The HIV/AIDS epidemic which broke out in Thailand 1988 was mainly caused by the widespread patronage of prostitutes. The Thai authorities responded with programmes which encouraged the use of condoms in commercial sex. These programmes were highly successful. However, prostitution has changed since the beginning of the epidemic, partly for economic and demographic reasons, but mainly because of the fear of AIDS. Fewer women practise prostitution, men patronize it less, and the price of commercial sex has risen. Prostitution is less likely to be practised in brothels and more likely to be practised in establishments like restaurants and bars. Moreover, as fewer native Thai women are willing to practise prostitution, foreign women are taking their place. In order to continue to control the epidemic, the authorities will have to adapt their programmes to the changing structure of commercial sex.
This report presents the first population-based estimates of maternal mortality in Vietnam. All the deaths of women aged 15-49 in 1994-95 in three provinces of Vietnam were identified and classified by cause. Maternal mortality was the fifth most frequent cause of death. The maternal mortality ratio was 155 deaths per 100,000 live births. This ratio compares with the World Health Organization's estimates of 430 such deaths globally and 390 for Asia. The maternal mortality ratio in the delta regions of these provinces was half that of the mountainous and semimountainous regions. Because a larger proportion of the Vietnamese population live in delta regions than elsewhere, the maternal mortality ratio for Vietnam as a whole may be lower than that of the three provinces studied. Maternal mortality is low in Vietnam primarily because a relatively high proportion of deliveries take place in clinics and hospitals, where few women die in childbirth. Also, few women die of the consequences of induced abortion in Vietnam because the procedure is legal and easily available.
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