Strengthened international cooperation helps improve population quality

Friday, 2017-07-14 14:52:03
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International cooperation is an important element during the implementation of population and family planning programmes towards achieving sustainable development goals. (Credit: NDO)
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NDO – For decades, international cooperation has proven to be an important factor in the implementation of population and family planning programmes in countries around the world, especially in developing countries like Vietnam, resulting in positive gains in socio-economic development.

Positive achievements

In the late 1970s, as a war-torn country, Vietnam faced a range of difficulties regarding socio-economic development with a fragile economy and signs of war aftermath still visible in most parts of the nation. Particularly, the high fertility rates of more than five children per adult female at that time, plus unmet needs for contraceptive and family planning services, added to the growing problems experienced in health care for women and their families, resulting in lower living standards throughout the country.

According to deputy head of the Ministry of Health's General Office for Population and Family Planning, Nguyen Van Tan, the population and family planning sector faced many difficulties and shortages, with support mainly provided by the socialist ally bloc, but which was also very limited with only simple contraceptives such as condom and pessaries available.

In 1977, shortly after Vietnam became a member of the United Nations, the United Nations Population Fund (UNFPA), as one of the first international organisations to be present and to provide support to Vietnam, established a cooperative relationship and actively assisted the Government of Vietnam through the provision of contraceptive devices, equipment, tools and services related to family planning, reproductive health care, as well as staff training, technical assistance and policy making.

As the only financial support source for Vietnam in the field at the time, when the country was embargoed, the UNFPA shared the same understanding with the government that all economic socio-economic achievements were difficult to attain in order to meet the basic needs of such a large population of over 50 million people.

For Vietnam, international support is not just about financial assistance but also support in technical supplies, management of training and research, and opportunities for access to advanced management techniques and technologies in population and family planning work.

Focusing on technical assistance, the UNFPA has deployed around 100 projects with funding of approximately US$190 million, focusing on human resources training, capacity building, analysis, and collection and treatment of data as the basis for policy formulation in the population sector.

Positive technical assistance has enabled Vietnam to effectively conduct population censuses and provide reliable data and information for policymaking. In addition to support in formulating population policies, the UN agency also provides quality reproductive healthcare services. Thanks to such support, the maternal and child health status in Vietnam has improved markedly; the average life expectancy of women has increased from 67.5 in the period of 1984-1989 to 71.6 during 2002-2006. The number of mothers and new-born deaths has decreased significantly.

With the government's efforts and effective support from the UNFPA and other international donors, Vietnam reached the target of reducing population growth rates and obtained replacement level fertility earlier than expected. Rather than reducing the total fertility rate to 2.9 with a population size of below 82 million in 2000 and reaching replacement level by 2015 as targeted by the Population-Family Planning Strategy, Vietnam has reached replacement level fertility since 2005, with a population size of only 78 million in 2000 and a total rate of 2.3 children per family.

The remarkable achievement helped Vietnam win the UN Population Award in 1999, and has contributed greatly to the impressive poverty reduction results that Vietnam has been recognised for by the international community. The country has become one of the fastest growing economies in the region and turned to a low middle-income country in the first decade of the 21st century.

According to Vice President Dang Thi Ngoc Thinh, population and family planning work is an important part of the national development strategy. It not only brings with it economic but also cultural and social significance, contributing to the national sustainable development. Therefore, right from the 1960s, Vietnam launched a family planning campaign. However, experience and investment in population and family planning was very limited at that time.

As a solid and persistent international organisation working in Vietnam for the last 40 years, the UNFPA has also acted as a bridge to expand Vietnam's relationship with other international organisations and partners, helping Vietnam to build the foundation for implementing population work and to control the population growth rate, as well as gradually improving the quality of population. “It can be said that cooperation between Vietnam and the UNFPA is very important in Vietnam's Population and Family Planning Programmes and this assistance is very valuable,” said Thinh.

Deputy Minister of Health Nguyen Viet Tien said that in the last 40 years, the UNFPA has made important contributions to the population, reproductive health and family planning programmes run by Vietnam and became its number one partner in this area.

Tien noted that with investment from the government and support from the UNFPA, Vietnam has achieved great results, with the average number of children per couple of childbearing age declining from 5.6 children in 1960 to 2.09 children in 2007 and has remained stable for the last decade. The population growth rate from 2% in 1960 decreased to 1% in 2016 with 66.8% of the population using modern contraception to prevent the birth of 27 million infants. Health indicators such as maternal mortality decreased from 233 per 100,000 live births in the 1990s to 69 per 100,000 in 2009 and 58.3 per 100,000 in 2016. Along with that, the quality of the population has been increasingly improved with life expectancy up from 40 in 1960 to 73 in 2015.

