Viet Nam -Multiple Indicator Cluster Survey - 2000

Publication date: 2000

Jl K A TONG Cl)C THONG KE ? ? A' ._ / ? A UY BAN BAO V~ VA CHAM SOC TRE EM VI~T NAM GENERAL STATISTICAL OFFICE VIETNAM COMMITTEE FOR PROTECTION AND CARE FOR CHILDREN ANALYSIS OF RESULTS OF THE MULTIPLE INDICATOR CLUSTER SURVEY II (MICSII) NHA XUAT BAN THONG KE STATISTICAL PUBLISHING HOUSE HA N(H - 2000 TONG C(JC THONG KE UY BAN BAO VJ:: VA CHAM SOC TRE EM VIJ::T NAM GENERAL STATISTICAL OFFICE VIETNAM COMMITTEE FOR PROTECTION AND CARE FOR CHILDREN A I A.1 '} A' I I A PHAN TICH KET QUA DIEU IRA DANH GIA MUC liEU • A ? A' ? A. THAP KY VE TRE EM VIET NAM . . Analyis of results of The multiple . indicator cluster survey in 2000 (MICS) NHA XUAT BAN THONG KE STATISTICAL PUBLISHING HOUSE HA N<)I - 2000 BAN BIEN SOAN . THE BOARD OF EDITORS Chu bien/ Head of the board of editors: TS. Nguy~n Van Tien, Ph6 T6ng C\lC Tntdng T6ng C\lC Thong ke (TCTK) Dr. Nguy~n Van Titn, Deputy General Director of the General Statistical Office (GSO). Thanh vi en/ Members of the board of editors: 1. TS. Tr~n Thi Thanh Thanh, B9 Tntdng- Chu nhi~m Uy ban Bao v~ va Cham s6c Tre em Vi~t Nam (UBBVCSTEVN). Dr. Tr&n Thi Thanh Thanh, Ministor - Chairperson of Vietnam Committee for Protection and Care for Children (CPCC). 2. Nguy~n Thi Th\lY Bao, Ph6 Chu nhi~m UBBVCSTEVN Deputy Minister- Chairperson of CPCC. 3. H6 81 Cue, V\1 Tntdng V1:1 Xa h9i- Moi tntdng, TCTK Director of the Social and Environmental Department, GSO. 4. Tong Thi Dua, Ph6 V1:1 Trudng V\1 Xa h9i- Moi trudng, TCTK Deputy Director of the Social and Environmental Department, GSO. 5. Trftn Ng9c Th~ch, Giam doc Trung tam Thong tin Thong ke UBBVCSTEVN Director of the Information and Documentation Centre, CPCC. 6. Vii Thtnh, V\1 Trudng V1:1 Ke ho~ch- Tai chinh va Qwin ly cac chuang trinh UBBVCSTEVN/ Director of the Planning, Finance and Programme Management Department, CPCC. 7. Nguy~n Dinh Chung, Chuyen vien V\1 Xa h9i- Moi trudng, TCTK Statistical Expert of the Social and Environmental Department, GSO. 8. D6 Anh Kiem, Chuyen vien V\1 Xa h9i- Moi trudng, TCTK Statistical Expert of the Social and Environmental Department, GSO. 9. Nguy~n Quang Phuong, Chuyen vien V\1 Xa h9i- Moi trttdng, TCTK Statistical Expert of the Social and Environmental Department, GSO. 10. L9 Tht Due, Chuyen vien V1:1 Xa h9i- Moi trudng, TCTK Statistical Expert of the Social and Environmental Department, GSO. 11. Nguy~n The Quan, Chuyen vien V1:1 Xa h9i- Moi trudng, TCTK Statistical Expert of the Social and Environmental Department, GSO. 12. Nguy~n Bui Linh, Chuyen vien V1:1 Xa h9i- Moi trudng, TCTK Statistical Expert of the Social and Environmental Department, GSO. 13. Nguy~n Thi Loan, Chuyen vien V1,1 Xa h9i- Moi trudng, TCTK Statistical Expert of the Social and Environmental Department, GSO. 14. Doan Thu~n Hoa, Chuyen vien V1,1 Xa h9i- Moi trudng, TCTK Statistical Expert of the Social and Environmental Department, GSO. 15. Nguy~n Tht Thuy, Chuyen vien V1,1 Xa h9i- Moi tru<ing, TCTK Statistical Expert of the Social and Environmental Department, GSO. 3 4 MUC LUC/ CONTENTS . . Danh sach cac bi~u do/ List of Figures . 7 LOi giro thi~u/ Introduction . 9-11 Tom hit ket qua cul)c dit~u tra cac m1,1c tieu cuoi th~p ky ve tre em Vi~t Nam 1991-2000/ Summary results of the Multiple Indicator Cluster Survey II (MICS) . 13 Ban do himh chinh Vi~t Nam/ The administrative map of Vietnam . 21 Bang tom Hit cac chi tieu chinh ciia cul)c dieu tral Main indicators of MICS . 22-23 Bang tom tAt cac cac chi tieu khong tho th~p qua dieu tra MICS/ Indicators for reporting not covered in MICS . 28-29 I. Giro thi~u/ Introduction . 31 Ca sa cua CUQC dieu tra/ Rationale . . . 31 Gi6'i thi~u khai quat ve Vi~t Nam/ General information on Vietnam . 32 Ml;lc dfch cua cu¢c dieu tra/ Objectives of the survey . , . 34 II. Phuong phap lu~n ciia cul)c dieu tra/ Survey methodology: . 35 Thiet ke mau/ Sample design: . . 35 Phieu phong van/ Questionnaires . . . . . . . . . . . . . . . 36 T~p huan va t6 chuc thu th~p soli~u te;ti d!a b1m/ Training and collection of data . 37 Xu ly va t6ng hqp so li¢u/ Data processing and tabulation . 38 Ill Cac d~c trung ciia m:\u va chat luqng soli~u/ Sample characteristics and data quality 41 Ty I~ tra lO'i/ Response rates . . . . 41 Phan bo tu6i va tnrang hqp thieu thong tin/ Age distribution and missing data . . . 41 Cac d~c trung cua nhan khAu h¢ gia dlnh dieu tra/ Characteristics of household population . . . 42 IV. Ket qua/ Results . 45 A. Ty 1~ chet tre em du6'i l tu6i va du6'i 5 tu6i/ Infant mortality rate (IMR) and under five mortality rate (U5MR) . 45 B. Ty l~ chet m~ do cac nguyen nhan lien quan den sinh de/ Maternal mortality rate related to child-bearing . . . . . . 47 C. Giao dt,1c/ Education . . . . . . . 47 Giao dl;IC tre em d¢ tu6i nha tre, mau giao/ Early childhood education . 47 Giao dl;lc ph6 thong/ Primary and secondary education . 48 T ., l" b""'t h- ., ,,:;.·1' /Ad ltl.t 51 y ~ 1e c 11 cua nguvl an u 1 eracy . . . . . 5 6 D. Nuac va cong trlnh v¢ sinh/ Water and sanitation . 52 Ngu6n nuac S<;tch/ Sources of drinking water. . 52 S' d h ,, 'h · . h/ S . . u l,lng o Xl 9P Vy sm amtat10n . ~ . 54 E. Suy dinh duong atre em/ Child malnutrition . 55 Tinh tr<;tng dinh du5ng/Nutritional status . 55 Nuoi con bang sua my/ Breastfeeding . 57 Str dt;Ing muoi i-ot/ Use of iodized salt. . 58 Cung cap b6 sung Vitamin A/ Vitamin A supplementation . 59 Can ni[mg sa sinh thap/ Low birth weight. . 60 F. Sue khoe tre em/ Child health . 61 Tiem chimg/ Immunization . 61 B¢nh tieu chay/ Diarrhoea . 63 Nhiem khuiln ho hap cap tfnh (ARI)/ Acute Respiratory Infection (ARI) . 65 Quan ly 16ng ghep cac b¢nh tre em (IMCI)/ IMCI initiative . 65 B¢nh sot ret/ Malaria . : . 67 G. HIV/AIDS . 68 Kien thuc ve HIV I AIDS/ HIV I AIDS knowledge . 68 Kiem tra HIV I AIDS/ HIV I AIDS testing . 71 H. Sue khoe sinh san/ Reproductive health . 72 Cac bi¢n phap tranh thai/ Contraceptive methods . 72 Cham soc tien thai san/ Antenatal care . 74 Cham soc khi sinh d6/ Assisted delivery . 76 I. Cac quyen tre em/ Child rights . 79 Dang ky khai sinh/ Birth registration . 79 Tre em m6 coi/ Orphanhood . 80 Soli~u dieu tra MICS/ Data of Multiple Indicator Cluster Survey . 81 Ph~ l~c 11 Annex 1: Thiet ke mfiu/ Sample Design .•. 183 Ph~ l~c 2/ Annex 2: U6'c hrqng sai so ch<,>n mfiu va khming tin c~y/ Estimation of sampling error and confidence interval . 187 Ph~ l~c 3/ Annex 3: Danh s~ich d'a ban dieu tra MICS/ List of EDs of MICS . 191 Ph~ l~c 4AI Annex 4A: Bang phieu hOi Dit~u tra danh gia cac m~c tieu cuoi tMp ky vi tre em Vi~t Nam I Model questionnaire End-decade Multiple Indicator Cluster Survey . 205 Ph~ l~c 4B/ Annex 4B: Phieu phong van xa/ plmang/ Community Questionnaire . 259 Danh sach cac bi~u do/ List of Figures Bi~u do 11 Figure 1. Phan b6 tu6i cua cac nhan khdu cua h¢ gia dinh di6u tra theo gi6'i tfnh/ Age distribution of interviewed household members by sex . . . . . 41 Bi~u do 2/ Figure 2. Ccr cau ph1;1 nii 15-49 tu6i phan theo nh6m tu6i/ Structure of women aged 15- 49 by age group . . . . 43 Bi~u do 3/ Figure 3. lf ac Juqng tre em chet du6'i 1 tu6i va chet du6'i 5 tu6i bang phucrng phap gian tiep theo m6 hinh blmg song North va Genral/ Estimated IMR and U5MR by indirect method following North and General models . . 46 Bi~u do 4/ Figure 4. Ty 1~ tre em d¢ 6-10 tu6i dang di hQC cap ti~u hQC/ Percentage of children 6-10 years of age attending primary school. . . . 49 Bi~u do 5/ Figure 5. Ty l~ tre em vao hQC 16'p 1 hQC t6'i 16'p 5 chia theo khu Vl.JC va theo vimg/ Percentage of children reaching grade 5 by area and region . . . . . . . . 50 Bi~u do 6/ Figure 6. Ty 1~ dan s6 Slr dl;lng phucrng ti~n h6 xf hqp v~ sinh chia theo khu Vl.JC va theo vung/ Percentage of population using sanitary means of excreta disposal by area and region 55 Bi~u do 7/ Figure 7. Phan b6 phan tram tre em theo tlni1 tr<;tng bU sfra mr;,/ Percent distribution of ' children by breastfeeding status . 58 Bi~u do 8/ Figure 8. Ty 1~ tre scr sinh c6 can n~n~ du6'i 2500gram chia theo tu6i cua mr;,/ Percentage of low birth weight infants (less than 2500 grams) by .mother-s age . . . . . 61 Bi~u do 9/ Figure 9. Ty I~ tre em tu 12-23 thang tu6i duqc tiem chung dily du tat cii cac lo<;ti vac-xin tfnh den thai diem dieu tra chia theo vung, khu Vl,l'C va theo trlr.h d¢ van hoa cua mf;/ Percentage of children aged 12-23 months fully immunized by the time of the ~urvey by area, region and mother's education . . . . . . . . 62 Bi~u do 10/ Figure 10. Ty 1~ tre em du6'i 5 tu6i bi tieu chay 2 tmin qua chia theo nh6m tu6i/ Percentage of under 5 children having diarrhoea two weeks prior to th~ survey by age group 64 Bi~u do 11/ Figure 11. Ty I~ tre em bt tieu chay chia theo trinh d¢ van hoa cua me ho~c nguai cham s6c/ Percentage of children having diarrhoea by education of mother or care taker . . . . . . . 64 Bi~u do 12/ Figure 12. Hieu biet ve HIV I AIDS cua pht,t nfr 15-49 tu6i/ !):.now ledge of HIV I AIDS atnong women aged 15-49 . . . . 71 Bi~u do 13/ Figure 13. Ty 1¢ plw nil duqc tiem phong u6n ·van dily du theo dung thai gian qui dtnh chia theo trinh d¢ van ho<i/ Percentage of women receiving dose against neonatal tetanus at scheduled time by education level . . 75 Bi~u do 14/ Figure 14. Ty 1¢ plw nfr khi mang thai duqc cham.s6c (tfnh cho nhfrng phy nil sinh con trong vong 1 nam tru6'c thai diem dieu tra)/ Percentage of pregnant women receiving antenatal care (for women with a birth in the year preceding the survey) . , . . . 76 Bi~u do 15/ Figure 15. Ty I~ phy nfr khi sinh de duqc cham s6c·(tinh cho s6 ph1,1 nil c6 <~inh con trong vong 1 nam tru&c thai diem ctieu tra)/ Percentage of women receiving assistant at delivery (for women with a birth in the year preceding the survey) . . . . . 77 7 8 Ldl Gldl THIEU . Tr;,i H()i nghf Thu(/ng dinh Thi gidi v€ tre em duqc td chuc tr;,i New York nam 1990, Chink phu Vi~t Nam da cam kit th1fc hi~n Tuyen b6' va Kithor;,ch hanh d()ng cua the'gidi v€ tre em. Th1Jc hi~n chi thf 34/ 1999/CT-TTg, ngay 27 thang 12 nam 1999 v€ ady nhanh vi~c th1fc hi~n cac ml:lC tieu den nam 2000 v€ tre em, to"ng ket Chuang trinh Hanh d()ng Quoc gia vi Tre em 1991-2000 va xay d1fng Chuang trinh Hanh d()ng Quae gia vi Tre em 2001-2010, trong khuon khd DZ! an " Phat trie"n cac Chi tieu Xa h(ji ·: Tdng Cl:lC Thong ke da chu tri va phoi hqp v(Ji Uy Ban Baa v~ va Cham soc Tre em Vi¢t Nam (CPCC) thlfc hi¢n cu()c di€u tra danh gia ml:lc tieu thQ,p ky vi tre em giai dor;,n 1991-2000 (MICS). Cu()c di€u tra MICS duqc th1fc hi~n vdi ciJ mdu 7628 h(j gia dinh thu()c 240 dta ban xa, phudng dr;,i di~n cho quae gia, thank thf, nang than, 8 vfmg d.ia ly thu(jc 61 tinh, thank pho: Hor;,t d(jng di€u tra thu thQ,p so' li~u tr;,i dfa ban duqc tien hanh trong 2 thang, tit thang 5 den thang 6 nam 2000. Day la CUQC diiu tra co slj h6 trq ky thuQ,t cua cac chuyen gia Thong ke Lien hqp quae, UNICEF vung, UNICEF Ha N()i v€ thiet ke' mdu, thiet kit bd.ng cau hoi, phdn mem nhQ,p tin, di;ic bi~t la phdn mem phan tich va tinh cac udc luqng suy r(jng ket qud di€u tra. Ml:lC tieu cua Cu()c di€u tra danh gia m¥C tieu thQ,p ky nhiim danh gia nhling tien b() ciing nhu nhling mi;it con to'n tr;,i trong vi~c th1fc hi~n Chztdng trinh Hanh d(jng Quoc gia, Gong udc Quy€n tre em thong qua gdn 70 chi so' Thong ke v(Ji cac khai ni~m, dtnh nghla va phudng phap tinh thong nhat thea Quae te: Ket qua cua cu()c di€u tra cung cap so' li~u cho vi~c xay dlfng Chudng trinh Hdnh d()ng Quae gia giai dor;,n 2001-2010. Baa clio phan tich thong ke nay mo ta kha chi tiet v€ cac llnh VlfC giao dl:lC, y te; dinh duiJng, nude sr;,ch, v¢ sinh moi truiJng, kien thuc cua ph¥ nit v€ HN I AIDS, cham soc sue khoe phl:l nfi, tre em, chap nhrj,n cac bi~n phap tranh thai, baa V~ cac quyen Cd ban Vd phat triln cua tre em. Cac bi~u so' li¢u duqc so sanh vm so' li~u cua h~ thong bao,cao dtnh ky va cac CUQC di€u tra chuyen nganh de" thay ro Slf bif!'n d6'i thea thiJi gian CUa cac ml:lC tieu Quae gia nhiim hudng tdi m¥C tieu nam 2000. Cac chi so' duqc phan td thea thdnh tht, nang than; 8 vung dta ly; gi(Ji tinh; nhom tu6'i; trinh d() van hoa Clta nguiJi m£;. D6ng thdi co tinh toan cac sai so' chc;m mcfu va khodng tin cQ,y. Chung toi hy Vf;mg cdc thong tin, so' li~u tom tilt trong tQ,p baa cao cung v(Ji cac t¢p so' li¢u cd sCI da lam sr;,ch se rat hliu ich cho cac nhd lam chinh sach, qudn ly va nghien cuu, ke" cd cua Vi~t Nam va Quoc te: Tdng Cl:lC Thong ke thlfc hi~n thdnh cong cu(jc di€u tra ndy vdi cac tieu chudn ky thuQ,t cao. Nhan d!p nay, thay mi;it Liinh dr;,o Tong Cl:lC Thong ke toi xin chan thdnh cam an UNICEF Hd N()i, Uy ban Bdo v~ va Cham soc tre em Vi~t Nam; cam an UNICEF vung v€ Sl/ h6 trq ky thuQ,t thong qua cdc chuyen gia trlJc tiitp; cam dn cac B(j, Nganh, Uy ban Nhan dan cac cap, Cl:lc Thong ke, Uy ban Bdo v~ va Cham soc tre em va cdc h() gia dinh (J 61 tinh, thdnh pho' co di€u tra ve' slf phoi hqp vd giup diJ tQ,n tinh de" cu()c diiu tra dr;,t ket quii. Chung toi tran trc;mg vd danh gia rat cao cac y kien dong gop cua cdc nha sit dl:lng thong tin va so' li~u trong tQ,p baa clio ndy. Cdc thong tin chi tiet xin gili ve' dfa chi: v~,~ xa h(>i- Moi tntdng, Tong c1,1c Thong ke So 2 Hoang Van Th1,1, Ba 81nh, Ha Nc)i. Tel. 84.4.8439871; 84.4.8433354; Email. tongthidua@hn.vnn.vn TS. Nguy~n Van Tien Pho Tdng cl!c Truong Tt/ng q"c Tho'ng ke Giam doc Dij an 9 10 INTRODUCTION In the World Summit for children held in New York in 1990, the Government of Vietnam committed itself to the implementation of the World Declaration and Plan of Action for children. In implementation of directive 3411999 ICT-TTg on 27 December 1999 on promoting the implementation of the end-decade goals for children, reviewing the National Plan of Action for children, 1991-2000 and designing the National Plan of Action for children, 2001-2010, in the framework of the "Development of Social Indicators" project, the General Statistical Office (GSO) has chaired and coordinated with the Committee for the Protection and Care for Children (CPCC) to conduct the survey evaluating the end- decade goals for children, 1991- 2000 (MICS). MICS has covered a sample size of 7628 households in 240 communes and wards representing the whole country, the urban area, the rural area and the 8 geographical areas in 61 towns I provinces. Field activities to collect data lasted 2 months, May- June I 2000. The survey was technically supported by statisticians from EAPRO, UNICEF regional offices, UNICEF Hanoi on sample and questionnaire designing, data input software, not least the software analyzing and calculating the estimates generalizing the results of survey. The goal of MICS is to evaluate the progress as well as the shortcomings in the implementation of the National plan of action, the Convention on the Rights of the child through nearly 70 statistical indicators with internationally accepted concepts, definitions and calculation methods. The data collected from survey have been instrumental to the formulation of the National Plan of Action, 2001-2010. This analytical and statistical report provides fairly detailed description of a wide range of activities: education, health, nutrition, safe water, sanitation, women 's knowledge on HIV I AIDS, woman and child health care, acceptance of contraceptive, protection of children's basic rights and the child right to development. Tables of data are compared with the data collected from periodic reports and specialized survey to highlight the change with time of all national goals towards the year 2000 goals. Statistics are disaggregated by urban, rural area; 8 geographical regions; gender; age groups; mothers's education. Sampling errors and confidence interval are also taken into consideration. It is our hope that the information and data summarized in this report and the basic, clean data set will be helpful to policy-makers, managers and researchers in Vietnam to the international community. High technical standards have been adopted for this effective survey. The GSO leading board avails itself of this opportunity to thank UNICEF Hanoi, the Committee for Protection and Care for Children, the UNICEF regional Office (EAPRO) for the technical assistance and consultancy. Our thanks also go to the line-ministries, the People ·s Committees at all levels, the local Statistical Offices, the Committees for Protection and Care for Children as well as the households in all 61 provinces I towns for their full cooperation and assistance without which the survey would not be successful. All comments by the users of information and data in this report are received with gratitude. Contact address: Social and Environmental Statistical Department, General Statistical Office (GSO) No2 Hoang Van ThL.J, Ba Dinh, Ha n9i. Tel. 84.4.8439871; 84.4.8433354; Email. tonqthidua@hn.vnn.vn Nguyln Van Tie'n, Dr. Deputy General Director of GSO National Project Director 11 12 T6M TAT KET QUA cuoc DrEU TRA cAc MlJC TIEU cu61 THAI> KY VE TRE EM vi-eTNAM 1991-2ooo SUMMARY RESULTS OF THE MULTIPLE INDICATOR CLUSTER SURVEY II (MICS) Cu(>c dieu tra danh gia cac mt,Jc tieu cuoi th~p ky ve tre em (8ieu tra MICS) dll<;'c Tong ct,Jc Thong ke (TCTK) tien h~mh trong nam 2000 Ia mot cu6c dieu tra mau dai dien chung toan quoc, thanh thifnong than v~ cho. 8 vung dja ly. Mt,JC dfch chfnh cua cu(>c dieu tra nay nham cung cap thong tin de danh gia thl/C tr~ng tre em va pht,J nl! va cac dieu ki~n kinh te xa h(>i c6 lien quan b Vi~t Nam vao cuoi th~p ky, danh gia nhl!ng tien b(> cOng nhll cac m~t con ton t~i trong vi~c thlfc hi~n cac mt,Jc tieu cua Chllong trlnh hanh d(>ng Quoc gia 1991-2000 va lam can cl! cho vi~c xay dlfng Chuang trlnh hanh d(>ng Quoc gia giai do~n 2001-2010. • 8e uoc lll<;'ng ty 1~ chet mE;l. cu(>c dieu tra MICS slt dt,Jng phllong phap l/oc lll<;'ng gian tiep (SISTERHOOD) thong qua hoi tat ca nhl!ng nglldi w 15 tuoi trd len ve cac trl!Cing h<;'p chet va chet lien quan den mang thai va sinh de cua cac ch! em gal do cung m(>t mE;l sinh ra. Theo ket qua dieu tra MICS, ty 1~ chet me Ia 95/100000, tl!c Ia cl! 100000 tre sinh ra · · s6ng thl c6 95 ba mE;l chet do nhl!ng nguyen nhan lien quan den sinh de. Giao dl)c • Ty I~ di h9C chung cua h9C sinh tieu h9C Ia 108,26%. • C6 93,52% tre em 6-1 o tuoi dang di h9c cap tieu h9c. Chenh l~ch gilta cac vung cOng Ia m(>t van de dang dll<;'c quan tam: Vung c6 ty I~ tre em d(> tuoi tieu h9C di h9C dung tuoi cao nhat Ia 98,76% trong khi vung thap nhat chi d~t 79,61%. Slf khac bi~t ve gioi tfnh tuy c6 xay ra nhllng chenh l~ch kh6ng nhieu. • Gan 90% so tre em nh~p h9C lop 1 h9C toi lop 5. 8ieu nay c6 nghia Ia cl! 1 oo tre em vao h9c lop 1 thl 4 nam sau chi con 90 em se h9c toi lop 5 va 1 0 em con l~i Se bo h9c ho~C h9c lop duoi do b! dup. • Van con 15,31% tre em 14 tuoi chua dat dl!<;'C tr]nh d(> tieu h9C, trong d6 CO 5,61% tre Multiple Indicator Cluster Survey II (MICS), conducted by GSO in 2000, is a sample survey representing the whole country, urban/rural areas and 8 geographical areas. The key goal of the survey is to provide information to evaluate the actual situation of children and women and the related socio - economic situation in Vietnam at decade's end, to assess the progress as well as the shortcomings in implementation of the National Plan of Action objectives, 1991-2000 and serves as a basis for the formulation of the National Plan of Action, 2001-2010. Maternal mortality rate • To estimate the maternal mortality rate, MICS used the indirect estimation method (SISTERHOOD), by interviewing all the people upwards of 15 on all cases of deaths and pregnancy and birth-related deaths of sisters born of the same mother. MICS showed the maternal mortality rate to be: 95/100000 live births, i.e. of the 100000 live births, 95 mothers die of child bearing-related causes. Education • The primary school gross enrolment rate is 108.26%. • 93.52% of primary school-age children (aged 6-1 0) are attending primary school. The disparity between areas is also an issue worthy of attention: the highest rate is 98.76% and the lowest rate is 79.61%. There is some disparity, but not much by sex. • Nearli 90% of children enrolled in grade 1 reached grade 5. This means that of every 100 children enrolled in grade 1, in four years time, 90 children reached grade 5, the remaining 10 either drop out or repeat in lower grades. • 15.31% of 14-year-old children do not finish primary education, of them 5.61% not 13 em 14 tu6i chua h9c xong lop 3. Neu kh6ng c6 bi$n phap Cl,l th~ cac em nay se Ia nhling nglfdi ion mu chii trong tlfong lai. • Ty 1$ biet chii cua nglfC!i I on ( 15 tuoi tro len) Ia 90,16%. Ty 1$ biet chii cua nh6m tuoi tre w 15-24 tuoi cao hon nhieu so voi cac nh6m tuoi cao tl155-64 va tl165 tuoi trb len. • C6 42,29% tre em trong d9 tuoi tt:r 3 den 5 tuoi dlf<;fC di mau giao va ri€mg tre em 5 tuoi thi ty 1$ nay Ia 58,82%. Tre em khu Vl/C thanh th! di mau giao gap gan 2 ian tre em nang than (66,08% SO Vdi 36,45%), ty 1$ tre em di mau giao khu vlfc Dong b~mg song Hong (DBSH) Ia 70,93% trong khi d cac vung Dong Bac, Tay Bac va Dong bang song CU'u Long (DBSCL) chi d~t muc 29-30%. • C6 3,4% tre em W 6-14 tuoi chua bao giC! den trlfdng. Trang d6 khu vvc nang than cao gap 3 ian SO VOi khu Vl/C thanh thi (3,89% SO voi 1 ,22%). Ty 1$ nay cao d~c bi$t C1 vung Tay Bac (15,45%), tiep den Ia vung 86ng Bac (5,96%) va vung DBSCL (4,93%). • • Ty 1$ tre em 11-14 tuoi di h9c trung h9c cd sb (cap II) Ia 74,58%. Ty 1$ nay thap xa so voi ty 1$ tre em 6-10 tuoi h9c ti~u h9c (93,52%). Nude s?ch va c6ng trinh v? sinh • Ty 1$ dan so tiep c~n nuoc s~ch Ia 51 ,8%. • Ty 1$ dan so sV dl,mg nlfdc may, gieng khoan c6 may born, gieng dao c6 thanh bao V$, nlfdC suoi dlt<;fC bao V$ CO h$ thong dan l9c va nlfoc mlfa ian llf<;ft Ia: 12,55%; 20,48%; 33,24%; 0,72% va 11,66%. • 44,07% dan so sv d1,mg phuong ti$n ho xf nhLt ho xf tlf hoai va ban tLt hoai, he xf doi nude-ban tv hoai, he xf suilabh: ho xf hai ngan cai ti~n va. he xf hai ngan truyen thong. Trang d6 c6 12,78% dan so sv dt,~ng he xf tl/ ho~i; 7,98% dan so sv dt,~ng ho xf d9i nvoc- ban tv ho~i. suilabh; 1,72% dan so sv d1,mg he xf hai ngan cai tien va 21,59% dan so sv dt,~ng he xf hai ngan truyen thong. Suy dinh duang tre em • C6 33,1% tre em 0-59 thang tuoi bi suy ' 14 finishing grade 3. Unless relevant measures are taken, they will grow up illiterate. • Adult literacy rate (over 15) is 90.16%. The literacy rate of 15-24 year olds is by far higher than the 55-64 year olds and over 65. • 42.29% of children aged 3-5 go to kindergartens and for the 5-year-olds, this percentage is 58.82%. Urban kindergarten- goers almost double their rural friends (66.08% and 36.45% respectively). The percentage of children going to kindergartens in the Red River area is 70.93%. That percentage in the North East, North West areas and the Mekong River Delta are 29- 30%. ' • 3.4% of children aged 6-14 never attend school, with those in rural area tripling those in urban area (3.89% and 1.22% respectively). This percentage is especially high in the North West (15.45%) followed by North East (5.96%) and the Mekong River Delta (4.93%). • The percentage of 11-14 year old children attending lower secondary school (2"d level) is 7 4.58%. This percentage is by far lower than that of 6-10 year old children attending primary school (93.52%). Water and sanitation • The percentage of people using (having access to) safe water is 51 .8%. • The percentage of people having access to piped water, tubewell/ borehole with pump, protected dug-well, protected spring and rain- water is: 12.55%, 20.48%, 33.24%, 0.72% and 11.66%. • 44.07% of the population use latrines of one kind or another: septic tanks, semi-septic- tanks, semi-septic-flush latrine, the suilabh, improved pit latrines and traditional pit latrines. The percentages are as follows: 12.78% using septic tanks; 7.98% using semi- septic tanks-flush latrines, the suilabh; 1. 72% using improved pit latrines and 21.59% using traditional pit latrines. Child malnutrition • 33.1% of children aged 0-59 months are dinh dl!Bng (SDD) can n~ng theo tuoi. 36.4% b! SDD chieu cao theo tuoi (coi c<;>c) va 5,6% tre em b! SDD can n~ng theo chieu cao (gay com). Ty 1~ suy dinh dl!Bng da dllc;1c giam vling ch~k trong vong 10 nam qua, tuy nhiem van con d mvc cao. Nuoi con bang sua mf1 • C6 31, 16% tre em bu hoEm toan siia m~ trong vong 4 thang dau; 37,53% tre em duc;1c an thvc an bo sung trong vong 4-6 thang dau, gan m<?t nlta tre em duc;1c an thvc an bo sung tl1 trong giai do<;in tl1 6 den 9 thang tuoi. C6 87,82% tre em 12-15 thang tuoi va 20% tre em 20-23 thang tuoi con tiep tt,.~c bu siia m~. Sa d1,mg mu6i i-6t • Ty I~ h9 gia d1nh dung muoi i-ot va dung muoi i-ot dung tieu chufin rat thap so voi mt,.~c tieu. C6 60,73% so h9 gia d1nh dung muoi i-ot. Trong d6 chi c6 39,48% so h9 dung muoi i-ot dung tieu chuan. 8ieu nay cho thay can thiet phai dfiy m<;inh cong tac truyen thong tuyen truyen, hlfdng dan Slt dt,.