Challenges to Rural Poverty Reduction in Viet Nam - Oxfam Blogs

Participatory poverty monitoring in rural communities in Viet Nam
84
Calculation of the level of assistance for some target groups is complicated,
particularly inter-ministerial Circular No. 24/2010/TTLT-BLĐTBXH-BTC dated 18 August
2010, guiding the implementation of Decree 67 and Decree 13. Many commune cadres
in mountainous ethnic minority areas do not know how to calculate the level of assistance
for people or households eligible for more than one type of assistance.
There is limited openness and transparency in the implementation of social
assistance policies. Most respondents at the monitoring points do not know the details
of social assistance policies.
People in ethnic minority areas who do not speak or write Vietnamese cannot
complete application forms. Many ethnic minorities reported the wrong age in their
ID cards and in permanent residence books, and lack required documentation such as
birth certificates, and certificates attesting to their wartime contributions. Procedures to
obtain “disability” certificates to be eligible for social assistance are also complicated.
Lack of local funding for the management of social assistance recipients under
Decree 67. For example Tuong Duong district-Nghe An has more than 5,000 social
assistance recipients; in 2011 alone, more than 1,700 cases were reviewed under
Decree 13. Due to a limited local budget, the district Department of Labour, Invalids
and Social Affairs faced many difficulties covering management costs. Decree 54 states
departments receive 1.92% of the total disbursement as management fees.
Mountainous districts do not have the adequate resources to provide occational
aid to households in need. According Decree 67, the “district has to cover the cost”
with support, if necessary, from the province, of providing occational aid to households
experiencing risks or who have other urgent requirements such as burial costs. However,
some districts, particularly the more remote lack the necessary resources.
3.3. Insurance
Voluntary social insurance policies are not yet popular in rural areas. Farmers and
those working in the informal sector lack understanding of voluntary social insurance
policies, and the level of periodic contribution is still high.
Health insurance policy for all. Poor, ethnic minority people in disadvantaged areas,
and children under six-years-old can benefit from health insurance subsidies introduced
as part of the Health Insurance Law. However, very few near-poor households buy
voluntary medical insurance cards (with a 50% or sometimes 80% subsidy). The
largest proportion (30% in 2011) near-poor households buying health insurance is in
Duc Huong commune, Ha Tinh.
Providing and distributing medical insurance cards and informing people of
the benefits of health insurance is problematic. Few grassroots cadres sufficiently
understand available health insurance to advise local residents. An alternative would be
village population and health collaborators who could help persuade villagers to buy
health insurance, and issue medical insurance cards to children under six years old.
There are also delays in issuing medical insurance cards in mountainous communes for a
number of reasons: delay in the listing of beneficiaries by communes; names, particularly
of ethnic minorities, are recorded incorrectly; long distances from remote villages to
commune center; children under six-years-old don’t have birth certificates; and delays
transferring the list of poor households from Labour, Invalids and Social Affairs agencies
to social insurance agencies. The services of selling health insurance, including selling
subsidised health insuarance for the near poor, are not yet user-friendly.
The benefits of health insurance for the poor are limited. The poor still face extra