Ha Noi, 12 August 2013 - Thanh, a worker in the Thang Long industrial Zone, is one of many young people who recently migrated to Hanoi in search for a job. Like many other Vietnamese youth who migrate from the rural regions to the city, Thanh has to pay higher fees for sexual and reproductive health services when accessing public health services.
“I migrated to Hanoi for a better job and moved away from the health center at which I was initially registered for my health insurance. When I now go to a public health clinic for reproductive health issues, I end up having to pay higher fees for services compared to those who are locally registered residents. I wish it was different as I now have difficulty accessing these services as I can’t afford them… ” says Thanh.
Today marks the International Youth Day, and this year the focus is on the issue of youth migration. Young people, aged 10-29 years old, make up approximately 38 per cent of the total population of Viet Nam, recording the highest proportion of young people ever in the country's history. This provides a unique and one-off economic opportunity for Viet Nam’s development, but also creates enormous challenges for the country. If Viet Nam wants to reap the full benefits of this demographic window of opportunity, investing in the education and health, including the sexual and reproductive health, of adolescents and young people is paramount.
The economic boom, along with the industrialisation and ubanisation of Viet Nam has led to many new employment opportunities in the cities, attracting large numbers of people looking for work outside their home town/province. Migration flows are dominated by young people aged 15-24, and the majority of these are women and girls who are in their reproductive age and many of them sexually active.
As young migrants move to the city for employment, they become separated from their families, communities, prevailing socio-cultural norms and social support systems, and as such become more vulnerable and prone to engaging in risky behaviors. Many young Vietnamese migrants are at a high risk to become victims of economic and sexual exploitation, especially during times of economic hardship.
Young migrants often face difficulty when accessing public health services because they are not registered in their destination cities. This means they are often unable to access critical public sexual and reproductive health services, leaving them vulnerable to unwanted pregnancies, unsafe abortions and STI/HIV infections. For example, a study in a 2009 found that only 40 per cent of female migrants planned to have gynecological check-ups.
Young migrants also often lack adequate knowledge on sexual and reproductive health. Many of them have only completed primary or secondary education, and comprehensive sexuality education is currently not taught in primary or middle schools in Viet Nam. For example, findings from the 2004 Viet Nam Migration Survey indicated that the majority of women migrants did not know the causes of sexually transmitted infections (STIs) or about how to prevent contracting STIs and how to treat them.
While Viet Nam has made impressive progress on sexual and reproductive health (SRH) and family planning (FP), most of the SRH/FP programmes are traditionally targeted towards married couples only. For example, the government has progressed well in implementing SRH counseling sessions for young couples entering marriage, but more programmes would be needed for those not yet married. Currently, no specific SRH/FP services are offered to unmarried youth, and service providers are not obliged to provide services to them. As a result, young people have often no place to go when in need of sexual and reproductive health information and services.
Given these challenges, the majority of Vietnamese young migrants, especially females, experience unmet needs for SRH information and services and are at risk of STI/HIV infections, unwanted pregnancies, unsafe abortion and sexual violence. Further investments in the provision of SRH information and services is crucial to ensure that young migrants stay healthy citizens. In turn, this improvement will greatly enhance Viet Nam’s productivity and prospects for socio-economic development.
Strengthening the health care system in order to be able to provide affordable comprehensive sexual and reproductive health information and services for young migrants would be highly recommendable. Access to adequate and affordable sexual and reproductive health information and services for young migrants can reduce their unmet need for these services and thereby minimize the incidences of unintended pregnancies, unsafe abortions and even maternal deaths.
Keeping young migrants healthy and productive will ensure their active contribution to Viet Nam’s productivity and development. Ensuring the availability of affordable reproductive health services for young migrants should therefore be a vital part of local government’s socio-economic development planning, especially in the industrialized zones. Young migrants have played a significant role in Viet Nam’s urban growth over the last decade, and the youth population represents an increasingly important proportion of the labor force in Viet Nam, both now and well into the future.
On this International Youth Day, let us all work together to ensure that all young Vietnamese people have access to adequate and affordable SRH services.