Health system stewardship and regulation in Vietnam, India and China

The health systems of many low- to middle-income countries are changing. The old assumptions of a dominant public health system alongside a smaller private sector are being challenged in many countries, making it essential that we assess, understand and apply concepts of governance in different contexts.   

Aim & Objectives

HESVIC aims to investigate regulation as it relates to wider governance of health systems in the area of maternal health in Vietnam (PDF), India and China. We aim to support policy decisions in these countries and beyond. Specific project objectives were:

  1. To examine the application of international standards in stewardship and regulation of maternal health activities.
  2. To outline national standards for stewardship and regulation of maternal health activities in the three study countries.
  3. To evaluate stewardship and regulation of maternal health care, services and systems within and across each study country, with a particular focus on the private sector.
  4. To disseminate the results and recommendations widely to the government and other key health sector stakeholders in the three study countries and to the professional/scientific community.
  5. To enhance the capacity of the partner research institutions in health systems research.
  6. To increase sustainable collaboration amongst country research institutions in pursuit of objectives of the FP7.


Different qualitative and quantitative methods were used. The project included seven work-packages (WPs). WP1 was devoted to developing methodology (details here (PDF) and here (PDF)); WPs 2–4 included data collection and analyses in the three countries, followed by comparative analysis in WP5; WP6 was devoted to knowledge management and capacity strengthening and WP7 comprised project coordination and management.


The results are helping us understand the principles and practices of regulation in the field of maternal health in Vietnam (PDF)India (PDF) and China (PDF) (see China summary (PDF)) and recommendations for policymakers and other key actors on improving regulation. 

The comparative report can be accessed here.

The HESVIC report is also available in Vietnamese (PDF)

Our results are also available in Mandarin and Vietnamese as well as English in India. 

HESVIC Chinese study (PDF) 
China Emergency Obstetric Care (PDF) 
Vietnam Emergency Obstetric Care 1, Vietnam Emergency Obstetric Care 2
India Emergency Obstetric Care (PDF) 
China Grievance Redressal 
China Antenatal Care (PDF) 
Vietnam Antenatal Care 1,Vietnam Antenatal Care 2
India Abortion (PDF) 

Other summaries can be found below: 

China Quality of Prenatal Diagnosis (PDF) 
China Grievance Redressal English (PDF) 
Vietnam Emergency Obstetric Care English (PDF) 
India Emergency Obstetric Care Poster

Partners & Collaborators

HESVIC Consortium comprises six partner institutions from different countries:  

  • Prince Leopold Institute of Tropical Medicine, Principal Investigator Dr Jean-Pierre Unger
  • Royal Tropical Institute, Principal Investigator Dr Maitrayee Mukhopadhyay
  • Hanoi School of Public Health, Lead Dr Bui Thi Thu Ha
  • Institute of Public Health, Bangalore, Principal Investigator Dr Narayanan Devadasan

The Consortium benefited from the participation of Country Research Advisory Groups in each study country in refining research focus and raising awareness and communication of project results.


The potential impact of the project will include improved practices of regulation in the field of maternal health and beyond in the three countries, thereby improving the health of billions of people. See our International policy brief (PDF) for more details.You can also watch a film where HESVIC researchers explain what we learnt during the project.