metadata: authors: 0: author: Swinkels,Robertus Antonius
1: author: Turk, Carrie
count: Vietnam
docna: 0: docna: Strategic planning for poverty reduction in
            Vietnam : progress and challenges for meeting the localized
            Millennium Development Goals
docty: Policy Research Working Paper
subtopic: Health Care Services Industry,Reproductive Health,Early Child and Children's Health,HIV AIDS,Hydrology,Cholera,Communicable Diseases,Leprosy,Inequality
teratopic: Poverty Reduction
abstracts: cdata!: This paper discusses the progress that
            Vietnam has made toward meeting a core set of development
            goals that the government recently adopted as part of its
            Comprehensive Poverty Reduction and Growth Strategy (CPRGS).
            These goals are strongly related to the Millennium
            Development Goals (MDGs), but are adapted and expanded to
            reflect Vietnam's national challenges and the
            government's ambitious development plans. For each
            Vietnam Development Goal, the authors describe recent trends
            in relation to the trajectories implied by the MDGs, outline
            the intermediate targets identified by the government, and
            discuss the challenges involved in meeting these. Relative
            to other countries of similar per capita expenditures,
            Vietnam has made rapid progress in a number of key areas.
            Poverty has halved over the 1990s, enrollment rates in
            primary education have risen to 91 percent (although there
            is a quality problem), indicators of gender equity have been
            strengthened, child mortality has been reduced, maternal
            health has improved, and real progress has been made in
            combating malaria and other communicable diseases. In
            contrast, Vietnam scores worse than other comparable
            countries in the areas of child malnutrition, access to
            clean water, and combating HIV/AIDS. A number of important
            crosscutting issues emerge from this analysis that need to
            be addressed. One such challenge is improving equity, both
            in terms of ensuring that the benefits of growth are
            distributed evenly across the population and in terms of
            access to public services. This will involve addressing the
            affordability of education and curative health care for poor
            households. Improvements in public expenditure planning are
            needed to align resources better to stated desired outcomes
            and to link nationally-defined targets to subnational
            planning and budgeting processes. There is also a need to
            address capacity and data gaps which will be crucial for
            effective monitoring.
geo_reg_key: 517198,517191
repnme: repnme: Strategic planning for poverty reduction in
            Vietnam : progress and challenges for meeting the localized
            Millennium Development Goals
display_title: Strategic planning for poverty
            reduction in Vietnam : progress and challenges for meeting
            the localized Millennium Development Goals
listing_relative_url: /research/2003/01/2138050/strategic-planning-poverty-reduction-vietnam-progress-challenges-meeting-localized-millennium-development-goals
topicv3: Water m1326522 137,Infant and Child Mortality m1326544 1446,Poverty m1326687 695,HIV/AIDS m1327522 1416,Health m1504661 3480
publishtoextweb_dt: 2010-07-01T00:00:00Z
historic_topic: Poverty Reduction
origu: PREM Sector Department (EASPR)
no_of_pages: 64
model_extractions: PoLicy RESEARCH WORKING PAPER 2961Ww PS276l

# Strategic Planning for Poverty Reduction in Vietnam

Progress and Challenges for Meeting the Localized Millennium Development Goals Rob Swinkels Carrie Turk The World Bank East Asia and Pacific Region Poverty Reduction and Economic Management Sector Unit January 2003
# | Po.icy RESEARCH WoRKING Paper 2961

## Abstract

This paper discusses the progress that Vietnam has made toward meeting a core set of development goals that the government recently adopted as part of its Comprehensive Poverty Reduction and Growth Strategy (CPRGS). These goals are strongly related to the Millennium Development Goals (MDGs), but are adapted and expanded to reflect Vietnam’s national challenges and the government’s ambitious development plans. For each Vietnam Development Goal, the authors describe recent trends in relation to the trayectories implied by the MDGs, outline the intermediate targets identified by the government, and discuss the challenges involved in meeting these.

Relative to other countries of similar per capita expenditures, Vietnam has made rapid progress 1n a number of key areas. Poverty has halved over the 1990s, enrollment rates in primary education have risen to 91 percent (although there 1s a quality problem), indicators of gender equity have been strengthened, child mortality has been reduced, maternal health has improved, and real progress has been made in combating malaria and other communicable diseases. In contrast, Vietnam scores worse than other comparable countries 1n the areas of child malnutrition, access to clean water, and combating HIV/AIDS.

A number of important crosscutting issues emerge from this analysis that need to be addressed. One such challenge 1s improving equity, both in terms of ensuring that the benefits of growth are distributed evenly across the population and in terms of access to public services. This will involve addressing the affordability of education and curative health care for poor households. Improvements 1n public expenditure planning are needed to align resources better to stated desired outcomes and to link nationally-defined targets to subnational planning and budgeting processes. There 1s also a need to address capacity and data gaps which will be crucial for effective monitoring.

This paper—a product of the Poverty Reduction and Economic Management Sector Unit, East Asia and Pacific Region— is part of a larger effort in the region to help governments move toward outcome-based planning for poverty reduction. Copies of the paper are available free from the World Bank, 1818 H Street NW, Washington, DC 20433. Please contact Nga Vinh Dao Lopez, room MC9-234, telephone 202-458-8032, fax 202-522-1671, email address nlopez@worldbank.org. Policy Research Working Papers are also posted on the Web at http://econ.worldbank.org. The authors may be contacted at rswinkels@worldbank.org or cturk@worldbank.org. January 2003. (46 pages) development issues. An objective of the series ts to get the findings out quickly, even if the presentations are less than fully polished. The papers carry the names of the authors and should be cited accordingly. The findings, interpretations, and conclusions expressed tn this paper are entirely those of the authors. They do not necessarily represent the view of the World Bank, its Executive Directors, or the countnes they represent.

Produced by the Research Advisory Staff
|

# Strategic planning for poverty reduction in Vietnam

Progress and challenges for meeting the localized Millennium Development Goals (MDGs) Rob Swinkels and Carrie Turk World Bank, Vietnam
# ACKNOWLEDGEMENT

This paper draws heavily on work done by others and benefits from numerous discussions with sector specialists. The goal setting work was undertaken under the umbrella of the Government-donor-NGO Poverty Task Force (PTF). We would like to thank all PTF members, especially Dr Cao Viet Sinh of the Ministry of Planning and Investment, Dagmar Schumacher and Nguyen Phong of the UNDP, Takao Shimokawa of JBIC, Sandro Pio of the ADB, Alan Johnson of DFID-UK, and Nisha Agrawal and Nguyen Nguyet Nga of the World Bank. We are grateful for the comments and support provided by Steve Passingham of DFID-UK, Indu Bhushan of the ADB, Pascale Brudon of the WHO and Tamar Manuelyan Atinc and Steve Price Thomas of the World Bank. Lastly, we would like to express our appreciation to Chris Shaw and Chris Gibbs and other World Bank Vietnam sector managers who provided active support to the goal setting process, and to Nguyen Thi Minh Hoa and Phung Thi Tuyet for their editorial support.
# Abbreviations

|ADB|AsianDevelopment Bank|
|---|---|
|CAS|Country Assistance Strategy|
|CG|Consultative Group|
|CPRGS|ComprehensivePovertyReductionandGrowth Strategy|
|DAC|DevelopmentAssistance Committee|
|DFID|Departmentfor InternationalDevelopment|
|GDP|<br>Gross Domestic Production|
|GIS|Geographic Information System|
|GoVN|GovernmentofVietnam|
|HEPR|<br>HungerEradicationandPovertyReductionprogram|
|HIV/AIDS|<br>HumanImmunodeficiencyVirus /AcquiredImmuno DeficiencySyndrome|
|IMF|InternationalMonetaryFund|
|IMR|<br>InfantMortalityRate|
|JBIC|<br>Japanese Bank for International Cooperation|
|MDGs|Millennium Development Goals|
|MOET|MinistryofEducation andTraining|
|MOF|MinistryofFinance|
|MOH|MinistryofHealth|
|MPI|MinistryofPlanningandInvestment|
|MTEFs|<br>MediumTermExpenditureFrameworks|
|NGO|<br>Non-Government Organization|
|NSEP|National Strategy forEnvironmental Protection|
|ODA|OfficialDevelopment Assistance|
|PAR|PublicAdministrationReform|
|PIP|<br>PublicInvestmentProgram|
|PREM|<br>PovertyReductionandEconomicManagement|
|PRGF|<br>PovertyReduction andGrowth Facility|
|PRSC|PovertyReduction Support Credit|
|PTF|PovertyTask Force|
|SEDS|Socio-Economic Development Strategy|
|TB|Tuberculosis|
|VDG|Vietnam DevelopmentGoal|
|VLSS|<br>Vietnam Living Standards Survey|
|WHO|WorldHealthOrganization|
# TABLE OF CONTENTS

# SUMMARY

T. COUNTRY CONTEXT.......cccsscscsesssesessesessacesscensesesssesecesenceeessessnesceesseetinesseseneesseeeseessesstssseresse Economic Growth qu... cesscssesssscssseessesssssescsecssseseeseeaeseesssecsseasccseessessecssesceaseesessesssetsesstatessee I Trends in poverty reduction and social indicators ...........ececesssesesesseseeeeseeneeseeteetsesststeteteeeenee I Structural and Governance Reforms<sup>...........ccccsscsseescescssecsceseesessncsaceecersrsaseesseeecesseessnesscsssaces4</sup> Challenges to sustained progress ..........ccccssssssescecsecceeessesesssseesesetsetscsscesssassecesetaseassacecetetsesnees 4 TI. PLANNING AND GOAL-SETTING IN VIETNAM.,.....c.cscscssesssssseseseseeseeeescesssesacerssesasaceeesetsseeeeseteeee The Socio-economic Development Strategy 0.0.0... cccsssessesssnecesseeteereeesseeeeaetseeseseeeeeeesees O The Comprehensive Poverty Reduction Strategy and the Vietnam Development Goals....... 5 The role of the Millennium Development Goals ............cccecssscsesseecertessssceseseeecsessetecesenesees D III. PROGRESS TOWARDS THE VIETNAM DEVELOPMENT GOALS.......c:csccssscsscssessesessssessescsessesere 12

|Vietnam Development Goals directlybasedonthe MDGS............cccccsssscsesseseseessessessssees 12|
|---|
|Goal One: Eradicate Poverty and Hunget............essscscssssseessessseceeeecseeeeseesseeseesesecseeeestteteee 12|
|Goal Two: Achieve BetterEducation for All... cessssecsessseeesesectseeseeeeseestersssesssesteteeee 1S|
|Goal Three: Reachgender equalityandempowerWOMEN .............::s:escssseseseecesateeresseseeeneee LY<br>|
|Goal Four: ReduceChild Mortality ..0........:ccscsssscscssssscssssetsessscsesesesesssssssseseessestecseserssessseees DD<br>|
|Goal Five: Improve maternal health .............cccccsscssscessecssecsseccesseeessesssecsseeeesssscstseesseecses DO|
|Goal Six: CombatHIV/AIDs, malariaandcommunicable diseases ..............cccccscceceeseeeeeees 30<br>|
|Goal Seven: EnsureEnvironmental Sustainability ........... cccccccseesesesecseeeeeeeeetssseeeeettetene OD|
|Vietnam Development Goals not directlybasedon theMDGS..............<br>cc eeeeseeeeteeteeeeeeees BO<br>|
|Goal eight: Reduce vulnerability 0.0.0...cscssescssesssessesscseccssecesesscesccseseseaesaceseasseestessetatere BO<br>|
|GoalNine: EnsureGoodGovernance forPoverty Reduction<sup>..............c:csccessessssccessseeereeeeee OT</sup>|
|Goal Ten: Eradicatepoverty andpreserve the culture and diversity ofethnic minorities.... 38|
|Goal Eleven: Ensuring pro-poor infrastructure development..............cccccssceseesseessecsseseeseesees OO|
|TV. CHALLENGES.........ccsssssesceccsscoeeesssceesassosessonscnssseseseceaecsccseeaecaeassetseesasssesencessssetssessessttseeetses 4Q<br>|
|Improving Equity 00...ceseccssssssssessssscsssscescassseaseccecsecsseecsssstsceseeassrsessessesscenssessccaseetesececeess 40<br>|
|Aligningresourcesto strategic targets...sssesessesessessesseessscesscessseasesssseteeseesssssccsetsseces FL<br>|
|Buildingcapacityandfillingdatagaps....cccscssssesssscessesesssscsscssscsesessesceecscesesessesrssaresees42|
# Boxes

|Box 1. Key actors involved intheworkon theCPRGS anddefining the Vietnam Development<br>Goalsandtargets...ssssssscssceceeeseeseceesserscsssceeesseesseceeseesasssseseesceeeateneesseaseaseaseasesssatessessessO|
|---|
|Box 2.MDGGoal One: Eradicate Povertyand Hunget..u...........cecssessesceeceseeseseeresssecessssesssessessseaeseeeLS|
|Box 3. MDGGoal Two: Achieve Better Education forAlloo...ceccccsecssessesseseesesseessresssssessesereee8|
|Box 4.MDGGoal Three: ReachGenderEqualityandEmpower Women................sccscsssssessssseessseeeeeQO|
|Box 5a.MDGGoal Four: Reduce ChildMortalitybytwothirdsby20150.00....cccesssesseeseeeesreeeeD4|
|Box 5b.MDG Goal Four: Reduce ChildMortalitybytwo thirdsby2015 .0.......eecscsssesesseesseseeeeee27|
|Box 6.MDG Goal Five: Improve Maternal Health (reduceMMRbythree fourthsby2015) ...........29|
|Box 7. The successful fight againstmalariaandTuberculosis inVietnam .............cccscecsesteerestesteeeeesDO|
|Box 8.MDG Goal Six: Combat HIV/AIDS, malariaandother disease..............ccccsssssccsseeeeeereeeeSl|
|Box 9.MDGGoal Seven: EnsureEnvironmental Sustainability...<br>cecsssscssssseseesesessesreeesenees DD|
|Box 10. GoalEight: Reduce vulnerability...<br>cssscsssssscsssssssssscsccsessssecseessesssesssstsscsssssesseseesesessesD 7|
|Box 11. Goal nine: EnsureGoodGovernance forPovertyReduction .0.........eeeeeeccsceseecssesesteeteesneeneedD|
|Box 12. Goal Ten: Eradicate PovertyandPreserve the Culture andDiversityofEthnic Minorities..38|
|Box13.GoalEleven:ProvidebasicinfrastructureservicestodisadvantagedgroupS............:000000039|

