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VietNam 2/3 of the way achieving the millenium development goals
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Vietnam is regarded by the international community as one of the developing countries which have made outstanding achievements in economic reform targeting growth and poverty reduction. During the past ten years, Vietnam's economy has been growing fast yet steadly. The average GDP growth rate per annum reached 7.2 percent during the period 2001-2010. The average GDP per capita in 2010 is expected to reach 1200 USD, three times what it was in 2000. As a result, Vietnam is now moving from being one of the poorest countries to lower middle income status.

Together with the fast and steady economic growth, there has been a considerable shift in the economic structure. The proportion of GDP from agriculture, forestry and fisheries has reduced from 23.2 percent in 2000 to 17 percent in 2010; the proportion from industry and construction has increased from 35.4 percent to 41.6 percent, while the proportion from the service sector has remained at 41.3 percent throughout the same period. This shift in the economic structure has brought about important changes in the labour structure. During this period, the proportion oflabour in the agriculture, forestry and fisheries sector declined from 65 peryent to about 50 percent, while the proportion in the industry and construction sector increased from 13 percent to 23 percent, and in the service sector from 15 percent to about 27 percent.

Economic growth and the shift in the economic structure are the result of a comprehensive policy reform aimed at establishing and developing market institutions. To date, the economic sectors have been established and are being developed consistently throughout the country, with linkages to the world market. Prices ofthe majority of commodities and services are decided by supply and demand interactions. The business and investment environment has been greatly improved, moving toward an "equal playing field" for all economic sectors. Vietnam is in the process of equitizing state-owned enterprises (SOEs). As a result, the number of SOEs has declined from 12,000 in the early 1990s to about 2,000 in 2010. The improved investment environment has attracted an increasing amount of foreign direct investment (FDI). The domestic private sector has witnessed considerable development, especially since the issuance (and later amendment) of the Enterprise Law, which assures the right of all to do business. After 25 years of Doi Moi (Renovation), Vietnam has changed from an economy strongly dependent on the public sector and cooperatives; the private sector now contributes more than 60 percent of the country's GDP, provides employment to 90 percent of the labour force, and accounts for over 70 percent of the total export value.

During the process of promoting market reform and economic growth, Vietnam has also integrated into the global economy by attracting foreign investment and exploiting market opportunities to promote export growth. From being dependent on the former socialist bloc's markets in Eastern Europe and the former Soviet Union, after 25 years of Doi Moi, Vietnam has established trade relations with nearly 200 countries and territories, and signed more than 90 bilateral trade agreements; while 84 countries and territories have initiated investment projects in Vietnam. Having joined ASEAN in 1995, Vietnam has fulfilled its commitments to trade liberalization within the framework of the ASEAN Free Trade Area (AFTA); Vietnam also acceded to the World Trade Organization (WTO) in 2007 and is an active member in the Asia Pacific Economic Cooperation (APEC) forum. Trade and investment liberalization has turned Viet N am into an open economy with the total export value equaling 150 percent of the country's GDP; the annual registered foreign investment capital during recent years has reached over 60 percent of GDP (implemented capital equivalent to about 17 percent).

Nonetheless, the new global situation has led to numerous challenges, i.e. to overcome the financial crisis and sustain the speed of recovery; and to ensure proper assistance to those negatively affected by the financial crisis, and global food and fuel price fluctuations. In the long run, global climate change also poses grave challenges to the continuation of economic growth, poverty mduction and the fulfillment of other socio-economic development goals.

Vietnam pays special attention to and places a high priority on fulfilling its commitments toward the international community with regard to the Millennium Declaration and the MDGs. They have been nationalized in accordance to Vietnam's conditions and been mainstreamed into the country's most important socio­economic strategies and plans. The Socio-Econoniic Development Strategy from 2001 to 2010 sets out the goal of "fast, efficient and sustainable development; economic growth must go in parallel with social advancement and equality, and environmental protection"; the 5-year Socio-economic Development Plans from 2001 to 2005, and consequently from 2006 to 2010 elaborate further on this attitude toward development, setting out a specific roadmap and policies to implement successfully the tasks and targets for socio-economic development in Vietnam, in line with the process of fulfilling the MDGs by 2015.

These strategic documents have established the groundwork for the development of a system of strategies and development plans covering different sectors. The Comprehensive Poverty Reduction and Growth Strategy (CPRGS), approved in 2002, closely combined the targets for economic growth and poverty reduction, ensuring social equality and sustainable development. The CPRGS also emphasizes that "poverty reduction is not only one of the fundamental social policies receiving special attention from the Government of Vietnam, but it also forms an indispensable part of the overall development goal"; CPRGS also emphasizes the goal of "pursuit of reforms and promotion of fast economic growth coupled with implementation of poverty reduction and hunger eradication efforts and social equality in order to limit the gap between the rich and the poor in different population groups and regions". In particular, this Strategy puts forward development goals specific for Vietnam (referred to as the Vietnam Development Goals VDGs), which support the promotion and enhancement ofthe MDGs implementation.

Vietnam has been able to mobilize considerable resources from domestic sources and international donors to support the implementation of the MDGs and VDGs. A number of National Target Programmes (NTPs) have been carried out to balance resource distribution and involve the public in poverty reduction, job creation, universal education, vaccination and combat against malnutrition among children, control HIV/AIDS and dangerous diseases, improve sanitation, clean water supplies, cultural development and expand information networks for the public, etc. In addition, the Government of Viet Nam has also made important strides in realizing MDGs for certain population groups, such as ethnic minorities and the poor in remote and difficult areas.

Vietnam has setured important achievements in poverty reduction, employment creation, health-care services for the public, especially for women and children, and continued to make significant progress in gender equality. Annual income per capita has increased three times within ten years. The social security system has been gradually expanded. The proportion of the budget expenditure for social welfare in education, healthcare, retirement pensions and social insurance has increased markedly. Other aspects of the public's material and spiritual life have also' experienced major improvements.

Vietnam has achieved or even exceeded many of the goals set for 2010. The country, however, still needs to make considerable efforts in order to achieve other goals such as reducing the maternal mortality rate, ensuring environmental sustainability and controlling the transmission of HIV/AIDS.

GOAL 1: ERADICATE EXTREME POVERTY AND HUNGER

Achievements

Vietnam is one of the most successful countries in eradicating hunger and reducing poverty. In the last two decades, Vietnam's poverty rate has been in constant decline, from 58.1 percent in 1993 to 28.9 percent in 2002, 16 percent in 2006, and 14.5 percent in 2008. On average, the number taken out of poverty is 1.8 million each year, from more than 40 million people living in poverty in 1993 down to 12.5 million in 2008.

The proportion of undernourished people, measured by the food poverty line, decreased from 24.9 percent in 1993 to 10.9 percent in 2002 and 6.9 percent in 2008. Compared to the poverty line of 1 dollar (PPP), Vietnam has far exceeded the Millennium Development Goal of "halving, between 1990 and 2015, the proportion of people whose income is less than 1 dollar (PPP) a day". This proportion declined from 39.9 percent in 1993 t04.1 percent in 2008.

Poverty reduction has taken place in all population groups, both in urban and rural areas, among the Kinh majority and the ethnic minorities and in all geographical regions (see Table 1.1). The urban poverty rate reduced from 25.1 percent to 3.3 percent between 1993 and 2008, and the rural poverty rate reduced from 66.4 percent to 18.7 percent during the same period(1). Among the ethnic minorities, remarkable achievements regarding poverty reduction can also be seen, with the poverty rate being reduced from 86.4 percent in 1993 to 50.3 percent in 2008. However the pace of poverty reduction among the ethnic minorities is much slower than that among the majority Kinh group. The main reason for this is that the ethnic minorities often live in unfavourable geographical regions, such as the mountains or highlands, with poor infrastructure and socio-economic conditions.

Table 1.1: Poverty rate from 1993 to 2008 (percent)

1993

1998

2002

2004

2006

2008

WHOLE COUNTRY

58.1

37.4

28.9

19.5

16.0

14.5

Urban - Rural:

Urban areas

25.1

9.2

6.6

3.6

3.9

3.3

Rural areas

66.4

45.5

35.6

25.0

20.4

18.7

Ethnic groups:

Kinh majority

53.9

31.1

23.1

13.5

10.3

8.9

Other ethnic groups

86.4

75.2

69.3

60.7

52.3

50.3

By sex of household heads:

Male

60.8

39.9

31.1

21.2

17.2

15.5

Female

47.9

28.2

19.9

13.2

11.8

10.8

By geographical regions:

Red River Delta

62.7

29.3

22.4

12.1

8.8

8.1

Northeast

81.6

62.0

38.4

29.4

25.0

24.3

Northwest

81.0

73.4

68.0

58.6

49.0

45.7

North Central Coast

74.5

48.1

43.9

31.9

29.1

22.6

South Central Coast

47.2

34.5

25.2

19.0

12.6

13.7

Central Highlands

70.0

52.4

51.8

33.1

28.6

24.1

Southeast

37.0

12.2

10.6

5.4

5.8

3.5

Mekong River Delta

47.1

36.9

23.4

19.5

10.3

12.3

Source: General Statistics Office, VHLSS 1993, 1998, 2002, 2004, 2006 and 2008.

