Decision No. 2013/QD-TTg Approving the Population and Reproductive Health Strategy of Vietnam for the period 2011-2020

Pursuant to …;

Approving the Population and Reproductive Health Strategy

of Vietnam for the period 2011-2020

____________

 

PRIME MINISTER

Pursuant to the Law on Organization of the Government dated December 25, 2001;

Pursuant to the Conclusion No. 44-KL/TW dated April 1, 2009 of the Politburo on the results of three years implementing Resolution No. 47-NQ/TW dated March 22, 2005 of the Politburo on further implementation of population policy and family planning;

Pursuant to Resolution No. 31/NQ-CP dated August 18, 2010 of the Government promulgating the Action Plan of the Government for the period 2010-2015 to implement Conclusion No. 44-KL/TW dated April 1, 2009 of the Politburo on the results of three years implementing Resolution No. 47-NQ/TW dated March 22, 2005 of the Politburo on further implementation of population policy and family planning;

Considering the proposal of the Minister of Health,

DECISION:

Clause 4 of Article 6Approves the Population and Reproductive Health Strategy of Vietnam for the period 2011-2020 with the following main contents:

1. Viewpoints:

a) The Population and Reproductive Health Strategy of Vietnam for the period 2011-2020 is an important component of the National Socio-Economic Development Strategy, contributing to improving the quality of human resources, enhancing the quality of life for each individual, each family, and the whole society.

b) Addressing population issues comprehensively, focusing on improving population quality, enhancing maternal and child health, leveraging the advantage of the "golden age" population structure, proactively adjusting population growth rates, and controlling sex ratios at birth.

c) Basic solutions for population work and reproductive health care include a coordinated and effective combination of mobilization, education, communication to change behavior, proactive, equitable, and fair provision of preventive services, and strict and effective sanctions against units and individuals violating regulations on prenatal diagnosis and sex selection.

d) Investment in population work and reproductive health care is investment in sustainable development, yielding direct economic, social, and environmental benefits. Increasing state budget investment, actively seeking foreign aid, and mobilizing people's contributions; prioritizing resource allocation for remote, mountainous, coastal, and island areas.

đ) Strengthening leadership and guidance from Party committees and authorities at all levels; enhancing the effectiveness of state management; mobilizing the participation of the entire society; continuing to improve organizational structures to effectively implement population work and reproductive health care.

2. Objectives:

a) General Objective: Improve population quality, enhance reproductive health status, maintain a reasonable low fertility rate, address population structure and distribution issues well, and contribute to successfully implementing industrialization and modernization.

b) Specific Objectives:

- Objective 1: Strive for a population growth rate of about 1% in 2015 and stabilize at around 1% in 2020; Human Development Index (HDI) at a high-middle level globally by 2020.

- Objective 2: Enhance health, reduce illness and mortality among children, significantly narrow disparities in child health indicators between regions.

+ Indicator 1: Reduce under-five child mortality rate to 19.3 per thousand in 2015 and 16 per thousand in 2020.

+ Indicator 2: Increase antenatal screening rate to 15% in 2015 and 50% in 2020.

+ Indicator 3: Increase newborn screening rate to 30% in 2015 and 80% in 2020.

- Objective 3: Enhance maternal health, significantly narrow disparities in maternal health indicators between regions.

+ Indicator: Reduce maternal mortality rate related to childbirth to 58.3 per 100,000 live births in 2015 and below 52 per 100,000 in 2020.

- Objective 4: Significantly reduce the rate of increase in sex ratio at birth, particularly focusing on provinces and centrally-administered cities with severe imbalances in sex ratio at birth, aiming to bring this ratio back to 105-106 male infants per 100 female infants by around 2025.

+ Indicator: Sex ratio at birth below 113 male infants per 100 female infants in 2015 and below 115/100 in 2020.

- Objective 5: Maintain a reasonable low fertility rate, fully meet family planning needs, and increase access to quality reproductive health services.

+ Indicator 1: Total fertility rate (average number of children born to a couple of reproductive age) reduced to 1.9 in 2015 and 1.8 in 2020.

+ Indicator 2: Population size not exceeding 93 million in 2015 and 98 million in 2020.

- Objective 6: Reduce abortion rates, basically eliminate unsafe abortions.