# Tables

|Table 1. Social Indicators, 1993— 1998 ou...cesssecesseeessssesecesseseesesenscesessacesssssscecsssecesssssscessssessseesened|
|---|
|Table 2. TheVietnam Development Goals*.............ccscccscseessssecssesesreesscesecessecsssessnecsecsssesseeesessseeseesLO|
|Table 3. TheDuration ofPrimarySchooling in selectedcountries, 2001........... cceeeseseeesseeeseseeeeeee<br>dl 7|
|Table 4. Decline in InfantandChild Mortality: International Comparison ................scescsscssssesseseseeees22|
|Table 5. Infant MortalityDeclinebyRegion, 1990-98 ...........eeeseessssssesesseseescsecerssetseesseaseesaesseseseeesQo|
|Table 6. InfantMortalityDeclinebyPoverty Status, 1990-98oooeecsessssseeseesecenssasssetetssesesseesQo|
|Table 7. Progress andprojections forMortality Indicators forDisadvantagedAreas..............:c000025|
|Table8.Malnutrition-InternationalComparison..............ccscssescsssssccssesscsscseessesscsssateaesasscesesassesseneenes<br>lO)|
# Figure

|Figure 1.GDP Growth Rate (percent) and Inflation(annual average percent)...........ccccssseereeed|
|---|
|Figure 2. Incidence of poverty in Vietnam inRural-Urban areas............ssessesscscsseseseesessseesseeeaceneseeed|
|Figure 3. Strategic PlanningFramework inVietnam ............eesssesesseseeeeceseeeesesacarescateceacrsanseeneaeeeeeeO|
|Figure 4. Faster-growing regions havereducedpoverty MOSt.............:ssssssssscesssscceseseeecsetsssssseseestetseee<br>lhS|
|Figure 5. Povertyreductionprojections under different growth SCenari0S..............:csesseseecessereeeeeeeeee4|
|Figure 6. IlliteracyRate of 15-24 year-olds in SelectedCountries, 1999.00...<br>eessseecesesceeesteeseeeee LO|
|Figure 7. Trends inPrimaryNetEnrolment Rates, 1993-1998,byincomequintile...Lb|
|Figure 8. PrimaryCompletion Rates forselectedcountries andregion, 1997 0.0...ceseeeecesesseeereeeed7|
|Figure 9. Girls as apercentage ofboys inprimaryandlower secondary education: Levels in<br>1993-98 and targets for 2005 00... eeecssesessesecesecsseseescceeesseesessscessssseseeseesteessesesssetateeeeeeeLO|
|Figure 10. Under 5 Mortality—progressmadeduring 1990-1998 andprojections for2010 and|
|Figure 11. Under 5 Mortality—progressmade during 1990-1998 andprojections for2010 and|
|Figure 12. Malnutrition: progressmade during 1990-1998 andprojections for2010 and 2015.........27|
|Figure 13. Maternal mortality—progressmade during 1990-1998 andprojections for2010 and|
|Figure 14. Contraceptive Prevalence rate progress andtargets1990-2015<br>oo...<br>eeseseeeteeteeteeene dl|
|Figure 15. Trends inthecompositionofVietnam's Forest Cover...........ccccssssessescesseseesseeteeeseeeneeeeedS|
|Figure 16. Marine catch inVietnam 1991-2001oeecsessessesecseeneseessesssssescesseessesoneeseseseeesesseeseeesDo|
|Figure 17. CountryComparison ofAccess to SafeWater, 2000 (percentage ofpopulation) .............34<br>Figure18Distributionof householdwell-beingrelativetopovertylineinVietNam..............000.36|
health surveys and learning-outcome surveys. The tracking of environmental indicators requires improvements both at the national and local level if progress is to be made. It will also be important to put in place a mechanism for collecting and analyzing qualitative information. Innovative approaches are needed to assess progress in areas defined as priorites by Government but that are not currently addressed through household surveys or administrative reporting systems. This includes information related to vulnerability, governance, domestic violence and the local level business climate. Outcome indicators are not yet well integrated into a framework that clearly demonstrates the hierarchical links between inputs, outputs, outcomes and impact and more research is needed to assess what inputs (policies and public spending) are needed to reach the defined outcomes. It will also be essential to link the analytical work to the policy-making process, which will require better networking and interaction among ministries research institutes and universities. And, lastly, strengthening provincial level capacity to analyse trends and causes of poverty will be essential given the substantial decision-making autonomy that exists at the provincial level.
## I. COUNTRY CONTEXT

### Economic Growth

Rapid economic growth and poverty reduction over the 1990s has meant that Vietnam has met — or nearly met — some of the MDGs within a decade of the internationally-chosen starting point of 1990. The real economy doubled in size during the decade, savings rates rose six-fold to around 25 percent of GDP, exports rose by an average of 25 percent per year, and Vietnam moved from a food deficit nation to become the second largest exporter of rice. Vietnam was highly vulnerable to the crisis in East Asia, since more than two-thirds of foreign investment inflows and two-thirds of export earnings come from the region. Government reacted to this challenge by adopting a highly cautious macroeconomic policy to avoid the possibility of a crisis. Figure 1 shows the evolution of GDP growth rate and inflation during this period.

Figure 1. GDP Growth Rate (percent) and Inflation (annual average percent) <!-- Start of picture text --> 10.02<br>82<br>8.0 8 :<br>60+ 4s —_ 48<br>4.0 5 .<br>0.0 ——<br>-4.0<br>1997 1998 1999 2000/r 2001/e<br><!-- End of picture text --> Source: World Bank (2002)

# Trends in poverty reduction and social indicators

Economic growth over the 1990s generated significant improvements in living standards. The incidence of poverty was halved from 70 percent to around 35 percent and the proportion of the population living in severe poverty fell to 15 percent. Across a broad front there were widespread and visible improvements in the lives of Vietnamese citizens (World Bank 1999). Preliminary evidence emerging from qualitative research suggests a continuation of improvements in living standards since the last household survey in 1998 (Shanks and Turk 2002).

A number of factors underlie these impressive gains in living standards. First, growth in the agriculture sector was an important driver of economic growth over this period. Higher incomes from agriculture brought benefits to the rural poor, nearly all of whom had access to agricultural land following the decollectivisation of agricultural production in the late 1980’s. Secondly, many of the poor were concentrated just below the poverty line in the early 1990s. A relatively small improvement in per capita expenditures was sufficient to push a large number of households into non-poor categories. Their proximity to the poverty line means, however, that these households remain highly vulnerable to the shocks and crises that impose heavy costs or undermine the livelihoods of rural households. Thirdly, though the gains were not evenly spread across regions, all groups and all parts of the country experienced improvements in living standards. The rate of decline in poverty was faster in urban areas, but rural populations also saw dramatic improvements in material well-being (Figure 2).

1
Figure 2. Incidence of poverty in Vietnam in Rural-Urban areas <!-- Start of picture text --> 70<br>60<br>50 “ @ 1993<br>. 01998<br>40<br>29<br>30 25<br>20 18<br>9<br>a<br>0 a<br>Rural Urban Rural Urban<br>Total Poverty Line Food Poverty Line<br><!-- End of picture text --> Source: World Bank et al, 1999 Progress in social outcomes - Social indicators also improved markedly over the period, with literacy rates reaching 92 percent, and infant mortality rates falling to below 40 per thousand (Table 1). Much of this success is due to past commitment to the development of human capital backed up by investment in basic social services. A considerable part of section three examines past performance in a range of social indicators and assesses the challenges to future progress.

Geographical inequality has increased — During the years between 1993-1998 the Gini index remained basically unchanged. More disaggregate analyses show that the poor did better than the rich, in relative terms (Paul Glewwe and Hai Anh Dang Hoang, 2002). However, these national level findings mask rising inequalities associated with geography and ethnicity. The gap between rural and urban areas has grown during the 1990s, and inequality between regions has widened, which is related to the uneven pattern of growth across regions. Analysis presented in section three will frequently refer to regional, ethnic and gender-based inequality in a range of important social and poverty outcomes.

2
.

Table 1: Social Indicators, 1993 — 1998

|Indicator<br>7<br>~|| 1993|1998|
|---|---|---|
|Human Development|||
|--Education|||
|Primaryenrollment rate (net)|||
|Female|87.1|90.7|
|Male|86.3|92.1|
|Lowersecondary enrollment rate (net)*|||
|Female|29.0|62.1|
|Male|31.2|61.3|
|Uppersecondary enrollmentrate(net)*|||
|Female|6.1|27.4|
|Male|8.4|30.0|
|—-Child Nutrition|||
|Incidence ofStuntingAmongChildren 0-59Months.|51|34|
|Female|51|33|
|Male|50|35|
|-- Adult Nutrition|||
|Incidence ofmoderate and severe malnutrition in adults (Body mass<br>index less than 18.5)|32|28|
|Female(nonpregnant)|32|30|
|Male|32|25|
|Access to infrastructure|||
|%ofruralpopulationwithpublic health center within thecommune|93|97|
|% ofruralpopulationwithaccessto cleanwater**|17|29|
|% ofurbanpopulation withaccessto cleanwater**|60|75|
|% ofpopulationusing electricityasamain sourceoflighting|48|77|
|Ownership rates ofConsumerDurables|||
|%households owingaradio|40|47|
|%householdsowingatelevision|25|58|
|%householdsowingabicycle|67|76|

- Footnote: * The rapid increase in secondary enrollment rates reverses a decline in enrollments in the 1987-1992 period.

*%C]ean water is defined to include piped water, deep wells with pumps and rainwater.

Source: World Bank estimates based on VLSS93 and VLSS98.

3
## Structural and Governance Reforms

Since 1998 the Government has begun to take crucial steps to address structural impediments to longterm high quality growth. The slowdown revealed some deep-seated distortions and inefficiencies in the economy, and the Government began a lengthy and deliberate process to design and build political consensus for a major structural reform program. The period 1999-2001 witnessed an energetic process of analytical work, detailed design and broad consultation of reform programs covering banking and state enterprise reform, trade liberalization, public expenditure management, and policies for private sector development. This in turn has led to a series of new policy announcements over recent months, and enabled a major PRGF/PRSC agreement to be reached with the IMF and the World Bank during 2001.

Although the policy and institutional environment in macro and structural policies and in public financial management has improved considerably, reform has lagged behind in the areas of governance and greater attention to building modern governance has now become particularly urgent. Governance reform has only recently received a priority position on the Government’s agenda. A five year Master Program for Public Administration Reform for 2001-2005 has been approved, but a detailed strategy for implementing reforms is yet to be formulated. A legal needs assessment has been carried out and an action plan is being drawn up. However, no decisive measures have yet been announced to combat corruption and this remains a major area of concern.

# Challenges to sustained progress

This paper looks forward to the strategic poverty and social targets that the Government of Vietnam is setting for the next five and ten years. Sustaining and building on the progress of the last decade poses several challenges (section IV), but two issues in particular are likely to define the extent to which outcome targets are met.

Addressing growing disparities — As said, the impressive achievements in poverty and social outcomes over the last decade overshadow important disparities in progress across regions and ethnic groups. Many of the targets that Government is setting will not be achieved without stronger efforts to reach disadvantaged groups. In addition to sector-specific measures, this will also require reforms in the allocation of public resources and improvements in the capacity of service providers to identify and target lagging areas and the poorest groups.

