The proposal is included in the draft Population Law, as Vietnam faces multiple challenges, particularly a declining birth rate.

Health Minister Dao Hong Lan reported recently that the total fertility rate nationwide is at its lowest in history. 2024 was the third consecutive year that the fertility rate fell to below the replacement level (2.1 children), currently only 1.91 children per woman. 

"If the birth rate continues to drop, Vietnam will end its 'golden population period' by 2039, the working-age population will peak by 2042, and after 2054, the population will begin to experience negative growth," he said.

Additionally, the gender imbalance at birth has remained high for nearly 20 years, becoming a pressing challenge. In 2024, the sex ratio at birth was 111.4 boys per 100 girls. If this trend persists, Vietnam is projected to have a surplus of 1.5 million men aged 15-49 by 2039, rising to 2.5 million by 2059.

The 2025 World Population Report by UNFPA showed that most people still want children, even in countries with the lowest birth rates. However, one in five people surveyed said they could not have the desired number of children, and 40 percent of those over 50 reported not achieving their desired family size.

The UNFPA survey, conducted on 14,000 people across 14 countries, found that over half of respondents cited economic factors as the main barrier to parenthood, including financial insecurity, unstable employment, housing costs, childcare expenses, gender stereotypes, and work-life balance pressures.

These findings align with the current situation in Vietnam.

In 2024, Vietnam’s average life expectancy reached 74.7 years, higher than many countries with similar income levels. However, healthy life expectancy is only about 65 years, meaning Vietnamese people live over a decade with health issues.

Physical stature, fitness, and quality of life remain limited in remote areas, ethnic minority regions, and among adolescent girls, particularly due to early marriage and consanguineous marriages in the Central Highlands and northern midland and mountainous areas.

The sex ratio at birth continues to rise above the natural balance. It was 110.5 boys per 100 girls in 2009, 111.5 in 2019, and 111.4 in 2024.

This imbalance risks disrupting family structures, leading to delayed or no marriages for some men, and increasing issues such as trafficking of women and girls, prostitution, gender-based violence, and transnational crime.

Breakthrough policies proposed

To address these issues, MOH has proposed several measures with a total estimated budget of over VND5,360 billion. These include cash or in-kind support for women giving birth, having two children, or having two children before age 35; subsidies for living expenses; support for preschool meal costs; and free or reduced prenatal check-up costs.

The Ministry estimated VND650 billion for cash or in-kind support for women having two children before age 35 and over VND151 billion for financial incentives for families with two daughters.

These measures aim to maintain the replacement fertility level, allowing women to have more time for childcare, encouraging men to support families, and reducing costs during pregnancy and childbirth to promote having two children, especially before age 35.

The Ministry believes these measures can prevent a deep and prolonged decline in birth rates, maintain replacement fertility, and mitigate labor shortages, population decline, and economic growth reduction.

In addition, according to calculations, the cost for two solutions to improve population quality, including pre-marital health examination consultation and prenatal and neonatal screening, diagnosis, and treatment, is more than VND3,000 billion.

In addition to financial support, MOH believes that it is necessary to change the youth’s perceptions about having children.

The declining birth rate is not unique to Vietnam but is a global issue. No country has successfully restored replacement fertility levels after a significant decline, despite economic measures.

Giang Thanh Long, a senior lecturer at the National Economics University (Hanoi), emphasized that encouraging childbirth cannot rely on urging or campaigning but requires indirect solutions to improve living conditions, healthcare, education, and long-term development opportunities.

Nguyen Dinh Cu, a population and development expert, suggested that alongside diverse practical support policies, such as cost assistance, PIT reductions, exemptions from community contributions for couples with young children, and subsidies for the elderly, there needs to be a shift in societal perceptions about childbirth among young people.

Phuong Thuy