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The changing donor landscape of health sector aid to Vietnam: A qualitative case study


  • Pallas, Sarah Wood
  • Khuat, Thi Hai Oanh
  • Le, Quang Duong
  • Ruger, Jennifer Prah


The study objective was to identify how donors and government agencies in Vietnam responded to donor proliferation in health sector aid between 1995 and 2012. Interviews were conducted with key informants from donor agencies, central government, and civil society in Hanoi in 2012 (n = 34 interviews), identified through OECD Creditor Reporting System data, internet research, and snowball sampling. Interview transcripts were coded for key themes using the constant comparative method. Documentary materials were used in triangulation and validation of key informant accounts. The study identified a timeline of key events and key themes. The number of donors providing health sector aid to Vietnam increased sharply during the late 1990s and early 2000s, then leveled off and declined between 2008 and 2012. Reasons for donor entry included Vietnam's health needs, perceptions of health as less politically sensitive, and donor interests in facilitating market access. Reasons for donor withdrawal included Vietnam's achievement of middle-income status, the global financial crisis, and donors' shifting global priorities. Key themes included high competition among donors, strategic actions by government to increase its control over aid, and the multiplicity of government units involved with health sector aid. The study concludes that central government and donor agencies in Vietnam responded to donor proliferation in health sector aid by endorsing aid effectiveness policies but implementing these policies inconsistently in practice. Whereas previous literature has emphasized donor proliferation's transaction costs, this study finds that the benefits of a large number of less coordinated donors may outweigh the increased administrative costs under certain conditions. In Vietnam, these conditions included relatively high capacity within government, low government dependence on aid, and government interest in receiving diverse donor recommendations. Vietnam's experience of donor proliferation followed by donor withdrawal illustrates a trajectory that other countries may experience as they transition from low-to middle-income status.

Suggested Citation

  • Pallas, Sarah Wood & Khuat, Thi Hai Oanh & Le, Quang Duong & Ruger, Jennifer Prah, 2015. "The changing donor landscape of health sector aid to Vietnam: A qualitative case study," Social Science & Medicine, Elsevier, vol. 132(C), pages 165-172.
  • Handle: RePEc:eee:socmed:v:132:y:2015:i:c:p:165-172
    DOI: 10.1016/j.socscimed.2015.03.027

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    References listed on IDEAS

    1. Djankov, Simeon & Montalvo, Jose G. & Reynal-Querol, Marta, 2009. "Aid with multiple personalities," Journal of Comparative Economics, Elsevier, vol. 37(2), pages 217-229, June.
    2. Knack, Stephen & Rahman, Aminur, 2007. "Donor fragmentation and bureaucratic quality in aid recipients," Journal of Development Economics, Elsevier, vol. 83(1), pages 176-197, May.
    3. William Easterly, 2002. "The cartel of good intentions: The problem of bureaucracy in foreign aid," Journal of Economic Policy Reform, Taylor & Francis Journals, vol. 5(4), pages 223-250.
    4. Andrew Rogerson, 2005. "Aid Harmonisation and Alignment: Bridging the Gaps between Reality and the Paris Reform Agenda," Development Policy Review, Overseas Development Institute, vol. 23(5), pages 531-552, September.
    5. Arnab Acharya & Ana Teresa Fuzzo de Lima & Mick Moore, 2006. "Proliferation and fragmentation: Transactions costs and the value of aid," Journal of Development Studies, Taylor & Francis Journals, vol. 42(1), pages 1-21.
    6. William Easterly, 2007. "Are aid agencies improving?," Economic Policy, CEPR;CES;MSH, vol. 22, pages 633-678, October.
    7. Buse, Kent & Walt, Gill, 1997. "An unruly mélange? Coordinating external resources to the health sector: A review," Social Science & Medicine, Elsevier, vol. 45(3), pages 449-463, August.
    8. Elisabeth Paul & Frieda Vandeninden, 2012. "Foreign Aid Transaction Costs: What Are They and When Are They Minimised?," Development Policy Review, Overseas Development Institute, vol. 30(3), pages 283-304, May.
    9. David Fielding & George Mavrotas, 2008. "Aid Volatility and Donor-Recipient Characteristics in 'Difficult Partnership Countries'," Economica, London School of Economics and Political Science, vol. 75(299), pages 481-494, August.
    10. Buse, Kent & Walt, Gill, 1996. "Aid coordination for health sector reform: a conceptual framework for analysis and assessment," Health Policy, Elsevier, vol. 38(3), pages 173-187, December.
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    1. repec:eee:socmed:v:206:y:2018:i:c:p:67-74 is not listed on IDEAS
    2. Pallas, Sarah Wood & Ruger, Jennifer Prah, 2017. "Effects of donor proliferation in development aid for health on health program performance: A conceptual framework," Social Science & Medicine, Elsevier, vol. 175(C), pages 177-186.


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