Moving beyond access — The social indicators show that public investment in human development over several decades has led to real achievements in terms of primary school enrolment rates and access to health care. The analysis shows that this important emphasis on universalizing access has been accompanied by some compromises in terms of the quality of services. Though 91% of primary school age children are enrolled in primary school, they complete one of the shortest primary school curricula in the world (in terms of tuition hours). And although 97% of communes havea health center, poor households explain that they are reluctant to use the low quality services that are available in those centers. Over the next decade there will be a need to shift the emphasis to addressing deficiencies in the quality of these services.

4
### II. PLANNING AND GOAL-SETTING IN VIETNAM

,

## The Socio-economic Development Strategy

Policy formulation and public actions in Vietnam are guided by a range of strategies and plans. The Government of Vietnam has articulated its development vision for the coming decade in the SocioEconomic Development Strategy (SEDS), which expresses a strong commitment to growth, poverty reduction and social equity. This document - prepared by the Communist Party of Vietnam and endorsed at the Ninth Party Congress in 2001 - lays out a path of transition towards a “market economy with socialist orientation”. It commits Vietnam to full openness to the global economy over the coming decade, and the creation of a level playing field between state and private sectors. It emphasizes that the transition should be “pro-poor”, and notes that this will require heavier investment in rural and lagging regions, and a more gradual reform implementation than is often recommended by the international community. It gives strong emphasis to poverty reduction and social equity, and a more modern system of governance.

The specific actions, needed to translate this vision into reality, are described in the draft five year plan for 2001-2005 and in a number of sectoral ten year strategies and five year plans. These sectoral plans and strategies are approved by the Prime Minister and each one of these strategies details a large number of targets and indicators. The strategies are often very broad and ambitious. The targets included in these strategies are generally not prioritized, are not costed, tend to emphasize inputs and outputs rather than outcomes, and are not based on evidence generated through analysis of high quality field data.

# The Comprehensive Poverty Reduction Strategy and the Vietnam Development Goals

Preparing the CPRGS - In early 2001, the Government of Vietnam began setting out the steps to develop their interim Poverty Reduction Strategy Paper (I-PRSP) into a more comprehensive document necessary to develop their Comprehensive Poverty Reduction and Growth Strategy (CPRGS). The Government described the CPRGS as an “action plan that translates the Government’s Ten Year Socioeconomic Development Strategy, Five Year Socio-economic Development Plan as well as other sectoral development plans into concrete measures with well-defined roadmaps for implementation (SRV, 2002). The links between the various components of the planning framework are presented in the CPRGS (Figure 1). The CPRGS was approved by the Prime Minister in May 2002.

5
# Figure 3. Strategic Planning Framework im Vietnam

<!-- Start of picture text --> Ten-Year Socic-Economic<br>Development Strategy<br>4 \/<br>. Comprehensive Poverty<br>manieheiianeae Re p| Reduction and Growth<br>——fo——<br>[seasons<br><!-- End of picture text -->

# Source: Socialist Republic of Vietnam, 2002

The Ministry of Planning and Investment (MPI) was assigned the task of drafting the CPRGS and MPI, in turn, established an inter-ministerial drafting committee to generate broad-based input from across Government into the drafting process. An important role was played by the Government-donor-NGO Poverty Task Force (PTF). The PTF was initially established to coordinate detailed analysis of poverty in Vietnam. But it then — at the request of the Government of Vietnam - continued as a mechanism for coordinating support to the development of the CPRGS (Box 1).

Box I. Key actors involved in the work on the CPRGS and detining the Vietnam Development Goals and targets

- © The Government of Vietnam, particularly the Ministry of Planning and Investment (MPI) who has led work on developing a CPRGS and the members of the 17-agency CPRGS Drafting Committee

- © The Government of Vietnam, particularly the Ministry of Planning and Investment (MPI) who has led work on developing a CPRGS and the members of the 17-agency CPRGS Drafting Committee, line ministries, but particularly the Ministries of Health, Education and Training, Transport, and Agriculture and Rural Development

- © Sub-national levels of government, who have interacted with the CPRGS Drafting Committee to respond to early drafts of the CPRGS

- © The Poverty Task Force (PTF), which provides a mechanism for Government-donor-NGO collaboration on strategy formulation for poverty reduction. Other Government-donor-NGO partnership groups have also been involved in the target-setting work in certain sectors

- © The Consultative Group (CG) Meeting, which over the last few years has allowed for formal dialogue between the Government of Vietnam and the donor community (including NGOs) on poverty diagnostics, strategy development and (in December 2001) target-setting for poverty reduction; and

° In the future, two government bodies, a CPRGS Steering Committee and a Poverty Unit, are likely to play an important role in overseeing the implementation of the CPRGS, including monitoring progress against defined targets and intermediate indicators 6
Identifying goals - Key to the task of formulating the CPRGS was the need to prioritize across the wide range of goals and targets in the SEDS and the five-year plan to identify those which would most effectively capture progress in reducing poverty and promoting social equity. This involves the identification of a set of clear development goals that embody the main development challenges ahead. In addition, associated outcome targets and intermediate indicators are needed that are able to describe the changes generated over time and which can be tracked and monitored regularly (annually or biannually) to assess progress towards the goals.

The eight core areas of analysis - In this context, the Government of Vietnam asked the Poverty Task Force (PTF) to support some background analysis in eight thematic areas. The eight themes were chosen by the Government as representing the heart of their strategy to fight poverty. Several of the themes had a direct link with the Millennium Development Goals. Others lay outside the territory defined by the MDGs but were chosen on the basis of their strategic importance in terms of promoting economic growth, poverty reduction and social equity. Through this work, the Government hoped to establish a clear monitoring framework for their CPRGS and other Government strategies. The goals and targets were presented and discussed in a series of eight papers that were commissioned to various agencies, each covering one thematic area':

1. Eradicating poverty and hunger;

2. Reducing vulnerability and providing social protection; 3. Providing quality basic education for all;

- 4, Improving health status and reducing inequalities;

5. Ensuring environmental sustainability; 6. Promoting ethnic minority development; 7. Enhancing access to basic infrastructure ; and, 8. Ensuring good governance for poverty reduction.

No paper was devoted specifically to gender issues, because the Government was already drafting a solid gender action plan (the ‘National Plan of Action for the Advancement of Women’) from which gender indicators could be taken. It was agreed that gender issues would be addressed in each of these thematic papers, though in practice this was more easily done in some sectors (such as health and education) than in others (such as environment). Where appropriate, the VDGs and the associated targets and indicators are broken down by sex, but this is not the case for all goals.

The analytical work for the eight papers all took national strategies as a starting point and explored the links with the MDGs’. In particular, analysis concentrated on:

- e Making the MDGs consistent with Government targets set in the 10 Year Socio-Economic Development Strategy for 2001-2010 and other sector strategies;

- e Identifying process indicators and intermediate indicators as well as the outcome targets and presenting a discussion of the key public actions needed to influence the intermediate indicators;

- e An emphasis on the quality of services delivered as well as access (such as in primary education);

' These papers can be downloaded from: www.vdic.org.vn. (A full reference list of these papers is provided at the end of this paper.)

> ? In a separate exercise, the United Nations Vietnam Country Team (2001) also published a progress report on the MDGs in Vietnam.

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- e Raising the bar where the original MDG has already been met in Vietnam (as in halving extreme poverty); and,

- e Making the set of indicators more comprehensive by including challenges not covered by the MDGs and that are currently ill-defined in Government documents (such as empowerment/governance, vulnerability, ethnic minority development) or where the Government of Vietnam traditionally puts special emphasis in its poverty reduction programs (for example, infrastructure development in remote areas).

Work on each of these papers was led by a nominated agency from the PTF. The lead agency was then responsible for coordinating the interaction with relevant Government agencies and civil society organizations while the analysis was taking place. This was usually coordinated through small working groups. Key issues for discussion within these groups included:

- e What do the goals and targets mean in Vietnam? How are they measured and where do they stand today? How does Vietnam performance compare internationally? What are the trends — cross-country and time trends in Vietnam?

- e Is this MDG (and its sub-indicators) right for Vietnam? Is it capturing all it needs to capture? How can it be supplemented? Is it consistent with GoVN goals, or how could it be brought into line with GoVN goals?

- e How can the localized MDGs (or VDGs), which are very aggregate outcome measures, be disaggregated into intermediate indicators that can be used to measure progress on a more short-term and regular basis?

- e How can the localized indicators be measured? By whom? What are the data limitations and how can they be addressed? How can equity issues — ethnic, gender, location - be explored in a meaningful way?

- @ What are the main policy, investment and institutional development issues influencing achievement of the VDGs and the intermediate indicators? What are the main challenges and priority strategic responses?

Consultations and discussions- Government agencies, NGOs and donors all participated in the working groups established to oversee the production of these documents. First drafts of the papers were discussed at a 3-day workshop held in September 2001 attended by nearly 100 policymakers and practitioners. In some areas there was immediate agreement that a goal was needed, but also that more work and discussion was necessary to assess what is realistic and attainable. Very tangibly, the workshop resulted in a tentative list of draft Vietnam Development Goals to serve as a basis for further consultation across Government. This work in progress was discussed by delegates at the Consultative Group meeting in December and there was strong support for the government proposal that these localized goals should form the backbone of the CPRGS. Further consultations on these drafts took place with sectoral ministries and agencies over the following months, while the CPRGS was being drafted. The final CPRGS — which now incorporates these VDGs - was approved by the Prime Minister in May 2002. The Vietnam Development Goals are represented in Table 2 below and are divided into two categories: (i) goals linking directly to the achievement of the MDGs and (ii) goals outside the MDGs but which are priorities in the Vietnam context.

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# The role of the Millennium Development Goals

Starting with the national plans and priorities - The emphasis in developing the VDGs has been on using nationally-identified strategic priorities as a starting point for setting goals rather than adopting the MDGs in their internationally-agreed form. This was important for a number of reasons.

First, Vietnam has reached, or nearly reached some of the MDGs. Poverty, for example, has been halved between 1990 and 2000. It makes sense, then, for Vietnam to define a new localised version of the poverty goal in order to motivate policy formulation over the coming years. Secondly, though Vietnam performs well on some of the access targets that dominate the MDGs — for example in basic education — there are urgent challenges associated with improving the quality of those services to international levels. The strategic emphasis differs slightly, then, from the internationally-defined challenge of improving access. Thirdly, Vietnam has its own strategic planning cycle with different start and endpoints from the MDGs. It is helpful to consider the 25-year cycle of the MDGs alongside the five and ten year cycles of the Vietnamese planning horizons. This allows measures and actions to be tailored to national outcome targets for 2005 and 2010 which are, in turn, consistent with international targets for 2015. Finally, there are areas which are particularly challenging for Vietnam at its current stage of development but which are not covered by the MDGs. As an example, although Vietnam has performed well in delivering basic social services, it has lagged behind in initiating necessary governance reforms which will be crucial to attaining some of the other outcome targets proposed in the national strategies.

The value of the MDGs - With national strategies as the driving force in identifying goals, what role did the Millennium Development Goals play and what value did they add to the national-level debates? In reflecting on the process of goal-setting over the past year, we would argue that the MDGs were a motivator in four specific ways.

First, they helped to turn the attention towards outcomes. The many goals and targets that had been identified in Vietnam previously — through the national strategic planning process ~ were a real mix of input, output and outcome targets. Although the goal-setting work in Vietnam covered a broader range of sectors than the MDGs, the structure of the MDGs — in particular, the clarification of goals and their accompanying targets and indicators — provided a useful format for structuring goals and targets in all the sectors covered by the VDGs. This framework, derived from the MDGs, provided a stronger and more consistent focus on outcomes than often found in strategy documents in Vietnam. In some cases, the MDGs have helped to prioritise goals within a sector such as the environment, or helped to raise the profile of particular problems such as HIV/AIDS and child malnutrition.

Secondly, the substantial international literature and analysis on the MDGs allowed the analytical work on goal-setting to be more rooted in international comparisons and experience.

