The 1994 International Conference on Population and Development in Cairo affirmed that everyone has the right to enjoy reproductive health and called upon countries to achieve universal access to sexual and reproductive health. This includes voluntary family planning, safe motherhood, skilled birth attendance and prevention of sexually transmitted infections, including HIV.
However, reproductive health problems remain the leading cause of ill health and death for women of child-bearing age worldwide. Every day, one thousand women around the world die from pregnancy-related complications. If all women who wanted to could access family planning services, the number of unintended pregnancies globally could be reduced by 50 million, the lives of 80,000 mothers who die from pregnancy or childbirth complications would be saved, and more than 500,000 newborn deaths could be avoided every year.
Viet Nam has a National Strategy on Population and Reproductive Health for 2011-2020 in place, and the goal of providing universal access to sexual and reproductive health, including voluntary family planning.
Of the 23 million women in Viet Nam between the age of 15-49 about 79 percent use some form of contraception. However, more than one-third of women who are not married have an unmet need for contraception. This unmet need is particularly high among ethnic minority women and female migrant workers. As a result, there is a significant number of unwanted pregnancies and unsafe abortions every year, especially among unmarried young people. In addition, there is often a lack of good family planning services at the provincial and district level.
As part of the Government’s goal to provide universal access to sexual and reproductive health, the care of pregnant women also needs to improve. There are, for example, big regional differences in the number of pregnant women who receive adequate antenatal care. Women in rural areas, ethnic minority women and women living in poor households are particularly disadvantaged. Often this is because they live far away from health facilities and lack the financial resources to pay for antenatal services. At the local level there is also a lack of facilities and equipment, and a shortage of competent health care providers.
Within the framework of the Government of Viet Nam and UN One Plan for 2012-2016, UNFPA collaborates with many different partners to ensure universal access to an integrated package of quality sexual and reproductive health services.
At the national level, we work with the Ministry of Health to support their implementation and monitoring of the National Strategy on Population and Reproductive Health. As part of this we support research on existing and emerging sexual and reproductive health issues. The evidence from this research can be used to develop effective and appropriate policies and programmes, and to better implement and monitor existing policies and programmes. We contribute to three areas in particular:
- Strengthening the health system in order to achieve universal access for everyone, including vulnerable groups, and to ensure that every individual can obtain and use affordable, quality reproductive health supplies whenever they need them.
- Developing cost-effective strategies to promote universal access, in particular addressing maternal health among ethnic minorities and the unmet need for family planning among young people and vulnerable groups.
- Using the evidence generated for policy advocacy efforts and scaling up successes within the framework of national strategies and programmes, supported by the necessary resources and political commitment.
We also work with the Ministry of Labour, Invalids and Social Affairs (MOLISA). Part of this support is focused on ensuring sex workers have access to HIV/AIDS prevention as well as sexual and reproductive health information and services. In addition, we collaborate with MOLISA to develop and monitor educational programmes on sexual and reproductive health, HIV/AIDS prevention and life skills for young people in vocational training institutes. Finally, we support their work to strengthen the social protection system for vulnerable groups, particularly older people and migrants.
Our support is particularly focused on disadvantaged people, such as migrants, ethnic minorities and people living in difficult-to-reach regions. This is for instance the case with our support to Quang Binh province in the north-central part of Viet Nam. Working with the provincial People’s Committee and Department of Health we support health system strengthening to address the unmet need for family planning, particularly among ethnic minorities and in difficult-to-reach areas of the province.
We also work in three other provinces – Kon Tum in the Central Highlands, Quang Binh in the Central Coast and Ninh Thuan in the South Central Coast region – that are home to many ethnic minority groups. Our activities here are part of a joint UN effort, which also includes UNICEF and WHO. In these provinces, the maternal mortality rate among the ethnic minority women is high. Our work is therefore focused on finding cost-effective ways to promote safe motherhood, with the aim to replicate successful models across the country so that other women can benefit from them.
Young people’s need for sexual and reproductive health services
There are currently 24.6 million young people (aged 10-24) in Viet Nam, making up almost one-third of the entire population. This is the highest-ever percentage of young people in Viet Nam’s history. Young people’s success and well-being require targeted policies and services to allow them to reach their full potential, also in the area of sexual and reproductive health.
Evidence shows that Vietnamese young people are becoming sexually active at an earlier age. This highlights their need for reproductive health services and information. However, young people often face problems when they try to access these services and information. About 35 percent of young people who are not yet married, for example, have an unmet need for contraceptives. There is also a significant number of unwanted pregnancies and unsafe abortions among young people, especially unmarried adolescents (between the age of 15-19) and youth. Children born to adolescent mothers are more likely to die than those born to women in their twenties, and the risk of maternal death is also higher among adolescents. This is therefore an important issue for Viet Nam to focus on.
In order to specifically address young people's needs for sexual and reproductive health services, UNFPA works with the Ministry of Home Affairs, the Youth Union and the National Assembly’s Committee for Culture, Education, Youth, Adolescents and Children to strengthen implementation of the National Youth Development Strategy for 2011-2020. We focus on four areas:
- Generating evidence on young people’s needs for sexual and reproductive health services, particularly among unmarried young people, young migrants and ethnic minority young people. This evidence will help the Government to develop appropriate policies and allocate sufficient budget.
- Ensuring the national youth strategy is put into operation through provincial plans of actions.
- Improving the capacity of government agencies working in the area of young people and helping them to better coordinate with other sectors such as health, education and employment.
- Promoting youth participation and engaging young people to oversee the development and implementation of youth specific programmes.