Reducing fertility and applying models to encourage lower numbers of children in each family have facilitated success for economic development programmes and improved people's lives in Vietnam. This is the foundation for the country to successfully implement the Millennium Development Goal (MDG) 3 for the eradication of extreme poverty, facilitating universal primary education and promoting gender equality, as well as the successful completion of MGD 5: reducing maternal mortality rate by three-fourths between 1990 and 2015.

Towards sustainable development

Lessons learned from Vietnam, particularly successful models in population and family planning, have been highly appreciated by international organisations and friends, and international cooperation, including the Vietnam-UNFPA partnership, has made a great contribution to such achievements.

According to Astrid Bant, UNFPA Country Representative in Vietnam, the first joint programme between the Government of Vietnam and UNFPA was launched in 1977. To date, the two sides have co-operated and implemented nine collaborative programmes, each of a five-year duration period, resulting in a total of nearly 100 joint projects. They have been implemented at all levels from central to local in 12 localities nationwide.

With a focus on people and meeting their needs, UNFPA has focused on providing technical and financial assistance to Vietnam to address the unmet needs of the population on methods of contraception and family planning, supporting people to exercise their basic rights in reproductive health and sexual healthcare so that they can have a better quality of life and health.

Thanks to international support, the number and percentage of women dying from complications during pregnancy or childbirth has decreased significantly. In general, family sizes are smaller, family members are healthier and the economy is substantially more stable than it was four decades ago. Millions of people have been educated on reproductive health and sexual health and have more opportunities to access information and services they need to gain optimal results.

During 2000-2015, policies and services on population and health care in Vietnam have been improved and adjusted appropriately to ensure human rights, promote economic growth and contribute to the achievement of the MDGs.

However, in the next phase, especially until 2030 with the Sustainable Development Agenda and the Sustainable Development Goals (SDGs), addressing the needs of vulnerable groups throughout their lifecycle is key to achieving the goals of sustainable development for Vietnam, as the disparities still exist and are likely to increase among vulnerable populations, including ethnic minorities, homosexual and transgender communities, internal migrants, sex workers, people living with HIV and the elderly.

Regarding long-term and new emerging demographic trends, such as the “golden population structure,” population aging and the growing migration flows associated with rapid urbanisation, as well as gender imbalance at birth, gender-based violence, rapid demographic changes from high fertility to low fertility and an increase in life expectancy, have resulted in both new opportunities and challenges for Vietnam. Globalisation and technologies also affect the lives of people in many ways. As such, international cooperation and support are becoming more important than ever.

Continuing the partnership in the coming time, cooperation among both sides will focus on long-term studies and is anticipated to help Vietnam take an initiative in launching policies to address new challenges in population. Successful models will continue to be replicated across the nation, such as maternity emergency, safe motherhood and ethnic minority midwives in mountainous areas.

In all UNFPA support programmes, national capacity building has always been a priority and has yielded remarkable results in the direction and development of population development policies, data collection and use, and research and training on population and development.

Currently, UNFPA is assisting Vietnam to develop the Population Law on the basis of human rights guarantees and adopting a lifecycle approach to address emerging demographic and development challenges. Over the next two years, the UN in Vietnam will actively support the UNFPA to assist Vietnam in the 2019 Population and Housing Census. This is also the fifth census the UNFPA along with the local government to be implemented in the programme.

Another priority of cooperation is to promptly respond to the basic needs of contraceptives, essential medicines, medical equipment, emergency obstetric devices and upgrades to the medical system and a number of medical facilities providing reproductive health and family planning services, especially in grassroots and disadvantaged areas.

In parallel with the improvement of reproductive health/family planning service quality, advocacy and educational communication are also being given great attention. Population and reproductive health education in schools have also received attention from the first programmes so far. The content of population and reproductive health education has been integrated into education and training programmes nationwide.

The management, administration and implementation method has been improved in the direction of enhancing the autonomy of local partners with technical assistance from the central government, enhancing responsibility and the executive role of Vietnam’s partners and applying the result-based management system. Thanks to this management method, cooperation between Vietnam and the UNFPA has become an inseparable part of many international development programmes in Vietnam in the field.