Decision No. 2013/QD-TTg dated November 14, 2011 of the Prime Minister approving Vietnam’s strategy for population and reproductive health during 2011 - 2020

THE PRIME MINISTER

Decision No. 2013/QD-TTg of November 14, 2011, approving Vietnam’s strategy for population and reproductive health during 2011-2020

THE PRIME MINISTER

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

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

Pursuant to the Government’s Resolution No. 31/NQ-CP of August 18, 2010, promulgating the Government’s 2010-2015 plan of action for implementation of the Politburo’s Conclusion No. 44-KL/TW of April 1, 2009, on the results of three years’ implementation of the Politburo’s Resolution No. 47-NQ/TW of March 22, 2005, on further setting up the implementation of population and family planning policies;

At the proposal of the Minister of Health,

DECIDES:

Article 1. To approve Vietnam’s strategy for population and reproductive health during 2011-2020, with the following principal contents:

1. Viewpoints:

a/ Vietnam’s strategy for population and reproductive health during 2011-2020 constitutes an important content of the national socio-economic development strategy, contributing to improving the quality of human resources and raising the quality of life of each person, each family and the entire society.

b/ To synchronously tackle population and reproductive health issues, focusing on raising the population quality, improving mother and child health, bringing into full play the advantages of the “golden population” structure, and proactively adjusting the population growth rate and controlling the sex ratio at birth.

c/ The fundamental solution for population and reproductive health work is synchronously and effectively combining behavior change education and communication and provision of preventive services in an active, fair and equal manner with imposition of severe sanctions on service providers that violate regulations on fetal sex diagnosis and selection.

d/ Investment in population and reproductive health care will be regarded as  investment in sustainable development, bringing about direct economic, social and environmental benefits. To increase state budget investment, get the best of donation sources and mobilize contributions from people; and prioritize investment resources for deep-lying, remote, mountainous, coastal and island areas.

e/ To enhance the leadership and direction of Party committees and administrations of all levels; to improve state management effectiveness; to mobilize the participation of the entire society; and to further consolidate the organizational apparatus so as to effectively implement population and reproductive health care work.

2. Objectives:

a/ General objectives: To raise the population quality, improve reproductive health, maintain a rational low birth rate and propertly settle population structure and distribution issues so as to contribute to the success of the cause of national industrialization and modernization.

b/ Specific targets:

- Target 1: The population growth rate will be around 1% by 2015 and kept stable at 1% by 2020; the human development index (HDI) will reach the world’s average-high level by 2020.

- Target 2: To improve child health and reduce child diseases, defects and mortality and significantly narrow the gap in child health indicators among areas and regions.

+ Norm 1: The under-5 child mortality rate will reduce to 19.3‰ by 2015 and 16‰ by 2020.

+ Norm 2: The prenatal screening rate among pregnant women will reach 15% by 2015 and 50% by 2020.

+ Norm 3: The newborn screening rate will reach 30% by 2015 and 80% by 2020.

- Target 3: To improve maternal health and significantly narrow the gap in maternal health indicators among areas and regions.

+ Norm: The maternal mortality ratio per 100,000 live births will reduce to 58.3 by 2015 and below 52 by 2020.

- Target 4: To sharply reduce the increase rate of the sex ratio at birth, paying special attention to provinces and centrally run cities facing severe sex imbalance at birth, so as to attain a male-to-female ratio of 105-106/100 by 2025.

- Norm: The sex ratio at birth will be kept at below 113 male infants/100 female infants by 2015 and below 115 male infants/100 female infants by 2020.

- Target 5: To maintain a rational low birth rate, fully meet people’s family planning needs and improve access to high-quality assisted reproductive services.

+ Norm 1: The total fertility rate (the average number of children of a couple of reproductive age) will reduce to 1.9 by 2015 and 1.8 by 2020.

+ Norm 2: The population will not exceed 93 million by 2015 and 98 million by 2020.

- Target 6: To reduce the abortion rate and basically eliminate unsafe abortion.

+ Norm: To reduce the rate of abortions per 100 live births to 27 by 2015 and below 25 by 2020.

- Target 7: To reduce reproductive tract and sexually transmitted infections; to proactively prevent, detect and provide early treatment for reproductive cancers, attaching importance to reproductive cancer screening for women aged 35-54.

