UNICEF Lao PDR Country Briefing Guide€¦ · For every child Health, Education, Equality, Protection ADVANCE HUMANITY LAO PDR COUNTRY BRIEFING GUIDE

For every childHealth, Education, Equality, ProtectionADVANCE HUMANITY

LAO PDRCOUNTRY BRIEFING GUIDE

Page 2


LAOS AT A GLANCELOCATIONA landlocked nation in Southeast Asiabordered by China, Vietnam, Thailand,Cambodia and Myanmar, theLao People’s Democratic Republic is aLeast Developed Country at thecrossroads of a dynamic and fastdeveloping region.

ECONOMYWith most of the population living assubsistence farmers, Laos is highlydependent on foreign aid and has alarge trade deficit. Most consumerproducts are imported, while exportsmainly depend on hydro-electricity andtimber.

POPULATION5.7 million1

Under 18 year olds2.8 million1

Under 5 year olds0.9 million1

FERTILITY RATE4.8 children per woman2

RURAL POPULATIONAbout 80%. At least 49 recognisedethnic groups

TERRAINTwo-thirds of the country ismountainous. The majority of thepopulation is concentrated in the rivervalleys, especially along the Mekong,and the two main plains of Vientianeand Savannakhet. Forest cover israpidly shrinking.3

LAND AREA236,800 sq km – slightly smaller thanthe United Kingdom.

CAPITAL CITYVientiane

I N D I A

C H I N A

Page 3


SOCIO-ECONOMIC ENVIRONMENTGNI per capita (US$)1 310GDP per capita (US$)4 304Health expenditure (% of govt exp.)4 3.4Education expenditure (% of govt exp.)6 8.5Defence and Security expenditure 2 12.6Radio sets per 1,000 people2 145TV sets per 1,000 people2 10Internet users per 1,000 people4 2.7Telephone lines per 1,000 people4 11% Working children (% of age 5-14 yrs)4 32Official development assistance (% of GNI)2 16Debt service (% of exports)2 8

STATUS OF CHILDREN AND WOMENInfant mortality rate per 1,0005 82Under five mortality rate per 1,0009 100Maternal mortality rate per 1,0009 530HIV/AIDS (reported cases)6 1,341% Immunization coverage7

DPT3 50Polio3 52Measles 42Pregnant women Tetanus 36

% Iodized salt consumption8 75% Exclusive breastfed 0-3 months8 26Child Malnutrition10 %

Chronic Malnutrition: stunting 41Acute malnutrition: wasting 15Underweight 40

% Net enrolment Primary School8 82boy/girl12 85/79

% Reaching grade-5 at primary level12 60boy/girl12 60/60

% Females (15+) illiterate9 39% Access to safe water urban/rural8 72/29% Access to sanitary disposal urban/rural8 65/19

FACTSANDFIGURES

1970-2004

1990-2002

1990-2001

1990-2002

2003

2004

2006

Life expectancy increased from 40.4 to 54.5 years4

Under-5 mortality rate dropped from 163 to 100 deaths per 1,000 live births17

Percentage of malnourished people dropped from 29 to 22%1

Primary School enrolment increased from 63 to 83%4

Poverty rate dropped to 29% (from 39% in 1997)15

HIV prevalence has been kept to less than 0.1%, the lowest in the region4

Laos on target to eliminate iodine deficiency disorders

POSITIVE TRENDS

Page 4


TIMELINE UNICEF IN LAOSMODERN HISTORY

Written constitution enacted. Laos ratifiesthe Convention on the Rights of the Child