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|Table 2: The Vietnam Development|Goals*|
|---|---|
|Millennium Development Goals|VietnamDevelopment Goals|
|Eradicating PovertyandHunger<br>Halving 1990 $1 adaypovertyand hunger<br>rates|Reducethe percentage ofpoor and hungry households<br>Target J: Reduceby40% theproportionofpeople livingbelow the internationalpoverty<br>linebetween2001 and2010<br>Target2: Reduceby75% thenumberofpeople livingunderthe international foodpoverty<br>line by<br>2010|
|UniversalizingPrimary education<br>Ensure all children complete primaryschool|Universalizeeducationandimprove education quality<br>Target 1: increase the net enrolment inprimary school to97% in2005 and to99% in2010<br>Target2. increase net enrolment rate injunior secondary school to80% in2005 and90%<br>by2010<br>Target 3: Eliminate thegendergap inprimaryandsecondaryeducationby2005, and the<br>gap with ethnic minorities in2010<br>Target 4: Increase literacyto95% ofunder-40-year-old womenby2005 and 100%by2010<br>Target 5;By2010 haveimproved the qualityofeducation and increase full-dayschooling<br>atprimary<br>level(exacttargetdependsonfunding).|
|Promotinggenderequality<br>Equalizingtheration ofgirls toboys in<br>education|<br> <br>Ensure genderequalityandwomenempowerment<br>Target J: Increase thenumberofwomen in electivebodies at all levels.<br>Target2: Increasetheparticipationofwomen inagenciesand sectors [includes ministries,<br>central agencies and enterprises] at all levelsby3-5% in thenext 10 years.<br>Target 3: Ensure thatthenamesofbothhusband andwife appears on the land-usenght<br>certificatesby2005<br><br>|
|Reduce Child Mortality<br>Reducethe 1990under-5 mortalityrateby two <br>thirdsby2015|Target 4: Reduce the vulnerability<br>ofwomen todomestic violence.<br>Reduce child mortality, child malnutrition and reduce the birth rate<br> | Zarget J:Reducetheinfantmortalityrate to30per 1000 livebirthsby2005 and25by<br>2010 and at amore rapidrate indisadvantagedregions (seebelow)<br>Target 2: Reduce theunder-5 mortalityrate to 36 per 1000 live birthsby2005 and32by<br>2010|
||get3:Reduceunderfivemalnutritionto25%by2005and20%by2010|
|ImproveMaternal Health<br>Reduce the 1990 maternal mortalitybythree<br>quarters|<br>Improve maternal health<br>Target 1: Reducethematemal mortality rateto 80per 100,000 live birthsby2005 and 70<br>by 2010 with particular attention todisadvantaged areas|
|CombatHIV/AIDs, malariaand other<br>disease<br>Haltandbegin toreversethe spreadof<br>HIV/AIDs, malaria and othermajor diseases|ReduceHIV/AIDS infection and eradicate other major diseases<br>Target 1: slowthe increase in thespread ofHIV/AIDsby2005 andhalve the rateof<br>mcreaseby2010.|
|Ensure Environmental Sustainability<br>Useprinciplesofsustainable development<br>|<br>Reversethe lossofenvironmental resources|Ensureenvironmental sustainability<br>Jarget J: Extend forest cover to43%by2010 (from33% in 1999);<br>Target 2: Ensurethat60%oftherural population has access to clean and safewaterby<br>2005and85%in2010.Thisshouldbethecasefor80%ofurbanpeoplein2005.|
|Halve theproportionofpeople without safe<br>drinkingwater|<br>Target3: Ensure there areno slumsandtemporaryhouses in alltownsand citiesby2010<br>Target4:Ensurethat allwaste-water intowns andcities istreatedby 2010<br>Target 5: Ensurethat all solidwaste is collected and disposed ofsafely in all towns and|
|Significantly improvethe livesofslum<br>|citiesby2010<br>|
|dwellers|Target6:Airandwaterpollutionmustattainnationalstandardsby2005|
|Vietnam develo|<br>pment goals andtargets wotdirectly based onMDGs|
|Reducing vulnerability|Target I: Increase theaverageincomeofthe lowest expenditure quintile to 140%ofthat in<br>2000 and 190% ofthat in 2010<br>Target 2: Reducebyhalfthe rateofpoorpeople falling back intopovertydue tonatural<br>disasters and other risks by<br>2010|
|reduction|Target2:Ensure budgettransparency<br>Targ<br>Implementlegalreformagenda|
|—|<br>Target2: Ensure entitlement ofindividual andcollective land-use rights in ethnic minontyand<br>mountainousareas|
||<br>Targ<br>Increase the proportionofethnic minority<br>people in authority<br>bodies atvarious levels|
|development|Target2: Expand the national transmission gridto900poorcommune centresby2005|
|Source: SocialistRepublic ofVietnam (2002<br>ofVDGsoutlinedintheCPRGS;additional|),VDG papers (see andofthis Chapter). “Note: these are asummary ofa larger set<br>onesrelatetoeconomicreformandculturaldevelopment.|

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For those VDGs linked directly to the MDGs, this connection was very clear, setting the VDGs in an international context, identifying achievements as well as areas where Vietnam lags behind, and ensuring that the goals were focused, realistic and achievable. This then motivated a more internationallyinformed analysis of the other VDGs — those goals which were not drawn directly from the MDGs. This is in contrast to the traditional approach in Vietnam to identifying targets and goals in the sectoral strategies. The targets and goals are often not based on evidence generated through a detailed situational analysis. High quality data collected from the field is rarely used to assess what might be realistic and achievable over a ten-year timeframe.

Thirdly, the process of identifying and setting goals and linking them to international commitments generated a considerable amount of debate. Though the analytical work was sectorally defined, the debates and discussions around this whole process of identifying core goals for Vietnam were very useful in highlighting some of the linkages between the goals and the cross-cutting themes important for making headway across a broad range of goals. For example, the importance of improving equity and the particular need to focus on regions and sub-groups that are not benefiting from growth as much as the majority population emerged as a factor defining future progress in a number of goals. And this, in turn, reinforced discussions around the affordability and quality of health and education services for these subgroups. Another example of a cross-cutting issue relates to infrastructure services in these poor areas and the importance of local level participation in resource allocation decisions surrounding these investments to ensure they respond to local needs and lead to clear accountability mechanisms.

Finally, the MDGs — being owned broadly by the international community - facilitated broad-based involvement in the process of defining the VDGs through various consultations and discussions. The neutrality of the MDGs which derives from not being the product of any one agency makes them a powerful instrument for mobilising international donors and NGOs and, by extension, their partners in the government agencies and local civil society groups. This in turn has helped create consensus and widespread buy-in of stakeholders around the goals, targets and indicators adopted by the Government in the CPRGS.

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### Il. PROGRESS TOWARDS THE VIETNAM DEVELOPMENT GOALS

The discussion of goals in this section covers the eleven Vietnam Development Goals emphasised in the CPRGS and set out in Table 2. This set of eleven VDGs incorporates the localized, adjusted versions of the MDGs, but also extends beyond this international set of goals to include some complementary goals chosen to address the particular challenges and priorities of the Government of Vietnam. For each goal and associated outcome target, this section examines recent achievements and projects future progress. A considerable amount of analytical work has already been undertaken in Vietnam using mainly data from the Living Standards Surveys in 1993 and 1998 and the four Participatory Poverty Assessments (PPAs) in 1999. This has set a sound basis for the analysis presented in these eight papers. Where information is available the past performance in Vietnam is set against international comparisons. The discussion of each goal includes an analysis of the main challenges and strategic issues confronting the Government as they seek to reach their stated outcomes. Section four looks at broader challenges which will influence achievement over several or all goals.

This section draws directly and substantially on the analysis presented in the eight thematic papers.

# Vietnam Development Goals directly based on the MDGs

## Goal One: Eradicate Poverty and Hunger

#### Achievements

MDGs already met - Vietnam has already met the international MDGs for poverty and hunger reduction. Although accurate estimates of poverty before the early 1990s are not available, many believe that in 1990 approximately 70 percent of the population was living under the poverty line’. By 1998, data show that the incidence of poverty had been halved to 37 percent (World Bank et al, 1999). Food poverty* reduced from 25 percent to 15 percent over the 1993-1998 period. Simulations based on data from 1993 and 1998 suggest that by 2001 32 percent of the population are under the poverty line and 13 percent are under the food poverty line.

National achievements mask regional differences - Poverty is not distributed evenly across Vietnam: mapping poverty by province through combining the Vietnam Living Standards Survey (VLSS) data and the 1999 Census data demonstrates that the poverty headcount varies from a low of 4 percent of the population in Ho Chi Minh City to a high of 78 percent in Lai Chau (Baulch and Minot 2001). Although the reduction in poverty between 1993 and 1998 occurred in both rural and urban areas, the 1998 VLSS showed that poverty was higher in rural areas and among ethnic minorities. The percentage of the population living below the total poverty line declined from 66 percent in 1993 to 45 percent in 1998 in rural areas and from 25 percent to 9 percent in urban areas. Using the food poverty line the decline in rural areas has been from 29 to 18 percent and from8 to 2 percent in urban areas over the same period.

Although poverty has declined in all seven regions of Vietnam, the pattern of these declines has been uneven. The greatest reductions have occurred in the South East and in the Red River Delta. The Northern Uplands and the Mekong Delta reduced poverty at a slower rate between 1993 and 1998. Poverty

> > The “poverty line” here refers to a line estimated by the General Statistics Office, using an internationallyrecognized methodology based on a national minimum set of food and non-food requirements. This is not the PPP $1 per day poverty line.

> * The “food poverty line” refers to the amount needed in Vietnam to obtain a basket of food that provides 2100 calories per person per day.

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reduction was closely associated with economic growth (Figure 4). Certain regions contribute more to overall poverty that others: the Northern Uplands, North Coast and the Mekong Delta together account for nearly 70 per cent of the poor in Vietnam.

Figure 4. Faster-growing regions have reduced poverty most <!-- Start of picture text --> Poverty Reduction and Growth Rate 1993-1998<br>EE RDO<br>es<br>Mekong Delta ——<br>South Central Coast jguaaaepe<br>0 P' —<br>a<br>AS Se A<br>0 10 20 30 40 % 50 60 70 80 90<br><!-- End of picture text --> Source: World Bank (2002a) The regional differences in poverty reduction and growth rates are caused by a number of factors that are likely to be related to endowments of physical infrastructure, access to and quality of social services and the quality of local government institutions. Differences in labor and natural capital endowments as well as in productivity performance across provinces also clearly playeda role.

# Targets andfuture challenges

In the CPRGS, the Government of Vietnam commits itself to a poverty reduction goal and two outcome targets that reflect the national strategic direction and that over-achieve the MDG by some way (Box 2).

<!-- Start of picture text --> Box 2. MDG Goal One: Eradicate Poverty and Hunger _ 7<br><!-- End of picture text --> Vietnam Development Goal: Reduce the percentage of poor and hungry households” Target 1: Reduce by 40 percent the proportion of people living below the international poverty line between 2001 and 2010 Target 2: Reduce by 75 percent the number of people living under the international food poverty line by 2010 Source: Socialist Republic of Vietnam (2002).

Beyond the MDGs- The first poverty reduction target essentially means that incidence of poverty will need to come down to 19 percent in 2010. If we take as a baseline the incidence of poverty in 1998 (37 percent), the target implies halving the number of poor people again between 1998 and 2010. Food poverty was about 13 percent in 2002, which means that by 2010 it should have been reduced to just 3 percent if the second target is to be met. The Government of Vietnam realises that job creation is the most important vehicle for reducing poverty and sharing growth among the population. Therefore, it has set a number of specific job creation targets. These targets are: creating 1.4 million jobs annually, increasing 5 Indicators of progress in reducing child malnutrition are included in the child mortality goal 13
the proportion of women hired in the new jobs created to 50 percent by 2010; and increasing the proportion of trained workers in the total workforce to 40 percent by 2010. This will demand rapid expansion of the private sector, the most efficient and effective creator of jobs. If regional gaps are to be closed, it will be important that jobs be created in all parts of the country.

The importance of equitable growth - Meeting these targets will require economic growth that is both rapid and that distributes benefits more evenly than in the past. Different patterns of growth across Vietnam will have different effects on Vietnam’s poverty reduction efforts. Growth that is concentrated in urban areas will raise incomes in the cities but have less immediate impact on the incomes of the majority of the poor located in rural areas, except through rural urban migration which is likely to speed up in the future. Figure 5 illustrates the potential impact on poverty reduction of different levels and patterns of growth in Vietnam. Four different scenarios are shown:

1. A base case projection assuming annual GDP growth rate of 5 percent and no change in the pattern of growth across regions;

2. A higher growth scenario based upon the CPRGS target of doubling real GDP by 2010 (requiring a real GDP growth rate of 7.5 percent till 2005 and 7 per cent till 2010); 3. An even growth scenario where all regions and locations (rural and urban) grow at the same rate (the 5 percent assumed in the base case scenario); and 4. A more uneven regional growth rate (5 percent overall), where the relative growth rates between the regions are based upon each region’s share of new enterprise registrations in 2000.

The final scenario sees the South East and the Red River Delta regions (incorporating Ho Chi Minh City and Hanoi City) experience the fastest growth and could be interpreted as a ‘growth pole’ scenario, whereby the majority of future growth is concentrated in two or three key regions.

Figure 5. Poverty reduction projections under different growth scenarios <!-- Start of picture text --> Projected general poverty reduction<br>38 ————_—_——_—--A ---~—<AnrsyYv— oO<br>°<br>@ 30<br>pany2 os —SSS 8<br>3 is)<br>= 20<br>~£ ===—-Uneven regional growth Sel<br>3 1S Base case =m 14<br>oa = TM Higher growth<br>10 a OS a, a i es a a |<br>2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010<br><!-- End of picture text -->

Source: World Bank (2002a).

Not surprisingly, achieving a higher growth rate will lift more people out of poverty. But the importance of ensuring that the benefits of growth are distributed widely are also highlighted with the even growth scenario — 5 percent real GDP growth distributed evenly across the population can achieve greater reductions in poverty than a higher growth rate (7 per cent) distributed unevenly across the population 14
(Figure 5). Distributing the growth less equally (relative to the base case) results in slower poverty reduction, roughly equivalent to reducing the overall GDP growth rate by 1.5 percentage points.