+ Norm 1: To reduce the number of reproductive tract infection cases by 15% and 30% by 2015 and 30%, respectively.

+ Norm 2: To reduce the number of sexually transmitted infection cases by 10% and 20% by 2015 and 2020, respectively.

+ Norm 3: The cervical screening rate among women aged 35-54 will reach 20% by 2015 and 50% by 2020.

+ Norm 4: The breast cancer screening rate among women aged over 40 will reach 20% by 2015 and 50% by 2020.

+ Target 8: To improve reproductive health of teenagers and the youth.

+ Norm 1: To increase the proportion of points providing teenage- and youth-friendly reproductive health services to the total number of service delivery points to 50% by 2015 and 75% by 2020.

+ Norm 2: To reduce the number of teenagers getting unwillingly pregnant by 20% and 50% by 2015 and 2020, respectively.

- Target 9: To improve reproductive health among specific population groups (immigrants, people with disabilities, HIV-infected people and people of ethnic groups at risk of racial deterioration); and meet the needs for reproductive health care for victims of gender-related violence, calamities or natural disasters.

+ Norm: To increase the rate of people having access to reproductive health care services among specific population groups to 20% and 50% by 2015 and 2020, respectively.

- Target 10: To intensify health care for the elderly.

+ Norm 1: To increase the rate of medical establishments of district or higher level having elderly health care service delivery points to 20% and 50% by 2015 and 2020, respectively.

+ Norm 2: To increase the rate of elderly people having access to community-based health care services to 20% and 50% by 2015 and 2020, respectively.

- Target 11: To accelerate population distribution in conformity with national socio-economic development orientations; and further integrate population factors in the making of policies and elaboration of local and sectoral socio-economic development master plans and plans.

3. Major solutions:

a/ Leadership, organization and management:

To intensify the leadership and direction of Party committees and administrations at various levels of population and reproductive health care work, considering it a key content of Party Committees’ and administrations’ working programs and plans. To professionalize population and reproductive health care personnel of various levels, ensuring effective implementation of population, reproductive health care and maternal and child health protection programs, schemes and projects. To stabilize and improve the capacity of grassroots population and reproductive health care personnel to serve communication and education about, and provision of population and reproductive health care services; to monitor and manage targeted subjects in each household, especially those in deep-lying, remote, coastal and island areas. To increase the effect and effectiveness of population and reproductive health care work, which will be managed under national target programs; to step by step apply the model of using intermediary payment instruments (customer card, health insurance card) to pay population and reproductive health care service charges for charge-exempt people. To formulate an inter-sectoral coordination mechanism so as to effectively carry out population and reproductive health care work. To intensify inspection, examination and evaluation of the observance of laws on population and reproductive health care, paying special attention to inspection, examination and handling of organizations and individuals providing fetal sex diagnosis and selection services; to enhance the role of communities in supervising the observance of laws and policies.

b/ Behavior change communication and education:

To intensify the dissemination and education of population and reproductive health policies and laws, especially those on control of sex imbalance at birth. To regularly update and provide information on population, sex ratio at birth and reproductive health to Party committees, administrations, socio-political organizations and prestigious persons in the community. To conduct intensive and effective communication and education campaigns in a manner suitable to each group of targeted subjects in terms of content, form and approaching method; to prioritize those facing difficulty accessing population and reproductive health information and services. To expand and improve the quality of population and reproductive health education, including also HIV prevention and control, gender equality, sex imbalance at birth and sexual health education inside and outside school. To properly combine public information with direct communication through a network of population collaborators and disseminators of various sectors and associations; to intensify the use of modern communication means such as Internet, multi-media communication, and mobile phone.

c/ Population and reproductive health services:

- To consolidate the service delivery networks at different levels, focusing on difficulty-hit areas and assuring the provision of essential population and reproductive health care service packages at service establishments of all levels, especially at the grassroots level. To further support commune-level service establishments in different forms, including forming mobile support teams and building appropriate patient transport systems for each area or region. To raise the quality of services by perfecting technical regulations and processes; intensify inspection, supervision and evaluation of the observance of professional regulations and technical processes by service establishments; upgrade infrastructure facilities, further supply equipment and organize training courses for population and reproductive health care service providers.