~ng muoi l-ot, cQng nhlf quan ly san xuat, phan phoi, ILIU thong va bao quan muoi i-ot. Bo sung vien nang Vitamin A • Trong vong 6 thang trlfoc thai di~m dieu tra, c6 59,66% tre em tl1 6-59 thang tuoi va 65,30% tre em 6-36 thang tuoi dl!c;1C uong Vien nang Vitamin A lieu cao. Van con 14,55% so tre em 6-59 thang tuoi khong dl!c;1C uong Vitamin A bo sung. Tre so sinh thap can • 7,27% tre sCI sinh c6 can n~ng luc sinh duoi 2.500 gram. Ty I~ nay khac khong nhieu so voi cu(>c dieu tra VLSS1997/98 (7,97%). Ty 1~ tre sCI sinh thap can c6 quan h~ ch~t che voi tuoi cua me luc sinh. Phu nii 45-49 tuoi c6 hCin 20% so tre sinh ra bj thap can, trong khi ty I~ nay d nh6m pht,.~ nii 25-29 tuoi chi duoi 5%. Tiem chimg • Ty I~ tre em 12-23 thang tuoi duc;1c tiem day du 6 IO<;ii vac-xin tfnh den thai di~m dieu tra dlfc;1C tong hc;1p tlJ nhltng tre em CO XUat tr1nh the 93,30%. malnourished with low weight for age ( <-2 SD). 36.4% have low height for age (stunting) and 5.6% have low weight for height (wasting). Malnutrition rate has been sustainably reduced, but it is still high. Breastfeeding • 31.16% of children under 4 months are exclusively breastfed; 37.53% of infants received complementary feeding from 4-6 months old, nearly half of infants are provided with supplementary food from 6-9 months old. Breastfeeding continue for 87.82% of children from 12-15 months old and 20% of children 20-23 months old. Use of iodized salt • The percentage of household using iodized salt and specially using adequately iodized salt is very low against the objective set out. 60.73% of households use iodized salt, of them only 39.48% using adequately iodized salt (>15 ppm). Hence, the need to promote advocacy and social mobilization on the use of iodized salt, as well as production, distribution, circulation and storage of iodized salt. Vitamin A supplementation • 6 months before the survey, 59.66% of children from 6-59 months old and 65.30% of children from 6-36 months old were given high-dose Vitamin A capsules. 14.55% of this age-bracket children were not provided with Vitamin A supplements. Low birth weight • It was estimated that 7.27% of infants weighed less than 2500 grams at birth. It did not differ much from what had been collected in a similar survey conducted in 1998 (VLSS 1997/98, 7.97%). The percentage of low birth weight children is closely related to the mother's age at birth. Women aged 45-49 had more than 20% of low birth weight infants. This percentage in women from 25-29 was only less than 5%. Immunization • The percentage of children 12-23 months old fully immunized, by the survey period, synthetized from immunization cards was 93.30%. 15 B~nh ia chay ·• C6 11 ,32% tre em dllai 5 tuoi b! tieu chay trong khoang thdi gian hai tuan tnrac thdi di~m dieu tra. So li$u cho thay tre em b! tieu chay cao nhat o nh6m tre em w 6-11 thang va 12- 23 thang tuoi. Phlldng phap nuoi tre va lo~i thuc an c6 th~ Ia nguyen nhan lam cho tre em mac b$nh tieu chay cao, d~c bi$t vao giai do~n tre em bat dau cai sCta. • Ty 1$ tre em b! tieu chay cOng c6 slf khac bi$t theo trlnh d<) van hoa cua nglldi m~. theo vung va theo khu Vl/C. Vung DBSH va Dong Nam B<) va Tay Bac c6 ty 1$ tre em b! tieu chay thap nhat (6-8%), cac vung con l~i ty 1$ tre em b! tieu chay dao d<)ng W 11-17%. • C6 tai 93,93% tre em dll<;1c uong ORS ho~c cac chat long c6 tac dl,mg bu nllac va muoi khoang. The nhllng chi c6 20,20% tre em b! tieu chay dll<;'C UOng nhieu hdn Va tiep t1,1c an nhll cO (ho~c an nhieu han blnh thlldng ho~c chi ft hdn m<)t chut) . Nhiem khuan h6 htfp cfip tinh • C6 9,26% tre em b! nhiem khuc:ln ho hap cap tfnh trong thdi gian 2 tuan trllac thdi diem dieu tra. C6 60,38% tre em bi nhiem khuc:ln ho hap cap tfnh dll<;1C kham ho~ · C chlta b~nh d ndi thfch h<;1p. Quan ty !6ng ghep cac b~nh tre em (fMC!) • Trong tong so tre em dL1<;1c dieu tra c6 43,08% tre em b! tieu chay ho~c b! om trong 2 tuan qua. Trong d6 chi c6 17,84% tre em om dli<;'C uong nhieu hdn Va tiep ti,JC an ( dli<;1C cham s6c thfch h<;1p t~i nha). Ty 1$ tre em om dll<;1c cham s6c thfch h<;1p t~i nha cao nhat Ia vung Dong Nam B<) (23,03%), tiep theo Ia Dong bEmg song Hong (22,82%), thap nhat Ia vung Dong bang song CLtu Long (9,37%) va cac vung con l~i ty 1$ nay trong khoang 16 den 1 ~%. Nh6m ph1,1 nCt c6 trinh d<) d~i h9c cao dang c6 28,60% con cua ho dlldc cham s6c thfch h<;1p t~i nha khi om, va" ty 1$ nay c6 xu huang giam neu trinh d<) van hoa cua m~ ho~c nglldi cham s6c thap han. • Dau hi$u pho bien d~ cac ba m~ quyet d!nh dlla con ngay l~p tltc tai cac cd so y te Ia khi tre sot cao han (chiem 78,09% so nglldi 16 Diarrhoea • 11.32% of children under 5 had diarrhoea within two weeks before the survey. Data pointed to 6-11 month-old and 12-23 month- old children being the worst-hit by diarrhoea. The disease is attributed to child care method and food, particularly at the beginning of the weaning period. • The percentage of diarrhoea-affected children varied with the mother's education level, region and geographical areas. This percentage was th.e lowest in the Red River Delta, the Southeast and the North West. In the other areas it ranged from 11-17%. • As much as 93.93% were given ORS or other rehydration fluid and mineral salt. However, only 20.20% · of diarrhoea children were given more rehydration fluid and continue to . eat as normal (more or less at same level as before) . Acute Respiratory Infections (ARt) • 9.26% of children were affected with ARI within two week before the survey period. 60.38% of children with ARI were provided with medical care at health institutions. Integrated Management of Childhood Illnesses (fMC/) • Of the total number of children surveyed, 43.08% were affected with diarrhoea or ill within two weeks before the survey, of them only 17.84% given more fluid and food (appropriate home management). The percentage of sick children given home-based proper care was highest in the Southeast (23.03%), followed by the Red River Delta (22.82%). The lowest rate was in the Mekong River Delta (9.37%) and in the remaining areas (16-18%). University/college level women have 28.60% of their sick children properly attended to at home. The rate showed a downward trend with the low education level of mothers or care-takers. • The common symptom for mothers to decide to bring their children to health centres , without delay is higher fever (78.09% of the tra lai), tiep d6 Ia dau hi$u tre 6m n?ng han (52,25%), thu ba Ia dau hi$u tre kho tho (41 '14%). • C6 71,97% so ba mt? nh~n biet dl1c;1c ft nhat hai dau hi$u can phai dlla con ngay l~p t(tc toi co Sd y te. Ty I~ nay cOng c6 Sl/ khac bi$t dang ke giiia cac vung: Cao nhat Ia vung 86ng Bac (91 ,88%), tiep d6 Ia Bac Trung B<? (82, 12%) va 86ng bang song Cllu Long (81 ,34%), thap nhat Ia 86ng Nam B<? chi c6 49.44% va 86ng bang song Hong 55,96%, Tay Bac 57,73%, 2 vung con l~i d~t tren 70%. 8ang chu y Ia ty 1$ nay khong khac bi$t dang ke giiia thanh th! va nang than. Phong b~nh sot ret • Han 95% tre em dl1c;1c ngu man. Tuy nhien d nhiing vung c6 nguy co sot ret cao nhll vung Tay Bac thi ty 1$ tre em ngu man chi d~t 78,2%. • T~i cac vung c6 nguy co sot ret cao nhll 86ng Bac, Tay Bac, Tay Nguyen ty 1$ tre em b! sot trong vong 2 tuan trlloc th(!i diem dieu tra W 8-17%. Tuy nhien cGng t~i nhiing vung nay ty 1$ tre em dl1c;1C uong thuoc thfch h<;1p khi b! s6t rat thap ( dlloi 15% ). HIV/AJDS • Chi c6 29,66% so pht,J nii 15-49 tuoi c6 hieu biet dung ve ca 3 each tranh lay nhiem HIV/AIDS (chung thuy, luon sLJ' d1,1ng bao cao SU trong quan h$ tinh dt,JC, Va kieng Clt sinh ho~t tinh dt,Jc). • C6 31 ,42% pht,J nii 15-49 tuoi ph an bi$t dl1c;1c 3 quan ni$m sai ve HIV/AIDS (HIV c6 the lay nhiem bang cac bi$n phap sieu tv nhien, ta thu~t; c6 the bi lay nhiem do muoi dot, ngllai trong khoe m~nh khong the bi nhiem HIV). • Chi c6 11 ,95% phl:J nii 15-49 c6 hieu biet day du ve HIV/AIDS. Ngllai dl1c;1c coi Ia c6 hieu biet day du neu phan bi$t dl1c;1C 3 quan ni$m dung va 3 quan ni~m sai ve HIV/AIDS. • C6 52% so ngllai dl1c;1C hoi biet noi c6 the kiem tra HIV/AIDS, chi c6 5,6% da di kiem tra HIV/AIDS, nhllng chi 76,40% so h9 quay l~i de biet ket qua kiem tra. respondents), then: more serious (52.25%) and lastly: difficult breathing (41.14%). • 71.97% of mothers were able to identify at least two symptoms to send their children to health centres. This percentage varied from one region to another: the highest was in the North East (91.88%), followed by the North Central Coast (82.12%) and the Mekong River Delta (81.34%). The lowest was in the Southeast (only 49.44%) and the Red River Delta (55.96%). It was 57.73% in the North West and 70% in each of the two remaining areas. There was not much difference between the urban area and the rural area. Malaria prevention • More than 95% of children slept under bed-net. However, in areas with high risk of malaria, such as in the North West, the· percentage of children sleeping under bed- nets was only 78.20%. • In areas with high risk of malaria: the North East, the North West, the Central Highlands, the rate of children got fever within two weeks before the survey is 8-17%. However, in these regions, the rate of children given proper medicine when they got fever is very low (less than 15%). HIVIAIDS • Only 29.66% of women aged 15-49 had a correct knowledge of the 3 main ways to prevent HIV transmission - having orily one uninfected sex partner, using condom every time or abstaining from sex. • 31.42% correctly identified three misconceptions about HIV transmission that HIV could be transmitted through supernatural means, that it could be transmitted through mosquito bites, and that a healthy-looking person could not be infected. • Only 11.95% of women aged 15-49 had sufficient knowledge about HIV/AIDS. Those who could identify 3 correct conceptions and 3 misconceptions about HIV/AIDS were considered having sufficient knowledge about HIV/AIDS. • 52% of the interviewed knew where to get tested for HIV/AIDS. About 5.6% had been tested, but only 76.40% among them returned for test-result. 17 Cac bi(?n phap tranh thai • C6 63,46% so pht,~ nCr 15-49 tuoi hi$n dang c6 chong. Trong d6 7 4,15% so pht,~ nCr nay hi$n t<i!i dang slt dt,~ng bi$n phap tranh thai, trong d6. 55,7% slt dt,~ng bi$n phap tranh thai hi$n d<i!i Va 18,45% Slt dt,~ng bi$n phap tranh thai truyen thong. Bi$n phap tranh thai pho bien nhat Ia d~t vong tranh thai (36,96%), tiep den Ia Hnh vong kinh (11 ,06%). cac bi$n phap nhLt xuattinh ngoai, tri$t san nlt, baa cao su, vien thuoc tranh thai c6 ty 1$ slt dt,~ng tV 5- 6%. Cac bi$n phap con l<i!i, moi bi$n phap c6 ty 1$ slt dt,~ng khong vLt<;~t qua 0,5%. Cham soc tien thai san • C6 66,94% so tre em sinh ra song c6 kha nang mien d!ch Vdi UOn van ron Sd sinh do cac ba m~ dLt<;lC tiem phong uon Van day du khi mang thai. • C6 75,42% so pht,~ nCr c6 thai dLt<;~c kham thai bdi can b9 y te, trong d6 68,34% dLt<;!C kham thai boi can b9 y te c6 trlnh d9 chuyen m6n (Bac sy, nli h9 sinh trung cap, nCr h9 sinh Sd cap). Cham soc phlf nil sinh ae • C6 84,03% so pht,~ nCr c6 thai dLt<;lc cham s6c boi can b(> y te khi sinh de, trong d6 69,61% so bam~ sinh con trong vong 1 nam trLtdC thdi diem dieu tra dLtdC dB de bdi can b6 y te c6 trlnh d9 chuyen m6n (bac sy, nCr. h(> sinh trung/sd cap). 13.49% pht,~ nii khi sinh de dLt<;jC dB de bdi ba dB/m1,1 Vlfdn, chu yeu t~p trung d vung 86ng Bac, Tay Bac va Tay Nguyen. Khai sinh • C6 72,24% tre em w 5-59 thang tuoi dLt<;!C khai sinh. 8ieu kien di lai kh6 khan va nhan thCtc cua gia dlnh. c6 le ·,a yeu to chfnh anh hLtdng den ty 1$ tre em dLt<;~c khai sinh. Tre m6 c6i va bo tri CUQC song cua tre em • C6 90,76% tre em 0-14 tuoi song Vdi ca bo va m~. NhLt v~y Ia c6 tdi 9,24% tre em song trong khung canh gia dlnh thieu vang bo 18 Contraceptive methods • 63.46% of women aged 15-49 are married, of them 7 4.15% being reported to be using contraceptive methods, with 55.7% using modern methods and 18.45% traditional methods. The most popular method was IUD (36.96%) and periodic abstinence (11.06%). Withdrawal, female sterilization, condom, pills were used by 5-6%. Other methods were also used, but not more than 0.5% each. Antenatal care • 66.94% of live births were immune against neonatal tetanus, as pregnant mothers were given sufficient doses of tetanus toxoid. • 75.42% of pregnant mothers received antenatal care with at least 1 time from health worker, of them 68.34% from skilled personnel (doctor, middle-level midwife and auxiliary midwife). Assistance at delivery • 84.03% of pregnant women were assisted at delivery by health workers. Doctors, middle/auxiliary midwives delivered about 69.61% of births occurring in the year prior to the survey. 13.49% were assisted at delivery by traditional midwives, mostly in the North West, North East and Central Highlands. Birth registration • The births of 72.24% of children from 5-59 months old were registered. Limited awareness on the necessity of registration and low access to registration facilities may be the main factors affecting the birth registration rate. Orphanhood and living arrangement of children • 90.76% of children aged 0-14 were living with both parents. 9.24% of children were not staying together with a father or mother or ho~c m~ ho~c ca bo va m~. Trong d6 1 ,36% so tre em khong song voi bo va m~ de do bo hoac me da chet, hoac ca bo va me da chet; 6.36% s'o tre em chi song voi m~ va .1 ,33% so tre em chi song voi bo. both parents, of them 1.36% not living with a biological parent because either the father or mother was dead, or both were dead; 6.36% of children were staying with their mother only (their father was either away or dead) and 1.33% of children . were staying with their father only (their mother was either away or dead) 19 20 Ban do hanh chlnh Viet Nam The administrative map of Vietnam Danh sach tinhl Thanh pho I.E>B song Hong/ Red River Delta 17 Ha N6i Ddn v! an h: rtgll'<'!iJ1tm2 18 HaiPhong 19 Ha Tay 20 Hai Dlfelng 21 HLlng YEm 22Thai Binh 23 Ha Nam 24 Nam El!nh 25 Ninh Binh II. E>eng sAc/ North east 1 Ha Giang 2 Tuyen Quang 3Cao Bilng 4 Lang Son 6 LaoCai 7 Yen Bai 8 Biilc Can 9 Thai Nguyen 12 Phu Th9 13 Vinh Phuc 14Biilc Giang 15Biilc Ninh 16 Quang Ninh Ill. Tiiy B~c/ North West 5 Lai Chau 10Son La 11 Hoa Binh IV. B~c Trung 89/ North Central Coast 26Thanh Hoa 27 NgheAn 28 Ha Tinh 29 Quang Binh 30QuangTri 31 Thiia Thien- Hue V. Duyim hai Nam Trung 89/ South Central Coast 32E>a N~ng 33Quang Nam 34 Quang Ngai 35 Binh E>inh 36 Phu Yen 37 Khanh Hoa VI. Tiiy Nguyen/Central Highlands 40Gia Lai 41 Kon Tum 42E>iilc lAc VII. E>ong Nam BC?/ Southeast 38 Ninh Thuan 39 Binh Thu;\in 43 Lam E>ong 44 T.P Ho Chi Minh 45 Binh Olfelng 46 Binh Phut'lc 47Tay Ninh 48 E>Ong Nai 49 Ba Ria- vong Tau . •.l VIII. E>B song Clru Long/ Mekong River Delta 50 LongAn 51 E>Ong Thap 52 An Giang 53 Tien Giang 54 Ben Tre 55Vinh Long 56Tra Vinh 57 can Tho 58S6cTrang 59 Kien Giang 60 Bac Lieu 61 Ca Mau 100 200 400 1000 ~' +-. 21 Main indicators of MICS wcs Nati Goal onal Indicator Calculation Method MICS Num- Goal ber Num -ber A 1 2 3 4 5 1. 1 1 Under-five Mortality Rate 1 Probability of dying by exact age 5 years 3ff/oo 2. 1 1 Infant Mortality Rate2 Probability of dying by exact age 1 year 31%o 3. 2 2 Maternal Mortality Ratio Number of deaths of women from pregnancy-related causes in a given 95 year I Number of live births in the year (expressed per 100,000 births). 4. 6 Children reaching grade five Proportion of children entering first grade of primary school who 88.85% eventually reach grade 5 5. 6 Net primary school attendance Number of children of primary-school age (6-10 years of age) currently 93.52% rate attending primary school/ Total number of children of primary-school age surveyed. Net lower secondary school Number of children of lower secondary-school age (11-14 years of 74.58% attendance rate age) currently attending secondary school/ Total number of children of secondary-school aQe surveyed. 6. 6 Proportion entering primary Number of children of school-entry age (6 years of age) who are 93.07% school currently attending grade 1 I Total number of children of primary- school entry age (6 years of age) surveyed. 7. 7 Adult literacy rate Number of household residents age 15 and over who are able to read 90.16% a letter or newspaper I Total number of household residents aged 15 years and over surveyed. Literacy rate of residents aged Number of household residents age 10 and over who are able to read 91.21% 10 and over a letter or newspaper/ Total number of household residents aged 10 years and over surveyed. 8. 5 Proportion of children aged 14 Number of children aged 14 years old completed grade 5/ Total 84.69% years old completed grade 5. number of children aged 14 years surveyed. 9. 5 Proportion of children aged 6- 14 Number children aged 6-14 years have never been attended school 3.40% years have never been attended /Total number of children aged 6-14 years. school. 10. 5 Proportion of children aged 14 Number of children aged 14 years completed grade 3/ Total number of 94.39% years completed grade 3 children aged 14 years surveyed. 11. Proportion of children aged 3- 5 Number of children aged 3 - 5 years attended kindergarten/Total of 42.29% years attended kindergarten. children aged 3 - 5 years 12. 4 4 Use of safe drinking water Number of household residents have access to safe drinking water I 51.8% Total number of household residents surveyed. 13. 5 4 Use of sanitary means of excreta Number of household residents in defined safe categories of sanitary 44.07% disposal facility I Total number of household residents surveyed. 14. 4 Percentageof primary school Number of primary school with safe water/Total of primary school 73.74% with safe water located in clusters surveyed 15. 4 Percentage of primary school Number of primary school with protected latrine I Total of primary 74.15% with protected latrine school located in clusters surveyed 16. 4 Percentage of communal health Number of communal health centre with safe water/Total communal 78.79% centre with safe water health centre located in clusters surveyed 17. 4 Percentage of communal health Number of communal health centre with protected latrine /Total 78.70% centre with protected latrine communal health centre located in clusters surveyed 18. 3 3 Underweight prevalence Number of children under-five years of age who fall below -2 standard 33.13% deviations (SDs) from the median weight-for-age of the NCHS/WHO standard (moderate and severe) I Total number of children under five years of age weighed Of which: Severe malnutrition Number who fall below -3 SDs (severe) I Total number of children 5.83% under five years of age weighed 1. This was estimated from MICS and for reference only. The figure of MOH is 42%o 2. This was estimated from MICS and for reference only. The figure of the Population and Housing Census on 1/April/1999 is 36.6'?/oo 22 Bang tom t~t cac chr tieu chinh cua CUQC dieu tra Mf!cliet. Mf!C MICS wcs tieu Chl lieu Phtldl1g phtip tfnh auac gia A 1 2 3 4 5 1. 1 1 Ty 1~ cMt ciia tre em dL!ai 5 tu6i1 Xac suat chet cua tre em dung 5 tu6i 39%o 2. 1 1 Ty I~ cMt ciia tre em dL!Cii 1 tu6P Xac xuat chet cua tre em dunq 1 tu6i 31%o 3. 2 2 Tyl~cMtm~ So ph\1 nl! chet do cac nguyen nhan lien quan den mang thai va 95 sinh de trong 1 nam xac djnh I So Ire em sinh ra song trong cung nam (tfnh tren 100.000 Ire sinh ra sonq). 4. 6 T y 1~ tre em vaa hQc lap 1 hQc tai Xac sua! Ire em vao hqc lop 1 b~c ti~u hqc hqc tcri lap 5 88,85% laps 5. 6 ry I~ tre em 6-10 tu6i dl hQc dung So tre em 6-10 tu6i dang hqc ti~u hqc/ T 6ng so Ire em 6-1 0 tu6i 93,52% tu6i. duqc dieu Ira. Ty I? tre em 11-14 tu6i di hQc dung So tre em 11-14 tu6i dang hqc !rung hqc ccr sCI/ T6ng so tre em 74,58% tu6i 11-14 tu6i duqc dieu Ira 6. 6 Ty I? tre em 6 tu6i dang di hQc lap 1 So tre em 6 tu6i dang hqc lap 1/ T6ng so tre em 6 tu6i duqc dieu 93,07% tra. 7. 7 Ty 1~ ngL!ai tan biet chit (tinh cha So nhan khau cua h¢ tt:r 15 tu6i trC!Ien c6 kha nang dqc m¢t bLrc 90,16% dan s615 tu6i tra ten) thu hay m¢t bai bao I T6ng so nhan kh~u 15 tu6i trC!Ien cua cac h¢ dieu tra. Ty I~ ngLI&i10 tu6i tra len biet chit So nhan kh~u cua h¢ tu 1 o tu6i trC!Ien c6 kha nang dqc m¢t bLrc 91,21% lhl! hay m¢1 bai bao I T 6ng so nhan kh~u 1 o lu6i lrCIIen cua cac h6 dieu Ira. 8. 5 Ty I? tre em 14 tuoi hQc xang lap 5. So tre em 14 tu6i hqc xong lap 5/ T6ng so Ire em 14 tu6i duqc 84,69% dieu tra. 9. 5 Ty I? phan tram s6 tre em 6-14 tu6i So Ire em 6-14 chua bao gia den truong/So tre em 6-14 tu6i duqc 3,40% chL!a baa gia den trLI&ng dieu Ira. 10. 5 Ty I? tre em 14 tu6i da hQc xang So tre em 14 1u6i hqc xong lap 3/ T6ng so tre em 14 tu6i dl!qc 94,39% lap 3 dieu Ira 11. Ty I? tre em tit 3 den 5 tu6i dL!qc di So Ire em lti 3 den 5 tu6i duqc di mau giao/ So Ire em 3 den 5 tu6i 42,29% mau giaa ducrc dieu tra. 12. 4 4 Ty I? dan s6 tiep c~n nuac sC}ch T6ng so nhan khau cua h¢ duqc liep c~n nucrc sC}ch/ T6ng so 51,8% nhan kh~u h6 dieu tra 13. 5 4 Ty I? dan s6 sil dt,mg h6 xi tl/ haC}i, So nhan kh~u cua h¢ c6 phucrng ti~n ho xf duqc li~t ke/ T6ng so 44,07% h6 xi d¢i nuac, ban fl/ haC}i, nhan kh~u cua cac h¢ dieu tra suilabh, h6 xi c6 ngan cai tien va h6 xi c6 ngan truyen thOng 14. 4 Ty I? ph§n tram s6 trL!ang lieu hQc So truong ti~u hqc thu¢c dja ban dieu tra c6 ngu6n nucrc uong 73,74% c6 ngu6n nL!ac u6ng hqp v? sinh hap ve sinh/T6ng so truang ti~u hoc thu6c dia ban dieu tra. 15. 4 Ty I? phan tram s6 trL!ang lieu hQc So truong ti~u hqc thu¢c dja ban dieu tra c6 ho xf hqp v~ 74,15% c6 h6 xi hqp v? sinh sinh/T6na so truong ti~u hoc thu6c dia ban dieu tra 16. 4 Ty I? ph8n tram s6 trC}m y te xa/phL!&ng c6 ngu6n nL!ac u6ng So trC}m y te xa, phl!C1ng lhu¢c dja ban dieu tra c6 ngu6n mJCic 78,79% uong hqp v~ sinh/T6ng so trC}m y te xa, phuang thu¢c dja ban hqp v?sinh dieu tra 17. 4 Ty I? ph8n tram s6 trC}m y te xa So trC}m y te xa phuang thu¢c dja ban dieu tra c6 ho xf hqp v~ 78,70% phL!&ng c6 h6 xi hqp v? sinh sinh/T6nq so tram y te xa phLtC1ng thu6c dia ban dieu Ira 18. 3 3 Ty I? suy dinh dL!E!ng can n~ng So tre em dLtCii 5 tu6i c6 can n~ng theo tu6i !hap dl!Cii -2 d¢ l~ch 33,13% thea tu6i chu~n cua can n~ng trung vj cua quan th~ !ham khao NCHS/WHO/T6ng so Ire em dl!Cii 5 tu6i duqc can. Rieng d¢ 11 tra len So t~e em durn 5 tu6i c6 can n~ng theo tu6i thap ducri -3 d¢ l~ch 5,83% chui'm cua can n~ng !rung vj cua quan th~ tham khao NCHS/WHO (SDD n~ng) I T6ng so tre em ducri 5 tu6i dLtqc can. 1. Day la ket qua di.I'Q'C 116'c lm;mg tLr CUQC dieu tra MICS va chi Slr dt,mg d~ tham khao. S61i¢u cua BQ y te Ia 42%o 2. Day Ia ket qua dtrQ'c tr6'c ltrQ'ng tlr cu(lc dieu tra MICS va chi si:r dt,mg d~ tham khao. So li¢u cua T6ng dieu tra Dan so va Nha b l/4/1999la 36,67%o 23 A 1 2 3 4 5 19. 3 Stunting prevalence Number of children under-five years of age who fall below -2 standard 36.40% deviations (SDs) from the median height-for-age of the NCHS/WHO standard (moderate and severe) I Total number of children under five years of age measured Of which: Severe malnutrition Number who fall below -3 SDs (severe) I Total number of children 11.92% under five _years of age measured. 20. 3 Wasting prevalence Number of children under-five years of age who fall below-~ standard 5.59% deviations (SDs) from the median weight-for-height of the NCHS/WHO standard(moderate and severe) 21. 12 Low Birth Weight Number of births in year preceding survey weighing below 2500 7.27% grams I Number of births in year preceding survey (to women survey_ecJ}. 22. 14 Iodized salt consumption Number of households with salt testing 15 ppm or more of iodine 60.73% iodate I Total number of households survey_ed. 23. 15 Children aged 6-59 months Number of children aged 6-59 months received the last high dose vitamin 84.66% received the last high dose vitamin A supplement at any time I Number of children aged 6-59 months A supplement at any time surveyed. Children aged 6-59 months with Number of children aged 6-59 months with correct timing of last high dose 59.66% correct timing of last high dose vitamin A supplement I Number of children aged 6-59 months surveyed. vitamin A supplement Children aged 6-36 months with Number of children aged 6-36 months with correct timing of last high dose 65.30% correct timing of last high dose vitamin A supplement I Number of children aged 6-36 months surveyed. vitamin A supplement 24. 15 Mothers receiving vitamin A Number of women who gave birth in year preceding survey who received 27.09% supplements a high dose vitamin A supplement within 8 weeks after birth IT otal number of women who gave birth in the ~ear ~receding surve~. 25. 16 Exclusive Breastfeeding Number of infants less than 4 months of age exclusively breastfed IT otal 31.16% number of infants less than 4 months of age surveyed. 26. 16 Continued breastfeeding at 12- Number of infants 12-15 months still receive breastfeeding I Total number 87.82% 15 months and at 20-23 months of children aged 12-15 months Number of infants 20-23 months still receive breastfeeding I Total number 20.77% of children aged 20-23-months survey_ed. 27. 