Nguyen Thi Thu Hang, Policy Coordinator, Young Lives Vietnam (Center for Analysis and Forecasting)
Viewed globally, Vietnam has made good progress in terms of meeting the MDGs. There have been significant successes in poverty reduction and in the universalization of primary education, but a lot remains to be done, as pointed out in the Viet Nam 2014 Multiple Indicator Cluster Survey final report (MICS 2014), the survey on the situation of women and children, which was launched in September in Hanoi. The MICs study gives important insights into children’s wellbeing in Vietnam, and what policy challenges remain. This blog summarises some key findings, drawing on the report and executive summary.
The MICS 2014 was conducted by the Viet Nam General Statistics Office, in collaboration with UNICEF. It was perfect timing as the report was presented at the beginning of a new school year for Vietnamese children, sending important findings and recommendations to policymakers and stakeholders on child protection and development. The report also provides evidence for evaluation of the MDGs as the year – and the MDGs themselves- comes to an end, and the Sustainable Development Goals (SDGs) begin.
Overall, Vietnam has made good progress in many aspects of child development and protection such as vaccination, availability of learning materials, secondary school attendance ratio. But a number of indicators show a stalling of progress particularly in the under-five mortality rate, child labour, early marriage rates among women aged 15-19, and primary school completion rate.
Let’s have a closer look at the findings:
Many have praised Vietnam’s progress in meeting the MDGs. In fact, Vietnam met the MDGs of reducing by two-thirds, between 1990 and 2015, the under-five mortality rate. In the latest data out of 1,000 live births, 20 children are dying. While since 1990 this is a significant improvement, there is little difference recorded over the last 10 years. Of these 20 deaths, 12 were in the first month of life.
It is striking to see the inequalities that exist between ethnic and economic groups of the population. While the rate of neonatal mortality rate is 8 per 1,000 live births for the ethnic majority, the corresponding rate for ethnic minority children is almost 4 times higher (29). The inequality is also severe across income groups: for neonatals 19 per 1,000 of the poorest group as compared to 7 out of 1,000 children born of the 60% wealthiest group. Not surprisingly, the gap is also clearly visible between rural and urban areas. Reinvigorating efforts to reduce child mortality, by focusing on those at greatest risk, needs to be a priority for the SDGs.
Breastfeeding and early nutrition
There is now huge public awareness of the importance of breastfeeding for early child development. While over 96% of children have been breastfed, the MICS report highlighted that only 24% of babies under 6 months were exclusively breastfed, with water-based feeding liquids frequently used.
Information is also provided on feeding for children aged 6-23 months, with concerns raised that only 59% of children received a diet of sufficient frequency and diversity, with rates lowest for ethnic minorities and the poorest children. This leaves us to wonder the reasons behind such results, and what might be done to improve early feeding.
We see very good advances in children’s vaccination levels between 2011 and 2014. The 2014 results show that the fully vaccinated rate of children aged 1-2 years was 76 % and 80% for children aged 2-3 years. However, we are concerned with the results regarding the protection of ethnic minority children: only 90% of children from ethnic minorities aged 1-2 years received the BCG injection (compared to the 98 % national average) while only 44% of ethnic minority children aged 1-2 years were vaccinated against hepatitis B (compared to the 78.5 % national average).
Diarrhoeal Disease Control
Worldwide, diarrhoea is a serious risk factor for young children, linked with undernutrition and with preventative mortality of many children under five. 8.6% of young children in Vietnam were reported to have had diarrhoea in the two weeks preceding the survey, but this rose to 18.5% for children from ethnic minorities. How parents seek remedy in diarrhoea cases raises some concerns. Less than half seek remedy from health facilities, public or private (almost 44% go to private facilities and over 35% go to public hospitals/health stations). Quite a high percentage, almost 25% seek remedy directly from a pharmacy, without seeking a doctor’s advice. Over 30% seek advice from family and friends or do not seek remedy at all.
While most education indicators have improved in 2014, the primary completion rate has fallen from almost 100% in 2011 to almost 96% in 2014. This suggests that Government needs to pay attention on the issue of primary completion and good transitions to secondary schools.
Despite high rates of pre-school enrolment there are some regional disparities, particularly relating to children in the Mekong River Delta. In the Red River delta, over 85% of children aged 3-5 years attend kindergarten, while less than 40% of children in the Mekong River delta do so. In this region, people live scattered along densely network of distributaries. Many parents are unable to take their children to kindergarten because many of the villages are often accessible only by rivers and canals rather than by road. Given the critical importance of the earliest years as formative for later development, there are powerful arguments to increase interventions for young children in order to overcome these issues of inaccessibility.
The majority of primary school aged children attended school but, as our research shows, the attendance rate decreases with higher levels of education and disparities widen. Of the 90% who completed lower secondary school, only 70% are ethnic minorities. As other recent Young Lives data highlights at older ages more girls are enrolled in school than boys.
The MICs also provides information on important aspects of child protection. Out of 10 children 7 have experienced psychological aggression or physical punishment during the month prior to the survey. Early marriage rates are still high – one in ten young woman, aged between 15 and 19, is married and this rate has increased by 2% since 2011. The report also reveals more than 16% of children in Vietnam experience child labour.
The MICS is a very important source of data, not only for Vietnam but for international researchers and policymakers. The results point out areas that require further intervention from government and communities. We see the importance of reducing the inequalities that start from a very early age and that continue to affect a child’s education and his or her future. But right now, the priority should be reducing mortality of under-five children and improving school progression for disadvantaged children.
Go here for the MICS 2014 report and executive summary