2/3/2011 IMPROVED FAMILY PLANNING AND MATERNAL HEALTH CONTRIBUTE TO POVERTY REDUCTION IN VIETNAM By Dinh Huy Duong The General Office for PFP, MOH PCC, Vietnam Contents of Presentation Part I. Achievements of the Population and Reproductive Health Programme in Vietnam Part II. Family Planning and Maternal Health Integrated into P overty Alleviation Strategies 1
2/3/2011 Part I. Achievements of the Population and Reproductive Health Programme in Vietnam Population of Vietnam, 1979-2009 Million 85.79 90 76.32 80 64.38 70 52.74 60 50 40 30 20 10 0 1979 1989 1999 2009 2
2/3/2011 Annual Increase of Population (.000) 1999-2009 1194.7 1163.4 1200 946.7 1000 800 600 400 200 0 1979-1989 1989-1999 1999-2009 Population Growth Rate 1979-2009 An annual 3 population growth rate 2.2 2.1 bewteen 1999 2 and 2009 is only 1.7 1.2%. 1.2 1 0 1979 1989 1999 2009 3
2/3/2011 Total Fertility Rate, 2001-2009 2.28 2.25 2.23 2.12 2.11 2.09 2.08 2.07 2.03 2009 2001 2002 2003 2004 2005 2006 2007 2008 Crude Birth Rate (CBR), 2009 21.9 Tây Nguyên 19.6 Trung du và miền núi phía Bắc 17.6 Đồng bằng sông Hồng 17.5 Đông Nam bộ 16.9 Bắc Trung bộ và Duyên hải miền Trung 16 Đồng bằng sông Cửu Long 17.9 Nông thôn 17 Thành thị 17.6 Toàn quốc 4
2/3/2011 Crude Death Rate (CDR) 1979-2009 7.3 6.5 6.3 5.6 1979 1989 1999 2009 Maternal Mortality MMR sharply decreased from 233/100,000 live births in 1990 to 80/100,000 in 2005. However, throughout the 2006-2009 period, MMR declined little. A big challenge to reach MDG of 58.3. 250 233 200 150 130 100 85 80 76 75.1 75 69 58.3 50 0 MDG 2015 1990 2001 2004 2005 2006 2007 2008 2009 5
2/3/2011 Pregnancy Management This increase reflects better prenatal maternal health care; better attitude and behavior of mothers towards health care during their pregnancy; better RH services. 96 94.6 94 93.1 92 89.9 90 88 86 84.6 84 82 80 78 2006 2007 2008 2009 Prenatal Checks- up Three prenatal checks-up – 88.3% . An important factor contributing to safer deliveries, reduction of obstetrical complications, maternal mortality and neonatal death. 89 88.3 88 87 86.4 86.2 86 85 84.6 84.3 84 83 82 2005 2006 2007 2008 2009 6
2/3/2011 Births Attended by Trained Health Workers Increased births attended by trained health workers is one of the main reasons for reduction of MMR 95 94.8 94.8 94.5 94.3 94 93.9 93.5 93.3 93 92.5 2005 2006 2007 2008 2009 Post-partum Care Over 60% of maternal mortality & more than 70% of infant mortality take place during delivery and 1st week. It is obvious that postpartum care is extremely important. 89.5 89.1 89 88.5 88 87.5 87.5 87 86.9 87 86.5 86 86 85.5 85 84.5 84 2005 2006 2007 2008 2009 7
2/3/2011 Obstetrical Complications Declined obstetrical complications significantly contribute to lowering MMR 3 2.8 2.5 2.5 2.2 2 1.5 1 0.5 0 2007 2008 2009 Steady Increase of CPR of Married Couples at Reproductive Age 90 79.5 76.8 80 73.9 68.8 70 65.7 61.1 60 50 40 30 20 12.8 11.1 10.7 10 0 Traditional Modern Traditional Modern Traditional CPR Modern CPR CPR CPR CPR CPR 2001 2005 2008 8
2/3/2011 Method Mix is Increasingly Diversified Others Others Traditional methods Traditional methods methods methods Traditional methods Others methods Pill Pill Pill 0.9% 0.9% 13.2% 0.3% 10.9% 16.6% 16.6% 5.6% 5.6% Condom Condom 5.9% 5.9% 55.7% 61.6% 61.6% Condom 8.9% 8.9% 13.2% 0.5% 0.5% 5.4% 1.3% IUD Steriliza-tion Steriliza-tion IUD IUD Steriliza-tion Injection,implant Injection,implant Injection,implant 1998 1998 2008 Challenges of the Population and Reproductive Health Programme in Vietnam Sustain an appropriate level of fertility; Deal with unbalanced SRB (SRB is 111 in 2009); Capitalize demographic bonus ; Cope with issues of “ageing population” ( 9.9% over 60 yrs. and 7.5% over 65 in 2009) Improve maternal health (prenatal, neonatal and postnatal), especially in mountainous, remote and isolated areas; Supply and distribute adequate, good quality contraceptives commodities suitable to clients’ needs; 9
2/3/2011 Challenges of the Population and Reproductive Health Programme in Vietnam (cont.) Provide good quality FP services and infertility treatment; Reduce abortion incidence and eliminate unsafe abortion; Reduce STIs, RTIs, HIV and reproductive tract cancer; Better meet SRH needs of special groups of population (adolescents, disabled people and old people etc.). Part II. Family Planning and Maternal Health Integrated Poverty Alleviation Strategies Poverty and P-RH/FP and maternal health are inter-related. Poverty Lack of Hunger, disease, opportunities & low mortality education level Unemployment, low income 10
2/3/2011 In Vietnam, b ased on MDGs and the country’s own aspirations, Viet Nam has also established its own 12 development goals (referred to as Vietnam’s Development Goals or VDGs), which include poverty reduction targets. The Government has issued many documents to guide the implementation of MDGs and VDGs. These include the Comprehensive Poverty Reduction and Growth Strategy. In these documents, population, RH/FP and maternal health are taken into account and recommended to be integrated into various programmes/projects, especially for the purpose of poverty reduction. “A model of integrated groups of communication on P-RH and savings, credit, agricultural extension” 1. Characteristics of group members: - Members at reproductive age and from poor households. - Living in the same area. - Voluntary participation in the group. - The group size: Between 25 - 35 people 11
2/3/2011 2.Objectives To help members to learn more about RH, FP, maternal and child health care; To help them to have good behavour for their own health, their families and communities; To share information on RH, FP, maternal health with their family, friends, neighbors; To learn and apply technical advances in agricultural production, cattle raising and small business; to support each other to properly use loans to increase their income; and to contribute to socio- economic development in hamlets/ villages. 3. Agenda of a Monthly Meeting Session 1: Presentation and discussion on P-RH, maternal health and family planning. Session 2: Introduction of knowledge, skills and technical advances in agricultural production, cattle/fish raising, small business etc. Session 3: Discussion on how to obtain loans from banks; how to best use loans. 12
2/3/2011 Why is the Model Successful? 1. Hundreds of thousands groups have been established throughout the country. This model is sustainable because group members can get real benefits. 2. Group members acquire new knowledge and skills on RH/FP and maternal and child health care. They are able to improve their own health status and that of their family members. Women and men know how to properly practice FP and space births. 3. Group members find it useful to learn and apply production knowledge and skills, and technical advances in agricultural production, cattle raising, handicraft or small business etc. 4. They feel happy and proud to contribute to socio- economic development in their hamlets/villages. 5. Activities of the group create the solidarity and friendship in a community. Thank you for your attention! 13
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