Viet Nam has made impressive economic growth and social development gains during the past 20 years, which have translated into better outcomes for children’s health, nutrition and access to water and sanitation. Infant and child mortality rates have halved since 1990. However, improvements are unequal and inequities are driven by ethnicity, household income, disadvantages of living in rural and mountainous areas and maternal education. The main causes of deaths in children less than five years old are neonatal causes, pneumonia, diarrhoea and undernutrition.
Ethnic minorities: Ethnic minority child mortality rates have actually increased during the last five years and an ethnic minority child is three times more likely to die in the first five years of life than a Kinh/Hoa majority child.
High neonatal mortality: In Viet Nam more than half of children dying before their fifth birthday die in the first 28 days of life and most within the first seven days of life . Low access to i) quality antenatal care and maternal nutrition, ii) safe delivery practices and iii) care of the newborn are the main drivers of deaths of newborns. Moreover, there is widespread under reporting of neonatal and stillborn deaths, especially in mountainous rural areas.
Stunting and anaemia: One-third of Vietnamese children less than five years old are stunted and one-third are anaemic, from poorly balanced diets, low exclusive breastfeeding rates, poor complementary feeding , worms and infections.
Low early and exclusive breastfeeding rates: Only around 20 per cent of mothers breastfeed their babies early and exclusively for six months – the lowest rate in South East Asia. The rates, in Viet Nam, are lowest in middle class and urban settings . Breastfeeding not only decreases incidences of stunting and obesity, but also decreases rates of various infections and can increase maternal bonding.
Sanitation and water/hygiene: Although there have been improvements at a national level, only 39 per cent of people in rural areas benefit from adequate sanitation , with 50 per cent of children less than five years old not able to access improved sanitation and 20 per cent of under fives not able to access improved water supplies. Hygiene knowledge and behaviour remain poor in rural communities and result in increased diarrhoeal diseases, other infections, worms and anemia .
HIV andAIDS: Children less than 15 years old make up almost 2 per cent of HIV-positive population in Viet Nam. The number of pregnant women with HIV was estimated to be about 4,100 in 2008 , and was expected to increase to 4,800 by 2012 . Without improved education and access to reliable information and PMTCT services, this could amount to more than 2,000 newborns infected with HIV, as estimated annually.
Injuries: Almost 8,000 young people under 19 years die every year from preventable injuries caused by drowning, road traffic injury and accidents, poisoning, falling, burns and animal bites . The death rates are two times higher for boys. These rates may rise with increasing use of motor vehicles.
Financing: Public healthcare financing is increasing, but ordinary Vietnamese people still have to pay around 70 per cent of total health expenditure from their own pockets , disproportionately affecting the poor and rural populations. Financial barriers to accessing routine healthcare services, covering the costs of long-term childhood illnesses and catastrophic expenditure such as a cesarean section or surgery after an accident can bankrupt whole families, increasing inequities between rich and poor. More funding is needed along with the more efficient and effective use of both human and financial resources already available for multi-sector approaches to address the root causes of inequities.
UNICEF’s Child Survival and Development Programme in the period of 2006-2011has contributed to the following results:
Policy Advocacy and Knowledge Generation:
Capacity Development and System Strengthening:
By targeting disadvantaged populations (children and their caregivers living in rural or urban poverty, ethnic minorities, those living with disabilities or affected by natural disasters), the Child Survival and Development Programme aims to sustainably reduce inequalities for disadvantaged children. These include addressing financial, supply and demand barriers to accessing maternal, newborn and child healthcare, nutrition, water and sanitation services. Local authorities and families will have greater access to information related to child development and how to live in a healthy and safe environment.
By strengthening the links between provincial monitoring and policy work, UNICEF can provide evidence to national policy-makers and help adjust national priorities and resource allocation on an ongoing basis.
 MOH (2012), MDG report 2012
 MOH (2011) MCH Department report 2011
 NIN (2010) Annual Nutrition Surveillance System 2009
 NIN (2011) Nutrition report 2011
 Central Population and Housing Census Steering Committee (2010), The 2009 Viet Nam Population and Housing Census Expanded Sample Results
 WHO Global Task Force on Cholera Control (2008) Cholera Country Profile: Viet Nam[online]
 MOH, WHO and UNICEF (2009) 2009 Joint Global Report on Health Sector Response to HIV and AIDS
 MOH (2009) HIV/AIDS Estimates and Projection 2007-2012
 MOH (2008) Injury Mortality Statistics of 2007
 UNICEF Viet Nam (2008) Health Equity Situation Analysis.