The food poverty rate also declined constantly in both urban and rural areas and among different ethnic groups. In 1993, up to 29.1 percent of rural inhabitants and 7.9 percent of urban residents were classified as living under the food poverty line, whereas in 2008, only 9.2 percent ofruraI inhabitants and 0.9 percent of urban inhabitants were classified as living under this line.

Not only the number of poor people but also the depth of poverty, measured by the poverty gap index, declined significantly (see Table 1.2)(2). The poverty gap index for the whole country fell dramatically from 18.4 percent in 1993 to 3.5 percent in 2008. The index fell in both urban and rural areas, among all ethnic groups, and across geographical regions.

Table 1.2: Poverty gap indexes from 1993-2008 (percent)

1993

1998

2002

2004

2006

2008

WHOLE COUNTRY

18.4

9.5

7.0

4.7

3.8

3.5

Urban - Rural:

Urban areas

6.4

1.7

1.3

0.7

0.8

0.5

Rural areas

21.5

11.6

8.7

6.1

4.9

4.6

Ethnic groups:

Kinh majority

16.0

7.1

4.7

2.6

2.0

1.7

Other ethnic groups

34.7

24.1

22.8

19.2

15.4

15.1

By sex of household heads:

Male

19.3

10.2

7.6

5.2

4.2

3.8

Female

15.2

6.9

4.4

2.9

2.6

2.3

By geographical regions:

Red River Delta

18.2

5.7

4.3

2.1

1.5

1.4

Northeast

27.1

15.8

9.7

7.0

5.6

6.5

Northwest

26.2

22.2

24.1

19.1

15.7

13.7

North Central Coast

24.7

11.8

10.6

8.1

7.7

5.3

South Central Coast

17.2

10.2

6.0

5.1

2.6

3.4

Central Highlands

23.6

22.9

16.7

10.6

8.8

7.5

Southeast

11.4

3.2

2.2

1.2

1.4

0.8

Mekong River Delta

13.8

8.1

4.7

3.0

1.8

2.3

Source: General Statistics Office VHLSS 1993, 1998, 2002, 2004, 2006 and 2008.

People's living standards have been constantly improving. The average consumption rate doubled from 1,935 thousand to 4,546 thousand VND/person/year (measured by actual prices converted to the level atJanuary 1998). In general, the increase in the average consumption rate among demographic groups is fairly equal.

The increase in the distribution gap of benefits from the overall economic growth of Vietnam has been marginal. The Gini coefficient for the consumption rate rose slightly from 0.33 in 1993 to 0.36 in 2008 (see Table 1.3). The Gini coefficient among different demographic groups rose slightly but remained low.

The urban-rural income gap has narrowed noticeably between 1999 and 2008. In 1999 the rural average income equaled 43.5 percent of the urban average income, and increased to 44.2 percent and 46.4 percent in 2002 and 2004 respectively. The rural income increase rate was higher than the urban rate between 1999 and 2008. The rural income increase rate in 2008 was 3.4 times that in 1999, while the urban income increase rate was 3.1 times. The highest per capita income increase between 1999 and 2008 was seen in the Red River Delta (3.8 times). The Central Highlands and the Mekong River Delta were lower (2.3 and 2.8 times respectively).

Apart from the increase in income and consumption rates, people's living standards have also improved (see Table 1.4). In the 2002-2008 period, the proportion of households possessing permanent houses went up from 16 percent to 28 percent. The proportion of households possessing at least one motorcycle also increased from 40 percent to 70 percent in the same period (and rose to 72.3 percent in 2009). Possession of other assets also increased in the same period.

Table 1.3: Gini coefficient in 1993-2008

1993

1998

2002

2004

2006

2008

WHOLE COUNTRY

0.329

0.350

0.370

0.370

0.358

0.356

Urban - Rural:

Urban areas

0.337

0.340

0.353

0.332

0.329

0.347

Rural areas

0.278

0.270

0.281

0.295

0.302

0.305

Ethnic groups:

Kinh majority

0.324

0.343

0.360

0.354

0.342

0.340

Other ethnic groups

0.252

0.240

0.279

0.310

0.301

0.307

By geographical regions:

Red River Delta

0.312

0.321

0.362

0.346

0.346

0.348

Northeast

0.243

0.279

0.325

0.342

0.336

0.337

Northwest

0.224

0.223

0.346

0.363

0.366

0.378

North Central Coast

0.243

0.287

0.300

0.307

0.323

0.310

South Central Coast

0.339

0.329

0.326

0.343

0.318

0.315

Central Highlands

0.325

0.337

0.359

0.356

0.363

0.353

Southeast

0.361

0.363

0.384

0.347

0.353

0.363

Mekong River Delta

0.314

0.296

0.301

0.317

0.302

0.311

Source: General Statistics Office VHLSS 1993, 1998, 2002, 2004, 2006 and 2008.

Table 1.4: Household possession of durable goods (percent)

2002

2004

2006

2008

Permanent houses

15.7

17.2

21.1

23.8

Motocycles

40.9

51.1

60.3

69.5

Telephones (including mobile phones)

13.6

23.7

35.5

63.7

Television sets

67.9

78.4

84.4

89.8

Stereo systems

6.3

9.9

13.1

16.1

Computers

2.6

6.2

8.1

11.5

Electric fans

68.4

79.4

81.6

85.6

Refrigerators

12.6

17.9

23.5

33.0

Electric rice cookers

37.4

52.4

61.0

71.6

Source: General Statistics Office VHLSS 2002, 2004, 2006 and 2008.

During the past two decades, Vietnam has always had high economic growth rates. GDP per capita measured by actual prices increased continuously from US$ 402 in 2000 to US$ 1,052 and US$ 1,064 in 2008 and 2009 respectively, and is expected to reach about US$ 1,200 in 2010.

The National Target Programme (NTP) for Employment and the Vocational Training Programme has successfully created more jobs, an important goal ofthe VDGs. The NTP has helped to create a further 1.6 million new jobs annually. Besides undertaking projects for job creation from the National Fund for Employment with preferential interest rates, the Programme also aims to develop labour markets through capacity building and modernization of30 to 40 job centres, strengthening labour market information systems, increasing the number of people receiving consultations and being introduced to jobs to 4 million over five years.

The programme for vocational training of the poor provided free vocational training courses to about 100,000 poor people between 2007 and 2009, of whom some 60 percent have subsequently been employed or self-employed, helping to generate income and reduce poverty. This programme has been highly regarded by various localities and is considered a sustainable approach to poverty reduction.

The country's work force also increased from 37.6 million people in 2000 to 47.7 million in 2009 (12.6 million in the urban areas and 35.1 million in the rural areas). The employment rate among people over 15 years of age for the whole country increased from 68.3 percent in 2000 to 74.2 percent in 2009. The unemployment rate in urban areas also decreased from 6.42 percent in 2002 to 4.65 percent in 2008 (it is expected that the urban unemployment rate will fall to 4.6 percent in 2010).

The employment structure is also increasingly shifting towards employed and paid jobs and away from self-employed jobs. Among self-employed jobs, the number of agriculture-related jobs has tended to decrease while non­agricultural jobs are increasing. However, there remains a huge difference between employment structures in urban and rural areas. In 2008, the employment rates in urban and rural areas were 54.4 percent and 27.5 percent respectively. In rural areas, agricultural labour also accounts for the majority of self-employed jobs.

The policy of providing soft loans to poor households has also helped to create jobs and alleviate poverty. During 2006-2009, about 5 million poor households were provided with soft credit, averaging 6 to 7 million VND/loan contract/household. In 2008, about 10 percent of households received loans from the Vietnam Bank for Social Policies (VBSP) and up to 33.5 percent received loans from other sources. The rate ofloans provided by the VBSP to rural households and ethnic minorities is significantly higher than that to urban households and the Kinh majority group. Generally, the loans were appropriately and effectively utilized. Access to loans has also been made more convenient and has helped to reduce the number of poor households.

