UMMS Affiliation

Department of Population and Quantitative Health Sciences

Publication Date


Document Type



Health Services Administration | Health Services Research | Infectious Disease | International Public Health | Virus Diseases


This article discussed Vietnam’s ongoing efforts to decentralize the health system and its fitness to respond to global health crises as presented through the Covid-19 pandemic. We used a general review and expert’s perspective to explore the topic. We found that the healthcare system in Vietnam continued to decentralize from a pyramid to a wheel model. This system shifts away from a stratified technical hierarchy of higher- and lower-level health units (pyramid model) to a system in which quality healthcare is equally expected among all health units (wheel model). This decentralization has delivered more quality healthcare facilities, greater freedom for patients to choose services at any level, a more competitive environment among hospitals to improve quality, and reductions in excess capacity burden at higher levels. It has also enabled the transformation from a patient-based traditional healthcare model into a patient-centered care system. However, this decentralization takes time and requires long-term political, financial commitment, and a working partnership among key stakeholders. This perspective provides Vietnam’s experience of the decentralization of the healthcare system that may be consider as a useful example for other countries to strategically think of and to shape their future system within their own socio-political context.


Healthcare system, Global health crises, Covid-19 pandemic, Low- and middle-income countries (LMICs), Public health responses, Vietnam

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

DOI of Published Version



Nguyen HV, Debattista J, Pham MD, Dao ATM, Gilmour S, Nguyen HL, Nguyen TV, Le PM, Nguyen PT, Tran ATN, Vu KD, Dinh ST, Hoang MV. Vietnam’s Healthcare System Decentralization: how well does it respond to global health crises such as covid-19 pandemic?. APJHM [Internet]. 2021Feb.28 [cited 2021Apr.12];16(1):47-51. Available from:

Journal/Book/Conference Title

Asia Pacific Journal of Health Management

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License