(LUẬN văn THẠC sĩ) effecting of educational level on self medication decition of patients in hochiminh city

INTRODUCTION

RESEARCH OBJECTIVE, RESEARCH QUESTION & RESEARCH HYPOTHESIS

The decision to seek healthcare is significantly influenced by an individual's knowledge, attitudes, and education This study aims to investigate how the educational level of adults affects their tendency to self-medicate when they are ill.

The study examines how sociodemographic factors and healthcare provider attributes impact self-medication behaviors among patients in Ho Chi Minh City This research aims to inform health policymakers seeking to enhance public access to appropriate self-medication practices.

Research Question and Research Hypothesis

Higher education levels improve individuals' ability to access and critically evaluate information Consequently, those with advanced education are likely to possess greater self-confidence in their medical knowledge, leading to increased self-medication practices compared to those with lower educational backgrounds This dissertation seeks to explore this relationship further.

- Are adult individuals with higher years of schooling more likely to be self-medicated facing typical diseases?

And the research hypothesis is:

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There is positive relationship between the level of education and the self-medication practices.

RESEARCH METHODOLOGY

This study employs descriptive statistics and an econometric model to address the research question Descriptive statistics will summarize and visualize the relationships between independent and dependent variables, specifically focusing on patients' knowledge and attitudes toward self-medication through numerical data and graphical representations Additionally, the econometric model will be utilized to examine the impact of various factors on self-medication behavior.

This study examines the behavior of individuals who utilized healthcare services, such as visiting a doctor or pharmacy, at least once in the past three months during periods of illness It recognizes that a patient may access medical services multiple times when unwell Consequently, the analysis focuses on the frequency of visits to healthcare providers rather than the individuals themselves.

The analysis utilizes cross-sectional data from a household survey conducted in Ho Chi Minh City, featuring structured interviews This primary dataset includes 120 patients and 227 interactions with healthcare providers, resulting in 227 observations for regression analysis using Stata 8.

THE ORGANIZATION OF THE THESIS

Chapter 1: presents the introduction including problem statement, research question, research hypothesis and research methodology and data source, and the unit of analysis

Chapter 2 provides definitions of self-medication, professional health care provider and types of illness which is focus in this study Theoretical framework is also discussed together with empirical researches The last section of this chapter is the model specification includes a justification of the empirical model, transforming concepts into variables

Chapter 3 introduces a general view about VietNam health care and drug utilisation This chapter focused on providing the information about self- medication practice in VietNam based on the reports of VLSS 1997-1998 and VNHS, 2001-2002

Chapter 4 introduces sampling method with sample size and interview technique The descriptive method will be used to describe characteristics, knowledge, and attitude toward of self-medication of respondents in Ho Chi Minh city Econometrics methods will be used to analyse influences of factors to self-medication of participants

Chapter 5 contains the conclusions and some policy implications

LITERATURE REVIEW

SOME DEFINITIONS

The Vietnam National Health Survey (2002) defines self-medication as the practice of patients using drugs without prior medical examination or a doctor's prescription This definition also encompasses instances where patients, dissatisfied with their initial treatment, choose to buy additional medications independently rather than seeking a follow-up consultation.

According to the World Health Organization (WHO, 2001), self-medication refers to the use of medications or seeking pharmacy consultations to address self-diagnosed conditions, as well as the ongoing use of prescribed drugs for chronic or recurrent diseases or symptoms without prior consultation with healthcare professionals.

The two definitions are largely similar in meaning, but the latter offers a more detailed explanation of self-medication cases Therefore, this study will adopt the definition provided by the WHO.

This study defines a professional health care provider as an individual with specialized health knowledge who offers consultation or treatment services These providers may work in various settings, including district hospitals, provincial hospitals, central hospitals, state facilities, private clinics, and private hospitals The term encompasses both practitioners of western medicine and those practicing traditional medicine.

This study categorizes illnesses into three types: (1) chronic severe illnesses, such as cancer and cardiopathy, which require ongoing medical examination and monitoring; (2) common illnesses like headaches and the flu, which can often be managed through self-care; and (3) conditions such as angina and gastritis that necessitate a doctor's consultation before treatment According to Dr Nguyet from ShiHospital and Dr Quang from Due Chinh Clinic, these diseases demand specialized treatment, including precise dosages and timing for medications, as well as careful combinations of treatments like antibiotics or steroids Therefore, patients should seek professional medical advice for appropriate care.

