Table 2 Overview of socio-economic and health system contexts in Cambodia, China, and Vietnam

Socio-economic contexts

Economic development

There are economic disparities across and within the countries of Cambodia, China and Vietnam.

The density of health workers is positively associated with the size of economies across and within the countries.

Social development

Cambodia has poor social development.

In Cambodia, poor primary education in the rural areas hampers the recruitment of candidates for medical education.

Health system contexts

Decentralization

China and Vietnam increased autonomy of public hospitals.

Cambodia decentralized the operation of health centers.

Increased autonomy of public hospitals in China and Vietnam resulted in brain drain at rural primary health facilities.

In Cambodia, decentralization allocated more funding to the health centers.

Health financing

China established New Rural Cooperative Medical Scheme.

Vietnam conducted mandatory health insurance.

Cambodia applied health equity fund, and official development assistance as financial incentives.

In China and Vietnam, health insurance schemes for universal health coverage improved demand for and utilization of health services in the rural areas.

In Cambodia, pro-poor health financing policies motivated rural health workers with more financial incentives.

Primary service delivery system

Vietnam and China abolished referral system.

Cambodia applied Minimum Package of Activities.

In Vietnam and China, abolition of referral system led to brain drain at primary health facilities.

In Cambodia, implementation of MPA partly caused no physicians at primary health facilities.

Private health sector

All three countries had prosperous private health sector.

In Vietnam and Cambodia, prosperous private health sector led to brain drain at rural primary health facilities, impeded implementation and determined effectiveness of financial incentives.