Vietnam and the MDGs; Progress but on-going disparities

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:

Infant mortality
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).

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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.

Child protection
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


Where are the children? The challenge of tracking in a longitudinal study of children

Anne Solon is the data manager for Young Lives. Her role involves working with our research partners to coordinate the complete survey cycle and coordinating the processes of survey design, piloting, training of field staff, data collection, data entry and data management. This is the first in a series of blogs about data management and first appeared on the UK Data Service DataImpact Blog.

Anne cropped_low-resI’m in an odd position of having to ask myself this question both personally and professionally. At home, I wonder why my two children are so quiet and where they are in the house. When they are at the childminder’s I wonder if they are at the park, a play group or if they got dropped off at school okay.
At work, the concern is slightly different with the children in the Young Lives project. Over the years we have found them (or not found them) in numerous locations and circumstances. It’s eye opening to relate their circumstances to that of your own children. I can easily predict where my children will be, or are likely to be, over the next 18 years. Their home address is, for all intents and purposes, ‘settled’.  What about the 12,000 Young Lives children and families spread out over Ethiopia, India, Vietnam and Peru?

Why we track?
Young Lives is following 12,000 children over 15 years. We have completed 4 rounds of data collection and are shortly beginning our 5th round. This means on average there would be 3 years between survey rounds where we would not normally be in contact with our children and families. By introducing a tracking visit in between survey rounds we can maintain contact with the families and children over a shorter period of time. This increased level of contact provides multiple benefits:
– Maintaining and strengthening our relationships with the Young Lives children and families
– Reduce time during the fieldwork locating children and households
– Easier to maintain contact with persons who do short but frequent movements
– Provides an opportunity to feedback about the project and ensure our respondents are happy to continue to participate

How we track?
Our countries are varied in size, demography, and economic status and no one approach for locating the children between rounds works universally across the four countries. Combine this with children who are growing older and becoming young adults thus migrating on their own and more likely not to have their own permanent ‘home address’ we have to be adaptable and quick thinking. Young Lives first visited these families in 2002 when the two cohorts of children were 1 and 8 yrs. old. Where are they now 13 years later at the ages of 14 and 21 yrs.? And can we predict where they’ll be in another 3 years?

In order to track our children we have implemented a system where we visit them at their last known address approximately every 1.5 to 2 years either on what’s known as a tracking visit or to conduct the main survey work. We ask questions confirming their current address, known contacts in the area (family/friends), if they expect to be moving in the foreseeable future and if so, where they would likely move and why. We have managed to keep our attrition rates across all countries and both cohorts below 6% but it hasn’t been easy or cheap. This is one of Young Lives mostly costly activities but at the same time it’s most vital.

Our ability to successfully keep our attrition rates low is down to the country teams. In each country we have a Principal Investigator who, among many other responsibilities, is charged with cohort maintenance. They manage a well-trained and dedicated team of fieldworkers who travel by plane, car, bus, tuk tuk, cart, boat, horse, donkey, and on foot to track our children across their respective countries. They visit family and friends of children who they cannot track in an effort to get a location and/or contact information for the child. They use mobile phones and emails as a mean of communication where possible.


On the back end each country has a data manager who collates, enters and manages this data. They update any contact information and keep records of new addresses of the children. They code the children according to movement history across sites and across rounds in order to predict movement of children in the future.

Can we predict their locations?
In addition to the above, the country teams must predict situations our children will be in at the age we are planning to visit them. For instance, will a large portion of our female ‘children’ be married at 21yrs? And will their in-laws continue to support their involvement in Young Lives? Will the boys be enrolled in national service and if so, can we still visit them during data collection? Do they migrate for work? Is this work full time or seasonal? Are they at school? Did they move with their families, alone or with friends?

So, not only do we want to know what their future holds, but where that future takes them.

More information on how we manage and plan our field work and on our tracking processes.


The Young Lives datasets from the first three rounds of household and child surveys are publicly archived and available to download from the UK Data Service, along with the documentation and questionnaires for each survey round. We completed fieldwork for the Round 4 survey in early 2014 and have released preliminary findings. Following data cleaning, we expect to archive the data in early 2016. The UK Data Service has developed a Study Guide for Young Lives which acts as an entry point for the data.

Will the SDGs advance progress for disadvantaged children?

by Paul Dornan, Senior Policy Officer, Young Lives

Paul_web comment

The end of the week sees the meeting to agree the Sustainable Development Goals. Don’t expect too many surprises; the document to be signed off has already been published. There are 17 proposed goals, with 169 targets. The good news is the impressive scope; the bad news is the impressive scope. The proposed goals cover new and important areas, and adopt new approaches, but the sheer number risks people picking and choosing between myriad targets. Pinning accountability for delivery, including through the development of national plans, is going to be the challenge.

