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Table of Contents

Executive Summary 1List of Acronyms and Abbreviations 8

Acknowledgments ^

I. General Issues 11

A. Introduction ' 11B. Objectives of the Survey 11C. Background information on children with disability in Vietnam 12

II. Survey Methodology 18A. Definition of children with disabilities (CWDs) 18B. Sample design 19C. Content of questionnaires 21D. Training/workshop on survey skills 22E. Checking information and processing data 23

III. Results of the Child Disability Surveys 24

A. Children with disabilities living in households 241. Characteristics of children with disabilities 24

in households2. General indicators of prevalence and severity of disability 243. Types of disabilities 264. Causes of disabilities 285. Education and vocational training . 306. Participation in daily life activities and social support in 31

the community7. Provision and use of rehabilitation services 338. Work status and job aspirations of children with disabilities 35

B. Children with disabilities living in institutions 371. Characteristics of CWDs, types and causes of disabilities 372. Means of admission to the inslilulion 393. Education and vocational training 404. Institutionalized disabled children's contact with family 415. Perceptions of children with disabilities about institution and staff 426. Work status and job aspirations of children with disabilities 44

in institutions

IV. Summary of Findings and Recommendations 46

V. References 53

VI. Annexes 561. List of tables from the community and institution surveys 562. List of figures included in the Report 59

THE 16 PROVINCES COVERED BY THE SURVEY

North East1. Lao Cai2. Ha Giang3 Cao Bang4. I anc| SciTT]

Quang Ninli |G.BAc Giang7. Thai Nguyen8. Bic Kan9. Tuyen Quang10 Yen Bai11 PI it'i 1 IIP12|y/inh Phiicl13 Die Minii

North West14 Lai Cliau15 Son La

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26|Thanh Hoa |27 NghS An28 Ha Tint)29 Ouang Binh30|Ouanc] Til [31 Thua ThiSn Hue

South Central Coast32|DaNaiig |33 Quang Nani34 Quanci Nciai35|BlnhDjnli|36 Phu Y6n37 Klianh H6a

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uVietnam Disability Survey 1998 Page 1c

EXECUTIVE SUMMARY

A community-based sample survey of 1,148 children with disabilities livingin households in 16 provinces/cities covering all eight economic regions of thecountry and an institution-based survey of 230 children with disabilities living ineight institutions were conducted in late 1998 under the direction of MOLISA, withfinancial and technical support from UNICEF. The main findings of the community-based survey and the institution-based survey on children with disabilities includethe following:

1. The generalized weighted child disability prevalence estimates for the countryas a whole was 3.1 percent of children aged 0-17 years old, implying that thereare about 1 million children with disabilities living in Vietnam today.

2. The two most prevalent types of child disabilities reported in the community-based survey were movement disabilities (22.4 percent of all reported childdisabilities) and speech disabilities (21.4 percent of all reported childdisabilities).

3. From the community-based survey, the main causes of disabilities in childrenwere congenital birth defects (55.0 percent of all reported causes of childdisabilities) and diseases (29.1 percent of all reported causes). These werealso the two main causes of disabilities reported among children withdisabilities living in institutions, with congenital defects accounting for almosttwo-thirds (64.6 percent) of all reported causes, and diseases accounting foralmost one-fourth (23.5 percent) of all reported causes of disabilities amongchildren living in institutions.

4. In the community-based survey, half of all reported disabilities in children wereclassified as severe disabilities. In the survey of eight institutions, the vastmajority of children with disabilities (90 percent) who were living in theinstitutions had severe disabilities.

5. Multiple disabilities were fairly common in children with disabilities. The averagenumber of disabilities in CWDs was 1.48 disabilities per CWD living inhouseholds and 1.64 disabilities per CWD living in an institution. Hearing andspeech disabilities tended to often occur together in the same child, as didspeech disabilities and fits/strange behavior disabilities.

6. Female children generally had lower reported disability prevalence rates thanmale children. This finding may be the result of both lower risks among femalechildren for some specific disabilities and also possible underreporting ofdisabilities in female children.

Vietnam Child Disability Survey 199G Page 2

7. The education level of children with disabilities was generally very low. In thecommunity-based survey, almost half of the school-age children (aged 6-17years old) with disabilities were illiterate (45.5 percent). Over one-third of CWDsaged 6-17 had never attended school and another one-sixth of the school-ageCWDs had dropped out. In the institution-based survey, the education situation

8. of CWDs was somewhat better. Only five percent of the CWDs had neverattended school, although over one-fourth of the CWDs in institutions haddropped out of school. In the institutions, 85 percent of children with disabilitiesaged 15-17 had not finished primary school. Very low proportions of the olderCWDs living in households or in institutions had completed secondary school.For both CWDs living in households and those living in institutions, non-attendance at school and dropping out of school appear to be mostly a functionof family poverty, lack of education programs for CWDs, inaccessibility ofschools to CWDs, and feeling ashamed or lacking confidence because of theirdisability.

9. From both the community-based survey and the institution-based surveyresults, it appears that vocational training for children with disabilities andemployment opportunities for older CWDs are quite limited. Apparently, inmany regions inadequate attention and resources have been allocated toappropriate vocational training and job creation programs to meet the needs ofthe vast majority of CWDs who have employment aspirations for the future. Forboth CWDs living in the community and those living in institutions, the rate ofvocationally trained disabled children was very low. In the community it wasfound that tailoring was one of the few professions some children withdisabilities were able to pursue successfully. The fact that over 90 percent ofCWDs hope to have a meaningful job in the future, highlights the need togreatly increase the opportunities and provide the means for them to achievetheir life goals, and help integrate them more into the community.

10.Awareness of local rehabilitation services was very low among children withdisabilities living in households (from the community-based survey). About one-third of all CWDs living in households have never sought treatment for theirdisability. Seeking treatment for child disabilities varied by region and urban-rural residence, with 90 percent of CWDs living in urban areas of the Red RiverDelta region seeking treatment, compared to only 29 percent of CWDs living inrural areas of the Central Highlands seeking treatment.

11.Although about one-fifth of CWDs were found to be using rehabilitative aidsand devices such as prosthetics, orthotics, hearing and vision aids, andwheelchairs, the rates of usage of these devices was quite low, consideringthat half of all CWDs living in households had severe, disabilities. The vastmajority of devices used were some type of glasses or vision aids. Less thanten percent of children with movement disabilities and less than two percent ofchildren with hearing disabilities used any kind of rehabilitative aid or devicewhatsoever. The vast majority of rehabilitative devices being used werepurchased rather than received through donation.

Vietnam Child Disability Survey 1998 , Pago 3

12. Only 5 percent of CWDs living in households in urban areas and 10 percent ofCWDs living in households in rural areas received any form of financial supportfrom the government and or the community, such as monthly allowances, freeor subsidized education, and/or free health cards. The level of support variedby region, with one-fourth of all CWDs in the North West region receivingsupport compared to only two percent of all CWDs in the South East regionreceiving support.

13. There appears to be a general social acknowledgment and/or acceptance ofchildren with disabilities in the general population. The community-basedsurvey found, that the vast majority of CWDs living in households reported thatlocal people had positive or favorable attitudes towards them (i.e., they aretreated normally or with kindness/sympathy). However, there was somevariation in attitudes of local people towards CWDs according to region andurban-rural residence.

14.In the institutions 6.5 percent of the CWDs had been abandoned by theirfamilies, another 2.6 percent had no families (orphaned), and 9.1 percent hadno contact with their families. However, most of the institutionalized CWDs hadweekly contact with family members. Contact with family varied according totype of disability, with more than one-third of children with fits/strange behaviordisabilities reporting they had no contact with family members.

15. Almost one-fifth of the CWDs in institutions said they did not like the institutionand the percentages who disliked the institution were higher among the olderchildren ,with disabilities living in the institutions (e.g.,, 31 percent of the 15-17year olds said they disliked the institution). The main reasons for disliking theinstitution were (1) they missed mother/father (40 percent); (2) they were bulliedor made fun of (38 percent); and (3) they were not treated properly (22percent). The vast majority (four-fifths) of CWDs in the institutions who saidthey liked the institution said they liked it because (1) they needed to be caredfor/looked after (36 percent); (2) the opportunity to make/play with friends atthe institution; (3) the opportunity to have state/government benefits (16percent); (4) the opportunity to be treated by a doctor/specialist (1 percent); and(5) all other reasons (12 percent). The vast majority of the CWDs living ininstitutions reported that they -were treated well by the institution staff (i.e.,treated normally or with kindness and sympathy).

16. By far, the children with fits/strange behavior disabilities appeared to be themost socially isolated, in that they had fewer friends, had lower participation inschool, work, and daily life age-typical activities and were less likely to reportthat they were treated well by local people in the community or by staff in theinstitutions. '

Vietnam Child Disability Survey 1998 Page 4

Children with disabilities who were attending school or attendingwork/vocational training were far more likely to have friends than those CWDs whodid not attend school or did not go to work/vocational training. Thus, it seems thatfuller participation and greater opportunities for CWDs in education, vocationaltraining, employment and daily community activities will help to minimize theirsocial isolation, maximize their integration in the community, and ultimately leadthem to a more fulfilling and economically and socially productive lives.

Unfortunately, the current situation of many CWDs includes: poverty-level :living conditions, low literacy and education levels, very limited vocational trainingand employment opportunities, and limited awareness of and access torehabilitative services (and rehabilitative aids and devices), and lack of adequatesocial integration in the community. The Government, community, humanitarianorganizations and the families of children with disabilities should make increasedefforts to finding concrete and effective solutions to these problems.

Recommendations:

1. As awareness of and support for children with disabilities and a range ofrehabilitation services for them are still quite limited, a nation-widecommunication campaign on topic of children with disabilities should beconducted.

2. Essential information widely disseminated in order to improve people'sawareness of the important role the community can play in helping children 'with disabilities in many aspects of their lives. This campaign shouldhighlight both the needs of and opportunities for children with disabilities,such as providing rehabilitation services and rehabilitation devices and aids(e.g., orthoses, prosthetic limbs, wheelchairs, hearing aids, braille books,etc), opening up educational opportunities, vocational training, job creation,and increased social integration of CWDs in the community. Attentionshould be given to the special needs of children with multiple disabilities andthose living in special institutions. Children with some specific types of Idisabilities such as fits/strange behavior disabilities may be more sociallyisolated and require greater attention and more innovative approaches tomeet the needs of this group. Media messages should target policy makers, jparents/caretakers of CWDs, community leaders, teachers, social workers,and business and health professionals to create more favorable andsupportive attitudes for providing greater educational and vocational jopportunities for children with disabilities are needed. " '

3. Expansion of the MOH's community-based rehabilitation programs and of Jjinclusive education programs are needed so that these programs can bemore closely linked together and scaled-up nationwide to reach all districts »,in all provinces.

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Vietnam Child Disability Survoy 1998 Page 5

4. The Government should ensure that children with disabilities are givenspecial attention in the implementation guidelines for the Ordinance onDisabled Persons promulgated in 1998. A more holistic approach to helpingchildren with disabilities is needed, with multi-sectoral collaboration at thenational, provincial, district, and community levels. The various ministriesand NGOs working with children with disabilities should work together toshare data and resources and coordinate child disability preventioncampaigns, early detection and screening procedures in the communities,and early interventions in health, education, and vocational rehabilitationand training programs targeting CWDs throughout the country.

5. The policies of the Government on the issue of child disabilities comes fromVietnam's traditions of humanitarianism and socialism. The approach of thevarious sectors toward children (and adults) with disabilities should be oneof inclusion and integration rather than exclusion/seclusion andsegregation/separation. The concept of socialization requires improving therole of the government and at the same time to encourage the efforts ofeach citizen and the non-governmental and private sectors to also play arole. Both public and private enterprises, social organizations, and domesticand international NGOs should participate in solving the challenges facingchildren with disabilities in Vietnam, such as health care, education,vocational training, and social integration into the community (e.g., sportingevents, play activities, arts, crafts and cultural festivals, communitydevelopment efforts, and other social gatherings and entertainmentactivities).

6. The governmental ministries involved with children with disabilities (MOH,MOET, and MOLISA) should expand integrated projects on community-based rehabilitation, and expand the training and retraining of (1) socialworkers and other professionals who are working in institutions for CWDs;(2) teachers who work with CWDs in special education and/or inclusiveeducation programs; (3) rehabilitation health professionals (e.g., orthopedicsurgeons, physical therapists, and nurses) who are working in hospitals,rehabilitation centers, and community-based service programs; (4)vocational training and occupational therapists; and (5) workshoptechnicians who make rehabilitative devices and aids for CWDs.Furthermore, special training or orientations are also needed for the parentsand relatives who take care of children with disabilities at home and forcommunity leaders and community organizations who can play a moreactive role in the integration of children with disabilities in community life.These measures will enable more children with disabilities to have realopportunities to improve their life and to integrate more fully into thecommunities.


7. The Government has decided to pursue more vigorously the inclusiveeducation approach to educating children with disabilities. However, incases of severe and multiple disabilities additional special schools mayneed to be built and existing facilities upgraded, to better meet the needs ofchildren with severe and multiple disabilities. The goal should be that thevast majority of children with disabilities should have at least a primaryeducation. To achieve even this modest goal will require a greatercommitment and effort on the part of all those involved.

8. Quality orthopedic devices and other rehabilitative aids and devices forchildren with different types of disabilities need to be made much morewidely available. Geographic, social and economic access to these devicesand aids is uneven. ,

9. To improve the quality of training centers, priority should be given toenrolling and training people with disabilities to serve as staff, as well asenrolling and training children with disabilities.

10. The Government should consider more specific measures to train, monitorand evaluate teachers, who. are teaching children with disabilities ininclusive education and special education schools or in vocational trainingcenters.

11. Institutions for CWDs and social welfare centers should be organized in themodern way of offering specialized services and activities for differentgroups in need, including children with disabilities. The government shouldprovide the grant and support for the institutions and centers to organize thecultural, vocational and other activities for children with disabilities using thecenters. The government should also help the business enterprises andworkshops where the child disabilities could work.

12. Because most child disabilities are caused by either congenital defects ordiseases which are preventable, much more proactive public health effortsare needed to reduce the incidence of all types of child disabilities in thefuture.

13. Attention should be given to the differentials in prevalence of disabilities infemale and male children to determine whether these differences are real orartifacts of the reporting biases for male and female children.

14. Provisions should be made to make rehabilitative devices more accessibleacross the country and establish a system for providing a safety net of freedevices for CWDs from families to poor to be able to purchase them.

15. Efforts to improve the publics' attitudes and understanding even further andto build the confidence and self-esteem of children with disabilities throughcounseling, roje models, and confidence-building and empowering activities, «

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16. In light of all of the above recommendations, serious thought and effortshould be given to finding the most practical, effective and sustainable(cost-effective) ways of implementing these recommendations, to ensurethat the benefits to children with disabilities will be both long-term andcontinuously improving over time.

The Vietnam Child Disability Survey was successfully conducted in late1998 in 16 provinces and cities, covering the major economic regions of thecountry. The survey results show a relatively clear picture of the current situationand characteristics of children with disabilities in Vietnam, and identifies a numberof areas where there is still a great unmet need for services to help children withdisabilities participate more fully in life and be more integrated in the community.The areas of greatest need are in the areas of expanding educational opportunitiesfor CWDs, in either inclusive or special education activities for CWDs, dependingon their needs, and making available to older CWDs a, much greater range ofvocational training and job opportunities. Another area of needed improvement isin the overall awareness of the general population about issues affecting CWDsand how people perceive CWDs and their potentials, and how they treat CWDsand try to integrate them into community life.

It is hoped that this document, especially the recommendations, will becarefully considered by both governmental and non-governmental organizations,as well as the UN bodies, international NGOs, donor agencies, in order to bringthem a better understanding of the problems and needs of CWDs, and so that theywill adopt more appropriate and effective policies, programs and serviceinterventions that will ultimately improve" the physical, material, emotional andsocial life of children with disabilities in Vietnam.

Vietnam Child Disability Survey 1998 Pago 8

LIST OF ACRONYMS AND ABBREVIATIONS

AIFOAWDCBRCHWCiCCMTSSCPCPCCCRSCWDDCOFDEDDOHDOETDETDOLISADPPPEPGSOGSRVGTZHCMCHHHIHPUHNUHVOICIDH

ICRCIEIVTISPOKAPK2LSMCNVMETMISMOCMOETMOHMOJ

Associazione Italiana Amici di Raoul FollereauAdolescents with DisabilitiesCommunity-based RehabilitationCommune Health WorkersCare in the CommunityCentral Medical Technical Secondary SchoolsCerebral PalsyCommittee for the Protection and Care of ChildrenCatholic Relief ServicesChildren with DisabilitiesDisplaced Children's and Orphan's FundDeutsche Entwicklungs Dienst '•Department of HealthDepartment of Education and TrainingDepartment of Education and TrainingDepartment of Labor, Invalids and Social AffairsDisability Policy and Program ProjectEpilepsyGeneral Statistical OfficeGovernment of the Socialist Republic of VietnamGeselleschaft Technische ZusammenarbeitHo Chi Minh CityHouseholdHandicap InternationalHanoi Pedagogic UniversityHanoi National UniversityHealth Volunteers OverseasInternational Classification of Impairments,Disability, And HandicapsInternational Committee of the Red CrossInclusive EducationInclusive Vocational TrainingInternational Society for Prosthetics and OrthoticsKnowledge, Attitude and Practice (test or survey)Komitee TweeLoss of SensationMedical Committee Netherlands VietnamMonitoring and Evaluation Team (VVAF)Management Information SystemMinistry of ConstructionMinistry of Education and TrainingMinistry of HealthMinistry of Justice

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Vietnam Child, Disability Survoy 1998 Pago 9

MOLISAMSAVCLNCPFPNGONIPNIDV

NLRNIESOOPODTAP & OPCPCEPDPHBPOPPOWERPRAPSBIPTPVOPWDRBRECFD

SBSCF/UKSESWTGTDCSETNAUNDPUNICEFUSAIDVBAVHVVINAREHAVNAHVNHSVTVVAFWCDOWVIWHO

Ministry of Labor, Invalids and Social AffairsMedical Scientific Aid Vietnam, Cambodia, LaosNational Committee for Population and Family PlanningNon Governmental OrganizationNational Institute of PediatricsNational Institute of Dermato-Venerology (Bach MaiHospital, Hanoi)Netherlands Leprosy ReliefNational Institute for Education and SciencesOrdinance on Disabled Persons in Vietnam (1998)Office of Disability Technical Assistance (Hanoi)Prosthetics and OrthoticsPeople's CommitteePresident's Committee on Employment of PWDsProvincial Health BureauProsthetics Outreach FoundationProsthetic and Orthotic World Education and ReliefParticipatory Rural Assessment/AppraisalPearl S. Buck InternationalPhysical TherapistsPrivate Voluntary OrganizationsPersons with DisabilitiesRadda Barnen (Swedish Save the Children)Research and Education Centre for the Disabled (HCMCity) (Also RECHC: Research and Education Centre forHandicapped Children)Strange BehaviorSave the Children Fund/United KingdomSpecial EducationSocial Work Training GroupTraining&Development Center for SpecialEducationTraining Needs AssessmentUnited Nations Development ProgrammeUnited Nations Children's FundUnited States Agency for International DevelopmentVietnam Blind AssociationVillage Health VolunteersVietnam Rehabilitation AssociationVietnam Assistance for the HandicappedVietnam National Health SurveyVocational TrainingVietnam Veterans of America FoundationWorld Concern Development OrganizationWorld Vision InternationalWorld Health Organization


ACKNOWLEDGMENTS

The Centre for Information and Statistics on Labour and Social Affairs,MOLISA, wishes to thank a number of organizations and individuals who madevaluable contributions to various aspects of the 1998 Vietnam Child DisabilitySurvey. We express our gratitude to UNICEF Vietnam, particularly Mr. Marc Ono,Chief of the Family Welfare and Child Protection Section and Mr. Vu Ngoc Binh,National Project Officer who made significant contributions to the 1998 VietnamChild Disability Survey in terms of financial and technical support for the study. Weespecially thank UNICEF consultant Mr.Tim Bond for providing valuable technicalassistance in the literature review, questionnaire and sample design, training, andtabulation plans and survey data analysis. We also offer special thanks andappreciation to UNICEF consultant Dr.Thomas T. Kane who provided crucialtechnical assistance to MOLISA in the data analysis, and in the drafting, editing,and finalizing the Final Report for the 1998 Vietnam Child Disability Survey. Dr.Kane made substantial contributions in the analysis of the data from thecommunity-based survey and the institution survey, redrafted and edited the finalreport, and added many important tables and figures that substantially improvedthe depth and quality of the report.^ We express our deep appreciation to thecooperating organizations that participated in the various phases of the surveytraining and data collection and processing, especially the Vietnam Committee forthe Protection and Care of Children (CPCC), various departments of MOLISA inHanoi, and provincial departments of labour, war invalids and social affairs(DOLISAs).

We thank the Central Steering Committee for organizing two regionaltraining workshpp on survey skills which were conducted in Hanoi and Ho Chi MinhCity. We also thank the participants of the regional and provincial trainingworkshops, including the Vice-Directors of the Department of Labour, Invalids andSocial Affairs, experts on social insurance, officers of CPCC, and supervisors andinterviewers (i.e., health care officers, social officers, and CPCC officers) for thesurvey fieldwork in the 16 selected provinces/cities. The survey enumerators andsupervisors are to be commended for their hard work during the survey fieldwork.Thanks and appreciation are also due to the experts of the Centre for Informationand Statistics on Labour and Social Affairs (CISLSA), experts of the Department ofSocial Protection, and members of the Central and Local Steering Committees onDisabled Children for their roles in the overall supervision of the implementation ofthe survey. Special appreciation is also expressed to the various departments ofMOLISA and DOLISAs involved in the survey data entry, general tabulations, andstatistical analysis. And finally, we express our deep appreciation to the childrenwith disabilities included in the survey, their families, and the eight socialinstitutions included in the survey, for their time, their cooperation, and the detailedand useful information they provided during the survey, which were essential tomaking the 1998 Vietnam Child Disability Survey a success.

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Vietnam Child Disability Survoy 1998 . Pago 11

I. GENERAL ISSUES

A. Introduction

The Vietnam Child Disability Survey 1998 was carried out by the Centre forInformation and Statistics on Labor and Social Affairs under MOLISA, with fundingand technical support from UNICEF. This survey was conducted from June 1998to February 1999. A total of 23,040 households in urban and rural areas in 16provinces were included in the community-based sample survey. A total of 96household cluster groups in the eight major regions of the country were selectedand interviews conducted directly in order to determine the number and rate ofdisability among children aged 0-17 years old and to obtain other socioeconomicand demographic information on children with disabilities (CWDs). Community-based survey information was obtained for 1,148 children with'disabilities living inthe sampled households and .an additional 230 disabled children living in eightinstitutions were also interviewed in a separate institution-based survey.

