The situation of children
Lao PDR is characterized by a high degree of geographical, cultural and linguistic diversity. Its population comprises 49 officially-recognised ethnic groups, divided into four major ethno-linguistic groups and six main language families.
Widespread poverty, particularly among the rural population, results in poor socio-economic conditions for women and children, with delivery and utilization of basic social services affected by differences in geography, gender and ethnicity.
Across all sectors the same, vulnerable groups suffer from multiple problems and are often deprived of the most basic needs and services. These are the populations living in rural areas without road access, households in the poorest quintile, and families with uneducated or poorly educated women.
The very high prevalence of stunting in children poses a serious challenge. Stunting affects 363,000, or 44%, of Lao children under 5 years old. Stunting varies significantly with geography, ethnicity, wealth and the mother’s educational level. UNICEF is focusing on the most deprived areas.
Lao PDR recorded significant declines in young child mortality, but still has one of the highest child mortality levels in South-East Asia. The under-five mortality rate has decreased from 170 per 1,000 live births in 1992 to 79 per 1,000 in 2011, largely due to improvement in socio-economic conditions combined with increased coverage of immunization, breastfeeding and other high impact interventions.
Stunting affects 363,000, or 44%, of Lao children under 5 years old
Disparities in young child mortality are marked across socio-economic groups, and the highest under-five mortality rates are found in the same groups with the highest child stunting rates - children in the poorest quintile are up to four times more likely to die before their fifth birthday than those from the richest. Most of the child deaths are preventable or treatable with high-impact low-cost interventions.
Lao PDR still has one of the highest maternal mortality ratios in the region. Anaemia and undernutrition affect a significant proportion of women, which increase the risk of maternal morbidity and mortality and low birth weight babies. Lao PDR also has the highest adolescent birth rate in the East Asia and Pacific region. HIV prevalence, although still low, shows a rising trend and is by no means under control.
In Lao PDR, an estimated 10% of under-five deaths are due to diarrhoea. The data show a strong association between water and sanitation (WASH) and diarrhoea, underweight and stunting.
Four out of five households do not dispose of children’s faeces correctly and hygienically
Lao PDR has steadily increased the access to safe drinking water but will need to accelerate the progress to reach the 80% national target by 2015. Sanitation coverage is progressing but over a third of the population still practise open defecation.
Inequities are far more glaring in sanitation than in water coverage. Hygiene practices need much improvement. Four out of five households do not dispose of children’s faeces correctly and hygienically, an indication of poor health awareness. School sanitation coverage has not progressed (41% in 2009, 42% in 2013).
Child development & protection
Primary education coverage is high, with a net enrolment ratio of almost 97%, but inefficiencies and inequities constrain progress towards universal primary education. The challenges include low survival rates to grade five, significant numbers of under-aged and over-aged pupils, and low attendance rates amongst the poorer groups.
Early Childhood Development (ECD) programmes cover a third of all children aged 3 to 5 years old, but attendance is low. The quality of most ECD programmes is inadequate, especially in rural areas. Nonetheless, children attending preschool were more likely to be ahead in developmental stage than those not attending preschool, especially in literacy and numeracy.
Challenges include low survival rates to grade five and low attendance rates amongst the poorer groups
Rapid economic development and social changes are exposing children to greater risks. These include the increasingly open borders and trade with neighbouring countries in preparation for ASEAN integration in 2015, displacement and resettlement due to large development projects, young appetite for consumer goods, growing urbanization and migration, and the breakdown of traditional family structures as parents and/or young people leave home to seek better opportunities elsewhere.