- To improve the quality of forecasts of demands for contraceptive devices and reproductive health goods. To perfect the logistic system and intensify management based on market fragmentation to assure sufficient and prompt provision of contraceptive devices and reproductive health goods for population, family planning and reproductive health care programs; to promote the marketing and sale of contraceptive devices.

- To expand the provision of the services of pre-marriage counseling and health-checks, prenatal and newborn screening and diagnosis for early treatment of some diseases and defects on the basis of building a system of prenatal and newborn screening and diagnosis centers under master plans and plans; to perfect technical processes and regulations on pre-marriage counseling and health-checks and prenatal and newborn screening and diagnosis, and transfer these techniques to provincial-level centers; to gradually include these services into the list of medical services covered by health insurance.

d/ Building and perfecting the system of population and reproductive health policies:

To actively review and study so as to supplement and perfect the system of laws and policies on population, control of sex imbalance at birth and reproductive health, especially intervening policies aiming to mitigate sex imbalance at birth, improve population quality, maintain a rational low birth rate, provide reproductive health care to youths and teenagers and protect and develop ethnic groups at risk of racial deterioration.

e/ Socialization, inter-sectoral coordination and international cooperation:

To widely mobilize sectors, socio-political organizations and the community to participate in communication, education and provision of population and reproductive health care services. To draw up and realize a roadmap to gradually reduce state subsidies. To gradually replace the current mechanism of paying population and reproductive health service expenses by allocating funds to service establishments with the use of intermediary payment instruments. To intensify international cooperation, proactively join international organizations and programs on population and reproductive health and make the best use of financial and technical assistance and experience of other countries and international organizations.

f/ Finance:

To increase state budget investment; further diversify investment sources from the community, businesses and the private sector for population, control of sex imbalance at birth and reproductive health care. State budget funds shall be used to assure the satisfaction of essential needs of population and reproductive health care work and the payment of population and reproductive health care service charges for those eligible for charge payment by the State. To continue implementing the population and family planning program according to the mechanism applicable to national target programs, allocating funds mainly to grassroots establishments in a public manner with specific norms suitable to each region, area and locality. To strictly manage and improve efficiency of state budget investment in population and reproductive health care work.

g/ Training, scientific research, information and data:

- To intensify training on managerial and professional skills for population and reproductive health care staffs on the basis of planning and grading service establishments, using standardized training curricula, contents and materials. To prioritize intermediate training in population-healthcare disciplines for commune-level population and family planning staffs; train midwives for villages and hamlets of difficult-to-access areas; and provide training in prenatal and newborn screening techniques. To step by step provide intensive training and tertiary and post-graduate training in population, obstetrics, pediatrics and geriatrics. To intensify scientific research activities and disseminate and apply outcomes of scientific, technological and technical researches on population, control of sex imbalance at birth and reproductive health.

- To raise the quality of the collection and processing of information and data on population and reproductive health on the basis of applying information technology and perfecting the system of indicators and norms; to adequately, accurately and promptly provide information to serve the direction, administration and management of population, control of sex imbalance at birth and reproductive health care work at various levels.

4. Implementation phases:

a/ Phase I (2011-2015):

To stick to the model of healthy small family and take the initiative in adjusting birth rates suitably to each region and area so as to maintain the national total fertility rate at around 1.9 by 2015. To concentrate on improving population quality through implementing pre-marriage counseling and health-check, prenatal and newborn screening activities and applying on a pilot basis the model of providing community-based health care for the elderly. To step up communication and education activities and perfect legal grounds for inspection and strict handling of prenatal sex selection practices and adopt support policies to control sex ratio at birth. To provide comprehensive reproductive health care services, increase the ability to access services and improve service quality for all people, especially those in difficulty-hit areas and difficult-to-access groups. To continue building a specialized database on population and reproductive health care.

b/ Phase II (2016-2020):

On the basis of evaluating the implementation of the strategy during 2011-2015, to make proper regulatory adjustments and comprehensively carry out solutions and tasks to fulfill objectives of the strategy. To expand intervening activities to improve population quality, provide comprehensive reproductive health care services, mitigate sex imbalance at birth and provide healthcare for the elderly. To intensify the exploitation and use of the specialized database on population and reproductive health care in service of planning, administrative management and provision of public services.