Lao Government establishes the NationalCommission for Mothers and Children

1986Market economy is introduced

Government participates inWorld Summit for Children1990

First comprehensive Country Programmeof Co-operation1982-96

1981First Basic Agreement signed bythe Lao PDR Government and UNICEF

1975Victory of the Pathet Lao. Proclamation of the

Lao People’s Democratic Republic.Adoption of centrally planned economy

1957-73Indochina War. Laos heavily bombed as the

USA supported the royalist governmentagainst the communist Pathet Lao

1955Laos becomes a member of the UN

1953Full independence from France,

as a constitutional monarchy

1941Japanese occupation

1895Modern Laos defined as a political entity,

becoming a French protectorate

1973 UNICEF Laos office opens in Vientiane,the nation’s capital

UNICEF establishes co-operation with Laos1952

1991 1991

Vientiane hosts Mekong River Commission HQand ASEAN summit. Government adoptsNational Poverty Eradication and Growth

Strategy and launches MillenniumDevelopment Goals campaign jointly with UN

2004 Government and UNICEF launch firstnational study on child trafficking

2003 UNICEF celebrates 30 years of activitiesin Laos

2002 UN Special Session on Children –Lao delegation includes two children

2000 Laos declared Polio free

Laos joins ASEAN, the Association ofSouth East Asian Nations

1997 First Lao report to theCommittee for the Rights of the Child1997

1994Friendship Bridge opens over the Mekong,linking Laos and Thailand

Prime Minister decrees all saltmust be iodized1995Luang Prabang declared a World Heritage Site 1995

2004

Page 5


NATIONAL GOVERNMENT• Single party government under the Lao People’s

Revolutionary Party• National Assembly elections held every four years• Media and judiciary state controlled• Governance, economic and legislative reform ongoing

since 1986• Provincial governments gaining local power through

decentralisation• National NGOs are not permitted

INTERNATIONAL RELATIONS• Becoming more engaged at an international level• Assumes ASEAN presidency 2004 - 2005• Stresses a foreign policy of peace and non-interference in the

internal affairs of other states• Normal Trade Relations status granted by the USA in 2004

ECONOMY• In the 1990s the Lao economy grew at an average rate

of 6.3% per year10

• The 1998-99 Asian economic crisis halted growth• After a period of recovery, growth now stands at

around 5.8%10

• Inflation and the Lao currency, the Kip, are stable• Growing foreign currency earners: gold, electricity and tourism• Government plans to use hydro-electric dams to generate

future growth• Major trade partners: Thailand, Vietnam, China and more

recently the EU• Laos is close to achieving self-sufficiency in rice• Private investment is encouraged but business oportunities in

Laos still limited by bureaucracy and corruption. Tax collectionsystems are weak, leaving the government with permanentbudget problems.

THE LAO CONTEXTPOLITICAL AND ECONOMIC TRENDS

Page 6


THE LAO CONTEXTTHE SITUATION OF WOMEN AND CHILDREN

73% of the Lao population live on less than $2 a day18

Disparities based on geography, gender and ethnicity areincreasingly evident, exacerbated by resettlement in remote areas.

Difficult terrain hampers development of infrastructure. Access tohealth, education, water and sanitation remains inadequate. Ruraland ethnic minority women and children are particularlydisadvantaged.

Child mortality rates have declined. The infant mortality ratedeclined from 134 per 1,000 live births in 1990 to 82 in 2000.However, child mortality rates remain among the highest in theregion with the majority of deaths caused by malaria, acuterespiratory infections and diarrhoea.

The maternal mortality rate is one of the highest in the region, dueto the absence of adequate pre-natal, delivery, and post-natal care.

Routine immunization coverage is on the decline and fullimmunization coverage is now only around 50%.

High malnutrition rates persist: 40% of children under five areunderweight for their age. Micro-nutrient deficiencies remain aproblem, though Laos has made great progress in reducing iodinedeficiency.

Despite improvements, 40% of the population still lack safe waterand 65% have no sanitation facilities. Difficult access to safewater places a major additional burden on women and girls, andpoor sanitation contributes to the high incidence of disease.

Page 7


THE SITUATION OF WOMEN AND CHILDREN

While primary school enrolment has increased, over 142,000school age children are still deprived of their right to education.Girls, notably from ethnic minority communities, are particularlydisadvantaged. Progress in education is hampered by low governmentinvestment, poor school facilities and an inappropriate curriculum.Teachers are often poorly qualified and inadequately paid.

