Situation Analysis of Migrant Health in Viet Nam The opinions expressed in the report are those of the authors and do not necessarily reflect the views of the International Organization for Migration (IOM). The designations employed and the presentation of material throughout the report do not imply expression of any opinion whatsoever on the part of IOM concerning legal status of any country, territory, city or area, or of its authorities, or concerning its frontiers or boundaries. IOM is committed to the principle that humane and orderly migration benefits migrants and society. As an intergovernmental organization, IOM acts with its partners in the international community to: assist in the meeting of operational challenges of migration; advance understanding of migration issues; encourage social and economic development through migration; and uphold the human dignity and well-being of migrants. This research was co-financed by the International Organization for Migration, World Health Organization and Nippon Foundation through the Sasakawa Endowment Fund. This publication has been issued without formal editing by IOM. Publisher: International Organization for Migration Green One – UN House (GOUNH) 304 Kim Ma Street, Ba Dinh District Ha Noi Viet Nam Tel.: +84 24 38 500 100 Fax: +84 24 37 265 520 Email: [email protected] Website: https://vietnam.iom.int/ Cover photo:©IOM/Xuan Hieu and Quang Anh ©WHO/Yoshi Shimizu © 2020 International Organization for Migration (IOM) All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without the prior written permission of the publisher. Situation Analysis of Migrant Health in Viet Nam ACKNOWLEDGEMENTS This research was co-funded by the International Organization for Migration (IOM), World Health Organization (WHO) and Nippon Foundation through the Sasakawa Endowment Fund. Overall guidance and supervision for this project were provided by Associate Professor Khue Ngoc Luong, Director of the Department of Medical Service Administration (MSA), Ministry of Health; David Knight, Chief of Mission, IOM Viet Nam and Dr. Kidong Park, WHO Representative to Viet Nam. MSA, IOM and WHO would like to express gratitude to individuals who conducted the study and provided technical inputs as the list on page iv. MSA, IOM and WHO would like to thank migrants and stakeholders, including government agencies, United Nations agencies, non-governmental organizations and civil society agencies, who gave their valuable time to participate in this research. The study team would also like to thank the Ethics Council, MSA for its technical review and inputs. Situation Analysis of Migrant Health in Viet Nam | iii List of individuals who conducted the study and/or reviewed this report. Ministry of Health, Socialist Republic of Viet Nam Department of Medical Service Administration Khue Ngoc Luong Khoa Trong Nguyen Ngoc Le Van Truong* Thu Do* Thang Duc Nguyen* Ha Noi Medical University Vung Dang Nguyen Nhi Tho Tran Thuy Thanh Nguyen International Organization for Migration (IOM) IOM Mission in Viet Nam Main Office Brett Dickson Aiko Kaji Hien Thu Bui* Kei Hirano Nadege Giroux IOM Ho Chi Minh City Sub-Office Jelena Cmiljanic Anh Le* IOM Global Migration Health Support Unit Kolitha Wickramage IOM Regional Office for Asia and the Pacific Patrick Duigan Montira Inkochasan World Health Organization (WHO) WHO Representative for Viet Nam Kidong Park Momoe Takeuchi Linh Dieu Pham* Phuong Thi Kim Nguyen Annie Chu Ngoc Hong Ho* WHO, Western Pacific Region Kira Fortune Britta Baer Editor Simon Drought *Interviewers/facilitators for focus group discussions iv | Situation Analysis of Migrant Health in Viet Nam TABLE OF CONTENTS ACKNOWLEDGEMENTS ......................................................................................................................... iii LIST OF FIGURES .................................................................................................................................... vi LIST OF TABLES ..................................................................................................................................... vii LIST OF ABBREVIATIONS AND ACRONYMS .......................................................................................... viii EXECUTIVE SUMMARY ........................................................................................................................... ix CHAPTER 1. INTRODUCTION ..................................................................................................................1 Background .......................................................................................................................................1 Research questions ...........................................................................................................................2 Methodology .....................................................................................................................................2 Study sites ....................................................................................................................................4 Study participants and sampling ..................................................................................................6 Data collection .............................................................................................................................6 Data analysis ................................................................................................................................7 Ethical considerations ..................................................................................................................7 Operational Definitions of Terminology ............................................................................................8 CHAPTER 2. LITERATURE REVIEW ...........................................................................................................9 Migration and Viet Nam ....................................................................................................................9 Socioeconomic context ................................................................................................................9 Internal migration ......................................................................................................................10 Outbound migration...................................................................................................................11 Inbound migration .....................................................................................................................13 WHA Resolution 61.17 on the Health of Migrants Global Operational Framework ........................13 Policy-Legal Frameworks ............................................................................................................13 Monitoring migrants’ health ......................................................................................................14 Migrant-sensitive health services ...............................................................................................14 Partnerships, networks, and multi-country frameworks ............................................................15 SDGs and migrant health in Viet Nam .............................................................................................16 SDG 3. Good Health and Well-Being ..........................................................................................16 SDG 5. Gender Equality ..............................................................................................................18 Health status of migrants ................................................................................................................20 Health impacts of migration on families left behind .......................................................................22 CHAPTER 3. RESULTS ............................................................................................................................23 Findings from interviews with migrants ..........................................................................................23 Reasons for migration ................................................................................................................24 Health-care access barriers model .............................................................................................25 Structural barriers ......................................................................................................................28 Financial barriers ........................................................................................................................32 Situation Analysis of Migrant Health in Viet Nam | v Cognitive barriers .......................................................................................................................34 Social support barriers ...............................................................................................................35 Results of stakeholder interviews and focus group discussions ......................................................37 Coordination and partnerships among stakeholders .................................................................39 Policy and legal framework development ..................................................................................40