THE UNCERTAINTY THAT SHAPES THE OPERATIONS OF HEALTH-FOCUSED NON-GOVERNMENT ORGANIZATIONS IN VIETNAM

Abstract

Objective: This research project explores how uncertainty shapes NGOs operating in the health sector in relation to other institutions, and how NGOs strategize to maintain their image and survive under uncertain conditions, while working to improve population well-being. Methods: The research questions were answered through qualitative methods. Twenty semi-structured interviews were conducted, thirteen with the representatives of NGOs, and seven with high-ranking government officers at both central and provincial levels. In addition, documents (decisions, proposals, reports) were reviewed. Results: Numerous uncertainties internal and external to NGOs greatly influence their operations. As a result, they adjust their mandates, roles vis-à-vis government, accountability, and delivery methods to manage these uncertainties. Although relations with government were sometimes difficult, in general NGOs confirmed that they supported government priorities. Several lessons about operations, programming, policy making, and relationship building have been learned through this study, resulting in recommendations being made to the government, to NGOs in Vietnam (including their headquarters), and to donors, aiming to facilitate smooth NGO operations and benefit communities. Conclusion: NGOs have no standing in the local socio-political structure, a problem arising from the government’s restrictive control of the civil society sector. NGOs do their best to avoid notice, “hiding themselves” to avoid attention or scrutiny. As a result, government-NGO relations are highly problematic, and NGOs often struggle to implement sustainable programs at the community level. Further studies are required to identify effective modes of NGO operations under such circumstances, including work to identify methods for strengthening NGO capacity, increasing appropriate donor engagement, and facilitating the localization of foreign NGOs.