UNICEF has made a significant contribution to the 1998 Vietnam ChildDisability Survey, in terms of funding and technical support for the study. UNICEFconsultant Mr. Tim Bond provided valuable technical assistance in the literaturereview, questionnaire and sample design, training, and tabulation plans and surveydata analysis. UNICEF consultant Dr. Thomas T. Kane provided crucial technicalassistance to MOLISA in the data analysis, arid in the drafting, editing, andfinalizing the Final Report for the 1998 Vietnam Child Disability Survey.

The Final Report and accompanying tabulation reports provide much of themain results of the 1998 Vietnam Child Disability Survey. More in-depth secondaryanalysis of the data may be planned for the future.

B. Objective of the Survey

The objective of the survey is to collect recent information on the prevalenceand types of child disability, the causes of child disability, the socio-demographiccharacteristics of children with disabilities, and the patterns of utilization ofrehabilitation services and the social and economic circumstances of CWDs. Thepatterns and norms of government and community support for functionalrehabilitation, education, vocational training, and job opportunities for children withdisabilities, and their level of integration in daily life in the community were alsoassessed in the survey.

Accurate and complete estimates of the number of children with disabilities,by age, gender, region of residence, type of residence (urban or rural), type ofdisability, cause of disability, educational and work status, and disabled children'sneed for and use of rehabilitation services in Vietnam are needed for policyformulation, program planning and decision-making, and for the evaluation ofdisability programs' impact on the lives of CWDs and their integration in community

Vietnam Cliild Dis:ihilily Suivuy 1991; Pago 12

life. The information is needed to plan training for teachers in special education, ainclusive education, and vocational training programs, and to train social workers,physical therapists, speech therapists, orthopedic specialists, other medical andpsychiatric specialists, prosthetics and orthotics workshop technicians, andcommunity-based rehabilitation workers. The information is also used to determinewhether the current supply of rehabilitative devices (e.g., hearing aids, orthoses,wheelchairs, special glasses, prosthetics, etc.) is sufficient to meet the demand forthese devices.

C. Background Information on Children with Disabilities inVietnam: Sources and Kinds of Data

Many of the sources of data on children with disabilities (CWDs) in Vietnamare similar to or the same as the sources of information for all persons withdisabilities, such as special surveys conducted by the Ministry of Labour, Invalids,and Social Affairs (MOLISA) and the Ministry of Education and Training/NationalInstitute of Education Sciences (MOET/NIES) and their collaborating Non-governmental organizations (NGOs), such as World Vision International (WVI),World Concern Development Organization, Catholic Relief Services (CRS), andthe Pearl S. Buck Foundation ( PSBR); from community-based rehabilitation (CBR)data collected by the Ministry of Health (MOH), the Committee for the Protectionand Care of Children (CPCC), and their collaborating international NGOs such asAssociazione Italians Amici di Rauol Follereau (AIFO), Radda Barnen, HandicapInternational, Vietnam Veterans of America Fund, and Save the Children/UK; andservice statistics from rehabilitation centers and orthopedic workshops servingchildren as well as adults run by MOLISA, the Department of Labour Invalids andsocial Affairs (DOLISA), and the MOH. In addition, there have been a number of ;disability project evaluations, needs assessments and situation analyses that havegenerated some new data on CWDs and rehabilitation services, and haveprovided some additional insights into the issues, problems, and program needs inthe field of disability and rehabilitation.

Unfortunately, there have been very few independent social science or • |epidemiological studies of children with disabilities conducted in Vietnam over thepast decade. The few examples we can cite here are (1) a qualitative study of »..,parents and non-disabled children's attitudes towards children with disabilities and jinclusive education, conducted by Le Ngo for the Goteborg University Sweden,1998; (2) a master thesis on rehabilitation services for PWDs (including CWDs) ^during Vietnam's economic transition by Daan Biermann of Catholic University of iNijmegen Netherlands, 1997; (3) a review study of child disability by Tim Bondand David Hayter for UNICEF, 1998; and (4) a UNICEF Situation Analysis of **children with disabilities in Viet Nam by Cao Mann Thang, 1997. ;|


I* Data on the prevalence of specific types of disability, their causes and the[ characteristics and needs of CWDs are used for planning, decision-making, and

monitoring and evaluation of service programs for CWDs. Several ministries,w especially MOLISA, MOH, and MOET collect data on CWDs and services provided[^ to CWDs. A number of NGOs also collect, process, and analyze disability data to

establish baseline measures, assess the current situation, monitor progress andt •' evaluate the impact of disability interventions in project areas. A number of data[^ collection approaches are used, but primarily data are collected through sample

surveys (e.g., MOLISA and MOET/NIES), the MOH's CBR worker house-to-housei • reporting system, and government and NGO service statistics (e.g. WVI, VVAF,L. VNAH, ICRC, HI) on disabled clients at rehabilitation centers (e.g., MOLISA,

DOLISA, and MOH centers), rehabilitation departments (MOH provincial hospitalj . rehabilitation departments, NIP); and vocational training centers, special education[.'• schools, and inclusive education programs (World Concern, CRS, Pearl S. Buck,

_ Radda Barnen, MOET/NIES) catering to the needs of CWDs. In addition to theMOH CBR services being provided in 29 provinces, the Committee for the

i;;. Protection and Care of Children (CPCC) does CBR services and monitoring forCWDs in seme 20 additional provinces. In the future, MOH will probably be taking

, over responsibility for CBR services in the provinces where CPCC has been' . overseeing some CBR services for CWDs.

L Despite the extensive amount of disability data collected, much of the dataare of questionable quality, accuracy, and completeness. The data are rarelyanalyzed in-depth. Very little documentation is provided on the methodology (e.g.,

:" sampling procedures, definitions used, duration and content of interviewer training,. -: and supervision and quality control measures during fieldwork, editing, coding, and

data processing). The data are not often shared or disseminated. Furthermore, thedifferent focus of different organizations and different definitions of disability usedoften make the data from the various sources difficult to compare.

No organization, to date, has collected comprehensive data on childdisability for all 61 provinces of the country. Much of the child disability datacollected so far tends to be for specific rehabilitation centers or institutes, or indistricts and communes where disability interventions such as community-basedrehabilitation (CBR), inclusive education (IE) programs, special education (SE)programs, and/or vocational training (VT) for children with disabilities are beingimplemented. Thus, for many provinces there are large gaps in our knowledge ofthe overall prevalence of child disability, the types and causes of disability, and theservices needed and services provided. The few large-scale data collection efforts,such as the 1994-1995 MOLISA Survey of severe disabilities, and the more recent1998 MOLISA Child Disability survey (reported on in this report), and the MOH'sCBR reporting system, have obtained data on disability from only a fraction of the

v country's provincial districts and communes.

Vietnam Child Disabil ity Smvoy 1998 Pago 14

Organizations, projects, and interventions providing services for childrenwith disabilities have different data needs for the different types of specializedservices they provide (e.g., physical rehabilitation, inclusive education, andvocational programs, programs targeting children aged 0-15, adolescents aged 13-17, programs for movement-disabled only, blind only, deaf only, learning disabledonly, etc.). Among the projects focusing on children with disabilities, the agedefinition of "children" varies from organization to organization and project toproject, e.g., the 1998 MOLISA/UNICEF Child Disability Survey defines children asaged 0-17 years; Radda Barnen's Inclusive Education Interventions define childrenas aged 0-16 years; and the MOH rehabilitation centers and MOET's NIESsurveys define children as aged 0-15 years).

Prevalence of Disabilities Among Children, Types of Disabilities andCauses:

Over the past decade, a number of different studies have estimated theoverall prevalence of disability in terms of numbers of CWDs and the percent ofthe child population having disabilities for specific study areas in Vietnam. Recentestimates from various sources on the number of children with disabilities inVietnam have varied from as low as 215,00-235,000 (for children aged 0-15reported by CPCC-CEDC program in 1995 and reported by MOLISA in 1995based on a national survey of severe disabilities only), to estimates at the high endof the range of between 1,000,000 and 1,230,455 CWDs reported by NIES in1995, by Hanoi's Children Hospital, and by MOLISA in 1992. The range inprevalence estimates in terms of the percent of the child population (ages 0-15, 0-16, or 0-17) having disabilities ranged from 2.0 percent to 6.2 percent of the childpopulation in specific study areas, which may or may not be representative of thecountry as a whole (See Table 1 and Figure 1).

Table 2 and Figure 2 show the distribution of child disabilities, by specifictypes of disability, for different areas of Vietnam and from different sources of data(i.e., various MOLISA and MOET/NIES surveys and MOH CBR data). There iswide variation in the distribution of CWDs by type of disability from the various datasources. Movement disabilities make up from 19 percent to 32 percent of allCWDs. Hearing and speech disabilities comprise between 19 percent and 31percent of all disabilities in children. Vision disabilities make up between 14percent and 22 percent of all disabilities. Estimates of learning disabilities vary themost from one data source to another, ranging from only 4 percent of all CWDsreported to have a learning disability in one survey, compared to 35 percent of allCWDs reported to have a learning disability in a MOH/Radda Barnen survey ofCWDs (see Table 2). ' -i

!i1

CL:

Viotnam Child Disability Survey 1998 ; Pagn 15

The 1998 Vietnam Child Disability Survey, conducted by MOLISA withfinancial and technical support from UNICEF, includes a preliminary report andaccompanying tabulation reports which were completed and released in Februaryof 1999. The survey covered 23,040 households in 16 provinces. A total of 1,148CWDs (ages 0-17 years) were identified in the survey, which is about five percent

' of the households surveyed, or 2.8 percent of the 41,037 children aged 0-17 livingin the households included in the survey. This translates to CWDs being about 1.0percent of the total population (114,816) living in the households included in thesurvey. About one-third of the children with disabilities had movement disabilities.

t •

L The two previously available major sources for national estimates ofdisability, indicated that children (ages 0-15) make up between 15 percent of all

! • • persons with disabilities (PWDS) (1994-1995 MOLISA Disability Survey, which1 - includes only moderate to severe disabilities) to 30 percent of all PWDs (MOH

CBR data, 1997) of all persons with disabilities (See also Kane, 1999). Although! children aged 0-15 years make up between 35 and 40 percent of the total!~- population, children have a lower prevalence of most disabilities compared to

adults, who have a longer period of exposure to risks of disabilities, especiallyI those disabilities caused by war, accidents, and aging.

Using data from the 1994-1995 MOLISA Disability Survey, we observe for. v the age group 0-15 years that movement disability is the largest category, with;•-.- about one-third of all disabilities being due to movement disability. Only 9 percenti of child disabilities were sight/vision disabilities. When comparing the distribution of

,* types of disability among children with the type of disability distribution for the totalpopulation combined, we find that children had a much higher proportion of thedisabled having speech disability (16 percent) compared to all disabled in thegeneral population (8 percent). Table 2 and Figure 2 show the distribution ofCWDs by type of disability for specific study areas from six different studies.Movement, speech, and sight disabilities, and (in some studies) learningdisabilities showed the largest shares of types of disabilities among children withdisabilities.

From the 1994-1995 MOLISA Survey we find that, among CWDs aged 0-15, almost two-thirds of them (61 percent) suffer from disabilities caused bycongenital defects, and almost one-third (32 percent) became disabled fromdiseases (Kane, 1999). Not surprisingly, less than one percent of CWDs haddisabilities due to war, and less than three percent had disabilities due to traffic orwork accidents (Kane, 1999).

Gender and Child Disability

: Available data indicate that there are substantial differences in the reportedprevalence of disability among males and females in the population at variousages, including the ages of childhood. These differences may be due todifferences in risks and incidence of certain disabilities in males and females, butmay also be due to reporting biases that may lead to under-reporting for onesex/gender or the other.


A recent UNICEF report suggests that there may be poor detection ofdisability in girls (Bond and Hayter, 1998). The percent of females out of the totalnumber of persons with disabilities is usually well below 50 percent even thoughfemales make up slightly more than half the population overall. The 1994-1995MOLISA Disability Survey of severe disabilities and the MOH CBR data bothindicate that reported prevalence of disability is lower among girl children thanamong boy children (Kane, 1999; Bond and Hayter, 1998). Most studies of CWDsconducted to date indicate that between 38 percent and 45 percent of CWDs arefemale (Kane, 1999).

The only exceptions to this pattern were found in a small disability surveyconducted in Lac Son district of Hoa Binh province where more female than maledisabled children aged 15 and under were identified, and in another disability studyconducted in Ha Tay province in 1997-1998, which found almost equal numbers ofmale and female children under age 16 years with disabilities.

Data from the 1998 MOLISA/UNICEF Child Disability Survey indicates thatamong children with disabilities aged 0-17 years, 42.9 percent (492/1148) werefemale, with the percent female among severe disabilities being 43.6 percent, andamong those with mild or partial disabilities being 42.0 percent. In this survey, thepercent of children with specific disabilities who females (girls) ranged from 37.6percent for the hearing impaired to a high of 44.4 percent for the sight impaired.

Educational Status of CWDs and Vocational Training for CWDs

A number of organizations, including the MOET/NIES's Center for Special !Education, Hanoi Pedagogic University's Training and Development Center forSpecial Education (HPU-TDCSE), and NGOs such as Radda Barnen, KomiteeTwee, MCNV, Pearl S. Buck Foundation, Catholic Relief Services, and Save the . ,Children/UK have been working to develop special education and inclusiveeducation programs for children with disabilities. The MOET/NIES and some of theNGOs have collected baseline survey data and program data to design, monitor, •.'.and evaluate the SE and IE interventions. However, only very limited hard data ofprogram impact has been reported. »••,

The number of CWDs participating in these education programs is still smallcompared to those CWDs in need of such education. The MOH's CBR program ~5has been working with the MOET to support the IE programs and pilot IE programs !have been initiated in at least 44 districts in some 36 provinces as of 1998. At aDecember 1999 Disability Workshop co-sponsored by the MOH and Health «Volunteers Overseas (HVO) in Hanoi, Dr. Trinh Due Duy of the MOET reported ^that 42,000 CWDs now attend IE schools, which conduct some 17,500 IE classes,and involve over 10,000 teachers who participate in the IE programs (Kane, 1999). •«

fci

n

r Vietnam Child Disability Survey 19911 Pago 17

The educational status and literacy rates among CWDs are lower thanchildren in the general population. Estimates of the number of SE schools and IEschools now operating and the number of CWDs enrolled in these schoolprograms vary from source to source. TDCSE reports that in 1996 there were atotal of 104 schools for CWDs (54 schools for deaf; 14 schools for blind and 36schools for the mentally retarded) (HPU, 1998). The MOET/NIES reports thatthere are 72 special education schools for CWDs. A 1998 UNICEF report by Bondand Hayter also states that as of May 1997 there were 72 special schools andcenters catering to the education needs of approximately 4,000 CWDs, with overhalf of these children being deaf children (Bond and Hayter, 1998). The 1998UNICEF report by Bond and Hayter cites a total of 43 schools for hearing andspeech impairments, 13 schools for visual impairments, and 17 schools forlearning impairments, with two-thirds of the special schools being located in HCMCity and Hanoi (and about one-quarter of special schools being located in HCMCity alone (Bond .and Hayter, 1998).

Regardless of the source of the estimates, the evidence suggests thatCWDs' access to special education schools has been very limited. It has beenestimated that in 1995 only 3 percent of CWDs had access to special schools(Thang, 1997). Although inclusive education programs for CWDs in mainstreamschools-has increasingly become the preferable alternative to meet the educationalneeds of CWDs, the numbers of CWDs participating in IE (42,000 CWDs) and SE(4,000 CWDs) combined make up only about five percent of all children withdisabilities.

Komitee Twee and the Hanoi Pedagogic University Training andDevelopment Center for Special Education,(HPU-TDCSE) recently estimated thatthe educational needs of only about 10 percent of children with hearing disabilitieswere currently being met (K2 and HPU-TDCSE, 1998).

It is clear from the existing data that the numbers of CWDs benefiting fromIE and SE programs, and from vocational training programs, fall well short of thetotal number of CWDs in need of such educational and vocational trainingprograms.

The results from the 1998 Vietnam Child Disability Survey, conducted byMOLISA and its collaborating organizations, are presented in Section III of thisreport. These new results provide more comprehensive and representativeinformation on the prevalence of child disability in Vietnam, by type and severity ofdisability, cause of disability, and information on awareness and utilization ofrehabilitation services by CWDs, background socioeconomic and demographicdata, and information on the social integration and educational status, and on thevocational training needs of CH^Ds in Vietnam.

Viotnam Child Disabi l i ty Guivoy 1998 Pago 18

II. SURVEY METHODOLOGY FOR THEMOLISA/UNICEF 1998 CHILD DISABILITYSURVEY

A. Definition of children with disabilities

The definition of disabled children applied to the survey corresponds to thedefinition of disabled people in the Ordinance, on Disabled Persons which wasapproved in July 1998 by the Parliament of Vietnam and which became effectiveon November 1, 1998:

"Disabled children are those aged 0-17 who lack one or some body parts orfunctions in various types of disability preventing action or making action of living,studying...". Some ministries and NGOs have targeted their child disabilityinterventions to slightly different age groups of children (e.g., aged 0-15, 0-16, orO-17 years old). The different age groups used by different organizations make itmore difficult to compare the data collected from the various organizations.

MOLISA and the MOH generally use the WHO definitions of impairment,disability, and handicap, which are defined briefly as follows:

Impairment (at the organ level): a loss or abnormality of body structure orof a physiological or psychological function (Examples: loss of a limb; loss ofvision) (WHO, 1998). It may be the result of disease, accident, congenital, orenvironmental agents. Impairment refers to a damage, weakness or disorder of astructure or psychological /biological function.

Disability (at the individual level): a reduced or absent ability to perform asa result of an impairment. The restriction or absence of a function (like movingaround, hearing, or communicating). Disability refers to a reduction or lack of somecapacity preventing actions in normal conditions.

Handicap (at the social level): disadvantages experienced by a person as aresult of a disability. The result of an interaction between an individual with animpairment or disability and barriers in the social, cultural or physical environmentso that (s)he cannot take part in mainstream community life on an equal level orfulfill a role that is normal (depending on age, sex, social and cultural factors)(Bond and Hayter, 1998). Handicap refers to an invalidity that makes a personunable to perform a part or whole of a normal action (considering age, sex, culturalfactors and social circumstances).

I,Viotnnm Child Disability Stirvoy 190fl P«igo 19c

More recently, WHO defines the more neutral term "activity" to replace theterm "disability" and the term "participation" to replace the term "handicap" in theInternational Classification of Impairments, Disabilities, and Handicaps (WHO,1998).

In this study disability data are examined for the major categories of types ofdisability identified by the World Health Organization (WHO) in their internationalclassification of impairments and disablement (WHO, 1998).

The main types or categories of disability reviewed in this report are thefollowing:

1. Movement/physical/motor/mobility -disabilities (includes amputees,paralyzed, persons suffering from polio, cerebral palsy (CP), clubfootand other birth defects, etc)

2. Hearing and Speech (communication) disabilities3. Sight/Visual/Seeing disabilities4. Learning (cognitive or intellectual) disabilities5. Strange Behavior (resulting from psychotic/mental illness, e.g.,

schizophrenia and depression)6. Fits/epilepsy (This relatively small category has been combined with

"Strange Behavior" in the survey data analysis7. Other disabilities (e.g., leprosy)

Along with the main types of disability categories mentioned above, there isa special category of persons with "multiple disabilities" which needs to be clearlyidentified. Persons with "multiple disabilities" have special service needs andpresent special challenges to policy makers and service providers, and thusaccurate data for this group is also required for proper monitoring.

Information on the causes of disability reported in this survey were coded into sixgeneral categories: (1) Congenital; (2) Disease; (3) Environmental Factors; (4)Accidents; (5) War Toxic Agents; and (6) Other Causes.

B. Sample design

1. Sampling frame

In the community-based survey, a multi-stage stratified random samplingprocedure was used to produce representative estimates of the prevalence of childdisability for the eight regions, for urban and rural areas and, after statisticaladjustments, for the country as a whole.

The sample design involved three stages of stratification. For the first stagethe whole country was divided into eight geographic-administrative regions. At thesecond stage 16 provinces/cities were randomly selected (one to threeprovinces/cities selected from each region). The selected provinces/cities werethen divided into two areas: rural communes and urban precincts/wards and asample of rural communes and urban precincts/wards were selected for each

Vietnam Child Disability Purvey I9(.»0 Page 20

province/city. In the last stage clusters of households were randomly chosen fromthe selected rural communes and urban precincts/wards.

2. Sampling and sample size

2.1 Community-based Household Survey in 16 Provinces

The total survey sample of children with disabilities living in householdsconsisted of 96 clusters of households (or 96 survey sites), that included a total of23,040 households and 114,816 persons. There were 48 urban household clusterswith a total of 12,|80 households from uirfcian areas, and 48.rural householdclusters with a total bf 1-0 ,$60 households ftom the rural areas. In each cluster ofhouseholds, approximately 260 households in urban areas and 220 households inrural areas were chosen. Over one-fourth of the country's provinces were includedin the study (or 16 out of 61 provinces). The selected 96 household clusters in thesample were from 16 selected provinces/cities, representing all eight geographic--administrative regions of the country. The sample clusters of households coveredsome 147 communes in 98 districts located in the 16 provinces/cities. It should benoted that urban areas were over-sampled to get a sample with a sufficientnumber of children with disabilities living in urban areas. From the 23,040households, a total of 1. 48 children aged Q-17., having disabilities were identifiedand interviewed (for you'nger children andijsorrie. severely disabled children theparents or other family numbers were interviewed instead of the child).

