Contraceptive use increases in north

"Women were so embarrassed that as soon as they saw doctors, they would be frightened," says Tran Thi Oanh, chair of Than Uyen District’s Committee for Population, Family and Children.

But population control workers are seeing some evidence that long-held social mores, including the idea that women should o­nly expose their genitals to their husbands, may be yielding to modernity.

Five years ago, almost no-one in the region was using birth control, says Oanh.

Now, thanks to public awareness campaigns, many women are asking for contraceptives and taking an active role in family planning, she says.

Officials are embarking o­n an ambitious plan to lower the number of new three-children households from 20 per cent to 3 per cent within the next 12 months. Families in the province average 3.3 children and an annual income of US$154.

The battle, though, will be an uphill o­ne, according to officials. Many women are terrified of the stigma that comes with deeply personal exams.

"Although [they] understand the benefit of reproductive healthcare, they dare not go for a gynaecological examination because they are afraid of their husbands," Oanh says.

Even the women who do go feel ashamed.

"They choose to keep it secret. Many women do not say a word after getting the examination. They run to their homes at a gallop," Oanh says.

A doctor turned population worker, Dao Thi Hoa, says appeasing the sometimes domineering Mong men is an important part of family planning.

She mentions o­ne case where a husband insisted o­n being present while doctors removed an inter-uterine device from his wife.

Unlike their wives, some men have not been quick to embrace the benefits of reproductive health care; some even sneak away when population control workers come to town, Hoa says.

Obstacles

Language is o­ne of the barriers social advocates face in Lai Chau. Almost all women, and the elderly, cannot speak popular Vietnamese, forcing social workers to rely o­n interpreters.

Population workers in the district of Phong Tho agreed that the success of population control was dependent o­n local-level officials. But as Nguyen Dinh Bach, chair of Lai Chau Province Population, Family and Children Committee points out, the role of those bureaucrats remains vague when it comes to family planning.

"It has become a primary concern for us to help authorities at a grassroots level understand and play their role as instructors in implementing population measures," Bach says.

Since early last year, the committee has spread the birth control message to ethnic minorities through songs about family planning. Bach says the tunes will eventually be compiled o­n CDs in Mong, Thai and Ha Nhi languages.