So watch out for press coverage, and an overheated blogosphere over the next few days.  Over the next few months, and indeed years, many discussions will flesh out what the SDGs will really mean in practice. With that implementation question in mind, a couple of reflections;

First, the context is changing. Consider a couple of points;
• Since 2001 the number of low income countries has halved, with so-called ‘graduation’ to middle income country status. With that rise in wealth has come concern that countries get richer and the people don’t. Inequality within countries, not just between them, is an increasing concern
• Overseas aid is falling as a share of external finance to poorer countries. Overseas Development Assistance (ODA) is worth about a third the value of remittances. Of course ODA remains important for many Ministries in poor countries, but while the MDGs aimed to align donor efforts, SDG success relies on national ownership
•  school enrolment at primary level in 1999 was 84% and by 2015 it had reached 93% . However, one in six children in low and middle income countries were not expected to reach the last primary grade. The policy problem is not simply one of access to interventions, it is of the effectiveness of systems.

Both the policies that the SDGs promote, and the accountability framework implied, need to reflect these changing realities. this will mean effective national ownership, moving beyond ‘access’ and towards more effective policies for children.

Second, one of the real advances over the Millennium Development Goals has been the recognition of the need for greater data disaggregation. Average progress often masks inequities. Proposed data disaggregation takes a number of forms – there has been a great recognition in the SDG debates about gender, understanding differences between women and men/ girls and boys. Some of that emphasis was there in the MDGs too, but it’s been given greater importance in the SDGs. There is a recognition that age matters and poverty measures are intended to be broken down by age and gender;

Goal 1, target 1 .2 “By 2030, reduce at least by half the proportion of men, women and children of all ages living in poverty in all its dimensions according to national definitions”

So it is not only a positive advance that we should begin to know more about child poverty from these SDG related measures, but that it will become more obvious that children are over represented among the poorest people.

Third, while there have been human development gains in the past decades, big problems remain. More young children are surviving to 5 years, with child mortality falling from 90 to 43 deaths per 1,000 live births between 1990 and 2015, but that global rate is still more than 10 times higher than the equivalent rate in the UK of 4 per 1,000 live births. And while building new services creates opportunities it hasn’t always ensured quality, nor done so with equity. There are big challenges to grapple with to convert the policy efforts towards increased enrolment, and more basic infrastructure towards better child wellbeing. Key messages from our longitudinal research on that front: invest early, and sustain interventions, address the multidimensional disadvantage which otherwise undermines children’s development. One key innovation in recent years has extended access to social protection systems, which help households manage risk in many countries. Ensuring good coverage for households with children is foundational to supporting the efforts of other policy interventions.

413A2421_low-res_girls playing clapping games3

Fourth, should be the role of science in supporting better policy delivery for children? Research not only helps understand the world, but it helps policy makers formulate better responses. Data collection is expensive, but hardly as expensive as ineffective schools or other social policies.

So how can research help? The potential of evidence based policy has been recognised in the SDGs, with a call for a ‘data revolution’ to support better policy by more and better data to support policy makers and to encourage accountability. But data alone won’t necessarily empower citizens or decision makers unless capacity exists within ministries and elsewhere to use that data effectively: evidence based policy requires more than evidence alone.

So, what would the SDGs have to do to create progress for poor children? From the experience of  Young Lives, I think the following will be critical;


• Create a climate for greater attention to be given to children, with a particular emphasis on the earliest phase of life when more happens in children’s lives than is really dealt with by policy.
• Encourage systems building of interventions for children. Since children’s lives are multidimensional, so too ought to be the systems which support them. Early childhood development and good social protection services which support wider health and education objectives both provide important models.
• Research can help inform options, but policy choices are political, not just technical.

This brings me back to square one;  for the SDGs to advance progress for children, accountability will be the key.

Investing in ECD isn’t just about social and economic growth

by Professor Martin Woodhead, Associate Research Director, Young Lives

Martin cropped_low-res

This week was the biennial UKFIET International Conference on Education and Development. This year’s theme was “Learning for Sustainable Futures – Making the Connections”, in perfect timing in the lead-up to the endorsing of the SDGs next week. The intention of the conference theme was to make us reflect on the implications of the SDGs vision for education and learning, especially Goal Four: ‘ensuring inclusive, quality education for all and promoting lifelong learning’.

It’s encouraging to see that early childhood development (ECD) is now more firmly on the new international development agenda – and not before time! SDG Target 4.2 proposes “by 2030, ensure that all girls and boys have access to quality early childhood development, care and pre-primary education so that they are ready for primary education.”

It was great to see, at the conference, a number of lively presentations and debates on early childhood development and to see some of this reflected in media coverage such as Sourovi De’s piece in the Guardian Development. Early childhood is the foundation for all that follows and, as Sourovi De points out, the most cost effective phase for investment to achieve good outcomes for children, families and society.