Implications for the Vietnam’s development targets. Based upon the projections it is clear that reducing the poverty rate by 40 percent will require either:

- e Growth of at least 7.5 per cent annually (in line with the targets set out by the SEDS and the CPRGS); or

- e Significant improvements in the sharing of the benefits of growth across regions, particularly in areas where there are high levels of poverty; or

- e Acombination of high growth and a more even distribution of growth.

To stimulate balanced growth in a decentralised system like Vietnam’s, the central government’s role is to ensure that the national investment framework is favorable, the barriers to movement of goods, capital and labor across provinces are minimal and that intergovernmental fiscal arrangements provide sufficient support to the poorer provinces. The central government can also help by facilitating capacity building measures for provinces to create a good business environment and by holding the provincial governments accountable for developing such an environment. This will be instrumental in bringing the provinces into mainstream development. It is also important that poorer provinces take steps to create a better climate for private domestic and foreign investment and to allocate public funds to redress the severest physical and social infrastructure deficits in their provinces.

# Goal Two: Achieve Better Education for All

## Achievements

By signing the Millennium Declaration, the Government of Vietnam has committed itself to achieving universal completion of primary education by 2015. This MDG includes three indicators: net enrolment rate in primary education, the literacy rate of 15-24 year olds, and the proportion of pupils completing grade 5. The conferences on Education for All (EFA) have set out additional goals including some that focus more explicitly on the quality of education, the achievement of learning outcomes and the need for free and compulsory primary education.

Access to education - In Vietnam net enrolment in primary education stands at 91 percent in 1998 —a very positive outlier by low-income country standards. Another successful outcome is youth illiteracy rates — these are not only much lower than the average for low-income countries, but are also lower than in neighbouring countries, even those with higher incomes (Figure 6).

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Figure 6. Mliteracy Rate of 15-24 year-olds im Selected Countries, 1999 <!-- Start of picture text --> : OMale<br>Youth Illiteracy by Sex, 1999 Female<br>50<br>40 &<br>x 35 t |<br>220 Pa :<br>4) ‘7] . Qe Kd<br>Lv a * © se<br>Bs)<br><!-- End of picture text -->

Source: DFID (2002) By this the Government has shown what can be achieved by prioritizing social sector investments. During the 1990s, primary enrolment rates in Vietnam improved for all expenditure groups and in all regions, for both the majority population and ethnic minority groups, and for both sexes. It is recognized, however, that the high enrolment rates for both girls and boys mask significant challenges in addressing disparities (socio-economic and geographic) in access, coverage and participation in education. For example, though the gap between the richest and poorest expenditure quintiles is closing, the net enrolment rate for the lowest income quintile is still 14 percentage points below the rate for the highest quintile (Figure 7).

Figure 7. Trends im Primary Net Enrolment Rates, 1993-1998, by imcome quintile <!-- Start of picture text --> Primary Net Enrolment Rates, 1993-1998 i1998<br>120<br>1005 g7_91 87 91 95 74 96 96i96<br>__ ae 82 ae * aa ES<br>40; | se Be ae ae o ae<br>204 |aa ‘2 a. = . =<br>Vietnam I H suet IV Vv<br>Income Quintile<br><!-- End of picture text -->

Source: DFID (2002) 16
Providing quality education - The successes in enrolment also sit beside deficiencies in quality: While primary school enrolment rate is high, many children do not stay in school to reach grade five: approximately one third of children that enrol do not complete primary education. This outcome is much worse than the average for East Asia and most of the neighboring countries (Figure 8) and represents a large waste of talent and resources.

Figure 8. Primary Completion Rates for selected countries and region, 1997 <!-- Start of picture text --> Primary Completion Rates, 1997 BMale<br>100 @ Female<br>70 aa | ot i at ae<br>0 Z Co: : ;<br>. ra &“ oe 2Y &Ro<br>NS 3° ye ea<br>x<br>Source: DFID (2002)<br>And even when they do complete primary school, students will have received<br>international norm for annual annual teaching/ learning time time (about 900-1000 hours), less than half the number of<br>tuition hours a child completing primary school in Sri Lanka would have had and only 40 40<br>number of hours a child of hours a child hours a child a child child in Thailand would have enjoyed (Table would have enjoyed (Table have enjoyed (Table enjoyed (Table (Table 3).<br>Table 3. The Duration of Primary Schooling in sclected countries, 2001<br>a<br>Hours per day (average) 3 | 6 | lc<br>Vos<br>otal hours per year 1200 1200<br>Hours per cycle 2887 7200 6000<br><!-- End of picture text -->

And even when they do complete primary school, students will have received approximately half the international norm for annual annual teaching/ learning time time (about 900-1000 hours), less than half the number of tuition hours a child completing primary school in Sri Lanka would have had and only 40 40 percent of the number of hours a child of hours a child hours a child a child child in Thailand would have enjoyed (Table would have enjoyed (Table have enjoyed (Table enjoyed (Table (Table 3).

Source: DFID (2002)

# Targets andfuture challenges

The proposed national goals and targets for the education sector as presented in the CPRGS reflect the challenges ahead in universalising primary education and ensuring that the quality of teaching and learning outcomes is improved, especially for the poor (Box 3).

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Box 3. MDG Goal Two: Achieve Better Education for All Vietnam Development Goal: Universalize education and improve education quality Target 1: Increase the net enrolment in primary school to 97 percent in 2005 and to 99 percent in 2010 Target 2: Increase net enrolment rate in junior secondary school to 80 percent in 2005 and 90 percent by 2010 Target 3: Eliminate the gender gap in primary and secondary education by 2005, and the gap with ethnic minorities in 2010 Target 4: Increase literacy to 95 percent of under-40-year-old women by 2005 and 100 percent by 2010 Target 5: By 2010 have improved the quality of education and increase full-day schooling at primary level (exact target depends on funding).

Source: Socialist Republic of Vietnam (2002) There are a number of reasons for children not being in school. There is considerable evidence that the key factor revolves around affordability: even when exempted from paying tuition fees, poor families often cannot afford the other costs associated with sending children to school. Additional causes of not being in school are lack of access to a school or the poor quality of education on offer that discourages parents from sending their children to primary school. But there are also crucial issues on the ‘demand’ side of education: for the poorest households, education may be a lower priority than basic survival, and children may need to work to contribute to household income or contribute to unpaid labour such as housework.

The goal and targets imply the need for a strategic focus within the education sector on important shortcomings. To achieve the targets, 1.6 million primary school-aged children -- currently out of primary school (1 million of them from the lowest two expenditure quintiles) -- will have to be included in mainstream education.

Three key challenges remain in relation to basic education: the elimination of socio-economic and geographic disparities, the expansion of basic education to meet the international targets of universal primary education, and the need to improve the quality of teaching and learning outcomes.

Eliminating disparities - Those children least likely to be at school — those in the lowest quintiles, those in the central highlands, northern uplands, central coast and Mekong Delta regions, and ethnic minority children will have to be particularly targeted. This will need to include measures accompanied by additional resources to reduce and eventually eliminate the direct costs of school attendance borne by poor families such as user charges. Enhancing school enrolment of ethnic minority children will also require the provision of education in their mother tongue at least as part of kindergarten-based school readiness programmes. Ethnic minority girls are often particularly disadvantaged due to a tradition of early marriage, in combination with late enrolment in grade one. Efforts to encourage school attendance by this sub-group will need to accommodate such cultural challenges.

Expanding basic education - Achieving universal primary education and providing free or affordable full-day schooling to all is clearly a formidable challenge. The current level of provision relies heavily on parental and community support. The government aims at increasing the percentage of students with full day schooling to 70%. This would require substantial additional resources on a recurrent basis. It is important that this does not lead to an increase in the private costs of education, which are already high for poor households. The most feasible initial option is better targeting of limited resources to enable all children who either do not attend or who do not complete primary education to benefit from half-day 18
schooling. This could then be gradually extended, through effectively targeted programmes, to facilitate the development of affordable full day basic education for all (DFID, 2002).

Raising and equalizing the quality of learning outcomes across regions and population subgroups will demand a full range of measures. The international education goals do not define specific quantifiable indicators of education quality, student performance or learning outcomes. Quality monitoring is a difficult task and most education authorities turn to input indicators such as the number of teachers or textbooks. The MDGs use literacy as a proxy indicator for educational performance but this suffers from a lack of a clear internationally agreed definition and testing measure. Reliable and scientific methods of measuring education outcomes exists in the form of ‘criterion reference tests’ and Vietnam is one of the few countries that has started to build national capacity in these techniques. A nationally representative sample survey of 70,000 grade five pupils was recently implemented that assessed learning outcomes by testing various dimensions of reading and mathematics. This will help in identifying which actions are paramount in addressing quality deficiencies. Among measures currently under consideration by MOET are: the extension of the instruction time to full-day education; reforming the curricula and teaching methods; upgrading facilities; strengthening education management; professional development for teachers; establishing education and training facilities of international standard; and, expanding the use of information technology.

# Goal Three: Reach gender equality and empower women

## Achievements

Gender equality in education - Vietnam performs well relative to countries of comparable income levels on many indicators of gender equality and this applies to the four internationally-agreed gender equality indicators. Data from the 1998 VLSS survey shows that there is little difference between male and female enrolment in primary, lower secondary and upper secondary school. (Figure 9). Vietnam performs well in comparison with low income country averages in this respect and this success is reflected in a genderbalanced youth illiteracy rate (see education goal). Gender differences in access to education are far more pronounced, however, in some ethnic minority areas and for the lowest quintile of the population.

Figure 9. Girls as a percentage of boys in primary and lower secondary education: Levels in 199398 and targets for 2005 <!-- Start of picture text --> 120 -<br>100, . =u = = = .<br>,<br>60 kg<br>|<br>40<br>20<br>; .<br>1993 1998 2005<br><!-- End of picture text -->

Source: DFID (2002) 19
Participation in wage employment -- Most men and women in Vietnam work as self-employed farmers. In 1998, 24 percent of men and 15 percent of women worked for wages anda still smaller proportion (20 percent of men and 10 percent of women) worked for wages in the non-agricultural sector. The National Strategy for the Advancement of Women to 2010 sets targets for women’s access to new jobs in the formal sector: the objectives specify that by 2005, 40 percent of new jobs in the formal sector will be taken by women and by 2010, 50 percent of new jobs should go to women. In 1998, women earned an average wage that was 87 percent of the male average wage. It will be important, as the formal sector grows, to ensure that women have the skills to compete for the better paid jobs as well as the lowerpaying service jobs (where they currently dominate).

## Targets andfuture challenges

## Box 4.

# MDG Goal Three: Reach Gender Equality and Empower Women

# Vietnam Development Goal: Ensure gender equality and empower women

Target 1: Increase the number of women in elective bodies at ail levels.

Target 2: Increase the participation of women in agencies and sectors [includes ministries, central agencies and enterprises] at all levels by 3-5 percent in the next 10 years. Target 3: Ensure that the names of both husband and wife appears on the land-use right certificates by 2005 Target 4: Reduce the vulnerability of women to domestic violence.

(Targets to improve equality in education are included in the education goal — which emphasizes universality of access to primary and lower secondary school) Source: Socialist Republic of Vietnam 2000 and Government of Vietnam (2001).

Representation in decisionmaking - Elections were held in 2002 to elect deputies to serve in the National Assembly for the next five years. Over one quarter (27 percent) of the newly-elected National Assembly deputies are women. Though this fell short of the target level of 30 percent, this still represents a slight increase of the last five-year term of the National Assembly (26 percent) which in turn was an increase over the previous term (18 percent). This level of female representation in national legislative bodies is high by Asian standards (comparing with 20 percent in China, 11 percent in the Philippines, 9 percent in Laos and 6 percent in Cambodia) but is less impressive at sub-national levels. The Government has set ambitious targets for the representation of women in political and government bodies over the coming decade. If met, this would see:

- © 15 percent of party committee members elected during the term of the 10 National Congress will be women;

- © 33 percent of National Assembly delegates during the 12" Legislature (2007-2012) will be women; and,

- © 28 percent of city/provincial People’s Councils members will be women in the 2004-2009 term (23 percent at district level).

In addition to specifying targets for these core areas covered by the gender equality MDG, the Government has set out a number of other important ways in which gender equality will be pursued. The National Commission for the Advancement of Women and the Women’s Union provided substantial input into the drafting of the CPRGS, which involved consulting women National Assembly delegates as well as Women’s Union members at local level. This input is reflected in a strong agenda for gender 20
, equality, which includes separate targets where gender concerns are pressing (for example, facilitating legal asset ownership) as well as mainstreaming gender equality across the various sectors.

Ensuring equality in legal ownership of assets - The CPRGS sets explicit targets for improving legal ownership of key assets (especially land) for women. This specifies that all land use certificates will be issued in the names of both men and women (rather than just the male household head) by 2005. This will be important in allowing women access to financial services as well as giving them greater security in case of the death of their husbands, separation or divorce.