;i / '; •%;, • :< ' . .Tj|£ coRlmuftfty-b^sfid survey was carried, out ip the following economic

regions a|)d proytnces_j(iils0 see map betweeti pages 9 arid 10):

I. Red River Delta Region V. Coastal Central Region1. Ha Tay Province 9. Da Nang Province2. Nam Dinh Province 10.Binh Dinh Province

II. North-East Region VI. Central Highlands3. Vinh Phuc Province 11. Kon Turn Province4. Quang Ninh Province5. Lang Son Province

'• ^J T- - i; ,'ill. North-West Region * ' Ull. Sk>uth East Region6. H'ba Binh Province 12. Binh Thuan Province

13. Binh Duong Province

IV. Northern Central Region VIII. Mekong River Delta7. Thanh Hoa Province 14. Dong Thap Province8. Quang Tri Province 15. Ben Tre Province

16.Ca Mau Province

Vietnam Child Disnbilily Survoy 1998 Page 21

i " 2.2. Additional test survey of children with disabilities'<»<

In addition to the community-based survey of the selected householdJ T clusters in the 16 provinces/cities, a quota sample test survey was also conductedu in each of the 16 provinces/cities, which included 20 more children with disabilities

(50 percent male and 50 percent female) were chosen according to the types ofi disability. The purpose of the test survey was to research and analyze disabilityI-* data in-depth and to complement the larger community-based survey data

collected on children with disabilities. This effort resulted in completed interviews: for an additional 320 children with disabilities.','.*

2.3, Survey of CWDs living in eight institutions

"" Among the 16 selected provinces, seven of the provinces have socialinstitutions caring for children with disabilities. A total of 249 disabled children wereselected from thes.e eight institutions. Whenever possible, the interviewers directlyinterviewed the CWD of father, mother, or other relative of the disabled children atthe institutions. A total of 230 interviews were completed for eligible children with

; disabilities at the eight institutions and these data were analyzed.

C. Content of questionnaires

There are three kinds of questionnaires used in this survey: (1) a householdsurvey questionnaire; (2) a survey questionnaire for individual children withdisabilities living in households; and (3) a survey questionnaire for children withdisabilities living in institutions. The questionnaires were designed and pre-testedin two household clusters in Ha Tay province. After implementing the pre-testsurvey the questionnaire was modified with technical assistance from Mr. TimBond, an expert consultant of UNICEF. The questionnaires were written in twolanguages: Vietnamese and English.

The household questionnaire was used to list the number of personsregularly living in the households, to obtain information on age, sex, ethnic group,education level, and to assess the disabled children's relationship to the head ofthe family.

: The main aim of the household survey was to identify children withdisabilities aged 0 to 17 years old living in the households who were to be laterinterviewed in the individual survey of children with disabilities.

The questionnaire for individual children with disabilities was used to collectdetailed information on disabled children in the selected households. The contentsof the questionnaire for the disabled children (sometimes their parents answeredthe questions instead of them) included:

Vietnam Child Di-,.i l>il i ly Su ivoy 1>Ji)B Pago 22

Basic personal characteristics such as age, sex, ethnic group, literacy,education level, school attendance and dropouts, information about the type ofdisability, cause of disability, severity of the disability, preventability of thedisability, awareness of rehabilitation services available for CWDs in the local area,whether treatment and functional rehabilitation for the disability were received(and, if yes, where treatment was received), perceived need for and actual use ofrehabilitative devices for the disability, vocational training received, participation indaily life activities in the community, number of friends and how the CWD is treatedin the community, relation with family, whether the CWD receives financialassistance (and if so, how much and source of support), current work status, typeof work, hours worked per day, and average salary per month, how job wasobtained, how CWD is treated on the job, satisfaction with job/work and reasons,future job aspirations and plans to achieve job aspirations. The same or similarquestions were asked in the community-based questionnaire and the institution-based questionnaire, although the institution-based questionnaire had slightlyfewer questions (41 questions) than the community-based questionnaire (50questions).

D. Training/workshop on survey skills

At central level

A training workshop on survey skills was organized by the Central SteeringCommittee in two regions: For the northern part of the country the training was inHanoi and for the southern part of the country the training was in Ho Chi Minh City.Participants of this training workshop were Vice-Directors of the Department ofLabour, War Invalids and Social Affairs, experts on social insurance, and officersof CPCC from the 16 selected provinces/cities. The total number of participants inthe survey training workshops were 48 persons from provinces/cities and 12persons from the central level having responsibility for supervising and controllingin the survey.

At province/city level •

In each of the 16 provinces/cities a training workshop was organized forenumerators and working leader teams. A working leader team consisted of threepersons: one health care officer, one social officer and one officer under CPCC.Enumerators carried out the collection of information on the children withdisabilities. The training workshop for enumerators was conducted fromSeptember 15 to October 5, 1998. The interviews (fieldwork) in the varioushousehold clusters were conducted from October 10 to 31, 1998. The supervisionof the implementation of the survey was carried out by the experts of the Centre forInformation Statistics on Labour and Social Affairs (CISLSA), experts of theDepartment of Social Protection, and members of the Central and Local SteeringCommittees on disabled children.

I ••Vietnam Child Disability Survey 1998 Pago 23

E. Checking information and processing data

The enumerators were responsible for filling out the questionnairescompletely and accurately. The working leader teams checked the informationrecorded on the questionnaires. The questionnaires were then sent to theDepartment of Labour, War Invalids and Social Affairs for data entry, generaltabulations, and analysis. All questionnaires from the provinces/cities were sent toCISLSA through mail/post.

After receiving ail questionncyres.'sSfom the 16 provinces/cities, experts ofCISLSA reexamined all the information,and coded the open-ended questions. Thedata entry and data processing were conducted from the first of November to the,end of December 1998 by experienced computer programmers of the ComputerSection under MOLISA, using EXCELL data base software and EPIINFO statisticalcomputer software programs for the analysis of the survey data on children withdisabilities.

c lP»j<;i

-r*!SB—r?

Vietnam Child Disability Survey 1098 Pa(jo 24

111. RESULTS OF THE COMMUNITY-BASED AND THEINSTITUTION-BASED CHILD DISABILITY SURVEYS

A. Children with disabilities living in households(community-based survey)

1. Background characteristics of CWDs

For comparison, Table 3 shows the age, gender, ethnic composition, placeof residence, literacy and vocational training status of CWDs from the community-based survey of 1,1.48 CWDs living in households, the test survey of 320 CWDsliving in households, and the survey of 230 CWDs living in eight institutions. Theage, gender and ethnic compositions of the three survey data sets are similar,except that the CWDs living in institutions were slightly older, on average, than theCWDs in the two household-based surveys, i.e., the community-based survey andthe test survey (See Table 3). The test survey was a quota sample, so an equalnumber of male and female respondents were, interviewed in each of the sixteenprovinces. Table 3 also indicates that CWDs aged 6-17 years old in the survey ofinstitutionalized CWDs had higher literacy levels and higher percentages who hadreceived some type of vocational training than the CWDs interviewed in thecommunity-based household survey and the test survey.

2. The general indicators of prevalence and severity of disability:

2.1. Percentage of children with disabilities among the population aged 0-17 years old (See Table 4). The 23,040 households chosen for the sample

survey included 41,037 children aged of 0-17. Of these children, 1,148 children or2.8 percent of all children in these households were identified as having adisability. Approximately 5 percent of the households in the general community-based sun/ey (or about one in every 20 households) had a child with a disabilityliving there (1,101 CWD households/23,040 total households in the sample = 4.8percent). From the community-based survey estimates of prevalence of childdisability, it was also possible to calculate weighted prevalence estimates that aregeneralized for the total population of Vietnam, using coefficients that adjust for thetrue composition of the population according to urban-rural residence and region ofthe country. The generalized results indicate that the prevalence of disability ofchildren aged 0-17 years old in Vietnam was 3.1 percent, and that 5.7 percent ofall households in the country has at least one child with a disability living there.

*'t

[Vietnam Child Disability Survoy 1998 Pago 25

r»

f. In the urban areas, the percentage of all children aged 0-17 havingdisabilities was 2.5 percent, while for urban female children 2.3 percent had adisability. The prevalence of child disability was higher in the rural areas, with thechild disability prevalence rate being 3.1 percent for all children aged 0-17 in therural areas, and a rate of 2.7 percent among female children aged 0-17 years inrural areas. The adjusted generalized child disability prevalence rate for all urbanareas of Vietnam was 2.5 percent, and for rural areas the rate was 3.3 percent.

Among the rural areas of the eight economic regions, the rural area with thehighest rate of child disability was in the Red River Delta region (4.6 percent),followed by the rural areas in the Central Coastal region (3.7 percent), with thelowest rate of child disability in rural areas being in the Central Highlands region(2.1 percent) (See Table 4).

Among the urban areas of the eight economic regions, the Red River Deltaalso had the highest rate of urban children with disabilities (3.3 percent), togetherwith the Central Highlands region (3.3 percent). The region with lowest prevalenceof child disability in its urban areas was the Mekong River Delta region (1.7percent) (See Table 4).

The percentage of urban households with at least one child having adisability ranged from a low of 1.8 percent in the North West region to a high of6.7 percent in the urban areas of the Central Highlands region. The percentage ofrural households with at least one child having a disability ranged from a low of 4.8percent in the North West region to a high of 8.3 percent in the Central Coastalregion (Table 4).

At the provincial level, the percentage of households with at least one child'having a disability ranged from a low of 3.0 percent in Ben Tre Province to a highof 6.5 percent in both Quang Tri and Nam Dinh Province.

The child disability prevalence rate, or the percentage of children aged 0-17years old who had disabilities ranged from a low of 2.1 percent in Ben Tre and HoaBinh Provinces to a high of 4.9 percent in Nam Dinh Province (See Figure 3). Itshould be noted that the child disability prevalence estimates for specific provincesare based on relatively small sample sizes and should be interpreted with caution.

2.2. Severity of Child Disabilities

In the general community-based survey, 49.8 percent of children identifiedas having disabilities, had what may be classified as mild, moderate, or partialdisabilities, while half (50.2 percent) of the CWDs were reported to have severedisabilities (e.g., total blindness, total deafness, mute, severe paralysis, etc.).Classification of the level of severity of child disability is based on a set of criteriaconditions or impairments which determine the extent to which the disability limitsthe persons ability to perform various activities.


There is substantial variation in the severity of the disability according to thetype of disability. For example, the percent of children with sight disabilities whowere severely disabled (60 percent) was almost twice as high as that for hearingdisabilities (32 percent severely disabled).

3. Types of disability:

3.1. Overview of types of disabilities and multiple disabilities (See Table 5and Figure 5)

Overall, among the seven types of disabilities, movement disabilities werereported to be the highest proportion of all disabilities among children (22.4percent), followed by speech disabilities (21.4 percent) and the lowest reportedtype of child disability was learning disabilities (3.6 percent) (See Figure 5).Among the 1,148 children in the survey with reported disabilities, there were a totalof 1,708 actual disabilities reported. This means that a substantial proportion ofCWDs had multiple disabilities. The average number of disabilities reported perCWDs was 1.49 disabilities per disabled child (1,708/1,148 = 1.49). However,there may have been some children who had three or more disabilities (e.g., blind,deaf and mute; or deaf, mute and movement disability).

In urban areas, among the seven general types of disabilities reported,movement/physical disabilities were reported to be the highest proportion of alldisabilities reported among children with disabilities (23.8 percent), followed byspeech disabilities (20.8 percent), with the lowest reported type of disability amongchildren being learning disabilities (2.5 percent) (See Table 5).

In rural areas, among the seven types of disabilities, the highest proportionof disabilities was speech disabilities (21.9 percent), followed by movementdisabilities (21.5 percent), with the least reported disability among children againbeing learning disabilities (4.4 percent) (See Table 5).

Sight/vision disabilities accounted for 17.4 percent of all reported disabilitiesin urban areas and 12.7 percent of all reported disabilities in the rural areas.Hearing disabilities accounted for only 6.9 percent of all reported disabilities inurban areas and 11.6 percent of all reported disabilities in the rural areas (SeeTable 5).

For comparison, Table 5 also shows the distribution of types of disabilitiesamong children with disabilities interviewed in the test survey and in the institution-based survey.

Vietnam Child Disability Survoy 1991) Pngo 27

3,2. Gender differentials in reported disabilities among children, byresidence and type of disability (See Table 6)

Among the eight economic regions of the country, in all but the CentralHighlands region, the prevalence of disability among male children aged 0-17years old was higher than the disability prevalence rate among female children inthose aged. On average, the reported disability rate for male children was 25percent higher than the rate for female children.

In all urban areas combined, the prevalence of disability among malechildren aged 0-17 years old was 2.69 percent, compared to a prevalence rate of2.26 percent among female children in those ages. In rural areas, the reportedprevalence of child disability was 3.46 percent among male children, compared to2.66 percent among female children. Thus, in urban areas reported disability ratesin male children were 19 percent higher than the reported disability rates in femalechildren. In rural areas male child disability rates were 30 percent higher thanfemale child disability rates.

In 13 of the 16 provinces/cities included in the community-based survey, thechild disability rate was higher for male children than for female children (data notshown). The exceptions were in Nam Dinh, Da Nang and Ca Mau provinces,where the child disability rates were about equal for male and female children aged0-17. Da Nang was the only province in which the child disability rate was actuallyslightly higher for female children, but the difference was not statisticallysignificant. The differences in reported prevalence of child disability between maleand female children could be due to underreporting of female disability and/or alower risk of disability (e.g., those caused by accidents, disease, etc) for femalechildren. It should again be noted that the sample sizes for individual provinceswere relatively small and thus the estimated child disability prevalence rates mayvary somewhat from the actual rates for each province.

In both urban and rural areas and among all seven types of disabilities, thereported rate of disabilities among boys was consistently higher than thecorresponding disability rate for girls aged 0-17. The highest differentials indisability rates among male and female children were for hearing and speechdisabilities, while the lowest differentials were for sight/vision disabilities and"other" disabilities. The male rate for hearing disabilities was 4.9 hearing disabledboys per 1000 boys, which was 58 percent higher than the reported rate of hearingdisabilities among girl children (3.1 hearing disabled girls per 1000 girls) (SeeTable 7).


4. Causes of disability

4.1. Cause of disability by type of disability (Table 8)

Among the major causes of disabilities classified in this survey, congenitaldefect (or defect from birth) was the most commonly reported cause (55 percent dfall reported causes of disability; with disease(s) being the second most commonlyreported cause of disability (29 percent of all reported causes). Accidents (fourpercent of all reported causes), toxic agents of . ar (six percent), environmentalfactors (two percent) and all other causes ( f> . :r percent) accounted for theremaining balance of causes of disability amon children with disabilities in thecommunity-based survey (See Table 8 and Figure u).

Again for comparison, Table 8 also includes the distribution of causes ofdisabilities among CWDs in the test survey and in the institution-based survey.

The distributions of the major causes of disabilities for each of the differentage groups of children (i.e., 0-5 years, 6-10 years, 11-15 years, and 16-17 yearsold) are shown in Figure 7. The proportion of all disabilities that are due tocongenital defects decreases with increasing age of the child, from 74 percent ofall causes among CWDs aged 0-5 years old, down to 46 percent of all causesamong CWDs aged 16-17 years old. The proportions of all other cause categoriesincrease with increasing age (or age group) of the children with disabilities. Forexample, only two percent of disabilities to CWDs aged 0-5 years old werereported to be due to toxic agents of war, but this percentage increases steadily toten percent of disabilities among CWDs aged 16-17 years old being reported to becaused by toxic agents of war. About one-fifth of disabilities to children aged 0-5years old were reported to be caused by various diseases, compared to almostone-third (31 percent) of all disabilities to children aged 16-17 years old beingreported to be caused by diseases.

Figure 8 shows that female children make up half of all CWDS caused byenvironmental factors, but female children make up less than one-third (32percent) of all child disabilities caused by accidents. Research reuslts from otherstudies also show that boys (males) are more prone to accidents than girls(females) (See Kane, 1999).

The percentage of different types of disabilities reported to be caused bytoxic agents of war are shown in Figure 9. Between 9 and 10 percent ofmovement/motor disabilities and fits/strange behavior disabilities in children aged0-17 years old are reported to have been caused by toxic agents of war, whilethree percent of sight disabilities and three percent of learning disabilities arereported to be caused by toxic agents of war.

Vietnam Child Disability Survey 1991! Pngo 29

It should be pointed out, however, that it is very difficult to accuratelyestablish the causal link between exposure to toxic agents and a specific disabilityoutcome. More in-depth epidemiological investigations are required: (1) todetermine the type of exposure (e.g., type of toxic agent; first, second, thirdgeneration effects); (2) to determine the means of exposure (e.g., the means orsource of exposure, such as direct aerial spraying, contact through airborneparticulates, contaminated food or water); (3) to determine the degree of exposure(e.g., the quantity, frequency, and duration of exposure); (4) to determine therelative risks of various health and disability outcomes in different exposure groupsor areas (high, moderate, low, and/or no exposure groups of individuals or areas;and (5) to obtain detailed medical histories and make clinical examinations of thespecific symptoms and severity of the health conditions in the reported cases (andevaluate these symptoms and conditions in relation to the time, intensity, andduration of exposure to the toxic agent or agents).

4.2. Rehabilitation treatment and care sought for disability(Figure 10)

In general, about two-thirds of children with disabilities in both urban andrural areas (combined) have sought some form of treatment for their disability.Nevertheless, a substantial proportion of children with disabilities in both rural andurban areas reported never receiving any treatment for their disability.

In the urban areas of all eight economic regions combined, the rate at whichchildren with disabilities reported having sought treatment was significantly higherthan the reported rate for seeking treatment in rural areas (76.9 percent in urbanareas compared to 62.2 percent in rural areas) (See Figure 10).

In the urban areas of the Red River Delta region, the rate at which CWDssought treatment for disabilities was the highest (90.2 percent); while the urbanareas of the North West region reported the lowest treatment rate for childdisabilities (62.5 percent) (See Figure 10).

The rural areas of the South East region had the highest reported disabilitytreatment rate for children with disabilities (77.8 percent); with the rural areas ofthe Central Highlands by far reporting the lowest disability treatment rate forchildren with disabilities (only 28.9 percent) (See Figure 10).

The reasons given for why children with disabilities in the rural areas did notgo to a health facility or other place for treatment/rehabilitation services includedthe following reasons: Too poor/poverty (46.8 percent); the treatment facilitylocation was too far from the house (9.5 percent); respondent did not know whereto go for treatment (2.8 percent); belief that the disability was too difficult to treatwell (2.8 percent) and the other reasons (38.1 percent). The reasons given inurban areas for not seeking treatment for the disability were: Too poor/poverty(49.5 percent); the treatment facility location was too far from the house (16.2percent); respondent did not know where to go for treatment (2.7 percent); belief

Vietnam Child Disability Sui vuy 1998 Page 30

that the disability was too difficult to treat well (1.8 percent) and the other reasons(29.7 percent).

5. Education and vocational training of children with disabilities

5.1. Literacy and education status (See Table 10 and Figure 11)

Among the 961 children with disabilities of school-age (ages 6-17 years old)who were living in the households included in the community-based survey, 45.5percent of them were illiterate. This illiteracy rate is higher than the nationalaverage for all children in that age group. In the rural areas, the percent of CWDsaged 6-17 years who are illiterate varied substantially according to the type ofdisability, ranging from illiteracy rates as high as 64.9 percent for children withspeech disabilities and 63.9 percent for children with strange behavior or fits, torelatively low rates of illiteracy of 28.6 percent for children with sight/visiondisabilities and 28.2 percent for children with learning disabilities. In the urbanareas, the percent of CWDs aged 6-17 years who are illiterate also variedsubstantially according to the type of disability, ranging from illiteracy rates as highas 71.3 percent for children with strange behavior or fits to an illiteracy rate of 33.6percent for children with sight/vision disabilities. (See Table 10 and Figure 11)

Of the 961 school-aged children with disabilities in the community-basedsurvey, over one-third of them (36.6 percent) had never attended school, almosthalf (47.6 percent) were currently attending school, and 15.8 percent of them haddropped out of school (See Figure 12).

The main reasons given by the 352 CWDs who had never attended schoolwere: family too poor (51.7 percent); no special school programme available forCWDs (32.7 percent); do not like school (7.1 percent); learning at home (2.6percent); no means of travel to school/school too far/no school available (2.3percent); ashamed (1.1 percent); and other reasons (2.6 percent) (See Figure 13).

The main reasons given by the 152 school-aged CWDS interviewed whohad dropped out of school were: ashamed (20.4 percent); family too poor (11.2percent); the CWD had no ability to learn (9.9 percent); the CWD does not like tolearn (3.3 percent); there was no school program for CWDs (1.3 percent); andother reasons (53.9 percent). (See Figure 13).

5.2. Vocational training

Among the 607 children with disabilities aged 11-17 years included in thehousehold survey, only 2 percent of these children had ever attended vocationalschool/training. Almost all of the very few CWDs who had received vocationaltraining received vocational training in sewing. Over the years, despite thegovernment policies issued on vocational training and job creation for disabledpersons, the awareness of and the availability of vocational training andemployment opportunities for older CWDs appear to be inadequate at all levelsfrom the national to the local level. Therefore, the number of disabled childrenaffording those services is quite small. Furthermore, vocational training programs

Vietnam Child Disnbility Survey 1998 Pago 31

and occupational professions do not currently meet the needs of persons withdifferent types of disabilities. It is clear that there is a large unmet need forvocational training of older children with different types of disabilities, to developtheir skills in a range of occupations (computers, manufacturing, arts, music, crafts,

.languages, tailoring/sewing, other services, etc.) and to open up meaningfuleconomic opportunities for these CVVD as they enter adulthood. Social andeconomic opportunities for CWDs are essential factors for their successfulintegration in their communities.

6. Participation in daily life activities and social support in thecommunity

6.1. Levels of participation of children with disabilities in daily activities:

For the seven main types of disability, the percentage of disabled childrenwho report full participation in typical activities for given age groups are generallyhigher than the percentages of children who report partial participation or noparticipation in typical daily activities for most of the regions examined in thisanalysis.

Children with sight disabilities have the highest percentage of participationin typical activities for given aged (62.8 percent), followed by children with learningdisabilities (43.6 percent). Children with fits/strange behavior disabilities had thelowest percentage reporting full participation (18.8 percent) in age-typical dailyactivities.

The data in Table 11 also indicate that most of the children with disabilitiesare able to participate, at least partially, in normal activities for children their age.Nevertheless, one-sixth of children with disabilities report that they have noparticipation in age-typical activities whatever. Clearly, increased efforts to providephysical, educational, and vocational rehabilitation for children with disabilities areneeded. However, improving family and community awareness of the needs of andpotential for children with disabilities to participate more fully in daily life activitiesshould also be given greater priority. These efforts will help to ensure that CWDsbecome more fully integrated into their communities.