16 Timely complementary feeding Number of infants 4-6 months old receiving breast milk and 51.46% complementary foods/ Total number of infants 4-6 months old surveyed. Infants 6-9 months old receiving Number of infants 6-9 months old receiving breast milk and 37.53% breast milk and complementary complementary foods/ Total number of infants 6-9 months old foods survey_ed. 28. 22 Fully immunized Number of children aged 12-23 months receiving BCG, DPT3, OPV3, 93.30% Measles vaccine before 1st birthday I Total number of children aged 12-23 months surveyed. 29. 22 Tuberculosis immunization Number of 12-23-month-olds receiving BCG vaccine before 1st 100% coverage birthday I Total number of children '!9_ed 12-23 months survey_ed. 30. 22 OPT immunization coverage Number of 12-23-month-olds receiving DPT3 vaccine before first 97.83% birthday_/ Total number of children '!9_ed 12-23 months surveyed. 31. 22 Polio immunization coverage Number of 12-23-month-olds receiving OPV3 vaccine before first 97.42% birthday I Total number of children aged 12-23 months surveyed. 32. 22 Measles immunization coverage Number of 12-23-month-olds receiving measles vaccine before first 96.99% birthday I Total number of children aged 12-23 months surveyed. 33. 22 Children protected against Number of mothers of infants aged 0-11-month-olds with at least two 66.94% neonatal tetanus doses of n within appropriate interval/ Total number of mothers of infants aged under-one-year-olds surveyed. 34. 23 ORT use Number of diarrhoea cases among children 0-59 months in 2 weeks 93.93% before survey who received ORT and/or recommended home fluids I Total number of diarrhoea cases among children under five years of age in two weeks preceding surv~ 35. 23 Home management of diarrhoea Number of diarrhoea cases among children aged 0-59 months taking 20.20% "more" fluids AND continued eating somewhat less, the same or more food I Total number of diarrhoea cases among children under five years of age in two weeks preceding survey. 24 A 1 2 3 4 5 19. 3 Ty 1~ suy dinh dvang chieu cao S6 tre em durn 5 tuoi c6 chieu cao theo tuoi thap duoi -2 d¢ lech 36,40% thea tuoi chu~n cua chieu cao !rung vj cua quan the !ham khilO NCHS/WHOI Tong s6 tre em durn 5 tuoi duqc do chieu cao; Rieng a¢ 11 tra len S6 tre em durn 5 tuoi c6 chieu cao theo tuoi thap duoi -3 d¢ l$ch 11,92% chu~n cua chieu cao !rung vj cua quan the !ham khao NCHS/WHO (n~ng)l Tong s6 tre em duoi 5 tuoi duqc do chieu cao. 20. 3 Ty I~ suy dinh dvang can n~ng S6 tre em durn 5 tuoi c6 can n~ng theo chieu cao thap durn -2 d\'J 5,59% thea· chieu cao l$ch chu~n cua can n~ng !rung vj cua quan the !ham khao NCHS/WHOI Tong_ s6 tre em durn 5 tuoi ducrc can, do; 21. 12 Ty 1~ tre sa sinh tMp can S6 tre em sinh trong nam truoc cu¢c dieu tra c6 tr9ng luqng scr 7,27% sinh durn 2500 grams I Tong s6 tre em sinh ra trong nam tru& cuoc dieu tra. 22. 14 Ty I~ h¢ gia ainh dung mu6i i-61 Tong s6 h\'J kiem tra c6 i-6t trong mu6i an I Tong s6 h¢ dieu tra 60,73% 23. 15 Ty I~ tre em tt16-59 thang tu6i Tong s6 tre em 6-59 thang tuoi duqc u6ng vitamin Abo sung I S6 tre 84,66% avqc u6ng vitamin A bo sung em 6-59 thang duqc dieu tra. Trang 66: T re em 6-59 thflng tu6i atJqC u6ng Tong s6 tre em 6-59 !hang tu6i duqc u6ng vitamin A b6 sung dung 59,66% I vitamin A b6 sung aung th<ii gian qui thOi gian qui djnh I S6 tre em 6-59 thang duqc dieu tra. arnh Tre em 6-36 thang tuoi avqc u6ng T6ng s6 tre em 6-36 thang tuoi duqc u6ng vitamin Abo sung dung 65,30% vitamin A bo sung aung thai gian qui thOi gian qui djnh I S6 tre em 6-36 !hang duqc dieu tra. arnh 24. 15 TY I~ M m~J avqc cung cap vitamin S6 phu nO' sinh con trong nam trLtoc cu¢c dieu tra duqc u6ng b6 sung 27,09% Abo sung vitamin A lieu cao trong thai gian 8 tuan sau khi sinh con I Tong s6 phu nO' sinh con tra11g niim truoc cu6c dieu tra. 25. 16 Ty I~ tre em avqc bu sua m~J hotm S6 tre em duqc bu sO'a m~ hoim toan trong vong 4 !hang dau I 31,16% loan trong vong 4 !hang aau To11g s6 tre em 0 den durn 4 thang_ tu6i ducrc dieu tra. 26. 16 Ty I~ Ire em 12-15 thang van con TY 1$ tre em 12-15 thang van con bu sO'a m~l Tong s6 tre em 12- 87,82% bu sua m~J 15thang Ty I~ Ire em 20-23 !hang van con TY 1$ tre em 20-23 !hang van con bu sO'a mEi!l Tong s6 tre em 20- 20,77% bU sua m~J. 23 thang 27. 16 T y I~ Ire em 4-6 thang tuoi avqc an S6 tre em duqc bu sO'a mEil va an thlic an bo sung trong vong 4-6 51,46% th(!c an bo sung krp thc'Ji thang I Tong s6 tre em duqc dieu tra. Ty 1~ tre em 6-<9 thang tuoi dvqc S6 tre em 6-<9 !hang duqc bu sO'a mEil va an thlic an bo 37,53% an thltc an bo sung k[p thai sung/Tong s6 tre em ducrc dieu tra. 28. 22 Ty I~ Ire em avqc tiem chUng aay S6 tre em 12-23 thang tuoi duqc tiem BCG, DPT3, OPV3, SCti 93,30% au trLtOc ngay sinh nhat dau lien I Tong s6 tre em 12-23 !hang tuoi ducrc dieu tra. 29. 22 Ty 1~ Ire em dvai 1 tu6i auqc tiem S6 tre em 12-23 thang tuoi duqc tiem BCG tn.roc ngay sinh nhat 100% phonglao dau lien IT ong s6 tre em 12-23 !hang tuoi duqc dieu Ira. 30. 22 Ty I~ tre em dvai 1 tuoi auqc tiem S6 tre em 12-23 !hang tuoi duqc tiem vac xin DPT3 trLtoc ngay 97,83% phdng B~ch Mu-Ho ga-U6n van sinh nh~t dau tien 1 Tong s6 tre em 12-23 thang tuoi duqc dieu tra. 31. 22 Ty I~ Ire em dvcii 1 tuoi auqc u6ng S6 tre em 12-23 !hang tu6i duqc u6ng vac xin OPV3 trl[('1C ngay 97,42% vac-xin phong bai li~t sinh nhat dau tien I Tong_ s6 tre em 12-23 thallf!_ tuoi ducrc dieu tra 32. 22 Ty I~ Ire em dvai 1 tuoi duqc tiem S6 tre em 12-23 thang tuoi duqc tiem phong si'li truoc nay sinh 96,99% phdng sai nhat dau lien I Tong s6 Ire em 12-23 !hang_ tuoi ducrc dieu tra. 33. 22 Ty I~ tre em duqc phdng ngtla u6n S6 ba mEil c6 con 0-11 thang tuoi duqc tiem phong u6n van day du 66,94% van ron sa sinh trong khaang thai gia thich hqp thea qui djnh IT 6ng s6 ba mEil c6 con 0-11 thang ducrc dieu tra. 34. 23 Ty I~ tre em br tieu chily auqc st'r S6 tre em 0-59 thang bj tieu chay trang 2 tuan truoc cu\'JC dieu tra 93,93% dt,mg ORT va cac chat long c6 lac duqc u6ng ORT valho~c u6ng cac chat long thich hqp I Tong s6 dt,mg bu nuac va mu6i khoang ca b$nh tre em bj tieu chay cua tre em 0-59 !hang duqc dieu tra. 35. 23 Ty I~ Ire em b! lieu chily duqc S6 ca b$nh tre em 0-59 !hang bj tieu chay duqc u6ng them nuoc 20,20% cham s6c t~i nha aung each ha~c cac chat long thich hqp va tiep tt,Jc an it han m¢t chut, an nhu co ha~c an nhieu hcrn I Tong s6 ca b$nh tre em 0-59 thang bj tieu chay trong 2 tuan truoc cu¢c dieu tra. - 25 A 1 2 3 4 5 ~ 24 Care seeking for acute Number oi children 0-59 months who had respiratory infection needing 60.38% respiratory infections assessment and were taken to an appropriate health provider I Total number of children 0-59 months who had respiratory illness needing assessment. 37. IMCI-1 Home management of illness Number of children 0-59 months old with illness in previous 2 weeks 17.84% who received proper home management of their illness I Total number of children aged 0-59 months reported with any illness in preceding 2 ~ weeks. IMCI-2 Care seeking knowledge Number of caretakers of children age 0-59 months who know at least 71.97% 2 signs for seeking care immediately I Total number of caretakers of childre~ed 0-59 months surveyed 39. IMCI-3 Use of bed nets Number of children aged 0-59 months who slept under a bednet on 95.86% the previous night I Total number of children 0-59 months surveyed. l Use of impregnated bednets Number of children aged 0-59 months who slept under an 30.56% impregnated bednet on the previous night I Total number of children Malaria treatment 0-59 months surveyed. 40. IMCi-4 I -- Number of children under-five reported to have fever in previous 2 6.54% I weeks who were treated with an appropriate anti-malarial I Total I number of children aged 0-59 months reported to have fever in previous two weeks. 41. HIV-1 I 1\nowledge of preventing Number of women who correctly state all3 ways of avoiding HIV 29.66% HIV/AIDS infection I Total number of women aged 15-49 years surveyed. 42. HIV-2 Knowledge of misconceptions of Number of women who correctly identify all 3 misconceptions about 31.42% HIV/AIDS HIV/AIDS I Total number of women surveved ~ HIV-3 Knowledge of mother-to-child Number of women who correctly identify all 3 means of vertical 41.83% transmission of HIV transmission I Total number of women surveyed 44. HIV-4 Attitude to people with HIV/AIDS Number of women expressing a discriminatory attitude towards people 52.36o/~- with HIV or AIDS! Total number of wom~n surveyed 45. HIV-5 I Women who know where to be Number of women who state knowledge of a place to be tested I Totai 52.04% tested for HIV number of women surveyed 46. HIV-6 Women who have been tested Number oi women who report being tested for HIV I Total number of 5.62% for HIV women surveyed 47. HIV-7 Adolescent sexual behaviour Median age at first pregnancy (years old) 21 48 10 Contraceptive prevalence Number of women aged 15- 49 years (currently married or in union) 74.15% who are using a contraceptive method i Total number of women who are currently married or in union surveyed. I I I Modern contraceptive method IUD, Condom, Sterilization, Implants, Injection, Pill, 55.7% Diaphragm/foam/jell~ 49. 11 Antenatal care Number of women 15-49 years attended at least 1 time during 75.42% I pregnancy by skilled health personnel/ Total number of women aged 15-49 years with a birth in previous year surveyed. 50. 11 Childbirth care Number of women 15-49 years attended during childbirth by skilled 84.03% health personnel I Total number of women aged 15-49 years with a ~ birth in previous ~ear surve~ed. 51. 15 I Night blindness in pregnant Number of women who gave birth in year preceding survey who had 5.8% women I night blindness while pregnant with last child I Total number of women c~ ~ who gave birth in year preceding survey. Birth registration Number of children 0-59 months whose births are registered I Total 72.24% number of children aged 0-59 months surveyed. --53. CR-2 Children's living arrangements Number of children 0-14 years not living with a biological parent I Total 9.24% number of children aged 0-14 years surveyed. 54. CR-3 7 Orphans in households Number of children 0-14years who are orphans I Total number of 3.08% children aged 0-14 years surveyed. 55. 6 Percentage of communes and Number of'communes and wards with a recreation spot (or recreation 29.54% wards with a recreation spot (or centre) for children I Total number of communes and wards surveyed. recreation centre for children)3 3. Recreation spot (or recreation centre) for children include cultural, art and recreational facilities like children's centre, cinema, theatre, park, zoo, soccer field, reading room, library, etc. These facilities should have at least 20% of time reserved for children's use in their plan of activities. 26 A 1 2 3 4 5 36. 24 Ty I? tre em 0-59 thang d11qc th8y 8o tre em 0-59 !hang bi nhiem khuan dlt<'lng ho hap can dLtqc 60,38% thuoc cham soc khi b1 nhiem kham va dieu t~ va da dLtqc kham/dieu tr! bC!i cac thay thuoc 1 khuan d11ang h6 Mp ·cap tin h. Tong so tre em 0-59 !hang b! benh dLt<'lng ho hap can dLtqc kham ' va dieu tri. ! 37. IMCI-1 Ty IQ Ire em 0-59 thang bt om 8o tre em 0-59 thang tuoi b! om trong 2 tuan vua qua dLtqc cham 17,84% d11qc cham soc thich hqp t"i nha s6c thich hqp t<,~i nha I Tong so tre ern 0-59 !hang b! om trong 2 tuan vua qua dLtac dieu tra. 38. IMCI-2 Ty I? ng11ai cham soc tre em biet 8o ngLtrn cham soc tre em o -59 thang tuoi biet it nhat 2 dau hi~u 71,97% khi nao phai d11a tre em tai cac ca benh t$1 can phai dLta tre toi ca sCI y te ngay l$p tt:rc/ Tong so say te ngltrn cham s6c tre em 0-59 thang dLtac dieu tra 39. IMCI-3 Ty I? tre em d11qc ngu man 8o tre em 0-59 thang dLtqc ngu man dem trLtoc I Tong so tre em 95,86% 0-59 thang tuoi dLtqc dieu tra. T y I~ tre em d11qc sir dt,mg man 8o tre em 0-59 thang cua cac vung c6 nguy ca sot ret cao (Tay 30,56% tam thuoc tranh muoi Bac, £long Bac, Tay Nguyen) dLtqc ngu man t~m thuoc tranh muoi dem trLtCic I Tong so Ire em 0-59 !hang tuoi dLtqc dieu Ira cua 3 vung Tay Bac, £long Bac, Tay Nguyen. 40. IMCI-4 Ty I? tre em dllai 5 tuoi b! sot ret 8o Ire em dLtrn 5 tuoi b! sot ret trong 2 tuan vua qua dLtqc dieu tr! 6,54% d11qc dif~u tn dung each dung each I Tong so tre em bi sot ret trong 2 tuan vua qua dLtqc dieu tra. 41. HIV-1 Ty I? ph(l mJ 15-49 co kien thlrc ph6ng tranh HIV/AIOS 86 ph~ ncr n6i dung 3 each d~ phong tranh nhiem HIV 'Tong s6 29,66% . ehy ncr 15-49 tuoi dlt~ dieu Ira. 42. HIV-2 T y I? ph(l niJ 15-49 tu6i phan bi~t S6 ph~ ncr 15 den 49 tuoi phan bi~t dung 3 quan ni~m sai ve 31,42% dllqc nhiJng quan ni?m sai ve HIV/AID8 1 Tong so ph~ ncr 15-49 tuoi dLtqc dieu tra. HIV/A/0$ 43. HIV-3 Ty t? ph(l nil hieu biet ve each lay 86 ba m~ phan bi~t dung 3 each lay truyen tn,rc tiep virus HIV !lr 41,83% truyen virus HIV til mf?'sang con. me sang con I Tong so phu ncr dLtac dieu Ira 44. HIV-4 Ty I? ph(l nil co thai d¢ dung dan 86 phu ncr c6 thai di) dung dan doi vrn ngLtrn bi nhiem HIV/AID8 1 I 52,36% doi vai ng11ai b! HIVIA/0$ Tong so phu ncr dLtac dieu tra. 45. HIV-5 Ty I? ph(l nil biet nai de kiem 86 phu ncr biet nai d~ ki~m tra HIV 1 Tong s6 ph~ ncr dLtqc dieu 52,04% traHIV tra. 46. HIV-6 Ty t? ph(l mJda kiem tra HIV 86 ph~ ncr da ki~m tra HIV I Tong so ph~ ncr dLtqc dieu tra 5,62% 47. HIV-7 Tuoi mang thai tan dau T uoi !rung vj I an mang thai dau lien 21 48. 10 T y I? chi'ip nh~n cac bi?n phap 86 ph~ ncr 15- 49 tuoi dang c6 chong c6 sv d~ng cac bi~n phap 74,15% tranh thai tranh thai! Tong s6 ph~ ncr 15-49 tuoi c6 chong dLtqc dieu tra. Trang do:Bi~n phap tranh thai hi~n £)~! v6ng, tri~t san, u6ng thu6c, tiem thu6c, cay thu6c dLtCii da, 55,7% d"i baa cao su, mang ngan. 49. 11 T y I? ph(l nil dt.tqc can b¢ y te 86 phu ncr 15-49 dLtac kham thai bdi can bi) y te trong thrn gian 75,42% kham thai khi mang thai mang thai! Tong s6 ph~ nrr 15-49 tuoi sinh con trong nam trLtCic dLtac dieu tra. 50. 11 Ty I? ph(l nil khi sinh de d11qc 86 ph~ ncr 15-49 khi sinh de dLtqc cham soc bcri can b9 y te 1 84,03% cham soc biJi can b¢ y te Tong s6 ph~ ncr 15-49 tuoi sinh con trong nam trLtoc dLtqc dieu Ira. 51. 15 Ty I? ph(l nil co thai b! quang ga 86 ph~ ncr sinh con trong nam trLtoc cui)c dieu tra b! quang ga khi 5,8% mang thai I Tong s6 ph~ ncr sinh con trong nam truoc cui)c dieu tra. !2 CR-1 Ty I? tre em 0-59 thang tu6i d11qc 86 tre em 0-59 thang da dLtqc khai sinh 1 Tong s6 tre em 0-59 72,24% khai sinh. thang dLtac dieu tra. 53 CR-2 Ty I? tre em 0-14 tu6i khong song 86 Ire em 0-14 tuoi khong song voi b6 m~ de I Tong s6 Ire em 0- 9,24% vai b6/mf? de 14 tuoi dLtac dieu tra 5t CR-3 7 Ty I? tre em m6 c6i 8o tre em 0-14 tuoi b! m6 coi I Tong s6 tre em 0-14 tuoi dLtqc dieu 3,08% Ira 55. 6 Ty I? pMn tram so xa, ph11ang co 86 xa, phlt<'lng thui)c d!a ban dieu tra c6 di~m (trung tam) vui chai 29,54% die'm (trung tam) vui chai giai tri giai tri danh cho tre em/ Tong so xa, phLt<'lng thui)c dja ban dieu danh cho tre em3 Ira. 3. Diem (trung tam) vui chai giai trf danh cho tre em bao gom cac ca sb van hoa, ngh¢ thu~t. vui chai nhu nha thieu nhi. r~p chieu phim. nha hat, cong vien, vuon thu, san b6ng da. phong d9c, thu vi¢n, 000 Gk ca sb nay phai c6 ft nhat 20% thai gian theo ke ho~ch ho~t d()ng d~mh cho tre em 27 Indicators for reporting not covered in MICS ws National Indicator Numerator and Denominator Data Source Data Goal Goal Num Number ber 56. 14 Median of urinary iodine The median value of urinary iodine MOH (IDD survey 1998) 14mcg/dl expressed as microgram(s) of iodine per deciliter of urine 57. 14 Low urinary iodine4 Number of children with urinary iodine MOH {IDD survey, 1998) N/A level< 10 mcg/dll Total number of surveyed children 58. 14 Percentage of school Number of school children 8-12 years of MOH (Survey), 1998 14.9% children 8-12 years of age age with a thyroid goitre I Total number of with a thyroid goitre5 surveyed children of the same year group 59. 15 Percentage of children 6- Number of children 6-59 months of age with MOH (Survey), 1998 10.8% 59 months of age with low I low serum vitamin A (<20 mirograms/dl) I I serum vitamin A Total number of surveyed children of the same year group 60. 9, 13 Percentage of women 15- Number of non- pregnant women 15-49 MOH (Survey),2000 22.7% 49 years of age with Iron years of age with haemoglobin level < Deficiency Anemia 12g/1 OOmlltotal number of non- pregnant women surveyed Number of pregnant women 15-49 years of MOH (Survey),2000 44% age with haemoglobin level < 11 g/1 OOml /total number of pregnant women surveyed - 61. 19 Polio cases Annual number of cases of acute flaccid MOH (RR)-1999 503 ~arallsis in under-five children 62. 19 Polio death Annual number of death cases of under five MOH (RR)-1999 0 children due to polio 63. 19 Eradication of polio6 Number of cases of wild polio virus found in MOH (RR) 0 1998, 1999 and 2000 64. 20 NNT cases Annual number of cases of NNT MOH (RR)-1999 219 65. 20 Death cases of NNT Annual number of death cases of NNT MOH (RR)-1999 159 66. 21 Measles cases Annual number of cases of measles MOH (RR)-1999 13604 67. 21 Death cases of measles Annual number of death cases due to MOH (RR)-1999 8 measles 7 Care of children in especially difficult circumstances 68. Percentage of orphans Number of orphans without support who CPCC (RR)-2000 70% without support who received regular financial assistance or who received regular financial are reared in social protection centres or in assistance or who are communities/Total of orphans without reared in social protection support centres or in communities 69. Percentage of children Number of children with disabilities assisted CPCC (RR)-2000 55% with disabilities assisted for rehabilitation in rehabilitation centres and for rehabilitation in at communities/Total of children with rehabilitation centres and disabilities at communities 70. Percentage of repatriated Number of repatriated children being CPCC (RR)-2000 100% children being reintegrated reintegrated in communities !Total of in communities repatriated children 71. Percentage of drug- Number of addicted drug children who CPCC (RR)-2000 50% addicted children assisted received care/Total of addicted drug for rehabilitation in drug children rehabilitation centres 4. There are 18 provinces with the median of urinary iodine < 1 Omcg/dl (IDD survey 1998) 5. For measurement of goitre rate in children in VietNam, the age group 8-12 is used 6. On October 29, 2000, WHO certified that the polio disease has been eliminated in VietNam 28 Bang tom tat cac cac chi tiim khong thu th~p qua dieu tra MICS Muc M1,1c Chi lieu Ph11ang phap tinh Nam bao cao/Nguon so li~u S61i~u tieu tieu wcs Quae gia 56. 14 1-61 ni¢u trung vj Gia tri !rung vi cua 1-61 ni¢u trong nu<'lc ti~u 89 y te (f>ieu tra)-1998 14mcg/dl duqc hi~u Ia s6 microgram cua 1-61 ni~u trong 1 decilit nu<'lc ti~u. 57. 14 TY 1¢ Ire em c6 1-61 ni¢u S6 tre em duqc xet nghi~m nuoc ti~u c6 i-61 89 y te (£lieu tra)-1998 N/A thap durn 1 Omcg/dl4 ni¢u thap durn 10 mcg/dll Tong s6 tre em duqc dieu tra 58. 14 TY I~ tre em 8-12 tuoi S6 tre em 8-12 tuoi dang hqc ti~u hqc b! 89 y te (£lieu tra), 1998 14,9% dang di hqc ti~u hqc bj bu<'lu co// Tong s6 Ire em duqc dieu Ira. bu<'lu co5 59. 15 TY I~ tre em 6-59 thang S6 tre em 6-59 thang tuoi c6 vitamine A 8¢ y te (£lieu tra) 1998 10,80% tuoi c6 vitamine A trong trong huyet thanh durn <20 huyet thanh durn mirograms/di!Tong s6 Ire em 6-59 thang 20microgram/dl tuoi duqc dieu tra. 60. 9, 13 Ty 1~ phl,J nO" 15-49 tuoi S6 phl,J nO" 15-49 tuoi khong mang thai c6 8¢ y te (£lieu tra)-2ooo 22,7% thieu mau muc haemo-globin trong mau < 12g/1 OOml !Tong s6 phl,J nO" 15-49 tuoi (kh6ng mang thai) duqc dieu tra S6 phu nO" 15-49 tu& mang thai co mvc haemoglobin trong mau <12g/100ml !Tong s6 8¢ y te (£lieu tra)-2000 44,0% _Qhu nil 15-49 tuoi mang thai di.1<1C dieu Ira 61. 19 S6 ca b! b<,~i li~t S6 ca bai lie! mem cap hang nam cua Ire B¢ y te (Bao cao djnh ky)-1999 503 em durn 5 tuoi 62. 19 S6 ca ch6t do b~i li~t S6 ca chet do bf?i li¢t hang nam cua Ire em 89 y te (8ao cao djnh ky)-1999 0 durn 5 tuoi 63. 19 Lo?i tr{! b~nh b~i tW' So ca b<,li li¢1 do vi rut hoang d<,~i trong 3 89 y te (8ao cao djnh ky)-2000 0 nam lien tu 1998 den 2000 64. 20 So ca u6n van sa sinh S6 ca u6n van sa sinh hang nam Bi? y te (Bao cao djnh ky)-1999 219 65. 20 S6 ca ch6t do u6n van S6 ca chet do u6n van sa sinh hang nam Bi? y te (Bao cao djnh ky)-1999 159 sa sinh hang nam 66. 21 S6 ca mac b~nh sai S6 ca mac b~nh sbi hang nam 89 y te (8ao cao djnh ky)-1999 13604 67. 21 S6 ca chet do sai So ca chet do b¢nh sbi hang nam Bi? y te (Bao cao djnh ky)-1999 8 7 Chi!im soc tre em c6 hoan dmh ri~c bi~t kh6 khan 68. ry 1~ tre mo coi kh6ng S6 tre em mo col khong nai nucmg llJa duqc U88VCSTE (8C djnh ky)-2000 70% nat n~~ang tva d11qc trq trg cap !huang xuyen va dugc nu6i ducrng cap th11c'mg xuyen va lf?i cac trung tam bao trg xa h¢i ho~c lf?i d11qc nu6i d11ang t?i cac c¢ng dong !Tong s6 tre em mo coi khong trung tam blio trq xa hQi nai nucmg llJa. ho~c i?i c¢ng dong 69. Ty 1~ tre em khuyet t(lt S6 tre em khuyet t~t duqc cham soc ho~c UBBVCSTE (BC djnh ky)-2000 55% r111ac cham soc hoac duqc phuc hoi chvc nang IT ong s6 Ire em dlli(c phi,JC hOi chlrc khuyet t~t nang 70. Ty 1~ tre em h6i h11ang S6 tre em hoi huang duqc tai hoa nh~p vao U88VCSTE (BC djnh ky)-2000 100% r111qc tai hoa nMp vao c9ng dong !Tong s6 tre em hoi huang c¢ng_ dong 71 . Ty 1~ tre em nghi~n hut S6 tre em nghi$n hut duqc cai nghi¢n durn U88VCSTE (8C djnh ky)-2000 50% r111qc cai nghi~n m9i"hinh thvc !Tong s6 tre em nghi$n hUt 4. C6 18 tinh khong dl_lt tieu chuAn i-ot ni~u tnmg vj duoi lOmcg/dl (Dieu tra 1998) 5. D(> tu6i M dieu tra danh gia ty I~ buou c6 tre em a Vi~t Nam tu 8-12 tu6i 6. Ngay 29 thang 10 nam 2000, WHO da xac nh~n Vi~t Nam da thanh toan duqc b~nh bl_li li~t 29 30 I. GICH THr:e;u; INTRODUCTION CCI sa cua cu9c dieu tra Thlfc hi$n cam ket trlfdc c(>ng dong Quoc te ve Tuyem bo va Ke ho~ch hanh d(>ng t~i H(>i ngh! Thli<;:Jng dinh The gidi vi tre em, hang lo~t nhLtng hanh d(>ng thiet thl,lc da dLt<;:Jc Nha nuoc va nhan dan Vi$t Nam trien khai thl,lc hi$n. Thfmg 8 nam 1991, Nha nlfdc Vi$t Nam da ky ban hanh "Lu~t bao v$. cham s6c va giao dl,lc tre em" va "Lu~t ph6 c~p giao dl,lc tieu h9c". Tiep d6, thang 12 nam 1991, H(>i nghj Quoc gia vi tre em da de ra Chucmg trinh hanh d(>ng Quoc gia vi tre em W 1991- 2000. Chuang trinh hanh d(>ng Quoc gia vi tre em Vi$t Nam da de ra cac ml,Jc tieu lon phai d~t dlt<;:Jc vao nam -2000 nhll sau: • Giam ty 1$ chet cua tre em dlldi 5 tu6i nam 1990 w 81%o xuong 55>/oo va ty 1$ chet cua tre em dltdi 1 tu6i w 46%o nam 1990 xuong dlldi 3CYko. • Giam ty 1$ chet m~ c6 lien quan den thai san w 110/100000 tre sinh ra song nam 1990 xuong con 70/100000. • Giam ty 1$ suy dinh dLtong tre em W 51,5% nam 1990 xuong con dlldi 30% vao nam 2000. • Den nam 2000, c6 90% tre em dLt<;:Jc ph6 c~p tieu h9c trlfdc tu6i 15, so con l~i h9c xong ldp 3 de kh6ng con tre em mu chlt khi bltdc vao tu6i 15. • Cham lo cu(>c song van hoa tinh than, phat trien vui choi lanh m~nh, phan dau den nam 2000 c6 50% cac huy$n qu~n cua cac tinh/thanh pho c6 co so van hoa, vui choi cho tre em. • 70% tre em c6 hoan canh dac biet kh6 khan dLt<;:Jc cham s6c boi c(>ng dong ho~c gia dinh; 70% tre em khuyet t~t dLt<;:Jc kiem tra sC!c khoe, dieu trj va phl,J hoi chC!c nang. • Nang ty 1$ dan so dlt<;:Jc dung nlfdc s~ch o thanh pho tlt 45% nam 1990 len 82% va d vung n6ng th6n tlt 21% len 80% vao nam 2000; dam bao 23% so h(> gia dinh n6ng th6n c6 ho xf h<;:Jp v$ sinh. Rationale In implementation of the commitments made to the international community regarding the Declaration and Plan of Action adopted at the World Summit for Children, a wide range of practical activities have been undertaken by the State and people of Vietnam. In August, 1991, the State of Vietnam promulgated the "Law on Child Protection, Care and Education" and the "Law on Universal Primary Education". In December 1991 the National Plan of Action for Children, 1991-2000 was adopted with the major goals to be attained by year 2000 as follows: • Reduce under 5 mortality rate from 81%o in 1990 to 55>/oo and infant mortality rate from 4~ko in 1990 to under 30%o. • Reduce mother mortality rate from 110/100000 live births in 1990 to 70/100000. • Reduce children malnutrition rate from 51.5% in 1990 to under 30% by 2000. • By year 2000, 90% of children achieve universal primary education before age 15, the remaining finishing grade 3, no illiterate children before reaching age 15. • Improve children's cultural life and healthy entertainment. 50% of districts in all towns/provinces have cultural and entertainment parks for children by 2000. • 70% of children in especially difficult circumstances are provided with care by communities or families; 70% of handicapped children are given medical and rehabilitation care. • 82% (up from 45% in 1990) of the urban population and 80% (up from 21%) of the rural population have access to safe water by 2000; 23% of rural households have proper latrines. 