The thesis attempts to isolate ways in which the political and economic changes
wrought by the northern Vietnamese state between 1945 and 1995 have influenced trends
in northern Vietnamese mortality and fertility over the same period. The thesis also
attempts to show how the demographic trends, and political and economic changes, have
influenced the demography of northern Vietnamese families-in particular the
demography of succession and of co-residence.
Between 1945 and the early 1980s the northern Vietnamese state pursued a
communist development strategy while fighting major wars. The economic institutions
introduced by the government were subverted on a large scale and were highly inefficient.
Neverthelss, from about the 1950s, mass campaigns and a system of locally-funded
rural health centres brought about a rapid decline in mortality. Fertility began to decline
slowly in the 1960s. Reasons for the decline included reduced infant mortality, wartime
disruption, rising education costs, and, in the cities, the introduction of old-age support
schemes. War deaths only partly undid the effects of the mortality decline and sustained
high fertility, so that the population continued to grow rapidly, and the mean number of
_ surviving children per woman reached historically unprecedented levels.
During the 1980s, the Vietnamese state began to abandon its communist
development strategy, in response to successive economic crises and to spontaneous
grass roots innovations. Economic reform disrupted the health system, which had
already been weakened through lack of investment; mortality nevertheless declined
slightly through the 1980s. The fertility decline continued, hastened by economic
expansion and the government's birth control program.