+ Indicator: Reduce abortion rate to 27 per 100 live births in 2015 and below 25 per 100 in 2020.

- Objective 7: Reduce reproductive tract infections, sexually transmitted infections; proactively prevent, detect, and treat early reproductive cancers, focusing on cervical cancer screening for women aged 30-54.

+ Indicator 1: Reduce reproductive tract infections by 15% in 2015 and 30% in 2020.

+ Indicator 2: Reduce sexually transmitted infections by 10% in 2015 and 20% in 2020.

+ Indicator 3: Increase cervical cancer screening rate for women aged 30-54 to 20% in 2015 and 50% in 2020.

+ Indicator 4: Increase breast cancer screening rate for women over 40 to 20% in 2015 and 50% in 2020.

- Objective 8: Improve reproductive health of adolescents and youth.

+ Indicator 1: Increase friendly reproductive health service provision points for adolescents and youth to 50% of total reproductive health service provision points in 2015 and 75% in 2020.

+ Indicator 2: Reduce unintended pregnancies among adolescents by 20% in 2015 and 50% in 2020.

- Objective 9: Improve reproductive health for special population groups (migrants, persons with disabilities, HIV-infected persons, ethnic minorities at risk of genetic deterioration); promptly meet reproductive health care needs of victims of gender-based violence and in disaster situations.

+ Indicator: Increase the proportion of special population groups accessing reproductive health services to 20% by 2015 and 50% by 2020.

- Objective 10: Enhance healthcare for the elderly.

+ Indicator 1: Increase the proportion of healthcare facilities at the district level and above providing points of service for elderly healthcare to 20% by 2015 and 50% by 2020.

+ Indicator 2: Increase the proportion of the elderly accessing community-based healthcare services to 20% by 2015 and 50% by 2020.

- Objective 11: Promote population distribution in line with national economic and social development orientations; strengthen the integration of demographic factors into policy planning, development planning, and economic and social development plans at all levels and sectors.

3. Main solutions:

a) Leadership, organization, and management:

Strengthen the leadership and guidance of the Party committees and administrative authorities at all levels over population work and reproductive health care. Population work and reproductive health care are key components in the regular programs and plans of the Party committees and administrative authorities. Improve the organizational structure for this work at all levels towards professionalization to ensure effective implementation of population programs, projects, and initiatives on reproductive health care, maternal and child health protection. Stabilize and enhance the capacity of grassroots-level staff working on population and reproductive health care to deliver communication, education, and provision of population services and reproductive health care; monitor and manage target groups down to each household, especially in remote, mountainous, coastal, and island areas. Enhance the effectiveness of population and reproductive health care management, implement this work under the National Target Program; gradually apply the model of service fee payment for those exempted from fees through intermediary payment means (customer cards, health insurance cards). Establish inter-sectoral coordination mechanisms to effectively carry out population and reproductive health care work. Strengthen inspection, audit, and evaluation of the implementation of laws on population and reproductive health, particularly inspections and audits, and strict handling of organizations and individuals providing sex selection services; enhance the role of community supervision in implementing policies and laws.

b) Communication, education, and behavior change:

Strengthen the dissemination and education on population and reproductive health policies and laws, particularly policies and laws on gender imbalance control at birth. Regularly update and provide information on population, gender balance at birth, and reproductive health to Party committees, administrative authorities, political-social organizations, and influential people in the community. Vigorously and effectively implement communication and educational activities with appropriate content, forms, and approaches for different target groups; prioritize hard-to-reach groups in terms of information and reproductive health services. Expand and improve the quality of education on population and reproductive health, including HIV prevention, gender equality, gender imbalance at birth, and sexual health both inside and outside schools. Combine mass media communication with direct communication through networks of population volunteers and industry propaganda officers; increase the use of modern communication tools such as the Internet, multimedia, and mobile phones.

c) Population and reproductive health services:

- Improve the service delivery network according to technical tiers, focusing on difficult areas, ensuring the provision of essential population and reproductive health care packages at all levels, especially at the grassroots level. Strengthen support for the commune level through various forms, including mobile teams, and establish appropriate referral systems for each region and area. Enhance service quality through the completion of regulations and technical procedures; strengthen monitoring and evaluation of the implementation of professional regulations and technical procedures by service providers; upgrade infrastructure, supplement equipment, and provide updated training for population service providers and reproductive health care providers.

