English - CEDAW Southeast Asia

CEDAW and the Law:
Indicator 87
Is there legislation ensuring access by women to appropriate
health-care services relating to pregnancy and maternity
In the last five years, the use of prenatal health-care services has increased. The
proportion of women receiving three or more prenatal examinations was 83.8 percent in
2003. 590 The percentage of women who received prenatal services from a doctor, nurse or
midwife increased from 71.0 percent in 1995-1997 to 86.0 percent in 2000-2002. 591 By 31
December 2003, 93.2 percent of ward clinics had midwives and obstetric-pediatric assistant
doctors. 592
Nevertheless, women from remote and mountainous regions still do not receive
adequate maternal health care due to cost, distance to health-care centres and traditional birth
practices. 593 The Viet Nam Demographic and Health Survey of 2002 (VDHS) indicates that the
percentage of women consulting trained medical staff for prenatal care is higher in urban (96
percent) than rural areas (84 percent). Prenatal care is highest in the Red River Delta (98
percent). An estimated 25 percent of mothers in the Central Highlands and Northern
Mountains received no prenatal services. Also, urban women receive care from doctors much
more frequently than rural women.
As to giving birth, the percentage of women giving birth with medical worker assistance
has increased continuously from 91.4 percent in 2000, to 92.1 percent in 2001, to 93.8 percent
in 2002, and to 95.8 percent in 2003. 594 However the VNHS in 2001-2002, reported that 17
percent of all Vietnamese women gave birth at home without a trained health-care worker
present at delivery. The main reasons for not giving birth at a health facility are: insufficient
time to get to a health facility (34 percent); no need to go (20 percent); distance (11 percent)
or too expensive (9 percent). Poor women, women from ethnic minorities and women living in
remote and mountainous regions have lower percentages in this area. Around 63 percent of
the Northern Mountain, and 75 percent of the Central Region, ethnic groups give birth at home
without the assistance of a trained health-care worker, compared to only 8 percent of Chinese
and Kinh women. Women in the poorest living standard group (44 percent) are far more likely
to give birth at home without trained help compared to women in the highest living standard
group (only 1 percent). Women living in areas like the North West (65 percent) and Central
Highlands (40 percent) are also much more likely to give birth at home without trained help
compared to women in areas like the Red River Delta (2 percent).
262
The average maternal mortality ratio in Viet Nam is 130 deaths per 100,000 live births. 595
The rates vary considerably across regions, with the Red River Delta and South East posting
46 deaths per 100,000 live births, while the Central Coast and Northern Mountains post 199
and 411 deaths per 100,000 live births respectively. 596 As prenatal care and births under
590
GSO Statistics, p. 62
591
Wells, op. cit., p. 40;
592
Combined Fifth and Sixth Periodic Report, p. 37
593
Wells, op. cit., p. 40
594
Ibid.
595
United Nations Population Fund, ‘The State of the World Population. The Cairo Consensus at Ten: Population,
Reproductive Health and The Global Effort to End Poverty’’, United Nations Population Fund, New York, 2004
(UNFPA Report)
596
Wells, op. cit., p. 7
Review of key legal documents and compliance with CEDAW