Download TIEU LUAN MOI at skknchat@gmail.com While the illnesses addressed by medical professionals in this category are not life-threatening, inappropriate treatment methods can have detrimental effects, impacting both patients and society at large.

This study focuses on individuals who experienced illnesses lasting no more than 30 days within the last three months, specifically examining angina, tonsillitis, and gastritis These conditions were selected based on health statistics from the Department of Health of Ho Chi Minh City, which indicate that they are among the most commonly treated diseases in local hospitals.

This section begins by reviewing consumer theory as the foundational framework for understanding the determinants of demand for health care services It then presents two widely used theoretical models for further analyzing health care demand: Grossman's human capital model and Andersen's behavioral model.

According to Jack (1993), the demand for health care services was described in the orthodox static utility-maximizing framework To examine the effect

The author explores the relationship between health status, income, and pricing on medical care demand, positing that individuals prioritize their health and select healthcare providers as their primary means of health production Additionally, individuals allocate their limited budgets to acquire a mix of goods and medical services that maximize their overall satisfaction, viewing health as one of several commodities within their preferred bundle of goods.

The utility function is represented as U(c,h), where c signifies the various goods consumed by individuals and h reflects their desired level of health Medical care is the sole input for health production, requiring B units of care to generate an additional health unit With an income of m and health status B, individuals face a budget constraint of c + Bh ≤ m, under the assumption that the prices for both consumption and medical care are equal to one An increase in the value of B, such as from 1 to 2, indicates a decline in health, necessitating more medical care and causing the budget line to shift inward The elasticity of demand for health is assumed to lie between 0 and 1.

1 implied that the individual prefer to consume more health and less good when being sick

When an individual encounters a fixed number of health care providers, and the cost associated with each provider remains unaffected by their health status, the budget lines illustrated in figure 2.1 represent the various options available for health care expenditures.

TIEU LUAN MOI download : skknchat@gmail.com 9 consumption bundles combined with a given provider in the two different states of health are aligned vertically

Figure 2.1: Available Health consumption bundles for individuals with different health status h r

Decisions regarding the selection of medical services, known as discrete choices, are analyzed using discrete choice econometric models For instance, as illustrated in Figure 2.1, an individual may prefer provider j=1 when in good health (e1), but when experiencing a decline in health (e2), their preference shifts to provider j=2.

The effect of income on provider choice

Health and healthcare are typically considered normal goods, meaning that as an individual's income increases, their demand for medical services also rises, as illustrated by a rightward shift in the budget constraint curve When preferences are quasilinear concerning consumption goods, changes in income do not influence the choices of medical providers.

TIEU LUAN MOI download : skknchat@gmail.com 10 individual, as shown in figure 2.2b In that situation, health is not a normal good

Figure 2.2: Effects of Income on Provider choices

The effects of price on discrete demand

Figure 2.3: Effects of Price on Provider choice h c

When healthcare providers increase their prices, it leads to a significant reduction in the consumption of their services, resulting in a lower overall health consumption level for individuals As the price of care rises, the budget line for purchased services shifts inward, indicating a decrease in available health-consumption bundles at a given health state and income level Consequently, individuals tend to consume fewer services when faced with higher provider prices, assuming all other factors remain constant.

The theory of consumer behavior offers insights into health care demand by assuming individuals seek to maximize utility and favor actions linked to the greatest expected benefits However, this approach primarily focuses on analyzing outcomes rather than exploring the decision-making process involved in health care choices, presenting both advantages and disadvantages.

Z.2.2 Grossman's theory of human capital and the demand for health care

EMPIRICAL STUDIES

This section presents two models that employ discrete choice econometric techniques grounded in consumer theory to estimate the likelihood of utilizing medical services and selecting specific types of healthcare providers.

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The initial model examines an individual's decision-making process regarding self-medication versus seeking professional healthcare providers, utilizing data from Vietnam (VLSS 1997 - 1998) It posits that an individual with a specific income level (y) aims to optimize their utility by selecting an ideal combination of health status (h) and consumption (c), represented by the utility function U(c,h).

To enhance health status, individuals can choose between professional healthcare providers and self-medication This model emphasizes the decision-making process involved in selecting healthcare options, particularly considering the costs associated with professional care.

