Introduction

Introduction

 

Introduction

© UNICEF Viet Nam\2006\Doan Bao Chau

ISSUE

In the past two decades, Viet Nam has achieved impressive results in health and nutrition. Life expectancy has improved and infant and child mortality rates have declined substantially. Between 1990 and 2005, the under-five mortality rates fell from 53 to 19 per 1,000 live births. During the same period, the infant mortality rate decreased from 38 to 16 deaths per 1,000 live births.

The fight against preventable childhood diseases has contributed greatly to these declines. Thanks to childhood immunization and other interventions, polio was eradicated in 2000, while maternal and neonatal tetanus was eliminated in 2005. In addition, the incidence of measles has plummeted by 95 per cent since 1990.

At the same time, effective strategies to prevent micronutrient deficiencies disorders, such as  night-blindness and mental retardation due to micronutrient deficiencies have been implemented nationally. With UNICEF’s assistance, Viet Nam has also made remarkable progress towards becoming self-sufficient in producing oral rehydration salts (ORS) and DPT vaccines. The government has also enacted enabling legislation.

Despite these achievements, the country still faces many challenges, including:

Inequity is emerging as a major issue as evidenced by the following disaggregated data:

• Maternal mortality rates are four times higher in the northern mountainous regions, home to many ethnic minorities, than in the lowlands.

• Infant mortality rates are generally higher among ethnic minorities.

• Differences in child malnutrition rates in poor and rich provinces are substantial.

Child and maternal under-nutrition rates remain unacceptably high. Twenty-five percent of children less than five years old are underweight while more than 40 per cent of pregnant women are anaemic. Malnutrition is associated with more than half of all childhood deaths.

Sustainability of several successful public health interventions such as immunization and vitamin still needs to be ensured to prevent any unintended effects of health reforms during this period of enormous economic change.

The country’s HIV epidemic has rapidly changed course in the last decade. No longer confined to injecting drug users, the virus has made inroads into the general population and is increasingly affecting young people, pregnant women and, in turn, newborn babies.

UNICEF’S RESPONSE

UNICEF seeks to help the Government attain its goals on health through various means including:

Promoting equity and improving access to health care services. UNICEF supports the government in developing policies, guidance and plans of action to promote equity and access to health care services for children, mothers and poor populations.  The support aims to improving the implementation of existing policies on free healthcare for children under six, extending immunization to population living in hard-to-reach areas, ensuring universal salt iodisation, targeting under-served populations including ethnic minorities and restricting the marketing of breast milk substitutes. Support is also given to develop models promoting health and nutrition care for young children and mothers especially in the areas with high ethnic minority and poor urban populations. 

Enhance the sustainability of the successful public health programmes such as Expanded Programme of Immunization (EPI) and micronutrient deficiency prevention by improving the government’s financing to these programme

Strengthened capacity of staff in the health sector and communities to coordinate, plan and implement behavior change communications for health and nutrition.

Prevention of HIV transmission from the mother to the child (PMTCT):  UNICEF supported the Government to develop the National Program of Action for PMTCT, which has been put into implementation since 2006. According to this programme, PMTCT will be expanded gradually and practiced nation-wide by the end of 2010. UNICEF also supports developing protocols relating to HIV and AIDS including paediatric HIV prophylaxis, treatment for opportunistic infections and antiretroviral formulations for infants.

PARTNERSHIPS

UNICEF Viet Nam’s Health and Nutrition programme works closely with UN agencies as well as bilateral and multilateral donors. UNICEF  is also linked closely  with other partnerships such as the Health Sector Partnership Group, the Interagency Coordination Committee for EPI, the United Nations Theme Group on HIV/AIDS, the Youth Affinity Group, and the Safe Motherhood and Newborn Health Group.