Vietnam's social security system is an effective tool in supporting the disadvantaged and vulnerable in society. In 2009, about 1.5 million individuals who had previously made contributions to the country received preferential loans. About 1.26 million people received regular social benefits, an increase of 720,000 people compared with 2005. The amount of benefits increased by nearly 50 percent compared to the level in the old regulations. Wealthier cities and provinces are providing benefits higher than the Government's minimum required level. Poorer provinces have been provided with increased budget allocations to ensure the provision of adequate social security benefits as required.

In addition to the MDGs, Vietnam has also set out its own development goals, including the provision of basic services and infrastructure for particularly difficult communes. To date, scores of power grids, medical clinics, schools, and running water facilities have been built in poor communes. Agricultural infrastructure such as small-scale irrigation systems has also been built to facilitate production. By 2009, up to 94 percent of poor communes had vehicular-access roads leading to the centre of the communes. All communes have their own medical centres. The percentage of communes with primary and secondary schools is 84 percent and 70 percent respectively.

Difficulties and challenges in poverty reduction

Poverty is currently viewed as a problem of the rural areas, especially in the difficult regions like the mountains or islands. More than 95 percent of the poor live in rural areas. The food poverty rate in the rural areas is 10 times higher than in urban areas. The depth of poverty is still considerably high in the Northwest, and Central Highlands, and the poverty reduction rate in these regions has seen a noticeable slowdown in recent years.

The poverty rate among the ethnic minorities is still considerably high. As of 2008, 50 percent of the ethnic minorities were still poor, and up to 31 percent suffer from food poverty. Chronic poverty reduction in a number of ethnic minority groups usually faces a number of difficulties and requires long-term measures. Despite accounting for only 14.5 percent of the total population, the ethnic minority groups make up more than half of the total poor in Vietnam. This indicates that poverty will continue to be a problem among the ethnic minorities in the future.

In addition, the poor are still concentrated in areas with particularly difficult socio-economic conditions. The pattern of unbalanced development between the different regions has existed for a long time, with the rural, mountainous, remote and ethnic minority areas developing much slower than other areas. Therefore, efforts to further reduce poverty will cost more, and approaches to poverty reduction will have to be more creative than previous efforts, especially to balance development between the regions. Therefore, more attention should be paid to the goal of social equality, both in the short term and in the long term.

In addition to the challenges of poverty alleviation among the ethnic minorities and the most difficult regions, the rapid pace of urbanization and the boom in immigration from the rural areas to the big cities has also increased the pressure for poverty reduction in the urban areas. Urban poverty can not only be seen through low income but also in the lack of access to healthcare services, education, clean water and sanitation, accommodation, social securi1y networks, employment opportunities and other community activities. In particular, the characteristics of unstable accommodation and the high mobility of temporary immigrants, or those without any housing registration, makes it all the more difficult for them to get assistance and access to public services.

GOAL 2: ACHIEVE UNIVERSAL PRIMARY EDUCATION

Achievements

By 2000, Vietnam had achieved the goal of universal primary education according to national standards(3). Over the past decade, Vietnam has continued to promote universal primary education. All the country's provinces and cities have achieved illiteracy eradication and universal primary education, according to national standards, and are currently striving for universal secondary education. The quality of primary education continues to improve. The target is not only for children to complete primary education but also to complete it at the right age. By 2009, the national net enrolment rate in primary education was 97 percent. This rate reaches almost 100 percent in big cities such as Ha Noi, Ho Chi Minh City, Da Nang, Hai Phong, and Thai Nguyen.

The literacy rate among people over 10 years of age has increased dramatically in the past decade. In 2008, the national literacy rate among those over ten years of age was 93.9 percent, of which the rate in urban areas was 96 percent, and in rural areas 92 percent (see Table 2.1). The literacy rate in the 10-40 age group is 96 percent and equal for both men and women.

Table 2.1: Literacy among those over 10 years of age (percent)

1993

1998

2002

2004

2006

2008

WHOLE COUNTRY

86.6

89.5

92.1

93.0

93.1

93.1

Urban - Rural:

Urban areas

93.3

94.1

96.0

96.3

96.0

96.1

Rural areas

84.8

88.0

90.9

91.9

92.1

92.0

Ethnic groups:

Kinh majority

91.4

93.7

95.1

95.9

96.0

95.9

Other ethnic groups

82.3

85.6

89.3

90.2

90.5

90.5

By sex of household heads:

Male

91.5

91.9

94.9

95.3

95.3

95.3

Female

70.5

72.5

80.6

81.8

80.6

81.7

By geographical regions:

Red River Delta

91.5

93.7

95.8

96.2

96.4

96.7

Northeast

85.9

88.5

90.8

93.1

92.9

92.4

Northwest

N.A.

N.A.

79.9

80.0

81.4

80.3

North Central Coast

91.0

93.7

94.2

94.1

94.1

94.4

South Central Coast

84.7

86.5

93.1

93.4

94.0

93.5

Central Highlands

64.0

76.9

86.0

87.7

88.6

88.7

Southeast

90.4

92.4

94.0

94.5

94.5

94.6

Mekong River Delta

82.0

89.0

94.5

90.6

90.8

90.8

Source: General Statistics Office VHLSS 1993, 1998, 2002, 2004, 2006 and 2008.

Note: N.A. = not available

In the academic year 2008-2009, the country had almost 2.8 million kindergarten children, 15.1 million primary and secondary school pupils and 1.68 million university and college students. The rate of enroIlment for primary school children increased considerably in the 1990s, from 90.3 percent in 1993 to 97 percent in 2008.

Social equality in education has largely improved, demonstrated by the increasing educational opportunities available to girls and ethnic minority children. Cutting or reducing school fees, granting scholarships and other supporting policies facilitate basic education to the majority of children from-poor families and those receiving preferential treatment policies. Since the academic year 2002-2003, ethnic minority students have been provided with textbooks, notebooks and other stationery to study. Bilingual books have been written to help teach children from several ethnic minorities that have their own script. Some localities have organized extra-classes in Vietnamese to help ethnic minority students in their leaning of other subjects.

Due to the policy of support for poor ethnic minority students, in the 4 years from 2006 to 2009, about 8 million poor students enjoyed free education and 2.8 million poor ethnic minority students were provided with free textbooks. It is estimated that in the 2006-2010 period about 10 million poor students will have benefited from free education. Since the academic year 2007-2008, vocational trainees, college and unitersity students from difficult backgrounds have been able to access soft loans to study (752,000 soft loans have been granted at the maximum amount of 800,000 VND per month).

The gap in the schooling rate between regions is almost negligible (see Table 2.2). The Red River Delta has the highest rate, at 98.6 percent, while the North Central Coast has the lowest rate, at 94.8 percent.

Table 2.2: Net enrolment rate in primary education (percent)

2006-2007

2007-2008

2008-2009

WHOLE COUNTRY

96.0

96.1

97.0

Red River Delta

98.0

97.4

98.6

Northeast

94.7

95.3

96.7

Northwest

95.9

97.2

97.5

North Central Coast

94.3

94.9

94.8

South Central Coast

95.1

94.4

95.3

Central Highlands

93.8

93.9

95.2

Southeast

97.4

97.7

98.2

Mekong River Delta

96.1

96.2

96.8

Source: Ministry of Education and Training.

Another achievement in Vietnam's primary education was the rapid increase in the enrollment rate of children with disabilities. In the academic year 2007-2008, this rate was 42.7 percent, five times higher than in the academic year 2003-2004. Nowadays, there are integration classes for children with disabilities in almost all cities and provinces. Thousands of primary school teachers have been trained in the pedagogical knowledge and skills required to teaching children with disabilities.

Advances in children's education are being clearly demonstrated in secondary education (see Table 2.3). The net enrolment rate in lower secondary education increased from 81 percent in the academic year 2006-2007 to 83.1 percent in 2008-2009. It is expected that by 2010, 100 percent of the cities and provinces throughout the country will have achieved the national standard for universal lower secondary education. The schooling rate has increased among all rural and urban areas, between Kinh and ethnic minority children, and between boys and girls.

The net enrolment rate in upper secondary school increased from 26.9 percent in 1993 to 68.1 percent in 2008. This rate increased three-fold in rural areas and among ethnic minority groups. Besides primary and secondary education, kindergartens and higher education (colleges and universities) also recorded many achievements. The number of college and university students increased from 1.4 to 1.7 million.

Table 2.3: Net enrolment rate in lower secondary education (percent)

2006-2007

2007-2008

2008-2009

WHOLE COUNTRY

81.0

82.7

83.1

Red River Delta

87.8

89.3

79.9

Northeast

81.5

82.9

84.5

Northwest

68.5

72.9

78.3

North Central Coast

89.5

89.3

90.6

South Central Coast

85.4

87.0

89.5

Central Highlands

74.4

76.1

78.7

Southeast

79.9

83.7

87.2

Mekong River Delta

70.4

72.2

76.4

Source: Ministry of Education and Training.