V is set as unity By doing that, the parameter p in the budget constraint equation (2.5) y=c+ V+pQ (2.5) is also the relative price of self-medication Q to professional care V

The consumption function can be derived from (2.5): c =y- V-pQ (2.6)

Suppose that h 0 is initial health status of an individual, the function of health level of one is: h = h 0 + RV + (R- s)Q (2.7)

The analysis indicates that the return on professional care (R) is greater than zero, while self-medication yields a return of R - c, where c represents the costs associated with medication errors due to misdiagnosis, which is a random variable with an expected value greater than zero This suggests that patients who opt for self-medication may experience lower efficiency compared to those who seek professional care.

Substituting (2.6) and (2.7) into the utility function U = U(c,h), we yields the general indirect utility function:

The welfare of an individual is influenced not only by the consumption of goods other than health care but also by their anticipated health status, which is determined by financial investments in professional medical treatment and self-care practices.

A model utilizing data from Kenya examines how individuals confront illness and select from various healthcare options, including government providers, private facilities, other health institutions, and self-care This model proposes that an individual's utility function is influenced by their health condition when making these healthcare choices.

In the context of health economics, Hij represents the health status of an individual selecting healthcare provider j for treatment during illness, while Cij denotes the consumption of all other goods The health production function illustrates the relationship between healthcare choices and overall health outcomes.

This equation shows that the expected improvement of health status depends on attributes of an individual )( and ~-, the quality of health care provider j received by the individual

The consumption function illustrates how an individual's income (Yi) and the cost of treatment (P1) from a healthcare provider (j) influence their consumption levels Specifically, it indicates that the amount spent on medical care is determined by both the individual's income and the expenses incurred for services received from that particular provider.

By substituting the health status equation (2.1 0) and the consumption function (2.11) into the utility conditional function (2 9), it gains a general utility function

The equation (2.12) describes an individual can gains the benefits from choosing a typical health care provider under conditions of characteristics of

TIEU LUAN MOI download : skknchat@gmail.com 20 an individual X, the attributes of the provider Z, the individual's income Y, user fees P paid for visiting provider j

To determine the probability of choosing a typical health care provide, the authors adopted a linear utility specification, then the general utility function may be rewritten as follow:

The utility function, represented as Vuã, systematically incorporates individual attributes and the quality of health care providers, while siJ serves as the residual component.

Let HCPi is health care provider indicator, the health care provider choice of an individual may be presented as

HCP; = j if UiJ> max { Uik} (2.15)

The individual i will choose the health care provider j if the expected utility received from it is higher than the other ones.

MODEL SPECIFICATION

This chapter provides definitions of two providers of medical service in this study, self-medication and professional health care provider, and types of

This study aims to explore the impact of education on individuals' health-seeking behaviors, specifically in relation to various illnesses It includes a theoretical framework that reviews three models of health care demand, supported by empirical studies.

Consumer theory views health as one of many commodities influenced by individual preferences, while Grossman's model positions health as a stock variable within the human capital framework In this context, human capital theory suggests that measures capturing the consumption value of improved health are minimal, whereas consumer theory allows for a more straightforward observation and quantification of health service demand (Jack, 1993) Additionally, Andersen's model offers a comprehensive approach to understanding the various factors influencing the utilization of health services.

The empirical study by Chang and Trivedi, discussed in section 2.3, explores how individuals allocate their income between self-medication and professional healthcare providers However, it does not address healthcare choices in the context of illness The second study provides insights into the decision-making process for those facing health-related choices.

"pertain only to public facilities", in case of multiple health care providers

Thus, constructing an appropriate empirical model to answer the research question needs some justifications based on the above analyses about theoretical framework and empirical studies

It's assumed that an individual when being illness will have to choose between self-medication and professional health care provider, the utility from the two alternative providers:

In the context of consumer behavior, the equation (Yi - Pj) aligns with equation (2.11), where ~ã represents consumer preferences, 0 denotes the quality of the provider, and sii signifies unobserved components It is assumed that consumers opt for self-medication when the expected utility surpasses that of seeking professional healthcare services.