31 Chuang trlnh h~mh d(mg cua H<)i ngh! Thuc;mg dlnh cOng nhu Chuang trlnh hanh d<)ng Quae gia cOng da dua ra sl,J' din thiet phai thiet l?p m<)t co che cho vi~c giam sat thl,J'c hi~n cac m1,1c tieu. Chuang trlnh Hanh d<)ng Quae gia cOng da neu r6 Tong c~,~c Thong ke Ia co quan c6 trach nhi~m thu th?p, xii ly so li$u lien quan toi vi$c danh gia tien b¢ da d9t du<;jc trong vi~c thl,J'c hi~n cac m1,1c tieu. Theo hu(Jng nay, Tong CI,JC Thong ke da tien hanh Cu<)c dieu tra danh gia cac mt,~c tieu trung h9n vi tre em nam 1996 va Cu<)c dieu tra danh gia ket qua thl,J'c hi$n cac mt,~c tieu vl tre em nam 2000. Ca hai cu<)c dieu tra nay deu du<;jc ho tr<;j tfch Cl,J'C cua UNICEF cave ky thu?t va kinh phf. Bao cao nay phan tfch cac ket qua da d9t dU<;jC trong Vi~C thl,J'C hi~n cac mt,JC tieu cua h<)i ngh! Thu<;jng dlnh va cac mt,JC tieu cua Chuang trlnh hanh d<)ng Quoc gia (CTHDQG) giai do9n 1991-2000. Gim thi~u khai quat wi' Vi~t Nam Nude C<)ng Hoa Xa H<)i Chu Nghia Vi~t Nam nam d khu Vl,J'C Dong Nam A. Phfa Bac giap C<)ng Hoa Nhan Dan Trung Hoa, phfa Tay va Tay Nam giap C<)ng Hoa Dan Chu Nhan Dfm Lao va Cam-Pu-Chia, phfa Dong va ph fa Nam giap bien Dong. Viet Nam c6 dien tfch tu nhien Ia 331 ngan km2 v(Ji 3/4 Ia doi. nui va C;;iO nguyen. Hai con song lon bat nguon ttl Trung Quae Ia song Hong va song Ciiu Long boi dap len chau tho Dong bang song Hong va Dong bang song Ciiu Long - Ia noi sinh song cua hon 40% dan SO Ca nude. Vi~t Nam Ia Quae gia gam han 50 dan t<)c anh em, trong .d6 da so Ia nguai Kinh (Vi~t). T9i thai diem 1/4/1999, dan so Vi~t Nam Ia 76,3 tri~u nguai va 76,5% dan so song o khu vl,J'c nang than. Toe d<) tang dan so blnh quan 1989/1999 Ia 1,64%/nam. Gia dlnh truyen thong gam 3 the h~ van Ia m<)t d~c trlfng cua h<) gia dlnh Vi~t Nam va c6 anh hudng rat ICJn tCJi Sl,J' phat trien cua xa h<)i. Buoc vao th?p ky 90, Vi~t Nam da c6 32 The World Summit Plan of Action and National Plan of Action mentioned the need to set up a monitoring mechanism. The National Plan of Action has also made it quite clear that GSO is the agency responsible for collecting and analysing data related to the evaluation of the progress in goal implementation. Pursuant to this set direction, GSO has conducted two surveys: one for evaluating the implementation of the mid-decade goals for children in 1996 and the other for assessing the achievement of the end-decade goals for· children in 2000. Both surveys have received an effective assistance from UNICEF, technically and financially. This report will analyze the results obtained in implementation of the World summit goals and National Plan of Action goals for the period 1991-2000. General information on Vietnam The Socialist Republic of Vietnam is situated in South East Asia, bordering on the People's Republic of China to the North; the People's Democratic Republic of Laos and Cambodia to the West and Southwest and washed by the East Sea to the East and the South. Vietnam covers an area of 331,000 square km, of which three fourths are mountains and highlands. Two large rivers taking their sources from China are the Red River and the Mekong River, the alluvium of which has built up the Red River Delta and the Mekong River Delta, the home of more than 40% of the country's population. Vietnam is inhabited by more than 50 ethnic communities, of which the Kinh (Vietnamese) are majority. On April 1st 1999 Vietnam's population was 76.3 million. 76.5% of the population live in rural areas. The 1989/1999 population growth rate averaged 1.64%. The traditional 3-generation family is still a characteristic feature of Vietnamese households, largely impacting on social development. The early 1990s have seen Vietnam's nhiJng blfCJC chuy§n bien tfch ClJC Va toan di$n ve kinh te-xa h(>i do nhiing thanh c6ng cua cong cu(>c 8oi mC:Ji dv~c tien hanh w nam 1986. Tu m(>t nlfCJc thieu d6i xay ra pho bien vao th;\lp ky 80, nam 1990 Vi$t Nam kh6ng nhiing da tv tuc llfdng thtJc rna con trd thanh nlfCJC XUat khau g~o dli'ng hang thet hai trem the giC:Ji. L~m phat W mete 774% nam 1986 dan dV9c ki§m che, chi con 67,4% nam 1990 va d~t mete blnh quan hang nam Ia 5,9% trong giai do~n 1995-1999. Toe d9 tang trlfdng kinh te blnh quan hang nam trong giai do~n W 1990-1997 d~t muc 8,01%, toe d9 nay dab! chiing l~i vao cuoi nam 1997 do tac d(>ng cua khung hoang kinh te - tai chfnh khu v!Jc, nhlfng van d~t toe d9 5, 76% vao nam 1998 va 6,7% nam 2000. TU' nam 1990 den 1999, GOP tang len gap doi, GOP blnh quan dau nglfdi tang gap 3 lan7 . San pham xuat khau chu yeu van Ia dau tho, cac san pham n6ng nghi$p, hang gia c6ng va cac san pham c6ng nghi$p che bien. Du c6 nhiing thanh tl!U dimg ke ve kinh te, nhlfng Vi$t Nam van Ia m(>t nvC:Jc ngheo, GOP binh quan dau nglfdi thap va cd sd h~ tang yeu kern. Thee danh gia cua cu(>c khao sat muc song nam 1997-1998 (VLSS1997/98) do Tong Cl,JC Thong ke tien hanh, hi$n van con 37,37% h9 ngheo (thee chuan ngheo thtJc pham va phi thtJc pham). Ve m~t xa h(>i: Tuy Ia m<?t nvC:Jc ngheo, nhvng nhiing chl so xa h(>i cua Vi$t Nam c6 th§ so sanh dVdc vC:Ji nhieu nvC:Jc c6 dieu kien kinh te kha hdn.· C6 90,16% dan so nglfdi ltJn biet chii, ty 1$ tre em di hc;>c cao, tuoi the;> blnh quan Ia 68. Chfnh sach doi mC:Ji va md clta da g6p phan nang cao ddi song va lam tien de cho vi$c thtJc hi$n cac chfnh sach xa h(>i. Tuy nhien cung nhiing thfmh tl!U kh6ng th§ phu nh;\ln trong m<?t th;\lp ky qua ve phat tri§n kinh te - xa h(>i, chfnh sach h9i nh$p va md clta cung lam gia tang va phat sinh nhiing thach thuc mC:Ji. Cac t$ n~n xa h<?i nhv ma tuy, m~i dam va d~c bi$t HIV/AIOS cOng c6 xu hvC:Jng gia tang. Nam d ella ng6 cua khu Vl,Jt 86ng Nam A Vi$t Nam tro thanh n~n nhan cua nhCmg cu<?c chien tranh keo dai trong hdn 100 nam qua. H;\lu qua chien tranh van c:On anh hlfdng lau dai tC:Ji nhieu m~t kinh te- xa h(>i, d~c bi$t Ia tre em va phl:J nil. comprehensive socio-economic changes, as a result of the achievements of the "doi mC:Ji" process initiated since 1986. From a food- deficient country, not least in the 80s, Vietnam has not only been self-sufficient in food since 1986 but also the 2nd rice-exporter in the world. Inflation from 774% in 1986 was controlled in due course to 67.4% in 1990 and averaged 5.9% annually in the 1995-1999 period. The annual average . economic rate from 1990-1997 was 8.01%. However, it slowed down in late 1997 as a result of the regional financial economic crisis, but scored 5.76% in 1998 and 6.7% in 2000. From 1990 to 1999, total GOP already doubled and the GOP per capita had a threefold increase7 . Exports included predominantly crude oil, agricultural products, processed goods and industrial products. For all the considerable economic achievements, Vietnam remains a poor country with low GOP and poor infrastructure. The data of VLSS 1997-98, conducted by GSO, showed that 37.37% of households have been living under poverty line (a food and non-food poverty line). Socially, Vietnam is a poor country, but its social indicators are comparable to many economically better countries. The adult literacy rate is 90.16%, the gross enrolment rates in primary and lower secondary levels are high and average life expectancy is 68. The "doi mC:Ji" and "open door" policy has helped improve the people's living conditions, a premise for the implementation of social policies. However, alongside of these undeniable socio-economic development in the last decade, the integration and open door policy has brought with it new challenges. Such social scourges as drugs, prostitution and especially HIV/AIOS have shown an upward trend. Located at the entrance to South East Asia, Vietnam has fallen victim to prolonged wars for more than a hundred years, with their aftennath adversely affecting many socio-economic development aspects, not least children and women. 7. Tfnh theo ty gia qui dcii rrvc riep ti:r tien Vi¢t ra Do Ia My thl GDP blnh quan dau ngLrai nam 1990 kho{mg 102USD va nam 1999 Ia 374USD/ By direct converting exchange rate from Vietnam dong to USD. the per capita average GDP in 1990 was about 102 USD and in 1999. 374USD. 33 O~c diem d!a ly nam trai dai tl.t Bac xuong Nam dan den rat kh6 khan trong vi_$c dau tlf, phat trien co sa h~ tang. Day Ia m¢t trong nhCtn~ nguyen nhan chu yeu t~o nen slf bat blnh dang ve kinh te va xa h9i gilia cac VUng, gilta khu VlJC thanh thj Va n6ng th6n, d~c bi$t Ia gilia mien nui va mien xu6i, gili'a dan t¢c thieu so va da so. La m¢t quae gia giap bien, Vi$t Nam c6 nhling thu~n IQi to IC!n cho vi$c phat trien kinh te, nhlfng dong thai cOng phai thuang xuyen duong dau vC!i nhling anh huang that thuang cua thai tiet nhv thien tai, baa h,Jt va h~n han gay thi$t h~i to IC!n ve san xuat, dai song va tlnh m~ng cua nhan dan. Blnh quan mCii nam c6 6 con baa va 4 tr~n ap thap nhi$t dCii do b¢ vao Vi$t Nam. MI!C dich cua cuqc dieu tra Cu(>c dieu tra cuoi th~p ky ve tre em nham: • Cung cap so li$u c~p nh~t va tin c~y d~ danh gia thlfc tr~ng tre em va phL:J nli nam 2000. • Cung cap so li$u danh gia ket qua thlfc hi$n cac mL;Jc tieu cua H(>i ngh! Thlf<;jng dinh The giCii cOng nhv Chlfong trlnh Hanh d¢ng Quae gia giai do~n 1991-2000. • Lam can c(t xay dlJng Chlfong trlnh hanh d¢ng Quae gia ve tre em giai do~n 2001- 2010. • Nang cao nang llfc chuyen m6n trong llnh VlJC thea d6i, giam sat va danh gia CaC mL;JC tieu cham SOC, baa V$ Va giao dL;JC tre em d cac cap. 34 The geographical North-South stretch has made it hard for us to invest in infrastructure development. It is one of the underlying causes of socio-economic inequalities between various regions, urban areas and rural areas, particularly between mountainous areas and the delta, the ethnic minority and the majority people. As a coastal country, Vietnam is endowed with major advantages for economic development, but, on the other hand, has to bear the brunt of capricious weather - natural disasters, storms, floods and droughts seriously affecting production, human lives and property. On the average, Vietnam is hit by 6 storms and 4 tropical depressions, annually. Objectives of the survey The end-decade survey on children is aimed at. • Providing up-to-date and teliable data to analyse the situation of children and women in 2000. • Providing data to assess the implementation of the World summit goals for children and of the National Plan of Action for Vietnamese Children, 1991-2000. • Serving as a basis (with baseline data and information) for development of the National Plan of Action for Children, 2001-2010. • Building professional capacity in monitoring, managing and evaluating all the goals of child protection, care and education at all levels. II. PHUONG PHAP LUAN CUA CUQC DIEU TRA/ SURVEY METHODOLOGY Thiet ke' mau Thiet ke mau cu6c dieu tra MICS d Viet Nam Ia m9t mau xac suat, hai cap dl19C pha·n thanh tang Va chum. CB mau ella CUQC dieu tra MICS 7628 h9. Dan mau dl19c slt dt,mg cho CUQC dieu tra nay Ia dan mau 3% cua Tong dieu tra dan so va nha d nam 1999. Mau dl19C Ch9n theo 2 cap, cap thCJ' nhat: Chon dia ban dieu tra mau tLt dan mau 3%. Mau· dieu tra 3% ban dau da dude chon voi xac suat b~mg nhau bdi cac d!a ban c6a Tong dieu tra dan so c6 so h9 xap xi bang nhau: Kholmg 100 h9 moi dja ban, tn:r khu Vl/C mien nui c6 blnh-quan khoang 80 he?. Mau cac dia ban dieu tra va mau cua cu6c dieu tra MICS dl19C phan tang theo vung, ttnh va theo thanh th! - nang than. M9t mau h$ thong gam 30 dja ban dl1<;1C ch9n cho moi vung, do d6 tong so d!a ban dieu tra se dLt<;1c ch9n cho cuc?c dieu tra MICS Ia 240 d!a ban. a blloc chon mau cap 2, chon mot mau h$ thong voi ty ~~~ co d!nh 1/3 so ti9 trong d!a ban dieu tra rnau da dlldC chon, tnJ mot SO ft cac trVdng h<;1p ca bi$t c6 m¢t so dja ban c6 qua nhieu h9 (xap xi 200 he? ho~c hdn) ty 1$ ch9n he? Ia 1/6. Vl v$y, c6 blnh quan khoang 33 h9 trong moi d!a ban doi voi cac vung ion va 27 he? trong cac vung nho. Phlfdng phap Ch9n mau cua CUQC dieu tra MICS dLt9c mota chi tiet trong pht,Jit,Jc 1. M~IU cua MICS Ia mau tll dieu chlnh quyen so 6 mete tang, nhung khong tl/ dieu chlnh quyen so d cap quoc gia va giCta cac tang. Do d6 can phai tfnh quyen so khi suy r(>ng cho khu Vl/C thanh thj/n6ng than va suy rc?ng d cap Quoc gia. Trang so 7628 h9 dV<;1c ch<;>n dieu tra, c6 30 h9 phai thay the do danh ban ke d!a ban cua Tong dieu tra dan so va nha 6 chu'a ch fnh xac hoac nharn lan ho ten chu ho. Viec chon h9 thay the dam ba~ tfnh ngau· nhi~n theo dung qui djnh ghi trong phlfdhg an cua BC8 dieu tra. Danh sach dia ban dieu tra MICS dlldc li$t ke chi tiet trong .pht,J lt,JC 3. . Sample design The sample for Vietnam's MICS is a two-stage, probability sample, stratified and clustered. The sample size of the survey covers 7628 households. The sample frame used for this survey is the Census 3% enumeration district area (ED) Sample of the 1999 Population and Housing Census. The sample is selected in 2 stages. Stage 1: Select the EDs from the Census 3% ED Sample. The Census 3% ED Sample had been selected with probability proportional to size, about 100 households in each cluster, with the exception of mountainous areas, 80 households on the average. The samples are stratified by region, province and urban-rural area . A systematic sample including about 30 clusters are selected for each region by systematic (random) selection. Thus the total EDs selected for MICS is 240. Stage 2: Select the households with a fixed ratio of 1/3 of the households in each cluster already selected in Stage 1. Thus, on the average, there are 33 households in each cluster for large regions and 27 households for small regions, except for particular cases where a cluster has too many households (approximately 200 or more) , in those cases, the selection ratio is 1/6. Further details on sampling are included in Annex 1. The MICS sample is self-weighting by stratum, but not at national level, or between strata. For weighting urban, rural and national level units, sample weights have been used. Of the 7628 selected households, 30 had to be replaced because their location in the 1999 Population and Housing Census was not identifiable or the names of household heads were found to be wrong. Selection of the substitution households has been done in the proper way to ensure probability. The list of MICS survey areas is provided in Annex 3. 35 Phieu phong van Phieu phong van cua MICS Vi$t Nam dll~c thiet ke dlfa trem Phieu phong van m~u cua UNICEF New York voi mot s6 sua doi nhll: So sung them cau hoi cho phu h~p voi Vi$t Nam ho~c de danh gia cac mt,Jc tieu rieng cua Vi$t Nam da dll~c de ra trong Chlldng trinh hanh dc)ng Quae gia; mc)t thay doi khac d6 Ia cac each to chuc cac phieu hoi nham h~n che t6i da trllong h~p mat phieu hoi va t~o thu~n l~i cho kiem tra va kiem tra logic giCra cac phan trong phieu hoi. Phieu phong van gem c6 3 mt,Jc: Ml,lC 1 gem cac phan hoi chung cho h9 gia dinh ho~c cac thanh vien h9 gia dinh. Ml,lC 2 gem cac phan phong van phl,J nU' trong d9 tuoi sinh de ( 15 den 49 tuoi). Mt,Jc 3 gem cac phan phong van tre em dlloi 5 tuoi. cl,l the: Myc 1: Phieu hoi h9 gia dinh Phan A: Thong tin chung cua h(J Phan 8: Danh sach h(J gia dinh Phan C: Giao dl)c Phan D: Lao d(Jng tre em Phan E: Tit vong ba mfJ lien quan den sinh de Phan F: Nuac sinh ho;:jl[ va dif3u ki{jm v~ sinh va TLSH cua HGf) Phan G: Sit dl)ng mu6i i-6t Myc 2: Phieu hoi ph~:~ nft trong d9 tu&i sinh, de Phan A: Tinh hinh chet cua tre sd sinh Phan 8: Phong b~nh u6n van (TT) Phan C: sue khoe ba mfJ & tre so sinh Phan D: so cac bi~n phap tranh thai Phan E:Kien thuc phong chong HIVIAIDS Myc 3: Phieu hoi tre em dttdi 5 tu6i 36 Phan A: f)ang ky khai sinh va giao dl)c ban dau Phan 8: Vitamin A Phan C: Nuoi con bang sua mf} Questionnaires The questionnaires for MICS in Vietnam are based on the New York UNICEF module questionnaires with some modifications and additions to fit in with Vietnam's context and to evaluate the goals set out in the National Plan of Action. The questionnaires have been arranged in such a way as to prevent the loss of questionnaire sheets and to facilitate the logic control between the items in the modules. Questionnaires include 3 sections. Section 1: general questions to be administered to families and family members. Section 2: questions for child bearing-age women (aged 15-49). Section 3: for children under 5. Section 1: Hc:>Usehold questionnaire Part A: Household information panel Part B: Household listing form Part C: Education Part D: Child labour Part E: Maternal mortality Part F: Water and sanitation Part G: Salt iodization Section 2: Questionnaire for child bearing- age women Part A: Child mortality Part 8: Tetanus toxoid (TT) Part C: Maternal and newborn health Part D: Contraceptive use PartE: HIV/AIDS Section 3: Questionnaire for children under five Part A:8irth registration and early learning Part 8: Vitamin A Part C: 8reastfeeding Phan o: Cham soc tre em 6mk1au Phan E: Bijmh sot ret Phan F: Tiem chung. Phan G: Nhfm trac tre em Ngoai phieu hoi thu th$p thong tin (J mltc h9 gia dlnh, cu¢c dieu tra MICS con thiet ke phieu hoi de thu th$p thong tin t~i c¢ng dong nham thu th$p nhling thong tin b6 sung cho m¢t so chi tieu khong the danh gia ho~c danh gia day du C1 mac h¢ gia dinh. Cac thong tin thu th$p gom dan so - dieu ki$n tl/ nhien-kinh te xa h9i cua d!a ban dieu tra, cac thong tin ve giao dt,JC, y te, cac thong tin Ve Vi$C thljc hi$n va trien khai cac dl/ an va Chlldng trinh hanh d¢ng vi tre em. De c6 thong tin chi tiet ve phieu hoi h¢ va phieu hoi c¢ng dong xin xem pht,J lt,Jc so 4. Sau khi dl!c;1c t6 chuyen vien va BCD hoan chinh, cac phieu hoi dl!c;1c chuyen tham khao lay y kien cua cac chuyen gia cua T6ng ct,Jc Thong ke, cac B¢, Nganh c6 lien quan. D~c bi$t Ia phieu hoi chi duc;1c in thanh phieu hoi chinh thuc sau khi ket thuc cong tac t$p huan va trien khai dieu tra thlr tai dia ban. Viec nay c6 tac d¢ng tich Cl/C den chat IL!c;1ng c6a cu¢c dieu tra MICS. T;Jp huii'n va to' cht.ie thu th;Jp so' li~u t~i dja ban De c6 Sl/ chi d~o thong nhat va t$p trung, m¢t Ban chi d~o Trung lfdng dl!c;1c thanh 1$p gom cac thanh vien cua TCTK, UBBVCSTE va UNICEF Ha N¢i. Cu¢c dieu tra MICS da huy d¢ng hdn 120 can b(> CO kinh nghi$m va SltC khoe tlr Cd quan T6ng Cl,JC Thong ke va Ct,JC Thong ke cua 61 tinh va thanh pho trong ca nl!CJC. C6 hai IC:Jp t~p huan cho cac dieu tra viem, nhan trac Vien, d(>i trlfdng Va giam sat Vien dl!c;1C t6 chLtc t~i Ha N<?i va thanh pho Ho Chf Minh. Moi IC:Jp t$p huan dL1<;1c thljc hi$n trong thoi gian Ia 5 ngay, trong d6 1 ngay dieu tra thlJ' va rut kinh nghi$m t~i d!a ban. Cac dieu tra vien, nhan trac vien dllc;1C bien che thanh 22 d(>i dieu tra, moi d¢i gom 3 dieu tra vien, 1 nhan trac vien va 1 d¢i tru?Jng. M¢t mo hinh giam sat gom 3 cap dl!c;1C trien khai trong suet qua Part 0: Care of illness Part E: Malaria Part F: Immunization Part G: Anthropometry Apart from the questionnaires to collect information at family level, questionnaires are also designed to gather information at community level supplementary to some . indicators that can not have data collected at family level. The information garnered includes local population, socio-economic and physical conditions, education, health and progress of projects/plans of actions for children. For details on household questionnaires and community questionnaires, please see Annex4. After being finalized by the expert group and the Steering Committee, the questionnaires are sent to be commented on by the professionals of GSO and of other related ministries and agencies. Questionnaires are officially printed after the training and pre-testing. This exercise is likely to have positive impacts on the quality of MICS. Training and collection of data To ensure uniformity and concentration, a Central Steering Committee was established, including GSO, Vietnam CPCC and UNICEF Hanoi. MICS involved more than 120 officials (who were selected based on their professional skills and their good health) from GSO and Provincial Statistical Offices of 61 cities and provinces throughout the country. Two training courses were opened for interviewers, anthropometry staff, team leaders and supervisors in Hanoi and Ho Chi Minh City. It was a 5-day training course, with 1 day for trial use of the questionnaires in the field and experience drawing. Interviewers and anthropometry staff were streamed into 22 teams, with each being comprised of 3 interviewers, 1 anthropometry staff member 37 tr1nh thu th~p so li$u t9i d!a ban: ThCt nhat Ia d9i tnrong giam sat chat llf~ng lam vi$c cua dieu tra viem, nhan tr~k viem, cap thCt hai Ia giam sat vien vung giam sat chat llf~ng va nghi$m thu phieu hoi cua d9i ( 11 giam sat vien vung, moi nglfdi phl,J trach 2 d9i). Cap thCt ba Ia BCD Trung U'ong giam sat chung toan b9 hoi?t d9ng cua cu9c dieu tra. Tai li$u hlfdng dan chi tiet ve nghi$p Vl,J cua cu¢c dieu tra MICS dlft;SC bien SOi?n ky gam: So tay huang dan nghi~p v11 cho EJ(Ji twang va Giam sat vCmg So tay huang d[m nghi~p VII cho EJieu tra vi en So tay huang dan nghi~p VII Nhan trac vi en So tay huang dtm thu thf!Jp phieu c(Jng dong. Ngoai ra, moi d9i khi xuong dja ban con c6 danh sach cac h9 dieu tra, h9 dt! phong; danh sach ban ke h9 gia d1nh va ban do d!a ban cua T6ng dieu tra d~m s6 va nha d 1/4/1999. Cong tac trien khai thu th~p so li$u t9i d\a ban dlf9C tien hanh trong thang 5 Va thang 6 nam 2000. 8e tfnh toan cac sai so phi ch<;>n mau, Cu¢c dieu tra MICS tien hanh phong van i9i gan 4% so h¢. Vi$c nay con nham de giam sat chat IL19ng ho9t d¢ng va slt'a chU'a k!p thC:li cac loi c6 the c6 cua dieu tra vien ngay ti?i dja ban. Xu /y va tong ht;rp so' litju Kiem tra thu c6ng: Ket thuc dieu tra, 1 OO% phieu hoi du9c kiem tra thu cong tnrCic khi tien hanh nh~p tin. Nh~p so li$u: 25 nh~p tin vien dL19c dL19c t~p huan ky trLICic khi tien hanh nh~p tin chfnh thCtc. Cac nh~p tin vien lam vi$c 2 ca tren 15 may vi tfnh trong khoang thdi gian tCt thang 7 den thang 8. Chlfdng trlnh nh~p tin 38 and 1 team leader. A three-level supervision model was observed throughout the data collection process. Level 1: T earn leader supervising the quality of interviewers' and anthropometry staff member' work; Level 2: Regional supervisors examining the quality · and collecting the questionnaires of teams ( 11 regional supervisors, each in charge of 2 teams). Level 3: the Central Steering Committee supervising the overall activities of the survey. Training manuals include: Professional Handbook for Team leaders and Regional supervisors Professional Handbook for Interviewers Professional Handbook for Anthropometry staff members Handbook on how to collect Community questionnaires Each team, when at fieldwork, was provided with lists of households for interview and reserve households; lists of household members and the local map of the 1999 Population and Housing Census on 1/April/1999. The collection of local data was done in May and June 2000. To calculate non-sampling errors, MICS re-interviewed nearly 4% of households. This exercise had a two-fold purpose: to supervise the quality of work and correct in time the possible mistakes made by interviewers. Data processing and tabulation Manual check: Upon completion of the survey, 100% of questionnaires were manually checked before entry. Data entry: 25 data entry staff members were trained before doing the actual work. They worked by 2 shifts on 15 computers from July to August, using the Eplnfo software. The programme was so designed to minimize the dl!~C viet tren Epilnfo, each thiet ke chl!dng trlnh cho phep h<~m che toi da vif[!c nh~p nham ma dia ban, rna he) va ma thanh vien; chl!dng trlnh nhiflp tin cOng cho phep can be) nhi[lp tin tl! ki§m tra qua trlnh nhi[lp cua mlnh ngay trong qua trlnh nh~p tin. Lam s~ch so lif[!u: Moi thong tin dl!~c nh~p vao may c6 th§ khong day du ho~c khong chfnh xac bai 2 nguyen nh~m: Do nh~p tin vien nh~p sai ho~c b~m thf:m thong tin ghi vao phieu bi sai (ngl!ei tra lei khai sai ho~c dieu tra vien ghi sai). Vi$c lam s~ch s6 lif[!u nham h~n che hai lo~i sai so nay: • 8§ h~n che toi da sai so do nhiflp tin vien, vif[!c nhiflp tin dl!~c tien hanh nh~p l~i 100%: moi dia ban dl!~C nh~p hai ian bdi 2 nh~p tin vien khac nhau. Bat ky slf sai khac nao giCta hai ian nh~p deu dl!~c ki§m tra l~i va qui ro trach nhif[!m thuc)c ve nh~p tin vien nao. • 8§ h~n che sai so do nguei tra lei khai sai ho~c dieu tra vien ghi sai, mc)t chl!dng trlnh lam s~ch dl!~c sv dt,mg cho phep kiem tra tfnh nhat quan, tfnh logic giCta nc)i be) Wng ml,Jc phieu hoi va giCta cac mi,JC phieu hoi. Chl!dng trlnh lam s~ch in ra toan be) cac thong bao loi, sau d6 cac can be) c6 chuy€m mon am hi§u nghif[!p VI,J dieu tra MICS ki§m tra trlfc tiep phieu hoi. Toan be) qua trlnh lam s~ch so lif[!u de loai bo hai loai sai so tren dl!dc tien hanh W kh.i bat dau nti~p tin cho den d~u thang 9. Qui trlnh lam s~ch so lif[!u tuan thu oghie-m ng~t nguyen tac bao dam tfnh chfnh xac, chat ll!