Soc Sci Med. 1995 Nov; 41(9): 1325-32.

The role of pharmaceuticals in the privatization process in Vietnam's health-care system.

Wolffers I.

Department of Social Medicine, VU-University, Amsterdam, The Netherlands.

The socialist republic of Vietnam had a centrally planned economy and a well-distributed health-care system that was free to all. Since 1989 the government implemented a free market policy (Doi Moi). Authorities tried to shift part of the cost to users of health care and to improve aspects of the health-care system that appeared to be ineffective. Private practice of physicians and pharmacists was introduced in Vietnam. The introduction of privatization had consequences for the public health services at provincial, district, village and hamlet level. This has changed the character of the health-care system. Pharmaceuticals play an important role in the transactions between practitioners and patients, because they are the tangible goods that are exchanged in the transactions between users and providers of health care. Medical anthropologists interprete use and ideas on pharmaceuticals in terms of local cultural categories or as metonymic signs of technologically advanced societies from whence they come. Use of pharmaceuticals can also be understood in a historical and political context. This article describes pharmaceuticals in the process of privatization in Vietnam and the way they are seen by the Vietnamese in the context of political change. Their use carries meanings of medicines about transformations in political economy and as such this can be seen as a metaphor for the changing Vietnamese health-care system.