The impact of health financing policies on the service delivery at the grassroots level: A case study in Vietnam

Objectives: This study analyzes the impact of health financing on the service delivery at the district health centers within the context of Vietnam's autonomous policy implemen-tation. Methods: Data was collected through secondary sources and qualitative methods in 2023. Thematic analysis was conducted based on four in-depth interviews and eight focus group discussions involving 40 key provincial, district, and commune stakeholders. Results: The study revealed that insufficient public funding for essential activities and input-based payment mechanisms failed to provide adequate incentives for improving the quality and efficiency of primary healthcare services. As a result, patients lack trust in the quality of services offered at the grassroots level. Many bypass these facilities in favor of higher-level specialist care, further reducing revenue for the district health centers under the autonomous policy. Conclusions: Adequate public financing and appropriate payment mechanism incentives are critical for delivering quality primary healthcare services at the grassroots level. Keywords: Health financing, Preventive, curative, Primary Health Care, Quality, Equity, Policy Vietnam.