7 - Conclusion

Summary

This analysis has explored attempts of the Communist Party of Vietnam (CPV) and the Vietnamese government to pursue greater health equity. The research question posed was why these efforts are so easily diluted. The study has analysed under which conditions positive welfare outcomes can occur inside an informal security regime despite this dilution. The work was based on assumptions of network theory about the nature of policy change (Heclo 1974; Mershon 1994; Sabatier 1987): policy learning may occur among the different actors of the regulatory network. A prerequisite for such learning is that core beliefs are translated into secondary beliefs. This happens when decision-makers can take expectations of all decisive actors into account. It is therefore helpful if they interact regularly. It is additionally beneficial if conflicting opinions over how to implement core beliefs can be mediated by policy brokers.

As this study intends not only to give insights into health and social policy in Vietnam, but also to contribute to the comparative theory of welfare regimes, the aim was to provide a theoretical framework structuring the empirical findings.

The regime model developed by Esping-Andersen (1993) proved to be a good starting point for the analysis. Specifically, the regime typology highlights one important aspect: welfare outcomes in Vietnam are not only influenced by the state, but by several actors including the family, community and the market. The application of the regime typology by Gough and Wood (2004) on developing countries provided additional insights into how welfare provision and regulation is fundamentally different between developed and developing countries.

As the analysis has shown, Vietnam's health policy can be described by the informal security regime. While Vietnam is — like every country — unique in terms of social policy, it also shares several similarities with other countries. Large parts of the society are not covered by any public social system due to the low formalization of labour and a huge informal sector.