Addressing and monitoring gender-based violence - Setting quantitative indicators for the reduction in gender-based and domestic violence is extremely hard. The actions to tackle violence against women outlined in the national strategy for the advancement of women revolve around bringing greater clarity to the legal framework. Indeed, they are part of a goal to improve the gender sensitivity of the legal framework rather than part of a goal against violence. International experience suggests that these actions will need to be supplemented by a more comprehensive package of measures that involve generating attitudinal changes as well as adjusting legal instruments. If these measures are successful, one might reasonably expect an increase in number of reported incidents of gender-based violence as the problem is addressed in a more open manner before the incidence starts to decline. There is, as yet, no reported baseline for the incidence of domestic or gender-based violence in Vietnam — nor are there any good proxy indicators which are readily available or collected. This should be addressed as part of a monitoring system that seeks to measure progress in gender equity.

# Goal Four: Reduce Child Mortality

This section will first discuss achievements, and targets and challenges related to reducing infant and child mortality, and will subsequently focus on reducing child malnutrition. It has been necessary to use a variety of data sources to illustrate the various dimensions of the challenges confronting the health sector and to examine both trends over time and issues of regional and socioeconomic inequality. This means that unfortunately different numbers for the same indicator appear throughout this section. This is illustrative of the problems of data quality — especially for infant, child and maternal mortality — within the health sector®.

## Infant and child mortality: achievements to date

Rapid declines in infant mortality - The infant mortality rate in Vietnam has declined at a remarkable rate by international standards — more than a fifth per decade over the last thirty years. Between 1990 and 1998, the infant mortality rate (IMR) declined from 44 per 1000 to 37 per 1000, while the under-5 child mortality (USMR) declined from 58 to 48 per 1000. This represents a decline of about 17 percent in both indicators. Despite starting from an already low base, Vietnam’s achievements in the 1990s compare favourably with those of other countries in the region. As shown in Table 4, the rate of decline in IMR in Vietnam has been greater than the average rate of decline in the East Asia and Pacific region in South Asia and in all low and middle-income countries.

_ This reduction is less dramatic for the USMR: it is lower than the average rate of decline in the East Asia and Pacific region, which is due to the already low base in 1990 (Table 4).

> ° For example, the VLSS data of 1998 show an infant mortality rate (IMR) of 26.9 per 1000 live births, while the 1999 census gives a figure of 35.6 per 1000.

21
<!-- Start of picture text --> / Vable 4: Decline in Infant and Child Mortality: International Comparison<br><!-- End of picture text -->

|l<br>|Rate ofDecline(1<br>|990-98)<br>|
|---|---|---|
|Region||MR|<sup>USM</sup>|
|Lowandmiddleincomecountries|<br>10.6||66||

# Source: ADB and WHO (2001)

This recent progress gives Vietnam an impressively low starting point (by international comparisons) for infant and child mortality. If Vietnam followed a pattern more typical of Asia, it would have an IMR approximately double its current level, given current per capita income levels. Given these low starting points, achieving the MDG — which calls for a two-thirds reduction in the infant and child mortality rates between 1990 and 2015 — is unrealistic.

But regional differences persist- The impressive national averages of infant and child mortality in Vietnam conceal wide variations at the regional levels. For example, the national average infant mortality rate is more than two and half times the rates observed in Red River Delta and Southeast region. The IMR in rural areas is about 150 percent greater than that in urban areas. In general, these indicators are high in the Central Highlands and Northern Uplands, closely followed by the North Central and Central Coastal regions. These significant differences in child and infant mortality reflect the large regional disparities in socio-economic levels and access to health services.

As Table 5 shows, it is more alarming that these regional disparities have increased. In the 1990s, infant mortality declined in urban areas by 32 percent, while rural areas experienced less than half of that rate of decline. In 1990, the rural IMR was about 80 percent greater than that in urban areas. This differential has grown to about 125 percent in 1998. These increasing inequities have serious implications for policy and need urgent attention.

22
Table 5: Infant Mortality Decline by Region, 1990-98 <!-- Start of picture text --> —SsC=“~*~*é~iSC‘“‘CSSC*‘LSOUOCO<br>fen<br>Red River Delta 35 27<br>North Central 38 37<br>i<br>a<br>——Ss=“‘*‘“‘*S*S*srSC~“‘CNTMTMTM~C*dP<br>Rint COS<br>Cd<br>[vetewsSSSSC“‘ir :<br><!-- End of picture text -->

# Source: 1990: GSO (1995), 1998: GSO (2000)

Other notable features of the decline in infant mortality in the 1990s are (i) remarkable decline in infant mortality in the Northern Uplands and (ii) lack of relative progress in the three central regions: North Central, Central Coastal and Central Highlands. The Northern Uplands, one of the poorest regions, has shown an impressive decline in infant mortality. These changes represent the highest rate of decline in the country. This shows that large improvements in infant and child health are possible even in poor and remote areas. Analytical work in Vietnam has showna positive relationship between the reach of child health services and reductions in child mortality. Reduction in infant mortality and the improvements in areas like the Northern mountains can probably be largely attributed to better provision of health services including immunization services. Greater targeting of the central provinces to increase access to health services and improve quality of life appears essential.

Less progress for the poor - Declines in IMR among poor households have been considerably lower than those among the non-poor (Table 6).

Table 6: Infant Mortality Decline by Poverty Status, 1990-98 <!-- Start of picture text --> IMR<br>VLSS 1992-93 VLSS 1997-98 % Change<br><!-- End of picture text --> Source: VLSS 1993 and 1998; Note: the VLSSs show much lower IMRs than the census.

23
These findings were confirmed by Wagstaff and Nguyet Nga (2002) who conclude that the impressive gains in child survival in Vietnam have been concentrated heavily among the better off, leading to increased socio-economic inequalities. They identify poorer coverage of health services and in lower educational levels of women as among the causes of this differential decline in child mortality between the poor and non-poor.

## Infant and child mortality: Targets andfuture challenges

# Box Sa. MDG Goal Four: Reduce Child Mortality by Ovo thirds by 2015

## Vietnam Development Goal: reduce child mortality, child malnutrition and reduce the birth rate

Target 1: Reduce the infant mortality rate to 30 per 1000 live births by 2005 and 25 by 2010 and at a more rapid rate in disadvantaged regions (see below) Target 2: Reduce the under-5 mortality rate to 36 per 1000 live births by 2005 and 32 by 2010 Source: Socialist Republic of Vietnam (2002) National targets for reductions in mortality rates are less ambitious than the MDGs. These are set down in the ten-year health strategy and included in the CPRGS as a core outcome targets. These targets specify that the IMR will fall to 25 per 1000 live births and the USMR to 32 per 1000 live births, representing a decline of 44 percent in both rates over the 1990-2010 period. They are also more realistic, however, than the MDGs, and achievable if there is a stronger focus than hitherto on regions where mortality figures are highest (Wagstaff and Nga Nguyet Nguyen, 2002). Projections demonstrate that both rates will have to reduce more rapidly over the coming decade than in the past if national goals are to be achieved (Figures 10 and 11).

## Figure 10. Infant Mortality — progress made during 1990-1998 and projections for 2010 and 2015

<!-- Start of picture text --> lee<br>45 teat<br>oe<br>0<br>1990 1998 2010 2015<br><!-- End of picture text --> Source: ADB (2002a) 24
Figure 11. Under 5 Mortality — progress made during 1990-1998 and projections for 2010 and 2015 <!-- Start of picture text --> os<br>Pol<br>2 40<br>ey eee<br>= 30<br>ps<br>0<br>1990 1998 2010 2015<br><!-- End of picture text --> Source: ADB (2002a) A need for sub-national targets - Analysis shows a positive relationship between infant mortality and poverty: infants have a lower chance of survival in poor provinces. Reaching goals will depend crucially on making rapid progress among the poorest 25 percent (Wagstaff and Nga Nguyet Nguyen, 2002) and in the most disadvantaged areas. These regional disparities in mortality rates suggests that there is scope for setting more ambitious targets, in line with the MDGs, for these areas (especially the central highlands and the northern mountains) (Table 7).

Tahle 7: Progress and projections for Mortality Indicators for Disadvantaged Areas.

|IMR<br>|[1990 <br>|2005<br><br>|2010|<br><br>|2015 <br>|atestValue|
|---|---|---|---|---|---|
|Northern|<br>f|<br><br>|<br>t<br>t|<br>t||
|Uplands<br>||||21|44 (1998)<br>|
|CentralHighlands|||||64(1998)|
|<br>Percentofunderweightchildren (0-59months) <br>|P|<br>||P|o<br>|<br>ff<br>|
|NorthernUplands<br>||. |<br>|35<br><br>||25<br><br>|41 (1997)<br>|
|CentralHighlands|f--[|3<br>|5<br>30|[25<br>|420997|

# Source: ADB and WHO (2001).

The Government of Vietnam is highly committed to reducing infant and child mortality. Given the competing demands for scarce resources in the country, focus over the coming decade should emphasize a 25
; few strategic areas. Improving access to maternal and child health services and changing health-seeking behaviour are two particularly important measures.

Access and quality of maternal and child health services im remote areas - Vietnam has an extensive health care delivery network with a large supply of health workers and well-organized national public health programs. However, the quality and use of service in poor and remote areas is low. In remote areas, where the density of population is low and it is not feasible to provide institution-based quality services, the government should consider providing round-the-year services through strengthened outreach, health posts, mobile teams and intensive campaigns. The poor provinces in the central and northern part of the country require special attention.

Tackling demand side issues - Children of poor women with low levels of education are more likely to die prematurely. These are the women who have lower demand for reproductive and child health services. Culturally sensitive communication activities will be required to generate better demand for reproductive and child health services. In addition, one of the major demand side constraints for utilization of child health services for poor households is the affordability of services. There is an urgent need to rationalize the health financing structure and make it more equitable. The Government needs to allocate more resources to improve the affordability of health services for the poor. There is a clear commitment to addressing this pressing need in the CPRGS.

# Malnutrition: achievements to date

Child malnutrition is still high - Unlike many other health outcome indicators where Vietnam outperforms expectations for its per capita income levels, child mainutrition levels remain one of the highest in the region: in 2000, one third of children under the age of five were underweight. Despite the good progress in recent years, Vietnam still has one of the highest rates of child malnutrition in the region. As shown in Table 8, the country lags behind many other developing countries and East Asia and Pacific countries. Even the latest figures at the end of the last decade do not compare favorably with other countries. Only countries in South Asia have performed consistently worse than Vietnam.

Table 8: Malnutrition - International Comparison

||PercentofUnderweightChildren (0-5 years)|
|---|---|
|Country|(period 1993 -2000)|
||a|

# Source: World Bank (2002c)

But, the current rate of malnutrition has to be viewed in the context of even higher levels in the recent past. In fact, there has been a remarkable decline in the prevalence of malnutrition in the last decade. Prevalence of malnutrition has come down from 52 percent in 1985 to 45 percent in 1995, 37 percent in 1999 and 33 percent in 2000.

26
.

## Malnutrition: Targets and challenges

# Box Sb. MDG Goal Four: Reduce Child Mortality by two thirds by 2015

{ Vietnam Development Goal: reduce child mortality, child malnutrition and reduce the birth rate Target: Reduce under five malnutrition to 25 percent by 2005 and 20 percent by 2010 Source: Socialist Republic of Vietnam (2002) Ambitious targets are set - In addition to the two targets for mortality rates, it is proposed that the child malnutrition indicator — often included as an indicator under poverty targets — be identified as an important strategic target for the next decade within the health sector. Efforts for improving nutrition will directly help in achieving the targets for infant and child mortality. The National Nutrition Strategy 20012010 puts significant focus on improving the nutritional status of the Vietnamese population, particularly, that of children and mothers and ethnic minority groups. The Government of Vietnam’s own national goals for reducing malnutrition, which imply a reduction of child malnutrition levels of 60 percent between 1990 and 2010, are more ambitious than the MDGs, which call for a halving of malnutrition between 1990 and 2015 (Figure 12). Projections suggest that these ambitious rates will be achievable if the rapid rates of decline over the 1990’s continue.

Figure 12. Malnutrition: progress made during 1990-1998 and projections for 2010 and 2015 <!-- Start of picture text --> 50Pe<br>= 30 = ;<br>5 ‘ . : ~ — ay '<br>s ‘ — — ;<br>10 —+ ——<br>1990 2000 2010 2015<br><!-- End of picture text --> Source: ADB and WHO (2002) Poverty reduction alone will not solve the malnutrition problem - In Vietnam, increased income and health services coverage—the factors contributing to the declines in infant and child mortality and improvements in reproductive health—have not operated to reduce child malnutrition. The VLSS93 and VLSS98 generally show only weak relationships between consumption expenditure and malnutrition indicators (Glewwe, Koch and Bui Linh Nguyen 2001). This implies that other factors such as feeding and childcare practices have a more dominant effect and addressing these factors as well as the use of safe water and sanitation will be important.

