MEETING THE MDGS

WITH EQUITY IN VIET NAM

Dr. NGUYEN HAI HUU

Director General

Department of Child Protection and Care

Ministry of Labour - Invalids and Social Affairs

Government of Viet Nam

November 2010

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1. SITUATION IN VIET NAM

ON MDG 1 FROM EQUITY

PERSPECTIVE

2

VIET NAM’S PROGRESS TOWARDS ACHIEVING THE MDGS

MDG target for 2015 Likelihood of Achievement

by 2015

Goal 1. Eradicate Extreme Poverty &

Hunger

On Track

Goal 2. Achieve Universal Primary

Education

On Track

Goal 3. Promote Gender Equality

and Empower Women

On Track for Education, but

lagging for women’s

empowerment

Goal4. Reduce Child Mortality On Track

Goal 5. Improve Maternal Health On Track

Goal 6. Combat HIV and AIDS,

Malaria and Other Diseases

On Track for Malaria and

Other Diseases, lagging for

HIV and AIDS

Goal 7. Ensure Environmental

Sustainability

On Track for Water, lagging

Sanitation and Biodiversity

Goal 8: Develop a Global Partnership

for Development

On Track

3

58.1

37.4

28.9

19.516 14.5

0

10

20

30

40

50

60

70

1993 1998 2002 2004 2006 2008

Trends in poverty

Whole country

4

64

56

44

30

1814

0

10

20

30

40

50

60

70

1980 1990 1995 2000 2005 2008

Trends in under five

mortality rate

5

0

20

40

60

80

100

120

1994-1995 2000-2001 2002-2003 2004-2005 2006-2007

Trends in primary and lower

secondary school net enrolment

rates

Primary NER Lower Secondary NER

percent

6

KEY ACHIEVEMENTS OF VIETNAM ON MDGS

Viet Nam is on track to achieve the majority of the MDGs: the country

has made remarkable progress in reducing poverty, improving

access to education and enhancing child and maternal health.

Percentage of people living below poverty line reduced from 58% in

1993 to 14% in 2008

Primary school enrolment increased from 69% in 1994-95 to 96% in

2006-07, with little sex gap.

Under-five mortality rate reduced from 56 per 1000 live births in 1990 to

14 in 2008.

Maternal mortality reduced from 200-249 per 100,000 live births in

1990 to 75 in 2008.

87% of the population in the urban area and 43% in the rural area

have access to improved water.

7

CHALLENGES AHEAD ON MDGs IMPLEMENTATION

While impressive achievements have been made, the

challenges remain ahead:

Prevalence of HIV increased from 0.04% in 1999 to 0.43% in

2009. The number of people living with HIV is expected to

increase an additional number of 280,000 by 2012, half of

whom will be young people.

63% of the population in rural areas have access to improved

sanitation.

Over 25% of the members of the National Assembly are women,

while less than a quarter of members of local people’s councils

are women.

Significant disparities exist between the national and sub-

national levels and between the Kinh majority and ethnic

minorities in terms of progress towards achieving the MDGs.

8

Meeting the MDG with equity is a major

challenge – there are growing

disparities:

- Among ethnic groups

- Among geographical areas

- Between urban and rural areas

9

85.4

75.269.3

60.7

52.3 49.853.9

31.1

23.1

13.510.3 8.5

58.1

37.4

28.9

19.516 14.5

0

10

20

30

40

50

60

70

80

90

1993 1998 2002 2004 2006 2008

Trends in poverty

Ethnic Minority Kinh and Chinese

Whole country

10

8.6

25.1

19.221

2.5

11.4

6.7

16.1

0

5

10

15

20

25

30R

ed

Riv

er D

elt

a

No

rth

ern

mid

lan

ds/m

ou

nta

ino

u

s a

rea

s

No

rth

cen

tra

l a

nd

cen

tra

l co

asta

l a

re

as

Ce

ntr

al

hig

hla

nd

s

So

uth

Ea

st

Me

ko

ng

Riv

er D

elt

a

Urb

an

Ru

ra

l

Poverty by Regions and Areas of

Residence 2008

11

0

5

10

15

20

25

30

35

40

Poorest 20% Second poorest 20%

Middle 20% Second richest 20%

Richest 20%

6.8 6.5 4.3 3.2 3.6

28.525.1

17.315.8

10.4

Underweight children by wealth index quintiles -2006

Severely Moderately

12

Above 80%

Between 50 and 80%

Below 50%

Percentage of

households using

safe water - 2009

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2. THE VIETNAMESE

GOVERNMENT’S

RESPONSE TO THE MDGs

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1. EXTENDING INTERNATIONAL COOPERATION

The Government of Vietnam strongly supports

the South-South cooperation among countries to

achieve the MDGs, particularly on issues related

to protection of, care for and education of

children. This is a good cooperation opportunity

for countries to achieve the MDGs together,

especially with social equity.