6.2. Friends of children with disabilities

6.2.1. Number of friends of children with disabilities by types of disability(See Table 12)

The majority of children with disabilities aged 6-17 report having more thanone friend. However, almost one-fifth (17.8 percent) of children with disabilitiesreport that they have no friends at all. The percent of CWDs who report havingmany friends and no friends varies substantially according to the type of disability.Children having sight/vision disabilities have the highest percentage reporting thatthey have many friends (60.5 percent) and the lowest percentage reporting thatthey have no friends (6.5 percent). On the other hand, children having fits or

Vietnam Child Disability Survey 199H Pago 32

strange behavior disabilities have, by far, the lowest percentage reporting theyhave many friends (14.2 percent) and the highest percentage reporting that theyhave no friends (38.3 percent) (See Table 12). Thus, children having fits or strangebehavior, have very limited social contacts, more limited participation in age-typicalactivities, and are much more likely to be illiterate. Therefore, children with thistype of disability may need special attention concerning their rehabilitation needs,and people in the community need to be better educated on ways to include thisgroup more fully in the community context.

6.2.2. Relationship of the social friendships of children with disabilities andtheir school attendance and work status. (See Table 13)

Attending school or having a job are likely to expose children withdisabilities to other people more frequently and to provide more opportunities forthem to develop friendships and understanding. There may also be a selectionbias in which the least disabled are the CWDs who are most capable of attendingschool or working and who are also the ones the least likely to be subjected todiscrimination and unfair or unkind treatment because of their disability. Childrenwith disabilities who were attending school or working were far more likely to reporthaving many friends than CWDs who never attended school or who were notworking. Similarly, only two or three percent of children with disabilities who areattending school or working report that they have no friends (See Table 13). Onthe other hand, 43 percent of children with disabilities who have never gone toschool reported having no friends. About one-fifth of the children with disabilities inthe three age groups 6-10, 11-14, and 15-17 who were not working reported thatthey had no friends (See Table 13).

6.3. Attitudes of the community towards children with disabilities(Table 14)

Children with disabilities reported that the majority of neighbors/localresidents had positive or favorable attitudes towards them, i.e., treated themnormally or with sympathy and kindness. Only a small proportion of people in bothurban and rural areas were reported to have frightened or negative attitudestowards children with disabilities. There were some regional variations in CWDsperceptions of local residents' attitudes towards them. Almost three-fourths (72.2percent) of CWDs in urban areas of the Central Highlands region reported thatlocal people had normal attitudes towards them, compared to only 40.8 percent ofCWDs in rural areas of the Mekong Delta region reporting that local residents hadnormal attitudes towards CWDs (See Table 14). Overall, in both urban and ruralareas of the country, over half of the CWDs reported normal attitudes of localpeople towards them, and another one-third reported sympathetic/kind attitudesshown to them by local residents.

.*i

]

Vietnam Child Disability Survoy 1998 Pa9° 33

The data suggest that there is a general social acknowledgment oracceptance of persons with disabilities, and of children with disabilities inparticular, and that awareness of and compassion for CWDs may have beenraised as the results of disability programmes supported by local authorities andindividuals. Thus, it may be that, to at least some extent, many individuals inVietnamese society follow the traditional cultural guideline of "an intact leaf wraps-up a torn leaf, resulting in more compassionate views, attitudes, and humanetreatment of children with disabilities living in the community.

However, there also appears to be some substantial variations in CWDs'perceptions of people's attitudes toward them according to the type of disabilitythey have. While two-thirds (66 percent) of children with sight disabilities thoughtpeople had normal attitudes toward them, only one-third (34 percent) of childrenwith fits/strange behavior disabilities thought people had normal attitudes towardsthem (See Table 15).

7. Provision and use of rehabilitation services

7.1. Children with disabilities' awareness of rehabilitation services in thelocal area (See Table 16)

Among the children with disabilities aged 6-17 years old included in thecommunity-based survey, only 2.5 percent of them knew about rehabilitationservices for disabled children in their local area. CWDs' awareness of rehabilitationservices according to type of disability is shown in Table 16. Awareness of localrehabilitation services was very low for children having all different types ofdisabilities, ranging from virtually no awareness among hearing and speechimpaired children and children with fits/strange behavior disabilities, up to a high ofonly eight percent awareness among vision impaired children (See Table 16).

The percentage of disabled children who knew about local rehabilitationservices varied somewhat according to region of the country: from a high of 21.6percent awareness of local rehabilitation services in the Red River Delta region toa low of 0.0 percent awareness in the Mekong River Delta region. Therefore, muchmore dissemination work is needed to raise awareness about rehabilitation centersand services provided throughout the country. The percentage of children withdisabilities who were aware of local rehabilitation services was very low in bothurban (3.6 percent) and rural (1.6 percent) areas. However, it should be mentionedthat low awareness of local rehabilitation services could also be a function of verylow availability or total lack of local rehabilitation services in many local areascovered in the community-based survey.

It appears that, at least until recently, physical, educational, and vocationalrehabilitation services have focused more on the rehabilitation of children withsome types of disabilities more than on those with other types of disabilities.

7.2. Use of rehabilitation services and rehabilitation aids and devices bychildren with disabilities (See Table 17)

Vietnam Child Disabil i ty Survey i'J'JH Pago 34

The use patterns of rehabilitative aids and devices by children withdisabilities are shown in Table 17, according to type of disability and type of deviceused.

Among the 250 children with sight/vision disabilities in the community-basedsurvey, about one-fifth (20.4 percent) used a rehabilitative device, with the vastmajority being some type of glasses. Only one child was reported as having anartificial eye. There were substantial differences between urban and rural areas inthe percentages of vision-disabled children using glasses and other rehabilitativedevices (41 percent for urban areas, but only 15 percent for rural areas).

Among the 383 children with movement disabilities, 9.1 percent were usingrehabilitative devices (3.7 percent were using crutches, 0.3 percent (1 child) had aprosthetic leg, 2.1 percent of the movement disabled children used wheelchairs,and 3.1 percent used other rehabilitative devices, including orthoses). Less thantwo percent of children with hearing and speech disabilities were reported to beusing rehabilitative devices or aids. In conclusion, for all types of disabilities theuse of rehabilitative aids and devices by children with disabilities was remarkablylow. It may be that both economic and accessibility factors are affecting the use ofrehabilitative devices for children with vision, hearing, movement and other typesof disabilities.

7.3. Sources of support for the rehabilitation devices used by children withdisabilities (See Table 18)

The results of the community-based survey shown in Table 18 indicate thatthe vast majority of rehabilitative aids and devices used by children with disabilitiesare purchased rather than received free by donation. In urban areas 73.8 percentof all rehabilitative devices used by CWDs for the different types of disabilitieswere purchased, and not received through donation. In rural areas 62.5 percent ofthe rehabilitative devices were purchased, with the rest being donated. However,these percentages are dominated by the large number of eye-glasses most ofwhich are purchased (87.8 percent of eye-glasses in urban areas are purchasedand 93.3 percent in rural areas are purchased). Of the 13 crutches in use, 10 ofthem (or 76.9 percent) were actually donated to the CWD free of charge. Of the 9wheelchairs in use by the movement-disabled children, two-thirds of them (6wheelchairs) were donated. The one false eye in use was also donated to the childin need. On the other hand, the one prosthetic leg in use and the one hearing aidin use were both purchased by the urban families of the two children having themovement and hearing disabilities, respectively.

Vietnam Child Disability Survey 190N P<ig° 35

7.4. Assessment of the usefulness of local rehabilitation services bychildren with disabilities

Among the small number of surveyed children with disabilities who knewabout local rehabilitation services, virtually all them stated that these services werevery useful.

7.5. Financial support and other assistance provided by the governmentsand local authorities of the provinces (See Table 19)

The results of the survey show that only 5.0 percent of CWDs in urbanareas and 10.2 percent of CWDs in rural areas had received some form offinancial assistance (monthly allowance, free or subsidized education, and/or freehealth cards from the government and/or from the community). The North Westregion had the highest level of support with almost one-fourth of all children withdisabilities receiving some form of assistance, compared to the South East region,where less than two percent of children with disabilities in either urban or ruralareas were receiving some form of government assistance.

Rural areas in all but one of the eight economic regions received morefinancial assistance and support proportionately than the urban areas in thoseregions. The one exception was in the case of the Northwest region, where ahigher percentage (25 percent) of urban CWDs received assistance compared to22.9 percent of the rural CWDs.

The results of the survey show that financial assistance and/or subsidiesprovided for children with disabilities are low, but it appears that the assistance isgiven more to the poorer regions and more rural areas, apparently following theguidelines of the government.

8. Work status and job aspirations for the future

8.1. Employment and working conditions of children with disabilities

The survey results show that out of 961 children with disabilities aged 6-17years old, 183 of them, or 19 percent of them, reported to be doing some type ofwork (including housework). Housework makes up 77.6 percent of the workreported by CWDs (142/183). Excluding housework, the percentage of childrenwith disabilities who are working is also low (4.3 percent or 41/961).

Families and business agencies sometimes provide convenient conditionsfor children with disabilities to participate in labor, and to provide work suited totheir abilities. However, only one CWD reported working in a family business. Onlyone CWD reported that he/she was begging as a type of work, and only one CWDreported to be working in a state enterprise. The remaining 38 CWDs reportedother types of work, some of which related to their vocational training such assewing/tailoring.

Vietnam Child Disability Survey 199!) Pago 36

The majority (58 percent) of the older working children with disabilitiesreported working less than four hours a day, 34 percent reported working 4-6hours a day, 7 percent worked 7-8 hours a day, and only one percent reportedworking more than eight hours a day.

8.3. Future desire to work

The vast majority (98.8 percent) of children with disabilities aged 6-17 saythey desire to work in the future and have aspirations for specific types of jobs(See Table 20). Table 20 shows the distribution of jobs desired by the children withdisabilities aged 6-17 years old, in total and according to specific types ofdisabilities. The most popular jobs desired by CWDs overall were in teaching (28.3percent); medical care professions (14.4 percent); engineering/electric repair work(14.0 percent); police/security work (10.8 percent); secretarial work (10.6 percent);and artistic work (10.3 percent).

In terms of how the CWDs intend to achieve their job aspirations, Table 21indicates that "hard individual work/study effort" was the most common responsefor a large proportion of CWDs (31.6 percent), with "help from the family" (24.7percent) and "help from the community" (17.9 percent) also playing an importantrole in many CWDs' hopes for achieving their career aspirations.

CWDs see individual hard work and study as particularly important meansof achieving job aspirations for tailoring (50.8 percent), teaching (38.6 percent),and artistic work (25.2 percent). On the other hand, help from family is seen as themost important way CWDs see as a means for achieving their aspirations for jobsin medical care professions (37.0 percent), engineering/electrical repair (29.6percent), and agriculture (21.8 percent) (See Table 21).

Community help also is seen by CWDs as an important way to get jobs inbusiness enterprises (34.3 percent) and police/security work (28.8 percent) (SeeTable 21). A substantial percentage of children with disabilities also expectgovernment assistance as a way to gain specific jobs such as police/security work(18.3 percent), medical professions (13 percent), and business enterprises (20percent). About one-fifth of the CWDs aspiring for the artistic professions say thathelp from friends and relatives and from government assistance programs arenecessary to achieve their job aspirations in the artistic professions.

3

na

Vietnam Child Disability Survoy 1998 Pf>9° 37

B. Children with disabilities living in institutions

1. Characteristics of CWDs, types and causes of disabilities

1.1. Characteristics of CWDs in institutions: types of disabilities, age andgender composition of CWDs in institutions

More than half of the children with disabilities in the institutions wereclassified as having speech disabilities (57.0 percent), and 47.4 percent wereclassified as having hearing disabilities. The percentage of the CWDs in theinstitutions who had sight, movements, and strange behavior/fits disabilities were14.4 percent, 16.5 percent, and 16.5 percent, respectively (See Table 22). MaleCWDs in the. institutions were slightly more likely than females CWDs in theinstitution to have sight and fits/strange behavior disabilities, and slightly less likelyto have hearing and speech disabilities, compared to females.

Of the 230 CWDs included in the survey of CWDs living in institutions, onlyone was reported to have a learning disability (0.4 percent). Based on expectedprevalence levels of learning disabilities in southeast Asian populations andestimates from other studies in Vietnam, it seems likely that both the community-based survey and the institution-based survey of CWDs have underestimated thenumber of children with learning disabilities. These children may have beenincorrectly classified into other categories such as strange behavior/fits, speechdisabilities, and the "other disabilities" category.

Overall, less than half (44.8 percent) of all the CWDs in the institutionsurvey were females. Almost half of the hearing (48.6 percent) and speech (49.6percent) disabled children surveyed in the institutions were female, compared toonly about one-third (36.4 percent) of children with sight disabilities and one-third(34.2 percent) of children having fits/strange behavior disabilities (See Table 22).

Only 5.7 percent of the CWDs included in the institution-based survey wereaged 0-5 years old, while 30.4 percent were aged 6-10 years old, 47.5 percentwere aged 11-15 years old, and 16.5 percent were aged 16-17 years old (SeeTable 3). The children with sight and movement disabilities that were surveyed inthe institutions tended to be much older, on average, than the other disabledchildren, with 54.6 percent of the sight disabled children and 42.1 percent of themovement disabled children being in the oldest age group (Table 23).

1.2. Multiple and severe disabilities

Children living in social institutions have a high percentage of multipledisabilities. The results of the institution survey interviews of 230 children withdisabilities living in the eight institutions show that the average number ofdisabilities observed per CWD was 1.64 disabilities per child. There were 377reported disabilities among 230 CWDs aged 0-17 years old (See Table 22). Half(50.3 percent) of the CWDs interviewed in the institutions had multiple disabilities,

Vietnam Child Disability Survey 'hJ'Jfi Page 38

compared to the other 49.7 percent of the children having only one disability. Thevast majority (90 percent) of the institutionalized CWDs interviewed had a severedisability. In both the institution-based survey and the community-based survey,hearing and speech disabilities were often found in combination in the same CWD.

1.3. Causes of disability

As with the community-based survey data on children with disabilities,congenital defects were the main cause of disability among CWDs living ininstitutions. Among all the CWDs surveyed in the institutions, two-thirds (68,3percent) were attributed, at least in part, to be caused by congenital factors.Diseases were reported to have caused one-fourth (24.8 percent) of the disabilitiesin the children surveyed at the institutions. Toxic agents of war were reported tohave caused 7.8 percent of the disabilities, while only 1 CWD (0.4 percent) wasreported to have become disabled due to an accident. The one accident case wasreported to have caused three different disabilities in the same individual (speechimpairment, fits/strange behavior, and an "other" disability). Other causes werereported as causing 4.3 percent of the disabilities in the surveyed CWDs in theinstitutions. The percentages add up to slightly more than 100 percent becausemore than one cause was reported in a few cases (Table 24).

Causes of disabilities of children living in institutions, according totype of disability

Sight disability: Congenital causes accounted for almost half (48.5percent) of the sight/vision disabilities, while diseases accounted for more than halfof the causes (54.5 percent) of the sight/vision disabilities in the children living inthe institutions. No other causes were reported for sight/vision disabilities. Thepercentages again add up to slightly more than 100 percent because more thanone cause was reported in one case (See Table 24).

Hearing disability: Congenital causes were reported to account for 88.1percent of the hearing disabilities, with less than one percent being caused bydisease, and a reported 4.6 percent being caused by toxic agents of war.

Speech disability: Similar to children with hearing disabilities, congenitalcauses were reported to account for 87.9 percent of the hearing disabilities, with6.1 percent reported being caused by disease, and 5.3 percent were reported tobe caused by toxic agents of war.

Movement disability: Congenital causes account for only about one-third(34.2 percent) of movement disabilities in the children surveyed in the institutions.On the other hand, diseases were reported to have caused well over half (57.9percent) of movement disabilities in these children, and toxic agents of war werereported to have caused almost one-fourth (23.7 percent) of the movementdisabilities in the children surveyed in the institutions (See Table 24).


Fits/Strange behavior disabilities: Congenital causes were reported toaccount for about three-fourths (76.3 percent) of fits/strange behavior disabilities inthe children surveyed in the institutions. Various diseases were reported to havecaused about one-fifth (21.1 percent) of these disabilities, and toxic agents of warwere reported to have caused almost one-fifth (18.4 percent) of the fits/strangebehavior disabilities in the children surveyed in the institutions (See Table 24).Multiple causes were reported for some cases.

Other disabilities:Congenital causes (51.8 percent) and diseases (51.8 percent) each were

reported to cause about half of the "other" disabilities reported among CWDssurveyed in the eight institutions, while toxic agents of war were reported toaccount for 7.4 percent of "other" disabilities (See Table 24). Multiple causes werereported for some children with "other disabilities".

2. Means of admission to the institution (See Table 25)

The three main ways that the children with disabilities came to be admittedinto the institutions were (1) They were brought to the institution by the family(father/mother/relatives) in almost half the cases (47.0 percent); (2) They werebrought by local authorities, such as the Labour, Invalids and Social AffairsDepartment (46.5 percent); and (3) The children had been abandoned by thefamily (6.5 percent).

A substantially higher percentage of children with movement disabilities(23.7 percent) and with sight/vision disabilities (12.1) percent came to theinstitution after being abandoned by their families, when compared to the averagefor all the CWDs combined of 6.5 percent being abandoned. Less than onepercent of the children with hearing disabilities living in the institutions had beenabandoned by their families.

Over half of the children with sight disabilities (51.5 percent) and movementdisabilities (55.3 percent) were brought to the institution by their parents/families(See table 25).

More than half of all children with hearing, speech or fits/strange behaviordisabilities were brought to the institution for other reasons by local authorities(56.9 percent, 54.2 percent, and 55.3 percent, respectively) (See Table 25). Forexample, some children (16.5 percent) were brought to the institutions by the localbranch of the Department of Labour, Invalids and Social Affairs because they wereorphans, destitute, or were otherwise qualified for government support.


3. Education and vocational training of children with disabilities

Only 5.7 percent of the children with disabilities in the institutions were notof the school aged 6-17 (i.e., 5.7 percent are less than six years old). Among theschool-age children with disabilities living in the institutions, 12.4 percent of themwere reported to be illiterate and that they have not attended school (See Table 3).This illiteracy rate is substantially lower than the illiteracy rate observed in thecommunity-based child disability survey, where 45.5 percent of all school-agedCWDs were illiterate (See Table 3). The percentages of male and female childrenwith disabilities who are illiterate are not very different from each other.

Of the 217 school-age CWDs living in institutions, two-thirds were currentlyattending school while only 5.1 percent had never attended school, and over one-fourth (27.2 percent) of the CWDs had dropped out of school (See Figure 12).

Apparently, the children in the institutions are more fortunate to havegreater access to both rehabilitation care and education than the generalpopulation of CWDs living in households. It is not known from these data whetherthe socioeconomic status of the parents of children with disabilities living ininstitutions is higher or lower than those having children with disabilities living athome.

3.1. Percentage of children with disabilities with various levels ofeducation (See Table 26)

The vast majority (78.3 percent) of school-age CWDs (ages 6-17 years old)living in the institutions have not yet completed primary education and 5.1 percenthad no schooling whatever. In fact, only 13.0 percent of the CWD aged 15-17 whowere surveyed in the institutions had completed primary school or higher schooling(and only one CWD had completed secondary school) (See Table 26). Thus, it isnot likely that these children have achieved a high level of literacy and knowledge.

3.2. Vocational training for children with disabilities

Among disabled children aged 6-17 living in the institutions, 15.2 percent ofthem (or 33 CWDs) were attending (13.8 percent) or had completed (1.4 percent)vocational training. Three-fourths (75.8 percent) of the CWDs receiving vocationaltraining were learning sewing/tailoring skills, while 21.2 percent were learningmusic, and 3 percent (or one CWD) was learning handicrafts and fine arts. All 7 ofthe CWDs getting vocational training in music had sight/vision disabilities. Of the25 CWDs getting vocational training in tailoring, 20 of them (or 80.0 percent) hadboth hearing and speech disabilities, while the remaining 5 of them (or 20.0percent) had movement disabilities. The one CWD receiving vocational training inhandicrafts and fine arts had a movement disability.

Violn.im Child Disabilily Survey 1991! , Pago 41

L

In two of the institutions run by DOLISA, there were no CWDs in the surveywho reported that they were receiving vocational training in the institution (one inNorth Central region and one in North East region) and in another DOLISA center

I in the Central Coast region, only one CWD out of the 28 CWDs interviewed at thatL institution (or 3.6 percent) reported that they were receiving vocational training.

Thus, it appears that the vocational training rates at these institutions are quite lowand that there is a real missed opportunity here to provide vocational training to

L- CWDs living in institutions.

4. Institutionalized disabled children's contact with family(-::•

The vast majority (90.9 percent) of children with disabilities living inI institutions had contact with their families (See Table 27).

4.1. Percent of institutionalized children with disabilities having contactwith family, by type of disability

Contact with family members among the children with disabilities living ini the institutions appeared to vary according to type of disability. While almost all

(98.2 percent) of the children with hearing disabilities had contact with familymembers, less than two-thirds (65.8 percent) of the children with fits/strange

! behavior disabilities had any contact with their families (See Table 27).

4.2. Frequency of meetings with family members

Among the CWDs living in institutions who had some contact with theirfamilies, almost half (48.3 percent) had weekly contact visits from their parents,while another 36.8 percent had contact visits from parents once a month. Theremaining 14.1 percent of those CWDs reporting having contact with their familieshad visits from parents less often than once a month. Weekly visits from parentswere less common among CWDs with sight/vision disabilities (17.9 percent) andthose with movement disabilities (25.8 percent), when compared to the

. percentages having weekly parental visits among the CWDs with hearing' disabilities (55.1 percent), speech disabilities (54.2 percent), and fits/strange

behavior disabilities 48.0 percent) (See Table 28).

4.3. Children with disabilities who had no contact with family

Among the CWDs surveyed in the institutions, 9.1 percent had no contact, with family members. Over one-third (34.2 percent) of children with fits/strange

behavior disabilities living in the institutions reported that they had no contact withtheir families, compared to less than two percent of hearing disabled childrenreporting no contact with their families.


A total of 6.5 percent of the CWDs surveyed in the eight institutions (orabout one in every 15 CWDs) had been abandoned by their parents and had nocontact with their families for this reason. Another 2.6 percent (or 6 CWDs)reported that they "had no family" as the reason for no contact. Among the 21CWDs who were reported to have been abandoned by their family or had nofamily, a total of 65 disabilities were reported, or an average of 3.1 disabilities perchild. Over half (57.1 percent) of these CWDs had both speech impairments andfits/strange behavior disabilities and other disabilities as well. The CWDs in theinstitutions who did have contact with their families had an average of 1.6disabilities per CWD, or about half the average number of disabilities among theabandoned and family-less CWDs. Thus, it appears that CWDs having multipledisabilities not only need more rehabilitation services, but they are less likely tohave the financial and emotional support and care of family members. It is alsopossible that having multiple disabilities may increase the likelihood of a disabledchild being abandoned by the family.