Malnutrition varies quite considerably across regions. However, the variation is not as large as in the case of other health sector indicators, such as infant mortality and access to reproductive health services. Even 27
<!-- Start of picture text --> Box 6. MDG Goal Five: Improve Maternal Health (reduce<br><!-- End of picture text --> <!-- Start of picture text --> MMR by three fourths by 2015) |<br><!-- End of picture text -->

Vietnam Development Goal: Improve maternal health Target 1: Reduce the maternal mortality rate to 80 per 100,000 live births by 2005 and 70 by 2010 with particular attention to disadvantaged areas Source: Socialist Republic of Vietnam (2002).

Faster progress in access to alternative means of contraception is required. Analysis by the Ministry of Health shows that 53 percent of maternal mortality is preventable and an additional 35 percent of maternal mortality could be averted through timely intervention. 70 percent of maternal mortality is believed to be caused by obstetric complications and unsafe abortions. Vietnam has the highest abortion rate in the world with the Ministry of Health estimating a total abortion rate per woman of 2.5. This high rate poses a significant health risk to women, with one third of women reporting a health problem following a pregnancy termination (World Bank et al, 2001). Though the Contraceptive Prevalence Rate has increased by 2 percent per annum over the past 10 years, measures are clearly still needed to provide better access to alternative means of contraception (see Figure 13).

Figure 13. Maternal mortality — progress made during 1990-1998 and projections for 2010 and 2015 <!-- Start of picture text --> 200<br>ay<br>100wa” 1 ‘ , 100 ' - id '.<br>fl ad “<br>|<br>50<br>1990 1999 2010 2015<br><!-- End of picture text -->

Source: ADB and WHO (2002) Major challenges exist for achieving the remaining targets. The percentage of births attended by trained personnel has been rising. National reproductive health targets (not stated explicitly in the CPRGS but included in the Government’s reproductive health strategy) state that 90 percent of births will be attended by 2010 (up from 77 percent in 1997). Forecasts based on past trends suggest that this could be achievable and would put Vietnam on course to cover all births by 2015. The major challenges in achieving these targets are four fold. First, improving access and quality of reproductive health services in remote areas; secondly, initiating culturally compatible communication activities, targeting both men and women, to generate a better demand for reproductive health services; thirdly, making reproductive health 29
services more affordable for the poor; and fourthly, strengthening emergency services and equipping hospitals in remote areas with skilled personnel and equipment (ADB and WHO, 2002).

# Goal Six: Combat HIV/AIDs, malaria ancl communicable diseases

## Achievements

HIV/AIDS prevalence is low but rising fast. HIV/AIDS has spread to all 61 provinces since 1990 when the first case was detected in Vietnam. Between 1990 and 2000 the number of reported HIV/AIDS cases rose at 7 percent per annum. WHO estimates that by the end of 2000, the number of HIV infected people in the 15-49 years old population was between 122,000 and 130,000 or around 0.29% (WHO, 2001). At the early stages of the epidemic the disease was confined mainly to injecting drug users. However, it has now spread to other population groups including sex workers, patients with tuberculosis and the general population. The Government’s policy towards promotion of condoms and safe needles has been ambiguous in Vietnam. In the absence of clear commitment from the Ministry of Health, local authorities have sometimes opposed promotion of condoms and safe needles for HIV/AIDS prevention (ADB and WHO, 2002).

Achievements in controlling malaria and tuberculosis have been spectacular and are perhaps Vietnam’s greatest success stories in improving health outcomes (Box 7)

## Box 7. The successful fight against malaria and Tuberculosis in Vietnam

Malaria - Vietnam is known to have one of the most successful malaria control programs in the world. Malaria incidence has fallen from 16 cases per 1000 persons in 1991 to merely 6 in 1998. At the same time, the number of malaria deaths dropped nearly one tenth of what it was in 1991, with fewer than three deaths out of 10,000 malaria cases. This success followed a radical change of approach in 1991, when Vietnam moved from a malaria eradication program, which involved DDT spraying and mass drug treatment, to a malaria control approach. This involved distributing impregnated bed nets, which currently protect over 10 million people, house spraying with an insecticide that has a one-year residual effect, distribution of free drugs (including locally produced artemisinin and its derivatives to treat falciparum malaria), and intensive health education of village heads and commune health staff in endemic areas. Key elements to this success have been: ®° High-level political and financial commitment leading to mobilization of activities from the central to the village level, leading to up to 2000 people working in the public sector on malaria control.

- © Offering free drugs and insecticides to the effected population.

- 9 Having an initial vertical structure that followed WHO guidelines for malaria control.

Tuberculosis - Vietnam’s Tuberculosis (TB) control program is also known to be among the most successful in the world. The program currently covers 99% of the population, up from 23% in 1985. The number of pulmonary smear-positive TB cases increased nine-fold from 6600 in 1986 to 55000 in 1998, but this is the result of many cases being undetected and untreated in the past, which are correctly diagnosed and treated today.

Source: World Bank et al (2001) and Schuftan and Le Dinh Cong (2001) 30
# Targets andfuture challenges

Making future projections for the prevalence of HIV/AIDS is methodologically problematic. The spread of HIV/AIDS from vulnerable groups to the general population suggests that the past trend of increasing prevalence is likely to continue for the next few years.

Serious policy changes is required to achieve the HIV/AIDS reduction targets. The Government has articulated its HIV/AIDS strategy for the next five years and the goal proposed here (Box 8) captures the direction outlined in the strategy. Recent work suggests that reaching this goal poses a number of serious institutional, practical and attitudinal challenges (United Nations, 2001). These include a review of the government’s “social evils” policy towards sex workers and injecting drug users. This policy tends to stigmatise these people and treat them as criminals, instead of regarding them as patients that need help. Massive efforts to change behavior, promote the use of condoms and safe needles, and improve treatment of sexually transmitted diseases are required

## Box 8. MDG Goal Six: Combat HIV/AIDS, otialaria and other disease

Vietnam Development Goal: Reduce HIV/AIDS infection and eradicate other major diseases Target 1: slow the increase in the spread of HIV/AIDs by 2005 and halve the rate of increase by 2010. Source: Socialist Republic of Vietnam (2002) Targets for contraceptive prevalence ambitious but achievable - The Government hopes that 70 per cent of couples will be using modern contraceptive methods by 2010, up from an estimated 40 percent in 1990. Recent analysis suggests that this is ambitious but also achievable if past improvements are continued into the next decade. This would set Vietnam on course for achieving “universal” (75 percent) access to modern contraceptive methods by 2015 (Figure 14).

- °

-

## Figure 14. Contraceptive Prevalence Rate (CPR) progress and targets 1990-2015

<!-- Start of picture text --> i ns 7 Be<br>0 eee |<br>CPR|<br>40ee<br>ig<br>nn<br>0<br>1990 2000 2010 2015 -<br>—" Progress made —="="="" Progress needed to meet MDG = = “= National target<br><!-- End of picture text -->

Source: ADB and WHO (2002) 31
Forest cover has increased but forest quality has declined. Unlike most of its neighbours, Vietnam has in all probability stopped the decline in its forested area and the country's total forest coverage also compares favourably with that of almost any other country. However, Vietnam has not been successful in protecting its rich and closed forests and the quality of its forest has deteriorated over time (Figure 15). Vietnam falls short of many other countries in protected area coverage. World-wide, the average country has 6.5 percent of its total land area within protected areas. Vietnam has about 3 percent of its area under protection and no coherent strategy is in place to protect even this small remaining area of highly biodiverse forest.

Figure 15. Trends im the composition of Vietnam's Forest Cover <!-- Start of picture text --> 2= 46 fp. vevsedeufecentvesetetgeepenetesieate footieTeneelesdteeeed<br>————— Fenny RR ai. Renee<br>RE ees | RESy ec sad FA een IR<br>1990 2000<br>O Poor/open/regenerating forests - Classes IIIal, Ia2, Ha, ITb<br>G) Medium quality/partially-closed forest - Class IIIb<br>Rich/closed forest - Class IV<br><!-- End of picture text -->

Source: NEA/ World Bank/ DANIDA (2002).

Marine fish catches are unsustainable. More attention is also needed to the protection of its marine resources. The destruction of Vietnam’s mangrove forest, mainly caused by expansion of shrimp farming, has caused a fast reduction in fish stocks leading to a steep decline in the fish catch per effort (Figure 16), threatening the sustainability of the marine fisheries sector.

Figure 16. Marine catch in Vietnam 1991-2001 <!-- Start of picture text --> 4000000 a CRN - — — 1<br>. j&xccatch per effort (t/H P) . a ‘ Lo.9<br>. —@@Total catch (t . - 0.8<br>3000000 ” a aca : Sa<br>a oe ee a 2<br>2500000 7 | | 7 . — oo - ot ‘Loe<br>2000000 . _ - a, Pe + 0.5<br>1500000 aa an i ; | we) 5 o-4<br>1000000 . ary aan ~ Pp. ee tool OR Dee ' 2 ar)<br>ttt - “ : oo fF 0.2<br>0<br>: nn on one L to<br>1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001<br><!-- End of picture text -->

33
Source: NEA/ World Bank/ DANIDA (2002). Catch is measured in tons (t) and capacity in horse power (HP).

<!-- Start of picture text --> Access to drinking water is crucial for reaching a number of VDGs. Sustainable access to safe<br>drinking water is part of the Government’s traditional emphasis on the role that investments in<br>infrastructure can play in reducing poverty (see below). Infrastructure forms the core of key targeted<br>programs to address poverty and these include the provision of clean drinking water systems and seven<br>other components. In 2000, 56 percent of the population had access to safe water. This is a commendable<br>increase from 48 percent in 1990. However, Vietnam is on the lower end regionally and globally for<br>access to safe water (Figure 17). Progress in this area will be essential for further success in reducing<br>infant and child mortality and malnutrition.<br>Figure 17. Country Comparison of Access to Safe Water, 2000 (percentage of population)<br>Mon<br>7}= nea me me me<br>oy, __ 2 oo 2 se oy my i<br>oo, ____ =a@eieig®®=s& &<br>—EemmnHHREHhHhtihmiim &i<br>y S § £& S§ FSF $F SS SC<br>e a?= ars rdry ws eo& > vA<br>Source: UNDP (2002a)<br>Urban slums have poor infrastructure. The urban poor in Vietnam live in areas with poor<br>infrastructure and the access to basic services (safe water, sanitation, water drainage, electricity,<br>garbage collection) is limited. Most slum dwellers have unstable jobs and unstable incomes and<br>their difficulties in securing permanent registration makes things worse. The VLSS data show an<br>urban poverty rate of 9 percent percent, but this is likely to be an underestimation, as many urban<br>slum dwellers are not registered.<br><!-- End of picture text -->

# Targets andfuture challenges

The CPRGS recognizes the importance of environmental protection for sustainable poverty reduction and growth and proposes a number of key measures. These include strengthening conservation of natural forests and protection of watersheds through the involvement of the people that depend on them for their livelihood, enhancing access of the poor to clean water, and halting urban pollution. To monitor progress towards environmental sustainability, six specific targets are identified (Box 9).

34
# Box 9. MDG Goat Seven: Ensure Environmental Sustainability

<!-- Start of picture text --> i<br><!-- End of picture text -->

## Vietnam Development Goal: Ensure environmental sustainability

Target 1: Extend forest cover to 43 percent by 2010 (from 33 percent in 1999); ‘ Target 2: Ensure that 60 percent of rural population will have access to clean and safe water by 2005 and 85 percent in 2010. This should be the case for 80 percent of urban people in 2005. Target 3: Ensure there are no slums and temporary houses in all towns and cities by 2010 Target 4: Ensure that all waste-water in towns and cities is treated by 2010 Target 5: Ensure that all solid waste is collected and disposed of safely in all towns and cities by 2010 Target 6: Air and water pollution must attain national standards by 2005 Source: Socialist Republic of Vietnam (2002) Challenges for implementing the environmental strategy. The first and biggest challenge for this VDG is implementation of the government’s NSEP. This requires concerted efforts to strengthen capacity in government agencies at the central and local level, creating opportunities for community participation, enforcing laws by expanding the choice of regulatory instruments and incentives, and allocating substantial resources to this plan.

While the first target only refers to extending forest cover, the CPRGS includes two indicators for monitoring forest quality. These are: the area of ‘special-use’ (protection) forest to be preserved, and the biodiversity rate of these protected areas. A weakness in Vietnam is the lack of a reliable system for monitoring forest cover. This could probably be improved by focusing more on quality than quantity and making more use of aerial photography and GIS, and by better coordination of data collection among the different agencies.

