Health and development in Vietnam : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Development Studies at Massey University

Abstract

This research investigates the current situation of Vietnamese people's health and development, with a particular focus on the wellbeing of Vietnamese women. Its central question is the impact of the political and economic reforms in Vietnam from 1986 onward, which reinstated the "family economy" and a number of free market principles within the country's socialist framework. It is based on a combination of field observations from an investigative visit to Vietnam in April 1994 and literature reviews covering concepts of development, Vietnamese culture, history, politics and economics. Wherever possible, Vietnamese sources (in English translation) have been incorporated. The first substantive chapter explores the connection between health, development and the environment, estabishing the interrelationship between the wellbeing of marginalised groups within a society and the meaning behind sustainable human development. The concept of wellbeing is argued as encompassing values of self-determination, while the concept of provision for sustainable livelihood is highlighted as a means to intercept the cycles of poverty and disease. A brief insight into aspects of Vietnamese cultural and social history up to the end of the colonial period is then offered, focusing on the organisation of the traditional village, so as to sign-post key aspects of culture and social organisation which have continued to influence the development of Vietnamese society. The following chapter gives the background to the process of political and economic reform in Vietnam from reunification in 1976 following the end of the Vietnam War identifying the ideological changes involved and outlining the macroeconomic impact of the reforms. The goals of current Vietnamese social policy are also considered. The final two chapters present data and analysis on the current state of Vietnamese people's wellbeing, identifying where possible the effects of recent policy changes. Topics covered are population, gender discrimination and the status of women, household poverty, education, employment, water supply and sanitation, women's health, child wellbeing, and the structure and operation of the Vietnamese health care system. The main findings are that the reforms have increased resource disparities between different groups in Vietnam and that the less advantaged, including a large proportion of Vietnamese women, face a serious decline in wellbeing unless changes occur in priorities for development.