More than half the population is under 20 years of age and lacksskills and opportunities. As the country opens up, new problemsare emerging such youth migration, HIV/AIDS and cross bordertrafficking.

Child protection issues have become increasingly evident in Laosas the country moves from a closed to a market economy andopens up to its neighbours and the region. The legacy of UXOcontamination continues to affect rural populations in 16 of 18provinces. Recent data suggests that 40% of victims are children.The number of children living or working on the streets isincreasing in urban areas, most aged between six and ten years.Glue sniffing, amphetamine use and prescription drugs abuse arereported to be on the rise among urban youth.

Trafficking, particularly of girls aged 14-18, is a growing problem.Lao children are most frequently trafficked to Thailand, where themajority end up in the domestic labour force, commercial sexindustry, agriculture, sweat shops or factories. The Governmentrecently signed a regional MOU to combat this trend.

While Laos is still considered a low prevalence country for HIV/AIDS the real incidence of infection may well be much higher. Thecountry is surrounded by countries in the midst of HIV epidemics.

Little is known about the extent to which HIV/AIDS is affecting thelives of children. Development of facilities for the care and supportof people living with HIV/AIDS - and strategies for the preventionof mother to child transmission - are in their infancy.

Page 8


UNICEF AT WORK

HEALTHAchieve MillenniumDevelopment Goal 4:Reduce deaths ofchildren under five bytwo-thirds by 2015:- ensure that 80% of

children under one areimmunized againstseven diseases in all142 districts of thecountry

- maintain polio-freestatus

- eliminate maternal andneonatal tetanus

- virtually eradicatemeasles

Improve the nutritionalstatus of childrenthrough vitamin Acoverage for 80% ofyoung children aged6-59 months

Improve the nutritionalstatus of children andwomen through theelimination of iodinedeficiency disorders(IDD) through universalsalt iodization by 2006

UNICEF is supporting the nationalexpanded programme on immunization(EPI) through training, vaccines andcold-chain equipment and servicedelivery. It is working with thegovernment and WHO to implementthe ‘Reaching Every District’ approach.UNICEF is advocating with thegovernment for sustained investmentin maternal and child health, and issupporting community mobilization tostimulate demand for immunizationservices.

UNICEF is providing advocacy andsupport for vitamin A and ironsupplementation and reduction ofintestinal parasites through schooldeworming.

UNICEF is supporting Lao saltproducers to continue producingenough iodized salt to cover 100% ofhuman needs. It is assisting thegovernment to control salt productionquality and monitor consumers’ saltconsumption.

Laos has made substantial progress inreducing child deaths but childmortality rates remain high - one in tenLao children dies before the age offive.

Routine immunization coverage iscurrently only 50% and the countryfaces major challenges to ensure basichealth services reach women andchildren. The government is aware ofthe problem and has renewed itscommitment to increase EPI coveragerates.

Under-nutrition, parasite infection andvitamin A deficiency continue to beserious problems.

75% of households now consumeiodized salt; iodization is a legalrequirement for salt manufacturers.

If political commitment and productionimprovements can be maintained, by2006 Laos could be the secondcountry in the region to achieve USIand eliminate iodine deficiencydisorders.

DevelopmentChallenges

UNICEF Actions Progress

Page 9




WATER AND SANITATIONIncrease the proportionof people with access tosafe drinking water by50% by 2015

Ensure 80% of thepopulation have accessto safe excreta disposalfacilities by 2020

Increase hygieneawareness

UNICEF is advocating for increasedpolitical attention to water andsanitation issues.

It is helping government agencies pipewater to rural houses and schools, andbuilding the delivery capacity of thestate rural water supply agency.

It is supporting development of anational water quality standard and acommunity-based water qualitysurveillance system.

UNICEF is assisting with constructionof latrines and septic tanks in ruralvillages and schools in targetprovinces.

Support hygiene awareness in schoolsthrough health education, teachertraining and deworming of schoolchildren.