The Government has continuously increased investment in education. The Government budget for education has increased from 15.5 percent in 2001 to 20 percent in 2007. In addition, the Government has mobilized support from businesses, institutions and socio-political organizations and foreign investors. Thanks to these efforts, a nationwide network of schooling institutions has been developed.

Basically, we have eliminated "barren communes" those without any pre-school primary schools are available in all communes, lower secondary schools at the commune or inter­communal cluster level, and upper secondary schools in all districts. Vocational training institutions, colleges and universities have been established in most major population centres, regions and localities, especially in underdeveloped regions such as the Northwest, Central Highlands, and Mekong River Delta. Many mountainous provinces and districts have boarding and half-day boarding schools for children of ethnic minorities (see Table 2.4).

Table 2.4: Number of schools at all levels (schools)

2005-2006

2006-2007

2007-2008

2008-2009

2009-2010

Pre-school

10,927

11,582

11,696

12,071

12,357

Primary

14,688

14,834

14,933

15,051

15,172

Lower secondary

9,383

9,635

9,781

9,902

10,060

Upper secondary

1,952

2,044

2,149

2,192

2,236

Higher education

255

298

346

369

376

Source: Ministry of Education and Training.

In addition to the school system for basic education and higher education, there are over 9,000 community learning centres, almost 700 continuing education centres at provincial and district levels, 1,300 computer centres, plus many universities implement distance learning programmes. Furthermore, many foreign language and professional training institutions operate in Vietnam. Education among ethnic minorities and in remote areas has made great progress. By the academic year 2007-2008, there were 278 ethnic boarding schools at the central, provincial, district and commune cluster levels.

Although the number of schools has increased in recent years, it has yet to meet the increasing demand of students, particularly at lower secondary level. The average number of students increased from 24 a class in academic year 2005-2006 to 36 students by 2008-2009. However, the number of teachers has continued to grow, partly contributing to lowering the student-teacher ratio, especially at lower secondary level (see Table 2.5).

Table 2.5: Basic indicators of primary and lower secondary education (percent)

2005-2006

2006-2007

2007-2008

2008-2009

Primary education

Proportion entering school at the right age

95.0

96.0

96.1

97.0

Proportion completing school

92.4

85.6

87.9

88.5

Students/teacher ratio

20.5

20.1

19.5

19.1

Teachers/class ratio

1.28

1.29

1.30

1.31

Students/class ratio

26.4

26.0

25.5

25.3

Lower secondary education

Proportion entering school at the right age

78.7

81.0

82.7

83.1

Proportion completing school

81.9

76.6

76.4

77.6

Students/teacher ratio

20.6

19.7

18.3

17.4

Teachers/class ratio

1.2

1.9

1.3

2.1

Students/class ratio

23.9

37.9

36.6

35.6

Source: Ministry of Education and Training.

Difficulties and challenges in education

Education quality remains low in comparison to the development demand of the country in the new era. While the scale of education development at all levels (educational, professional and vocational training) has better met the public need in recent years, educational quality is still limited. For example, in the academic year 2008-2009, about three percent of primary school­age children, roughly 200,000 children, do not attend school. Furthermore, it might be impossible to successfully increase the net enrolment rate in primary education to 99 percent by 2010, as in many localities such as Quang Nam, Quang Tri and Cao Bang, the rate of about 92 percent remains very low.

The primary school completion rate remains alarmingly low and differs significantly from region to region (see Table 2.6). Certain regions, such as the Nerthwest, Central Highlands and Mekong River Delta, had primary schpol completion rates barely reaching 80 percent, while other regions, including the North Central Coast, South Central Coast and Southeast, witnessed rates well over 90 percent.

In some provinces, such as Cao Bang, Soc Trang, Bac Lieu, Ha Giang, the primary education completion rate was even below 70 percent. This means that many school children had to retake classes or dropped out of school at a young age. The drop-out trend has become a worrying educational problem. By December 2007, the total number of drop-outs among lower secondary school students across the country was 63,729 equivalent to 1.1 percent of the total number of students at this level; the total number of drop-outs among upper secondary school students was 50,309 (a drop-out rate of l.66 percent).

Table 2.6: Primary school completion rate (percent)

2006-2007

2007-2008

2008-2009

WHOLE COUNTRY

85.6

87.9

88.5

Red River Delta

97.0

97.3

84.4

Northeast

82.3

84.8

87.8

Northwest

78.4

79.9

80.3

North Central Coast

90.5

92.9

92.8

South Central Coast

91.1

92.7

93.3

Central Highlands

78.4

79.6

80.4

Southeast

90.3

91.8

93.9

Mekong River Delta

75.0

79.7

80.8

Source: Ministry of Education and Training.

The proportion of children entering lower secondary schools at the right age has increased rather slowly in recent years, from 81 percent in the academic year 2006-2007 to 83 percent in 2008­2009. In particular, the rate in several provinces such as Ca Mau, Ha Giang, Lai Chau and Soc Trang was below 70 percent in 2008­2009. As a result, the target of increasing the proportion of children entering secondary school to 90 percent by 2010 is a real challenge, for the quality of education and students' standards are not easy to improve in the short term.

Even though universal primary education has met national, regional and provincial standards, several extremely disadvantaged communes still face problems(4). By December 30th 2007, 29 percent of 1,808 extremely disadvantaged communes had yet to meet the national standards for universal primary education. By regions, no province in the Central Highlands has achieved universal primary education for communes with difficulties while of the 11 provinces in the Northwest, only Lao Cai and Tuyen Quang have met this goal.

Illiteracy eradication for women and men under-40 by 2010 is also a hard-to-achieve target as the literacy rate for this age group was only 96 percent in 2008. Although this rate has gradually increased, it has been rather slow in recent years.

School facilities are insufficient and outdated. Although they have improved considerably in recent years, as of 2007, 11 percent of classrooms were in poor condition, especially those in remote areas. Libraries, laboratories, classrooms for specific subjects and teaching equipment are still inadequate and out of date, especially in universities.

The disparity in access to education among regions, between rural and urban areas, and between ethnic minorities and the majority population still exists. The rate of children entering school at the right age is still low in provinces such as Soc Trang and Bac Lieu. The literacy rate in the Northern mountainous areas and in ethnic minority regions is much lower than in the plains and among the majority Kinh ethnic group. The expenditure rate of households on their children is also lower in rural and mountainous areas.

GOAL 3: PROMOTE GENDER EQUALITY AND EMPOWER WOMEN

Achievements

Vietnam has comparatively high indicators of gender equality when compared with countries at a similar level in terms of development and income. According to the 2009 Human Development Report of the United Nations, Vietnam's Gender related Development Index (GDI) ranked 94th among 155 countries. The absolute value of the GDI has increased continuously during recent years: 0.668 in 1998, 0.689 in 2004, rand 0.723 in 2009. Also in this Report, Vietnam ranked 62nd among 109 countries in terms of Gender Empowerment Measure (GEM)(5).

Vietnam is closing the gender gap at a faster rate than almost any other country in Southeast Asia. Access to education is similar for both boys and girls. Women participate actively in socio-­economic activities. Vietnam ranked first among ASEAN countries in tenns of female representation in the National Assembly. Vietnam's attainment of gender equality in general education has been recognized by the United Nations Development Fund for Women (UNIFEM)(6).

Gender equality in education and training:

Vietnam has eliminated the gender gap in education. The percentage of female students has been rising continuously across all educational levels (see Table 3.1), especially at secondary and higher education levels.

The percentages of boys and girls from 6 to 14 years old enrolled in school (i.e. primary and secondary education) are similar (at around 94 percent) and have remained quite stable during recent years; any disparities between enrolment of boys and girls are virtually negligible.

Another gender equality achievement in access to education is the reduction of the gender gap in education among ethnic minorities. The rate of enrolment at primary and secondary school among ethnic minorities was the same for both boys and girls in 2008; the girls' enrolment rate was even slightly higher than that of the boys (see Chart 3.1).

Table 3.1: Percentage of female students at all educational levels

97-98

01-02

03-04

04-05

05-06

06-07

07-08

08-09

Primary

47.7

47.5

47.6

47.7

48.2

48.5

46.2

47.9

Lower secondary

47.0

47.5

47.8

47.9

48.1

48.3

48.8

48.5

Upper secondary

46.4

46.8

48.5

48.9

49.4

49.3

51.7

52.6

College

51.9

50.9

46.8

51.0

53.1

53.8

50.8

51.2

University

39.1

44.3

49.5

47.0

47.2

48.4

48.4

48.5

Source: Ministry of Education and Training.