5. Projects under the strategy:

- Project on communication for behavior change in population and family planning.

- Project on assurance of logistics and provision of family planning services.

- Project on racial quality improvement.

- Project on improvement of the capacity for managing population and family planning programs.

- Scheme on control of sex imbalance at birth.

- Overall scheme on population quality improvement.

- Scheme on population control in sea, island and coastal areas through 2020 (approved under the Prime Minister’s Decision No. 52/2009/QD-TTg of April 9, 2009).

- Project on communication for behavior change in maternal and child health care and reproductive health.

- Project on maternal and child health improvement.

- Project on reproductive tract infection and cancer prevention and control.

- Project on assisted reproduction.

- Project on teenager and youth reproductive health improvement.

- Project on improvement of reproductive health for specific population groups.

Article 2. Organization of implementation

1. The Ministry of Health shall assume the prime responsibility for, and coordinate with the Ministry of Planning and Investment, the Ministry of Finance, related ministries and sectors, the central Vietnam Women’s Union, socio-political organizations and provincial-level People’s Committees in, organizing the implementation of the strategy nationwide, ensuring a close combination between the strategy and relevant strategies implemented by other ministries and sectors; elaborate the national target program on population and family planning and the national target program on health (covering contents on reproductive health care) during 2011-2015 for submission to the Prime Minister for approval; study and propose national target programs on population and family planning and on health (covering contents on reproductive health care) during 2016-2020 and send them to the Ministry of Planning and Investment and the Ministry of Finance for summarization and submission to the Prime Minister; elaborate and implement annual plans on population and reproductive health in conformity with this strategy and the strategy on socio-economic development during 2011-2020; continue effectively implementing the scheme on population control in sea, island and coastal areas during 2009-2020 (the Prime Minister’s Decision No. 52/2009/QD-TTg of April 9, 2009); attach importance to accelerating the application of technical and social intervening solutions so as to mitigate factors affecting or causing racial deterioration; particularly, continue promoting communication about, and take the initiative in controlling and solving root causes of, sex imbalance at birth; revise the system of population and reproductive health laws and policies (including policies to boost socialization and encourage organizations and individuals to invest in the fields of population and reproductive health), making amendment or supplementation according to its competence or proposing competent agencies to do so in line with requirements of each development period; guide, inspect, summarize and make periodical reports on implementation results of the strategy to the Prime Minister; and organize preliminary and final reviews of the strategy at the end of 2015 and 2020, respectively.

2. The Ministry of Planning and Investment shall assume the prime responsibility for, and coordinate with the Ministry of Finance, the Ministry of Health and related ministries and sectors in, raising funds from official development assistance sources for population and reproductive health care programs and projects; include population (scope, structure, quality and distribution) targets and norms into annual and five-year national socio-economic development plans; guide the integration of population and reproductive health targets and norms in the elaboration and assessment of implementation results of sectoral and local socio-economic development master plans and plans; and organize statistical surveys on population annually and once every 5 or 10 years to serve the elaboration of socio-economic development plans and master plans, the formulation of policies and assessment of the strategy implementation.

3. Based on the annual state budget capacity, the Ministry of Finance shall assume the prime responsibility for, and coordinate with the Ministry of Planning and Investment in, allocating budget funds for the implementation of population and reproductive health programs, schemes and projects after they are approved; and guide, inspect and examine the use of funds for the implementation of these programs, schemes and projects according to the Law on the State Budget and other relevant laws.

4. The Ministry of Education and Training shall assume the prime responsibility for, and coordinate with related ministries and sectors in, organizing the implementation of the strategy on education development during 2011-2020 after it is approved; implement contents on gender, sex, population, reproductive health, gender equality and HIV prevention and control education for pupils and students; provide training in gender, sex, population, reproductive health, gender equality and HIV prevention and control for teachers, lecturers and school health staff; and incorporate  population targets and norms in development master plans and plans of its sector.

5. The Ministry of Labor, War Invalids and Social Affairs shall assume the prime responsibility for, and coordinate with related ministries and sectors in, organizing the implementation of the national strategy on gender equality during 2011-2020 (the Prime Minister’s Decision No. 2351/QD-TTg of December 24, 2010); adopt proper vocational training and employment policies to make the full use of the workforce, promote advantages of the “golden population” period; guide the incorporation of gender, sex, population, reproductive health and gender equality contents in training curricula of vocational training institutions; adopt policies to improve welfare for the elderly; and incorporate population targets and norms in development master plans and plans of its sector.

