MAP 1. SURVEY PROVINCES IN ADMINISTRATIVE MAP OF VIETNAM 1 ACKNOWLEDGEMENT The preparation and publication of this report was made possible with fund from The Ford Foundation. We would like to especially thank Dr. Charles Bailey, Representative for Vietnam and Thailand of the Foundation, whose vision and support allowed us to undertake this comprehensive study of the situation of people with disabilities in Vietnam. We highly appreciate the Department of Labour, Invalids and Social Affairs of Thai Binh, Quang Nam, Da Nang, and the Committee of Population, Family, and Children of Dong Nai, as well as People’s Committee together with all the local collaborators at 49 communes and wards where the survey was conducted for their effective support. Sincere gratitude is also extended to thousands of families and individuals who generously shared their information with the research team. Without their cooperation, this study could never been realized. Last but not least, we thank photographer Pham Hoai Thanh for his beautiful pictures that capture various aspects of life of people with disabilities whom we visited during our study. The Institute for Social Development Studies 2 TABLE OF CONTENTS PART 1. INTRODUCTION ......................................................................................... 5 1 BACKGROUND .......................................................................................................... 5 1.1 Rationale ............................................................................................................... 5 1.2 International definitions and models of disability ............................................ 6 1.3 An overview of the disability situation in Vietnam........................................... 7 1.3.1 Disability definition ....................................................................................... 7 1.3.2 Situations of disability ................................................................................... 8 1.3.3 Disadvantages of people with disability ........................................................ 9 1.3.4 Disability-related stigma and discrimination ............................................... 10 1.3.5 Traditional beliefs and cultural values towards PWD ................................. 11 1.3.6 New perspectives on disability .................................................................... 11 2 RESEARCH OBJECTIVE, APPROACH, AND QUESTIONS ........................... 12 2.1 Research objective ............................................................................................. 12 2.2 Research approach............................................................................................. 12 2.3 Research questions............................................................................................. 12 3 RESEARCH METHODOLOGY AND SAMPLE DESIGN ................................. 13 3.1 General concepts ................................................................................................ 13 3.2 Household survey ............................................................................................... 14 3.2.1 Questionnaires.............................................................................................. 14 3.2.2 Sampling design........................................................................................... 15 3.2.3 Fieldwork and Interviewing results ............................................................. 17 3.2.4 In-depth interviews and focus group discussions ........................................ 18 PART 2. RESEARCH FINDINGS ............................................................................ 19 4 PROFILE OF THE STUDIED PROVINCES ........................................................ 19 4.1 Thai Binh ............................................................................................................ 19 4.2 Quang Nam – Da Nang...................................................................................... 20 4.3 Dong Nai ............................................................................................................. 22 5 SOCIO-ECONOMIC CHARACTERISTICS OF HOUSEHOLDS HAVING PEOPLE WITH DISABILITY......................................................................................... 24 5.1 Demography of Disadvantage ........................................................................... 24 5.2 Poor Assets.......................................................................................................... 26 5.3 Poor accessibility ................................................................................................ 29 5.4 Low Income and Expenditure........................................................................... 30 5.5 Disability as Constraints of Livelihood Improvement.................................... 31 6 SOCIAL AND ECONOMIC CHARACTERISTICS OF PEOPLE WITH DISABILITY ...................................................................................................................... 34 6.1 Demographic characteristics............................................................................. 34 6.1.1 Age ............................................................................................................... 34 6.1.2 Gender.......................................................................................................... 35 6.1.3 Marital status................................................................................................ 35 6.2 Educational attainment ..................................................................................... 36 6.3 Employment........................................................................................................ 38 6.4 Disability situation ............................................................................................. 40 7 DIFFICULTIES FOR PEOPLE WITH DISABILITY.......................................... 45 7.1 Difficulties in the performance of daily activities ........................................... 45 3 7.2 Difficulties in education ..................................................................................... 49 7.3 Difficulties in accessing healthcare service ...................................................... 55 7.4 Difficulties in employment ................................................................................ 58 7.5 Difficulties in marriage and having children................................................... 63 7.6 Difficulties in social participation and access to information ........................ 68 7.7 Difficulty in participation in cultural and sporting activities ........................ 71 7.8 Multivariate analysis ......................................................................................... 74 8 DISABILITY-RELATED STIGMA AND DISCRIMINATION .......................... 81 8.1 General perceptions, attitudes and practices towards PWD ......................... 81 8.2 Disability and education .................................................................................... 89 8.3 Disability and employment................................................................................ 90 8.4 Disability and marriage and childbearing ....................................................... 93 8.5 Disability and social participation ................................................................... 95 8.6 Perception of the PWD of their rights.............................................................. 96 8.7 Multivariable analysis ..................................................................................... 101 9 SUPPORTS TOWARD PWD ................................................................................. 106 9.1 Legal provisions ............................................................................................... 106 9.2 Institutional structure of support ................................................................... 109 9.3 Policy implementation ..................................................................................... 111 9.4 Support for PWD at the surveyed communities ........................................... 112 PART 3. CONCLUDING REMARKS ..................................................................... 116 REFERENCE ......................................................................................................... 119 4 PART 1. INTRODUCTION 1 BACKGROUND 1.1 Rationale People with disabilities (PWD) are an important social issue in Vietnam. According to government statistics, as of 2003, there were more than 5 million people with disabilities (PWD) in Vietnam, accounting for 6.3 percent of the total population. Nearly 8 percent of Vietnamese households had members who were PWD and most of these households were poor. Up to 80 percent of PWD are dependent on support from their family or social assistance provided by the state and/or community. Government policies, concretized most specifically in the 1998 Ordinance on Disabled Persons, often emphasize the importance of care and support for PWD. Budget shortages and poor management, however, limit both the scope and depth of those supports. Efforts to mobilize community resources to help PWD also face many difficulties, such as a low degree of awareness regarding the rights and needs of PWD, or the presence of stigma and discrimination towards PWD’s from certain segments of the population. In 2006, assisted with a grant from the Ford Foundation, the Institute for Social