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Human resources for health are the central issues for advancing any health system (World Health Organisation, 2006). The availability of skilled health workers is critical to assuring the quality of healthcare services, including maternal health services. While the Vietnamese government acknowledges the importance of ensuring sufficient human resources for the health system, analysis of existing, albeit limited information, indicates a number of potential issues, including an imbalance and maldistribution of the essential health workforce, shortages of appropriately skilled health workers and constraints in management and utilisation of health workers. Good governance of the health workforce will help to improve the quality of health care, assure equity in health, and should help to improve efficiency in the use of health resources.This study was designed to understand how governance issues influence the organisation of the healthcare services at the commune and district levels and how this, in turn, influences the motivation, competencies, and performance of health workers.