6. The Ministry of Science and Technology shall assume the prime responsibility for, and coordinate with the Ministry of Health in, drawing up and directing scientific researches on population and reproductive health, especially those on improvement of population quality.

7. The Ministry of Natural Resources and Environment shall assume the prime responsibility for, and coordinate with the Ministry of Health and related ministries and sectors in, incorporating population targets and norms in development master plans and plans of its sector.

8. The Ministry of Culture, Sports and Tourism shall assume the prime responsibility for, and coordinate with the Ministry of Health, the Ministry of Education and Training, related ministries and sectors, the central Vietnam Women’s Union and provincial-level People’s Committees in, organizing the implementation of the overall scheme on development of physical strength and stature of Vietnamese people during 2011-2030 (the Prime Minister’s Decision No. 641/QD-TTg of April 28, 2011) and the strategy on development of Vietnamese families during 2011-2020, with a vision toward 2030, after it is approved; and integrate  contents on population and reproductive health into cultural institutions, aiming to realize prosperous, progressive and happy small families.

9. The Ministry of Information and Communications shall assume the prime responsibility for, and coordinate with the Ministry of Health in, further guiding and directing mass media agencies in promoting and renewing information, communication and education for behavior change in population, reproductive health and gender equality; strictly handle acts of publishing publications or information products with contents violating population and reproductive health policies; and incorporate population targets and norms in development master plans and plans of its sector.

10. The Ministry of Agriculture and Rural Development shall assume the prime responsibility for, and coordinate with the Ministry of Health and related ministries and sectors in, incorporating population-related contents in agricultural, forestry and fishery extension programs; and guide, direct and examine migration activities under socio-economic development master plans.

11. The Committee for Ethnic Affairs shall assume the prime responsibility for, and coordinate with related ministries and sectors in, organizing communication, dissemination and education activities to urge ethnic minority people to observe population and reproductive health policies and laws; elaborate and submit to competent agencies for promulgation, and guide and organize the implementation of, specific policies to support the implementation of population and reproductive health policies in deep-lying, remote, ethnic minority and extreme socio-economic difficulty-hit areas.

12. Vietnam News Agency, Voice of Vietnam, Vietnam Television and other mass media agencies shall increase broadcasting time, quantity of and quality of programs and articles on population and reproductive health.

13. Ministries, ministerial-level agencies and government-attached agencies shall, within the scope of their assigned functions and tasks, implement the strategy.

14. Provincial-level People’s Committees shall organize the implementation of the strategy in their localities under the guidance of the Ministry of Health and other ministries and functional sectors; elaborate and implement five-year and annual plans of action on population and reproductive health in line with this strategy and local socio-economic development plans of the same period; take the initiative in mobilizing resources for the implementation of the strategy; combine the implementation of this strategy with other related strategies in the localities; arrange sufficient cadres, civil servants and public employees to perform population and reproductive health work in localities; boost inter-sectoral coordination; take into account population and reproductive health when making policies on local socio-economic development; regularly examine the implementation of the strategy in their localities; and make annual reports on the implementation of the strategy in their localities according to current regulations.

15. The Central Committee of the Vietnam Fatherland Front, the Vietnam General Confederation of Labor, the central Vietnam Women’s Union, the central Ho Chi Minh Communist Youth Union, the central Vietnam Peasants’ Association, the central Vietnam Elderly People’s Association, Vietnam Family Planning Association and other member organizations of the Fatherland Front, and social organizations shall, within the scope of their functions and tasks, participate in implementing this strategy; boost communication and education to raise awareness about population and reproductive health care among their organizations; and participate in the making of policies and laws, state management and supervision of the implementation of laws on population and reproductive health.

Article 3. This Decision takes effect on the date of its signing.

Article 4. Ministers, heads of ministerial-level agencies, government-attached agencies and related agencies and organizations, and chairpersons of provincial-level People’s Committees shall implement this Decision.-

Prime Minister
NGUYEN TAN DUNG