This paper aims to understand how the performance of welfare institutions can be relevant to its social and cultural environment and focuses on how reforms in the healthcare sector have led to the current situation in Vietnam by comparing Hong River Delta (Nam Loi Commune) in North and Mekong River Delta (My Hoa Commune) in South of the country. For example, it explores how the characteristics of traditional and cultural arrangements affect the performance of welfare institutions, especially in the formal healthcare service sector. Formal welfare defines the achievement of preventive healthcare service system by commune health stations. Commune health stations in North and South show the differences in its operations. Nam Loi commune health station in North supplies preventive health services and programs to their residents and the people actively participate in them. It enables the stations to provide better and effective preventive medical service. However, My Hoa commune health station in South provides corrective treatment services to the residents. Because the people react differently to healthcare services and visit the stations only when necessary, which hinder the stations to plan and implement preventive medical services persistently. The reason for this difference between the two regions is directly derived from the level of coordination and cooperation with residents, not from the institutional or political capacity such as public health facilities and operational policy.