A newly married couple attending the ceremony
HA LONG CITY, QUANG NINH PROVINCE, VIET NAM. According to the 2009 Population and Housing Census, young people aged between 10 to 24 years account for nearly 30 percent of the population. Young people in Viet Nam are the most mobile group, as many leave home for further studies, while others migrate seasonally or permanently for better job opportunities. Sexual and reproductive health norms and behavior are changing rapidly among young people in Viet Nam. One-third of young people still face barriers when trying to access reproductive health information or services they require and deserve.
Reaching youth through marriage registration ceremonies
- Dear honored guests, we are gathered here today to witness the giving and receiving of the marriage vows.
- Do you take this woman as your wedded wife?
- Yes, I do.
- Do you take this man as your wedded husband?
- Yes, I do.
- I now pronounce you husband and wife. Before signing your marriage certificate, I would like to invite you to a counseling session on sexual and reproductive health skills and knowledge.
Above is the first part of a marriage registration ceremony for newly married couples organized in Ha Long city, Quang Ninh province in October 2011. This is an initiative designed and implemented by the Viet Nam Family Planning Association (VINAFPA), with technical assistance from the United Nations Population Fund (UNFPA) and financial support of the Government of Luxemburg.
The model, entitled “Sexual Reproductive Health Communication and Counseling Integration in Marriage Registration Ceremonies”, has been implemented in the four wards of Quang Ninh, Hue, Nghe An and Can Tho provinces since 2008.
The main focus of the model is to provide sexual and reproductive health knowledge and life skills for young couples before starting their own family. After receiving counseling, young couples receive marriage registration certificates in formal ceremonies. The model works to make reproductive rights a reality by supporting family planning services throughout the four project wards. These services, as well as the information needed to make good choices, are usually provided as part of a range of reproductive health services.
The model has also supported behaviour change communication activities that promote gender equality, prevent gender-based and domestic violence, improve women’s status in the family and society, and promote men’s responsibilities. In addition, many awareness-raising activities have been organized, with active participation from adolescents and young people to equip them with information and knowledge related to pregnancy, family planning, reproductive health, and prevention of HIV and AIDS.
"We employ a multi-sectoral approach that considers reproductive and sexual health issues as one aspect of personal development, with links to a range of other health and social services. Young people need appropriate information, education and health services. Promoting knowledge of sexual and reproductive health, and conflict resolution and negotiation skills, can help young people protect themselves from non-consensual sex, unwanted pregnancies and sexually transmitted infections (STIs), including HIV. It can also help them make responsible and informed decisions about their lives," said Mr. Bruce Campbell, UNFPA Representative in Viet Nam.
Limited access to information, life skills education and services make young people vulnerable
Mr. Thanh, a taxi driver and Ms. Loan, who works in a hotel, are one of five young couples who attended the marriage registration ceremony in Ha Lam ward, Ha Long city in October 2011. Thanh and Loan are 24 years old and their wedding party will be organized next month. Like many other Vietnamese young people, they do not have sufficient knowledge about sex and relationships, reproductive health and HIV. "Whenever I have a question about sex, I usually seek the information on the internet. Sometimes I discuss it with my friends. However, sex is easy to joke about, but difficult to talk about," says Thanh.
In urban areas, young people are exposed to images and stories about sex in the media every day. Like Thanh, they talk to their friends and look for information on the internet. Vietnamese parents are hesitant to talk about sex with their children, as they are afraid that it will encourage sexual experimentation. "I feel shy about discussing sex with my parents and they also avoid talking about it to me. In fact, my parents never talk about sex and sexual health with me," says Loan.
Thanh and Loan are happy to receive their marriage certificate
Research has revealed various reasons for unwanted pregnancy, including incorrect use of contraceptives , limited access to reproductive health services and lack of life skills, for example, ability to negotiate condom use. Reliable data is limited, possibly owing to the stigma associated with abortion.
The second Survey Assessment of Vietnamese Youth also shows that young people still know alarmingly little about HIV/AIDS. Only 42.5 percent of Vietnamese youth aged 15 to 24 have comprehensive knowledge of HIV transmission, far less than the global target of 95 percent by 2010.