5. Perceptions of CWDs about the institution and staff

5.1. Children with disabilities who like/dislike the institutions

The vast majority of the children aged 6-17 surveyed in the institutions saidthey liked the institution (81.6 percent of all children interviewed). Still, asubstantial proportion of almost one-fifth of the CWDs aged 6-17 said they did notlike the institution (18.4 percent). Overall, female CWDs were only slightly morelikely than male CWDs to say they disliked the institution (20.0 percent versus 17.2percent, respectively).

5.11 Percent of institutionalized children with disabilities who say they likethe social institution, by age group '•'•]jiNone of the male or female CWDs aged 6-10 years old surveyed in the

institutions said that they disliked the institution. However, reported dislike for the ;"institution increased with increasing age of the male and female CWDs. AmongCWDs aged 11-14 years old, one-fifth of the male CWDs (20.0 percent) and overone-fourth of the female CWDs (26.3 percent) said that they disliked the institution. "*]Furthermore, among CWDs aged 15-17 years old, almost one-third of the male ICWDs (31.2 percent) and 40.9 percent of the female CWDs said that they dislikedthe institution (See Table 29). It may be that the younger CWDs were less likely to "1report on their like or dislike for the institution, and let their parents/family report on Ithis item, which may be biased towards liking the institution.

11n3


5.1.2. Reasons why children with disabilities like the institution

The five main reasons CWDs said why they liked the institution were: (1)they need to be cared for/looked after (35.6 percent); (2) the opportunity tomake/play with friends at the institution (34.5 percent); (3) the opportunity to haveState/government benefits (16.4 percent); (4) the opportunity to be treated bydoctor/specialist (1.1 percent); and (5) all other reasons (12.4 percent). (See Table30).

The need to be cared for was the most common reason given for liking theinstitution among the hearing, speech and movement disabled children (47.1percent, 42.4 percent, and 40.9 percent, respectively). However, the most commonreason given for liking the institution among children with sight/vision disabilitiesand fits/strange behavior disabilities was the opportunity to play with otherchildren/friends (37.5 percent and 46.7 percent, respectively) (See Table 30).

5.1.3. Reasons why some children with disabilities dislike the institution

The three main reasons why some children said they disliked the institutionwere: (1) they missed their father/mother (40 percent); (2) they were-bullied andmade fun of (37.5 percent); and (3) they were not cared for properly (22.5 percent).

5.2. Perceptions of how children with disabilities are treated by the staff inthe institutions

In response to the question on how" they feelthe CWDs are treated at theinstitutions, 88.3 percent of the CWDs aged 6-17 stated they are treated very well(with sympathy and kindness); 7.0 percent said they are treated normally; and 4.4percent said they staff "showed pity" on them; and only 0.4 percent gave otherresponses (See Table 31). Children with fits/strange behavior disabilities living ininstitutions were the least likely to report they were treated with sympathy andkindness (73.7 percent) by the staff, compared to 82 to 95 percent for the othertypes of disabilities. Children with movement disabilities living in institutions werethe most likely to report they were shown pity (7.9 percent) by the staff, comparedto 0.0 to 4.6 percent for the other types of disabilities (See Table 31).

Viotnnm Child Disabil i ty Survey 1998 Page 44

6. Work status and job aspirations of children with disabilities

6.1. Work status of children with disabilities living in institutions

Only 3.7 percent of the children with disabilities aged 6-17 years old living inthe institutions reported that they were currently working (or eight children, halfmale and half female). All of those reporting they were working said they wereworking less than four hours a day and only one reported that they received moneyfor their work, which was less than 50,000 Viet Nam Dong per month. One of the :workers was doing tailoring, six were doing household work, and one was doing"other" work. The majority of them (62.5 percent) said they worked in order to trainthemselves in work/vocational skills.

6.2. Job aspirations for the future

Virtually all of the children with disabilities aged 6-17 who were asked abouttheir job aspirations in the future stated a specific job that they aspired to do in thefuture. Children under six years old were not asked the question on job aspirations. ;The most commonly mentioned jobs aspirations for CWDs in the institutions were itailoring (28.1 percent), teaching (27.2 percent), medical care professions (13.4percent), and electronic repair (13.4 percent). The job aspiration patterns were •"}similar for males and for females, except that males were more likely to aspire to !tailoring jobs than females (32.8 percent for male CWDs versus 22.1 percent forfemale CWDs), and female CWDs were more likely to aspire to medical care jobs ""]than were male CWDs (22.1 percent and 6.6 percent, respectively) (See Table i32). About 8 percent of the CWDs aspired to jobs in the music profession andabout 5 percent aspired to jobs in the handicrafts and fine art. It has already been "]mentioned that there is a low level or non-existence of vocational training available .Iat many of these institutions, and that there is a greater dislike for the institutionsamong the older CWDs living there. Given the almost universal aspiration of the '"CWDs to do some meaningful job or profession in the future, it is clear that there isgreat unmet need for vocational training and job orientation of the CWDs forpursuing work and other opportunities to become more integrated into the " H "surrounding community.

There were significant differences in job aspirations according to the type of 1disability the children had. Children with hearing and speech disabilities were, by 'far, the most likely to aspire to tailoring jobs in the future (49.5 percent and 43.8percent, respectively), especially among the male children with these disabilities. "jChildren with sight disabilities were the most likely of all types of disabilities to 'aspire to the handicrafts and fine arts and music professions. Over one-fourth(25.8 percent) of children with sight disabilities aspired to the handicrafts and fine "Harts jobs, and another 12.9 percent of them aspired to the music professions (See *••Table 32).

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Vietnam Child Disnbilily Survey 1998 P«i9" 45

Children with movement disabilities were, by far, the most likely to aspire tojobs in medical care (29.7 percent), and this was especially true among femalechildren with movement disabilities (53.3 percent). Children with movementdisabilities were also the most likely to aspire to jobs in the electronic repairprofessions (24.3 percent), and this was especially true for male children withmovement disabilities (36.4 percent aspiring to electronic repair jobs). However,electronic repair jobs were apparently not desired very much by female childrenwith movement disabilities, with only 6.7 percent of the females aspiring forelectronic repair jobs (See Table 32).

L. And finally, and interestingly, children having fits/strange behaviordisabilities were found to be the most likely CWDs to aspire to jobs in teaching.

i.These results indicate that much more needs to be done to develop

vocational training activities for CWDs and to conduct vocational training in a range: of professional skills suitable for children with different types of disabilities.u.

6.3. Ways for CWDs to realize their job aspirationsi

'... CWDs living in institutions wore asked how they could realize their jobaspirations. Almost half (46.5 percent) of the CWDs with job aspirations stated

; they could achieve their aspirations through hard individual work and study by: themselves (See Table 33). Only 14.3 percent mentioned help from the family,

15.2 percent mentioned help from the community, 7.8 percent mentioned help fromfriends and relatives, and 11.5 percent mentioned that state policies to assist thedisabled would help them achieve their job-aspirations (See Table 33).

There were substantial variations in the ways mentioned to achieve jobaspirations according to the type of job desired. Hard study was mentioned by 75.9percent of those aspiring to medical care jobs and 57.4 percent of those aspiring totailoring jobs. More than half (58.8 percent) of those aspiring to music professionssaid they would need the help from their families to achieve their aspirations.Those aspiring for jobs in teaching were the most likely (25.4 percent) to say theywould need to rely on state policies to assist the disabled in order to achieve theiraspiration of becoming a teacher (See Table 33).

Vietnam Child Disability Suivey 1991! Pngo 46

IV. SUMMARY OF FINDINGS AND RECOMMENDATIONS

A community-based sample survey of 1,148 children with disabilities livingin households in 16 provinces/cities covering all eight economic regions of thecountry and an institution-based survey of 230 children with disabilities living ineight institutions were conducted in late 1998 under the direction of MOLISA, withfinancial and technical support from UNICEF. The main findings of the community-based survey and the institution-based survey on children with disabilities includethe following:

1. From the community-based survey, the unweighted prevalence of rates ofdisability among children aged 0-17 years old was 2.8 percent for the countryas a whole, and was 2.5 percent for urban areas and 3.1 for rural areas. Thegeneralized weighted child disability prevalence estimates for the country as awhole was 3.1 percent of children aged 0-17 years old, and for urban areas therate was 2.5 percent and for rural areas the rate was 3.3 percent. Thegeneralized national estimate of the child disability prevalence rate of 3.1percent implies that there were about one million children with disabilities inVietnam in 1998 (3.1 percent times 31,650,000 children aged 0-17= 981,950CWDs).

2. The two most prevalent types of child disabilities reported in the community-based survey were movement disabilities (22.4 percent of all reported childdisabilities) and speech disabilities (21.4 percent of all reported childdisabilities). The prevalence of learning disabilities in this survey was quite lowcompared to other studies and may have been underreported or misclassifiedinto other categories of types of disability.

3. From the community-based survey, the main causes of disabilities in childrenwere congenital birth defects (55.0 percent of all reported causes of childdisabilities) and diseases (29.1 percent of all reported causes). These werealso the two main causes of disabilities reported among children with «idisabilities living in institutions, with congenital defects accounting for almost • ]two-thirds (64.6 percent) of all reported causes, and diseases accounting foralmost one-fourth (23.5 percent) of all reported causes of disabilities amongchildren living in institutions.

4. In the community-based survey, half of all reported disabilities in children wereclassified as severe disabilities. In the survey of eight institutions, the vastmajority of children with disabilities (90 percent) who were living in theinstitutions had severe disabilities.

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Multiple disabilities were fairly common in children with disabilities. The averagenumber of disabilities in CWDs was 1.48 disabilities per CWD living inhouseholds and 1.64 disabilities per CWD living in an institution. Hearing andspeech disabilities tended to often occur together in the same child, as didspeech disabilities and fits/strange behavior disabilities. f|

41

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6. Female children generally had lower reported disability prevalence rates thanmale children. This finding may be the result of both lower risks among femalechildren for some specific disabilities and also possible underreporting ofdisabilities in female children.

7. The education level of children with disabilities was generally very low. In thecommunity-based survey, almost half of the school-age children (ages 6-17years old) with disabilities were illiterate (45.5 percent). Over one-third of CWDsaged 6-17 had never attended school and another one-sixth of the school-ageCWDs had dropped out. Thus, less than half of school-age CWDs living inhouseholds were currently attending school. In the institution-based survey, theeducation situation of CWDs was somewhat better. Only five percent of theCWDs had never attended school, although over one-fourth of the CWDs ininstitutions had dropped out of school. In the institutions, 85 percent of childrenwith disabilities aged 15-17 had not finished primary school. Nevertheless,about two-thirds of the institution-based CWDs were currently enrolled inschool. Very low proportions of the older CWDs living in households or ininstitutions had completed secondary school. For both CWDs living inhouseholds and those living in institutions, non-attendance at school anddropping out of school appear to be mostly a function of family poverty, lack ofeducation programs for CWDs, inaccessibility of schools to CWDs, and feelingashamed or lacking confidence because of their disability.

8. From both the community-based survey and the institution-based surveyresults, it appears that vocational training for children with disabilities andemployment opportunities for older -CWDs are quite limited. Apparently,inadequate attention and resources have been allocated to vocational trainingand job creation programs to meet the needs of the vast majority of CWDs whohave employment aspirations for the future. For both CWDs living in thecommunity and those living in institutions, the rate of vocationally traineddisabled children was very low. In the community it was found that tailoring wasone of the few professions some children with disabilities were able to pursuesuccessfully. The fact that over 90 percent of CWDs hope to have a meaningfuljob in the future, highlights the need to greatly increase the opportunities andprovide the means for them to achieve their life goals. This effort will also helpthem to integrate more in the community.

9. Awareness of local rehabilitation services was very low among children withdisabilities living in households (from the community-based survey). About one-third of all CWDs living in households have never sought treatment for theirdisability. Seeking treatment for child disabilities varied by region and urban-rural residence, with 90 percent of CWDs living in urban areas of the Red RiverDelta region seeking treatment, compared to only 29 percent of CWDs living inrural areas of the Central Highlands seeking treatment.

Vietnam Child Disability timvuy I'J'JB Page 48

10. Although about one-fifth of CWDs were found to be using rehabilitative aidsand devices such as prosthetics, ortholics, hearing and vision aids, andwheelchairs, the rates of usage of these devices was quite low, consideringthat half of all CWDs living in households had severe disabilities. The vastmajority of devices used were some type of glasses or vision aids. Less thanten percent of children with movement disabilities and less than two percent ofchildren with hearing disabilities used any kind of rehabilitative aid or devicewhatsoever. The vast majority of rehabilitative devices being used werepurchased rather than received through donation (73.8 percent in urban areasand 62.5 percent in rural areas).

11.Only 5 percent of CWDs living in households in urban areas and 10 percent ofCWDs living in households in rural areas received any form of financial supportfrom the government and or the community, such as monthly allowances, freeor subsidized education, and/or free health cards. The level of support variedby region, with one-fourth of all CWDs in the North West region receivingsupport compared to only two percent of all CWDs in the South East regionreceiving support.

12.There appears to be a general social acknowledgment and/or acceptance ofchildren with disabilities in the general population. The community-based 'survey found that the vast majority of CWDs living in households reported thatlocal people had positive or favorable attitudes towards them (i.e., they aretreated normally or with kindness/sympathy). However, there was some !variation in attitudes of local people towards CWDs according to region andurban-rural residence.

. i13. In the institutions 6.5 percent of the CWDs had been abandoned by their

families, another 2.6 percent had no families (orphaned), and 9.1 percent hadno contact with their families. However, most of the institutionalized CWDs hadweekly contact with family members. Contact with family varied according totype of disability, with more than one-third of children with fits/strange behavior . . .disabilities reporting they had no contact with family members. I

14. Almost one-fifth of the CWDs in institutions said they did not like the institution ^and the percentages of CWDs who disliked the institution were higher amongthe older children with disabilities living in the institutions (e.g., 31 percent ofthe 15-17 year olds said they disliked the institution). The main reasons for ,*disliking the institution were (1) they missed mother/father (40 percent); (2) they ]were bullied or made fun of (38 percent); and (3) they were not treated properly(22 percent). The vast majority (four-fifths) of CWDs in the institutions who said ~they liked the institution said they liked it because (1) they needed to be cared • jfor/looked after (3G percent); (2) the opportunity to make/play with friends at theinstitution; (3) the opportunity to have state/government benefits (16 percent); **(4) the opportunity to be treated by a doctor/specialist (1 percent); and (5) all Jother reasons (12 percent). The vast majority of the CWDs living in institutionsreported that they were treated well by the institution staff (i.e., treated normallyor with kindness and sympathy). 1

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Vietnam Child Ois.ibility Sinvoy 1991! Piig° 49

15. By far, the children with fits/strange behavior disabilities appeared to be themost socially isolated, in that they had fewer friends, had lower participation inschool, work, and daily life age-typical activities and were less likely to reportthat they were treated well by local people in the community or by staff in theinstitutions.

Children with disabilities who were attending school or attendingwork/vocational training were far more likely to have friends than those CWDs whodid not attend school or did not go to work/vocational training. Thus, it seems that

I fuller participation and greater opportunities for CWDs in education, vocational'«" training, employment and daily community activities will help to minimize their

social isolation, maximize their integration in the community, and ultimately leadi them to a more fulfilling and economically and socially productive lives.I-

Unfortunately, the current situation of many CWDs includes: poverty-level| living conditions, low literacy and education levels, very limited vocational training' • • • and employment opportunities, and limited awareness of and access to

rehabilitative services (and rehabilitative aids and devices), and lack of adequate! social integration in the community. The Government, community, humanitarian

organizations and the families of children with disabilities should make increasedefforts to finding concrete and effective solutions to these problems.

RECOMMENDATIONS:

1. As awareness of and support for children with disabilities and a range ofrehabilitation services for them are still quite limited, a nation-widecommunication campaign on topic of children with disabilities should beconducted.

2. Essential information widely disseminated in order to improve people'sawareness of the important role the community can play in helping children withdisabilities in many aspects of their lives. This campaign should highlight boththe needs of and opportunities for children with disabilities, such as providingrehabilitation services and rehabilitation devices and aids (e.g., orthoses,prosthetic limbs, wheelchairs, hearing aids, braille books, etc), opening upeducational opportunities, vocational training, job creation, and increased socialintegration of CWDs in the community. Attention should be given to the specialneeds of children with multiple disabilities and those living in specialinstitutions. Children with some specific types of disabilities such as fits/strangebehavior disabilities may be more socially isolated and require greater attentionand more innovative approaches to meet the needs of this group. Mediamessages should target policy makers, parents/caretakers of CWDs,community leaders, teachers, social workers, and business and healthprofessionals to create more favorable and supportive attitudes for providinggreater educational and vocational opportunities for children with disabilities areneeded. The expectations of and opportunities for CWDs should be raised,rather than limited, in the future.

Vietnam Child Disabil i ty Survey '199(5 Page 50

3. Expansion of the MOH's community-based rehabilitation programs and ofinclusive education programs are needed so that these programs can be moreclosely linked together and scaled-tip nationwide to reach all districts in allprovinces.

4. The Government should ensure that children with disabilities are given specialattention in the implementation guidelines for the Ordinance on DisabledPersons promulgated in 1998. A more holistic approach to helping children withdisabilities is needed, with multi-sectoral collaboration at the national,provincial, district, and community levels. The various ministries and NGOsworking with children with disabilities should work together to share data andresources and coordinate child disability prevention campaigns, early detectionand screening procedures in the communities, and early interventions in health,education, and vocational rehabilitation and training programs targeting CWDsthroughout the country.

5. The policies of the Government on the issue of child disabilities comes fromVietnam's traditions of humanitarianism and socialism. The approach of thevarious sectors toward children (and adults) with disabilities should be one of .'•inclusion and integration rather than exclusion/seclusion andsegregation/separation. The concept of socialization requires improving the roleof the government and at the same time to encourage the efforts of each icitizen and the non-governmental and private sectors to also play a role. Bothpublic and private enterprises, social organizations, and domestic andinternational NGOs should participate in solving the challenges facing children jwith disabilities in Vietnam, such as health care, education, vocational training, 'and social integration into the community (e.g., sporting events, play activities,arts, crafts and cultural festivals, community development efforts, and other jsocial gatherings and entertainment activities).

6. The governmental ministries involved with children with disabilities (MOH, IMOET, and MOLISA) should expand integrated projects on community-basedrehabilitation, and expand the training and retraining of (1) social workers andother professionals who are working in institutions for CWDs; (2) teachers whowork with CWDs in special education and/or inclusive education programs; (3)rehabilitation health professionals (e.g., orthopedic surgeons, physical _therapists, and nurses) who are working in hospitals, rehabilitation centers, and jcommunity-based service programs; (4) vocational training and occupationaltherapists; and (5) workshop technicians who make rehabilitative devices and .„aids for CWDs. Furthermore, special training or orientations are also neededfor the parents and relatives who take care of children with disabilities at homeand for community leaders and community organizations who can play a more «.active role in the integration of children with disabilities in community life. These •]measures will enable more children with disabilities to have real opportunities toimprove their life and to integrate more fully into the communities. «*

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7. The Government has decided to pursue more vigorously the inclusiveeducation approach to educating children with disabilities. However, in cases ofsevere and multiple disabilities additional special schools may need to be builtand existing facilities upgraded, to better meet the needs of children withsevere and multiple disabilities. The goal should be that the vast majority of

I. children with disabilities should have at least a primary education. To achievek- even this modest goal will require a greater commitment and effort on the part

of all those involved.

8. Quality orthopedic devices and other rehabilitative aids and devices for childrenwith different types of disabilities need to be made much more widely available.

I Geographic, social and economic access to these devices and aids is uneven.

9. To improve the quality of training centers, priority should be given to enrolling! and training people with disabilities to serve as staff, as well as enrolling and

training children with disabilities.

; 10.The Government should consider more specific measures to train, monitor andevaluate teachers, who are teaching children with disabilities in inclusiveeducation and special education schools or in vocational training centers.

11. Institutions for CWDs and social welfare centers should be organized in themodern way of offering specialized services and activities for different groups inneed, including children with disabilities. The government should provide thegrant and support for the institutions and centers to organize the cultural,vocational and other activities for children with disabilities using the centers.The government should also help the business enterprises and workshopswhere the child disabilities could work.

12. Because most child disabilities are caused by either congenital defects ordiseases which are preventable, much more proactive public health efforts areneeded to reduce the incidence of all types of child disabilities in the future.

13.Attention should be given to the differentials in prevalence of disabilities infemale and male children to determine whether these differences are real orartifacts of the reporting biases for male and female children.

14. Provisions should be made to make rehabilitative devices more accessibleacross the country and establish a system for providing a safety net of freedevices for CWDs from families to poor to be able to purchase them.

15. Efforts to improve the publics' attitudes and understanding even further and tobuild the confidence and self-esteem of children with disabilities throughcounseling, role models, and confidence-building and empowering activities.

Vietnam Chi ld D i s a b i l i t y Survey 1998 Page 52

16. In light of all of the above recommendations, serious thought and effort shouldbe given to finding the most practical, effective and sustainable (cost-effective)ways of implementing these recommendations, to ensure that the benefits tochildren with disabilities will be both long-term and continuously improving overtime.

The Vietnam Child Disability Survey was successfully conducted in late 1998 in16 provinces and cities, covering the major economic regions of the country. Thesurvey results show a relatively clear picture of the current situation andcharacteristics of children with disabilities in Vietnam, and identifies a number ofareas where there is still a great unmet need for services to help children withdisabilities participate more fully in life and be more integrated in the community.The areas of greatest need are in the areas of expanding educational opportunitiesfor CWDs, in either inclusive or special education activities for CWDs, dependingon their needs, and making available to older CWDs a much greater range ofvocational training and job opportunities. Another area of needed improvement isin the overall awareness of the general population about issues affecting CWDsand how people perceive CWDs and their potentials, and how they treat CWDsand try to integrate them into community life.

It is hoped that this document, especially the recommendations, will becarefully considered by both governmental and non-governmental organizations,as well as the UN bodies, international NGOs, donor agencies, in order to bringthem a better understanding of the problems and needs of CWDs, and so that theywill adopt more appropriate and effective policies, programs and serviceinterventions that will ultimately improve the physical, material, emotional andsocial life of children with disabilities in Vietnam.

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IV. REFERENCES

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Cao Mann Thang. 1997. Children with disabilities in Vietnam: A SituationAnalysis and Proposed Activities. Report Prepared for UNICEF.

