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| Medical care for mothers and newborns at the Pediatric Department, Thanh Nhan Hospital (Hanoi)__Photo: Minh Quyet/VNA |
Facing a sustained decline in fertility rates and rapid population aging, Vietnam is under growing pressure to adjust its population policy. On June 3, the National Assembly Standing Committee passed the amended Ordinance on Population, officially removing the regulation that limited each couple to having at most two children. This is the latest effort of the central authority to deal with national demographic challenges.
Population - not just numbers, but a development strategy
In April, the Politburo issued Conclusion 149, calling for stronger and more coordinated efforts in implementing Resolution 21-NQ/TW of 2017 on population work. The shift is clear: Population policy is no longer just about family planning, but about sustaining a healthy, balanced, and stable population for Vietnam’s long-term development.
In Vietnam, the fertility has dropped from 2.11 children per woman in 2021 to 2.01 in 2022, 1.96 in 2023, and 1.91 in 2024, the lowest level in the country’s history, and it may continue to fall in the coming years.
It is anticipated that Vietnam’s "golden population" period will end by 2039. The working-age population is expected to peak in 2042, and from 2054 onward, the country could enter a phase of negative population growth. This trend is likely to result in labor shortages, a shrinking population size, and accelerated population aging, all of which could have significant impacts on socio-economic development
To deal with these challenges, relevant policies should be revised, requiring integrated solutions involving not only the health sector but also education and social protection.
Ho Chi Minh City’s initiative
Ho Chi Minh City - the country’s largest city - is already feeling the pressure of these demographic shifts. In 2024, the city’s fertility rate dropped to 1.39 children per woman, far below the national average of 1.91 and significantly under the replacement level of 2.1.
The city is also aging quickly. By the end of 2024, over 1.1 million residents, or nearly 12 percent, are aged 60 and above. The number of older residents in the city is growing fast - 243,500 more seniors were added between 2017 and 2024, averaging nearly 35,000 new elderly citizens per year. If current trends continue, the city could face major labor shortages and strain on its welfare systems in the years to come.
In an effort to address this, the Ho Chi Minh City People’s Council in last December adopted Resolution 40, offering direct financial support to women who give birth to two children before turning 35. The city offers a one-time cash grant of VND 3 million (about USD 120) to eligible mothers to help cover out-of-pocket prenatal care and hospital costs not covered by health insurance.
For pregnant women and newborns from poor, near-poor, or socially protected households, especially those living in island communes, an additional VND 2 million is provided if they participate in prenatal or newborn health screenings. Women who give birth to twins during their first pregnancy before age 35 also qualify.
The support is not limited to individuals. Local communes and wards that maintain a 60 percent of two-child rate among married couples for three consecutive years receive a bonus of VND 30 million and a certificate of merit of the district-level People’s Committee chairperson. Those that sustain this performance for five consecutive years are awarded VND 60 million and a certificate of merit. District-level administrations also grant VND 1 million to communes that incorporate gender-balance measures in their community regulations.
Despite the well-meaning effort, experts say cash incentives like this will not be enough to convince people to have more children.
“Three million dong is symbolic. It’s not going to change someone’s decision to have another child,” said Dr. Pham Thi Thuy, a lecturer at the branch of the National Academy of Public Administration in Ho Chi Minh City. She told Thanh Nien (Youth) newspaper that couples considering a second child are often more concerned about long-term support - especially access to childcare, education, housing, and income tax breaks.
Tran Ngoc Hai, Director of Tu Du Hospital - the leading obstetrics and gynecology hospital in the city, made a similar point. He praised the new incentive but noted that real change requires “a package of extended postpartum leave, paternity leave, and a more supportive cultural environment” for families.
According to census data, it is social and educational factors that make couples not want to have children or to have more children. For example, women are required to return to work just six months after giving birth, while public daycare centers only accept children from 18 months of age. Although private daycare centers may accept younger children, they are often expensive. In some areas, there are informal home-based daycare services, but despite efforts by local authorities to manage them, some of these facilities fail to meet standards for hygiene, healthcare, and child safety.
Experts agree that Vietnam must tackle the root causes of low fertility. According to Pham Chanh Trung, Head of the Population and Family Planning Branch under the Ho Chi Minh City Health Department, most couples would be happy to have two children if they had access to affordable housing, quality education and healthcare, and reduced income taxes. Without having these structural issues addressed, he warned, financial rewards alone are unlikely to solve the current challenges.
Why a new Population Law matters
Looking back to 2018, the Ministry of Health began drafting a Population Law in line with Resolution 21. But progress stalled amid concerns over vague language and unfeasible provisions. At the time, legislators suggested waiting until the release of data from the 2019 National Population and Housing Census.
Now, the drafting process is back on track. The ministry plans to submit the draft law to the National Assembly later this year. The new version is expected to be based on up-to-date data from the National Population Database, allowing for more targeted policymaking.
Pending the formulation and promulgation of a new Population Law, on June 3, the National Assembly Standing Committee passed the amended Ordinance on Population, officially removing the regulation that limited each couple to having at most two children.
Under the ordinance, couples have the right to decide on the timing, number, and spacing of their children based on age, health status, education, employment, income, and their capacity to raise children — all on the basis of equality. The ordinance takes effect immediately upon its adoption.
The new regulation aligns with earlier guidelines of the Party that remove disciplinary measures for families with more than two children. This move marks a clear transition away from restrictive population control measures toward a more supportive and developmental approach.
However, there remain other legislative tasks to be done. Conclusion 149 also clearly states the necessity to focus on reviewing, amending, supplementing, and finalizing population-related mechanisms, policies, and legislation.
Appropriate mechanisms and policies should be adopted to encourage couples and individuals to have two children, with priority given to those in areas with low fertility rates and ethnic minority populations. These policies should aim to maintain the replacement fertility rate and reduce the gender imbalance at birth, toward restoring the natural sex ratio as soon as possible.
Policies should also be devised to improve elderly healthcare, with a focus on increasing average life expectancy, extending healthy life years, and ensuring adaptation to population aging while enhancing population quality.
In addition, consideration should be given to policies that support women who have two children before the age of 35, as well as employment-related policies, allowances, and support for workers raising young children.
In sum, Vietnam’s population strategy is undergoing a fundamental transformation. The new Population Law, if enacted, will provide an essential legal foundation for that shift. But laws alone are not enough. Real change will require a concerted effort to deliver practical support: childcare services, housing solutions, tax relief, and labor protection that enable families to grow and thrive.
In localities like Ho Chi Minh City, this work has already begun. The true test will be how effectively national and local policies come together to support families, not just in principle, but in everyday life.- (VLLF)
