Living longer, but the "healthy living" gap is still large
Mr. Le Thanh Dung - Director of the Population Department (Ministry of Health) - said that Vietnam is facing 4 major challenges: Reduced birth rates below replacement levels; gender imbalance at birth; rapid population aging and limited population quality. These challenges intertwine, directly impacting the lives of each family and the long-term development foundation of the country.
According to the report summarizing population work in 2025, the total birth rate continued to decrease over the years: from 2.01 children/woman (in 2022) to 1.96 (in 2023) and 1.91 (in 2024) - the lowest ever recorded.
Notably, the replacement birth rate of 2.1 children is currently only maintained in about 17% of provinces and cities. This means that most localities have fallen into the group of low birth rates. “If low birth rates persist, the risk of shrinking population size in the future is present, leading to labor shortages and increasing the burden on the social security system” - Mr. Le Thanh Dung warned.
In parallel with the decrease in birth rates, the sex ratio at birth is still high: In 2024 it is 111.4 boys/100 girls. This is a sign of the risk of male surplus in the future, leading to many consequences such as difficulties in marriage, changes in family structure and social problems arising if not controlled promptly.
Another challenge that is accelerating strongly is population aging. Vietnam officially entered the aging phase in 2011 and is expected to become a country with an aging population after 2036.
In 2024, the average life expectancy reached 74.7 years, but the number of years living healthy is only about 65 years. The gap between "long life" and "healthy life" poses a major requirement for long-term health care, social services, as well as preparing resources to meet the increasing needs of the elderly population group.
The Ministry of Health acknowledges that policies to support and encourage sufficient birth of two children in many places are still limited; mainly in the construction or pilot phase, not strong enough to create clear and sustainable changes.
Completing institutions, implementing the Population Law from July 1, 2026
Deputy Minister of Health Do Xuan Tuyen said that in 2025, population work continues to receive attention from the Party and the State, with many important documents creating a corridor for the new phase. Notably, the Population Law has been passed by the National Assembly and will take effect from July 1, 2026.
Leaders of the Ministry of Health request that the issuance of guiding documents for implementation must be timely and synchronous, ensuring effectiveness at the same time as the Law takes effect. According to the plan, guiding decrees and circulars need to be completed no later than May 15, 2026.
Along with that, the Ministry of Health will advise on consolidating the National Steering Committee for Population and Development; prepare a conference to summarize activities and deploy population work tasks in 2026. Another important task is to soon stabilize the organizational model of the population work apparatus according to the two-level local government model, ensuring smooth operation of the system from the province to the grassroots level.
The population work orientation for 2026 is identified in the context that Vietnam is simultaneously facing many demographic challenges. The top priority is to encourage having enough two children, gradually bringing the birth rate back to the replacement level, suitable to the characteristics of each region, region and population group. At the same time, continue to control gender imbalance at birth through communication to change behavior, improve institutions and increase supervision of technology abuse to choose gender.
In parallel, improving population quality is promoted through pre-marital health consultation - examination, prenatal and neonatal screening, consolidating the quality of family planning services. With aging, the message is not only "living longer" but also to move towards "healthy living", reducing the burden of disease, increasing the ability to self-care and participate in social life of the elderly.
The average life expectancy of 74.7 years is a welcome milestone. But for that joy to be complete, Vietnam will have to solve the "double problem" of low birth rates and population aging with substantive actions: Clear institutions, strong enough resources, reliable data, solid organizational structure and synchronous solutions that correctly address the problems of the people - especially young families and the labor force" - Deputy Minister of Health Do Xuan Tuyen said.