The second target aims to reach a safe and clean drinking water coverage of 60 percent of the rural population by 2005 and 85 percent by 2010. Although the institutional, financial and policy environments for this indicator are largely in place, Vietnam is unlikely to meet this goal. From 1990 to 2000, the overall safe water coverage increased 8 percent (from 48 to 56 percent). Even if population growth were zero, to achieve the 2010 level, coverage would have to increase an average of 5 percent each year between 2005 and 2010. Sri Lanka, Nepal and Paraguay were the countries with the greatest increases in access to safe water during the last decade, yet these countries averaged only about 1.7 percent growth in coverage annually.’ Analysis presented in the VDGs background paper shows that a 80 percent coverage in 2015 is probably a more realistic target (UNDP, 2002a). This would still require doubling the current rate of improving access to safe water (from a 0.8 percent to a 1.6 percent net increase per year), but this is more feasible given other countries’ experiences.

Targets 3-5 reflect the due attention given to urban development issues in the CPRGS, which stresses the need to develop policies for urban housing development for the poor, and minimise health risks for the poor by adopting pollution control measures. In the CPRGS the Government announces it will develop a national urban development strategy and this would enable the actions outlined to be addressed in a consistent manner while promoting balanced urban development. The government now acknowledges the problem of social exclusion in the urban areas and the lack of access of unregistered urban migrants to basic services and that labor migration and household registration policies need to be reviewed. This presents an important step forward for addressing the pressing urban poverty issues.

TMwww.oecd.org/dac/indicators 21 August 2001.

35
The sixth specific target focuses on reducing pollution in order to improve the quality of water and air. The Government is in the process of finalizing national standards for air and water quality, and also working towards strengthening the environmental monitoring network.

# Vietnam Development Goals not directly based on the MDGs

A number of the Vietnam Development Goals are not directly based on the MDGs. These either refer to aspects of poverty not well addressed in the MDGs such as vulnerability and governance/ empowerment, or they respond to particular challenges that have emerged in Vietnam such as reducing poverty among ethnic minorities, or reflect the emphasis the Vietnamese government puts on infrastructure development in ‘isolated and difficult’ areas for poverty reduction.

## Goal eight: Reduce vulnerability

Many households are vulnerable to shocks. There is an explicit recognition in the CPRGS that gains in poverty reduction should be sustainable and that non-poor households should be prevented from falling back into poverty and hunger. Many recent quantitative and qualitative studies have emphasized the high levels of vulnerability which even non-poor households face to individual, household and communitylevel shocks. The proximity of non-poor households to the poverty line means that just one episode of ill health for an economically active member of a near-poor household is sufficient to push households into poverty, or even hunger (World Bank et al 1999; World Bank 2002b) (see Figure 18).

Figure 18 Distribution of household well-being relative to poverty line in Viet Nam <!-- Start of picture text --> 15<br>, ~~FoodPoverty poverty line line<br>§<br>g<br>g<br>S<br>i<br>0<br>2500 §000 7600 10000<br>Real per capita expenditure (VND 000s, Jan 1988)<br><!-- End of picture text --> This is the case in many countries and there is a considerable amount of new work on measuring vulnerability to suffering declines in consumption and falling into poverty. In the CPRGS, the Government of Vietnam adopts a specific target for addressing vulnerability which supplements the other poverty reduction targets (Box 10).

36
### Box 10. Goal Fight: Reduce vulnerability

Target 1: Increase the average income of the lowest expenditure quintile to 140 percent of that in 2000 and 190 percent of that in 2010 Target 2: Reduce by half the rate of poor people falling back into poverty due to natural disasters and other risks by 2010

### Source: Socialist Republic of Vietnam (2002).

A broader approach to addressing vulnerability is required - The Government’s traditional approach to reduce vulnerability has been providing social assistance to defined vulnerable groups such as humanitarian support for the aged and disabled, and subsidies for production inputs and transport services. But in the CPRGS the government recognises the importance of additional measures for reducing vulnerability that are related to building the assets of the poor and near-poor households and increasing their ability to manage risk. Some proposed measures to that effect include: improving access to affordable health care, improving access to agricultural extension to help diversify farm incomes; and improved disaster mitigation and response mechanisms. However, to make sufficient progress in reducing vulnerability, the government should take some additional measures such as enhancing access to savings facilities, and fully relax restrictions associated with being a migrant with temporary residential status.

# Goal Nine: Ensure Good Governance for Poverty Reduction

Serious improvements in the area of governance are required. The Government faces pressing, crosscutting governance challenges which will need to be met in order to achieve the desired outcomes. The CPRGS includes some goals for improving governance (Box 11) and elaborates some actions to be undertaken in the areas of public administration reform, the promotion of grassroots democracy and legal reforms.

<!-- Start of picture text --> Box 11, Goal nine: Ensure Good Governance for Poverty Reduction — |<br><!-- End of picture text -->

Target 1: Effectively implement grass-roots democracy Target 2: Ensure budget transparency

## Target 3: Implement legal reform agenda

Source: Socialist Republic of Vietnam (2002) No detailed plan for public administration reform yet exists. A five year Master Program for Public Administration Reform for 2001-2005 has been approved, but a detailed strategy for implementing reforms is yet to be formulated. The CPRGS therefore lacks detail in specifying concrete actions for the next few years. The Government has carried out a legal needs assessment and an action plan is being drawn up. The action plan emphasizes legal needs for the poor and the CPRGS draws on this work to define clear tasks in improving the access of the poor to justice.

Better accountability is required at the local level The Government has articulated its commitment to the implementation of the grassroots democracy decree throughout the country and this is fundamental to ensuring that poor communities are fully involved in planning and resource-allocation decisions at the commune level. Community-level consultations held to discuss with poor communities the draft CPRGS found that these was little implementation of this Decree to date and that there was high demand at the community level for strengthened accountability systems and mechanisms for greater community participation (Shanks and Turk, 2002). Improved performance will require considerable training and 37
information dissemination at the commune level. Mechanisms to monitor progress on a regular basis will also be needed.

The meed for monitoring of public service and actions. Greater participation by poor households will require that more information on a broad range of issues of importance to poor people is more widely available — to poor people and to civil society organizations which work to support them or represent them. Some measurement of information flows and dissemination could be extremely useful in indicating progress towards greater participation. Citizen feedback should be actively sought on public actions and services. In many countries, mechanisms such as scorecards and rankings by households of the quality of public services have provided a powerful tool in reorienting public services to be more useful and relevant to those who use them. These could be used in Vietnam to provide monitoring information on many of the sectors included in the core VDGs and targets set out in this chapter while also giving poor people more influence in the content and nature of public actions.

# Goal Ten: Eradicate poverty and preserve the culture and diversity of ethnic minorities

Ethic minority developments requires special attention across all sectors. There is a cross-cutting regional dimension to the current social and poverty situation in Vietnam and to the challenges for achieving the VDGs, as we have discussed above. This regional dimension is strongly correlated to the presence of ethnic minorities, as many live in some of the most lagging regions. Over 13 percent or about 10 million people in Vietnam belong to an ethnic minority group. Analysis using various criteria has shown that while progress has been made, reduction in poverty for these minority groups has been much slower than the national average.* Between 1993 and 1998, the poverty rate among ethnic minorities reduced from 86 percent to 75 percent, in contrast to a reduction from 54 percent to 31 percent for the Kinh majority.

The CPRGS clearly stipulates that, to achieve the VDGs, special attention will have to be paid to eradicating poverty among the main ethnic minorities. As a result, all CPRGS targets and progress indicators will be broken down by main ethnic group so as to enable close monitoring of the progress made. The CPRGS also identifies a number of special targets and indicators for the main ethnic minority groups to be embedded in the sectoral targets. Such targets refer to closing the gap between ethnic minorities and the rest of the population for each of the sectors. However, some areas cannot be fully addressed within any one sector and deserve special attention. This has led to the following three additional targets (Box 12).

Box 12. Goal Ten: Eradicate Poverty and Preserve the Culture and Diversity of Ethnic Minorities

## Target 1: Preserve and develop the reading and writing ability of ethnic languages

Target 2: Ensure entitlement of individual and collective land-use rights in ethnic minority and mountainous areas Target 3: Increase the proportion of ethnic minority people in authority bodies at various levels Source: Socialist Republic of Vietnam (2002) Pre-school programs in ethnic languages will be important. Educational achievements of ethnic minorities in the past ten years have lagged behind national ones (see for example the analysis by Baulch ® It should be noted that a substantial diversity in development progress exists among these ethnic groups. The Central Highland minorities lag behind most substantially with a level of expenditure that has remained stagnant since 1993. Of its inhabitants, 91 percent live below the poverty line. Of the northern upland minorities, about 73 percent are poor. Separate targets may be warranted for several groups.

38
et al, 2001). Given that many of the ethnic minorities are not fluent in Vietnamese, enhancing school enrolment of ethnic minority children will also require the provision of education in their mother tongue at least as part of kindergarten-based school readiness programmes.

Land use certificates for upland need to reflect local realities. Enhanced living standards of ethnic minorities require a more intensive, diverse and sustainable use of uplands. A key constraint here is land allocation. A recent review points towards the need to speed up land allocation and improve land titling measures for all categories of land that are in line with ethnic community traditions, practices and systems (UNDP, 2002b).

More government staff of ethnic origin is required. Ethnic minority members rarely participate actively in local governance processes for various reasons, and few are employed as government staff. As a consequence, they have little influence over government decisions that affect their lives. To improve this, a further increase in the proportion of government personnel of ethnic origin is required. And far more input from ethnic minority households, and more decentralization in anti-poverty programs is needed than has occurred up to now (see targets on governance).

# Goal Eleven: Ensuring pro-poor infrastructure development

Infrastructure investments are important in Vietnam’s targeted poverty reduction plans, The Government of Vietnam attaches great importance to the role that investments in infrastructure can play in reducing poverty. Infrastructure forms the core of key targeted programs to address poverty — notably the Hunger Eradication and Poverty Reduction program (HEPR) and the national Program for Socioeconomic Development in Communes in Especially Difficult Circumstances (“Program 135”). The Government’s socio-economic development strategy similarly emphasizes the role of pro-poor infrastructure development. Infrastructure is usually regarded more as an input than an outcome in its own right. Investment in schools is a means to achieving better education outcomes. Investment in rural transport is a tool for opening up remote areas to markets and social services and so is a means for achieving poverty reduction and better social outcomes. But given the importance of infrastructure in Government’s own strategic plans and given the level of resources allocated to infrastructure, it is appropriate that the expected impact of infrastructure development be specified and formulated into a national goal with explicit targets (Box 13). Box 13. Goal Eleven: Provide basic infrastructure services to disadvantaged groups Target 1: Provide basic infrastructure to 80 percent ofpoor communes by 2005 and 100 percent by 2010 Target 2: Expand the national ‘transmission grid to 900 poor commune centers by 2005 Source: Socialist Republic of Vietnam (2002). “Essential infrastructure” in the goal and target refers to the eight components included in Program 135: basic road access, schools, health centres, clean drinking water systems, electrification, markets, post offices, and irrigation. Identifying the proportion of communes with access to these facilities and services will form the foundation of regular monitoring and serve as intermediate indicators. Gauging the impact of infrastructure on changes in welfare of poor individuals or poor communities will be important. In addition, some kind of mechanism to include citizen feedback on the quality and relevance of infrastructure and infrastructure services could be very valuable. Affordability is likely to arise as an issue and prioritization should be guided by consultation with the local beneficiaries at the commune levels, so as to meet local needs and increase the awareness for operation and maintenance responsibilities.

39
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- Baulch, Bob, Truong Thi Kim Chuyen, Domonique Haughton and Jonathan Haughton (2001). Ethnic minority development in Vietnam: a socio-economic perspective. Draft.

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- Swinkels, Rob and Carrie Turk (2002). Localising the MDGs: Vietnam case study. Training paper for ‘Attacking Poverty’ course. PREM, World Bank, Washington DC.

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<!-- Start of picture text --> Vietnam Development Goals (VDGs)/Millennium Dev. Goals (MDGs) background papers<br><!-- End of picture text -->

|(allavailableat:www.vdic.org.vn)|
|---|

- Asian Development Bank (2002). Localising MDGs for poverty reduction in Vietnam: Ensuring good governance for poverty reduction. Strategies for achieving the Vietnam Development Goals.

- Asian Development Bank and World Health Organization (2002). Localising MDGs for Poverty Reduction in Vietnam: Improving health status and reducing inequalities. Strategies for achieving the Vietnam Development Goals.

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- United Nations Development Program (2002a). Localising MDGs for Poverty Reduction in Vietnam: Ensuring environmental sustainability. Strategies for achieving the Vietnam Development Goals.

- United Nations Development Program (2002b). Localising MDGs for Poverty Reduction in Vietnam: Promoting ethnic minority development. Strategies for achieving the Vietnam Development Goals.

- World Bank (2002a). Localising MDGs for Poverty Reduction in Vietnam: Eradicating poverty and hunger. Strategies for achieving the Vietnam Development Goals.

- World Bank (2002b). Localising MDGs for Poverty Reduction in Vietnam: Reducing vulnerability and providing social protection. Strategies for achieving the Vietnam Development Goals.

- World Bank (2002b). Summary of the eight papers on Localising MDGs for Poverty Reduction in Vietnam: Achieving the Vietmam Development Goals: an Overview ofProgress and Challenges. Strategies for achieving the Vietnam Development Goals.

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