Enhancing the protection of maternal and child health

Accordingly, over the past 20 years, from 2001 to 2023, Vietnam's child mortality rate has decreased, the under-five mortality rate has halved from 39.6% to 18.2%, and the infant mortality rate has dropped nearly 2.5 times from 29.5% to 11.6%.

Meanwhile, the rate of child malnutrition continues to shorten steadily and sustainably. As of 2023, the malnutrition rate in children under five years old has gone down to 9.7% (underweight) and 18.2% (stunted).

According to reports from localities without data from the private health sector, the number of abortions has decreased significantly in the past decade, from more than 300,000 cases in 2010 to less than 200,000 cases from 2020 to now.

However, the abortion rate in the Red River Delta and Southeast regions is often higher than the rest of the country.

The number of obstetric accidents has hardly decreased from 2015 to now, about 5 to 6 cases in 1,000 births.

On the other hand, the rate of early screening tests for all three diseases for pregnant women during pregnancy is still low. Accordingly, the rate of women giving birth being tested for HIV and hepatitis B during pregnancy tends to decrease in the period 2020-2021 to now; the rate of those tested for syphilis has improved quite slowly since 2016 and only reaches about 30% to 31%.

Sharing this issue, Director of the health ministry's Department of Mothers and Children Dinh Anh Tuan said that the protection of maternal and child health and reproductive health in Vietnam is currently facing many difficulties and challenges.

There are still great disparities between regions and groups in terms of maternal and child health and nutrition indicators. Unequal investment in facilities, equipment and human resource development between localities and regions leads to the quality of services in ethnic minority-inhabited and mountainous areas not improving as expected.

Notably, economic development, especially in developing cities, industrial parks and export processing zones, leads to the increase in the number of young workers (especially female workers), causing an increasing demand for reproductive and sexual health care for workers, which involve counselling and provision of highly effective contraception, gynaecological examination and treatment, sexually transmitted diseases, reproductive tract cancer screening, prevention of harassment, and sexual violence.

However, the reproductive health care system has not yet met the current need. There is no specific service for each age group and no program to provide contraception services for groups of unmarried people.

Premarital and unsafe sex is becoming increasingly common, whilst the need for contraception has not been fully met.

Infections with sexually transmitted diseases, unwanted pregnancies, abortions and unsafe abortions, and childbirth at adolescence create adverse effects on health as well as learning and job search opportunities for young people.

According to Deputy Minister of Health Tran Van Thuan, currently, the care for maternal and child health and reproductive health in Vietnam has been posing new problems and major challenges.

Over the past five years, the maternal mortality rate has slowly decreased, revealing large disparities between regions.

Child malnutrition is improving, but the rate of stunting is still high in ethnic minority and mountainous areas, while overweight and obesity are increasing in urban areas.

The rate of women with non-communicable diseases such as breast cancer, cervical cancer, high blood pressure, and gestational diabetes is increasing.

Meanwhile, there is a shortage of qualified human resources in the obstetrics and paediatrics sector, especially in remote areas.

The situation requires more drastic solutions and actions. It is crucial to review, update and develop professional guidance documents in maternal and child health care and reproductive health, which must follow legal regulations such as the Law on Health Insurance and the Law on Pharmacy.

National programmes such as Nutrition in the First 1,000 Days should be accelerated.

More efforts should be exerted to reduce maternal and child mortality, malnutrition in disadvantaged areas and ethnic minorities; enhance training of obstetric and paediatric staff at all levels; improve the quality of medical technical services.

It is also necessary to maintain the role of village-based midwives in disadvantaged areas and raise the responsibility of central hospitals in directing and providing technical support and supervising local health facilities.