Viet Nam

Following its reunification in 1975, Vietnam had a young population and a high fertility rate. Over the next 25 years, the country underwent a dramatic demographic transition, marked by declining birth rates, improved infant mortality rates, and increased life expectancy.

A significant milestone came in 1988 with the adoption of the one-or-two-child policy, which led to a sharp rise in contraceptive use and abortion rates. As a result, Vietnam’s total fertility rate (TFR) fell from nearly 5 births per woman in 1979 to 2.1 (replacement level) by 1990. Today, it has further declined to 1.8, remaining below the replacement threshold.

However, fertility rates vary by region and demographic group. The Central Highlands and Northern Uplands, home to many of Vietnam’s ethnic minority communities, continue to have higher fertility rates, while urban centers—where the majority Kinh population, ethnic Chinese, and other groups reside—tend to have significantly lower birth rates.

With over two-thirds of its population in the working-age group (15-64 years old), Vietnam is currently in a demographic dividend period (2010–2040)—a crucial window of opportunity for economic growth. However, to fully capitalize on this potential, the country must invest in high-quality education, workforce training, and job creation. Recognizing the long-term risks of below-replacement fertility, the Vietnamese government is now considering adjustments to its population policy to prevent potential future labor shortages.

DKT Mekong’s Reach in Vietnam

DKT Mekong is committed to expanding reproductive health access across Vietnam, ensuring affordable, high-quality family planning solutions are widely available. Our key project locations include:

  • Northern Vietnam: Ha Noi, Hai Phong, Thai Nguyen
  • Central Vietnam: Da Nang, Quang Binh, Nghe An, Thua Thien Hue
  • Southern Vietnam: Ho Chi Minh City, Can Tho, Ben Tre, Vinh Long, Thanh Hoa

Through innovative social marketing, strategic partnerships, and targeted interventions, DKT Mekong continues to play a vital role in supporting Vietnam’s reproductive health landscape and adapting to its shifting demographic needs.

Migration Trends and Geographic Overview of Vietnam

Vietnam has experienced both internal migration and net emigration, both for humanitarian and economic reasons, for the last several decades.  Internal migration – rural-rural and rural-urban, temporary and permanent – continues to be a means of coping with Vietnam’s extreme weather and flooding.  Although Vietnam’s population is still mainly rural (66%), increasing numbers of young men and women have been drawn to the country’s urban centers where they are more likely to find steady jobs and higher pay in the growing industrial and service sectors.

Geographic Overview:

Location: Southeast Asia, bordered by the Gulf of Thailand, Gulf of Tonkin, and the South China Sea, as well as China, Laos, and Cambodia.
Total Area: 331,210 sq km (Land: 310,070 sq km, Water: 21,140 sq km).
Land Boundaries: 4,616 km in total, sharing borders with:

  • Cambodia: 1,158 km
  • China: 1,297 km
  • Laos: 2,161 km

Vietnam’s strategic location and diverse geography have played a crucial role in shaping its economic, demographic, and migration patterns.

Cambodia

Cambodia is a predominantly rural nation with one of the most ethnically and religiously homogenous populations in Southeast Asia. Over 95% of its inhabitants are Khmer, and more than 95% adhere to Buddhism. The country’s population size and age structure underwent significant fluctuations in the 20th century due to conflict and mass casualties.

During the Khmer Rouge regime (1975–1979), an estimated 1.5 to 2 million people—approximately 25% of the population—lost their lives due to execution, starvation, disease, or forced labor. Emigration surged, and the fertility rate plummeted during this period.

Following the overthrow of the Khmer Rouge in the 1980s, fertility rates nearly doubled, returning to pre-regime levels of approximately seven children per woman. This increase was partially attributed to improved infant survival rates. However, starting in the early 1990s, Cambodia experienced a sustained fertility decline. The total fertility rate dropped from 3.8 in 2000 to 2.9 in 2010, with variations influenced by income level, education, and urban versus rural residency.

Despite declining fertility rates, Cambodia maintains a youthful population, ensuring continued population growth due to demographic momentum. Mortality rates have improved, life expectancy has increased, and contraceptive use has become more widespread. However, childhood malnutrition remains a persistent challenge. Significant disparities in health indicators exist between urban and rural regions, with rural communities facing higher poverty levels and limited access to healthcare services.

Cambodia is predominantly a country of migration, driven by the search for work, education, or marriage.  Internal migration is more prevalent than international migration, with rural to urban migration being the most common, followed by rural to rural migration.  Urban migration focuses on the pursuit of unskilled or semi-skilled jobs in Phnom Penh, with men working mainly in the construction industry and women working in garment factories.

Most Cambodians who migrate abroad do so illegally using brokers because it is cheaper and faster than through formal channels, but doing so puts them at risk of being trafficked for forced labor or sexual exploitation.  Young Cambodian men and women migrate short distances across the Thai border using temporary passes to work in agriculture, while others migrate long distances primarily into Thailand and Malaysia for work in agriculture, fishing, construction, manufacturing, and domestic service.

Cambodia was a refugee sending country in the 1970s and 1980s as a result of the brutality of the Khmer Rouge regime, its ousting by the Vietnamese invasion, and the resultant civil war.  Tens of thousands of Cambodians fled to Thailand; more than 100,000 were resettled in the US in the 1980s.  Cambodia signed a multi-million-dollar agreement with Australia in 2014 to voluntarily resettle refugees seeking shelter in Australia.  However, the deal has proven to be a failure because of poor conditions and a lack of support services for the few refugees willing to accept the offer.

