Negotiating Compliance: The Case of Autonomous Hospitals in Vietnam

Maternal death is one of the highest causes of global mortality. Governments have long used regulation to improve maternal health but concurrent fiscal‐decentralisation reforms can undermine clinical performance. This article focuses on public Vietnamese hospitals to explore how regulatory complianc...

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Bibliographic Details
Published inDevelopment policy review Vol. 33; no. 3; pp. 373 - 390
Main Authors Lê, Gillian, Thu Thi Bui, Ha, Mirzoev, Tolib, Thanh Nguyen, Ha
Format Journal Article
LanguageEnglish
Published Oxford Blackwell Publishing Ltd 01.05.2015
Subjects
Childbirth & labor
Compliance
Decentralization
Government
hospital autonomy
Hospitals
Maternal & child health
maternal healthcare
Mortality
Regulation
Regulatory compliance
Studies
Vietnam
Vietnam
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Summary:Maternal death is one of the highest causes of global mortality. Governments have long used regulation to improve maternal health but concurrent fiscal‐decentralisation reforms can undermine clinical performance. This article focuses on public Vietnamese hospitals to explore how regulatory compliance is pursued in decentralised health facilities, since Vietnam has seen increasing autonomisation of public hospitals in the last decade while simultaneously experiencing marked reductions in the maternal mortality ratio. Our analysis suggests that autonomisation has allowed regional regulatory regimes to emerge and that regulatory compliance must compete with other priorities. Compliance can therefore be rethought as a negotiation having implications for how government and maternal health advocates persuade self‐sufficient hospitals to take on wider health‐system goals.
Bibliography:istex:21041AAE5C23A7379A736359737A7E9C3D1C4286
ArticleID:DPR12112
ark:/67375/WNG-G5Q4JBRB-H
ObjectType-Article-1
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content type line 23
ISSN:0950-6764
1467-7679
DOI:10.1111/dpr.12112