Where j= 1 if individual choose self-medication and j = 0 for professional health care To estimate the probability of choosing self-medication, the equation should be:

It's assumed that the utility function is linear; the equation (2.18) 1s separable in deterministic and stochastic preference:

The deterministic part of utility can be presented as follow: t m vii= a/r;- Pi)+ LflJexie + LAJkzjk (2.20) e=l k=l

The deterministic component of an individual's utility function when selecting healthcare provider j is influenced by the individual's income, the costs associated with purchasing healthcare, their unique characteristics, and the quality of the healthcare provider.

From the equation (2.20), the deterministic part of utility from self- medication is: t m v;; = at (r; - ~) + L flteXie + L AuZtk (2.21) e=l k=l

And the utility from professional health care provider is: t m

Vo; = ao(r;- Po)+ LfloeXie + LAokZok (2.22) e=l k=l

The linear nature of the utility function indicates that the marginal utility of income remains constant across different scenarios Consequently, the equations for marginal utility in both situations demonstrate that the individual’s utility derived from income is equivalent, as expressed in the formulas: $ t m v;i - VOl = al cr;- ~) + Lf3texie + L~kzlk - ao(r;- Po) + Lf3oeXoe + LAokZOk $ and $ t m v;i - Vo; = ap + L fleXie + L AkZlk $ This consistency in marginal utility reinforces the principle that income variations do not affect the overall utility for the individual.

The probability statement (2.24) could be rewritten as follow:

The probability function (2.25) indicates that an individual's decision to choose between self-medication and professional healthcare when facing illness is influenced by the price differences of both options, personal preferences, and the characteristics of healthcare providers Consequently, this leads to the formulation of the regression function.

In this study, the dependent variable in our regression function is binary, representing self-medication with a value of one and professional health care providers with a value of zero Given the nature of limited dependent variables, traditional ordinary least squares regression is unsuitable due to various econometric issues To address these challenges, nonlinear estimation techniques such as probit and logit analyses are employed The probit model utilizes the cumulative normal function, while the logit model relies on the logistic function, both employing maximum likelihood estimation However, the logistic function is preferred for its lower computational cost (Long, 1997) Consequently, the binomial logit model is utilized to analyze the discrete variable in this research.

In the context of healthcare choices, patients face two alternatives: self-medication (r = 0) and professional care (r = 1) The probability (Pr) of selecting either option is influenced by various factors, including price differences (X1), individual characteristics (X2), and the attributes of the healthcare providers (Z3) The regression function highlights how these elements impact patients' decisions when confronting illness.

2.4.2 Transforming theoretical framework into variables

Table 2.1 List of variables and Expected Signs

Dependent Variable: Choice of provider conditional on being sick choice =1 Self-medication, professional health care= 0

Difference in price (X J) difpri Difference in cost for getting medical services +

Characteristics of individual (X2) edu Completed years of education + age Age in years gender =1 Male; =0 Female married = 1 if married; = 0 otherwise + dayill Number of days of illness + ms O=Uninsured ; 1 = Insurance

Attributes of health care providers (Z3) diftime quality

The time taken to access medical services can significantly impact patient recovery Research indicates that patients believe they would recover more quickly if they received consultations from qualified healthcare providers This highlights the importance of timely access to professional medical care in enhancing health outcomes.

The left hand side of regression function (2.27) is a dummy variable referring to the choice of an individual i, 1 for self-medication, 0 for visiting doctor

Previous research on the effect of price on health care seeking behavior has yielded mixed results Studies by Litvack and Bodart (1993) and Lavy and Germain (1994) demonstrated that price significantly influences health demand In contrast, findings from Lacroix and Alihonou (1982) and Akin et al (1998) suggest different outcomes, highlighting the complexity of the relationship between price and health care utilization.

WB (1987) concluded that price has relatively little influence on health care demand

The price of medical care encompasses not only direct payments for goods and services but also additional expenses such as lost income and travel costs For individuals enrolled in health insurance, these hidden costs can significantly impact their overall financial burden.

Download TIEU LUAN MOI at skknchat@gmail.com Research shows that forgone consumption of medical services is minimal or nonexistent for individuals employed in informal labor markets without health insurance Jack (1997) highlights that travel costs can help researchers assess healthcare demand when monetary prices show little variation Additionally, Gertler and Vander Gaag (1990) utilized travel costs as the sole measurable expense in their healthcare study.