Gender equality can also be seen in education quality. A number of social studies have identified that the care given by the family, school, and society towards boys and girls is similar. In 2008, average education expenditure per household was the same for both boys and girls. On average, each household spent approximately 1,879 thousand VND/year for a boy's education and 1,806 thousand VND/year for a girl's.

Gender equality in employment:

Equality in employment is a prerequisite to securing women's status. Among the new jobs created annually, women take up about 49 percent. By 2010, the number of women in the total labour force is expected to reach 49.4 percent, almost achieving the established target of 50 percent.

Table 3.2 indicates that women's participation in the labour force was 4 percentage points lower than that of men. The total number of working hours per year by women (1,453 hours) was almost the same a.s those by men (1,565 hours) in 2008. However, men's average annual earnings are considerably higher than women's precisely because men's working hours are higher than women's. Nonetheless, there was no significant difference between the average earnings per hour among men and women. In 2008, the average earnings per hour for men and women were 13.6 and 12.8 thousand VND respectively.

Table 3.2: Employment and earnings among the working population
(men 15-60 years of age, women 15-55 years of age)
 

Professions

2002

2004

2006

2008

Men

Women

Men

Women

Men

Women

Men

Women

Labour force participation rate (%)

94.5

91.7

93.6

89.7

92.7

89.7

92.6

88.6

Total working hours per year

1570

1519

1533

1493

1557

1496

1565

1453

Average earnings per year (1000 VND)

7056

6104

10697

9475

14368

12456

21394

18702

Average earnings per hour (1000 VND)

4.5

4.0

6.9

6.3

9.2

8.3

13.6

12.8

Source: General Statistics Office.

The gender structure in the main professions has improved. The percentage of women working as managers, professionals, secretaries and staff was equal that of men. However, women tend to be employed more frequently in agricultural and simple jobs. In contrast, the percentage of men occupying technical jobs was much higher than women. In 2008, the rate of highly skilled technical workers was 20 percent for men and less than 10 percent for women (see Table 3.3).

Table 3.2: Gender structure in the main profession (percent)

Professions

2002

2004

2006

2008

Men

Women

Men

Women

Men

Women

Men

Women

Managers, professionals, secretaries and staff

9.4

9.9

11.5

11.6

12.4

13.4

14.1

14.7

Agricultural labour

56.4

61.5

52.7

57.4

50.1

54.3

48.8

53.3

Technical labour

14.7

7.6

16.0

8.2

18.2

9.3

20.3

9.8

Unskill labour

19.5

21.0

19.9

22.9

19.3

23.0

16.9

22.2

Source: General Statistics Office.

Women are increasingly equal to men as self-nominated and nominated candidates for seats in the National Assembly and the People's Councils; and as leaders in political, social and professional organizations.

The rate of female officials in administrative agencies from district level to central level was 31.1 percent, of which women accounted for 18.4 percent of leaders. Women are becoming increasingly equal to men in terms of their opportunities to draft and enforce rules and regulations in agencies and organizations. Similarly, at the commune level, women constituted 16.27 percent of the total officials in charge. Women have, therefore, gained a greater say in socio-economic development at the local level.

The percentage of female participation in people's elected bodies has continually increased (Chart 3.2). Particularly at commune level, the percentage of women's representation in the People's Councils has increased from 16.1 percent to 19.5 percent over the two terms 1999-2004 and 2004-2009.

Women account for 25.8 percent of the deputies in the National Assembly for the 2007-2011 term (Chart 3.3). Improvements have also been made in terms of the educational level of female representatives in the National Assembly. The proportion of women deputies with university and higher education degrees increased from 30.3 percent in the 1992-1997 term to 44.9 percent in the 1997-2002 term, 50.2 percent in the 2002-2007 term and 59.1 percent in the 2007 -2011 term.

The Government of Viet Nam has paid great attention to the need to draft laws on the basis of a gender equality approach. The National Assembly adopted the Law on Gender Equality in 2006, creating the legal framework for the promotion of gender equality and the advancement of women. The Law on Domestic Violence Prevention and Control was issued in 2007 with a view to ensuring gender equality within the family. The equal rights of women in terms of property ownership and the use ofland was also reflected in the 2000 revised Law on Marriage and Family and the 2003 amended Land Law.

National strategies such as the Comprehensive Poverty Reduction and Growth Strategy, the National Strategy on Reproductive Health 2001-2010, the Education Development Strategy 2001-2010, the National Strategy for the Advancement of Women to 2010, and the National Target Programme of Poverty Reduction 2006-2010 all include reference to the need to promote gender equality in order to empower women and ensure women's rights. Gender mainstreaming represents a crucial requirement set out by the Government for several socio-economic programmes and policies.

Difficulties and challenges in gender equality

Although there is no gender gap in children's access to basic education, the enrolment rate of girls and female students at the higher levels of education tends to fall behind that of boys and male students, especially in the rural and remote areas because of the difficult socio-economic conditions. Gender disparities in education still prevail among the elderly. In 2008, the literacy rates of the population over 10 years old were 96 percent for men and 91 percent for women. However, among the over 50 year-old population, the disparity increased to 94 percent for men and 79 percent for women. Gender disparities in literacy rates remain particularly high among ethnic minorities. Accordingly, the literacy rates for over 50 year-old men and women were 77 percent and 49 percent, respectively. In 2008, the proportion of the over 20 year-old population with no educational degree was approximately 18 percent for men and 31 percent for women.

In employment, women face certain disadvantages compared with men. The percentage of women employed in simple jobs remains higher than that of men. According to results of the General Statistics Office's VHLSS, women spend twice as much time as men on household chores (calculated among those having a job outside the family), and this disparity remained unchanged throughout the 2002-2008 period.

Politically, the percentage of women involved in management and leadership at the highest level in the term 2007­-2011 dropped slightly compared with tbe previous term (2002-­2007). The percentage of women's representation in the National Assembly dropped from 27.3 percent (2002-2007) to 25.8 percent (2007-2011). The percentage of women holding ministerial and equivalent posts decreased from 12 percent (2002-2007) to 4.5 percent (2007-2011).

Domestic violence, mainly against women and children, remains a serious problem in Vietnam, particularly in rural, mountainous and remote areas. Among domestic violence cases, 90 percent of the victims are women; the remainder being mostly children and old people. In a survey conducted in 2006 on women and children in Vietnam, as many as 64 percent of women aged 15-49 resigned themselves to violent behaviour from their husbands. The rate was higher in rural areas (72 percent) than in urban areas (42 percent).

Women and child trafficking was first detected in Vietnam about 10 years ago, and has had serious consequences for the victims and their families. The situation has shown signs of worsening. From 1998 to 2007, more than 6,680 women and children were reported of being trafficked; over 21,000 were absent for a long time and are suspected of having being trafficked abroad. What is even more worrying is that these figures only reflect reported cases, and the actual figures may be much higher.

Gender bias means that privileges and respect tend to be reserved for men rather than for women in social and domestic activities. The rate of female householders remains very low, particularly among ethnic minorities. In 2008, the nationwide rate was 26 percent, yet among ethnic minorities the figure was only 12 percent. Moreover, female householders are often single women. According to the VHLSS 2008, about 62 percent of female householders were single women.

Perhaps even more significantly, this gender bias has led to the tendency among families to favour male children. With medical assistance, many couples have tried to give birth to baby boys rather than baby girls. According to a census conducted by the General Statistics Office in 2009, the ratio of newly born boys to girls was 111:100. This ratio surpassed the normal ratio of the country of 103:107. The impacts of such gender disparity will have serious social consequences in the future.

GOAL 4: REDUCE CHILD MORTALITY

Achievements

Reducing child mortality

Under-jive mortality rate (U5MR): The under-five mortality rate fell from 58%o in 1990 to 24.4%o in 2009 (expected to remain at 24%o in 2010). The established target is to reduce the rate to as low as 19.3 %o by 2015. As a result, the rate has been reduced by half by 2009.

Currently, the rate is equivalent to that of countries with income per capita 3 to 4 times higher than Vietnam's. Vietnam is reducing the rate of under-five mortality faster than the average for the Asia-Pacific region. The "Strategy for People's Health Care and Protection (2001-2010)" established targets for a reduction of under-five mortality to 36.0%0 by 2005 and 32.0%0 by 2010. Viet Nam has far exceeded these targets.

lnfant mortality rate (IMR): In the 1990-2009 period, the infant mortality rate declined from 44.4%o to 16%o, which was only 1.2%o higher than the target set for 2015. Thus, assuming progress is maintained, Vietnam is on track to meet the established target ahead of schedule. The dramatic decrease in the infant mortality rate has contributed significantly to the reduction of the under-five mortality rate. It should be noted that diseases are not the main cause of child mortality in Viet N am, as nearly 75 percent of deaths among children over one year old result from injuries, with drowning and traffic accidents being the two highest causes of child deaths recently.