The age of marriage is rising, and sexual activity outside marriage is increasing in urban areas. Young women find themselves at risk of forced sex, unwanted pregnancies, unsafe abortions, and sexually transmitted diseases, including HIV. Contraceptive use, though higher among urban youth than their rural counterparts, remains infrequent. Continued high levels of unwanted pregnancies and unsafe abortions indicate a considerable unmet need for family planning among young women.
The national family planning programme in Viet Nam provides contraception and reproductive health information to different population groups, particularly married couples. These services are also offered to adolescents and youth, but access has been limited and recent analysis of data from the Multiple Indicator Cluster Survey suggests more than 10 per cent of young people have “unmet need” for Sexual and Reproductive Health services.
Empowering young women and men
Ms. Hanh and Mr. Cuong, 28 years old, were married in 2008. They are enjoying their married life and have a two-year-old son. They are one of five couples who participated in the first marriage registration ceremony organized in Ha Lam ward, Ha Long city, Quang Ninh province in 2008.
Hanh recalls that three years ago, like many other young people, she knew little about safe sex and reproductive health. "I felt like a fish out of water before getting married. When I listened to the radio or TV talking about safe sex, I did not really understand what it was. There were many things about married life that I wanted to know but I did not know who I should ask," says Hanh.
On the day Hanh and Cuong came to the commune peoples' committee to register their marriage, they were invited to attend the marriage registration ceremony, together with other young couples in the commune. When they were asked about their knowledge of sexual and reproductive health they did not know how to answer. After receiving the counselling on sexual and reproductive health, both Hanh and Cuong gained a lot of interesting and useful information that they never had before. "The counsellor provided us with information and knowledge on safe sex, family planning, gender equality, conflict resolution and negotiation skills that helped me protect myself from non-consensual sex, unwanted pregnancies and STIs, including HIV," added Hanh.
Hanh says that in the past she thought that family planning was the wife's matter, not the husband’s. Now she has learned that if both husband and wife discuss this together and select an appropriate contraceptive method, both can enjoy a healthy sex life. The information and knowledge provided by the counsellor has helped Hanh take good care of her family. Whenever she needs more information about sexual and reproductive health, she asks the ward's counsellor for advice. "I feel very lucky to participate in the model. I also learned about the economics of raising children, and the value of planning our life together, which I found extremely useful for my life, and you can see that I enjoy my married life very much," she says.
Scaling up the model throughout the country
The UNFPA-VINAFPA model funded by the Government of Luxemburg has helped Vietnamese youth in the project sites acquire the skills necessary to develop and sustain healthy and happy lives, particularly in areas with unmet needs of sexual and reproductive health including family planning. While the model will be phased out in May 2012, it will be scaled up to 2,000 other communes and wards throughout the country in June 2012 and will be financed through the national budget. This is also a good example of a UN supported demonstration model that is now being taken to scale through government resources.
Reproductive health services and information for adolescents and youth are under-resourced. Most of the adolescent reproductive health programmes and activities to date have been pilot projects financed primarily by international resources. Few of the pilots have been rolled out to other areas, and sustainability is a concern for many of the existing pilot schemes.
“With technical support from UNFPA, we are promoting healthy sexuality. We acknowledge young people have the right to have safe sex, so we have created an environment for them to talk about this," said Dr. Nguyen Thi Hau, Chairwoman of the Quang Ninh Family Planning Association. However, she stresses that: "To optimize the effectiveness of this model, a short pre-marital education course for couples should be conducted in which information and knowledge on sexual and reproductive health, life skills and other related issues can be provided. The model should be scaled up nationwide with more training for young couples."
Investing in health for young people and adolescents: a smart choice
Viet Nam has entered a period known as the ‘demographic bonus’, recording the highest proportional level of young people who are entering the workforce in Viet Nam’s history. "Today, young people between 10 to 24 years represent almost a third of the total population. While this demographic window is open, Viet Nam has an opportunity to take advantage of this tremendous resource by ensuring that every young person has access to basic social services, health, education and training, so that they are well prepared to make a significant contribution to Viet Nam’s continued socio-economic growth and development," said UNFPA’s Mr. Bruce Campbell.