But there are risks if this narrow instrumental lens on babies and children becomes the sole rationale for investing in policies and services. Early childhood isn’t just about preparing children to become productive, useful citizens. It is a crucial and quite extraordinary life phase, to be respected in it’s own right, with young children and families entitled to a quality environment, health and education now, and not just because of the benefits that may follow later. (more…)

Book Review: ‘Education in South America’

By Santiago Cueto, Country Coordinator for Young Lives in PeruSantiago Cueto_CROP

Internationally, education has been heralded as a key instrument for individual and national development. How much has been accomplished towards realising the goal of quality education for all is a matter of debate and research. Recently a series of nineteen volumes has been planned to overview recent research for every region in the world. The series is edited by Colin Brook of the University of Durham and published by Bloomsbury. The most recently (fourth) published volume focuses on Education in South America, edited by Simon Schwartzman, and prompted these reflections. (more…)

Not all child migration is trafficking and not all child work is slavery

Jo Boyden, Director, Young LivesJo Boyden

This week, the UK Prime Minister, David Cameron, announced during his visit to South East Asia that new measures, enshrined in the Modern Slavery Act, will come in to force to curb the growth of human trafficking and slavery. This has, of course, thrown the whole issue of modern-day slavery and trafficking back into the media limelight.

Away from that limelight however, there are other discussions that attempt to go beyond the headlines. Open Democracy’s Beyond Slavery is one such effort. Gina Crivello and I recently posted a blog there on child migration and schooling.

This week on the same Beyond Slavery blog, Mike Dottridge, the former director of Anti-Slavery International has written an uncomfortable but important truth; in the outrage caused by the continued existence of child trafficking and slavery throughout the world today, these practices are all too readily inflated to cover all forms of child migration and work. In this way, a legitimate cause for concern is all too readily translated into inappropriate responses. (more…)

What needs to be done to keep child marriages trending down

Alula Pankhurst, Country Director, Young Lives Ethiopia
This blog originally appeared in The Conversation  on 23 June 2015

The broader African and international lobby against child marriage and other harmful traditional practices has grown tremendously in recent years. Its political clout is being felt right down to the grassroots level with positive outcomes.

These campaigns are being stepped up. Last week, the African Union launched a campaign to end child marriage in Africa. This produced a common position on ending child marriage.

Last week also saw the annual Day of the African Child (June 16). Joined-up thinking and campaigning led to this year’s theme of accelerating collective efforts to end Child Marriage in Africa.

To galvanise all this support and translate commitments to action, the Ethiopian government has planned a National Girl’s Summit on June 25. This follows a similar summit in London last year, where the country committed to ending female genital mutilation and child, early and forced marriage by 2025. (more…)

Beyond the rhetoric: understanding the links between child labour and education

by Renu Singh, Country Director of  Young Lives India

On World Day Against Child Labour, we are once again reminded of the innumerable children who are continuing to work in inhumane conditions in sweat shops, mines, factories and behind Renu Singh_IMG_1153_CROPclosed doors from where their voices are never heard.

Over the past decade the number of children in paid occupations has reduced in India from over 12 million in 2001 to over 4 million in 2011. After a prolonged wait, the Cabinet has recently banned all forms of child labour for those under the age of 14. This was mainly to align itself with the Right to Free and Compulsory Education Act, 2009 which makes education a fundamental right for all children in the age group 6-14 years. While the Child Labour (Prohibition and Regulation) Act of 1986 banned the employment of children up to the age of 14 in hazardous occupations, this proposed Amendment bill prohibits employment of children below 14 years in all occupations and processes, other than family enterprises and farm lands (after school hours and holidays). I’ve commented on this amendment elsewhere. (more…)

Rising school enrolment, plunging test scores

Renu Singh_IMG_1153_CROPWriting for Ideas for India this week, Young Lives India Country Director Renu Singh finds that the rise in school enrolment is associated with a worrying decline in learning standards. She stresses that an exploration of factors leading to this decline is essential in the wake of increasing investment in elementary education.  “Achieving the ‘Education for All’ goal cannot rest on access to schooling and enrolment alone; it requires focusing on a meaningful and relevant curriculum, human resource management systems that ensures regularity and accountability, and availability of qualified and professionally trained teachers, that would enable enhanced student retention, attainment and achievement”.

Read her article at:

“I do not like my school, since the teachers beat me badly”: how corporal punishment makes children feel

by Virginia Morrow, Senior Researcher, Young Lives

Ginny cropped_low-resOne of the success stories of the Millennium Development Goals has been the increase in enrolment of children in primary schools. However, little attention has been paid to the daily experiences of children in school, from their viewpoints, and the role corporal punishment plays in those experiences.

Corporal punishment is widely used in schools globally despite international concern about the effects on children and the implications for their capacity to benefit from school.  And yet it persists. Changing social policies send clear messages about practices that are not acceptable, but the eradication of corporal punishment in schools globally is proving difficult, and India is no exception. Violence against girls is now high on the Indian political agenda, after the horrific fatal gang rape of a female student in Delhi in 2012 led to widespread demonstrations demanding an end to sexual violence against girls and women.

However,  more ‘normal’ forms of violence may go unnoticed or unquestioned, and limited academic attention has focussed on children, and how patriarchy leads to gendered differences in the way boys and girls are treated at home, school and society at large. Social divisions based on caste, class and socio-economic status remain predominant, and violence against the powerless by those in power is common. (more…)