Child nutrition:

The child underweight rate declined from 25.2 percent in 2005 to 21.2 percent in 2007 and 18.9 percent in 2009 (it is expected to fall to 18 percent in 2010). The national target for 2010 was to reduce underweight rate in under-fives to below 20 percent. Vietnam achieved a rate of 19.9 percent in 2008, two years ahead of the established target date.

According to the malnutrition classifications, most of the malnourished children under five years old suffer from Level I malnutrition (approximately 94 percent); the rate of children suffering from Level III malnutrition was very low. Certain provinces, such as those in the Red River Delta and Southeast regions, had no cases of under-five malnutrition. In 2007, the three provinces with the lowest rates of malnourished children were Hanoi (9.7 percent), DaNang (12.9 percent) and Ho Chi Minh City (7.8 percent); while the three provinces with the highest rates were Lai Chau (30 percent), Dak Lak (30.4 percent), and Dak Nong (31.9 percent). A three to four fold disparity exists between more developed provinces and less developed ones.

Child immunization:

In the period 2001-2010, the immunization rate for infants remained high, at over 90 percent. As a result, Vietnam has succeeded in sustaining the eradication of poliomyelitis (since 2000) and the elimination of neonatal tetanus, as well as significantly reducing the rate of children contracting dangerous infectious diseases through the Expanded Child Immunization Programme.

In particular, in this period, the Expanded Child Immunization Programme has achieved the basic objectives proposed in the 2006-­2010 Five-year Plan. About 82 percent of children under one have been fully immunized with seven types of vaccine; the rate for poliomyelitis, BCG and VGB vaccination being even higher (over 90 percent). Certain achievements in the preceding period, including the eradication of poliomyelitis and the elimination of neonatal tetanus, have been successfully sustained. Vietnam has gradually implemented a large scale Japanese B encephalitis vaccination programme for children from one to five years of age, as well as the typhoid and cholera vaccination programme for children in high risk areas. The rate of children contracting diphtheria and pertussis has been significantly -reduced (they are now respectively 6.8 and 4 times lower in 2009 than in 2001). A hib vaccine has been included in the Expanded Child Immunization Programme through the introduction of the DPT- VGB-Hib synthetic vaccine.

Compared to other countries in the region, particularly those with higher level of income per capita, the rate of infants contracting measles in Vietnam is relatively low and has continued to decrease(7).

Difficulties and challenges in child healthcare

Although the infant mortality rate has been reduced across the country, the pace has not been uniform in all regions (see Table 4.1). The main reason for this has been the disparities in socio­- economic development, which have led to big differences in living conditions, sanitation and the availability of healthcare, services, etc.

The child mortality rate in the mountainous and difficult areas and among poor households is 2- 3 times higher than that in the low land areas and among higher income households. Compared to the national average, the Northwest and Central Highlands have always had a higher infant mortality rate and the pace of reduction has been slower, while the more developed regions such as the Red River Delta and Southeast have a much lower infant mortality rate than the national average. Disparities between the regions have been reduced somewhat, but still remain. For instance, the gap between the Northwest and Southeast has reduced from three times in 2005 (33.9%0 compared to 10.6%0) to almost 2.5 times in 2008 (21 %0 compared to 8%0), but still remains very high.

Table 4.1: Infant mortality by region (1/1000)

2005

2006

2007

2008

WHOLE COUNTRY

17.82

16.00

16.00

15.00

Red River Delta

11.50

11.00

10.00

11.00

Northeast

23.90

24.00

22.00

21.00

Northwest

33.90

30.00

29.00

21.00

North Central Coast

24.90

22.00

20.00

16.00

South Central Coast

18.20

18.00

17.00

16.00

Central Highlands

28.80

28.00

27.00

23.00

Southeast

10.60

8.00

10,00

8.00

Mekong River Delta

14.70

11.00

11,00

11.00

Source: General Statistics Office.

High infant mortality rates remain in certain provinces. In the 2005-2008 period, the highest IMR across the country was Kon Turn (62.6%o in 2005; 48%o in 2008); Ha Giang came second (55.8%o and 40.0%o, respectively); with Lai Chau third (44.0%o and 33.0%o, respectively). The IMRs in these provinces were 5-6 times higher than those in more developed cities and provinces such as Hanoi (7.9%o and 7.0%o), and 2-3 times higher than the national average (17.8%o and 15. 0%o respectively).

Child mortality rates vary across income groups and the differences have widened overtime (see Chart 4.3). Statistics from the 1992/93 and 2006 VHLSS show that child mortality declined in all income groups, but the rate was always lower in the high income groups than in the low income ones. Worryingly, the gap between child mortality rates for the poorest and richest groups has widened-from 31%o in 1993 (71%o compared to 40%o) to 39%o in 2006 (59%o compared to 20%o).

Regarding child nutrition, difficult regions like the Northwest and Central Highlands are those with the highest rates of child malnutrition, about 1.5 times higher than the national average. Provinces with less favourable economic conditions had higher rates of under-five malnutrition level Il and III (including both underweight and stunting malnutrition) than more developed cities and provinces. For example, Lai Chau (7.6 percent), Son La (5.9 percent) and Gia Lai (6.1 percent) had much higher rates than provinces in the Red River Delta and the Southeast, such as Bac Ninh (2.9 percent), Hai Duong (1.2 percent), Ninh Thuan (3 percent), and Binh Phuoc (2.6 percent).

Of increasing concern recently has been the overweight and obesity rate for those under-five. The current rate is 6.2 times higher than it was in 2000 and has increased in both rural and urban areas. Indeed, despite having emerged quite recently, child overweight and obesity is increasing even faster in rural areas than in urban areas.

GOAL 5: IMPROVE MATERNAL HEALTH

Achievements

Maternal mortality: Maternal mortality decreased from 233/100,000 live births in 1990 to 80/100,000 live births in 2005 and 69/100,000 live births in 2009, and is expected to reduce to 68/100,000 live births by 2010 (Chart 5.1). However, throughout the 2006-2009 period, the maternal mortality rate remained unchanged. Thus in order to accomplish this goal, as well as the goal of reducing maternal mortality to 58.3/100,000 live births by 2015, Vietnam needs to put even more effort into implementing its policies and programmes.

Prenatal check-ups and births attended by trained health workers: Women's reproductive health has improved as the number of pregnant women receiving more than three prenatal check-ups has increased over recent years. The national average reached 86.4 percent in 2008 and was even higher in some region, such as the Red River Delta (98.5 percent), the South Central Coast (94.5 percent) and the Southeast (94.5 percent). This reflected improvements in the quality of prenatal care in recent years. It was also an important factor contributing to safer deliveries, as well as the reduction of obstetrical complications, maternal mortality and neonatal deaths.

The high and sustained number of women receiving more than 3 prenatal check-ups during pregnancy and having births attended by trained health workers is one of the main reasons for the reduction of maternal mortality. The national average was 95 percent, of which two regions, the Red River Delta and the Mekong River Delta, had 100 percent.

Table 5.1: Birth attended by trained health workers (percent)

2005

2006

2007

2008

WHOLE COUNTRY

92.71

94.30

94.8

94.8

Red River Delta

99.92

100

100

100

Northeast

88.95

91.40

91.6

92.1

Northwest

63.20

87.20

79.7

79.2

North Central Coast

90.97

97.40

98.2

98.6

South Central Coast

96.00

96.9

98

97.9

Central Highlands

85.25

86.8

91.3

91.6

Southeast

99.14

99.2

99.4

99.4

Mekong River Delta

97.97

99.8

99.9

100

Source: Ministry of Health

Pregnant women receiving two doses of tetanus vaccination: Nationwide, almost 95 percent of pregnant women received two doses of tetanus vaccination. Recently, this figure has increased in the Central Highlands (to almost 93 percent) and decreased in the Northwest (to as low as 80 percent).

Table 5.2: Pregnant women receiving two doses of tetanus vaccination (percent)

2005

2006

2007

2008

WHOLE COUNTRY

92.71

94.6

94.0

94.5

Red River Delta

99.92

99.8

99.6

99.8

Northeast

88.95

91.7

91.5

93.5

Northwest

63.20

87.2

85.1

79.6

North Central Coast

90.97

98.4

98.0

97.7

South Central Coast

96.00

98.4

98.2

98.5

Central Highlands

85.25

88.5

86.8

92.8

Southeast

99.14

96.3

97.0

97.0

Mekong River Delta

97.97

96.3

96.2

97.0

Source: Ministry of Health

Difficulties and challenges in maternal healthcare

Geographical factors, the educational level of mothers and traditional practices in mountainous, remote and disadvantaged rural areas constitute major obstacles to the reduction of maternal mortality. In addition, the ability to access reproductive healthcare services may also be a cause affecting differences in the maternal mortality rate.

