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Life is much better for the 26 million Vietnamese children today than it was just two decades ago. Viet Nam's population is young with 14.3 per cent of the total male and 13.4 per cent of the total female population under 16 years of age. Most attend primary and secondary school; most have access to adequate health care and can expect to live longer than their parents. High immunisation coverage helped eradicate polio in 2000 and maternal and neonatal tetanus in 2005. Measles incidence has plunged by 95 per cent since 1990, but a recent upsurge in 2008 and 2009 has shown the need for continuous diligence. Cases of Vitamin A deficiency have become very rare.
Finding the children left behind:
But this impressive overall success conceals the fact that disparities are widening between the rich and the poor, the Kinh majority and ethnic minorities, and between urban and rural areas. It is the girls and boys living in these persistent pockets of poverty that must be reached. Child poverty in Viet Nam today is more prevalent than traditional poverty statistics reveal. They cannot tell us whether children's basic needs are being satisfied, as distinct from those of the adults they may live with. With support from UNICEF, Viet Nam recently developed its own child-specific approach to poverty, based on basic needs like education, health, shelter, social inclusion and protection. Using this method to go beyond monetary poverty, rates show that, in 2006, about one third of all children below 16 years of age, or seven million children, can be considered poor. One third of children below five are stunted as a result of chronic malnutrition. More than one out of every three children is not fully immunized by the age of five. Almost half of all children do not have access to a hygienic sanitation facility in their home and two thirds of all children do not have a children's or picture book to read.
Unsafe water and sanitation accounts for half of most of the communicable diseases in Viet Nam, while 2008 figures show about 20 per cent of children are considered underweight and malnourished. Child injury is an important cause of death in children older than one year, the majority from drowning, traffic accidents, poisoning and cuts. And despite relatively low overall prevalence, the HIV epidemic among children is no longer confined to higher risk groups like child sex workers and drug users. The number of people living with HIV is expected to increase to around 280,000 by 2012, including about 5,500 children (approximately 2%). Meanwhile, user fees for social services like health and education are putting unprecedented pressure on families towards income generation and contribute to widening disparities. With increased migration and family breakdowns Vietnamese children are at greater risk of abuse, exploitation, violence and neglect.
In 2006, 40 per cent of children living in rural areas were poor, compared with about 10 per cent of children living in cities. Child poverty rates were highest in the Northern mountainous regions, up to 78 per cent in the North West and North East, and in the Mekong River Delta as much as 60 per cent of children were identified as poor.  Disparities persist in education with about 75 per cent of urban children attending pre-school compared with only 51 per cent of those in rural areas.
The ethnic minority gap:
The country's ethnic minority population, who tend to live mainly in rural and mountainous areas, has benefited least from the country's economic growth. Poverty levels though falling, were at 49.8 per cent in 2008 in ethnic minority populations, compared with 8.5 per cent for the Kinh majority. In fact, ethnic minority children make up far more than 60 per cent of all poor children. Facing language barriers and long, difficult treks to school, in 2006 just over 60 per cent of ethnic minority children completed the first five years of primary education, compared with 86 per cent of Kinh children. Secondary school attendance was a reality for only 65 per cent ethnic minority children, as opposed to almost 82 per cent of Kinh children. In addition, research shows that due to the high cost of school fees, almost a third of ethnic minority households have a child that drops out of school before completing a grade; this is true for 16 per cent of Kinh families.
Maternal mortality ratios are much higher in mountainous and remote areas, such as the Central Highlands and northern mountains. The infant mortality rate (IMR) also remains high in the Central Highlands and in the North West. In 2006, the North West had an IMR of 30 per 1,000 live births, more than three times higher than in the majority ethnic Vietnamese Kinh Southeast (8 per 1,000 live births). Poor children under five years old are twice as likely to die before their fifth birthday as wealthy children.
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