The Ministry of Health is seeking public feedback on a Draft Plan to Control the Sex Imbalance at Birth for 2026-2035, which aims to bring Vietnam’s sex ratio at birth back to its natural balance over the next decade.

VietNamNet is publishing the series "Addressing the sex imbalance at birth", examining gaps, challenges and issues that require further consideration in the draft plan through expert analysis and commentary.

Under the draft plan, the Ministry of Health proposes studying and developing policies to recognize, honor and support exemplary families with two daughters that have effectively followed population policies.

The draft also calls for research into different forms of needs-based support for specific groups. Local authorities would be guided and encouraged to develop mechanisms for timely recognition and rewards for families raising daughters who are well-behaved and perform well academically, while complying with policies aimed at reducing the sex imbalance at birth.

Prof. Giang Thanh Long, a senior lecturer at the National Economics University in Hanoi, and Dr. Trinh Phuong Thao, a lecturer at the Faculty of Social Work at Hanoi National University of Education, both argue that such measures need to be viewed as part of a much broader strategy rather than treating financial support as a solution capable of directly correcting the sex imbalance at birth.

According to the two experts, the root of the problem lies not simply in whether some families have access to sex-selection technologies. At a deeper level, the perceived need to have a son remains embedded in society. Unless that preference changes, an isolated financial incentive is unlikely to produce lasting results.

It cannot simply be reduced to ‘paying families to have daughters’

Thao said support for families with two daughters should be considered within the broader strategy for controlling the sex imbalance at birth. Alongside financial or other assistance, Vietnam needs to change social norms that favor sons, improve the status of women and girls, curb prenatal sex selection, strengthen social protection for older people and improve data-based monitoring.

Support for families with two daughters should therefore not be regarded as the centerpiece of the policy, she said, but rather as one tool within a broader package of measures.

Long similarly argued that measures limited to “encouragement” are unlikely to provide a strong enough incentive to change behavior. He said policymakers should consider more concrete economic tools and a broader support ecosystem for families rather than relying solely on public communication campaigns or a single policy.

The use of financial incentives, however, also requires careful consideration.

Citing international experience, Thao said there is insufficient evidence to assume that cash rewards or financial support directly reduce the sex ratio at birth. Delhi’s Ladli conditional cash transfer program for parents of girls in India, for example, coincided with changes in the registered sex ratio, but evaluations have suggested that the results may partly reflect increased birth registration for girls. There has not been sufficient research to isolate the program’s impact on the sex ratio at birth.

In Vietnam, some localities have already introduced rewards and recognition for families or communities. However, Thao said the amount of money distributed, the number of families receiving assistance or the number of localities implementing such schemes cannot automatically be regarded as evidence of policy success, as there is no quantitative data isolating the impact of these incentives on the sex ratio at birth.

If a support policy is introduced, authorities therefore need to define from the outset exactly what it is intended to change: whether preference for sons declines, whether families become less likely to have additional children simply because they do not yet have a son, and whether girls receive greater investment, care and more equal opportunities.

Does prioritizing girls amount to inequality?

Another question is whether policies specifically benefiting families with daughters could create reverse inequality for boys.

Thao argued that gender equality does not mean every group in every circumstance must receive exactly the same level of support. When one group faces disadvantages rooted in gender bias, allocating additional resources to address those disadvantages does not automatically constitute discrimination.

The key question is whether such preferential measures help narrow gaps between the sexes in status, rights, opportunities and access to benefits. If additional resources help girls overcome disadvantages created by son preference, such measures could contribute to substantive gender equality.

Thao cautioned, however, that the policy could backfire if it inadvertently reinforces the perception that having daughters is a disadvantage that requires “compensation.”

This is also a concern Long particularly emphasized. He said financial support for families with daughters must be carefully designed so that it does not send the message that girls require “compensation.” He pointed to a dilemma: supporting all girls would require enormous resources, while restricting assistance to certain families could reinforce the very notion of “compensation.”

Does support have to be limited to families with two daughters?

Questioning the feasibility and boundaries of the “families with two daughters” criterion, Long said policymakers would need to clarify a range of scenarios. Should a high-income family with two daughters receive support? What about a low-income family with one son and one daughter? Would a single woman raising two daughters qualify? And how would the policy apply if parents divorced or subsequently had a son?

Thao said that if “families with two daughters” remain the target group, policymakers must first clearly define what the policy is intended to achieve.

Is the goal to discourage families from continuing to have children simply because they do not yet have a son? Is it to create positive examples that challenge the belief that families “must have a son”? Or is it intended to support girls who are experiencing disadvantage?

Thao also argued that the value of girls should not be measured by criteria such as being “academically successful” or “accomplished.” If the objective is to advance gender equality, she said, policies should instead seek to guarantee girls equal rights, opportunities and access to healthcare, education, skills development and other resources.

Vo Thu