The reproductive healthcare service network, though strengthened, remains inefficient in remote and mountainous areas. Many reproductive healthcare centres at provincial level have gone into decline. As for reproductive healthcare at the district level, the infrastructure is not yet fully in place. In addition to unfavourable working conditions, at all levels insufficient numbers of medical staff are available. As for the staff structure, the ratio of university educated staff to primary and intermediate level staff remains low.

GOAL 6: COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES

Achievements

HIV prevention: Vietnam has essentially restrained the HIV growth rate to under 0.3 percent of the National Strategy against HIV/AIDS in 2004-2010 period. The current HIV prevalence is estimated to be 0.28 percent (all ages). However, according to the estimated report and forecast on HIV / AIDS in 2007-2010 period in Vietnam, the HIV prevalence in adult (from 15 to 49 years old) was 0.44 percent in 2010 and could increase to 0.47 percent in late 2012. Therefore, the intervention programmes need to be scaled up.

By December 31, 2009 HIV-positive cases had been reported in 70.51 percent of communes/wards, 97.53 percent of districts and 100 percent of provinces. The total number of people living with HIV was 160,019, the total number of patients with AIDS­related illness was 35,603 and the number of deaths caused by AIDS was 44,540. Nationwide, HIV prevalence is 254,000 in 2010 and is estimated to increase to 280,000 in 2012. Likewise, nationwide HIV prevalence is 187 per 100,000 people but this ratio varies among localities.

HIV cases have been reported nationwide in all provinces/cities, and communes The HIV epidemic in Viet Nam is still in a concentrated stage, with the highest HIV prevalence found in specific populations namely injecting drug users (IDU), female sex workers (FSW) and men who have sex with men (MSM). The risk of infection and outbreak remain quite high, particularly in some provinces ofthe Northwest such as Dien Bien and Son La and some big cities. HIV prevalence among women attending antenatal clinics and among male military recruits has begun decreasing and continues to be observed at low levels (Table 6.1).

Table 6.1: HIV prevalence among key groups at higher risk of HIV exposure (percent)

2001

2005

2006

2007

2008

2009

Injecting drug users

29.4

25.6

23.1

20.2

20.3

18.4

Female sex workers

4.7

3.5

4.2

3.9

3.1

3.2

STI patients

2.3

2.5

2.2

1.9

2.1

1.7

Pregnant women

0.30

0.35

0.37

0.34

0.27

0.28

Male military recruits

0.93

0.32

0.16

0.21

0.28

0.15

Source: Ministry of Health

In the past five years, the reported number of people contracting HIV through unsafe sex showed a worrying upward trend, from 12 percent in 2004 to 27 percent in 2008 and 29 percent in 2009. Although the number of males having sexual intercourse with female sex workers is low, this group could put other vulnerable groups at risk, having a dramatic effect on the HIV situation in Vietnam.

HIV incidence remains mainly within the 20-39 age group, accounting for 80 percent of total cases. Of these, the number of HIV-infected in the 20-29 age group decreased from 52.7 percent in 2006 to 45.4 percent in 2009 while those of the 30-39 age group increased from 30 percent to 39.7 percent. Moreover, males also made up the majority of reported cases (73 .2 percent) in 2009.

The ratio of men and women being infected by HIV is estimated to reduce gradually reduce to 2.5 men : 1 woman by 2012. This change reflects the growing risk of intimate partner, transmission from men who have contracted HIV through high­risk behaviors (unsafe drug injection and unsafe sex work) to their spouses or regular sexual partners. Nevertheless, men will continue to account for the majority of people living with HIV and new HIV infection.

Vietnam has been actively implementing various activities and measures to prevent HIVsuch as the adoption and active implementation ofthe National Strategy on HIV / AIDS Prevention and Control in Vietnam by 2010 and Vision Towards 2020, with specific steps and an action plan to calling for interdisciplinary participation for HIV / AIDS prevention; The Law on the Prevention against the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV / AIDS) protects the rights of people living with HIY. Other legal instruments and policies have been amended and ratified to create a stronger and more consistent legal framework for HIV prevention.

Vietnam has achieved good initial results in HIV prevention. However, the decrease in the HIV prevalence has only appeared for two years, which cannot be considered sustainable. Vietnam will face number of changes in the coming years in ensuring a sustainable HIV prevention, treatment and care response.

Malaria: During the past 15 years, the number of malaria patients in Vietnam has decreased by 83 percent (from 1.1 million cases to less than 100,000 cases). Many provinces have reported no cases of malaria in recent years. According to the World Health Organization, Vietnam has successfully controlled the incidence of malaria.

Malaria infections and mortality decreased over the 2000-2009 period. In 2000, the number of malaria patients was 293,000 and there were 71 deaths. In 2009, the number of malaria patients had dropped to 60,867 cases (of which 826 were children below 5 years old and 62 were pregnant women), a 79.7 percent decrease from 2000, and 27 deaths.

The Central Coast, Central Highlands and Southeast regions consistently had the highest rates of malaria infections and mortality.

Since 2000, every year 10 to 12 million people in malaria­plagued areas have been protected by free anti-mosquito insecticides, of which, from 1.2 to 2 million people were protected with chemical sprays and 9.5 to 10 million with insecticide-treated mosquito nets. According to 2006 surveys, some 94.5 percent of children from 0 to 56 months sleep under mosquito nets. The figures for urban, rural and ethnic minority areas were 88.5 percent, 96.4 percent and 91.8 percent respectively. From 1 - 2 million doses/year of malaria medicines were provided for free. The number of children from 0 to 59 months receiving appropriate malaria treatments within 24 hours of symptoms being detected was 80 percent.

Tuberculosis: Vietnam ranked 12 out of 22 countries in the world with the most tuberculosis patients and is the third in the region, following China and the Philippines. In the 2005-2008 period, the number of detected tuberculosis cases increased year on year while the number of tuberculosis­ related deaths declined, albeit at a modest rate. In 2009, however, the number of cases declined by 500 compared with 2008. Specifically, the ratio of new incidences of AFB positive pulmonary tuberculosis was 62.7/100,000 people; detected cases in all forms of tuberculosis was 116.2/100,000 people. Of these, the rate of new incidences of AFB positive pulmonary tuberculosis has declined over the years, from 64.2/100,000 in 2007 to 62.4/100,000 in 2008 and to 61.7/100,000 in 2009. Tuberculosis infection and mortality are still concentrated mainly in Southern areas, respectively accounting for 52.7 percent and 64.5 percent of the national figures. The mortality to infection rates in Southern provinces was 2.1 percent, 1.6 times higher than in Central and Northern provinces (1.3 percent).

Vietnam has implemented various active and effective measures such as the enhancement, expansion and integration of public healthcare services in communities of mountainous districts, the expansion of tuberculosis prevention activities to special targets, the development of tuberculosis prevention programmes for the poor, temporary-resident and homeless groups, as well as the development and implementation of public and private healthcare partnerships. Moreover, the National Tuberculosis Prevention Programme also organized monitoring activities to support tuberculosis prevention at all levels in maintaining the quality and timely discovery and settlement of issues arising in the course of Programme implementation.

Difficulties and challenges in prevention of HIV/AIDS, malaria and other diseases

The developments in the legal and policy environment provided a powerful framework for the implementation of the national HIV response; however there are also a number of overlapping policy and regulatory documents and sets of measures. Despite provisions in the Law on HIV enabling greater access to prevention services for key populations at higher risk, Vietnam still faces considerable barriers in establishing and scaling-up effective interventions such as Needle & Syringe Program (NSP) and Condom Use Programme (CUP) at the local level. In addition, despite amendments to the Law on Drugs inconsistencies remain between public security measures to control drug use and sex work and public health measures to reach the populations engaged in those activities.

There has been progress in scaling up prevention, treatment and care services but sustained efforts are needed to ensure key populations at higher risk, namely injecting drug users (IDUs), sex workers and men who have sex with men (MSM), have sufficient access. There is also a lack of targeted interventions for female IDUs and the primary sexual partners of people living with HIV and IDUs. Sustained efforts are needed to fill these gaps in the national HIV response. Moreover, HIV prevention, treatment, care and support services need to be established in prisons, and in Medical - Education - Social Labour Centres. At present, these services are not almost exited or very limited.

