This proposal is part of the draft Circular guiding the implementation of the National Target Program on Healthcare, Population, and Development for the 2026–2035 period, which the Ministry of Health recently sought public comment on. The proposal comes as young people are marrying later, and Vietnam's birth rate has reached a historic low of 1,91 children per woman, below the necessary replacement rate.

In fact, the average age of first marriage for young people in Vietnam is increasing. In the five years from 2019 to 2024, the average age of marriage rose from 25,2 to 27,3 years, nearly double the increase observed over the preceding 20 years. Notably, TP HCM recorded the highest average age of first marriage nationwide at 30,4. The Southeast and Mekong Delta regions also show many men delaying starting families until after age 30.

Financial pressure, the desire to focus on career development, or difficulty finding an ideal partner are key reasons young people are reluctant to date, marry, or have children. The prolonged low birth rate is causing a severe labor shortage and accelerating population aging. Projections indicate that within 50 years, the social structure will be inverted, with two children bearing the responsibility of caring for four elderly individuals.

To address this, the Ministry of Health proposes offering courses that provide knowledge and skills in marriage, family, reproductive and sexual health, pregnancy, childbirth, parenting, and family financial management for couples preparing to marry. The Ministry of Health will develop and standardize a nationwide set of materials and train instructors and health-population officials for local implementation. Annually, about 20% of communes, wards, and special zones are expected to organize at least one class or specialized session for young people preparing to start families.

Mass wedding in Hanoi. Photo: Pham Chieu

In addition to encouraging early marriage, the draft also proposes launching a campaign to encourage having two children in 10 localities with birth rates below the national average: Ha Noi, TP HCM, Can Tho, Khanh Hoa, Dong Nai, Tay Ninh, An Giang, Dong Thap, Vinh Long, and Ca Mau. These localities will strengthen communication, counseling, and implement support policies to encourage couples to have two children, helping to address the prolonged declining birth rate trend in many urban and economically developed areas.

Recently, the Ministry of Health proposed allowing localities to determine monthly financial support levels for children from birth until 36 months of age to revive the low birth rate. In addition to the monthly allowance for children up to three years old, the draft suggests expanding other support packages, such as lunch costs for preschool children or direct rewards for women who achieve the goal of giving birth before age 35.

Regarding infertility prevention efforts, the Ministry of Health proposes strengthening communication, counseling, and screening for young people, couples preparing for marriage, and couples of reproductive age nationwide. Notably, the draft suggests piloting infertility risk screening in communes with industrial zones within 10 provinces and cities experiencing low birth rates. Priority will be given to couples married for over 12 months without children, especially those where one or both spouses work in industrial zones.

Le Nga