Central Census Steering Committee. 1999. Report on the Preliminary Resultsof the 1 April 1999 Population and Housing Census. (8 pages) Hanoi.

Chalker, Prudence. 1994. Children With Learning Difficulties: Current Provisionand Opportunities. Report for Catholic Relief Services. Hanoi.

Chalker, Prudence. 1998. Evaluation Report: Disability Programme of Save theChildren/UK, Ho Chi Minh City, Vietnam.

Chalker, Prudence, Le Due Phuc, Le Van Tac, et al., 1998. Mid-Term Reviewof Inclusive Education Vietnam Program of Catholic Relief Services in ThuongTin District, Ha Tay Province. Hanoi: CRS.

Chu Dung, Doan My Hue, Le Thi Phuong Loc, et. al. 1997. Directory ofDisability Services in Ho Chi Minh City.

Kane, Thomas T. 1999. Disability in Vietnam 1999: A Meta-Analysis of theData. Report Prepared for the Displaced Children and Orphans Fund and WarVictims Fund. December, 1999.

• Komitee Twee (K2) and Training and Development Centre for SpecialEducation (TDCSE). 1998. Proposal for the Development of Early InterventionServices for Hearing Impaired Infants in Vietnam. TDCSE Hanoi PedagogicUniversity and K2 Education of Hearing Impaired Children Program.

Kristiansson, Bengt, and Rita Liljestrom. 1993. Report on Evaluation Mission ofCommunity-Based Rehabilitation in Vietnam April 4 - May2, 1993 (Draft).Evaluation conducted for Radda Barnen.

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Le Ngo. 1998. Attitudes of Parents and Children without Disabilities TowardsChildren with Disabilities in Inclusive Education. Research Paper. GoteborgUniversity Sweden. Hue.

Le Van Tac, Pham Kirn, Nguyen Thi Mai Ha. 1998. Bao Cao: Danh GiaChuong Trinh Giao Due Tre Khiem Thinh O Vietnam (Evaluation of Program onEducation of Children with Hearing Impairments in Vietnamese). Funded byKomitee Twee. Hanoi.

Le Van Tac, Pham Kim, Nguyen Thi Mai Ha. 1998. Evaluation Report: K2Program Education of Hearing Impaired Children in Vietnam. Hanoi.

MOLISA. 1999. Vietnam Child Disability Survey 1998: Preliminary Report.Central Steering Committee on Child Disability Survey. Hanoi. February 1999.

MOLISA. 1998. Test Survey of 1998 Community-based Survey on DisabledChildren: Presentation of the Data. Central Steering Committee on ChildDisability Survey. Hanoi. December 1998.

MOLISA. 1998. Survey on Disabled Children in Institutions: Presentation of theData. Central Steering Committee on Child Disability Survey. Hanoi. December1998.

• MOLISA. 1998. 1998 Community-Based Survey on Disabled Children. Central |Steering Committee on Child Disability Survey. Hanoi. December 1998. '

• MOLISA. 1998. Questionnaire of 1998 Community-Based Survey on Disabled '.Children: Presentation of the Data. Central Steering Committee on ChildDisability Survey. Hanoi. December 1998.

• MOLISA (Central Steering Committee on Child Disability Survey). 1998.Supporting Documentation: (1) Definitions Used in the 1998 Disabled ":Children's Interview; (2) Sample Design for the 1998 Survey for Disabled • (Children in Vietnam; (3) A Practical Guide to Interviewers for the 1998 Surveyon Disabled Children; (4) Components of Child Disability Survey; and (5) iProposed Project for Survey on Disabled Children in Vietnam in 1998. )

• NIES. 1997. Survey on Disabilities in 14 Communes, Ha Tay Province. Center 1for Special Education. (Text, Tables, and Graphs) Hanoi. '

• NIES. 1999. Statistics of Surveys on Disabilities. Selected Districts and jProvinces.

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Violnnm Child Disnhility Stirvoy 1901! P-IJJO 55

Nordin, Annika, Nandeni de Silva, and Dang Xuan Hoai. 1996. InclusiveEducation in Vietnam: An Evaluation of the Support by Radda Barnen 1991-1995. Hanoi: Radda Barnen.

Radda Barnen, Catholic Relief Services, and Save the Children/UK. 1998.inclusive education in Vietnam: 1991-1998: An Introduction to theImplementation and Achievements of Inclusive Education Projects.

Robijn, Jan. 1991. Community Integrated Education of the Disabled Child.Report to UNICEF. Hanoi.

Ta Thuy Hanh and Dotti McArthur. 1997. Report on the Progress of the Re-Launch of Radda Barnen's Support Towards CBR/lnclusive Education ofChildren with Disabilities; Special Focus on Community-Based Support forInclusion. Radda Barnen.

Tran Thi Thu Ha. 1991. Case Study on Vietnamese Cerebral Palsied Childrenin IPCH During 10 Years (1981-1990). Rehabilitation Department of IPCH.Hanoi.

UNICEF. 1997. Project Proposal: Early Detection and Intervention for ChildrenAged 0-5 with Disabilities in Vietnam.

Viotiuim Chile) Ois;jbility Survey 1991! Pago SO

IV. ANNEXES

Annex 1. List of tables from the community and institutionsurvey

1- Table 1. Estimates of Prevalence of Child Disability for Selected Areas ofVietnam, from Various Sources: 1990-1999.

2. Table 2. Percent Distribution of Child Disabilities in Vietnam, By Specific Types,from Various Sources: 1991-1999.

3- Table 3. Characteristics of Children with Disabilities from the Community-basedSurvey in 16 Provinces of Vietnam, the Test Survey, and the Survey of CWDsin eight Social Institutions: 1998.

4. Table 4. Percent of Children with Disabilities among the Population aged 0-17Years Old, By Regions and Urban-Rural Residence: 1998.

5. Table 5. Percent Distribution of Children with Disabilities, By Type of Disability,Region, and Urban-Rural Residence in Vietnam (Community-Based Survey; ;

Test Survey; and Institution Survey Results): 1998.

6. Table 6. Prevalence of Disability among Male and Female Children aged 0-17 :Years, By Region and Urban-Rural Residence in Vietnam: 1998. !

7. Table 7. Prevalence of Disability among Male and Female Children aged 0-17 "iYears, By Type of Disability: Vietnam 1998. ;

8. Table 8. Percent Distribution of Ctiuses of Disability among Children aged 0-17 ;Years, By Age Group: Vietnam 1998. I

9. Table 9. Percent of Children with Disabilities who sought Treatment, By Region '!and Urban-Rural Residence in Vietnam: 1998. '

10.Table 10. Percent of Children with Disabilities aged 6-17 Years Old who >are Illiterate, By Type of Disability and Urban-Rural Residence in =Vietnam: 1998.

11.Table 11. Percent Distribution of Children with Disabilities aged 0-17 Years *'Old, By Levels of Participation in Age-Typical Activities: Vietnam 1998.

12.Table 12. Percent Distribution of Children with Disabilities aged 0-17 Years *'Old, By Number of Friends and Type of Disability: Vietnam 1998. a

II. . '. ... -., .. - _ . . m -av*»Ji •?.-.,•

ivf

Viotnnm Child Oisnhility Survey 1990 Pa(J° r'7

I. 13.Table 13. Percent Distribution of Children with Disabilities aged 0-17 YearsL Old, By Number of Friends and whether Attending School or Work: Vietnam

1998.!

L 14. Table 14. Percent of Children with Disabilities aged 0-17 Years Old PerceivedAttitudes of the Local People towards CWDs, By Region, and Urban-Rural

| Residence in Vietnam: 1998.» • • .

15.Table 15. Percent of Children with Disabilities aged 0-17 Years Old, By: Perceived Attitudes of the Local People towards CWDs, and Type of Disability:^ Vietnam 1998.

i 16.Table 16. Percent of Children with Disabilities aged 6-17 Years Old who are1 • Aware of Any Rehabilitation Services in the Local Area, By Type of Disability:

Vietnam 1998.iI; 17.Table 17. Percent of Children with Disabilities aged 0-17 Years Old Using

Rehabilitative Devices, By Type of Device and Type of Disability: Vietnam| 1998.

18.Table 18. Percent of Children with Disabilities aged 0-17 Years Old Usingj Rehabilitative Devices, By whether Devices were Bought or Donated, Type of

Device and Urban-Rural Residence in Vietnam: 1998.

19. Table 19. Percent Distribution of Children with Disabilities Receiving Support,By Type of Support, Region, and Urban-Rural Residence in Vietnam: 1998.

; 20.Table 20. Percent Distribution of Future Job Aspirations of Children withDisabilities aged 6-17 Years Old, By Type of Disability: Vietnam 1998.

21.Table 21. Percent Distribution of Ways Children with Disabilities Expect toAchieve their Aspirations for Specific Jobs/Occupations in the Future: Vietnam1998.

22.Table 22. Percent of Children with Disabilities Living in Institutions HavingSpecific Types of Disabilities, By Gender and Percent Female for each Type ofDisability: 1998.

23.Table 23. Percent Distribution of Children with Disabilities Living in Institutions,By Type of Disability and Age Group: 1998.

24.Table 24. Percent Distribution of Reported Causes of Disability amongChildren with Disabilities Living in Institutions, By Type of Disability: 1998.

25. Table 25. Percent Distribution of Children with Disabilities' Means of Admissionto the Institutions, By Type of Disability: 1998.

Vietnam Child Disability iJ invoy '10915 Page 58

26.Table 26. Percent Distribution of Education Levels of Children with DisabilitiesLiving in Institutions, By Age Group: 1998.

27.Table 27. Percent Distribution of Family Contact with Children with DisabilitiesLiving in Institutions, By Type of Disability: 1998.

28.Table 28. Percent Distribution of Frequency of Family Contact with Childrenwith Disabilities Living in Institutions (among CWDs who have some contactwith their family), By Type of Disability: 1998.

29.Table 29. Percent Distribution of Children with Disabilities According to theirLike/Dislike for the Institutions where they are Living, By Age Group andGender: 1998.

30.Table 30. Percent Distribution of Children with Disabilities who Like theInstitutions where they are Living, By Reason they Like the Institution and Typeof Disability: 1998.

31.Table 31. Percent Distribution of Children with Disabilities' Reports on How theInstitution Staff Treat them, By Type of Disability: 1998.

32.Table 32. Percent Distribution of Future Job Aspirations of Children withDisabilities Living in Institutions, By Gender and Type of Disability: 1998.

33.Table 33. Percent Distribution of the Ways Children with Disabilities Living inInstitutions say they Expect to Achieve their Job Aspirations in the Future, BySpecific Jobs/Occupational Aspirations.

"I

3n]3

VioliKjm Child Dis.ibility Survey 199(! Pago 59

Annex 2. List of figures included in the Report

1. Figure 1. Prevalence of Disability in Children in Vietnam, Selected Sourcesand Areas: 1991-1999.

2. Figure 2. Types of Disabilities among Children with Disabilities in Vietnam,Selected Sources: 1991-1998.

3. Figure 3. Prevalence of Disability in Children aged 0-17 Years Old in Vietnam:Selected Provinces: 1998.

4. Figure 4. Percent of Children with Disabilities in Vietnam who are SeverelyDisabled, By Type of Disability: 1998.

5. Figure 5. Percent Distribution of Children with Disabilities in Vietnam, By Typeof Disability: 1998.

6. Figure 6. Reported Causes of Disabilities in Children in Vietnam: 1998(Percent of All Causes).

7. Figure 7. Percent Distribution of Causes of Disabilities in Children aged 0-17Years Old in Vietnam, By Age Group: 1998.

8. Figure 8. Percent of Children with Disabilities who are Female, By Cause ofDisability: Vietnam 1998.

9. Figure 9. Percent of Child Disabilities Reported to be Due to Toxic Agents ofWar, By Type of Disability: Vietnam 1998.

10. Figure 10. Percent of Children with Disabilities Seeking RehabilitationTreatment, By Region and Urban-Rural Residence in Vietnam: 1998.

11. Figure 11. Percent of School-Age Children with Disabilities Who areIlliterate, By Type of Disability: Vietnam 1998.

12. Figure 12. Percent of School-Age Children with Disabilities who NeverAttended School and Percent who Dropped out of School: CWDs inHouseholds and in Institutions: Vietnam 1998.

13. Figure 13. Reasons for Never Attending School and Reasons for Dropping outof School among Children with Disabilities Living in Households: Vietnam 1998.

Vietnam Child Disability Survey I'.)U8 Page 60

Table 1. Estimates of Prevalence of Child Disability in Vietnam, SelectedAreas of Vietnam and from Various Sources: 1990-1999.

Prevalence of Disability in VietnamArea ofVietnam

National

ChildrenAged 0-15

National

ChildrenAged 0-1 7

National

(730 comin 29provinces)

ChildrenAged 0-1 5

National

ChildrenAged 0-15

National

ChildrenAges 0-15

Populationof Area

71,719,032

27,401,000

76,606,000

31,648,000

ChildrenAged 0-1 7

76,606,000

27,728,000

ChildrenAged 0-15

27,100,000

27,900,000

ChildrenAged 0-1 5

69,163,500

Total

25,245,000

Childrenages 0-15

Year

1994-1995

1998

1 998

1998

1998

1990-

1999

1992

Prevalence ofDisability AmongChildren %

2.80% ofchildren aged0-17 years old(unweighted)

3.10%generalizedOC \ H~Y~IO I"G

3.84% ofchildren aged0-15 (based onreported 1million disabledchildren in 1998

Between1 .5%-6%

(most saybetween 5% and7 %) (some useWHO estimatesfor region)

4.87 % (impliedby reported

1,230,455disabledchildren 0-1 5)

Prevalenceof SevereDisability %

0.86% oftotalpopulationaged 0-1 5

1.41% ofchildren0-17 haveseveredisabilities

1.57% oftotalpopulation(or 30% ofall disabled)

EstimatedNumber ofDisabled

234,829CWD in 1995(severelydisabledonly)

981,088Children withdisability in1998, basedonprevalenceestimate(generalized)

1,000,000CWD in 1998

Range of215,485 to1,230,455CWDs, citedfigures orimplied bythe reportedprevalencerates)

T"

DataSource

MOLISASurvey ofSevereDisability

MOLISA/UNICEFSurvey of 16provinces(results arepreliminary)

MOHCBRdata from 730communes in70 districts of29 provinces

Rates cited inreports,speeches,presentationsby MOLISA,MOH, CPCC,MOET/NIES,UNICEF,Bond andHayter(1998)

MOLISAStatistics(See Le VanTac, PhamKirn, NguyenThi Mai Ha.1998)

131=

Vietnam Child Disability Survey 15)98 Page 61

Area ofVietnam

Vinh PhucProvince

Hoa BinhProvince

HaTayProvince

14Provinces

Vinh PhucProvince

Hoa BinhProvinces

QuangNinhProvince

Ninh Binh

Populationof Area

42communes

6communesin Lac SonDistrict

Thuong TinDistrict

14communes

19 Districts

6RB IEpilotcommunes

Luong SonDistrict

Yen HungDistrict

Yen KhanhDistrict

Year

1998

1996

1996

1991-1996

1998

1999

1999

1999

Prevalence ofDisability AmongChildren %

6. 2% of children0-1 5 (or 32% ofall disabled)

1.5% of childrenages 0-15

2.63% ofchildren 0-15

3.0% of children0-15

2.22% ofchildren 0-1 6(range1.7%-3.2%)




Prevalenceof SevereDisability %

Most of

CWDsreportedwere severecases

0.58% ofchildren0-1 5 (or22.2% ofalldisabledchildren)

0.93% ofchildren0-1 5 (or31% of alldisabledchildren)

0.56 % ofchildren 0-15 (or22.6% of allCWDs)0.58% ofchildren0-1 5 (or29.0% of allCWDs)

0.64 % ofchildren0-1 5 (or29. 3% of allCWDs)

EstimatedNumber ofDisabled

DataSource

Vinh Phuc'sPeople'sCommitteeJune20,1998

Bierman,1997

MOET/NIESChildrenDisabilitySurvey

NIES/CSESurveys onChildren withDisabilities(Le Van Tacetal, 1998)

MOET/NIES/RB IE Survey




Note: Different age groups are used to denote children in the different studies/surveys(e.g., 0-15,0-16, or 0-17 years old). Table 1 is adapted from Table 1 in the report"Disability in Vietnam in 1999: A Meta Analysis of the Data" (Kane, 1999) .

Vietnam Child Disability Survey l!)'.)8 Pago 62

Table 2. Percent Distribution of Child Disabilities in Vietnam, by Specific Types: Various Sources: 1991-1999.

Types of Child Disability in VietnamPercent Distribution of PWDs

Type ofDisability

Mobility/Motor/Movement

Hearingand

Speech/Communi-cation

Vision/Sight/

Learning/intellectualmental

StrangeBehavior/ErraticBeh

Epilepsy/Fits

Loss ofSensation/leprosy

OtherDisabilities

Total(100%)

MOLISA SevereDisability Survey(Children Aged0-15)1994-95

34.3

10.2 +

15.9 =

26.1

9.0

12.7

10.7

Included

With SB

NA

7.2

100

NIES Surveys

187 communes(Children Aged 0-15)1991-93

19.6

11.2 +

17.0 =

27.2

15.1

25.8

1.2

NA

NA

10.1

100

Ha Tay ProvinceNIES

1<1 communes(Children Aged0-15) 1996

18.9

7.5 +

16.7 =

24.2

20.0

24.8

NA

NA

NA

12.1

100

Vinh PhucNIES

6 commune(ChildrenAged 0-1 5)1998

32.1

22.0

14.0

15.8

5.1

11.0

NA

0.0

100

MOLISA/UNICEFSurvey

16 provinces(ChildrenAged 0-1 7)1998

22.4

9.7 +

21.4 =

31.1

14.6

3.6

16.2

IncludedWith SB

NA

12.0

100

TienGiangProvinceMOH/RB

6 communes(ChildrenAged 0-1 6)1998

22.7

"i

19.4

21.6 !

i

35.3 "]

0.41

°'7 1NA -1

0.0 "I

100 _

NA - indicates information not reoorted seoaratelv: SB - indicates "stranqe behavior" category; -1* - indicates percentages in the column adds up to slightly more than 100 % (possibly due to multiple disabilities).

Note: Different age groups are used to denote children in the different studies/surveys ;j(e.g., 0-15,0-16, or 0-17 years old). Total numbers add up to more than the total number of children withdisabilities surveyed because some children had multiple disabilities.Adapted from Table 2 in "Disability in Vietnam in 1999: Meta Analysis of the Data" (Kane, 1999) .

3


Table 3. Characteristics of Children with Disabilities in 16 Provinces of Vietnam,the Test Survey, and the Survey of CWDs in Eight Institutions: 1998.

(.Characteristics of CWDs

| Genderf M a l e

Female

-,rAge Group'.: 0 - 5

f 6-1011-15

; 16-17T*Ethnic GroupL Kinh

Tayv- Others

"RegionRedRiverD.

T" N-EastI, N-West

rN-CentralCent CoastCent HighS-EastMekong D.

I Education Status: % Illiterate(CWDs aged 6-1 7)

i% never attending school

Vocational Training Status:% CWDs aged 6-17 who ever did VT

r % CWDs aged 6-17 who ever worked

% seeking treatment for disability

% of CWDs with severe disabilities

Mean # of disabilities per CWD

Total (%)(Number of CWDS Surveyed)

Community-Based Survey% Distribution

55.644.4

16.630.639.713.2

89.13.07.9

14.617.74.8

14.113.07.6

12.715.4

45.5

36.6

1.219.0

68.4

50.2

1.49

100(1148)

Test Survey

% Distribution

50.050.0

17.829.729.722.8

89.12.88.1

12.518.86.2

12.512.56.2

12.518.8

51.7

44.9

0.814.4

71.9

44.4

1.86

100(320)

Institution-Based Survey% Distribution

55.244.8

5.730.447.516.5

93.53.03.5

26.014.40.03.9

12.20.00.0

43.5

12.4

5.1

15.23.7

NA

79.1

1.64

100(230)

. NA: Question was not asked in the Institution-Based Survey.

Vietnam Child Disability Survoy HHUt Page 64

Table 4. Percent of Children with Disabilities Among the PopulationAged 0-17 Years Old, By Regions andUrban-Rural Residence: 1998

Regions and Urban-Rural Residence

1. Red River DeltaUrban areaRural area

2. North EastUrban areaRural area

3. North WestUrban areaRural area

4. North CentralUrban areaRural area

5. Central CoastUrban areaRural area

6. Central HighlandUrban areaRural area

7. South EastUrban areaRural area

8. Mekong River DeltaUrban areaRural area

Total Vietnam:Urban areaRural area

Percent of

Housholds

with CWDs

AdjustedEstimates

Percent (N)6.86 (2880)4.43(1446)7.46 (1434)4.74 (4320)4.19(2337)4.84 (1983)4.38 (1440)1.80 [778)4.83 (662)6.28 (2880)4.62 (1538)6.51 (1322)6.79(2880)2.00(1501)8.34(1379)5.32(1440)6.68 (778)4.98 (662)5.10(2880)3.84(1512)6.14(1368)4.88 (4320)2.24 (2325)5.41 (1995)5.68(23,040)3.60(12,235)6.12 (10,805)

Percentage of Children with DisabilityAmong children aged 0-17

Total

Adjusted Estimates

Percent (N )4.4 (4311)3.3 (1895)4.6 (2496)2.6 (7145)3.0 (3460)2.6 J3685)2.3 (2420)1.8 (1022)2.4 (1398)3.6 (5345)2.5 (2683)3.7 (2662)3.3 (5250)1.9 (2442)3.7 (2808)2.3 (3481)3.3 (1638J2.1 (1843)2.7 (5389)2.5 (2637)2.9 (2752)2.4 (7732)1.7 (3635)2.5 (4097)3.1 (41,073)2.5(19,412)3.3(21,661)

Female

Percent (N)

3.2 (2074)4.2

2.72.4

1.81.6

2.43.0

1.83.2

3.12.4

1.82.4

1.72.0

2.32.7

n3

3

LI

IIVietnam Child Disability Survey 1998 Pago 65

Table 5. Percent Distribution of Children with Disabilities,By Type of Disability and Urban-Rural Residence in Vietnam: 1998.Results from the Community-Based Survey, Test Survey,and Institution-Based Survey of the 1998 Vietnam Child Disability Survey.

