellency Mr. Reizo Utagawa, Managing Trustee, The Nippon Foundation; Professor Takusei Umenai, Chairman of the Department of Health Policy and Planning of Tokyo University and Head of the RDF Project Committee,
I am both delighted and honored to address the Third International Meeting on Essential Drugs and Community Health Services. I have the privilege on behalf of the United Nations Children's Fund (UNICEF) to convey my appreciation and congratulations to the Ministry of Health and to the delegation from the Nippon Foundation for organizing such an important conference. The outcome of such a high powered forum will certainly have a crucial impact on reinforcing alliances and laying the foundations for strong health systems, where quality community health services are accessible to all, particularly the most disadvantaged families.
Let me take this opportunity to express UNICEF's respect and appreciation to the government of Vietnam and the Ministry of Health in particular for their commitment to improve the health situation of the people and children of Vietnam. Indeed, what you have accomplished here has reawakened hope in many countries in the region and particularly among developing countries. Your political commitment to the health of children has allowed Vietnam to reach the mid-decade goals. In 1996, 95% of children were immunized against the main childhood diseases and Vietnam has been declared Xerophthalimia-free since 1989. For the second year in a row, the UNICEF report, Progress of Nations, has put Vietnam in the first rank for its performance in the area of under-five-mortality. Despite this great feat, many challenges still lie ahead to ensure that all families and children have access to health services.
The rapid socio-economic change in Vietnam has had great impact on the availability and quality of basic services and in particular health care.
Although the Doi Moi reform process has achieved a major reduction in poverty since 1986, poverty remains widespread and the most pressing challenge. The gap between urban and rural areas has widened and the disparities between provinces and districts have also increased-consequently, existing basic services are unable to cope with the needs of impoverished areas and disadvantaged groups.
The implementation of community level health programs has weakened. The current capacity weaknesses stem from limited financial resources, complicated management systems, lack of technical expertise and little experience or knowledge in influencing behavior change. Other issues include: decrease of state support to the public health system; decrease of resource availability and quality of care; decrease of economic access to services; decrease of access for poor people.
Indeed, the generosity of the Nippon Foundation and its support to the health sector through the setting up of revolving drug funds at the district level will help the Ministry of Health cope with the rapid changes and address some of the issues. We believe that the immediate achievements of the program will include:
1. Availability of essential drugs, even in impoverished areas and at affordable cost;
2. Increased access to quality care;
3. Improvement of community participation in planning, carrying out and monitoring health activities together with health workers;
4. Empowerment of the family with the information and skills necessary to make the right and correct decisions for the health of its members.
The study conducted jointly between MSH, Tokyo University and the Ministry of Health on revolving drug funds is a main step toward the achievement of these objectives. The results of this study will prove what the Ministry of Health and UNICEF staff are observing in the field: there are clear differences between project areas in terms of services utilization, drug availability, quality of care, as well as confidence of people toward health personnel. The results of this study and this meeting are a great opportunity to find the ways and means to further improve health services in Vietnam and the region.
Finally, I would like to thank again Professor Le Van Truyen, whose support has been fundamental to the implementation of the revolving drug fund program in Vietnam. I would like to pay special tribute to the Nippon Foundation and Mr. Utagawa for their humanitarian action and for helping us in saving children's lives.
