Vietnam - Health
Wars in Vietnam since 1946 have undermined much of the progress made by the DRV, RVN, and SRV in the health field. Damage to urban hospitals in the north was especially severe. A 1976 World Health Organization report indicated the dimensions of that destruction: 24 research institutes and specialized hospitals, 28 provincial hospitals, 94 district hospitals, and 533 community health centers; all destroyed mainly as the result of US bombing. Three decades of intermittent war has also had a devastating effect on health conditions in the south.
At the war's end in 1975, many endemic diseases were observed to be on the increase, in alarming contrast with trends among other affected countries in Southeast Asia. The World Health Organization (WHO) reported in 1976 that malaria had been both widespread and increasing in the south in 1975. During 1965–74, 5,000 cases of bubonic plague were occurring annually, with a mortality rate of 5%. Saigon was said to have had a tuberculosis rate two to three times that in neighboring countries, while leprosy (involving an estimated 80,000–160,000 cases) was increasing.
Since reunification in 1975, some progress in health care has been made, and the incidence of many contagious diseases has been reduced. However, the incidence of tuberculosis, which had been largely controlled (99 cases per 100,000 people reported in 1996), rose again to 189 cases per 100,000 people as of 1999. Commonly reported diseases in Vietnam were diarrheal disease (22,422 deaths in 1995); malaria (136,069 cases in 1993); and tuberculosis (35,813 in 1994). Venereal and paravenereal diseases were said to have afflicted 1 million persons in the south (about 5% of the total population) and, WHO claimed, 80% of RVN soldiers. Opiate addiction affected about 500,000 persons. As of 1999, the number of people living with HIV/AIDS was estimated at 100,000 and deaths from AIDS that year were estimated at 2,500. HIV prevalence was 0.24 per 100 adults. Tobacco consumption has increased from 1.0 kg (2.2 lbs) a year per adult in 1984–86 to 1.1 kg (2.4 lbs) in 1995.
During the early 1980s, foreign visitors routinely reported observing severe cases of malnutrition and shortages of medical equipment and supplies. While conditions have generally improved as agricultural production has increased, most Vietnamese continue to live at the minimum level of subsistence. In February of 1996, Vietnam was considering fortification of foods with iron and vitamin A. In 1995, the Vietnamese government issued the National Plan of Action for Nutrition (1995–2000), which aimed to eliminate food insecurity, reduce malnutrition, and reduce micronutrient deficiencies. About 39% of all children under 5 were classified as malnourished in 2000.
Vietnam reported life expectancy in 2000 to be 69 years and infant mortality to be 27 per 1,000 live births. Maternal mortality was 160 per 100,000 live births in 1998. As of 2002, the crude birth rate and overall mortality rate were estimated at, respectively, 20.9 and 6.1 per 1,000 people. Immunization rates for children up to one year old in 1997 were tuberculosis, 96%; diphtheria, pertussis, and tetanus, 95%; polio, 95%; and measles, 96%.
Family planning services were provided to 2,157,000 people in 1992. An estimated 75% of married women (ages 15 to 49) were using contraception in 2000. Abortion is available on request. Vietnam's fertility rate in 2000 was 2.2, down nearly 2% from the previous 5-year period.
In 1991, the country had 275,560 physicians, 58,912 nurses, and 14,813 midwives. In 1992, there was a nurse to doctor ratio of 4.9. About 97% of the population had access to health care services in 1993. In 2000, 56% of the population had access to safe drinking water and 73% had adequate sanitation. As of 1999, there were an estimated 0.5 physicians and 1.7 hospital beds per 1,000 people. As of 1999 total health care expenditure was estimated at 4.8% of GDP.