Cambodia experiences high migration levels, driven by employment, education, and marriage. Internal migration, primarily rural-to-urban, is more prevalent than international migration. Phnom Penh attracts workers, with men in construction and women in garment factories.

Many Cambodians migrate abroad through informal brokers due to lower costs and faster processing, despite risks of trafficking and exploitation. Short-term migration to Thailand for agricultural work is common, while others seek jobs in Thailand and Malaysia in agriculture, fishing, construction, and domestic service.

In the 1970s-80s, Cambodia was a major refugee-sending country due to the Khmer Rouge, Vietnamese intervention, and civil war. Tens of thousands fled to Thailand, and over 100,000 resettled in the U.S. A 2014 refugee resettlement deal with Australia failed due to poor conditions and lack of support services.

Geography & Population

  • Location: Southeast Asia, bordering Thailand, Vietnam, Laos, and the Gulf of Thailand.
  • Area: 181,035 sq km (Land: 176,515 sq km, Water: 4,520 sq km).
  • Borders: Total 2,530 km (Thailand: 817 km, Vietnam: 1,158 km, Laos: 555 km).
  • Population Centers: Densely settled in Phnom Penh (2.21M, 2022), with distribution linked to the Tonle Sap and Mekong Rivers.

Ethnicity, Language & Religion

  • Ethnic Groups: Khmer (95.4%), Cham (2.4%), Chinese (1.5%), Others (0.7%).
  • Languages: Khmer (official) 95.8%, Minority languages 2.9%, Chinese 0.6%, Vietnamese 0.5%, Others 0.2%.
  • Religions: Buddhism (97.1%), Islam (2%), Christianity (0.3%), Others (0.5%).

Laos

Laos remains a predominantly rural country with a young and rapidly evolving population—nearly 55% of its people are under the age of 25. However, progress in health and socioeconomic development has been uneven, with disparities persisting across geographic regions, ethnic groups, and income levels.

Over the past few decades, Laos has made notable strides in poverty reduction, cutting its poverty rate nearly in half from 46% in 1992/93 to 22% in 2012/13. Despite these achievements, rural-urban inequalities remain pronounced, and income disparity is widening. The most vulnerable populations continue to be those in remote highland areas, particularly ethnic minority communities

Fertility, Health, and Mortality Trends

The total fertility rate (TFR) in Laos has seen a significant decline from approximately 6 births per woman in 1990 to 2.8 in 2016, yet it remains one of the highest in Southeast Asia. Fertility rates are notably higher in rural and remote areas, particularly among ethnic minorities, lower-income households, and the less educated, while urban, wealthier, and more educated populations tend to have fewer children.

Although mortality rates have improved considerably, Laos still faces high maternal mortality rates and persistent childhood malnutrition, which pose ongoing challenges for public health.

The Path Toward a Demographic Dividend

With declining fertility and mortality rates, Laos is entering a phase where its working-age population is expanding while its dependent population shrinks. This demographic shift presents an opportunity for economic growth—a demographic dividend—over the coming decades. However, to fully capitalize on this potential, Laos must enhance access to quality education and ensure productive employment opportunities for its growing workforce.

Although primary school enrollment is nearly universal, dropout rates remain high, particularly in rural areas. Secondary school enrollment has improved but still lags behind, with girls facing greater educational barriers. Addressing these challenges will be crucial in unlocking Laos’ full economic and social potential.

Laos has historically been a country of emigration and internal displacement due to conflict and a weak economy. The Laos civil war (1953 – 1975) mainly caused internal displacement (numbering in the hundreds of thousands).  Following the end of the Vietnam War in 1975, indigenous people in remote, war-struck areas were resettled and more than 300,000 people fled to Thailand to escape the communist regime that took power.  The majority of those who sought refuge in Thailand ultimately were resettled in the US (mainly Hmong who fought with US forces), and lesser numbers went to France, Canada, and Australia.

The Laos Government carried out resettlement programs between the mid-1980s and mid-1990s to relocate ethnic minority groups from the rural northern highlands to development areas in the lowlands ostensibly to alleviate poverty, make basic services more accessible, eliminate slash-and-burn agriculture and opium production, integrate ethnic minorities, and control rebel groups (including Hmong insurgents).

For many, however, resettlement has exacerbated poverty, led to the loss of livelihoods, and increased food insecurity and mortality rates.  As the resettlement programs started to wane in the second half of the 1990s, migration from the northern highlands to urban centers – chiefly the capital Vientiane – to pursue better jobs in the growing manufacturing and service sectors became the main type of relocation.  Migration of villagers from the south seeking work in neighboring Thailand also increased.  Thailand is the main international migration destination for Laotians because of the greater availability of jobs and higher pay than at home; nearly a million Laotian migrants were estimated to live in Thailand as of 2015.

Location: Southeastern Asia, northeast of Thailand, west of Vietnam

Area: total: 236,800 sq km, land: 230,800 sq km, water: 6,000 sq km

Land boundaries: total: 5,274 km; border countries (5): Burma 238 km; Cambodia 555 km; China 475 km; Thailand 1,845 km; Vietnam 2,161 km

Population distribution: Most densely populated area is in and around the capital city of Vientiane; large communities are primarily found along the Mekong River along the southwestern border; overall density is considered one of the lowest in Southeast Asia

Ethnic Groups: Lao 53.2%, Khmou 11%, Hmong 9.2%, Phouthay 3.4%, Tai 3.1%, Makong 2.5%, Katong 2.2%, Lue 2%, Akha 1.8%, other 11.6% (2015 est.)

Languages: Lao (official), French, English, various ethnic languages

Religion: Buddhist 64.7%, Christian 1.7%, none 31.4%, other/not stated 2.1% (2015 est.)