~ng, tfnh thl/C te cua SO lif[lu dieu tra. Xt1 ly, t6ng h~p so lif[!u: Sau khi cd ban hoan thanh viec lam sach so lieu, so lieu dl!dc chuy§n w EPI6 sang ·sPSS, de sau d6 tat ~a cac bien dl!~C ma hoa l~i (recede) thanh cac phan nh6m, phan t6 phu h~p Vdi yeu cau phan tfch va t6ng h~p cua cuc)c dieu tra MICS. Gong vif[!c t6ng h~p so lif[!u dl!~c chia lam hai giai do~n: Giai do~n 1 nham cung cap so lif[!u cho xay dlfng Chl!dng trlnh hanh dc)ng Quae gia, giai do~n hai nham cung cap so lif[!u cho vif[!c phan tfch chuyen sau va xuat ban an pham. Vif[!c xv ly so lif[!u dl!~c tien hanh tren SPSS version 10.0. Thei gian xv ly solif[!u giai do~n 1 ket thuc vao ngay 10 thang 9. Tfnh quyen so suy rc)ng ket qua dieu tra: Nhl! da trlnh bay a tren, Mc)u cua dieu tra MICS Ia mau tl/ dieu chlnh quyen so d mltc tang, nhl!ng khong tl/ dieu chlnh quyen so a possible erroneous entry of locality, household and household member codes. Internal consistency checks were also performed to help data-entry staff members ensure quality control. - Data cleaning: Errors on data are due to 2 reasons: mistake of the data entry staff members or the information itself was wrong (wrong statement of respondents or registered wrongly by interviewers). Data cleaning was to minimize these two errors. • To minimize the errors made by data entry staff members, all the records were double- entered by two different members. Any error detected between the two entries was re- checked to find out which one is wrong. • To minimize the errors due to wrong statements of respondents or wrong registration by interviewers, a cleaning programme was used to check the consistency and logic in the items of questionnaires and between the questionnaires. The cleaning programme printed out all the errors, then questionnaires were checked by qualified officials. Data cleaning started in to early September. This process was closely observed to ensure the accuracy, quality and practicality of all the data collected. Data processing and tabulation: Upon the completion of data cleaning, data were exported from EPI6 to SPSS to be re-ceded into sub-groups to facilitate the tabulation and analysis of data in MICS. Data tabulation was done in 2 stages. Stage 1: Tabulation of baseline data for use in the preparation of the National Plan of Action; Stage 2: Providing data for in-depth analysis and publication. Data processing was performed on SPSS version 10. Stage 1 ended on September 10. Weight used for generalizing results: As presented earlier, MICS sample was self- weighting by stratum, but not at national and inter-stratum levels. So, weights had to be 39 cap quae gia va gilia cac tang. Do d6 can phai tfnh quyen SO d~ suy rc;:>ng SO li$U cap Quae gia Va khu VlfC thanh thj/n6ng than. Quyen SO dllc;lc tfnh toan gem quyen so goc va quyen so dieu chlnh. Quyen so goc dllc;lc tfnh toan tn§n Cd Sd xac suat chon mau CUa mau 3% ttJ dan mau TDTDS va Nha d 1/4/1999, xac suat ChQn mau cap I (xac suat ChQn dja ban) va xac suat ChQn mau cap II (xac suat ChQn h9). Do qua trlnh dieu tra c6 trliC:lng hc;lp c6 m<?t so h9. phi,J nli va tn3 em khong hoan thanh phong van nE'm can phai tfnh toan quyen so dieu chlnh. Quyen so dllc;lc tfnh toan rieng h9 gia dlnh, cho phi,J nil trong d9 tuoi, tre em dlloi 5 tuoi CUa tltng VUng, khu VI,J'C thanh thj/n6ng than. Uoc lllc;lng sai so ch9n mau va khoang tin c~y: C6 hai lo~i sai so gem sai so ch9n mau Va sai SO phi ChQn mau. • Sai so phi ch9n mau phat sinh do c6 sai sot trong qua trlnh thu th~p Va Xlr ly SO li$U ch~ng h~n nhll phong van nham h9. phong van kh6ng thanh c6ng h9 gia dlnh, phit3u hoi thiet ke kh6ng ro rang dan den nglldi tra IC:li hi~u sai, dieu tra vien dien d~t cau hoi sai ho~c kh6ng chfnh xac ho~c do nh~p tin vien nh$p tin sai. Ve m~t ly ttlUyet kh6ng th~ lo~i bo hoan toan sai so lo~i nay. Cuc;:>c dieu tra MICS da co gang h<~m che toi da sai so lo~i nay thong qua toan b9 cac ho~t d9ng: bien so~n tai li$u, thiet ke phieu hoi; t$p huan, to ch(tc chi d~o va giam sat thu th$p so li$u t~i dja ban; quan ly giam sat nh$p tin Va Xlr ly SO li$u nhll da mo ta o ph an truoc. • Sai so ch9n mau phat sinh do thiet ke mau va c6 th~ danh gia dllc;lC ve m;;a thong ke. VC:Jc lllc;lng cac sai so chQn mau dllc;lc tien hanh cho mc;:>t so chi tieu chfnh cua CUQC dieu tra MICS. Thong qua lldc llfc;lng sai so mau se cho phep danh gia d9 tin c$y va tinh khoang tin c$y. C6 nhieu phlldng phap khac nhau d~ uC:Jc lllc;lng sai SO ChQn mau tuy thUQC Vao each ChQn mau. Cuc;:>c dieu tra MICS sl'r d1,.1ng phlldng phap lldc lllc;lng phlldng sai cluster (chum) cuoi cung. Chi tiet cua ky thu$t nay dllc;lc m6 ta trong phan phi,J 11,.1c 2. 40 calculated to generalize data at national, urban/rural levels. The weights used included original weights and adjusted weights. Original weights were based on sampling probability of the 3% sample from the 1999 Population and Housing Census on 1/April/1999, sampling probability stage I (cluster - sampling probability) and sampling probability stage II (household sampling probability). As a number of households, women and children failed to fulfil the interviews, the calculation of adjusted weights was necessary. Weights were calculated separately for households, child bearing-age women and children under 5 in each region, urban/rural areas. Estimated sampling errors and confidence interval: There are 2 kinds of errors: sampling and non-sampling errors. • Non-sampling errors were attributable to mistakes in collecting and processing data, e.g. interviewing wrong households, unsuccessful interviews of households, not clear questionnaires resulting in wrong comprehension, wrong or inaccurate interpretation of questions or wrong data entry. Theoretically, it was impossible to rule out these kinds of errors. Efforts were made to minimize these errors by: compiling training materials, carefully designing the questionnaires, training, closely monitoring the collection of data, supervising data entry and data processing as described earlier. • Sampling errors stemmed from sample design and could be assessed statistically. Estimation of sampling errors was performed for some key indicators in MICS. The estimation of sampling errors would allow us to assess the reliability and calculate the confidence intervals. The methodology adopted to estimate the sampling error depended much on how the sample was chosen. The Ultimate Cluster Method of Variance Estimation was adopted in MICS. Full technical details of the method were included in Annex 2. nr. cAc DAc TRUNG cDA MAU v A CHAT LUQNG so u~u; SAMPLE CHARACTERISTICS AND DATA QUALITY Ty 1~ tra lot Ty 1$ hoan thanh phong van cua cu(>c dieu tra MICS rat cao. Day Ia m(>t can cLr de danh gia chat llfc;mg cua cu(>c dieu tra. Nhlf da trlnh bay o phan trem, trong so 7628 he) dl!c;!c chQn, c6 kho2.mg 30 h9 (bang 0.39% soh(>) phai thay the do danh sach b2m ke dla ban cua T6ng dieu tra dan so va nha d chua chfnh xac hoii3c nham 12m h9 ten chu h(>. Trong cac h(> dl!c;!C phong van, c6 9346 phi,J nii trong d(> tu6i sinh de, thl 9117 nglfoi hoan thanh phong van (ty 1$ hoan thanh phong van d~t 97.55%); C6 3107 tre em duai 5 tu6i , trong d6 c6 31 04 tre em hoan thanh phong van (ty 1$ hoan th~mh phong van Ia 99.90%). Phan bo' tuo/ va trLfimg hCJp thitfu thong tin Bieu do so 1 cho thay dan so cac nh6m d9 tu6i tLt 9-17 tu6i chiem ty 1$ cao hdn so vai cac do tu6i khac va c6 mot chut bieu hien don tu6i o. trong nh6m d(> tu6i nay. C6 th~ bieu hi$n t~p trung tu6i vao cac d(> tu6i chan 0 va 5. 8ieu nay the hi$n tlfdng doi r6 d phi,J nii 15, 20, 30, 40 va 50 tu6i. Response rates The interview completion rate of MICS was satisfactorily high, a good basis to evaluate the quality of the survey. As explained earlier, of the 7628 selected households, about 30 (0.39% of households) had to be replaced as the local map of the 1999 Population and Housing Census was not accurate or there was something wrong in the names of household heads. Of the interviewed households, there were 9346 child- bearing age women, of them 9117 successfully interviewed (the response rate was 97.55%); Of the 3107 under 5 children, 3104 completed interviews (yielding a response rate of 99.90%). Age distribution and missing data As shown in Figure 1, the 9-17 age group population made up a higher rate than other age groups and exhibited some distortions comparatively clear around age 15, 20, 30, 40 and 50 for female and ages ending in 0 and 5. Bi~u do 1/ Figure 1. Phan bo tuoi cua cac nhan khfiu cua he) gia dlnh dieu tra theo gi6i tinh Age distribution of interviewed household members by sex 2.5 2 ~ 1.5 0.5 0 5 10 15 20 30 35 40 45 50 55 60 65 Tutii/ Age 1--Nam/ Male -Nil'/ Female I TnrC1ng hc;Jp thieu thong tin: Cac truong hc;!p thieu thong tin (missing) ho~c tra Missing data: Missing data of "Don't know" answers to certain questions in the 41 lai "Khong biet " (Don't know) doi voi m(>t so cau hoi cua phieu dieu tra cho phep danh gia chat ILt9ng so li$u dieu tra. Cl,l th~: • C6 o, 15% so nglfai W 5 tu6i trd len khong CO thong tin ve cap hQC va 0,2% khong CO thong tin ve lOp da hQC xong. • 8oi voi phl,J nv w 15 den 49 tu6i, c6 15,37% chi nho tu6i ma khong nho dLt9c thang va nam sinh ( chu yeu Ia khong nho dlf9C thang sinh). NhG'ng nglfai phl,J nlt nay thuang t~p trung C1 nh6m c6 trlnh d9 van hoa thap d mien nui, vung sau, vung xa. Day Ia dieu da du9c tfnh den w truoc, vl v~y dieu tra vien da dlt9C hlfdng dan rat ky khi t~p huan d~ c6 th~ khai thac chfnh xac nhat ve tu6i. So trlfang h9p phl,J nv khong tra lai cau hoi ve ngay tiem phong uon van cua lan sinh de gan nhat Vdi thai di~m dieu tra Chiem ty 1$ 0, 16%. • 86i voi tre em dLtoi s tu6i, c6 0,8% tre em chi khai bao tu6i ma kh6ng khai bao day du ve thang va nam sinh, 1.48% khong dLt9c can n~ng va 2,44% kh6ng dLt9c do chieu cao. Truong h9p kh6ng dL19c can n~ng ho~c do chieu cao chu yeu do tre em khong c6 m~t C1 nha ho~c chau be con qua nho va gia dlnh "kieng" vl vi$c can do c6 th~ lam anh hlfdng toi con/chau h98. Nhln chung, ty 1$ thieu thong tin trong cac: cau hoi rat thap. Day Ia m(>t dam bao g6p phan nang cao chat llf9ng cua cu(>c dieu tra MICS. Cac d~c trung ct.ia nhan kha'u h9 gia dinh dieu tra Ty 1$ gioi tfnh cua ·mau dieu tra MICS Ia 97,17%, ket qua nay tlfdng doi phu hdp voi ket qua T6ng dieu tra dan sola 96,70% . Ket qua suy r(>ng mau cho thay c6 25,04% SO h(> song t~i khu Vl/C thanh thi Va 74,96% so h9 song t~i khu Vl/C nong thon.· So sanh giG'a cac vung cho thay vung 8BSH chiem 21,54% so h9 cua ca nlfoc, tiep d6 Ia 8BSCL (20,54%), Dong Nam 89 (16,56%) va thap nhat Ia Tay Sac chi chiem 2,49%. questionnaires affected the quality of the survey data, viz: • 0.15% of population upwards of 5 did not provide any information on educational level and 0.2% on finished grades. • 15.37% of female respondents from 15-49 did not report a complete birth date (i.e. month, year, particularly month). These women were in poorly educated groups in mountainous, remote areas. In anticipation of this, interviewers were carefully trained to get the most accurate information on age. 0.16% of women who had delivered a child at a time closest to the survey could not report the date of their last tetanus toxoid injection. • 0.8% of children under 5 did not have a complete birth date recorded (i.e month and year). 1.48% of them were not weighted and 2.44% were without measure of height. The reasons are the children not being present, being too small or their mothers refused to have their young children weighted/ measured because of their superstition8 . Overall, the missing information rate was low, which helped ensure the survey quality. Characteristics of household population The sex ratio of MICS samples was 97 .17%; that from the 1999 Population and Housing Census was 96.70%. Sample generalization results showed 25.04% of the households living in urban areas and 74.96% living in rural areas. A comparison between areas showed that the Red River Delta made up 21.54% of the country's households, followed by the Mekong River Delta (20.54%), the Southeast (16.56%) and lowest in the North West, only 2.49%. , _ 8. ~9t s~ ,nguai, cao_ tu6i ,~lin con t?n t~i nhfrng quan ni¢m l~c h~u. hQ khong d~t ten con bang nhfrng cai ten d7~· D~1 kh1 _hQ ~1eng ca nhLmg 10'1 khen tOt/ Outmoded concepts still survive among old-age people who are against g1vmg beautiful names to children. even praises. 42 So nhan khau binh quan 1 h9 Ia 4,5 ngll'oi, c6 47,23% so h9 dieu tra c6 tU 4-5 nguoi. £>a so cac h9 c6 tre em dll'oi 15 tuoi (72,41%) va 1 ph1,1 nil trong d9 tuoi sinh de (86,36%) va c6 29,57% so h9 c6 ft nhat 1 tre em dU'oi 5 tuoi. C6 25,76% so phi,J nil 15-49 tuoi song (J khu vlfc thanh thi. Vung c6 tY 1$ ph!,J niltlf 15-49 tuoi cao nhat Ia vung DBSCL (21 ,99%). Bieu do SO 2 cho thay Cd cau ph!,J nil 15-49 chia theo nh6m tuoi: Trong so phi,J nil tCt 15-49 tuoi thi ph1,1 nil tCt 15-19 tuoi chiem 20,54%, ty 1$ nay c6 xu hU'ong giam d cac nh6m d9 tuoi cao hdn va chi con 8,87% a nh6m d9 tuoi 45-49. The number of members per household was 4.5, with 47.23% of .interviewed households having 4-5 people. Most households had children under 15 (72.41%) and a child- bearing age woman (86.36%) and 29.57% of households had at least 1 child under 5. 25.76% of women aged 15-49 lived in urban areas. The Mekong River Delta was found to have the largest number of 15-49 year old women (21.99%). Figure 2 shows the structure of women aged 15-49 by age. Of the women aged 15-49, those from 15-19 made up . 20.54%. The percentage showed a downward trend at higher age groups and stood at 8.87% at the 45-49 group. Bi~u do 2/ Figure 2. Co cau phl;l nfrlS-49 tu6i phan theo nh6m tu6i Structure of women aged 15-49 by age group £>a so phi,J nil 15-49 hi$n dang c6 chong (63,46%), ph1,1 nil goa chong/lyd!fly than chi chiem 4,8% va con lai Ia 31,75% so chlla bao gio c6 chong. C6 64,.06% da tCtng sinh de. Ve trinh d9 van hoa, phi,J nil 15-49 c6 trinh d9 trung h9c cd sd chiem ty 1~ cao nhat (42, 17%), tiep den Ia tieu h9c (24,97%) va trung h9c pho thong (18,71%). Dang chu y Ia c6 toi 7,34% khong c6 bang cap gi. C6 50,84% so tre em dlloi 5 tuoi Ia nam gioi. £>a so tre em c6 mf? ho~c nglldi cham s6c ' 63.46% of women 15-49 years of age were married; widowed/divorced/separated women accounted for only 4.8% and the remaining 31.75% had never been married. 64.06% had delivered at least once. Women aged 15-49 with lower secondary education accounted for the highest rate 42.17%, then with primary education (24.97%) and upper secondary education (18.71%). 7.34% of women are without any diploma or certificate. 50.84% of children under 5 were boys. Most children had mothers or caretakers with 43 c6 trlnh d9 tieu h<;>c ho~c trung h<;>c cd sa (69,05%), 12,84% so tre em c6 m~ Ia ngvai kh6ng c6 bang cap gl. 8ay Ia yeu to kh6ng the khong tfnh den trong vi$c phan dau thl,fc hi$n cac muc tieu ve cham s6c tre em, dac biet Ia tre em ·dvoi 5 tu6i. · · 44 primary education or lower secondary education (69.05%), 12.84% of children have mothers who are without any diploma or certificate. That should be taken into account in the fulfilment of the child-care objectives, particularly of children under 5. IV. KET QUA/ RESULTS A. Ty 1~ chet tre em dud'i 1 tuol va dU'd'i 5 tuol Ty 1$ chet tre em dl1Cii 1 tuoi Ia xac suat chet cua tre em trl1dc ngay sinh nh~t dau tiem. Ty 1$ chet cua tre em dVCii 5 tuoi Ia xac suat chet cua tre em trVdc ngay sinh nh~t lan th(/ 5. Trang cuc?c dieu tra MICS, phl1dng phap uCic IVc;:lng ty 1$ chet cua tre em dl1di 1 tuoi va dVdi 5 tuoi dlja vao ky thu$t l1dc IV~ng gian tiep (Phl1dng phap Brass). Thea phVdng phap nay, phieu hoi cua MICS dl1~c thiet ke de hoi tat ca phl,J nCr trong de? tu6i sinh de de xac d!nh tong so tre em sinh ra song, so con sinh ra song hi$n dang con song, so con sinh ra song nhl1ng hi$n nay da chet va gidi tfnh cua tre em sinh ra song. So li$u de l1dc IU~ng ty 1$ chet dV~c ghi trong Bang 2.2. So con sinh ra song blnh quan 1 phi,! nCr trong de? tuoi 15-19 Ia 0,029 va len tCii 3,921 doi vCii pht,~ nCr 45-49. so tre em sinh ra song va da chet tfnh den th<':Ji diem dieu tra tinh blnh quan cho 1 phl,J nCr Ia 0,062. Ty 1$ nay thap nhat o nh6m ph1,1 nCr c6 de? tu6i W 25-29. Tuy nhien cOng can IVU y rang nh6m de? tu6i cua pht,~ nCr 25-29 khong c6 bieu hi$n bat thu<':Jng ve phan bo de? tuoi (xem bang phan bo tu6i o phan truoc) Cac l1dC ll1~ng chet cua tre em dl1di 1 tu6i va dl1di 5 tuoi CO dV~C thong qua Slt dt,~ng phan mem QFIVE cua Lien hi$p quoc. Thea y kien cua cac nha chuyem mon, mo hlnh bang song Bac (North) Ia tVdng doi thich h~p vdi Vi$t Nam. Tuy nhien, neu con nghi ng<':J gl ve mo hlnh d6 thl cung c6 the dung mo hlnh Chung (General), vl mo hlnh nay Ia pho bien vdi mc;>i quoc gia. Cac Vdc ll1~ng chet cua tre em dl1Cii 1 tu6i va duoi 5 tuoi cho cac nam tham khl10 W 1986 den nam 1998 dUde trlnh bay d Bieu do so 3. Nam 1998 du~c dua vao chi nham de tham khao ch(! khong du~c sLJ' d1,1ng de uCic lv~ng vi thea cac nha chuyen mon thl 2 nh6m de? tuoi 15-19 (tVdng (!ng voi nam 1999) va 20-24 (tl1dng (!ng voi nam 1998) khong nem Slt dl,lng de lJdC ll1~ng 9 • A. Infant mortality rate (IMR) and under five mortality rate (USMR) IMR is the death probability of the child before his/her first birthday. U5MR is the death probability of the child before the fifth birth day. In MICS, the methodology of estimating IMR and U5MR was based on the indirect estimation technique (known as the Brass Method). MICS questionnaires were so designed to ask all child-bearing-age women to confirm the number of live births, the number of children still alive now, the number of children born alive but died afterwards and the gender of live births. The data· to estimate the mortality rates were included in Table 2.2. The live births on the average per woman aged 15-49 was 0.029 and was as much as 3.921 for women aged 45-49. The live births but already dead by the time of the survey, on the average per woman was 0.062. The percentage was lowest in women aged 25-29. However, in women aged 25-29, there was not any unusual indication in age distribution (see the table on age distribution in the last part). . Estimation of IMR and U5MR were obtained by using the United Nations QFIVE software. In our opinions, the North model was relatively suitable to Vietnam. However, in case of doubts the General model could be used, as it was common to all countries. Estimations of IMR and U5MR, for reference years from 1986 to 1998 were included in Figure 3. The 1998 data were included for easy reference and not for estimation because, according to several specialists, the two age-groups-15-19 (corresponding to 1999) and 20-24 (corresponding to 1998) should not be used for estimation 9 . 9. Huang dan u6'c llT<;mg ty I¢ chet tre em theo ttrng bu6'c m(>t cua Lien h9'P qu6c- New York nam 1990/ Step- by-step Guide to Estimation of Child Mortality, United Nations- New York, 1990. 45 Quan sat Bi~u do so 3 chung ta thay xu hLJC:Ing giam ty 1$ chet theo ca hai m6 hinh bang song giam tlldng doi deu, kh6ng c6 d(>t bien W nam 1986 den 1997. So lieu nam tham khao Ia nam 1997 Ia c6 the ch&p nh~n dLJ~c mE[!c du n6 c6 th~ thap hdn thlfc te m(>t chut. Ty 1$ tre em chet dLJC:Ii 1 tu6i c6 theo ca hai m6 hinh bang song (General va North) Ia 30%a va 31%a. Ty 1$ chet cua tre em dLJC:Ii 5 tu6i cua ca hai m6 hlnh Ia 39%a 10• Toan b(> ket qua tfnh toan va so li$u c6 the tham khao de aanh gia chat ILJc;:Jng so li$u dLJ~c trlnh bay b Bang 2.2. Figure 3 shows comparatively downward trend of mortality rate in both models (North and General), without any abrupt changes from 1986 to 1997. Data of the reference year, 1997, were acceptable, though possibly a little lower than they really were. The IMR in both General and North models were 30%a and 31%a respectively. The U5MR in both models were 39%a10 • Related data for calculation of IMR and U5MR are presented in Table 2.2. Bi~u do 3/ Figure 3. lfac hrQ'Ilg tre em chet du6'i 1 tu6i va chet du6'i 5 tu6i bang phuong phap gian tiep theo mo hinh bang song North va Genral Estimated IMR and USMR by indirect method following North and General models 90 80 71 68 66 70 "' 60 61 ~ 60 60 c.:: ~· - 50 ·>. 46 . 40 42 43 30 20 30 1986 1989 1992 1995 1998 Niim tham kh:io/ Years of reference -+-Chet du(1i I tut)i/ IMR (North) ----6---Chet tltrt'ti I tui\if IMR (GENERAL\ Ty 1$ chet cua tre em dLJC:Ii 1 tu6i theo dieu tra MICS thap dang k~ so vC:Ii tY 1$ chet tfnh toan dV<;'C tu cu(>c dieu tra cht;>n mau 3% cua T6ng dieu tra dan so va nha b 1/4/1999. So li$u tY 1$ chet cua tre em dLJC:Ii 1 tu6i tfnh duoc w cu6c eMu tra MICS chid~ tham khao, T6ng ct,Jc Th6ng ke de ngh! sii dl,mg ty 1$ chet cua tre em dLJdi 1 tu6i tfnh dLJ~c tu cu(>c dieu tra cht;>n mau 3% cua T6ng dieu tra dan so va nha b 1/4/1999 Ia 36,7% bbi vi ca mau tfnh cho cu6c dieu tra MICS nho hdn nhieu $0 Vdi Mau 3% cba T6ng dieu tra dan so va nha d, do d6 sai so ChQn mau IC:In hdn so Vdi Mau 3%. -Chet dul1i 5 tu6i/ USMR (North) --*"-Chet du6i 5 tu<ii/ U5MR (GENERAL) The IMR in MICS was by far lower than the IMR obtained in the 3% sample survey of the Population and Housing Census on 1/April/1999. The IMR in MICS is only for reference and GSO suggested the use of the IMR of 36.7% obtained in the 3% sample survey of the Population and Housing Census on 1/April/1999 because the sample size of MICS was much smaller than the Census 3% ED Sample. Sampling errors were, therefore, bigger than those in the Census 3% ED Sample. I 0. TY I~ chet cua tre em dtrc1i 1 tu6i theo so li~u Di6u tra 3% ci1a T6ng di6u tra dan so va nha b 1/4/1999 Ia 36.7%a. Cling theo soli~u ctla Di6u tra nhan kMu hQc va s(rc khoe nam 1997. ty I~ chet ella tre em du<Ji 1 tu6i Ia 34.5%a va ella tre em du<Ji 5 tu6i Ia 46%a/ Data on IMR from the 3% sample survey of the Population and Housing Census on l/April/1999 was 36.7%o. Data collected by the Demographic and Health survey,1997. showed IMR to be 34.5%o and U5MR 46%o. 46 B. Ty 1~ chet mlJ do cac nguyen nhiin lien quan den sinh de Chi tieu nay cho phep dimh gia chfnh xac tinh tr~mg cua pht,J nii, kha nang tiep c~m voi cac dich vu cham s6c sue khoe, chat ILJ<;'ng cua cac d!ch Vt,J y te Cd ban trong vi~c dap ling cac yeu cau cham s6c sue khoe. Thong tin ve muc de) va xu huang cua ty I~ chet mE? Ia khong chi cho phep danh gia rui ro cua pht,J nii khi mang thai va khi sinh de, ma con cho phep danh gia sue khoe cua pht,J nii n6i chung va theo mc)t y nghTa r¢ng hdn, n6 cho phep danh gia tinh tr<;mg kinh te - xa hc)i cua chfnh ban than ngVC1i pht,J nii. Khai niem chet me de chi tat ca nhiing trU'dng h<;'p chet cua ph.t,J nii ke w khi mang thai, chet trong khi sinh de va cho toi 42 ngay sau khi de. Ty I~ chet m~ dU'<;JC tfnh bang so trLJdng h9p chet mE? Hnh tren 100 ngan tre em sinh ra song. 8e vac ILJ<;Jng ty 1$ chet mE?, cu¢c dieu tra MICS slt dt,Jng phU'dng phLJdng phap U'oc ILI<;Jng giim tiep (SISTERHOOD) thong qua hoi tat ca nhiing nglfdi w 15 tuoi tro len ve cac trLJdng h9p chet va chet lien quan den mang thai va sinh de cua cac ch! em gal do cung m9t mE? sinh ra. Bieu so 2.1 trinh bay so li~u de tfnh toan ty 1~ chet mE?. Ty 1~ chet mE? dLJ<;Jc tfnh tren cd so tong ty suat sinh (TFR) cua nam 1989 Ia 3,8. Ty I~ chet m~ tfnh toan dV<;Jc bang 95/1 ooooo. 8ieu nay c6 nghTa Ia cu 1 ooooo tre em sinh ra song thi c6 95 ba mE? chet do cac nguyen nhan lien quan den sinh de. Ty 1~ nay cao hdn so voi muc tieu cua CTH8QG Ia phan dau giam ty I~ chet mE? con 70/100000 vao nam 2000. c. Giao dvc Giao dt,~c Ia mc)t dieu ki~n tien q,uyet cho chong nghEm kho, phan dau binh dang nam nii, bao v~ tre em khoi b! b6c lc)t lao d¢ng ho~c phai lao d¢ng trong dieu ki~n nguy hiem, b! xam h~i tinh dt,~c v.v . Giao d~;~c tre em d<? tu6i nha tre, m~u giao: Theo so li~u cua cuc)c dieu tra B. Maternal mortality rate related to child- bearing · The indicator provided an accurate picture of women's situation, their access to health care services, and the nature of basic health services. The information on the level and the trend of maternal mortality rate provided some basis to assess not only the risks facing women in pregnancy and birth but also the health of women in general and in a broader sense. It gave us an insight into the socio-economic situation of women themselves. The conception of maternal mortality is referred to all cases of women's death since pregnancy, death at birth and to the 42nct day afier birth. Maternal mortality is calculated based on the number of mother's death on 1 00000 live births. To estimate the maternal mortality rate, MICS used the indirect estimation technique (SISTERHOOD) by interviewing all people aged 15 or over on all cases of death and pregnancy and birth-related deaths of all biological sisters born. Table 2.1 presents all the data for the calculation of maternal mortality. The maternal mortality rate is calculated based on the Total Fertility Rate (TFR) of year 1989, which was 3.8. The calculated maternal mortality rate was 95/100000, meaning of 100000 live births, 95 mothers died of child-bearing related causes. This rate was higher than the goal set in the National Plan of Action to reduce maternal mortality rate to 70/100000 by year 2000. C. Education Education is a vital pre-requisite for combating poverty, empowering women, protecting children from hazardous and exploitative labour and sexual exploitation etc. Early childhood education Children in creche in VLSS 1997-1998 47 VLSS 1997/98 thl c6 rat It tre em trong d(> tu6i. tCt 6 den 35 thang tu6i dl,f<;:Jc di nha tre: Nam 1998 chi c6 4,29%. Ty 1$ nay c6 sl,l' khac bi$t giCta thanh th! (13,91%) va n6ng th6n (2, 15%) va c6 Sl,J' khac bi$t giCta cac vung: Hai vung c6 ty 1$ tre em di nha tre cao nhat Ia vung 8BSH (9,95%) va 86ng Nam b(> (6,71%), trong khi d6 8BSCL chi c6 1,54% tre em di nha tre. Ty 1$ tre em di nha tre ding c6 sl,l' khac bi$t giCta gia dlnh c6 thu nh~p cao va thu nh~p thap: 20% s6 h9 giau nhat c6 tdi 14,47% tre em di nha tre, trong khi 20% s6 h9 ngheo nhat chi c6 0,77% (chemh l$ch 18 lan). 