This study examines how educational levels influence individuals' choices of healthcare providers, assuming travel costs are negligible due to data collection limitations Consequently, the cost of self-medication is defined as the monetary expenditure on medications, while for those consulting professional healthcare providers, costs include both the price of prescribed medications and consultation fees.

The price difference between self-medication and visiting a doctor is calculated by subtracting the total cost of self-medication from the total cost of a doctor's visit This price disparity is anticipated to positively influence the likelihood of individuals opting for self-medication instead of seeking professional medical advice.

This part will introduce variables of individual characteristics which affects his or her choices about what kind of medical services into econometric model:

CONCLUSION

This chapter presents key concepts related to health care services, including self-medication, professional health care providers, and types of illness It outlines a theoretical framework comprising three models that explain the demand for health care services The consumer theory views health as a commodity influenced by individual preferences, while Grossman's model considers health as a stock variable within the human capital framework This approach emphasizes the importance of measuring the consumption value of health in understanding its demand.

The demand for health services is more easily measured within consumer theory, as noted by Jack (1993), while improved health status serves as a lower bound Andersen's model offers a framework for understanding the various factors influencing the utilization of health services This chapter presents two empirical studies that contribute to the development of the empirical model.

In short, based on theoretical framework, there are three groups of variables in the empirical model: difference in prices, characteristics of patients and attributes of health care providers

VIETNAMESE HEALTH CARE AND DRUG UTILAZATION

Trends in health care seeking behaviour ofindividuals

Table 3.1 Annualized health services contact rates, by provider

Drug vendor/Pharmacy visits/Self-medication

According to the VLSS 1998 data, the annualized contact rate for the public sector is 1.42, while private clinics have a higher rate of 1.76 In contrast, drug vendors exhibit contact rates that are nearly four to five times greater than those of both public and private sectors Additionally, the utilization of health services varies among demographic groups, with females demonstrating a higher annual contact rate per capita than males across all age groups, recording 11.3 compared to 9.3 Table 3.2 further illustrates the distribution of total health service contacts across different providers in 1998.

Table 3.2: Distribution of total health services contacts across providers in 1998

Drug vendor/Pharmacy visits/Self-medication

Research indicates that a significant number of individuals depend on drug vendors for managing their health issues, with these vendors responsible for approximately two-thirds of all service interactions The prevalence of self-medication through drug vendors is largely due to its convenience, the time saved compared to lengthy examinations, and the often cumbersome administrative processes associated with health facilities.

TIEU LUAN MOI download : skknchat@gmail.com 35 regulating prescriptions and drug sales are not properly followed by pharmacies (VNHS, 200 1 )

Private health care is crucial in Vietnam, accounting for 80% of health expenditures and around 50% of healthcare delivery It presents a stark contrast between high-quality, expensive services for the wealthy and low-cost, poor-quality care from inadequately trained providers for the less affluent, often operating outside government oversight A significant issue with private health care is the neglect of externalities; while providers may focus on individual patient care, this approach can undermine public health objectives and lead to inefficient resource allocation For instance, the misuse of antibiotics can contribute to increased resistance, impacting future treatment options for the entire population.

The Cost of Health Services

The cost of health services encompasses not only the official fees set by healthcare providers but also includes expenses for medications, medical supplies, and informal payments This highlights the significant influence that medical service costs have on healthcare accessibility and decision-making.

The current challenge in Vietnam's medical system is the inequitable access to healthcare services, particularly affecting the poor Financial constraints and geographical barriers hinder their ability to receive adequate medical care Additionally, healthcare services and supplies in impoverished and remote regions often lack the quality found in more affluent areas, where competition with private providers exists.

Health insurance significantly lowers the cost of accessing healthcare services, leading to increased demand for medical care In Vietnam, there are three health insurance programs: one compulsory and two voluntary Currently, the Vietnam Health Statistics Report (VHSR) indicates that 9.8 million individuals are enrolled in voluntary health insurance, representing 12 percent of the population.

Despite having VHI coverage, the benefits are insufficient to fully cover hospital visit costs, leading to minimal out-of-pocket expenses averaging VND 92,410 for insured individuals in public hospitals (VLSS, 1998) Data from the VNHS indicates only a marginal difference in health service utilization between insured and uninsured individuals This disparity is partly due to uninsured individuals facing financial and geographic barriers to accessing healthcare, even though they tend to have a higher incidence of illness Conversely, those with health insurance experience lower illness rates and greater access to health services Looking ahead, the government aims to expand health insurance to address these disparities.

