Appropriate solutions are needed to maintain replacement fertility levels.

NDO - The national fertility rate is trending down below the replacement level, from 2.11 children/woman (2021) to 2.01 children/woman (2022), to 1.96 children/woman (2023), and is estimated to be 1.91 children/woman in 2024, the lowest level in history and is forecast to continue to decrease in the following years.

Regional fertility gap

The estimated total fertility rate in 2024 is 1.91 children/woman (down 0.05 children/woman compared to 2023), not reaching the 2024 plan target of 2.1 children/woman.

In 2024, the fertility rate in urban areas (estimated at 1.67 children/woman) and rural areas (estimated at 2.08 children/woman) will continue to be below the replacement level. In the past two decades, the trend of low and very low fertility has been concentrated in urban areas, where socio-economic conditions are developed and urbanization is high.

There is a significant difference in fertility rates between regions and groups, and fertility rates are still high in localities with difficult socio-economic conditions. The Northern Midlands and Mountains (estimated at 2.34 children per woman) and the Central Highlands (estimated at 2.24 children per woman) are still the two regions with high fertility rates. The remaining four socio-economic regions have fertility rates around the replacement level or low fertility rates. Of which, the Southeast is still the region with the lowest fertility rate in the country (estimated at 1.48 children per woman).

In the group of 9 provinces in the replacement fertility zone, 7/9 provinces have fertility rates continuing to fall below the replacement fertility level.

In the group of 21 provinces in the low fertility region, 13/21 provinces have a fertility rate that continues to fall below the replacement level. In the low fertility provinces, there are not many policies or intervention models to encourage people to have two children.

Policies to support and encourage people to have two children and intervention models to increase birth rates are in the process of being developed, proposed and piloted, so they are not strong enough to increase birth rates in provinces and cities in this region.

In the group of 33 provinces in the high fertility region, 10/33 provinces have seen their fertility rates fall below replacement levels. In high fertility provinces, support for promoting the use of contraceptives is limited, and in some places, local budgets only guarantee free contraception for poor and near-poor households and social protection.

The fertility rate has fallen below the replacement level for three consecutive years and will continue to fall in the coming time if there are no appropriate measures and solutions.

Many policies encourage childbirth and maintain replacement fertility.

On December 11, 2024, Ho Chi Minh City issued Resolution No. 40/2024/NQ-HDND on reward and support policies for collectives and individuals who perform well in population work.

Accordingly, the policy supports 3 million VND for women who give birth to two children before the age of 35 in the city and 2 million VND for pregnant women and newborns from poor and near-poor households, social protection beneficiaries, and those living in island communes when performing prenatal and newborn screening.

Many competitions, promoting knowledge about population.

Mr. Pham Chanh Trung, Head of the Department of Population and Family Planning of Ho Chi Minh City, said that the City's support of this part of the budget is just one of many solutions to solve the problem of the city's low birth rate. This policy is just the first solution and is partial support for medical expenses when performing pregnancy check-ups, prenatal screening - newborn screening and co-payment of hospital fees after being paid by health insurance.

Ho Chi Minh City has also passed a resolution on tuition-free support for nearly 500,000 secondary school students. It is expected that in the first meeting of the year, it will continue to consider and pass a special resolution on free preschool and high school support for all students in the city.

The city's health sector is also urgently submitting a specific resolution on supporting the cost of pre-marital health examination for all couples registering for marriage and supporting the entire cost of prenatal screening - newborn screening for city residents. All of these are solutions that have been, are being and will continue to be implemented to solve the problem of the city's low birth rate.

In Hai Phong, according to Ms. Tran Thi Thu Hang, Head of the Hai Phong Population Department, after many years of implementation with the efforts of the entire political system and the support of the people, the population work of Hai Phong city in recent years has achieved important results, contributing to the socio-economic development of the city: The natural population growth rate remains below 1%; the replacement fertility rate has been maintained for more than a decade (in 2009 it was 2.16 children/woman, in 2019 it was 2.20 children/woman, in 2023 it was 2.19 children/woman); the size of a family with 2 children is increasingly widely accepted.

"The sex ratio at birth in the city has been gradually controlled; population quality has been improved in many aspects; population services have been expanded, with increasingly high quality; model activities and projects to improve population quality have been widely deployed throughout the city," said Ms. Hang.

Although Hai Phong's birth rate has been maintained at the replacement level for many years, according to Ms. Hang, it is still not stable and has unpredictable fluctuations, especially with a tendency to decrease birth rates. The rate of infertility and sterility is on the rise, the trend of young men and women getting married late and having children late... is an issue for population work in the coming time.

In 2024, the city has allocated nearly 12 billion VND to support policies under Resolution No. 15/2022/NQ-HDND. The whole city has 2 groups and 572 eligible individuals who are encouraged and supported to maintain the replacement fertility rate and 155 population collaborators who receive encouragement and support when completing assigned targets.

With efforts in advising and implementing policies, especially policies to encourage and support to maintain replacement fertility levels, to promote and support the implementation of goals under Resolution No. 21, thereby promoting communication activities and raising awareness of people, especially young men and women, young couples with a sense of responsibility to family and society to stabilize population size.

Need to implement synchronously to maintain replacement fertility

According to the Department of Population, Ministry of Health, in order to synchronously and effectively implement the Birth Rate Adjustment Program, the People's Councils of provinces/cities have issued and continued to deploy and implement resolutions to support and encourage population work in the new situation.

Population policy advocacy.

The policies support family planning services, handling complications due to the use of contraceptives; support for couples of childbearing age who have given birth to two children to use long-term contraceptives; purchase contraceptives; reward and encourage communes, wards and towns in improving population quality, reducing the number of third children in high birth rate areas, giving birth to two children in low birth rate areas; and providing monthly allowances for collaborators.

In 2024, some provinces with high birth rates have issued detailed plans to implement the birth rate adjustment program and arranged funds to purchase and ensure free provision of contraceptives for policy beneficiaries, specifically Bac Kan province purchased contraceptive injections and syringes for free for all people in the province who need to use modern contraceptives through a service package; Yen Bai province provided a full range of modern contraceptives and a quality family planning service package for all people in need (including adolescents and young people).

Source: https://nhandan.vn/can-giai-phap-phu-hop-de-duy-tri-muc-sinh-thay-the-post854327.html