Under local laws, unmarried mothers are forbidden from registering the birth of their baby which means the child is not entitled to legal protections in the hermit country. Earlier this month, the policy was laid bare when mothers in a South Pyongyang province flocked to hospitals with their infants for shots while the children of unwed mothers were turned away.
A source in the area told Radio Free Asia that to get a vaccine as part of the annual “UN shots” programme a child would need a birth certificate – something which those born outside of marriage are not entitled to.
The source explained: “Last week, local hospitals in our province provided nutritional supplements to infants younger than one-year-old and toddlers five and younger.
“They also gave shots to prevent polio and tuberculosis.
“Babies born out of wedlock were not included on vaccination lists after last year because their births have not been registered.
“Only children whose birth certificates are confirmed by the health authorities are included on the vaccination list.”
A second source was quoted by the radio as saying the number of unwed mothers in North Korea is on the rise.
Despite remaining largely cut-off from the outside world, the attitude of many North Koreans towards marriage is changing.
More and more people are engaging in premarital sex which is leading to a rise in the number of children being born to unmarried mothers.
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When the opening of the immunisation programme is announced each year, families scramble to their local hospital to avail of the free shots and food aid.
North Korea relies heavily on aid programmes from UNICEF and other UN agencies.
Poverty is rife in the nation of 25.5 million.
The offer of free food and vaccines is highly prized by parents, many of whom are struggling to feed their children.
In 2017 a defector from North Korea revealed harrowing details of the lengths people go to just to find food.
Lee Wi-ryeok told of how as a child he was fed corn extracted from cow dung.
He old Daily NK: “If a cow excreted kernels of corn in the form of diarrhoea, we would rinse them out and eat those.”
During the North Korea famine of 1994 – 1998 he lived at an orphanage in the secretive state.
Despite the famine ending, hunger remains a way of life for millions of North Koreans.