Population access to safe waterincreased from 30 to 58% between1990 and 2002.

National Water and Sanitation Strategyand Hygiene Law adopted in 2001.

A ministerial decree on water qualitytargets was approved in 2003.

42% of people now use sanitaryexcreta disposal.

Health and hygiene are now part of thenational school curriculum.The Blue Box, a hygiene educationtool, has been developed anddistributed to primary schools.4,000 primary school teachers havebeen trained to lead children through“hygiene education games”.

EDUCATIONAchieve universalprimary education by2015 (MDG - MillenniumDevelopment Goal 2)

Eliminate genderdisparity in primary andsecondary education,preferably by 2005, andto all levels of educationby 2015 (MDG -Millennium DevelopmentGoal 3)

UNICEF is advocating with thegovernment to increase investment inbasic education, in accordance withthe MDG goals.

UNICEF is advocating with thegovernment to raise awareness of theimportance of girls’ education.

It is also supporting the creation of achild-friendly school environment,including teacher training, gendersensitization and improvement ofschool hygiene facilities.

The primary school enrolment rate for2003/2004 is 82% according to theMinistry of Education – a 1% annualincrease over the past five years. Laoscurrently has one of the lowest publiceducation investment rates in the region,with real government spending oneducation having declined in recent years.

There is increased governmentawareness regarding the importance ofgirls’ education. There has been amodest reduction in the gender gap inprimary education, from 77 girls per100 boys in 1991 to 84 per 100 in2003. Accelerated investment isrequired for Laos to reach the MDGeducation targets. Teaching standardsand physical conditions of schoolsneed further improvement.

Page 10


CHILD PROTECTIONSocial and economicchange within Laos iscreating newvulnerabilities and risksfor children and youngpeople

Raise awareness aboutthe illegality and harmfulconsequences of failingto protect children fromviolence, abuse andexploitation

Support thedevelopment of aprotective environmentfor children and youngpeople in Laos, includinglegal and socialprotection

UNICEF is focussing on exposing andreducing dangers to children at risk ofchild trafficking and abuse, childsexual exploitation, children affectedby UXO, and by drugs and violence.

UNICEF is working to improve thelegal response to child victims ofviolence, abuse and exploitation andto support children in conflict with thelaw.

UNICEF is active to ensure childrenhave access to information to protectthemselves from the dangers of UXOin the most heavily affected areas.

UNICEF support to the government toimplement the Convention on theRights of the Child in the Lao context:- preparation and adoption of a

comprehensive law on children- reporting to the Committee on the

Rights of the Child- building knowledge and

understanding of the Conventionby local officials and teachers

- developing child friendly materials

The government is making concertedefforts to protect children, signing aregional MOU against trafficking.A National Plan of Action to CombatCommercial Sexual Exploitation ofChildren has been drafted. A law hasbeen adopted on the Development andProtection of Women, including childtrafficking.

Child sensitive investigationprocedures adopted and implementedin 6 provinces, working with theMinistry of Public Security and thePeople’s Supreme Prosecutor.A national coordinating committee onjuvenile justice has been established.

UXO risk reduction education for childrenhas been incorporated into the schoolcurriculum in 30 of the most heavily UXOaffected districts of the country.

Awareness of child rights issues hasincreased, however professional skillsbuilding and concrete application of childrights principles will require a long terminvestment.



Page 11


Laos is still considered alow prevalence country forHIV/AIDS, but it is at highrisk since it shares borderswith five countries withgrowing epidemics.Poverty is widespread andyoung people are highlyvulnerable to HIV throughlabour migration, primarilyto Thailand

Strengthen family andcommunity-based care,and health care systemsto provide support andtreatment to people livingwith HIV/AIDS, includinginfected children

Prevent mother to childtransmission (PMCT) byreducing the proportionof infants with HIV by20% by 2005

UNICEF is supporting a Lifeskillsprogramme for vulnerable youth,both in and out of school. In 2004, theprogramme reached 46,800 youngpeople in villages, and over 10% of allfourth and fifth graders nationally.

