A couple welcomes their baby at Hùng Vương Hospital in HCM City’s District 5. The city is considering new birth-promotion policies in an effort to raise its low fertility rate of 1.53 children per family. — VNA/VNS Photo Đinh Hằng

HCM CITY — With the lowest fertility rate in the country, HCM City is pursuing incentive policies for married couples to have at least two children, including support for social housing and payment of hospital fees to reduce child-raising costs.

According to the Ministry of Health’s latest report last year, the city is one of 21 provinces and cities in the country with low to very low fertility rates.

The city’s fertility rate was 1.76 children per women of reproductive age in 2000, and fell to 1.53 children 20 years later.

The drop in fertility rates could pose serious threats to the country’s future, experts said.

Although the rate tended to increase over the last few years, with 1.33 children in 2018 and 1.39 children in 2019, the trend for married couples to have fewer children has continued.

Phạm Chánh Trung, head of the city’s Division of Population and Family Planning, talked with Tuổi Trẻ (Youth) newspaper about the low fertility rate and proposed incentive policies encouraging more births in the city.

What are the consequences of a low fertility rate?

Based on the experience of some countries, most birth-promotion policies have no effect on raising the fertility rate when there are very low replacement fertility rates, although huge investments were made to implement these policies.

This will have a detrimental impact on the city’s demographic structure and socio-economic development in the future. The first disadvantage is an aging population, putting more pressure on the social security system for the elderly such as pensions, health insurance, social welfare benefits and health care.

The next disadvantage is a decline in human resources, especially young workers, affecting the city’s socio-economic development. On the other hand, the cost of birth-promotion policies will put pressure on the city’s budget. This budget should be used for improving the quality of the population.

What has HCM City been doing to improve the total fertility rate?

This question is extremely difficult not only for HCM City or Việt Nam, but also for many other countries. The city is finalising a draft proposal on population policies for the 2021-25 period and will submit it to the People's Council, possibly at the end of this year.

The city’s draft proposal has some differences compared to the draft proposal of the Ministry of Health on providing financial support for couples with two children in cities and provinces with low birth rates.

Specifically, the city is pursuing comprehensive support policies for couples with two children, focusing on financial support for hospital fees and the purchase of social housing.

At the same time, there are solutions to help couples reduce the financial burden of childcare such as improving nutritional health and health care for mothers and children, and proposing exemptions or reductions for personal income tax.

Childbirth is not just a familial private matter but also a national concern. Therefore, an appropriate fertility rate would prolong the golden period of population structure and slow down the aging population rate.

Could you speak more about the policies about hospital fees and social housing?

If the draft proposal is approved, couples in the city would receive a co-pay for the rest of their hospital fees after deducting medical expenses covered by health insurance when giving birth to a second child.

The city would provide one-time support of no more than 10 per cent of total value of social housing for each couple with two children from a poor household, no more than 5 per cent for a near-poor household, and no more than 3 per cent for a non-poor household.

Population policy is facing major barriers, so should localities with a low total fertility rate like HCM City remove the planned childbirth policy? Should it shift from the existing limit of two children to encouraging three children or more? And should the current slogan “Each couple should have two children" be changed to "Each couple can decide how many children they want"?

Based on experiences from other countries and opinions of researchers, the implementation of population policies promoting more births needs to be considered carefully. In particular, each policy must be based on the wishes, legitimate rights and interests of the people.

Conducting birth-promotion is not just a change in the number of children per family. The policy needs to create optimal conditions for couples of child-bearing age to be able to raise their children properly, because children are the most important resource for furture socio-economic development.

The city’s population policies should be in line with the main goal of the country’s population strategy by 2030 to improve population quality. — VNS