TIEU LUAN MOI download : skknchat@gmail.com 37 coverage will greatly impact the amount of health care services used as well as the medical facilities chosen by users.

Self-medication and reasons

According to data from the Vietnam National Health Survey (VNHS), self-medication is the preferred treatment method for 73% of illnesses nationwide, closely aligning with the 1998 Vietnam Living Standards Survey (VLSS) estimate of 69% This trend shows little variation across genders and between urban and rural populations Notably, aside from the 0-5 age group, there are minimal differences in self-medication rates among various age categories This may be attributed to the heightened attention parents give to infants and young children, often opting for professional medical examinations before administering medications Nevertheless, a significant 66.5% of illnesses in small children are still treated through self-medication (VNHS, 2001).

Self-medication practices vary significantly among different ethnic groups, with only 49% of minorities in the Central region and Central Highlands engaging in it, compared to 77% among Southern ethnic minorities Additionally, a substantial proportion of self-medication is observed among the Kinh-Hoa and Northern mountain ethnic minorities, with rates ranging from 73% to 74% (VNHS, 2001) In contrast, the disparity in self-medication based on education levels among patients is minimal.

The main reason given for self-medication is that the illness is considered to be only minor The less severe the illness the more patients resort to self-

Many individuals engage in self-medication, often opting for over-the-counter medications without consulting a healthcare professional, as illustrated in Figure 3.1 The predominant reason for this behavior is the reliance on previous prescriptions, which accounts for 11 percent of cases Additionally, 7.5 percent of respondents believe there is no possibility of a cure, while only 2 percent cite difficulties in accessing medical facilities as a reason for self-medicating.

Figure 3.1 Selected reasons for self-medication by age group

(Source: Vietnam National Health Survey 2001-02)

-. Medicine procured using old prescription ,_No cure possible

Age significantly influences the tendency of self-medication, with older patients more likely to reuse old prescriptions or believe there is no cure for their ailments This trend is associated with the prevalence of long-term chronic diseases in older individuals, who often focus on maintaining their health rather than seeking new treatments for conditions perceived as incurable.

Many individuals have previously sought medical consultations but eventually become accustomed to their treatments, leading them to believe that further examinations are unnecessary As a result, they often resort to purchasing the medications they have used in the past.

3.2 DRUGS UTILISATION AND SOURCE OF DRUGS FOR SELF-

Between 1987 and 1992, Vietnam's "Doi Moi" economic reforms led to a significant liberalization of pharmaceutical production, resulting in a three-fold increase in drug production and a ten-fold rise in drug imports By 1995, the drug market stabilized, ensuring the availability of essential medications to meet healthcare needs and public demand From 1990 to 2001, drug expenditure per capita rose from $1.50 to $6.00, with drug utilization comprising approximately 90% of total household healthcare expenditure.

The rise in drug availability has not been matched by a robust information infrastructure, resulting in irrational drug use and wastage of limited resources (Chuc, 2002) As the private sector increasingly dominates the market, the surge in pharmaceutical options and domestic demand has contributed to the tendency for over-prescription and dispensing (Cederlof).

In recent years, patients have increasingly accessed a wide range of medications, including prescription drugs, often without professional healthcare guidance This trend has resulted in a significant portion of medical treatments being conducted outside the traditional healthcare system, with individuals frequently relying on self-medication and, at times, seeking advice solely from drug sellers as their primary source of medical consultation.

According to VNHS (2001), 75% of patients who self-medicate obtain their medications from pharmacies, with 10% sourcing from private practitioners and 12% from state medical facilities In contrast, only 3% of patients receive medications from traditional medicine practitioners without an examination, as these practitioners typically assess the pulse before prescribing treatment.

More than 25% of patients from ethnic minorities purchase medications directly from state-run medical facilities, while only 4% obtain drugs from private medical establishments In contrast, 11% of the Kinh-Hoa community self-medicate by sourcing drugs from private facilities Additionally, approximately 3% of Kinh-Hoa patients turn to traditional medical practitioners for self-medication, a figure that is quite similar to the 2% observed among other ethnic minorities.