Support for self help groups in 5provinces, providing important social andeconomic support for children and adultsaffected by HIV and AIDS. SupportBuddhist monks to give spiritual support toHIV positive families and to advocate forcommunity acceptance and compassion.

UNICEF is helping build an innovativePMCT programme supportingVientiane’s Mother and Child hospitalto supply HIV positive pregnantwomen with anti retroviral drugs.

Assessments have shown increasedknowledge about HIV/AIDS by youngpeople.

People with HIV/AIDS haveexperienced increases in self-esteem,reduction in community discriminationand improvements in family income asa result of self help groups andcommunity education by monks.

The Lao Government hasdemonstrated strong commitment topreventing mother to childtransmission, and has established aNational PMCT Task force.

HIV/AIDS



ADVOCACY AND COMMUNICATIONCreate opportunities forchildren and youngpeople in Laos toexpress themselvesthrough the mass media

Develop the Lao media’scapacity to report onpriority issues affectingchildren, young people andfamilies. Ensure mediareporting on sensitivetopics is conducted in anethical manner whichprotects children

Build commitment tochildren’s issues amonggovernment leaders,parliamentarians andmass organizations

UNICEF is supporting training ofchildren in radio reporting, scriptwriting and producing in fourprovinces.

UNICEF is supporting production anddistribution of a media handbook,Child Rights and Media Ethics in LaoPDR, with the Lao Journalists’Association. Assistance withworkshops and field reporting onissues such as child health, HIV AIDSand child trafficking. Support forchild-friendly communicationmaterials.

Support for high level advocacyoutreach, including a national meetingon immunization and training for LaoNational Assembly information staff.

This pilot project is providing Laochildren and young people with theopportunity to learn media skills andgain confidence in expressingthemselves.

Children’s issues are receiving higherprofile in the local media, and reportsare more child-sensitive.

The Meena cartoon character has beenadapted to the Lao context andbroadcast through TV, booklets andposters.

Children’s issues are slowly gaining ahigher profile with government leadersand parliamentarians.

Page 12


UNICEF AT WORKSUPPORTING WOMEN AND CHILDREN

SOME US DOLLAR COSTSFOR TYPICAL UNICEF WORK IN LAOSPrint one textbook about HIV/AIDS, drugs andreproductive healthOne child’s set of textbooks and learning materialsAnnual cost of routine vaccines and injection materialsfor one childSend one child to school for a yearOne rain water jar that can store 2,000 litresConduct community-based HIV/AIDS activities in onevillage, per yearProduce a “Blue Box” for health and hygienepromotion in schoolsTrain one teacher on Lifeskills approach to HIV/AIDS,drugs and reproductive healthProvide one child with five years of primary educationTrain one unqualified teacher through a teacherupgrading courseSupport for an HIV positive member of a self-helpgroup, per yearConstruct a well for a schoolBuild a two-room latrine in a schoolHelp a community create a child-friendly learningenvironment in their primary schoolInstall a piped water or gravity fed water supplysystem for 50-70 householdsOperational costs to deliver 4 rounds of immunizationservices in one districtProcure syringes and safety boxes for nationalimmunization coverage, per yearCosts of vaccines to immunize 80% of childrennationwide, per year

39c.

$5$10

$15$35$45

$60

$68

$100$200

$300

$500$800

$3,000

$4,000

$4,500

$180,000

$1,500,000

Page 13


TRAVELThe country can now be entered through a growinga number of international borders, including theairports in Vientiane and Luang Prabang. Visas areavailable on arrival at major border crossings. Directlong-haul travel is not possible: the nearest hubs areHanoi and Bangkok. Internal flights may be subjectto sudden change, while road travel can be limitedby road quality and security updates.

CLIMATELaos has a tropical climate with a six-month wetseason from May to October. The dry season is mildto cool from November to January: jackets arerequired during the evening and early morning,particularly in the north of the country. FromFebruary, temperatures rise until the rains arrive.