'Types of-Disability

'Sight

THearing

Speech

Movement

Fits/StrangeBehavior

Learning

Other

"Total (%)

(N)

Community Based Survey

%Reporting

21.8

14.4

31.9

33.4

24.1

5.4 •

17.9

148.9%

(1148)

% Distribution of allReported

Total

14.6

9.7

21.4

22.4

16.2

3.6

12.0

100%

(1708)

Urb

17.4

6.9

20.8

23.8

16.7

2.5

11.9

100

(707)

Rur

12.7

11.6

21.9

21.5

15.9

4.4

12.1

100

(1001)

Test Survey

%Report-

ing

25.9

15.0

32.8

52.5

33.4

'5.3

21.2

186.1%

(320)

%Distribution

of allReported

13.9

8.1

17.6

28.2

18.0

2.9

11.4

100%

(596)

Institution-BasedSurvey

%Reporting

14.3

47.4

57.0

16.5

16.5

0.4

11.7

163.8%

(230)

%Distribution

of allReported

8.8

28.9

34.7

10.1

10.1

0.3

7.2

100%

(377)

Note: The total number of disabilities adds up to more than the total number of children with disabilities becausesome children have multiple disabilities.


Table 6. Prevalence of Disability among Male and Female ChildrenAged 0-17 Years, By Region and Urban-Rural Residencein Vietnam: 1998.

Region andUrban-RuralResidence

1. Red River DeltaUrbanRural

2. North-EastUrbanRural

3. North-WestUrbanRural

4. North-CentralUrbanRural

5. Central CoastUrbanRural

6. Central HighlandsUrbanRural

7. South-EastUrbanRural

8. Mekong DeltaUrbanRural

TotalUrbanRural

TotalNumber ofMales 0-17

2237958

1279

377218101962

1282529753

279713781419

268312481435

1759827932

27241363

' 1361

394318932050

21,19710,0061'1,191

TotalNumber of

Females 0-17

2074937

1137

337316501723

1138493645

254813051243

256711941373

1722811911

266512741391

378917422047

19,8769,40610,470

Percent ofMales 0-17

with Disability

4.293.444.93

3.023.372.70

2.501.703.05

3.542.694.37

3.212.004.25

2.563.511.72

3.263.083.45

2.411.743.02

3.092.693.46

Percent ofFemales 0-17

With Disability

3.763.204.22

2.552.672.44

1.671.831.55

2.672.382.98

2.531.763.20

2.733.082.41

2.141.812.44

1.901.722.05

2.482.262.66 u

30

I Vlotnarn Child Disability Survey 1990 Pago 67

Table 7. Prevalence of Disability Among Male and Female ChildrenAged 0-17 Years, By Type of Disability: Vietnam 1998.

•»

EC0

L

ti.

Type ofDisability

Sight

Hearing

Speech

Movement


Learning

Other

Total (%)

(N)

Percent of Population Aged 0-17 Years OldHaving Specific Types of Disabilities

Totalo/Jo

0.61

0.40

0.89

0.93

0.67

0.15

0.50

2.80

(41,073)

Males 0-17%

0.66

0.49

1.05

1.03

0.74

0.17

0.52

3.09

(21,197)

Females 0-17%

0.56

0.31

0.72

0.83

0.60

0.13

"0.48

2.48

(19,879)

Ratio Maleto Female

1.18

1.58

1.46

1.24

1.23

1.31

1.08

1.25

Note: Total number of disabilities adds up to more than the number of CWDs because some childrenhave multiple disabilities. These rates are not adjusted for composition differences in the surveysample from the general population.

Vietnam Child Disability Survey 1<)<J« Pago 68

Table 8. Percent Distribution of Causes of Disability Among ChildrenAaged 0-17 Years, By Age Group: Vietnam 1998.Results from the Community-Based Survey, Test Survey,and Institution-Based Survey of the 1998 Vietnam Child Disability Survey.

Causes ofDisability

Congenital

Diseases

Environment

Accidents

Toxic Agentsof War

Other Causes

Total (%)

(N)

Community Based Survey

%Reporting

62.7

33.1

4.1

2.3

7.2

4.4

113.8%

(1148)

% Distribution of allReported

55.1

29.1

3.6

2.0

6.4

3.9

100%

(1307)

Test Survey

%Reporting

64.7

38.8

2.2

0.6

15.0

3.8

125.1%

(320)

%Distribution

of allReported

51.8

31.0

1.8

0.5

12.0

3.0

100%

(400)

Institution-BasedSurvey

%Reporting

68.3

24.8

0.4

0.0

7.8

4.3

105.6%

(230)

%Distribution

of allReported

64.6

23.5

0.4

0.0

7.4

4.1

100%

(243)

Noie: The total number of reported causes of disabilities add up to more than the total number of childrenwith disabilities because some children have multiple disabilities and some specific disabilities havemore than one reported cause of that disability.

]

3

n3

L

[•

II

Vietnam Child Disability Survoy 1998 Page 69

Table 9. Percent of Children with Disabilities who sought Treatment,By Region and Urban-Rural Residence in Vietnam: 1998.

LL

Regions andUrban-Rural Residence

1, Red River DeltaUrbanRural

2, North EastUrbanRural

3, North WestUrbanRural

4, North CentralUrban _,Rural

5, Central CoastUrbanRural

6, Central HighlandUrbanRural

7, South EastUrbanRural

8, Mekong River DeltaUrbanRural

TotalUrbanRural

Percent of CWDs whoever sought treatment

TotalPercent (N)

90.2 (61)61.1 (113)

74.8(103)77.3 (97)

62.5 (16)45.7 (35)

80.0 (70)65.0 (97)

65.1 (43)50.9 (108)

79.6 (54)29.0 (38)

78.5 (65)77.8 (81)

72.5 (69)64.3 (98)

(1148)76.9(481)62.2 (667)

FemalePercent (N)

82.8 (29)57.1 (49)

76.6 147J79.5 (39)

66.7 (6)38.5 (13)

78.8 (33)62.9 (35)

63.2 (19)54.4 (46)

81.5 (27)35.0 (20)

82.6 (23)79.4 (34)

56.2 (32)70.0 (40)

(492)74.5(216)62.7 (276)

Source: 1998 Vietnam Child Disability Survey (Community-based Survey).

Vietnam Child Disability Survey I'JiKi Pago 70

Table 10. Percent of Children with Disabilities aged 6-17 Years OldWho are Illiterate, By Type of Disability andUrban-Rural Residence in Vietnam: 1998.

Type ofDisability

Sight

Hearing

Speech

Movement


Learning

Other

Total (%)

Percent of Population Aged 6-17 Years OldWho are Illiterate by Types of Disabilities and

Urban-Rural ResidenceTotal

% (N)

31.2 (215)

56.8 (139)

65.7 (297)

45.7 (324)

66.9 (248)

34.5 (55)

42.8 (152)

45.5 (961)

Urban% (N)

33.6 (110)

65.1 (43)

66.7 (123)

47.9 . (146)

71.3 (101)

50.0 (16)

43.9 (.66)

NA (412)

Rural% (N)

28.6 (105)

53.1 (96)

64.9 (174)

43.8 (178)

63.9 (147) .

28.2 (39)

41.9 (86)

NA (549)

Note: Total number of disabilities adds up to more than the number of CWDs becausesome children have multiple disabilities. These rates are not adjusted forcomposition differences in the survey sample from the general population. 1

1

33D3

-ftOliiiKftMiWAtMPm",»)»»,-».»••».«.•. ...«r.»«- ".I- .f*WKdBS«**«;i»»»»'e-"if »i-.!J»WW*., .'-V -flf-^ffiftiK'n 1 •.flWnWwmtlW «"O1TO •"»

c Viotnarn Child Disability Survey 1090 Pago 71

t[I

Table 11. Percent Distribution of Children with Disabilitiesaged 0-17 Years Old, By Levels of Participationin Age-Typical Activities: Vietnam 1998.

Type of Disability

Sight/Vision Disabilities

Hearing Disabilities

Speech Disabilities

Movement Disabilities

Fits/Strange Behavior

Learning Disabilities

Other Disabilities

Total for all Children with

Disabilities

Percent Distribution of CWD level of

participation in age-typical activities

Full

participation

Percent

62.8

34.6

34.2

28.2

18.8

43.6

50.7

44.0

Partialparticipation

Percent

31.6

41.8

36.9

44.6

49.1

43.6

36.6

38.5

No

participation

Percent

5.6

23.6

29.0

27,2

32.1

12.9

12.7

16.6

Total

Percent (N)

100 (250)

100 (165)

100 (366)

100 (383)

100 (277)

100 (62)

100 (205)

100 (1148)

Note: Number of disabilities add up to more than the total number of children with disabilities

because some children have multiple disabilities.


Table 12. Percent Distribution of Children with Disabilitiesaged 6-17 Years Old, By Number of Friends andType of Disability: Vietnam 1998.

Type of Disability

Sight/Vision Disabilities

Hearing Disabilities

Speech Disabilities




Other Disabilities

Total for all children withdisabilities (aged 6-17)

Total

Percent (N)

100 (215)

100 (139)

100 (297)

100 (324)

100 (248)

100 (55)

100 (152)

100 (961)

Manyfriends

Percent

60.5

24.5

27.6

38.3

14.5

43.6

44.7

42.2

Few

friends

Percent

32.6

50.4

40.4

37.6

46.4

41.8

34.9

39.4

One

friend

Percent

0.5

0.7

0.7

0.6

0.8

1.8

0.0

0.5

No

friends

Percent

6.5

24.5

31.3

23.5

38.3

12.7

20.4

17.8

Note: Number of disabilities add to more than the total number of children with disabilities becausesome children have multiple disabilities.

"]W, J

rT^:«fti'Wfff^«nMt '-i^wttftflftw' ^-^N':^.'--''' . •, ,-.-wfv>"-"'1'*>'' '':' - ••*;#»'*-•**

L

LLEL.L:E

L


Table 13. Percent Distribution of Children with Disabilitiesaged 6-17 Years Old, By Number of Friends andwhether Attending School or Work: Vietnam 1998.

School and Work Status

School Status

Attending schoolNot Attending School

Work Status

Not Working

By age6-1011 - 1415- 17

WorkingBy age

6-10

11 - 14

15- 17

Total (N)

TotalPercent (N)

100 (609)

100 (352)

100 (778)

100 (333)

100 (287)

100 (158)

100 (183)

100 (21)

100 (82)

100 (80)

100 (961)

Manyfriends

61.19.7

36.5

35.1

38.3

36.1

66.7 '

85.7

63.4

65.0

42.2

Few

friends

35.5

46.3

41.4

44.7

38.3

39.9

31.2

14.3

34.2

32.5

39.4

One

friend

0.2

1.1

0.6

0.6

0.4

1.3

-

-

-

-

0.5

No

friend

3.3

42.9

21.5

19.5

23.0

22.8

2.2

-

2.4

2.5

17.8

Vietnam Child Disability Survey I'JOft Pago 7<l

Table 14. Percent Distribution of Children with DisabilitiesAged 0-17 Years Old Perceived Attitudes of theLocal People towards CWDs, by Region, andUrban-Rural Residence in Vietnam: 1998.







6. Central HighlandUrbanRural



TotalUrbanRural

Total CWDsAged 0-17

% (Number)

100 (174)100 ( 61)100 (113)

100 (200)100 (103)100 ( 97)

100 ( 51)100 ( 16)100 ( 35)

100 (167)100 ( 70)100 ( 97)

100 (151)100 ( 43)100 (108)

100 ( 92)100 ( 54)100 ( 3 8 )

100 (146)100 ( 65)100 ( 81)

100 (167)100 ( 69)100 ( 98)

100(1148)100 ( 481)100( 667)

Attitudes of Local People towards CWDs(Percent Distribution Across)

Normal Attitudes

58.667.254.0

47.040.853.6

64.762.565.7

53.952.954,6

44.444.244.4

65.272.255.3

56.847.764.2

50.363.840.8

50.454.752.5

ShowsSympathy

28.719.733.6

47.552.442.3

29.431.228.6

32.334.330.9

39.746.537.0

21.713.034.2

24.724.624.7

41.931.949.0

34.833.336.0

Shows Pity

9.86.6

11.5

5.06.83.1

3.96.22.9

10.210.010.3

5.34.65.6

7.613.00.0

8.912.36.2

4.22.95.1

7.17.96.4

AreAfraid/Shows

Fear

0.61.60.0

0.00.00.0

0.00.00.0

0.61.30.0

0.70.00.9

1.11.80.0

1.41.51.2

0.00.00.0

0.50.80.3

Others

2.34.90.9

0.50.01.0

2.00.02.9

3.01.44.1

9.94.6

12.0

4.40.0

10.5

8.213.83.7

3.61.45.1

4.23.34.8

3

LVietnam Child Disability Survey 1990 Pago 75

[

EL

Table 15. Percent of Children with Disabilities aged 0-17 Years Old,By Perceived Attitudes of the Local People towards CWDs,and Type of Disability: Vietnam 1998.

Type ofDisability

Sight

Hearing

Speech

Movement


Learning

Other

Total

Total CWDsAged 0-17

% (Number)

100(250)

100 (165)

100(366)

100(383)

100(277)

100 (62)

100(205)

100(1148)

Attitudes of Local People towards CWDs(Percent Distribution Across)

Normal Attitudes

66.0

45.4

41.5

45.4

33.9

53.2

57.6

53.4

ShowsSympathy

23.6

40.0

42.6

40.0

49.5

30.6

30.2

34.8

Shows Pity

6.0

7.3

9.3

9.7

8.7

6.4

7.3

7.1

AreAfraid/ShowsFear

0.8

1.2

0.8

0.5

1.4

1.6

0.0

0.5

Others

3.6

6.1

5.7

4.4

6.5

8.1

4.9

4.2

Viotriam Child Disability Survey 1998 Pago 76

Table 16. Percent of Children with Disabilities Aged 6-17 Years OldWho Are Aware of Any Rehabilitation Services in theLocal Area, By Type of Disability: Vietnam 1998.

Type ofDisabilitySight

Hearing

Speech

Movement


Learning

Other

Total

Total Number of CWDsAged 6-1 7

IN)(215)

(139)

(297)

(324)

(248)

(55)

(152)

(961)

Percent Aware of LocalRehabilitation Services

Percent8.4

0.0

0.0

1.2

0.4

1.8

0.0

2.5

Note: Total number of disabilities adds up to more than the number of CWDs becausesome children have multiple disabilities.

]

[

I!I;I


Table 17. Percent of Children with Disabilities aged 0-17 Years Old UsingRehabilitative Devices, By Type of Device and Type of Disability:Vietnam 1998.

Type ofDisability

Sight

Hearing

Speech

Movement


Learning

Other

Total

TotalCWDsAged0-17

% (N)

100(250)

100(165)

100(366)

100(383)

100(277)

100 (62)

100(205)

100(1148)

%using

any ,device

%

20.4

1.2

1.4

9.4

2.9

6.4

8.3

8.1

Type of Rehabilitative Device Used by CWDs(Percent of CWDs Using Specific Devices)

Glasses

20.0

0.6

0.3

1.0

0.7

4.8

3.9

4.9

FakeEye

0.4

0.0

0.0

0.0

0.0

0.0

0.0

0.1

HearingAids

0.0

0.6

0.5

0.0

0.0

0.0

0.0

0.2

Crutches

0.0

0.0

0.0

3.7

0.7

1.6

1.5

1.1

WheelChair

0.0

0.0

0.5

2.1

0.4

0.0

1.0

0.8

ProstheticLimb

0.0

0.0

0.0

0.3

0.0

0.0

0.0

0.1

Other

0.0

0.0

0.0

2.1

1.1

0.0

1.9

0.9

Note: The number of disabilities is greater than the number of children with disabilities because somechildren have multiple disabilities. Some children may also use more than one device.


Table 18. Percent of Children with Disabilities aged 0-17 Years OldUsing Rehabilitative Devices, By whether Devices wereBought or Donated, Type of Device and Urban-RuralResidence in Vietnam: 1998.

Type ofRehabilitativeDevice

Glasses

False Eye

Hearing Aids

Crutches

ProstheticLimbs

Wheelchair

Other

Total

Total CWDs Aged 0-17

Urban% (Number)

100(41)

100(1)

100(1)

100(5)

100(0)

100(5)

100(8)

100(61)

Rural% (Number)

100 (15)

- (0)100*(1)-

100(8)

100*(1)

100(4)

100(3)

100(32)

Percent of CWDs Using Devices that wereBought or Donated

(Percent Distribution Across)

DeviceBought

Urban

87.8

0.0*

100.0*

40.0

-

20.0

62.5

73.8

DeviceBought

Rural

93.3

-

100.0*

12.5

100.0*

50.0

33.3

62.5

DeviceDonated

Urban

12.2

100.0*

0.0*

60.0

-

80.0

37.5

26.2

DeviceDonated

Rural

6.7

-

0.0*

87.5

0.0*

50.0

66.7

37.5

Note: "*" signifies that the percent calculation is based on only one case.

,1

1mnJ

L;Vietnam Child Disability Survoy 1998 Pago 79

Table 19. Percent Distribution of Children with Disabilities Receiving Support,By Type of Support, Region, and Urban-Rural Residence in Vietnam: 1998.







6. Central HighlandUrbanRural



TotalUrbanRural

Total CWDsAged 0-17

% (Number)

100 (174)100 ( 61)100 (113)

100 (200)100 (103)100 ( 97)

100 ( 51)100 ( 16)100 ( 35)

100 (167)100 ( 70)100 ( 97)

100 (151)100 ( 43)100 (108)

100 ( 92)100 ( 54)100 ( 38)

100 (146)100 ( 65)100 ( 81)

100 (167)100 ( 69)100 ( 98)

100(1148)100 ( 481)100 ( 667)

Assistance Received(Percent Distribution Across)

% Who ReceivedAny Support

% (Number) %17.2 (30) 1009.8 (6) 10021.2 (24) 100

7.5 (15) 1005.8 ( 6) 1009.3 ( 9) 100

23.5 (12) 10025.0 ( 4) 10022.9 ( 8) 100

6.0 (10) 1004.3 ( 3) 1007.2 ( 7) 100

5.3 ( 8) 1002.3 ( 1) 1006.5 ( 7) 100

3.3 ( 3) 1001.8 ( 1) 1005.3 ( 2) 100

1.4 ( 2) 1001.5 ( 1) 1001.2 ( 1) 100

7.2 (12) 1002.9 (10) 10010.2 (2) 100

8.0 (92) 1005.0 (24) 10010.2 (68) 100

MonthlyAllowance

86.733.3100.0

20.050.00.0

83.3100.075.0

30.00.0

42.9

25.0100.014.29

66.70.0

100.0

50.00.0

100.0

66.7100.060.0

59.850.063.2

Free/SubsidyEducation

3.316.70.0

80.050.0100.0

16.70.025.0

60.0100.042.9

75.00.0

85.7

33.3100.00.0

0.00.00.0

33.30.0

40.8

34.833.335.3

FreeHealthCard

10.050.00.0

0.00.00.0

0.00.00.0

10.00.014.3

0.00.00.0

0.00.00.0

50.0100.00.0

0.00.00.0

5.416.71.5

Others

0.00.00.0

0.00.00.0

0.00.00.0

0.00.00.0

0.00.00.0

0.00.00.0

0.00.00.0

0.00.00.0

0.00.00.0


Table 20. Percent Distribution of Future Job Aspirations of Children withDisabilities aged 6-17 Years Old, By Type of Disability: Vietnam 1998.

Future JobAspirations

Tailoring

Agriculture

Teaching

Police

Medical CareProfession

Secretary

EngineeringElectricRepair

Trade/Business

Handicrafts/Fine Arts

Others

No JobDetermination

Total PercentTotal(Number)

Total CWDsAged 6-1 7

% CWDswho desireTotal job

% (Number)

6.3 (61)

5.7 (55)

28.3 (272)

10.8 (104)

14.4 (138)

0.6 (6)

14.0 (135)

3.6 (35)

10.3 (99)

4.8 (46)

1.0 (10)

100(961)

Type of Disability(Percent Distribution Across)

Sight

5.6

3.7

32.1

8.8

14.4

1.4

12.6

2.3

11.6

6.0

1.4

1001215)

Hearing

9.4

5.8

29.5

10.1

7.9

0.0

14.4

2.2

16.5

3.6

0.7

100(139)

Speech

8.1

4.0

25.9

16.2

12.1

0.0

15.2

3.0

11.8

3.0

0.7

100(297)

Move-ment/

Mobility

7.1

5.6

28.1

8.6

12.3

0.9

17.3

3.7

10.5

4.9

0.9

100(324)


5.6

6.5

31.5

8.9

15.3

0.0

14.9

2.4

10.9

2.8

1.2

100(248)

Learning

12.7

1.8

29.1

9.1

25.5

0.0

14.5

0.0

5.5

1:80.0

100(55)

Other

6.6

9.2

19.7

15.1

16.4

0.7

11.8

6.6

9.9

3.3

0.7

100(152)

11"11ttii

Vietnam Child Disability Survey ID98 Pngo 81

Table 21. Percent Distribution of Ways Children with Disabilities Aged 6-17 YearsOld Expect to Achieve their Aspirations for Specific Jobs/Occupationsin the Future: Vietnam 1998.


Tailoring

Agriculture

Teaching

Police


Secretary

EngineeringElectricRepair

Trade/Business

Handicrafts/Fine Arts

Others

No JobDetermination

Total % (N) %

Total CWDsAged 6-17

% CWDswho desire Totaljob (Mum) %

6.3 (61) '100

5.7 (55) 100

28.3 (272) 100

10.8 (104) 100

14.4 (138) 100

0.6 (6) 100

14.0 (135) 100

3.6 (35) 100

10.3 (99) 100

4.8 (46) 100

1.0 (10) 100

100 (961) 100

Way CWDs Expect to Realize Their Job Aspirations(Percent Distribution Across)

Hardworkself

study

50.8

18.2

38.6

19.2

21.0

100.0

28.2

31.4

25.2

63.0

0.0

31.6

Withhelpfrom

family

31.2

21.8

25.7

14.4

37.0

0.0

29.6

8.6

21.2

13.0

0.0

24.7

Withhelpfrom

community

6.6

18.2

20.2

28.8

13.0

0.0

, 18.5

34.3

13.1

10.9

0.0

17.9

Withhelpfrom

relative/friends

1.6

12.7

7.4

8.6

11.6

0.0

12.6

5.7

20.2

0.0

0.0

9.6

With state/govt

assistance

4.9

1.8

6.6

18.3

13.0

0.0

5.9

20.0

18.2

2.2

0.0

9.7

Otherways

4.9

27.3

1.5

10.6

4.4

0.0

5.2

0.0

2.0

10.9

0.0

5.5

NoAnswer

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

1.0


Table 22. Percent of Children with Disabilities Living inInstitutions Having Specific Types of Disabilities,By Gender and Percent Female for each Type of Disability: 1998.

