The Lao People's Democratic Republic

	Population in Lao PDR
	Reproductive Health in Lao PDR

The Lao People's Democratic Republic (Lao, PDR), commonly known as Laos, is located in Southeast Asia. It shares borders with China's Yunnan province, Myanmar, Thailand, Cambodia and Vietnam and has no sea coast. Much of Lao PDR is mountainous.

Population in Lao PDR

Lao PDR's relatively small population (5.52 million in 2002) is widely dispersed in a country roughly the size of the United Kingdom or Ghana, with only around 23 people per square km. However, this population is growing rapidly, mainly due to its large and highly fertile adolescent population, coupled with a declining crude death rate. If this pace of growth is sustained, Lao PDR's population will pass 10 million by 2025, increasing the pressure on limited arable land and the natural environment.

Lao PDR's population is disproportionately young, with more than half under the age of 20. This poses major, and unavoidable, challenges for planners and policy-makers in providing accessible education of sufficient quality, as well as attractive and adequately paid employment opportunities as they reach working age. Already many young people, especially in those living close to national borders, are migrating to seek more lucrative job opportunities promised by Lao PDR's wealthier neighbours, particularly Thailand. Many choose not to return to their homeland.

Although Lao PDR has made some progress in reducing poverty, it remains one of the poorest countries in Asia and the least developed country in Southeast Asia. It is ranked among the world's least developed nations in the UNDP Human Development Index. Eighty percent of Lao PDR's public investment programme is funded by foreign aid. Lao PDR is committed to halving absolute poverty by 2015, and leaving behind its least-developed nation status by 2020.

Economic development that has taken place over the last few years has been concentrated in the capital, Vientiane, and a few other areas, widening the gap between urban and rural populations in terms of wealth, opportunities and access to basic services .

A very high dependency ratio makes saving difficult for most working individuals and families. This problem should decrease as today's young adolescents reach working age, presenting the opportunity for greater savings and reducing poverty – as long as there are enough attractive job opportunities for them.

Reproductive Health in Lao PDR

Improving reproductive health in Lao PDR is both an end in itself and a means to reduce poverty by creating a healthier, better-educated population with greater control over family planning.

Since the 1970s, Lao PDR has made significant improvements in the reproductive health of the population, particularly women, with UNFPA support. Many more mothers are surviving childbirth than were even a few years ago, and many more children are surviving their first few months and years. The total fertility rate fell from 5.6 in 1995 to 4.9 in 2000.

However, the reproductive health status of girls and women, particularly members of ethnic minorities and those living in rural areas, is still poor. The country still has among the highest maternal mortality ratios and infant mortality rates in the region. In rural areas, women and adolescent girls have shorter intervals between births, marry younger, bear children younger, and have a higher fertility rate.

Adolescent reproductive health is a particular concern. Over 18 percent of women start their families before the age of 20, and around 15 percent of all births are to adolescents aged 15–19. Anecdotal evidence suggests that increasing numbers of unmarried girls are having unsafe abortions, which can lead to sometimes fatal health complications. The very high level of fertility among adolescent girls also highlights their vulnerability to HIV/AIDS and other sexually transmitted diseases. Bearing children and marrying young also reinforce the disadvantage suffered by women and girls; they are associated with lower literacy and educational attainment, as well as limiting access to other development opportunities.

Advocacy and education efforts on reproductive health and family planning, many of them supported by UNFPA, seem to be working. Some 32 percent of married women report using modern contraceptive methods in 2000. However, the Reproductive Health Survey 2000 found that nearly 40 percent of couples who would otherwise use family planning services could not do so, mainly because of the cost or lack of access. Only 13 percent of births were attended by a health professional in 2000. UNFPA supports the supply of contraceptives and reproductive health services through the public sector in Lao PDR.

Lao PDR is surrounded by countries with more serious HIV/AIDS problems, yet it has so far escaped a major epidemic – less than 0.04 percent of the population is HIV-positive, according to recent sentinel surveillance data. The efforts of various donors supporting the National Commission for the Control of AIDS have resulted in a high level of awareness among the general population. However, the serious and growing epidemics in several of Lao PDR's neighbours, and increasing population mobility both within and across Lao PDR's borders, make the country increasingly vulnerable. Swelling drug use among young people also adds to the risk of HIV/AIDS spreading.

More population and reproductive health statistics from Lao PDR can be found at the UNFPA global website.