8ieu dang n6i Ia trong 5 nam tCt 1993 den 1998, ty 1$ tre em di nha tre kh6ng dlt<;:JC cai thi$n hdn ma CO XU hlfdng giam di: Ty 1$ tre em di nha tre cua cu(>c dieu tra VLSS1992/93 Ia 5,57% (cao hdn 1% so vdi nam 1998). Thee s6 lieu dieu tra MICS, c6 42,29% tre em trong d(> · tu6i tCt 3 den 5 tu6i dli<;:Jc di mau giao va rieng tre em 5 tu6i thl ty 1$ nay Ia 58,82%. Tre em khu Vl,J'C thanh th! di mau giao nhieu gan gap 2 lan tre em n6ng th6n (66,08% SO Vdi 36,45%), ty 1$ tre em di mau giao khu vl,l'c 8BSH Ia 70,93% trong khi a cac vung 86ng Bac, Tay Bac va 8BSCL chi d~t mCtc 29-30%. Tre em kh6ng dli<;:JC di mau giao chu yeu ch!u Sl,J' quan ly CUa 6ng/ba ho~c anh/chj, m()t s6 khac dlf<;:Jc glti nhLJ'ng ngLiC:li thieu vi$c lam a n6ng th6n (nhLJ'ng nglidi nay· thuC:lng Ia nhCtng ngLiC:li tlidng doi nhieu tu6i) ho~c thue nguoi giup vi$c a khu vl,l'c thanh th!. N6i chung nhCtng tre em nay chi dLi<;:Jc "nu6i" ma kh6ng dlt<;:JC d~y cac kien thltc can thiet trlidC khi vao hc;>c ldp 1. Giao d~:~c phb thong Trlfdc cu(>c dieu tra MICS, VLSS 1997/98 cOng c6 s6 li$u nghien cCtu ve ty 1$ di hc;>c dung tu6i cua tre em cap tieu hc;>c. Ty 1$ di hc;>c dung tu6i cua tre em cap tieu hc;>c nam 1998 Ia 92,6%. Ty 1$ nay da tang len vao thoi diem dieu tra MICS va da dat tdi 93,52%. So sa~h vdi cu(>c dieu tra VLSS 1992/93 cho phep khang d!nh Sl,f gia tang m(>t each 6n d!nh cua chi tieu nay (ty 1$ nay cua VLSS 1992/93 Ia 78,00%). Ty 1$ nay Vli<;:Jt xa so Vdi mt,JC tieu cua H(>i ngh! Thlf<;:Jng dlnh. Van de cua Vi$t Nam Ia d cho van con ton khac bi$t thee vung, khu Vl,J'C. Trong khi vung 8BSH ty 1$ nay Ia 98,76% thl d vung Tay Bac chi d~t 79,61% (Chenh 48 data revealed very few children, 6-35 months old, going to creche: In 1998, the percentage was only 4.29%, with great difference between the urban areas (13.91%) and the rural areas (2.15%) and·between regions. The highest percentage reported was in the Red River Delta (9.95%) and the Southeast (6.71%) while it was only (1.54%) in the Mekong River Delta. The percentage also differed between high-income and low-income families 20% of the richest households had 14.47% of children going to kindergarten, while 20% of poorest households had only 0.77% (a gap of 18 times). Noteworthy was the fact that from 1993 to 1998, the creche enrolment rate showed a downward trend. The percentage reported in VLSS 1992/93 was 5.57% (1% higher than in 1998). Data from children in kindergarten in MICS showed 42.29% of children aged 3-5 going to kindergartens and for 5-year-olds, the percentage is 58.82%. The number of urban kindergarten -goers doubled that in rural areas (66.08% and 36.45% respectively). This rate in the Red River Delta was 70.93% and in the North East, North West and the Mekong River Delta was 29-30%. Children not going to kindergarten were in the care of grand parents or older siblings; of the under-employed in the rural areas (mostly elderly people) or of hired people in the urban areas. Overall, these children were "fed" but not provided with necessary knowledge in preparation for grade 1. Primary and secondary education By the VLSS 1997/98, 92.6% of children 6-10 years of age were attending primary schools in 1998. This rate was 93.52% in the year 2000, as found by MICS. A comparison with VLSS 1992/93 pointed to the sustained improvement of this indicator (78.00% in VLSS 1992/93). The primary school attendance rate by far exceeded that of the World Summit Goals. The issue is the disparity between regions and areas. The rate in the Red River Delta was 98.76% but in the North West, it was only l~ch 19,15%). Khu vvc thanh th! Ia 97,39%, cao hem 4,71% so voi khu vlfc n6ng th6n. Slf khac bi$t ve gioi cua ty 1$ nay tuy kh6ng nhieu, nhllng van xay ra d khu Vl/C nong than (nam: 93,54%, nCr: 91 ,77). 79.61% (a disparity of 19.15%). In the urban areas, it was 97.39%, 4.71% higher than in the rural areas. The rate disparity by gender, though not much, was found in the rural areas (male: 93.54%, female 91. 77%). Bi~u do 4/ Figure 4. Ty I~ tre em dl) 6-10 tu6i dang di hQC cap ti~u hQc Percentage of children 6-10 years of age attending primary school Thanh th!/ Urban Nang than/ Rural £lBSH/ Red River Delta DB/ North East TB/ North West BTB/ North Central Coast DHNTB/ South Central Coast TN/ Central Highlands £lNB/ Southeast f)BSCU Mekong River Delta ••• 0 10 20 30 Ty I~ tre em nh~p h<;>c lop 1 h<;>c toi lop 5 (Xem bang 7.4). Ty 1$ nay cho phep danh gia neu 100 tre em Vao h<;JC lop 1 thi 4 n~m sau con baa nhieu tre em h9c toi lop 5. Day Ia m<?t chi tieu chat ll1<;1ng danh gia ket qua d~y va hoc cua hoc sinh, mat khac viec dam baa khang b! h9c dup, ho~·c bo h9c ft nhat 4 nam dau tien cua cap ti~u h<;>c Ia m<)t yeu to quan tr<;>ng g6p phan vao vi$c pho c~p ti~u h<;>c, duy tri tfnh on d!nh cua ty 1$ biet d<;>c biet viet. Ket qua dieu tra MICS cho thay ty I~ nay Ia 88,85%. 8ieu nay cOng c6 nghTa Ia c6 11,15% tre em bo h<;>c ho~c b! h<;>c dup trong 4 nam dau tien cua trl!C:lng ti~u h<;>c. Ty 1$ nay kh6ng c6 sv khac bi$t c6 y nghTa thea gioi, nhllng l~i khac bi~t giCta cac vung va gilta thanh th! va n6ng than. Vung c6 ty 1$ tre em nh~p h<;>c cap m<?t h<;>c toi lop 5 cao nhat Ia vung DBSH (96,51 %), trong khi vung thap nhat Ia DSSCL chi d~t 76,14% (mU'c chenh l$ch Ia 20,37°/o). 40 50 60 70 80 90 100 % Percentage of children entering grade 1 and eventually reaching grade 5 (see Table 7.4 ). This percentage allows us to see if 100 children enter grade 1, how many will reach grade 5 four years later. This is an indicator evaluating the teaching and learning quality. On the other hand, non-repetition and non drop-out at least in the first 4 years of primary school are an important factor for the universalisation of primary education and the sustainability of literacy. 88.85% of children enrolled in grade 1 reached grade 5 after four years. It also means that the remaining 11. 15% either drop out or repeat in the first 4 years of primary school. By gender, there was virtually no difference, but there was a disparity between regions and urban- rural areas. The Red River Delta was reported to have the highest rate of children reaching grade 5 (96.51%), while in the Mekong River Delta, this rate was only 76.14% (a balance of 20.37%). '49 Bi~u do 51 Figure 5. Ty ~~ tre em vao hQC 16'p 1 hQC t6'i 16'p 5 chia theo khu Vf!C va theo vimg Percentage of children reaching grade 5 by area and region DBSH/ Red River Delta ti~~g~g~ DB/ North East TB/ North West p~~~~~ BTB/ North Central Coast ~~~~~iii DHNTB/ South Central Coast TN/ Central Highlands DNB/ Southeast 8~~:j~~ DBSCL/ Mekong River Delta tJ:~E~§~ 0 10 20 30 40 50 60 70 80 90 100 % Chvdng trinh hanh d(mg Quoc gia de ra mt,JC tieU phan dau "cJen nam 2000, 90% tre em se aat trinh cJo tieu hoc tnJac cJo tuoi 15 va SO tre em con f?i phai. hQC xong fop 3, cJe khong co tre em mu cha khi buac vao tuoi 15". Mt,JC tieu nay dV<;'C dEmh gia bang: Ty 1$ tre em 14 tu6i tot nghi$p ti~u h9c va ty 1$ tre em 14 tu6i hQC het lop 3. (xem bang 7.5 Va 7.6). Theo ket qua dieu tra MICS, c6 84,69% tre em 14 tu6i hoan thanh ti~u hoc va 94,39% tre em 14 tu6i hQC het lop 3. . Nhv v~y gan di?t mt,Jc tieu CTHBQG 1991-2000 Ia 90% tre em dat trlnh do ti~u hoc trvoc tu6i 15. Rieng khu vlfc thanh ttil thl m0c tieu nay da vvc;n (94,59% tre em 14 tu6i tot nghi$p ti~u hc;>c), nhvng khu vlfc nang than li?i chi di?t m(fc 82,79%. Hai vung VV<;'t mt,JC tieu chung Ia 8BSH (96,95%) va Duyen hai Nam Trung B9 (92,48%). Va dieu dang lvu y Ia vung Bong Nam b(> Ia m(>t trung tam chfnh trl- kinh te - van hoa ty 1$ tre em 14 tu6i hQC het lop 5 chi di?t 88,97%. £)~ hoan thanh va duy trl ben vltng mt,~c tieu nay m(>t m~t phai giam toi da so tre em 6-14 tu6i chva bao gio den trvong (ty 1$ chung Ia 3,4%, rieng Tay Bac c6 15,45% tre em 6-14 tu6i chva bao gio den trvong), m~t khac tang ty 1$ tre em nh~p h9c lop 1 dung tu6i (chi di?t 93,07% tre em 6 tu6i di h9c lop 1). 50 The goal set out in the National plan of action is: "By year 2000, 90% will have finished primary education below 15, and the rest finishing grade 3 with no illiterate children at age 15". This goal is assessed by: the rate of 14 year olds finishing primary school and the rate of 14 year olds finishing grade 3. (see Table 7.5 and Table 7.6). As shown in MICS, 84.69% of 14-year olds finished primary school and 94.39% of 14-year olds finished grade 3. The goal for universal primary education has failed, with urban areas outstripping the common goal (94.59%), but the rural areas standing at only 82.79%. Two good performing regions were: the Red River Delta (96.95%) and the South Central Coast (92.48%) and regrettably, the North East South, a socio-economic-cultural centre, failed (only 88.97%). Fulfilling and sustaining this goal called for minimizing the rate of children never- attending school (the overall rate was 3.4%, that in the North West was: 15.45%). On the other hand, it is necessary to promote enrolment at right age in primary education for children 6 years of age. The percentage of children enrolled at right age in grade 1 was 93.07% in the year 2000. M(>t van de khac cOng dang dl!<;'C quan tam d6 Ia van de tre em chlfa bao gio den trl!ong. C6 3,4% tre em tCt 6-14 tuoi chua bao gio den truong. Ty 1$ tre em 6-14 tuoi chua bao gio den trl!ang o khu vlfc n6ng th6n cao gap 3 lan so v6i khu vlfc th~mh th! (3,89% so v6i 1 ,22%). Ty 1$ nay cao d~c bi$t a vung Tay Bac (15,45%), tiep den Ia vung 86ng Bac (5,96%) va vung 8BSCL (4,93%). Day Ia 3 vung c6 dieu ki$n di 19i kh6 khan, riemg d vung nui phfa Bac dan elf song kh6ng t~p trung do d6 tre em phai di h9c xa. Vi$c dau tlf ma cac trl!ang n(>i tru se g6p phan giam dang k~ ty 1$ nay. Ty 1$ tre em 11-14 tuoi di h9c trung h9c ccJ sa (cap II) Ia 74,58%. Ty 1$ nay giam dang k~ so v6i ty 1$ tre em 6-1 o tuoi h9c ti~u h9c (93,52%) do tre em b! ll!U ban, bo h9C (d cap ti~u h9c ho~c trung h9c co sa). Ty I~ biet chft cua ngtti:li 18n . Nang cao ty 1$ biet chU' cua ngl!oi 16n Ia ket qua CUa gi~lO d~C tre em Va ngl!<;'C l9i trlnh d9 giao d~c cao cua nglfdi ldn g6p phan tfch CI/C VaO Vi$C phan dau d9t cac m~c tieu Ve giao d~c tre em. Ty 1$ biet chU' cua ngl!ai ldn dl!<;'C tfnh bang ty 1$ phan tram nhU'ng nguoi w 15 tuoi tra len biet d9c tfnh irong tong s6 nguai w 15 tuoi tra len. Thea ket qua cua cu(>c dieu tra MICS, ty 1$ biet chU' cua nglfoi ldn Ia 90,16%. Ty 1$ biet chU' ngl!oi ldn khac bi$t c6 y nghla giU'a cac vung (Cao nhat Ia DBSH: 95,56%, thap nhat Ia vung Tay Bac: 72,40%), giU'a thanh th! va nang th6n (96, 76% so Vdi 87,82%). Van de bat blnh d~ng gilia nam va nU' ve trlnh d(> van hoa. DEmh gia van de nay thong qua so sanh chemh l$ch ve ty le biet chU' giU'a nam va nU'. Slf bat blnh d~ng giU'a nam va nU' th~ hi$n d tCfng VUng, kh6ng nhU'ng d khu VI/C n6ng th6n ma ca d khu Vl!C thanh thi. Mltc chenh l$ch ty 1$ biet chCt gilia nam va nCr vung thap nhat Ia 3,25% va vung cao nhat len tdi 19,96%. Vung c6 mvc bat blnh d~ng cao Ia vung Dong Bac (chenh l$ch nam nU' Ia 11 ,58%), vung Tay Bac (19,96%) va Tay Another issue of concern is the percentage of children never attending school. 3.4% of 6-14 year olds had never been to school. The rate of 6-14 year olds never attending school in the rural areas tripled that in the urban areas (3.89% against 1.22% ). This rate was very high in the North West (15.45%), followed by the North East (5.96%) and the Mekong River Delta (4.93%). These 3 regions are characterized by inaccessibility and scattered living, especially in the North mountainous areas, where most children have to walk long distances to school. Investments in building boarding schools would help improve the situation. The rate of children aged 11-14 attending lower secondary school (2"d level) was 74.58%. This rate was by far lower than 6-10 year olds enrolled in primary school (93.52%), as a result of repetition and drop- outs (at primary school or lower secondary school). Adult literacy Improving adult literacy is the outcome of child education, and adult education, in its turn, helps promote the fulfillment of child education goals. Adult literacy rate is calculated based on the percentage of the literate people 15 year olds and over. The adult literacy rate was 90.16%. The adult literacy rate varied significantly by region (highest in the Red River Delta: 95.56%, lowest in the North West: 72.40%), between urban and rural areas (96.76% and 87.82% respectively). Male-female inequality in education - This issue could be looked at by comparing the disparity between male-female literacy rate. The male-female inequality was reported in each region, in both rural areas and urban areas. The male-female literacy rate discrepancy was lowest at 3.25% and highest at as much as 19.96%. The highest inequality rate was in the North East (11.58%). in the North West (19.96%) and in the Central Highlands (9.94%). These three areas are 51 Nguyen (9,94%). 8ay Ia 3 vung c6 ty I~ dan t<)c thieu so cao. Bat blnh d~ng gii1a nam va ni1 b khu v!Jc nong thon Ia 8,88%, b khu v!Jc thanh th! Ia 2,88%. Bat blnh d~ng nam ni1 trong nh6m dan so w 55-64 tu6i va 65 tu6i trd len lan lu~t Ia 16,37%, 31,82%. Giam dan o cac nh6m tu6i tre hdn va chi con 1,58% d nh6m tu6i 15-24 tu6i. D. Nud'c va cong trinh v~ sinh Nguon mtdc Sl(lch NLICJc sc;:tch Ia m<)t nhu cau thiet yeu dam bao sue khoe con ngL!C:li. NLIC1c kh6ng h9p v~ sinh Ia m<)t nguyen nhan gay ra cac b~nh nhll cac b$nh ve mat, ta, thlldng han va b~nh ky sinh trung. NLICJc uong b! nhiem khu~n ho~c chua cac hoa chat gay 6 nhiem c6 anh hlldng den sue khoe con ngLIC:li. 8e tfnh ty 1~ dan so tiep c$n nuoc sc;:tch, each tot nhat Ia tien hanh dieu tra chon mau, lay mau nLICJC de phan tfch, xet nghi~m va danh gia d!Ja tren cac tieu chu~n hoa-ly. each lam nay rat ton kern va kh6ng the ap dl,lng trong cu<)c dieu tra MICS. DLICJi day Ia phlldng phap xac d!nh ty I~ dan so tiep c$n nuoc sc;:tch trong cu<)c dieu tra MCSII: BLtdc 1: Tinh ty I~ dfm so slr dt:~ng cac nguon nLtdc Sl(lch (Chua dung h~ so chuy~n d6i). Trong CUQC dieu tra MICS, cac nguon nuoc dL19c gc;>i Ia nguon nuoc sc;:tch gom: Nvoc may (nl!CJC may trong nha, ngoai nha, nl!CJC may c6ng c<)ng), gieng khoan c6 may bdm, gieng dao c6 nap d$y va c6 thanh bao v~. nl!CJC ml!a va nLICJC suoi CO h~ thong dan IQC dl19C bao v~. Tat ta cac nguon nl!CJC kh6ng dl19C nhac den 0 day kh6ng dl19C gc;>i Ia nguon nLICJc sc;:tch. T6ng c<)ng chung c6 78,66% dan so sll' d1,1ng cac nguon nLICJc sc;:tch, trong d6: 12,55% dan so sll' d1,1ng nl1<':1c may, 20,48% dan so sll' d1,1ng nLICJc gieng khoan c6 bdm, 33,24% dan so sll' d1,1ng nvoc gieng dao c6 thanh bao v~. 0,72% dan SO Slr d1,1ng nl!CJC SUOi CO h~ thong dan lc;>c va 11 ,66% dan so sll' d1,1ng nl1<':1c mua. Nguon nl1<':1c may chiem vai tro quan trc;>ng t<;:~i 52 inhabited predominantly by ethnic minorities. The male- female inequality in rural areas was 8.88% and in urban areas was 2.88%. In the 55-64 age group and upwards of 65, it was 16.37% and 31.82% respectively. It declined in younger age group and was only 1.58% in those aged 1 p-24. D. Water and sanitation Sources of drinking water Safe drinking water is a basic necessity for good health. Unsafe drinking water can be a significant carrier of diseases such as eye- diseases, cholera, typhoid and schistsemiases. Drinking water can also be tainted with chemicals, physical contaminants with hamful effects on human health. To have the statistics of the population rate having access to safe water needs, in the first place, sample surveys, analysing, testing and evaluating water samples, based on phisco-chemical standards such a procedure, being very costly, could not be applied in MICS. The following steps were applied in MICS to identify the rate of population using safe water. Step 1: Calculating the non-adjusted rate of. population using safe water sources In MICS, water sources considered to be safe included: piped water (into dwelling and into yard or plot, public tap), tubewell/ borehole with pump, protected dug-wells, protected spring and rainwater. All water sources other than the above - mentioned sources are not considered safe water sources. Overall, 78.66% of the population were reported to use safe water sources. Of which 12.55% of the population using piped water; 20.48%, tubewell/ borehole with pump; 33.24%, protected dug-wells; 0.72%, protected spring and 11.66%, rain water. Piped water play an important part in urban areas (49.03%), so did well-water and khu vlfc thanh th! (49,03%), trong khi nguon gieng va nLtac mLta chiem vai tro quan tr9ng d khu vlfc nang then (14,08% dfm so nang then dung nLtac mLta, 57,75% dung nLtac gieng). Vung nui phfa Bac, Tay Nguyen va 8BSCL Ia nhiing vung can phai dlt<;jc quan tam dau tlf ve nLtac s<;~ch. 8~c bi$t Ia vung 8BSCL c6 hdn 40% dan so dung nLtCic song d~ an uong. Buac 2: Tinh ty I~ dan so tiep c~n nuac s~ch (Da dung h~ so chuy~n doi). Can phan bi$t khai ni$m "nvac s9ch" va "nguon nLtac s<;~ch" trong cu(>c dieu tra MICS. Nglfdi ta c6 th~ n6i "lo9i/nguon nLtCic gieng khoan c6 bdm Ia lo9i/nguon nlfac s9ch", nhlfng 19i khong th~ kh~ng djnh "tat ca cac gieng khoan c6 bdm deu cho nLtCic s9ch". Tren thlfc te c(t 1 o gieng khoan dang sl! dt,mg thi chi c6 8 gieng c6 nLtac dam baa tieu chuan nltdC S9Ch, trong trudng h<;:Jp nay ta CO h(J SO chuyen a6i nuac s<;Jch (hay n6i g9n hdn: h(J so chuyen a6i) Ia 0,8. Tren cd sd tfnh dLt<;jc h$ so chuy~n doi, ta tfnh ra dLt<;:Jc ty 1$ dan so tiep c~n nltac s9ch bang each nhan ty 1$ dan so sl! dt,mg nguon nLtac s9ch (da-dVc;1c nhac den C:l bLtCic 1) vai h$ so chuy~n doi. Vi dl): c6 20,48% dim so sl! dt,mg nvCic gieng khoan c6 bdm, h$ so chuy~n doi cua gieng khoan c6 bam Ia 0,8. Do d6 ty 1$ dan so tiep c$n nvoc s9ch w nguon nLtac gieng khoan c6 bam Ia: 20,48% X 0,8 = 16,38%. Bi~u dvai day trlnh bay ket qua tinh toan ty 1$ dan so tiep c~n nvac s9ch thea phLtdng phap da trinh bay C:l tren. rainwater in rural areas (14.08% of rural population using rainwater and 57.75% using well-water). The North West and North East, the Central Highlands and not least the Mekong River Delta- where more than 40% used river water for cocking/drinking needed more investment in safe water. Step 2: Calculating the adjusted rate of population having access to safe water "Safe water" and "Safe water sources", as concepts, are somehow not exactly the same in MICS. "Safe water sources" do not necessarily mean that the water samples from these sources are safe. For example: Tubewell/ borehole with pump is considered safe water, but as matter of fact, of 1 0 wells, only 8 wells produce safe water, in which case the adjusted coefficient is 0.8. Given the adjusted coefficient, we c;an calculate the percentage of population having access to safe water by multiplying the percentage of population using safe water sources mentioned earlier in step 1 by the adjusted coefficient. For example: Given 20.48% of the population having access to tubewell/ borehole with pump, the adjusted coefficient of tubewell/ borehole with pump was 0.8. So, the percentage of population having access to tubewell/ borehole with pump was: 20.48% x 0.8 = 16.38%. The table below shows the calculation results of the percentage of population having access to safe water by the method referred to above. 53 Bi~u I Table 1. Ty I~ dan so tiep c~n nu6'c s~ch Percentage of population having access to safe water Nuac may Nuac may Nuac may Giang Giang Nuac suoi NUCJC mua/ Rain water Chung/ trong nha/ ngoai cong khoan c6 dao c6 c6 h$ Total Piped nha/ c(lng/ may bam/ thanh bao thong ong into dwel- Piped into Public tap Tube-well/ v$1 Prot- dan lqc/ ling yard or bore-hole ected dug Prot- 1. Phan tram dan so str dt,mg cac nguon nuac s~ch/ % of population 78.66 y~iQ9~<3fE!Y.J?!E!!.~C>~!.~E!~(DM . . __ . __ . . 2. H$ so chuy~n d6i/ Adjusted coefficient . i . r§ · ·· i$d~n··;;e;ii~i>c$nnli6C: ·· ;;~c;hi ·· · a;~ ···· · of population having access to safe water(%) 51.85 12.06 12.06 Ket qua cua bieu trim cho thay ty 1$ dan so tiep c~n nl!oc s~ch Ia 51,85%. Ty 1$ nay thap so voi mt,~c tieu cua CTHDQG Ia 80% dan so dung nl!oc s~ch nam 2000. H$ so chuyen a6i trong bang tren dl,fa vao ket qua tfnh toan W m¢t so cu¢c dieu tra h¢ gia dlnh trl!oc kia cua TCTK. De c6 h$ so chinh xac hdn cfin c6 cu¢c dieu tra chuyen m6n sau. Sl't dl:Jng ho xi h~p v~ sinh Phl!dng ti$n ho xf hc;1p V$ sinh gam: Ho xf tl,l' ho~i. ho xf d¢i nl!oc (ban tl,l' ho~i. suilabh), ho xi c6 ngan cai tien (lo~i c6 ong thong hdi), ho xf c6 ngan tn.iyen thong. C6 44,07% dan so sv dt,mg phL!dng ti$n ho xf hc;1p v$ sinh, ty 1$ nay o khu vtJc thanh th! Ia 81,77% va 32,49% 0 khu Vl,l'C nang th6n. Hai vung c6 ty 1$ dan so slt dt,mg phL!dng ti$n ho xi hc;1p v$ sinh Ia DBSH (75,43%) va Dong Nam B¢ (59,69%). Ty 1$ nay cao hdn h~n so voi DBSCL (14,27%), Tay Bac (20,65%) va Tay Nguyen (22,23%). 54 plot with pump well ected spring 0.42 0.07 20.48 33.24 0.72 11 .66 . . . --······ 0.8 0.4 0.4 0.8 0.42 0.07 16.38 13.30 0.29 9.33 As shown in the above table, the percentage of population having access to safe water was 51.85%. This percentage was lower than the goal set out in the National Plan of Action: 80% of the population having access to safe water by the year 2000. In the above table, the coefficients were based on the results obtained from the household surveys conducted by GSO previously. Accurate coefficients need in-depth, specialized surveys. Sanitation Sanitary means of excreta disposal include: septic tanks, flush toilet (semi-septic, suilabh), improved pit latrines (with air-shaft), traditional pit latrines. It is found that 44.07% of the population were found having access to sanitary means of excreta disposal. The urban percentage was 81.77% and the rural percentage was 32.49%. In the Red River Delta, the percentage was 75.43% and in Southeast (59.69%). This percentage was by far higher than that in the Mekong River Delta (14.27%), the North West (20.65%) and the Central Highlands (22.23%). Bi~u do 6/ Figure 6. Ty I~ dan so sir d~ng phuong ti~n ho xi hQ'p v~ sinh chia theo khu vf!c va theo vimg Percentage of population using sanitary means of excreta disposal by area and region Thanh thj/ Urban N6ng th6n/ Rural DBSH/ Red River Delta 88/ North East TB/ North West BTB/ North Cental Coast DHNTB/ South Cental Coast TN/ Central Highland DNB/ Southeast 88SCU Mekong River Delta 0 10 20 C6 18,23% dan s6 kh6ng c6 h6 xf, trong d6 cao nhat Ia DHNTB voi 42,35% dan s6 kh6ng c6 h6 xL H6 xf "cau ca" Ia m(lt lo~i h6 xf 19 thi€m pho bien o DBSCL (68,28%) - voi lo~i h6 xf nay chat thai dli9c thai xu6ng ao dg nuoi ca hoiflc thai tnJc tiep xu6ng song, kenh, r~ch gay 6 nhiem nguon nlioc va mat v$ sinh. E. Suy dinh du6'ng a tre em Tinh tr~ng dinh dltdng Trong m(lt quan thg tre em c6 tlnh tr~ng dinh dliong t6t, phan b6 tr9ng ILi<;jng va chieu cao tre em Ia m(lt phan b6 chugin. Danh gia tlnh tr~ng dinh dLiBng dli<;jc thl/c hi$n thong qua so sanh can n~ng va chieu cao cua tre em voi phan b6 chu~n nay. Quan thg tham kh~lO dLi<;jc sl'r dl,mg cho dimh gia tlnh tr~ng dinh dLi6ng tre em cua cu(lc dieu tra MICS Ia quan the NCHS. Cu(lc dieu tra MICS cho phep danh gia 3 chi tieu dinh dLiBng sau day: • Can n~ng theo tuoi cho ph~m anh tlnh tr~ng thieu dinh dLiBng kinh nien trong qua khu h~c moi xay ra gan thoi diem nghien cw. Tre em c6 cfm niflng theo tuoi thap dlioi 2 d(l l$ch chu~n so voi can niflng trung v! cua quan thg tham khao NCHS se dL.tc;:JC xem Ia can n~ng thap (suy dinh dLiBng). 