Vietnam is ready to participate and host the

international conferences and events on

cooperation to meet the MDGs generally and

particularly on child rights. 15

2. THE DEVELOPMENT AND USE OF A MULTI-

DIMENSIONAL CHILD POVERTY MEASUREMENT

Developed by MOLISA, and other line ministries, with

UNICEF support from 2006 to 2010

Measures depivation experienced by children in 8

domains: (i) nutrition, (ii) health, (iii) education, (iv)

housing, (v) improved water, (vi) environmental

sanitation, (vii)entertainment, (viii) social protection (lack

of accessibility to public and governmental social

support)

Uses household survey data (VHLSS and MICS)

Develop policies and add more approaches based on

the monetary measures and poverty, influences the

objectives of programmes and possibly lead to new

programmes (e.g. child benefits)

Focus on MDG 1, but related to to many MDGs because

of its multidimensional nature

16

5

26

13

61

21

13

34

22

62

29

0

10

20

30

40

50

60

70

Urban Rural Kinh/Hoa

ethnic

children

Ethnic

minorities

children

Total

Monetary and non-monetary child

poverty in 2008 by areas of residence

and ethnic groups

Monetary child poverty Non-monetary child poverty

17

12

41

26

33

316

11

46

22

39

13

53

0

10

20

30

40

50

60

Monetary and non-monetary child

poverty by Regions in 2008

Monetary child poverty

Non-monetary child poverty

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3. ESTABLISHMENT OF SOCIAL WORK

AND A SOCIAL SECURITY SYSTEM

Result of years of cooperation by

MOLISA and UNICEF

Develop a cadre of professional

social workers, develop a social

security system

Sustainable approach to address

child poverty, and child protection

and care 19

4. DEVELOPING A CHILD PROTECTION

SYSTEM IN VIETNAM In cooperation with UNICEF, Save the Children in

Vietnam, Plan, Childfund and World Vision,

MOLISA has been developing and implementing

the pilot child protection system in 120

communes, 30 districts and 15 provinces/cities

from 2009 to 2011.

To create a safe environment on preventing

children from vulnerable risks, intervening to

reduce the harm, supporting vulnerable children

for integrating into the community by

systematically providing 3 level child protection

services (prevention, detecting and intervening,

supporting for social integration)

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5. RESULTS-BASED BUDGETING

FOR CHILD HEALTH

Equity of access, outcomes, and financing are

challenges in Viet Nam

Current system of planning, budgeting, and allocating

scarce resources is not optimal

Marginal budgeting for bottlnecks (MBB) is a results-

based planning and budgeting tool that:

(i) focuses attention on the most important gaps and barriers

("bottlenecks") to essential health care in the existing health

system;

(ii) provides a menu of interventions that can be used on the

demand side, or supply side, of health care; and

(iii) estimates the total extra ("marginal") investment cost to

achieve increased progress.

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Viet Nam 2011

-12

Viet Nam 2013 -

14

Viet Nam 2015

-16

Reduction in under five

mortality

25.4% 31.3% 38.4%

Reduction in maternal

mortality

24.9% 25.9% 26.0%

Additional cost per capita

per year in current $US

Of which:

- Family oriented community

based services

- Population oriented

schedulable services

- Individual oriented

schedulable services

$0.96

$0.38

$0.12

$0.96

$0.93

$0.43

$0.20

$0.30

$2.19

$0.54

$1.44

$0.22

Total additional funding

needs per year in current

$US

$85 million per

year

$85 million per

year

$204 million per

year

Preliminary results showing costs (US$) and potential outcomes

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KEY FINDINGS – MBB VIET NAM

Viet Nam has the potential to reduce under-five mortality, and

maternal mortality, and accelerate achievement of the MDGs

very rapidly over time, and at relatively little per capita cost.

Significant gains in health and equity are available for relatively

little additional cost by addressing "missed opportunities" within

an otherwise high coverage and functioning health system.

Viet Nam needs to now invest more in the first and second

level curative care, including the Comprehensive Emergency

Obstetric Care (CEOC) if it is to make deeper inroads into

maternal and neonatal mortality.

Policy decisions and resource allocations need to explicitly

target equity of access and outcomes.

Highly related to MDG 4

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THANK YOU FOR YOUR ATTENTION!

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