DRUG UTILAZATION & SOURCE OF DRUGS FOR SELF-MEDICATION IN VIETNAM

National Drug Policies are designed to ensure a reliable supply of high-quality medications to meet health protection needs and promote the rational use of drugs in both curative and preventive healthcare The Vietnamese National Drug Policy (VNDP), supported by SIDA and WHO, encompasses eight key components: monitoring essential drugs and antibiotic use, regulating animal antibiotic use, establishing hospital drug and therapy councils, ensuring drug quality assurance, managing drug manufacturing and distribution, promoting traditional medicine, training pharmaceutical personnel, enhancing drug information systems, and fostering scientific research and international cooperation in the pharmaceutical sector.

The VNDP does not explicitly address self-medication or the role of pharmacists, yet its objectives of ensuring quality drugs and promoting rational drug use encompass these aspects Essential drug lists serve as a guideline to enhance the availability of quality medications and encourage their rational use However, the effectiveness of implementing essential drug lists is significantly increased when paired with educational programs, ongoing follow-up, and mechanisms that guarantee a consistent supply of high-quality drugs.

TIEU LUAN MOI download : skknchat@gmail.com 42 t2.2 Antibiotic Resistance

Vietnam faces a significant challenge with high levels of antibiotic resistance, as highlighted by multiple studies (Ha, 1991; Tornquist et al., 2000; Bogaert et al., 2002) Key factors contributing to this issue include the overuse, irrational use, and ineffective use of antibiotics, often stemming from individuals self-medicating (VNHS, 2001) This growing resistance threatens to undermine the country's health achievements, as it hampers the control and prevention of infectious diseases Even when antibiotics are prescribed by healthcare professionals, patients frequently deviate from recommended treatment guidelines, such as opting for a two-day course instead of the advised ten-day course, often due to financial constraints or a lack of awareness regarding the risks of antibiotic resistance (WB, 2001 b).

The VNDP, established by the government, aims to regulate the irrational and indiscriminate use of drugs across the nation from 2001 to 2015 To effectively combat antibiotic resistance, a comprehensive education and communication campaign is necessary to limit the overuse of antibiotics by consumers, pharmacists, and health workers However, the government faces a potential conflict of interest due to the tension between its commercial interests in the pharmaceutical sector and the overarching public health benefits.

The Ministry of Health plays a crucial role in drug management in the country, acting as both the primary owner and regulator of drug production and importation For more information or to download related materials, please contact skknchat@gmail.com.

CONCLUSION

Despite Vietnam's impressive economic growth, with GDP doubling every decade over the past twenty years, it remains relatively poor However, the UNDP reports that Vietnam's Human Development Index improved significantly, rising from 120 in 1995 to 108 in 2005 This progress indicates Vietnam's commitment to not only enhancing its economy but also advancing its healthcare sector.

Vietnam's healthcare system is undergoing a significant transformation, driven by the rise of the private healthcare sector and pharmaceutical industry, which has altered the health-seeking behavior of individuals and households However, the government has struggled to effectively regulate and monitor the quality of care and medications provided by these private entities, resulting in adverse outcomes like the rise of antibiotic resistance With a population exceeding 80 million, health insurance in Vietnam has the potential to target large groups and distribute risk more effectively.

2005) However, the proportion of insured individuals is not high, just covers

The government is enhancing the public health insurance system to improve access to healthcare facilities for 12 percent of the population by promoting the use of insurance cards.

Self-medication is a prevalent health-seeking behavior in Vietnam, primarily driven by the perception that illnesses are minor and do not require professional consultation This practice is not limited to Vietnam; it is also observed in developed countries While self-medication can be safe and appropriate in certain contexts, economic factors play a significant role, particularly for individuals with lower income or education levels, who may view medical consultations as more costly than purchasing medications directly.

SELF-MEDICATION BEHAVIOUR OF PATIENTS IN HO CHI MINH CITY

CONCLUSIONS AND RECOMMEND A TIONS

Tiêu đề	Effect Of Educational Level On Self-Medication Decision Of Patients In Ho Chi Minh City
Tác giả	Pham Quang Anh Thu
Người hướng dẫn	Dr. Nguyen Van Ngai
Trường học	National University of HCM
Chuyên ngành	Development Economics
Thể loại	Thesis
Năm xuất bản	2007
Thành phố	Ho Chi Minh City

Định dạng
Số trang	94
Dung lượng	2,41 MB