30 40 50 60 70 80 90 100 % 18.23% of the population did not have latrines, with a record high in the South Central Coast: 42.35% of the population with no latrines. "Fish pond" latrine is a kind of open latrine very common in Mekong River Delta (68.28%)- with human waste discharged into ponds as food for fish, or directly into rivers, canals, arroyos, polluting water sources seriously. E. Child malnutrition Nutritional status In a well-nourished population, there is a standard distribution of height and weight for children. The nutritional status can be gauged by comparing the child's weight and height to this standard distribution. The standard , of reference population used in MICS is the NCHS standard. Three following nutritional indicators are used in this survey: • Weight for age is a measure of malnutrition, either from the past or just recently. Children whose weight for age is more than two standard deviations below the median of the reference population are considered underweight (malnourished). 55 • Chieu cao theo tu6i cho phan anh tlnh tr~mg thieu dinh dl1Bng kinh ni€m do h~u qua cua b$nh kinh nien ho~c thieu dinh dl1Bng trong thoi gian dai trong qua khCJ'. Tre em c6 chieu cao theo tu6i thap dl1oi 2 d(> l$ch chu§n so voi chieu cao trung v! cua quan thg tham khao NCHS se dl1CJC xem Ia (thap coi). • Cuoi cung, can n~ng theo chieu cao phan anh tlnh tr~ng thieu dinh dl1Bng trong khoang thoi gian gan voi thoi digm nghien cCtu. Tre em c6 can n~ng theo tuoi thap duoi 2 d(> l$ch chu§n so voi can n~ng trung v! cua quan thg tham khao dl1CJC xem Ia gay com. Chi tieu nay ch!u anh hl1dng bdi nhling thay doi c6 tfnh Chat mua Vt,J anh hl1dng tOi Vi$c cung cap Iuong thljc ho~c b$nh d!ch. 8g nghien cCtu danh gia sau hon nguai ta con phfm suy dinh dl1Bng ra thanh SOD d(> I, II , Ill bang vi$c so sanh can n~ng ho~c chieu cao voi cac ngl1Bng tCt -2SD den -3SD (ngl1Bng SOD d(> 1), W -3SD den -4SD (ngl1Bng SOD d(> II) va duoi -4SD (SOD d(> II I). Trong cu(>c dieu tra MICS, c6 2,2% so tre em duoi 5 tuoi khong dl1CJc can n~ng ho~c khong dl1CJc do chieu cao. M(>t s6 tre em khac c6 can n~ng ho~c chieu cao bat thl1ong Vl1CJt ra ngoai ph~m vi danh gia cho phep. Tat ca nhli'ng tre em d6 b! lo~i ra khoi ket qua tinh toan. C6 33,1% so tre em dl1oi 5 tuoi bi SOD can n~ng theo tuoi, trong d6 SOD can· n~ng theo tuoi d(> 11 va 111 (SDD n~ng) Ia 5,8%. C6 36,4% tre em duoi 5 tuoi bi SDD chieu cao theo tuoi (coi c9c), trong d6 SOD chieu cao theo tuoi d(> II trd len Ia 11 ,9%. Va cuoi cung, c6 5,6% tre em duoi 5 tuoi bl SDD can n~ng theo chieu cao (gay com). Cac nghien cCtu cho thay ty 1$ suy dinh duong tre em duoi 5 tuoi da giam m(>t each vCtng chac trong vong 10 nam veta qua. Tuy nhien, Vi$t Nam cGng van chl1a d~t mt,~c tieu giam ty 1$ suy dinh dl1Bng tre em dl1oi 5 tuoi xu6ng dl1oi 30% vao nam 2000. Tre em d cac vung Dong Bac, Tay Bac, Bac Trung B(> va Tay Nguyen c6 nguy co bl thap can Va COi CQC cao hon cac VUng COn l~i. Nguy co suy dinh dl1Bng cua nh6m tre em thanh thl thap hon tre em nong then, nh6m tre 56 • Height for age is a measure of chronic malnutrition due to some chronic illness or failure to receive adequate nutrition over a long period. Children whose height for age is more than two standard deviations below the median of the reference population are considered short for age or stunted. • Finally, weight for height reflects recent nutritional deficiency. Children whose weight for height is more than two standard deviations below the median of the reference population are classified as wasting. This indicator may exhibit significant seasonal shifts associated with changes in the availability of food or disease prevalence. Malnutrition is classified into level I, level II and level Ill, by comparing weight or height to the standard from -2SD to -3SD (level 1), . from -3SD to -4SD (level II) and under -4SD (level II 1). In MICS, 2.2% of children under 5 was not weighed or measured. Others whose measurements are outside a plausible range are excluded. 33.1% of children under 5 were underweight, of them 5.8% severely malnourished (level II and Ill). 36.4% of children under 5 were stunted (too short for their age), of them 11 .9% were with severe stunting (level II and Ill). Finally, 5.6% of children under 5 were wasted (too thin for their height). Studies have confirmed a sustained decline of under 5 malnutrition rate in the last decade. However, no matter what kind of measurements is adopted, weight for age or height for age, Vietnam has no\ met the national goal of reduction of the malnutrition rate to under 30% by the year 2000. Children in the North East, North West, North Central Coast and Central Highland are more likely to be underweight and stunted than other, in the rest of country. Urban children are less likely to be malnourished than rural em c6 m!?/ngLtoi cham s6c c6 trlnh d9 van hoa cao thap hdn so voi nh6m tre em c6 m!?/ngLtoi cham s6c trlnh d9 van hoa thap. Nh6m tre em dLtoi 1 tu6i c6 nguy cd suy dinh duang thap hdn nh6m tre em cac do tuoi tu6i khac. Tre em nii c6 nguy cd SOD cao hdn tre em nam (chenh l$ch W 2-3%). Trong vong 5 nam W 1995 den nam 2000, ty 1$ suy dinh dLtBng can n~ng theo tuoi giam W42,6% 11 xuong con 33,1%. Muc giam d9t blnh quan 1 nam Ia 1 ,9%. 8au tLt v~t chat de giam ty 1$ suy dinh duang Ia m9t bi$n phap quan tr9ng, tuy nhien kh6ng phai Ia bi$n phap duy nhat: Ty 1$ suy dinh duang c6 the giam nhanh hdn nija neu nhlt c6ng tac giao dt,JC, tuyen truyen de nang cao kien thuc cua cac ba m!? ve cham SOC tre em dlfc;:IC quan tam hdn. Nghien cuu nh~n thuc cua cac ba m!? ve cham soc tre e.m o cac phan dLtoi day se cho thay dieu do. Nuoi con bang sCi'a m~ Nu6i con bang siia m!? bao v$ tre em khoi b$nh t~t. day Ia nguon dinh dLtBng re tien va an toan. Tuy nhien, c6 nhieu ba me cai siia cho con qua s.6m va chuyen sang dung cac nguon thuc an khac. M1,1c tieu H9i ngh! Thlfc;:lng dlnh da de ra Ia cho tre em hoan toan bu siia m!? trong vong 4 d§n 6 thang dau va tiep tt,Jc nuoi con bang seta m!? va thuc an b6 sung cho den nam 2 tuci. Trong cu(>c dieu tra MICS, tre dLtc;:lc hoi xem da dlfc;:IC uong nhltng l09l do uong nao trong vong 24 gio qua. Tre em dlfc;:lc coi Ia "hoEm toan bu siia m!?" neu ngoai bu siia m!? tre em chi dLtc;:lc uong b6 sung vitamin, muoi khoang ho~c thuoc. Tre em "an thuc an b6 sung" gom tre em dLt<;:!c bu siia m!? va an cac lo9i thuc an ran ho~c cac l09i thuc an mem nhLt siia bo, siia b(>t, chao, b(>t. C6 31 , 16% tre em bu hoan toan sera me trong vong 4 thang dau. 37,53% tre em an thuc an ran b6 sung trong vong 4- 6 thang va hdn m(>t nLJ'a tre em dltc;:lc an thuc an b6 sung trong vong 6-9 thang. C6 87,82% tre em nh6m tu6i tU 12-15 thang van con tiep tt,JC bu sera m!? va ty 1$ nay giam Xuong COn 20% khi tre em dltc;:IC 20-23 thang tu6i. children, and so are the children cared for by mothers/care-takers with high education level compared to those whose mothers/care-takers have lower education level. Children under 1 are less exposed to malnutrition risks than those in other age brackets. Girls seem to be more likely to be malnourished than boys (with a disparity of 2-3%). In the period 1995-2000, the underweight prevalence (weight for age) decreased from 42.6% 11 to 33.1%. That means the rate decreased by 1.9% annually. Although material investment is a very important measure to reduce malnutrition rate, it is not the only solution. The malnutrition rate could be reduced faster if training and propagation of knowledge on child health care for mothers are paid more attention. Data on mothers' awareness of child health care below shows evidences on this. Breastfeeding Breastfeeding for the first few years of life protects children from infection, provides an ideal source of nutrients, and is economical and safe. However, many mothers stop beastfeeding too soon, and there are often pressures to switch to other food. The World Summit for Children Goal states that children should be exclusively breastfed for four to six months, and that breastfeeding should be continue with complementary food, well into the 2nd year of life. In MICS, mothers/ care-takers were asked about the kind of beverages that their children had consumed 24 hours prior to the interview. "Exclusive breastfeeding" refers to children who receive only breastmilk and vitamins, mineral supplements, or medicine. "Complementary feeding" refers to children who receive breastmilk, solid and semi-solid food- cow's milk, ·powdered milk, gruel, rice flour soup . 31.16% of children under 4 were exclusively breastfed. 37.53% of infants are provided with supplementary food at age 4-6 months old. More than half of .children were given complementary foods at age 6-9 months. By. age 12-15 months, 87.82% were still breastfed and by age 20-23 months, 20% were still breastfed 11. S6li¢u dieu tra m~tc tieu.trung h~n dtaTCIK nam 1996 (MICS 1996)/Figure from MICS 1996 by G.S.O 57 Bieu do so 7 cho thay chi tiet hem ve tlnh tr~ng bu slta m~ theo thang tuoi cua tre em. Ngay ca khi tre em moi 1-2 thang tuoi thi van c6 ty IE;! dang ke tre em dung cac lo~i do uong ho~c tht,fc pham kh6ng phai Ia siJa m~. Figure 7 shows the detailed pattern of breastfeeding status by the child's age in months. Even at the earliest ages (1-2 months), a substantial number of children have received liquids or foods rather than breastmilk. Bi~u do 7/ Figure 7. Phan bo phan tram tre em theo tlnh tr;,~ng bu sua m~ Percent distribution of children by breastfeeding status 100% 80% 60% 40% 20% 0% 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 Thang tuoi/ Age in months 0 Khong bu sua m~/ Non-breastfed m Chi bu sera m~ va thuc an bo sung/ Breastmilk and supplements Ell Chi bu sera m~ va nuac uong/ Breastmilk and water only • Chi bu sera m~/ Exclusively breastfed SLt d~;~ng muoi i-ot Thieu i-ot trong che d9 an hang ngay Ia nguyen nhan quan trqng nhat dan den ch~m phat trien ve trf tuE;! ma le ra c6 the phong nglla dll<;JC. Slt dl,lng muoi i-ot trong muoi an hang ngay Ia each c6 hiE;!u qua va ft ton kem de phong nglla roi lo~n thieu i-ot (IDD). Muoi i- ot dung tieu chuan phai chua ham lllt;:~ng i-6t d~t m(tc 15ppm (parts per million) tr6 len. Trong cu(>c dieu tra MICS, dieu tra vien dllt;:~c hllCJng dan de slt d~,Jng mau thlt ham lllt;:~ng i-6t trong muoi an cua h9 gia dlnh. Trong so nhiJng h9 gia dinh c6 kiem tra muoi, chi CO 60,73% SO h(> gia dJnh CO Slt dl,lng muoi l"ot, trong d6 chi c6 39,48% so h9 CO Slt dt,mg muoi i-ot d~t nong d(> l-ot 15ppm (ty IE;! h(> gia dlnh Slt d1,1ng muoi i-ot nam 1995 Ia 49,37% 12). Ty IE;! nay thap xa so voi m1,1c tieu Quoc gia Ia 90% so h9 gia dlnh sLJ' dt,mg muoi l-ot d~t mltc tieu chuan 20ppm vao nam 2000. 8ang lllU y Ia vung 86ng Bac, Tay Bac CO nguy Cd roi lo~n do thieu i-ot cao nhllng chi Use of iodized salt Deficiency of iodine in the diet is the greatest cause of otherwise preventable mental retardation. Salt iodization is an effective, low- cost way of preventing Iodine Deficiency Disorders (IDD). Adequately iodized salt contains 15 ppm (parts per million) of iodine or more. In MICS, interviewers were trained how to test household salt for iodine levels by means of a test kit. Of the households tested for iodized salt, only 60.73% used iodized salt, of them only 39.48% using adequately iodized salt contains 15 ppm of iodine (the percentage of households using iodized salt in 1995 was 49.37% 12). This percentage was by far lower than the national goal of 90% households using 20 ppm iodized salt by year 2000. Noteworthy was the fact that in the North West and the North East, where IDD was 12. S6 li¢u cu¢c dieu tra m1,1c tieu trung h~n niim 1996 (MICS 1996)/ Figure from MICS 1996 by G.S.O 58 c6 gan 40% h9 gia dinh dung muoi i-ot d~t tieu chuan cho phep. Neu khong c6 nhling bi~n phap thfch h<;'p Vi~t Nam se khong d~t mt,JC tieu Quoc gia Ia thanh toan tlnh tr~ng roi loan do thieu i-ot vao nam 2005. Chi c6 mot nlfa so m§u muoi dl!dc kiem tra tai ho c6 chcia nong d9 i-ot d~t tieu .chuan cho thay' can phai tang cllang kiem tra giam sat chat IL!c;mg san xuat va bao quan muoi l-ot a Vi~t Nam. Cung cfl'p bb sung Vitamin A Thieu ht,Jt Vitamin A (VAD) se lam suy yeu h~ thong mien djch Cd the, tang nguy Cd chet bai cac b~nh tre em va lam suy yeu s(fc khoe cua phL:J nll c6 thai. N6 cGng Ia nguyen nhi'm cua benh kho mat va dan den mu loa d tre em. Tat ca' cac nguy Cd d6 c6 the phong nglta dl!<;'C thong qua cung cap bo sung Vitamin A. Theo khuyen nghi cua UNICEF/WHO thi tat ca cac · nvC1c c6 ty 1~ tre em chet dvC1i 5 tuoi vlfgt qua ngllang 70 tren 1000 tre em sinh ra song ho~c d nhling n!JC1c ma tinh tr~ng thieu Vitamin A van con Ia m(>t van de c6 y nghla s(fc khoe c(>ng dong thl nen thlfc hi~n chlldng trinh kiem soat tinh tr~ng thieu Vitamin A. Theo ket qua danh gia tht!c hi~n cac mt,~c tieu gilla ky cho tre em da ket luan Viet Nam dl!dc coi Ia da thanh toan dl!<;'C b~nh kho mat do .thieu Vitamin A13 vi ty I~ kho mat Ia 0,1% (trong d6 rieng the loet giac m~c Ia 0,005%) thap hdn h~n vC1i nguang ma WHO coi Ia c6 y nghla sCtc khoe c(>ng dong. Chlldng trinh Vitamin A dang dlf<;'c trien khai a Vi~t Nam cung vC1i chien IL!<;'C day m~nh cai thi~n blla an nham duy tri ket qua d6 m<?t each lau dai va ben vling. C6 59,66% so tre em 6-59 thang tuoi dl!<;'C uong vitamin A dung thai gian qui d!nh (trong vong 6 thc'mg tfnh den thai diem dieu tra), 15,63% uong dlfc;JC tren 6 thang, 9,37% khong r6 dl!<;'C uong khi nao. Van con 14,55% so tre em khong dl!<;'c uong vitamin A bo sung. Vung Tay Sac va Tay Nguyen c6 ty I~ tre em 6-59 thang tuoi khong dll<;:lc u6ng vitamin A cao nhat (hdn 27%), day Ia hai vung c6 dieu ki~n di l~i kh6 khan hdn cac vung khac. high, only nearly · 40% of households using adequately iodized salt. Unless proper measures were taken, VN would not be able to eradicate IDD by year 2005. Only half of the salt sample tested in households was adequately iodized salt, which pointed to the need to promote iodized salt quality control and use in Vietnam. Vitamin A supplementation Vitamin A Deficiency (VAD) impairs children's immune systems, increasing their chances of dying of common childhood diseases and undermines the health of pregnant and lactating women. It can also cause xerophthalmia and blindness in children. Yet it can be easily prevented by Vitamin A supplementation. UNICEF and WHO recommend that all countries with an under 5 mortality exceeding 70 per 1000 live births, or where Vitamin A deficiency is a public health problem, should put in place a programme for control of Vitamin A deficiency. The review of the mid-decade goals has recognized Vietnam as a xerophthalmia-free country due to Vitamin A deficiency 13 , as the xerophthalmia rate, being 0.1% (with corneal ulcer only 0.005%), was much lower than the threshold considered by WHO as a public health implication. The Vitamin A programme has been under way in Vietnam, alongside of a strategic dietary improvement to sustain the achievements made. 59.66% of children aged 6-59 months received vitamin A at the scheduled time (within the 6 months prior to MICS); 15.63% did not receive the supplement in the last 6 months but did receive one prior to that time; 9.37% were given a vitamin A supplement but their mothers/care-takers could not specify when. 14.55% of children did not receive any vitamin A supplement. Vitamin A supplementation coverage for children aged 6-59 months was the lowest in the North West and the Central Highlands (over 27%) where accessibility was more difficult than in other areas. 13. Bao cao phan tfch , danh gia th~rc hi¢n cac m~tc tieu gitra ky cho tre em Vi¢t Nam 1996-1998/ Analysis and evaluation of the implementation of mid-term goals for Vietnamese children 1996-1998. 59 Tre em tLt 6-11' 36-59 thang tuoi dli9C uong vitamin A dung thai gian qui djnh thap nhat (dlloi 60%) va cao nhat Ia nh6m tre em 12-23 thang tuoi (70,51%). Ty 1$ tre em dL19c uong vitamin A va dL19c uong vitamin A dung thai gian qui dlnh c6 the cao hon vi thai diem dieu tra roi vao dung luc c6 m¢t so d!a phlldng dang chuan b! thlfc hi$n chien dlch cho tre em uong vitamin A. Trong nhiing nam gan day, Chllong trlnh vitamin A chi cung cap cho tre em 6-36 thang tuoi. Trong tong so tre em w 6-36 thang tuoi, CO 82,27% tre em dli9C uong vitamin A, trong d6 65,30% tre em dli9C uong vitamin A dung thai gian qui djnh. Can n~ng sd sinh thap Tre c6 can n~ng so sinh thap Ia tre em c6 tr9ng IL19ng luc sinh thap dlloi 2500 gram. Vi chi c6 70% tre em sinh ra song dli9C can n~ng luc sinh (ri€mg o nang than, ty 1$ nay Ia 64%), vi v~y nhiing tre em dL19c can c6 the Ia m¢t mau ch$ch cua tat ca tre em sinh ra song. Phvong phap tfnh: Ty 1$ phan tram tre em c6 can n~ng so sinh thap dlloi 2500 gram dL19c voc 1v9ng w 2 cau hoi trong phieu hoi cua cu¢c dieu tra MICS: ThCt nhat Ia danh gia cua ba me ve kfch thlloc Cd the cua tre luc sinh (rat lan, lon hdn binh thllang, nho hon binh thllang, rat nho ho~c kh6ng biet), thCt hai Ia can n~ng so sinh cua tre em do ba mf? nho lt;li hay dL19c ghi ra W so y bt;l. Ket qua tfnh toan cho thay, c6 7,27% tre em sinh ra song CO can n~ng Sd sinh dlloi 2500 gram, ty 1$ nay khang c6 khac bi$t lon voi ket qua cua cu¢c dieu tra VLSS1997/98 (7,97%). Ty 1$ nay khac bi$t c6 y nghla giiJa thanh thl va nang than: Trong khi khu Vl/C thanh thi chi c6 1 ,95% tre em sinh ra song c6 can n~ng dlloi 2500 gram thi ty 1$ nay 0 nang than len toi 8,48%. Bieu do so 8 cho thay c6 moi quan h$ tvong doi ch~t che giiJa can n~ng so sinh va tuoi cua mf?. Ty 1$ tre Sd sinh thap can tCt 8,73% o nh6m ba m~? 15-19 giam m¢t nLl'a xuong con 4,62% 0 nh6m bam~? w 25-29 tuoi roi lt;ll tang dan theo tuoi cua m~? va len toi 22,37% o nh6m ba m~? 45-49 tuoi. Bi$n phap 60 The percentage of children aged 6-11 months, 36-59 months given vitamin A supplement at the scheduled time was the lowest (under 60%) and the highest percentage was for children aged 12-23 months (70.51%). The percentage of children receiving vitamin A supplement and receiving vitamin A supplement at scheduled time might be higher as the survey coincided with the local preparations for the vitamin A supplementation campaign. Over recent years, only children of 6-36 months have been provided with vitamin A. Of the 6-36 months old, 82.27% received vitamin A, of them 65.30% receiving vitamin A at the scheduled time. Low birth weight Infants who weigh less than 2500 grams at birth are categorized as low birth weight babies. Since only 70% of live births are weighed (in rural areas, the rate is 64%), those who are weighed may be a biased sample of all births. Calculation method: the percentage of births weighing below 2500 grams was estimated from 2 information in the questionnaire: the mother's assessment of the child's size at birth (i.e. very small, smaller than average, average, larger than average or unidentified.) and the mother's recall of the child's weight or the weight as recorded on the health card. Results of calculations showed that 7.27% of live births weighed less than 2,500 grams, not much different from the results of VLSS1997/98 (7.97%). This rate differed significantly between urban and rural areas: 1.95% and 8.48% respectively. Figure 8 shows a relatively close relation between birth weight and mother's age. The rate of low- birth weight infants dropped by half from 8. 73% in the 15-19 year old mothers to 4.62% in the 25-29 year old mothers. It then went up with the mother's age to 22.37% in the 45-49 year old mothers. phan dau giam so ba m~ sinh de mu<?n tCt 4_9- 49, dong thdi tang Clfdng tV van, hVdng dgm cac ba me tre c6 th~ se g6p phan giam dang k~ ty 1$ tr~ so sinh thap can trong tvong lai. Reduction of late expectant mothers (aged 40- 49), counseling and educating young mothers might help bring down substantially the rate of low birth weight children. Bi~u d6 8/ Figure 8. Ty I~ tre so sinh co can n~ng dm1i 2500 gram chia theo tu6i cua m~ Percentage of low birth weight infants(< 2500 grams) by mother's age 25 20 := 15 Ill _J ~ 10 5 0 15-19 20-24 25-29 30-34 35-39 40-44 45-49 F. SLit:: khoe tre em. Tiem chLmg Chvong trlnh tiem chung phong nglla cac b$nh tre em da thl,fc hi$n trong nhieu nam qua d Vi$t Nam. Theo chVdng trlnh nay, tre em se dV<;1c tiem chung phong nglla 6 b$nh gem: Lao (1 mOi), B9ch hau- ho ga- uon van (3 mOi), B9l li$t (uong 3 lan) va sC:Ji (1 mOi) trvoc ngay sinh nh~t dau tiem. Trong cu(>c dieu tra MICS, cac ba m~ dlf<;jc yeu cau dlfa ra the tiem chung cho tat ca tre em dlfdi 5 tuoi. f)ieu tra vien se ghi l9i ngay tiem cua Wng lan tiem vao phieu hoi. Ba m~ cOng dV<;jc hoi tham do d~ khai bao tat ca cac mOi vac-xin rna tre da dV<;1c tiem nhvng chva dV<;'c ghi trong the. Chi c6 27,42% ba m~ xu at trlnh the tiem chung cho dieu tra vien d~ ghi phieu. Con l9i Ia 43,04% n6i c6 the nhvng kh6ng dva the cho dieu tra vien (trong d6 c6 nhieu trvong h<;1p the tiem chung dlf<;jc llfu gilt t9i tr9m xa) va Tu6i cua m~/ Mother's age F. Child health. Immunization The EPI (Expanded Programme on Immunization) has been implemented for many years in Vietnam. Within the context of the programme, children are immunized against 6 diseases: Tuberculosis (1 dose), diphtheria - pertussis - tetanus (OPT - 3 doses), polio (3 doses) and measles (1 dose) before their first birth-day. In MICS, mothers were asked to provide vaccination cards for children under 5. Where dates of vaccinations could be found. Mothers were also probed to report any vaccinations children received that were not recorded on the card. Only 27.42% of mothers presented vaccination cards to interviewers. 43.04% said they had vaccination cards but did not show them to interviewers (saying that cards were kept at health centres) and 29.54% said their children 61 29,54% khong c6 the. Trong hai trvong h~p nay, dieu tra viem m6 ta van tat Wng lo~i vac- xin va yeu cau ba m~ nhC:I l~i cac mOi vac-xin da tiem cho tre, rieng vac-xin phong b~ch hau - ho ga - uon van va vac-xin phong b~i li$t dieu tra vien yeu cau ba m~ nhd l~i xem tre em da dlf~C tiem ho~C uong bao nhieu ian. Cac ba me, dac biet Ia cac ba me c6 trlnh d(> van hoa thap' thlfdng rat kh6 nhd tio~c kh6ng the nhC:I tl!ng lo~i vac-xin ma con mlnh da dU'~C uong hO~C tiem, SOIU'~ng Va thdi gian tiem cua tl!ng lo~i vac-xin. 8oi vC:Ii trlfdng h<;jp c6 xuat trlnh the, ty 1$ tre em dlldi 1 tu6i dlf~c tiem chung day du Ia 93,30%. Ty 1$ nay b khu vlfc thanh th! Ia 94,04% va nong thon Ia 92,64%. Ty 1$ tre em dlldi 1 tu6i dL!~C tiem chung day du thap nhat Ia vung Tay Nguyen Ia 82,96% {Xem Bieu do so 9). did not have vaccination cards. In the last 2 cases, interviewers made a short description of each vaccine and asked mothers to recall the doses children had received, and for OPT and Polio, how many times. Overall, it was difficult for mothers with poor schooling to remember every vaccine their children had received, how many times and the dates of vaccination. Based on vaccination cards, the percentage of children under 1 fully immunized was 93.30% - 94.04% in urban areas and 92.64% in rural areas. The lowest immunization rate of children under 1 was in the Central Highlands: 82.96% (see Figure 9) Bi~u do 9/ Figure 9. Ty 1¢ tre em tir 12-23 thang tu6i dU(_)'c tiem chung day du tat ca cac lo~i V~C-Xirt tinh den thai di~m dieu tra chia theo Vtmg, khu Vt!C Va theo tr)nh dl) van hoa cua m~ 62 Percentage of children aged 12-23 months fully immunized by the time of the survey by region, area and mother's education Thanh thj/ Urban Nang than/ Rural 8BSH/ Red River Delta £)8/ North East BTB/ North Central Coast DHNTB/ South Central Coast TN/ Central Highlands 8NB/ Southeast 8BSCL/ Mekong River Delta 0 10 20 30 40 50 60 70 80 90 100 B~nh tieu chay Mat nvoc do b$nh tieu chay Ia nguyen nhan chfnh gay tl! vong tre em o Vi$t Nam. Cham s6c tai nha benh tieu chay (Home management ·of diarrhea) bang each sl! d1,mg muoi ORS ho~c Ia cac chat long c6 tac d1,mg bu nlfoc khac c6 the giam dang ke tlt vong cua tre em. Vi$c ngan ngLJ'a tinh tr'ilng mat nvoc va suy dinh dvang d tre em bang each cho uong nhieu nVoc hdn va tiep tl,JC cho tre em an Ia m(>t chien Jvqc quan tr9ng trong vi$c quan ly kiem soat b$nh tieu chay Trong cu(>c dieu tra MICS, cac ba mt? (ho~c ngVai cham s6c) dVqc hoi ve b$nh tieu chay trong khoang thai gian 2 tuan trLJoc thai diem dieu tra. Neu tre b! tieu chay trong khoimg thai gian d6, ngvai mt? se dLJqc hoi mot chuoi cac cau hoi sau d6 de xac dinh tre dtic;Jc an ho~c uong gi, tre dVc;JC an/uong. nhieu hdn hay ft hdn. C6 11 ,32% tre em dvoi 5 tuoi b! tieu chay trong khoang thC1i gian hai tuan trvoc thai diem dieu tra (Bang 4.3). Bieu do so 10 cho thay r6 xu hvong mac b$nh tieu chay cua tre em chia theo nh6m tuoi. Tre em dVoi 6 thang tuoi ty 1$ tieu chay chi o m(tc 7,30%, sau d6 tang d(>t bien o nh6m tuoi 6-11 thang (18,49%), tiep t1,1c duy tri o mCtc cao o nh6m tuoi 12-23 thang (17,65%), roi sau d6 giam dan va den nh6m tuoi 48-59 thimg thi ty 1$ nay xap xi voi nh6m tre em dV6i 6 thang tuoi (6,81% ). Nguyen nhan Ia do khi dVoi 6 thang tuoi tre em chu yeu dVc;JC bu slta mt?, w thang thlt 6 hau het tre bat dau chuyen sang an thCtc an bo sung (an b(>t, an chao, an siia . ), ty 1$ tieu chay tang d¢t bien vi tre kh6ng k!p thfch nghi voi cac yeu to moi trvang nhv nvoc ban ho~c do tre chva dVc;Jc cham s6c dung each ho~c thCtc an khong phu hc;Jp voi tre em . Ty 1$ tieu chay o cac nh6m 12-23, 24-35 thang tuoi van duy tri d mltc cao vi m~c du tre da dan dan thfch nghi, nhvng vao nh6m tuoi nay hau het tre em da bat dau cai slta. Diarrhoea Dehydration caused by diarrhoea is a main cause of mortality among children in Vietnam. Home management of diarrhoea - either through Oral Rehydration Salts (ORS) or a Recommended Home Fluid (RHF) - can prevent many of these deaths. Preventing dehydration and malnutrition by increasing fluid intake and continuing to feed the child are also important factors for managing diarrhoea. In the MICS questionnaires, mothers/care-takers were asked to report whether their child had had diarrhoea in the two weeks prior to the survey. If so, the mother was asked a series of questions about what the child had to drink and eat during the episode and whether this was more or less than the child usually ate and drank. Overall, 11.32% of under 5 children had diarrhoea in the two weeks preceding the survey (Table 4.3). Figure 1 0 shows the diarrhoea prevalence by age-group. Children under 6 months had a prevalence of 7.30%, which went up dramatically among children age 6-11 months (18.49%), sustained at a high level 17.65% among children aged 12-23 months, then declined among the elder groups. For children aged 48-59 months, prevalence was more or less the same as with children under 6 months (6.81%). Related to the causes is the fact that children under 6 months were mainly breastfed exclusively, from the 61h month, most children were . given supplementary foods (gruel, porridge, milk substitutes, . ). The diarrhoea prevalence jumped up because of children's failure to adapt themselves to the new environment, e.g. unsafe. water or improper care or unsuitable foods. The peak of diarrhoea prevalence occurred in the weaning period among children aged 12-23, 24-35 months. 