- Improve the quality of forecasting and planning for contraception and reproductive health products. Complete the logistics system and strengthen market segment management to ensure timely and adequate supply of contraception and reproductive health products for family planning and reproductive health care programs; promote social marketing and widespread distribution of contraception.

- Expand the provision of pre-marriage counseling and health check-up services, screening, diagnosis, and early treatment of certain diseases and defects before and after birth based on establishing pre-birth and neonatal screening and diagnosis centers according to planning and plans; complete counseling and health check-up procedures, pre-birth and neonatal screening and diagnosis standards, and transfer technology to provincial-level centers; gradually include these services in the list of medical services covered by health insurance.

d) Building and improving the population and reproductive health policy system:

Actively review, study, supplement, and improve the legal and policy system on population, gender imbalance control at birth, and reproductive health, particularly policies aimed at reducing gender imbalance at birth, enhancing population quality, maintaining a reasonable low fertility rate, reproductive health care for youth and adolescents, and protecting and developing ethnic minorities at risk of genetic deterioration.

đ) Socialization, inter-sectoral coordination, and international cooperation:

Mobilize extensively all sectors, political-social organizations, and the community to participate in population communication, education, and reproductive health services. Gradually reduce the level of state subsidies. Shift the payment method for reproductive health services from direct funding to service providers to payments through intermediary means. Strengthen international cooperation, actively participate in international organizations and programs on population and reproductive health; proactively seek financial, technical, and experiential assistance from other countries and international organizations.

e) Finance:

Increase investment from the state budget; promote diversification of investment sources from the community, businesses, and private individuals for population work, gender imbalance control at birth, and reproductive health care. The state budget must ensure essential needs for population work, reproductive health care, and policy implementation for those supported by the state. Continue implementing the population-family planning program under the national target program mechanism, with transparent budget allocation, clear standards, focused on grassroots levels, and suitable for different regions. Strictly manage and enhance the efficiency of state budget investment in population work and reproductive health care.

g) Training, scientific research, and data information:

- Enhance training and capacity building for population and reproductive health workers based on technical planning and tiered management, with standardized programs, contents, and materials. Prioritize completing secondary-level population-health training for village-level family planning staff; train midwives in difficult areas; train pre-natal and neonatal screening techniques. Gradually implement advanced training, undergraduate, and postgraduate studies in population, obstetrics, pediatrics, geriatrics. Strengthen scientific research activities, disseminate and apply research results, technology, and techniques related to population, gender imbalance control at birth, and reproductive health.

- Improve the quality of data collection and processing on population and reproductive health based on applying information technology and perfecting indicator systems; provide accurate, timely information and data to serve guidance, management, and control of population work, gender imbalance control at birth, and reproductive health care at all levels.

4. Implementation Phases:

a) Phase I (2011 - 2015):

Persistently implement small healthy families, proactively adjust birth rates according to each region to maintain the national total fertility rate at 1.9 children by 2015. Focus on improving population quality through pre-marriage counseling and health checks, prenatal and neonatal screenings, pilot models for community-based elderly care. Intensify communication and education measures, complete legal frameworks, strictly enforce penalties for sex-selective abortion practices, and implement support policies to control gender ratios at birth. Fully implement reproductive health care services, increase access and improve service quality for all groups, especially in difficult areas and hard-to-reach populations. Continue to improve specialized databases on population and reproductive health.

b) Phase II (2016 - 2020):

Based on evaluating the implementation of the 2011-2015 phase, adjust policies appropriately, comprehensively implement solutions and tasks to achieve the strategic goals. Expand interventions to improve population quality, comprehensive reproductive health care, limit gender imbalance at birth, and elderly health care. Intensify exploitation and utilization of specialized databases on population and reproductive health for planning, administrative management, and public service provision.

5. Strategic Projects:

- Project on Communication for Behavioral Change in Population and Family Planning.

- Project on Ensuring Logistics and Family Planning Service Provision.

- Project on Improving Genetic Quality.

- Project on Enhancing Program Management Capacity in Population and Family Planning.

