Economic giant, social minnow

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UN urges Vietnam to prioritize improving healthcare, education services


Two students (R) pass waiting relatives as they exit the gate of a high school after taking part in a college admission test in Hanoi on July 5. The United Nations has urged Vietnam to improve social services like education and health to ensure a better life of local people.

Vietnam's economic development over the last decade has not been matched by social development, and its human development index is below average, a UN official says.

"This year's global Human Development Report shows that Vietnam's human development index (HDI) value for 2011 is very similar to last year. The country is in the medium human development category and ranks 128th out of 187 countries surveyed," said Setsuko Yamazaki, the United Nations Development Program country director in Vietnam at the launch of the 2011 Vietnam Human Development Report on Wednesday (November 9).

UN's HDI measures three basic dimensions of human development a long and healthy life, access to education and knowledge, and a decent standard of living.

According to the report, titled Social Services for Human Development, Vietnam's HDI value has increased by an impressive 37 percent over the last twenty years.

However, Yamazaki said Vietnam's progress over time in the three HDI indicators (life expectancy, schooling and economic growth) shows that overall human development advancement is mainly due to economic growth.

Between 1990 and 2011, per capita income in Vietnam increased by an astonishing 228 percent, she said.

"On the other hand, progress in social development, including health and education, has been less rapid and has contributed less to Vietnam's HDI. And compared to other medium human development countries Vietnam's 2011 HDI is below the average, as well as below the average for countries in East Asia and the Pacific," she said.

Vietnam's HDI rose 11.8 percent between 1999 and 2008. Income growth has contributed more than half (55.7 percent) of this growth, while improved life expectancy and education have contributed 31.8 percent and 12.6 percent respectively.

The report argues that the same level of priority and investment now needs to be given to improving human development outcomes as is accorded to growing Vietnam's economy.

"There is considerable variation in levels of human development. Wealthier provinces like Hanoi, Ho Chi Minh City and Da Nang have levels of human development comparable to China, Jordan and Belize. Poor provinces like Lai Chau and Ha Giang have human development levels similar to Papua New Guinea and Swaziland," the UNDP said in a statement to launch the report.

"I hope this report provides additional input for policymakers to make smart investment decisions for the social sector, at the national and sub-national levels, in order to achieve the full potential of human development in Vietnam," Yamazaki said.

As specific components of human development, the report looks in detail at health and education services and the financing of these.

Education crisis

The report found that the bulk of health and education expenditure comes from private household spending which is at much higher levels than the 30 percent considered optimal for social equity and continued human development.

"For instance, while at the primary school level household spending accounted for 17.5 percent of overall expenditure, at the tertiary level this rose to over fifty percent. These costs put a significant burden on poor and disadvantaged households, especially at higher levels of education," it said.

A leaked cable from the US Embassy in Hanoi to the US State Department in Washington DC in 2010, titled "Education reform in Vietnam: everyone being left behind", said the Vietnamese educational system is widely regarded as being in crisis at all levels.

"MOET's (Ministry of Education and Training) implementation of reforms has been slow and limited at all levels, according to many American and Vietnamese educators. Teaching methods remain too passive, with students having little chance to interact with the teacher, discuss issues, or ask questions.

"One recent study found that 83 percent of students graduate lacking soft skills such as analytic and problem solving abilities, and teamwork and managerial skills."

The cable reported evidence of the low quality of education in Vietnam, including vocational school teachers who have little practical work or teaching experience, poorly equipped classrooms and little interaction between schools and potential employers through internships or job fairs.

Demand for higher education remains high from students, families, and investors and companies that increasingly want to hire those with bachelor's degrees, forcing a rapid increase in the number of universities in Vietnam and deficiencies in the quality of administration and teaching, the cable said.

Besides improving education, the human development report also called on countries to ensure universal access to quality and affordable health services.

In Vietnam, 56 percent of overall healthcare expenditure came from household spending which denotes a "catastrophic impact" on poor and vulnerable households, with 8.1 percent of households in 2008 spending more than 20 percent of their total household expenditure on health and 3.7 percent being impoverished as a direct result of their high healthcare spending.

Vietnam has made significant strides in narrowing health and education gaps. Infant and maternal mortality rates have fallen, most children receive vaccinations and most births are attended by trained health workers.

According to a survey launched last month, nearly half the respondents said they were not satisfied with healthcare service and procedures at a number of leading hospitals in Hanoi.

Heavy workloads and low payment are to blame for the bad attitude among medical staff and many people have resorted to paying extra money to get better service, the report said.

Satisfaction was lowest with the K Hospital for cancer patients. More than 63 percent of the respondents complained about the services provided by this hospital, according to the survey conducted by the Vietnam National Union of Health Workers in July this year.

Four other hospitals surveyed were Viet Duc, Bach Mai, E Hospital and the Central Ob-Gyn Hospital.

Tran Thi Thanh Tam, vice chairwoman of the union, said many people were not satisfied because of the long wait, the lack of care and respect shown by the medical staff, and late intervention in emergency cases.

Around 10 percent of the dissatisfaction was caused by rudeness and heartlessness of the medical staff, she said.

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