Limitations in the quantity and quality of human resources inhibit the expansion of best practices at both the provincial and district level. HIV programs have limited incentives to attract and retain competent staff and the rapid turnover of staff creates a cycle of limited technical capacity. In addition, the stigmatization of HIV is a disincentive for those working in the sector. These challenges are not limited to the health sector only; some of the other ministries involved in the HIV response are also affected.

Malaria prevention in Vietnam continues to face certain challenges. The number of people residing in malaria-plagued areas remains high (24.2 million people in 2009, accounting for 27.6 percent of the population), concentrated mainly in forests, ethnic minority, remote and border areas. The movement of the population between areas not affected by malaria, areas mildly affected and severely affected is high and uncontrollable. This may cause instability in malaria prevention and risks of malaria outbreaks in both departure and destination locations. Healthcare staff in forests, villages and remote areas are still lacking in numbers, expertise, and funding.

Regarding tuberculosis, human resources, experience and facilities in treating multi-drug resistant tuberculosis are insufficient at all levels, especially the district level. The rampant circulation of anti-tuberculosis drugs on the market and the uncontrolled activities of private healthcare facilities have exacerbated the multi-drug resistant tuberculosis situation.

Coordination mechanisms between hospitals and local clinics, support activities from the locality and participation by civil society organizations are limited and often ineffective. Moreover, cooperation between the Tuberculosis Prevention Programme and the HIV / AIDS Prevention Programme is limited.

GOAL 7: ENSURE ENVIRONMENTAL SUSTAINABILlTY

Achievements

Mainstreaming principles of sustainable development into national policies and development programmes: In the past 10 years, environmental protection and sustainable development institutions and regimes have been established and goals incorporated into national policies and development programmes. Policy and legal frameworks on environment protection have been enacted fairly simultaneously and continually reviewed and amended in accordance with new circumstances. Significant laws on resources and environment have been passed. The Strategic Orientation for Sustainable Development in Vietnam (Agenda 21) was ratified by the Government in August 2004. This sets out the basic principles arid overall orientation for sustainable development.

Vietnam is actively implementing Agenda 21 (directing a sustainable development strategy) to realize the goal of ensuring environmental sustainability. The country has made certain achievements in sustainable development: promoting new forestation; enhancing the quality of forest coverage; better utilizing and effectively exploiting natural resources; preventing environmental pollution and degradation and dealing with environmental incidents; restoring and improving the ecological environment; and reversing the trend of declining environmental resources. Spending in the environment sector has improved. Since 2007, Government's environmental expenditure accounts for 1 percent of the total national budget. Policies on diversifying investments in environmental protection and improvement have achieved initial success. Policies to support enterprises in environmental protection have gradually taken effect. Many enterprises invested in new technologies and developed waste processing systems to help improve the environment.

Halting degradation of natural resources and environment: Thanks to efforts in protection, restoration and replanting, forest coverage increased from 27.8 percent in 1990 to 33.2 percent in 2000 and approximately 40 percent in 2010. Currently, Vietnam has 128 nature reserves with a total area of more than 2.5 million hectares, a 28 percent increase in area prior to the accession to the Convention on Biodiversity in 1994. The total area of nature reserves accounts for some 7.5 percent of Vietnam's territory.

Provision of safe drinking water and basic sanitation: By the end of the 1990s the rate of rural population with access to safe drinking water was relatively low, approximately 30 percent. In 2008, 89.4 percent of the population had access to clean water; approximately 63 percent of rural households had sanitary toilets; about 80 percent of schools, 82 percent of clinics, and 72 percent of ward centres had sanitary water systems and toilets. Regions with difficult water source conditions such as mountainous areas and high-saline plains have been given priority in investments.

Improvement of people 's living conditions: Viet Nam has continued to implement activities to eradicate temporary shelters (slum conditions) for the poor and provided material or financial assistance for people living in poor and extremely difficult areas to improve their homes. Several urban areas have initiated re-planning or removal of areas with temporary shelters that lacked basic sanitary conditions, or relocated people living on boats or along irrigation canals. arger cities have planned programmes to build houses for people of low incomes. Moreover, housing assistance for the poor and vulnerable has become a social movement for organizations, enterprises and communities. The Fund for the Poor - established by the Fatherland Front in 2000 - has called for donors and already helped build and repair 889,000 homes by 2009. The Housing and Population Census on April 1 st, 2009 showed that permanent dwellings accounted for 46.3 percent of total households, semi-permanent 37.9 percent, non-permanent 8.0 percent and crude 7.8 percent. Compared with 10 years previous, non-permanent and temporary shelters have decreased from 36.8 percent to 15.8 percent. This shows that efforts to improve housing for the poor have achieved some positive results.

Difficulties and challenges in ensuring environment sustainability

Nonetheless, environmental protection still faces limitations. Natural resources are still being over-exploited and ineffectively utilized. Many resources are not properly protected and are facing degradation or destruction. Several environmental protection targets set out in the 5-year and annual plans have not been achieved. Furthermore, Vietnam is among the countries most likely to be adversely affected by global climate change and sea­level rises and frequently suffers from natural disasters. Therefore, ensuring environmental sustainability is one of Vietnam's biggest challenges, which will require even greater efforts in the future.

GOAL 8: DEVELOP A GLOBAL PARTNERSHIP FOR DEVELOPMENT

Vietnam has made great strides in developing a global partnership for development. It successfully carried out its role as a non-permanent member of the United Nations Security Council (2008-2009) and is currently acting as Chair of ASEAN in 2010. It has implemented its World Trade Organization (WTO) accession commitments as well as other trade liberalization and investment protection commitments. Efforts to develop a global partnership have helped Vietnam to mobilize foreign investment capital (FDI) and Official Development Assistance (ODA), enabling the opportunities presented by trade liberalization and international markets to further promote economic growth and poverty reduction.

Some three years after WTO accession, Vietnam's competitiveness has improved but progress has been slow. There have been no significant changes in export structure, while the trade deficit is becoming more of a concern. The future challenge for Vietnam may be the shifting trend of ODA, where long-term and preferential loans will be replaced by an increasing number of less preferential loans, which requires the country to utilize ODA in a more efficient manner. In addition, keeping medicine prices affordable is also another big challenge facing Vietnam and its public in the near future./.

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* This is a sumary of the Millenium Development Goals 2010 National Report "Vietnam 2/3 of the way achieving the Millenium Development Goans and towards 2015". The report was presented to the UN Summit in September 2010.

(1) The poverty rate as used in this report is the proportion ofthe population whose per capita expenditure is below the poverty line (by international standards). The food poverty lines applied in 1993,1998,2002,2004,2006 and 2008 were 750, 1287, 1382, 1500, 1915 and 2607 thousand VND per capita per year respectively, which are the equivalent sufficient expenditure for 2,100 Kcl/person/day offood. The poverty lines applied for 1993, 1998,2002, 2004, 2006 and 2008 were 1160, 1790, 1917, 2077, 2560, and 3358 thousand VND per capita per year respectively, which are the equivalent sufficient expenditure for 2,100 Kcl/person/day of food plus certain basic non-food expenditure like housing and clothing.

(2) The higher the poverty gap index the greater the difference between the poverty line and the average consumption rate of the poor.

(3) According to Vietnam's national standards, communes, wards and towns can be recognized as achieving universal primary education if more than 80 percent of 14-year-old children have completed the primary curriculum. For mountainous and difficult areas, the standard is over 70 percent. Districts and provinces must have more than 90 percent oflocal facilities and institutions recognized as reaching the standards of universal primary education. For mountainous and difficult areas, the standard is over 80 percent.

(4) According to the criteria set out in Decision No. 1 64/2006/QD- TTg dated 11 July 2006 by the Prime Minister approving the list of the extremely disadvantaged communes, borderline communes to be included in the investment priority list of Programme 135 phase II; and Decision No.113/2007/QD-TTg dated 20th July 2007 by the Prime Minister including more communes, hamlets and villages in the investment list of Programme 135 phase II and the coastal, tidar and island communes to be included in the investment list of the NTP for Poverty Reduction period 2006-2010.

(5) The GEM indicator for 2007 was 0.561, ranking 52nd among 93 countries.

(6) At the 2008 Global Summit of Women, international delegates recognized Vietnam's achievements in promoting gender equality and acknowledged Vietnam as a country with a high rate of female participation in socio-economic activities. In the 2007 Global Monitoring Report of the World Bank (WB) and the International Monetary Fund (IMF), Vietnam was noted for its remarkable achievements in gender equality in recent years.

(7) According to a World Health Organization report in 2009.
 
 
 
 
Source: The Vietnam’s Socio-Economic Development Review - No.63, September 2010
 
VietNam Government