- Initiative on Controlling Gender Imbalance at Birth.

- Comprehensive Initiative on Improving Population Quality.

- Initiative on Coastal and Island Population Control until 2020 (approved by Decision No. 52/2009/QĐ-TTg dated April 9, 2009 of the Prime Minister).

- Project on Communication for Behavioral Change in Maternal and Child Health Care, Reproductive Health.

- Project on Improving Maternal and Child Health.

- Project on Prevention and Control of Sexually Transmitted Infections and Cervical Cancer.

- Project on Assisted Reproduction.

- Project on Improving Adolescent and Youth Reproductive Health.

- Project on Improving Reproductive Health for Special Populations.

Article 2. Implementation Organization

1. The Ministry of Health shall take the lead and coordinate with the Ministry of Planning and Investment, the Ministry of Finance, relevant ministries and sectors, the Vietnam Women's Union Central Committee, political and social organizations, and People's Committees of provinces and centrally governed cities to implement the Strategy nationwide, ensuring close integration with other strategies led by other ministries and sectors; develop the National Target Program on Population and Family Planning and the National Target Program on Health (including reproductive health care content) for the 2011-2015 period and submit them to the Prime Minister for approval; study and propose the National Target Program on Population and Family Planning and the National Target Program on Health (including reproductive health care content) for the 2016-2020 period to be sent to the Ministry of Planning and Investment and the Ministry of Finance for consolidation and submission to the Prime Minister; develop and implement annual plans on population and reproductive health care that are consistent with this Strategy and the Socio-Economic Development Strategy for 2011-2020; continue to effectively implement the Project on Controlling Population in Coastal and Island Areas for the 2009-2020 period (Decision No. 52/2009/QD-TTg dated April 9, 2009 of the Prime Minister); focus on accelerating the implementation of technical and social intervention measures to reduce factors affecting and deteriorating the quality of the gene pool; particularly, it is necessary to further intensify propaganda, warning, and proactive control and resolution of deep-rooted causes leading to gender imbalance at birth; review and amend or supplement laws and policies on population and reproductive health care according to their respective development stages (including policies promoting socialization and encouraging organizations and individuals to invest in population and reproductive health care areas) within their authority or recommend competent authorities to do so; guide, inspect, compile the situation of implementing the Strategy, and report periodically to the Prime Minister; organize mid-term reviews at the end of 2015 and final evaluations at the end of 2020.

2. The Ministry of Planning and Investment shall take the lead and coordinate with the Ministry of Finance, the Ministry of Health, and relevant ministries and sectors to mobilize Official Development Assistance (ODA) for programs and projects related to population and reproductive health; integrate population targets and indicators (size, structure, quality, distribution) into annual and five-year socio-economic development plans at the national level; guide the integration of population and reproductive health targets and indicators into the formulation and evaluation of results of strategic, planning, and socio-economic development goals of sectors and localities; organize annual, five-year, and ten-year population surveys to serve the formulation of socio-economic development plans, policy-making, and evaluation of the Strategy's implementation.

3. The Ministry of Finance shall take the lead and coordinate with the Ministry of Planning and Investment, based on the state budget capacity each year, allocate the budget to implement programs, projects, and proposals on population and reproductive health after they have been approved; guide, inspect, and audit the use of funds for the implementation of approved programs, projects, and proposals on population and reproductive health in accordance with the State Budget Law and other relevant laws.

4. The Ministry of Education and Training shall take the lead and coordinate with relevant ministries and sectors to implement the Strategy on Education Development for the 2011-2020 period after its approval; carry out education on gender, sexuality, population, reproductive health, and gender equality for students and trainees; provide training for teachers, lecturers, and healthcare staff in schools on gender, sexuality, population, reproductive health, gender equality, and HIV prevention; integrate population targets and indicators into sectoral development planning and planning.

5. The Ministry of Labor, Invalids, and Social Affairs shall take the lead and coordinate with relevant ministries and sectors to implement the National Strategy on Gender Equality for the 2011-2020 period (Decision No. 2351/QD-TTg dated December 24, 2010 of the Prime Minister); develop policies on vocational training and job creation to maximize labor force utilization and leverage the demographic dividend phase; guide the inclusion of education on gender, sexuality, population, reproductive health, and gender equality in vocational training programs; develop policies to improve welfare for the elderly; integrate population targets and indicators into sectoral development planning.

