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Polities appeal to the principle of distributive justice when justifying the right to inclusion and exclusion they claim for themselves with respect to immigrants: to each their own place. This paper attempts, in a first stage, to explain the nature of the link between distributive justice and an alleged right to inclusion and exclusion, as manifested in the political use of indexicals such as ‘we’, ‘here’, and ‘now’. Drawing on an analysis of the European Union, it subsequently shows why the use of political indexicals, when officials exercise the EU’s putative jus includendi et excludendi, is only possible by invoking the utterance of a first ‘we-here-now’ that has no referent. The relation between distributive justice and an alleged right to inclusion and exclusion*a polity as a nomos, as I will call it*is rendered both possible and continuously undermined by an anomos*the invocation of a polity and a world that are not and cannot be in empirical space and time. Keywords: borders; political reflexivity; European Union; inclusion/exclusion (Publication online: 7 November 2008) Citation: Ethics & Global Politics. Vol. 1, No. 4, 2008, pp. 193-212. DOI: 10.3402/egp.v1i4.1893

Background: Knowledge of the aggregate effects of multiple socioeconomic vulnerabilities is important for shedding light on the determinants of growing health inequalities and inequities in maternal healthcare.Objective: This paper describes patterns of inequity in maternal healthcare utilization and analyzes associations between inequity and multiple socioeconomic vulnerabilities among women in Vietnam.Design: This is a repeated cross-sectional study using data from the Vietnam Multiple Indicator Cluster Surveys 2000, 2006, and 2011. Two maternal healthcare indicators were selected: (1) skilled antenatal care and (2) skilled delivery care. Four types of socioeconomic vulnerabilities – low education, ethnic minority, poverty, and rural location – were assessed both as separate explanatory variables and as composite indicators (combinations of three and four vulnerabilities). Pairwise comparisons and adjusted odds ratios were used to assess socioeconomic inequities in maternal healthcare.Results: In all three surveys, there were increases across the survey years in both the proportions of women who received antenatal care by skilled staff (68.6% in 2000, 90.8% in 2006, and 93.7% in 2011) and the proportions of women who gave birth with assistance from skilled staff (69.9% in 2000, 87.7% in 2006, and 92.9% in 2011). The receipt of antenatal care by skilled staff and birth assistance from skilled health personnel were less common among vulnerable women, especially those with multiple vulnerabilities.Conclusions: Even though Vietnam has improved its coverage of maternal healthcare on average, policies should target maternal healthcare utilization among women with multiple socioeconomic vulnerabilities. Both multisectoral social policies and health policies are needed to tackle multiple vulnerabilities more effectively by identifying those who are poor, less educated, live in rural areas, and belong to ethnic minority groups.Keywords: healthcare; skilled antenatal care; skilled delivery; multiple socioeconomic vulnerabilities; inequity; inequality(Published: 29 February 2016)Citation: Glob Health Action 2016, 9: 29386 - http://dx.doi.org/10.3402/gha.v9.29386This paper is part of the Special Issue: Millennium Development Goals in Vietnam: the Progress and Social Determinants. More papers from this issue can be found at www.globalhealthaction.net