TOURISMTwo World Heritage Sites are attracting increasingnumbers of visitors: the former royal capital, LuangPrabang, and the ancient Khmer temple of Vat Phu.Adventure and eco-tourism, exploring the mountains,forests and rivers, is also growing but numbers arestill small.

LANGUAGELao is a tonal language with a phonetic script. Mostethnic minorities have their own languages. Englishis the language of commerce and tourism in thecities. Older, educated Lao people may speakFrench, while parts of the north are dominated byChinese and parts of the south by Vietnamese.

HEALTHThere are no health facilities operating atinternational standards. Minor injuries or illnessescan be treated at clinics and hospitals in Vientiane.Emergencies require evacuation to Thailand.

CURRENCYThe Kip cannot be exchanged outside Laos. In 1994US$1 bought 720 Kip. In early 2005 one dollar wasworth about 10,000 Kip. Thai Baht and US dollarsare readily accepted in urban centres. There are afew international ATM machines in Vientiane andcredit cards are accepted in some urbanestablishments.

MEDIAThe Lao press, television and radio are state-controlled.Local radio is a powerful tool for reaching audiences,but due to the mountainous terrain more than half therural population lives outside broadcasting range.Thai TV, freely viewable near the countries’ borders,is more popular than Lao channels. Satellite TV andforeign press are available in the main cities, andinternet use is available in the urban areas, but isrelatively slow.

FACTS FOR VISITORS

Page 14


Policy InquiriesMs Olivia Yambi, RepresentativeEmail: [email protected]

Programme InquiriesMs Desiree Jongsma, Programme CoordinatorEmail: [email protected]

Media InquiriesMs Ruth Landy, Advocacy & Communication Section HeadEmail: [email protected]

General InquiriesUNICEF Lao PDR Country OfficePO Box 1080Km3 Thadeua RoadVientiane, Lao PDR

Telephone: 856 21 315200-4Facsimile: 856 21 314852Email: [email protected]

CONTACTS

1 Government of Lao PDR National Statistical Centre Yearbook 2003. Vientiane.2 UNICEF The State of the World’s Children 2005. New York.3 UNDP Country Common Assessment 2000. Vientiane.4 UNDP Human Development Report 2004 . New York.5 World Bank World Development Report 2003 . Washington DC.6 Committee for Planning and Cooperation, Lao PDR. 2003. Government expenditures by sector 2002-03. Vientiane.7 ADB Key Indicators of Developing Asian and Pacific Countries 1985-2003. Manila8 National Statistic Centre (NSC)/National Institute of Public Health/UNICEF, Lao PDR. Multiple Indicators

Cluster Survey 2000. Vientiane.9 NSC and State Planning Committee, Lao PDR. Lao Reproductive Health Survey, 2000. Vientiane.10 Ministry of Health, Lao PDR, June 2004.11 WHO/UNICEF Joint Reporting Form on Vaccine Preventable Diseases, Jan-Dec 200312 Ministry of Education (MoE), Lao PDR. 2004. Annual Bulletin13 MoE, Department of Non-Formal Education, Lao PDR Lao National Literacy Survey 2001 Final Report14 State Planning Committee and NSC, Lao PDR Lao National Health Survey, 2000. Vientiane.15 World Bank Lao PDR Economic Monitor 2004. Vientiane.16 National Centre for Environmental Sanitation and Water Supply (Nam Saat), Lao PDR. 2002.17 UNICEF Progress for Children, A Child Survival Report Card, Vol 1 2004.18 World Bank World Development Indicators 2004.

References

Imagery Credits

Photographs UNICEF/Jim Holmes

Page 7: Poster “The Lord Buddha has compassion for all”, artist: Vongsavanh Damlongsouk

c

Documents

UNICEF Lao PDR Country Briefing Guide€¦ · For every child Health, Education, Equality, Protection ADVANCE HUMANITY LAO PDR COUNTRY BRIEFING GUIDE