Type ofDisability

Sight

Hearing

Speech

Movement


Learning

Other

Total

Percent of CWDs Aged 0-17 Having Specific Types ofDisabilities

Total%. (N)

14.4 (33)

47.4 (109)

57.0 (131)

16.5 (38)

16.5 (38)

0.4 (1)

11.7 (27)

163.9(230)

Male% (N)

16.5 (21)

44.1 (56)

52.0 (66)

17.3 (22)

19.7 (25).

0.0* (0)

12.6 (16)

162.2(127)

Female_% (N)

11.6 (12)

51.5 (53)

63.1 (65)

15.5 (16)

12.6 (13)

1.0* (1)

10.7 (11)

166.0(103)

%Female

36.4

48.6

49.6

42.1

34.2

100.0*

40.7

44.8

Note: Total number of disabilities adds up to more than the number of CWDs becausesome children have multiple disabilities.

"*" signifies that the percent calculation is based on only one case.

]

]

1

L

[

L


Table 23. Percent Distribution of Children with Disabilities Living inInstitutions, By Type of Disability and Age Group: 1998.

Type of Disability

Sight

Hearing

Speech

Movement


Learning

Other

Total

Total CWDs Aged 0-17

% (Number)

100(33)

100(109)

100(131)

100(38)

100(38)

100 (1)

100(27)

100(230)

Percent in each Age Group(Percent Distribution Across)

0-5Years Old

6.1

5.5

7.6

2.6

10.5

0.0*

11.1

5.6

6-10Years Old

12.1

45.0

45.8

10.5

29.0

100.0*

29.6

30.4

11 -14Years Old

27.3

39.4

36.6

44.7

42.1

0.0*

44.4

40.4

15-17Years Old

54.6

10.1

9.9

42.1

18.4

0.0*

14.8

23.5

Note: Total number of disabilities adds up to more than the number of CWDsbecause some children have multiple disabilities.



Table 24. Percent Distribution of Reported Causes of Disability amongChildren with Disabilities Living in Institutions, By Type ofDisability: 1998.

Type ofdisabilityand

% female

Sight

% female

Hearing

% female

Speech

% female

Movement

% female

Fits/StrangeBehavior% female

Learning

% female

Other

% female

Total

% female

Total

% (N)

100 (33)

36.4

100(109)

48.6

100(131)

49.6

100 (38)

42.1

100 (38)

34.4

100* (1)

100.0

100 (27)

40.7

100 (230)

44.8

Causes of Disabilities(Percent Distribution Across

Congenital/ birth

defects

48.5

18.8

88.1

50.0

87.8

62.5

34.2

46.2

76.3

37.9

0.0*

0.0*'

51.8

42.9

68.3

46.5

Disease

54.6

50.0

0.9

0.0

6.1

0.0

57.9

36.4

21.0

62.5

100.0*

100.0*

51.8

50.0

24.8

47.4

Environ-ment

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0*

0.0*

0.0

0.0

0.0

0.0

Accidents

0.0

0.0

0.0

0.0

0.8

0.0

0.0

0.0

2.6

0.0

0.0*

0.0*

3.7

0.0

0.4

0.0

Toxicagentsof war

0.0

0.0

4.6

40.0

5.3

42.9

23.7

44.4

18.4

28.6

0.0*

0.0*

7.4

0.0

7.8

38.9

Other

0.0

0.0

8.3

33.3

6.9

33.3

0.0

0.0

2.6

0.0

0.0*

0.0*

0.0

0.0

4.4

30.0

Note: Row percentages add up to slightly more than 100 percent because more than one cause wasreported for a few children with disabilities (i.e., for 13 disabilities, more than one cause ofdisability was reported)."*" signifies that the percent calculation is based on only one case.

*]

]

3

0Vietnam Child Disnbilily Survey 1!)98 Page 85

Table 25.I*Percent Distribution of Children with Disabilities according toMeans of Admission to the Institutions,By Type of Disability: 1998.

[ •I

Type of Disability

Sight Disabilities

r Hearing Disabilities

Speech Disabilities




Other Disabilities

Total

TotalPercent (N)

100 (33)

100(109)

100(131)

100 (38)

100 (38)

100 (1)

100 (27)

100(230)

Way in which children wereadmitted to institution

(Percent Distribution Across)

Abandonedby family

12.1

0.9

2.3

23.7

5.3

0.0*

3.7

6.5

Brought toinstitution by

family

51.5

42.2

43.5

55.3

39.5

0.0*

45.4

47.0

Other

36.4

56.9

54.2

21.0

55.3

100.0*

48.2

46.5

Note: the table columns do not add up to 100 percent because many of thechildren had multiple disabilities.


Vietnam Child Disability Survey l',)!)8 Page 8C

Table 26. Percent Distribution of Education Levels of Children with Disabilities

Living in Institutions, By Age Group and Gender: 1998.

Age Group andGender

6-10 Years OldMalesFemales

11 -14 Years OldMalesFemales



CWDsAged 6-17% (Number)

100(70)100(35)100(35)

100(93)100(55)100 (38)

100 (54)100(32)100(22)

100(217)100(122)100 ( 95)

Illiterate

17.117.117.1

8.69.17.9

13.012.513.6

12.412.312.6

Education Level of CWDs Living in Institutions(Percent Distribution Across)

eNot

completedprimary

77.180.074.3

81.780.084.2

74.181.263.6

78.380.375.8

CompletedPrimary

5.72.98.6

9.710.97,9

11.13.1

22.7

8.86.611.6

CompletedSecondarySchool

0.00.00.0

0.00.00.0

1.83.10.0

0.50.80.0

Completedhigherschool

0.00.00.0

0.00.00.0

0.00.00.0

0.00.00.0

Ii

1]13

•• >.SWB*:M-nV

Vietnam Child Disability Survoy H)9!) Pago 87

L

rL Table 27. Percent Distribution of Family Contact with Children with

Disabilities Living in Institutions, By Type of Disability: 1998.

LL;|:iL.V

: . . .

' • • - •

-.-.

Type ofDisability

Sight

Hearing

Speech

Movement


Learning

Other

Total

Total CWDsAged 0-17

Percent (N)

100 (33)

100 (109)

100 (131)

100 (38)

100 (38)

100* (1)

100 (27)

100 (230)

Percent CWDs whohave any contact

with Family

84.8

98.2

90.1

81.6

65.8

100.0*

77.7

90.9

PercentCWDs who

have weeklycontact with

Family15.2

54.1

63.4

21.1

31.6

100.0*

55.6

43.9

Note: Total number of disabilities adds up to more than the number of CWDsbecause some children have multiple disabilities.


Vu.'lnam Child Disability Suivoy I'.IU.H Pnyo 80

Table 28. Percent Distribution of Frequency of Family Contact with Childrenwith Disabilities Living in Institutions (among CWDs who havesome contact with their family), By Type of Disability: 1998.

Type ofDisability

Sight

Hearing

Speech

Movement


Learning

Other

Total


% (Number)

100(28)

100 (107)

100(118)

100 (31)

100 (25)

100* (1)

100(21)

100 (209)

Frequency of Family Contact(Percent Distribution Across)

Contact at leastonce per week

17.9

55.1

54.2

25.8

46.0

100.0*

71.4

48.3

Contact at leastonce per month

46.4

35.5

34.7

48.4

32.0

0.0*

14.3

36.8

Contact less oftenthan once a month

35.7

9.3

11.0

25.8

20.0

0.0*

14.3

14.8

Note: Total number of disabilities adds up to more than the number of CWDs reporting some family contact,because some children have multiple disabilities.


3

I!

ccc


Table 29. Percent Distribution of Children with Disabilities Aged 6-17 Years Old,According to their Reported Like/Dislike for the Institutions where theyare Living, By Age Group and Gender: 1998.

Age Group andGender


Total


Total


Total


Total

CWDs Aged 6-1 7

% (Number)

100 (35)100 (35)100 (70)

100 (55)100 (38)100 (93)

100 (32)100 (22)100 (54)

100 (122)100 (95)100 (217)

Percent of CWDs Who Say Like/Dislike theInstitution where they are living(Percent Distribution Across)

They Like theInstitution

100.0100.0100.0

80.073.777.4

68.8• 59.1

64.8

82.880.081.6

They Dislike theInstitution

0.00.00.0

20.026.322.6

31.240.935.2

17.220.018.4

HiV

Vietnam CKId Disability Survey I91J8 Pago 90

Table 30. Percent Distribution of Children with Disabilities who Like the Institutionswhere they are Living, By Reason they Like the Institutionand Type of Disability: 1998.

Type ofDisability

Sight

Hearing

Speech

Movement


Learning

Other

Total

Total CWDsAged 0-17

% (Number)

100(16)

100(102)

100(118)

100(22)

100 (30)

100* (1)

100(21)

100(177)

Reasons why CWDs like the Institution(Percent Distribution Across)

Need to belooked

after/cared for

12.5

47.1

42.4

40.9

16.7

0.0*

19.0

35.6

Opportunitiesto meet/playwith friends

37.5

35.3

35.6

4.6

46.7

100.0*

23.8

34.5

To haveaccess tomedical

care

6.2

0.0

0.8

4.6

0.0

0.0*

0.0

1.1

To havegovernment

/statebenefits

18.8

11.8

15.2

27.3

33.3

0.0*

33.3

16.4

Otherreasons

25.0

5.9

5.9

22.7

3.3

0.0*

23.8

12.4

Note: Total number of disabilities adds up to more than the number of CWDs because somechildren have multiple disabilities.


]

1£J

cVietnam Child Disabil i ty Survey 1998 Pago 91

"* Institution Staff Treat them, By Type of Disability: 1998.

[•v,*

ri .

i....

Type ofDisability

Sight

Hearing

Speech

Movement


Learning

Other

Total


% (Number)

100 (33)

100(109)

100(131)

100(38)

100(38)

100 (1)

100(27)

100 (230)

CWDs reports on how they are treated by Staff(Percent Distribution Across)

Staff actnormally

15.2

3.7

8.4

10.5

21.0

0.0*

14.8

7.0

Staff showpity

3.0

0.9

4.6

7.9

2.6

0.0*

. 0.0

4.4

Staff arekind/treat them

well

81.8

95.4

87.0

81.6

73.7

100.0*

85.2

88.3

Others

0.0

0.0

0.0

0.0

2.6

0.0*

0.0

0.4

Note: Total number of disabilities adds up to more than the number of CWDs because some childrenhave multiple disabilities.


Vietnam Child Disabiliiy Survey HJMJI Page <)<

Table 32. Percent Distribution of Future Job Aspirations of Children withDisabilities Living in Institutions,By Gender and Type of Disability: 1998.

Type ofDisability

SightMaleFemale

HearingMaleFemale

SpeechMaleFemale

MovementMaleFemale


MaleFemale

LearningMaleFemale

OtherMaleFemale

TotalMaleFemale

TotalCWDsAnf*HA\y Cx4

0-17

% (Num)

100(31)100(20)100 (11)

100 (103)100(52)100 (51)

100(121)100(61)100(60)

100(37)100(22)100(15)

100(34)100(24)100(10)

100* (1)- (0)

100* (1)

100(24)100 (15)100 (9)

100(217)100 (122)100 (95)

Job Aspiration For the Future(Percent Distribution Across)

Tailor

0.00.00.0

49.559.639.2

43.854.133.3

8.19.16.7

14.716.710.0

0.0*-

0.0*

16.726.70.0

28.132.822.1

Music

12.920.00.0

8.77.79.8

7.46.68.3

2.70.06.7

2.90.010.0

0.0*-

0.0*

8.36.711.1

7.87.48.4

Teacher

35.535.036.4

26.226.925.5

29.8•31.128.3

8.14.513.3

50.045.860.0

0.0'-

0.0*

29.220.044.4

27.227.027.4

Police

3.25.00.0

0.00.00.0

0.81.60.0

0.00.00.0

2.94.20.0

0.0*-

0.0*

0.00.00.0

0.50.80.0

MedicalCare

6.40.018.2

8.73.813.7

10.74.916.7

29.713.653.3

5.98.30.0

0.0*-

0.0*

12.513.311.1

13.46.6

22.1

Handicraft/FineArts

25.825.027.3

0.00.00.0

0.00.00.0

5.49.10.0

0.00.00.0

0.0*-

0.0*

0.00.00.0

4.65.73.2

ElectricRepair

16.115.018.2

4.80.09.8

5.80.011.7

34.336.46.7

5.94.210.0

100.0*-

100.0*

29.226.733.3

13.413.113.7

TradeBus-iness

0.00.00.0

0.00.00.0

0.00.00.0

2.74.50.0

0.00.00.0

0.0*-

0.0*

0.00.00.0

0.50.80.0

Other

0.00.00.0

1.91.92.0

1.61.61.7

18.922.713.3

17.620.810.0

0.0*-

0,0*

4.26.70.0

4.65.73.2

Note: Total number of disabilities adds up to more than the number of CWDs because some childrenhave multiple disabilities.


**,

il

Vn'lM.-im Child Dis.-ihility Survey I <)!)/! P.-HjO 03

Table 33. Percent Distribution of the Ways Children with DisabilitiesAged 6-17 Years Old and Living in Institutions say theyExpect to Achieve their Job Aspirations in the Future,By Specific Jobs/Occupational Aspirations.


Tailoring

Music

Teaching

Police


ElectronicRepair

Trade/Business

Handicraft/Fine Arts

No JobDetermination

Total % (N) %

Total CWDsAged 6-17

% CWDswhodesiro Totaljob (Num) %

28.1 (61) 100

7.8 (17) 100

27.2 (59) 100

0.5 (1) 100

13.4 (29) 100

13.4 (29) 100

0.5 (1) 100*

4.6 (10) 100

4.6 (10) 100

100 (217) 100

Ways CWDs Expect to Realize Their Job Aspirations(Percent Distribution Across)

Hardworkself

study

57.4

29.4

23.7

0.0

75.9

48.0

100.0*

100.0

0.0

46.5

Withhelpfrom

family

13.1

58.8

15.2

0.0

10.3

3.4

0.0*

0.0

0.0

14.3

With helpfrom

community

21.3

5.9

15.2

100.0

3.4

27.6

0.0*

0.0

0.0

15.2

Withhelpfrom

relative/friends

3.3

0.0

20.3

0.0

0.0

10.3

0.0*

0.0

0.0

7.8

With state/govt

assistance

4.9

5.9

25.4

0.0

10.3

10.3

0.0*

0.0

0.0

11.5

No '"""""Answer

0.0

0.0

0.0

0.0

0.0

0.0

0.0*

0.0

100.0

4.6

Note: "*" signifies that the percent calculation is based on only one case.

Violnam Child Disabil i ty Survey I'l'JH P;ujo 0.)

Table 34: Causes of disabilities by types of disability (Percent Distribution)(Unit: percent)

Causes of

disability

Birth

Disease

Environmental

Accident

Natural

calamity

By toxin agent

of war

Others

Total

62.7

31.1

2.3

4.1

-

7.2

4.4

Sight

62.0

31.2

2.8

4.0

-

4.0

8.8

Hearing

72.7

27.9

-

1.2

-

6.0

2.4

Speech

76.2

27.0

0.1

1.4

-

7.6

1.13

Movement

51.2

39.9

3.9

8.1

-

10.7

2.6

First/

Strange

behavior

64.2

39.7

2.5

2.5

-

12.7

2.9

Learning

61.3

33.9

-

3.2

-

3.2

4.8

Other

62.0

37.6

2.0

1.5

-

7.3

4.9

# • • • ' s! *

O- -.,, o =

Figure 1. Prevalence of Disability in Children in Vietnam,Selected Sources and Areas: 1991-1999

PC Vinh Phuc

MOLISA1992

MOHCBR1998

Rb/NIES Vinh Phuc

MOH Hoa Binh LSD

MOLISA/UNICEF 1998

NIESHaTay

NIES Hoa Binh

NIES Quang Ninh

NIES Ninh Binh

NIES 14 Prov

0

Percent of Population of Children

°//o6

Severely DisabledTotal Disabled

7

Source: Selected MOLISA, MOH, MOET/NIES and NGO Surveys and CBR data 1991-1999.(Children aged 0-15, 0-16, or 0-17)

Figured

100%

80%

60%

40%

; 20%

Types of Disabilities Among Children with Disabilities inVietnam, Selected Sources: 1991-1998

Percent Distribution

•Other DisabilityHStrange Beh/Epil^LearningdVisionBHearing&Speech• Movement

1994-1995 Severe Disability Survey. . . . . .

:-:••* «•

Figure 3. Prevalence of Disability in Children Aged 0-17 YearsOld in Vietnam, Selected Provinces: 1998

Percent of Population of Children Aged 0-17 Years OldVitenam Total

.UrbanRural

Ha Tay ProvinceNam Dinh Province

Lang SonVinh Phuc

Quang NinhHoa Binh

Thanh HoaQuang TriDa Nang

Binh DinhKon Turn

Binh ThuanBinh DuongDong Thap

Ben TreCa Mau

(Children With Disabilities (Survey) QGen<

0 1 6Source: MOLISA/UNICEF 1998 Vietnam Child Disability Survey.

Figure 4. Percent of Children with of Disabilitieswho are Severely Disabled in Vietnam,By Type of Disability: 1998

Page 98

Percent of CWDs Severely Disabled

Severely Disabled

All CWDsMovement Hearing Speech Sight LearningStrangeBeh Other

Type of DisabilitySource: MOLISA/UNICEF 1998 Vietnam Child Disability Survey (Adapted from Table 10 P. 23 Presentationof the Data: 1998 Community-Based Survey on disabled Children).

B£I 1—J

•t > *••--•:% I

Figure 5. Children With Disabilities in Vietnam By Typeof Disability: 1998 (Percent Distribution)

Hearing9.7%

Speech21.4%

Sight14.6%

-Movement22.4%

Other12.1%

Learning Fits/Strange Beh3.6%. 16.2%

Source: MOLISA/UNICEF 1998 Vietnam Child Disability Survey

FIGURE 6. REPORTED CAUSES OF DISABILITIES IN CHILDRENIN VIETNAM: 1998 (PERCENT OF ALL CAUSES)

Congentiai55.1%

Environmental2.0%

Disease29.1%

Other Causes3.9%

War Toxic Agents6.3%Accidents

3.6%

E^a

Source: MOLISA/UNICEF 1998 Child Disability Survey. Percentages based on all reported causes, which is greater than the number ofCWDs in the survey. Some CWDs had multiple disabilities and multiple causes reported for some of their disabilities.

] tptSM^ i** > ">-t K ;:--'j :: • • | ; '• • ! ? -. :• | j I } ! • : . . - ..

Paae 10i

Figure 7. Percent Distribution of Causes of Disabilities inChildren Aged 0-17 Years Old in Vietnam,By Age Group: 1998

100%

80%

60%

40%

20%

0%0-5 years 6-10 years 11-15 years 16-17 years

SOURCE: MOLISA/UNICEF 1998 Vietnam Child Disability Survey.

nother CausesED EnvironmentalM\Nsr Toxic AgentsCHAccidents[^Disease• Congenital

Figure 8. Percent of Children with Disabilities Who AreFemale, by Cause of Disability: Vietnam 1998

60

50

40

30

20

10

0

Percent

CausesCD Congenital^Disease• EnvironmentalHAccidents^War Related/ToxinOOther Causes

Percent Female


^s *za s*?a *•-- -f '• : ?

Raja 103

Figure 9.

12

10

8

4

Percent of Child Disabilities Reported to be Causedby Toxic Agents of War, by Type of Disability:

Vietnam 1998

oPercent of Disability Due to War Toxic Agents


•All DisabilitiesS MovementmHearingnSpeech^Sight^Learning• Fits/Strange BehD Others

Figure 10.Pane

Percent of Children with Disabilities SeekingRehabilitative Treatment, By Region and Urban-RuralResidence in Vietnam: 1998

Red River Delta UrbanRed River Delta Rural

North East UrbanNorth East Rural

North West UrbanNorth West Rural

North Central UrbanNorth Central Rural

Central Coast UrbanCentral Coast Rural

Centra! Highlands UrbanCentral Highlands Rural

South East UrbanSouth East Rural

Mekong Delta UrbanMekong Delta Rural

Vietnam UrbanVietnam RuralVietnam Total

Percent Seeking Treatment

0 20 40 60 80Percent Seeking Treatment

100

Source: MOLISA/UNiCEF 1998 Child Disability Survey.

t-.-t* t

Figure11. Percent of School-Age Children withDisabilities Who Are Illiterate, By Type ofDisability: 1998

Percent . . - - • .

^All Disabilities^MovementEEJHearing• SpeechHSightunlearningmFits/Strange Beh• Others

Percent of CWDs Aged 6-17 IlliterateOthersSource: MOLISA/UNICEF 1998 Vietnam Child Disability Survey (Community-Based Survey)

Fiq"fe 1Z *•"=<»"'°f Chi|dren with Disabilities Aged 6-17 Yearsin Vi6t°]dm

W1h9°98eVer At'ended SCh°01 °r Wh° D«>P-SOut100


CDNow in SchoolSlDropped Out

Never Attended

0CWDs in Households CWDs in Institutions

SSon aTe S™ 1"8 V'e'nam CMd ^ (C~^-Based Survey and^fi fe^Ji ft-^^« fr- 1 J - m—————• «.-"» Z , ^ B--—~| f. .., ,| • . 5 ^5 . -

Figure 13. Percent Distribution of Reasons why Children withDisabilities Aged 6-17 Years Old Are not AttendingSchool or Have Dropped Out: Vietnam 1998

100

80

60

40

20


CU Other Reasons•AshamedHi School too far/no transport• Learn at HomeEH Don't like schoolMNo BE/IE; difficult to learn• Family too poor

0Reason Never Attended Reason Dropped OutSource: MOLISA/UNICEF 1998 Vietnam Child Disability Survey (Community-Based Survey)

UNICEF Alternate Inventory LabelIII Illl Illll Mill IIIIIIIIIIIIIIIIIIIIIIIIIHI

Rcf0007FTN I I I I I I I I I H I I I

Item # CF-RAI-USAA-DB01 -2003-963268ExR/code: EVL/2003/VTN 98/25 / 03.06.14

Viet Nam child disability Survey 1998.Date Label Printed 18-Dec-2002

VTN/1998/0025

Vietnam Child Disability Survey 1998

s0b? - unicef · u c vietnam disability survey 1998 page 1 executive summary a community-based...

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