63 Bi~u do 10/ Figure 10. Ty I~ tre em dum 5 tu6i bj tieu chay 2 tuan qua chia theo nhom tu6i Percentage of under 5 children having diarrhoea two weeks prior to the survey by age group 0-5 6-11 12-23 24-35 36-47 48-59 Thang tu6i/ Age in months Ty 1~ tre b! tieu chay c6 slf khac bi~t ro thea trlnh d9 van hoa cua m~ (Xem Bieu do so 11 ). Cac ba m~ c6 trlnh d9 van hoa thap thl ty I~ tre em b! tieu chay cao hem tre em Ia con cua cac ba m~ c6 trlnh d9 van hoa cao. The child diarrhoea prevalence varies remarkably by the mother's educational level (See Figure 11 ). Children of mothers with lower education levels appear to be more likely to have diarrhoea than the others. Bi~u do 11/ Figure 11. Ty I~ tre em bj tieu chay chia theo trlnh de) van hoa ciia m~ hol)c nguai cham soc Percentage of children having diarrhoea by education of mother or care taker Kh6ng bang cap/ Tieu h<;>c/ Primary THCS/ Lower Upper secondary DHCD/ University, No diploma school secondary school THPT/ school college Ty 1~ tre em b! tieu chay cOng c6 slf khac bi~t thea vung va thea khu vtfc. Vung DBSH, Dong Nam 89 va Tay Bac c6 ty I~ tre em b! tieu chay thap nhat (6-8%), cac vung con 19i ty 1~ tre em bi tieu chay dao d(>ng W 11-17%. Tre dV<Jc cham s6c t9i nha nhll the nao khi b! tieu chay: C6 dli<Jc sU' dt,mg ORS hoi;lc 64 Child diarrhoea prevalence also showed a difference by region and area. It was lowest (6-8%) in the Red River Delta, the Southeast and the North West, for other areas, it varied from 11-17%. How were children taken care of at home when they had diarrhoea?. Were they cac dung djch c6 tac d~,Jng bu nlldc va muoi khoang kh6ng? C6 dLt9C uong nhieu nlldC hdn va tiep t~,JC an kh6ng? Hai cau hoi nay dLt9C tra IC:Ji trong bang 4.4. C6 toi 93,93% tre em dLt9c uong ORS ho~c cac chat long c6 tac d1,1ng bu nlldC va muoi khoang. The nhLtng chi c6 20,20% tre em bj tieu chay dl1<;1C Uong nhieU hdn va tiep t1,1c an. Ty I$ nay thap va c6 th§ Ia m(>t nguyen nhan gay suy dinh dvong va ty 1$ tii vong cao 6 tre em dLtoi 5 tuoi. Xin nh~k l~i Ia m1,1c tieu giam ty 1$ ti1 vong 6 tre em dvoi 5 tuoi xuong 30%o va giam ty 1$ suy dinh dvong xuong dlldi 30% vao nam 2000 kh6ng d~t. Chien ll19C trong giai do~n tdi can quan tam hdn den cac bi$n phap d§ nang cao ty 1$ tre em b! tieu· chay dV9c cham s6c thfch h9p t~i nha - tre em dl19C uong nhieu hdn va tiep ti,JC an (ft hon m(>t chut, an nhv cO hoc?c an nhieu hdn binh thvC:Jng). · Nhiem khu~n ho hap cap tinh (ARI) Nhiem khu§n h6 hap cap tfnh Ia m(>t trong nhiJng nguyen nhan hang dau gay tv vong 6 tre em 6 Vi$t Nam. Trang cu(>c dieu tra MICS, tre em dvoc coi Ia bi nhiem khu§n h6 hap cap tfnh neu "tre bi ho, th6 nhanh/th6 gap hoc?c kh6 th6 do cac nguyen nhan 6 ng!Jc ho~c khong bie't nguyen nhan. C6 9,26% tre em b! nhiem khu§n h6 hap trong khoang thC:Ji gian 2 tuan trvoc thC:Ji di§m dieu tra (Bang 4.6). Khi tre b! ARI, tre em thvC:Jng dV9c den kham b$nh t~i cac phong kham cua thay thuoc tll (25,82%), tiep den Ia tr~m y te (22,40%). Nhan vien y te then/ban cOng c6 m(>t vai tro dang k§ trong vi$c kham/chva b$nh (8,67%). Dieu dang quan tam Ia c6 toi 14,86% tre em dV9c gia dlnh/ngvC:Ji than hoc?c b~n be chG'a ho~c d6i khi d§ tre em tv khoi. Tre em dLtdc chiia benh thu(>c nh6m nay thvC:Jng rat kh6 ki§m soat vi$c sii d1,1ng thuoc, doi khi chi thuan tuy dlfa vao kinh nghi$m cua nglldi khac hoc?c cua ian mac b$nh trvoc, vi v~y rat kh6 IVC:Jng dl1<;1c h~u qua. Khi tre em bi nhiem khu§n h6 hap cap tfnh chi c6 60,38% dlldc kham va chii'a benh 6 ndi thich h<;1p. Day" Ia dieu can phai IW y trong chien ll1<;1C hanh d(>ng cua giai do~n tdi. Quan ly long ghep cac b~nh tre em (IMCI) Chlldng trlnh quan ly long ghep cac b$nh tre em (IMCI) Ia chvdng trinh dv9c de xvong bai UNICEF va WHO nham ket h9p cac bi$n phap ki§m soat va dieu tr! 5 nguyen nhan gay tv vong hang dau cua tre em, d6 Ia: nhiem given ORS, or recommended home fluids and mineral salt? Did they receive increased fluids and continue eating? The answers to the two questions are provided in Table 4.4. 93.93% of children were given ORS, and home recommended fluids and mineral salts. But only 20.20% of children having received increased fluids and continued eating. This rate was low and might cause malnutrition and high mortality rate among under 5 children. It should be recalled that the goal of reducing U5MR to under 30%o and the malnutrition rate to less than 30% by year 2000 are not achieved. In the forthcoming period, the strategy is to increase the percentage of children with diarrhoea receiving appropriate home management- more fluids and continued eating (less than usual, as usual, a little more than usual). Acute Respiratory Infection (ARI) ARI is one of the leading causes of deaths in Vietnam. In MICS questionnaires, children with ARI were defined as those who had an illness with a cough accompanied by rapid and difficult breathing. 9.26% of children had an ARI in the 2 weeks prior to the survey (Table 4.6). When having ARI, children were taken to private physicians (25.82%) or to commune health centres (22.40%). Village health workers also had an important to play in medical check-up and treatment (8.67%). Up to 14.86% were attended to by the family, relatives or friends. Sometimes the infection worked itself out. Overall, this kind of treatment was purely empirical, either from the experience of other people or previous cases, and the use of medicine, being hardly be controlled, might result in bad consequences. Only 60.38% of children with ARI were taken to an appropriate health provider. This point should be taken into consideration in mapping out a strategy for the forthcoming period. IMCI initiative The Integrated Management of Childhood Illnesses (IMCI) initiative was developed by UNICEF and WHO with combined strategies for control and treatment of popular diseases in children: acute 65 khuan ho hap cap tfnh, mat nllCJC do tieu chay, soi, sot ret va suy dinh dtJBng. Ml;IC tieu d~t ra nham nang cao ky nang cua nhan vien y te, cai thi$n h$ thong y te, cai thi$n th6i quen cua gia dlnh va c(>ng dong trong vi$c phong ngCta va quan ly sdm cac b$nh tre em. Cham soc thich hqp t?i nha cac b$nh cua tre em Ia m(>t b(> ph~n cau thanh cua chlldng trinh IMCI. Cham soc thfch hqp t?i nha Ia khi b! tieu chay ho~C b! om tre em dtl<;'C Uong nhieu hdn va tiep tl,Jc an nhv blnh thvC:Jng. Bang 4. 7 cho biet nhltng thong tin ve hanh vi an va uong cua tre em khi om. Trang tong so tre em dt1<;1c dieu tra c6 43,08% tre em b! tieu chay ho~c b! om trong 2 tuan qua. Trang d6, 32,12 % dtl<;'C uong nhieu hdn trong khi om Va 67,67% dtl<;'C tiep h,JC an (an ft hdn m(>t chut, nhv cO ho~c an nhieu hon). Nht1ng chi CO 17,84 % tre em om dtl<;'C uong nhieu hon va tiep tl,Jc an (dt19c cham soc thfch h9P tc;~i nha). Ty 1$ tre em om dll<;'C cham s6c thfch hQp tC;ll nha cao nhat Ia vung Bong Nam B9 (23,03%), tiep thea Ia Dong bang song Hong (22,82%), thap nhat Ia vung Dong bang song Cllu Long (9,37%) va cac vung con lc;~i ty 1$ nay trong khoang 16 den 18%. Nh6m phl;J nv c6 trinh d9 dc;~i h<;>c cao d~ng c6 28,60% con cua h<;> dtJQC cham SOC thfch hQp tC;li nha khi om, va ty 1$ nay c6 xu hlldng giam neu trinh d9 van hoa cua mf? ho~c ngtJC!i cham s6c thap hdn. Ty 1$ tre em om dtl<;'C cham s6c thfch h<;'p tc;~i nha con thap d~t ra van de Ia phai quan nhieu tam hdn nva den vi$c nang cao kien thltc cua mf? va ngtJC!i cham s6c. Nang cao kien thCtc cua mf?/ngtJC!i cham s6c de h<;> biet khi nao Ia thC!i diem thfch hQp de dtJa tre di kham b$nh tc;~i cac Cd so y te Ia m(>t b(> ph~n cau thanh cua chlldng trlnh IMCI. Trang cu(>c dieu tra MICS, mf?/ngvoi cham s6c dV<;'C yeu diu de xac d!nh tat ca cac tri$U chCtng khien ngvC!i mf? quyet d!nh l~p tCtc dva con dl kham/chva b$nh tC;li cac co so y te. Cau tra IC!i pho bien nhat (chiem 78,09% so ngVC!i tra ICii) Ia khi tre em sot cao hon, tiep d6 Ia dau hi$u tre om n~ng hon (52,25%), thu ba Ia dau hi$u tre kh6 tho (41,14%). Ty 1$ cac ba mf? tra IC!i cac dau hi$u tre khong the uong hay bu dVQC, tre tho nhanh hdn, c6 lan mau trong phan trong khoang 18 den 23% va thap nhat Ia dau hi$u tre uong kh6 khan hon chi c6 9,15%. 66 respiratory infections, diarrhoeal dehydration, measles, malaria and for combating against malnutrition. IMCI focuses on the improvement of case management skills by health workers, upgrading the health system and improvement of family and community practices in the prevention and early management of childhood illnesses. Appropriate home management of illness is one component of IMCI. It implies giving more fluids and continuing to feed sick children appropriately. Table 4.7 presents information on the drinking and eating behaviour of sick children. Of the interviewed children, 43.08% were reported to have had diarrhoea or some other illness in the two weeks preceding the survey. Of these, 32.12% w~re given more fluids during the illness, and 67.67% continued eating (i.e. ate somewhat less, the same or more): Overall, only 17.84% of ill children received increased fluids and continued eating as recommended under the IMCI programme. The percentage of ill children receiving the IMCI recommended care was highest in the Southeast (23.03%), followed by the Red River Delta (22.82%), the lowest percentage was reported in the Mekong River Delta (9.37%) , in the other areas, it varied between 16-18%. The group of university/college level women showed 28.60% of the ill children receiving appropriate home management. This statistics showed a downward trend with mothers/care- takers having lower education level. This pointed out to the need for promoting knowledge of mothers and care-takers. Probing on the knowledge of mothers and care-takers about when it is appropriate to seek care for ill children is also a topic for interview in this survey. Mothers/care-takers were asked to name all of the symptoms that would cause them to take a child to a health facility right away. The most response (given by 78.09% of mothers) was that they would take their child to a health facility right away if he/she developed a fever. 52.25% said that the child becoming sicker would cause them to take him/her to a health facility and 41.14% mentioned difficult breathing, between 18-23% of mothers cited an inability to breastfeed, fast breathing, blood in stools and 9.15% (the lowest rate) cited drinking poorly as reasons for taking a child to a health facility right away. C6 71,97% so ba me nhan biet dLtac ft nhat hai dau hi$u can phai dlfa con ngay· l~p tete toi Cd so y te. Gilta cac vung, ty 1$ nay cOng c6 slf khac bi$t dang k§: Ty 1$ nay cao nhat o vung Bong Bac (91 ,88%), tiep d6 Ia Bac Trung Be? (82, 12%) va Bong bang song Cl!u Long (81 ,34%), thap nhat Ia Bong Nam Be? 49,44% va Bong bang song Hong 55,96%, Tay Bac 57,73%, 2 vung con l~i d~t trem 70%. Bang chu y Ia ty 1$ nay khong khac bi$t dang k§ gilta thanh th! va nong thon. B~nh sot ret B$nh sot ret dang c6 nguy Cd pht,JC hoi va bung phat tro l~i o tat ca cac vung o Vi$t Nam. Theo Niem giam Thong ke Y te nam 1997, Vung c6 nguy cd sot ret cao Ia vung Tay Nguyen (2697 nglfoi sot ret tfnh tren 100000 dan), tiep den Ia vung Tay Bac (1491/100000), Bong Bac (857 /1 ooooo). Cac vung con l~i ty 1$ ngLtdi sot ret dao dc?ng tlt 160 - 600 tfnh tren 100000 dan. Voi de? bao phu cua b$nh sot ret nhlf tren, sot ret c6 th§ dlf<;!C xem Ia mc?t trong nhCtng nguyen nhan gay tt1 vong cao o tre em Vi$t Nam. Bi$n phap phong ngva nhLt ngu man va man tam thuoc di$t muoi c6 tac dt,Jng giam dang k§ tre em b! sot ret ho~c tv vong do SOt ret. 0 nhltng VUng CO nguy Cd SOt ret cao, khi tre b! sot phai dlf9C xem nhlf Ia b! b$nh sot ret va l~p tete cho tre u6ng thuoc phong b$nh sot ret. Tre b! cac tri$u chl1ng sot ret nhlf sot ho~c run nguoi phai dL19c dlfa ngay toi cac co so y te. Va vi$c pht,JC hoi tre sot ret can phai dLt<;:lC uong nhieU nl/OC va an. Trong cuc?c dieu tra MICS, phan hoi ve benh sot ret dLtdc hoi cho toan bo tre em thuoc m·au dieu tra. T~t nhien khi xem xet so lieu c~n nghien CUu sau hdn 0 nhltng VUng CO nguy Cd SOt ret cao. £)a SO tre em dlfoi 5 tuoi dlf<;JC ngu man vao dem trlfoc thoi di§m dieu tra (95,86%). Tuy nhien. t~i vung Tay BacIa vung nguy cd cao nhLtng chi c6 78,2% tre em dlf<;Jc ngu man. Ba vung c6 nguy Cd sot ret cao Ia Bong Bac, Tay Bac va Tay Nguyen ty 1$ tre em dl/Oi 5 tuoi dL/<;:lC ngu man CO tam thUOC trlt muoi lan 1119t Ia 26,09%, 38,89% va 37,47%. Ty 1$ tre em b! sot trong hai tuan trLtoc thoi di§m dieu tra cua vung Bong Bac, Tay Bac va Tay Nguyen lan ILt<;Jt Ia 16,24%, 8,99%, 71.97% of mothers knew at least 2 symptoms for taking their child without delay to health facility. This rate differs much among regions: highest (91.88%) in the North East, then the North Central Coast (82.12%) and the Mekong River Delta (81.34%), and lowest, 49.44% and 55.96% in the Southeast and the Red River Delta respectively. It was 57.73% in the North West and 70% in the remaining two regions. However, there was hardly any difference between urban areas and rural areas. Malaria Malaria is showing signs of breaking out again throughout Vietnam. According to the 1997 Health Statistics Yearbook, the highest risk area was the Central Highlands (with 2697 having malaria per 100000 people), followed by the North West (1491/100000), and the North East (857/100000). In the remaining regions, the rate ranged from 160-600/100000. With such a malaria prevalence, it can be looked upon as an important cause of death of children in Vietnam. Preventive measures especially the use of bednets impregnated with Permetherin, can help prevent malaria. In malaria high-risk areas, recommendations suggest treating any fever in children as a malaria, by immediately giving the child a full course of anti-malarials. Children with severe symptoms, such as fever and convulsions, should be taken to health facility. Also children recovering from malaria should be given extra liquids and food. In MICS, questionnaires on malaria were put to all children. Naturally, more attention was given to the study of the data collected from malaria high-risk areas. Most under 5 children (95.86%) slept under bednets the night prior to the survey interview. However, in the North West, a malaria high-risk area, only 78.2% of children slept under bednets. In 3 malaria high-risk areas: the North East, the North West and the Central Highlands where the percentage of children sleeping under impregnated bednets were 26.09%, 38.89% and 37.47%, respectively. The prevalence of fever in the 2 weeks preceding the survey in the North East, North West and the Central Highlands was 16.24%, 67 --- ~------· 17%. Tuy nhiem t~i 3 vung nay ty 1$ tre em b! sot dUc;1C uong thUOC thfch hc;1p de chlta b$nh sot ret (chloroquine, fancidar, Quinine) rat thap, cao nhat Ia Tay Nguyen cOng khong vuc;1t qua 15%, trong khi l~i dUc;1C uong CaC lo~i thuoc khong c6 tac dt,mg phong chong sot ret voi ty 1$ rat cao (Dong Bac: 64,59%, Tay Bac: 80,56% va Tay Nguyen: 69,04%). G. HIV/AIDS Kien thli'c ve HIV/AIDS M9t trong nhiing chien 1uc;1c quan tr9ng trong phong chong HIV/AIDS Ia nang cao nh$n thCtc dung dan each lay nhiem va each phong ngCta HIV/AIDS. Trong so pht,.~ nii 15-49 tuoi a Vi$t Nam, c6 87,24% so pht,J nii duc;1c nghe n6i ve HIV/AIDS (Bang 5.1 ). Ty 1$ nay c6 sl,( khac bi$t giiia thanh th! (96,9%) va nong thon (83,9%) dieu nay don gian Ia van de HIV/AIDS d~c bi$t duc;1c quan tam han a khu Vl,J'C thanh thj. Trinh d9 van hoa cua pht,J nii cOng c6 anh huang dang ke den ty 1$ nay: Trong khi nhiing ngudi khong bang cap chi c6 43,8% duc;1c nghe n6i ve HIV/AIDS thi ty 1$ nay tang gap doi a nhiJng ngudi CO bang tieu hQC va d~t ty 1$ 97,6% doi voi pht,.~ nii c6 bang Trung h9c pho thong va 89,4% doi voi pht,J nii c6 trinh d9 d~i h9c cao d~ng. Ty 1$ pht,.~ nii 15- 49 duc;1c nghe n6i ve HIV/AIDS cao nhat thu(>c ve vung Dong Nam b9 va DBSH (tren 90%) va thap nhat Ia cac tlnh mien nui nhu Tay Bac (67, 1%) va Tay Nguyen (78,0%). Theo Uy ban Quoc gia phong chong HIV/AIDS tfnh den 30/12/1999, c6 61/61 tlnh phat hi$n ra cac ca b! nhiem HIV, ca nuoc c6 17130 ngudi b\ nhiem HIV, 2965 ngudi da chuyen sang AIDS trong d6 154814 ngudi da chet. Con so nay thap han nhieu lan so voi thl,(c te vi con rat nhieu ngudi chua du<;ic kiem tra. Do d6 du a dong bang hay mien nui, thanh th! hay nong thon thi HIV/AIDS cOng Ia m(>t van de can phai duc;1c nh$n thCtc day du. Vi$c van con gan 13% pht,J nii trong d9 tuoi sinh de, kha lon pht,.~ nii mien nui khong dl!c;1c nghe n6i give HIV/AIDS (33% a vung Tay Bac) th$t sl,( Ia m(>t van de dang lo ng~i can phai dUc;1C giai quyet trong nhiing nam toi. 8.99% and 17% respectively. However, in these three regions, the percentage of children receiving anti-malarials (Chloroquine, Fansidar, Quinine) was low; the highest percentage was found in the Central Highlands, but not more than 15%. On the other hand, the percentage of children receiving other drugs than the aiJ.ti-malarials was very high (64.59% in the r'lorth East; 80.56% in the North West and in the Central Highlands: 69.04%. G. HIV/AIDS HIV/AIDS knowledge One of the most important strategies for preventing HIV/AIDS infection is the promotion of accurate information of how HIV/AIDS is transmitted and how to prevent transmission. Among women aged 14-49 in Vietnam, 87.24% have heard of HIV/AIDS. (see Table 5.1 ). The percentage differs between urban areas (96.9%) and rural areas (83.9%), simply because HIV/AIDS is given more attention to in urban areas. Women's education level also substantially contributes to this percentage. Of those with no education, only 43.8% have heard of HIV/AIDS, this percentage doubles among those with primary education: 97.6% for those with secondary education and 89.4% for those with education/college education. Women age 15-49, who have ever heard of HIV/AIDS, were reported to reach the largest percentage (over 90%) in the Southeast and the Red River Delta. The lowest percentage was in the mountainous provinces in the North West (67.1 %) and the Central Highlands (78.0%). According to the National AIDS Committee, by December/30/1999, HIV cases were reported from 61/61 provinces, with 17130 HIV-infected people, 2965 developed into AIDS of whom 1548 died14• The figure was much lower than what it really was, because a majority in the population had not been tested. The fact that nearly 13% of child-bearing age women, mostly in the mountainous areas, have not heard anything of HIV/AIDS (33% in the North West) is a matter of concern, that should be addressed in the coming years. 14. Nien gi<hn Thong ke Y te niun 1999/ Health Statistics Yearbook, 1999 68 Trong cu(>c dieu tra MICS, moi phl,J nCr 15-49 tu6i dLt<;1c hoi m(>t so quan ni$m dung va m¢~ so quan ni$m sai ve phlfc:Jn.g th(Jc lay nhiem va phong tranh HIV/AIDS de nguoi ph1,1 nCr llfa ch9n. C6 65,17% so phl,J nCr cho rang quan h$ tlnh d1,1c chung thuy c6 th§ phong ngU'a dL1<;1c lay nhiem HIV. C6 65,26% so ph1,1 nCr cho rang Slt d1,1ng bao cao SU dung each moi ian quan h$ t]nh dl,lC CO th§ phong nglta dlf<;1c lay nhiem HIV. C6 37,20% cho rang c6 th§ ngan ngU'a lay nhiem HIV/AIDS bang each kieng cCr sinh ho~t tlnh d1,1c. Ty 1$ nglfdi hi§u dung ca 3 each trfmh lay nhiem HIV/AIDS (tra ldi "c6" doi Vdi ca 3 bi~n phap phong nglta Vlta neu) Ia 29,66%, ty 1$ tra loi dLt<;1c ft nhat m(>t trong 3 bi$n phap phong ngU'a Ia 74,44%. Dieu nay cOng c6 nghla Ia c6 25,56% so phl,J nCr 15- 49 tubi dlf<;1C hoi kh6ng biet g] ve 3 bi$n phap phong ngL!a da neu. Theo so li$u cua Uy ban Quoc gia phong chong HIV/AIDS, ty 1$ mac b$nh HIV/AIDS cao nhat a nh6m 20-2915 tu6i, the nhlfng ty 1$ phl,l nCr hi§u dung ve 3 each tranh lay nhiem HIV/AIDS kh6ng kh<k bi$t lam so vbi nh6m ph1,1 nCr 15-20, th~m chf con thap hdn nh6m phl,J nCr 35-49. C6 72,8% so phl,J nCr tra loi rang HIV/AIDS kh6ng th§ lay truyen b~mg cac bi$n phap sieu tl,l' nhien nhlf cung bai, phu thuy, ta thu~t (c(J 100 nglfdi thl c6 27 nglfdi cho rang ta thu~t phu phep c6 th§ lam cho nguoi ta b! lay nhiem HIV/AIDS!), chi c6 40,66% so phl,J nCr cho rang muoi dot kh6ng th§ lam lay nhiem HIV, 60,41% cho rang m(>t nglfoi tr6ng khoe m~nh van c6 th§ dang b! nhiem HIV. Chi c6 31,42% so ph1,1 nCr biet phan bi$t dL1<;1c quan ni$m sai ve HIV/AIDS. Va c6 78,27% so phl,J nCr phan bi~t dlf<;1C ft nhat m(>t quan ni$m sai Ve HIV/AIDS. Cac quan ni$m sai ve HIV/AIDS c6 nguon goc do trlnh d9 van hoa thap. 8ieu nay c6 th§ thay khi xem xet so li~u bang 5.2. Trong bi§u nay, ty I~ phl,J nCr cho rang HIV/AIDS kh6ng th§ lay truyen bang cac bi$n phap sieu tl,l' nhien cua nh6m phl,l nCr kh6ng c6 bang cap, c6 bang ti§u h9c, c6 bang THCS, c6 bang THPT, THCN lan llf<;1t Ia (%): 18,05; 57,51; 79,97; 93,20; 94,45. SlJ khac bi$t theo vung, In MICS, women aged 15-49 were asked about correct conceptions and misconceptions on HIV/AIDS transmissions and prevention. 65.17% believed that having only one uninfected sex partner could prevent HIV transmission. 65.26% believed that · using condom every time one has sex could prevent HIV transmission, and 37.20% agreed that abstaining from sex prevented HIV transmission. Overall, 29.66% knew all the three ways of preventing HIV/AIDS (responding "Yes" to the three preventive measures referred to above.) and 74.44% were aware of at least one of the means of preventing transmission. That means 25.56% of interviewed women aged 15-49 unaware of three ways preventing transmission above. According to the National AIDS Committee, the HIV/AIDS prevalence is highest in the people aged 20-2915. However, the percentage of women in this age group having sufficient knowledge of the three measures of preventing HIV/AIDS transmission did not differ much from the women aged 15-20, ever lower than the women aged 35-49. 72.8% of women stated that HIV/AIDS could not be transmitted by the supernatural means- sorcery, voodoo (of every 100 people, 27 believed that voodoo could make people HIV/AIDS positive!); 40.66% of women said that AIDS could not spread by mosquito bites. 60.41% said that even a healthy-looking person could have been infected. Only 31.42% of women were able to recognize all three misconceptions about HIV/AIDS and 78.27% of women were able to identify at least one misconception. Misconceptions of HIV/AIDS stem from the low education. This can be seen in Table 5.2. It showed the percentage of women who stated that HIV/AIDS could not be transmitted by supernatural means, varied a great deal with the level of education: for women with no education: 18.05%; those with primary education: 57.51 %; those with lower secondary education: 79.97%; those with 15. Nien giam Thong keY te nam 1999/ Health Statistics Yearbook, 1999 69 thea khu vljc ve thljc chat chfnh Ia khac bi$t ve trlnh dQ van hoa. Bang 5.3 cho thay c6 79,96% so pht,J nil cho rang HIV/AIDS c6 the lay W m~ sang con. 77,13% cho rang c6 the lay tryen trong thC!i ky mang thai, 64,75% cho rang c6 the lay truyen trong khi de va 47,46% cho rang c6 the lay truyen qua bu sila m~. Ty 1$ tra IC!i dung 3 each lay truyen HIV/AIDS tlt m~ sang con

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