6. The Ministry of Science and Technology shall take the lead and coordinate with the Ministry of Health to build and direct the implementation of scientific research activities on population and reproductive health, especially on improving population quality.

7. The Ministry of Natural Resources and Environment shall take the lead and coordinate with the Ministry of Health and relevant ministries and sectors to integrate population targets and indicators into sectoral development planning.

8. The Ministry of Culture, Sports, and Tourism shall take the lead and coordinate with the Ministry of Health, the Ministry of Education and Training, relevant ministries and sectors, the Vietnam Women's Union Central Committee, and People's Committees of provinces and centrally governed cities to implement the Comprehensive Program on Developing Physical Fitness and Stature of Vietnamese People for the 2011-2030 period (Decision No. 641/QD-TTg dated April 28, 2011 of the Prime Minister) and the Strategy on Family Development for the 2011-2020 period and vision to 2030 after its approval; integrate population and reproductive health content into cultural institutions aimed at the goal of small families, prosperity, progress, and happiness.

9. The Ministry of Information and Communications shall take the lead and coordinate with the Ministry of Health to strengthen guidance and direction for mass media agencies to intensify and innovate information, propaganda, and educational activities to change behavior regarding population, reproductive health, and gender equality; strictly handle the publication of printed materials and information products containing content violating population and reproductive health policies; integrate population targets and indicators into sectoral development planning.

10. The Ministry of Agriculture and Rural Development shall take the lead and coordinate with the Ministry of Health and relevant ministries and sectors to integrate population content into agricultural extension programs, forestry extension programs, fisheries extension programs, and rural development programs; guide, direct, and inspect the implementation of relocation work according to the socio-economic development planning.

11. The Committee for Ethnic Affairs shall take the lead and coordinate with the Ministry of Health and relevant ministries and sectors to organize propaganda, dissemination, education, and mobilization to implement population policies and laws on reproductive health for ethnic minorities; build and submit to competent authorities for issuance, provide guidance, and organize the implementation of special support policies for population and reproductive health in remote, mountainous areas, areas with ethnic minority populations, and areas with particularly difficult economic and social conditions.

12. Vietnam News Agency, Voice of Vietnam Radio, Vietnam Television, and other mass media organizations shall increase broadcasting time, number of articles, and improve the quality of propaganda on population and reproductive health in their programs, special sections, and columns.

13. Ministries, ministerial-level agencies, and government-affiliated agencies shall participate in implementing the Strategy within their assigned functions and tasks.

14. People's Committees of provinces and centrally-administered cities shall organize the implementation of the Strategy at the local level in accordance with the guidelines of the Ministry of Health and relevant ministries and sectors; develop and implement five-year and annual action plans on population and reproductive health that are consistent with this Strategy and the socio-economic development plan of the locality during the same period; actively mobilize resources to implement the Strategy; effectively integrate the implementation of this Strategy with related Strategies in the area; allocate sufficient staff to handle population work and reproductive health care at the local level; intensify inter-sectoral coordination; integrate population and reproductive health content into policy planning for socio-economic development at the local level; regularly inspect the implementation of the Strategy at the local level; report annually on the implementation of the Strategy in the area in accordance with current regulations.

15. It is requested that the Vietnam Fatherland Front Central Committee, the General Confederation of Labor of Vietnam, the Vietnam Women's Union, the Communist Youth Union of Ho Chi Minh Central Committee, the Vietnam Farmers' Union, the Vietnam Elderly Association, the Vietnam Family Planning Association, and other member organizations of the Front, and social organizations, within their respective functions and tasks, participate in organizing the implementation of the Strategy; intensify propaganda and educational work to raise awareness about population and reproductive health within their organizations; participate in building policies, laws, state management, and supervision of the implementation of laws on population and reproductive health.

Article 3. This Decision takes effect from the date of issuance.

Article 4. Ministers, heads of ministerial-level agencies, heads of government-affiliated agencies, and heads of related agencies and organizations, Chairmen of provincial and centrally-administered city People's Committees shall be responsible for enforcing this Decision.