Does family planning work in a Chinese way

The demographic and economic characteristics of China make it necessary to do family planning work in China in a Chinese way. Special characteristics of China and corresponding strategies are detailed 1) China is rather underproductive and underdeveloped, with a huge population, whose growth must be curtailed while industrial and agricultural production is enhanced. 2) In the next 10 years, a large number of young people will center childbearing age, prompting a government policy favoring late marriage and one child per couple. 3) China is large and heterogeneous, and regional authorities should have some population policymaking functions to take sociocultural differences into account. 4) Male child preference ideology in rural areas has been gently combated with a resulting increase in family planning rate from 65.1% to 74.2% from 1979 to 1983. Family planning authorities have made considerable progress, as demonstrated by figures such as a drop of women's total fertility rate from 5.68 in the 60s to 2.07 in the 70s. The task at hand remains large: the population at the end of 1983 was 1,024,950,000. However, family planning is an element of state policy, the marriage law, and the constitution, and mored an more, societal ideology. Government policy equates family planning with child wellness and societal welfare and attempts supportiveness of couples showing positive birth limiting attitudes. An ample system of family planning programs and resource persons furnishes education, a variety of high quality methods are available, and contraceptive research is some of the best in the world.     

A brief introduction to China's family planning programme

China's family planning program is described in reference to its goals, approaches, and achievements. Between 1949-83, China's population increased from 541 million to 1,024,950,000. The population has a young age structure, and the median age is 22.9 years. 80% of the population is rural, and 90% of the population lives in the southeastern region of the country. In view of this demographic situation, the government recognizes the need to control population growth. China's goals for the year 2000 are to increase industrial and agricultural input by 400% and to keep population size below 1.2 billion in order to ensure that per capita income increases. In accordance with these goals, the government, in 1979, began advocating a 1-child policy. To ensure the survival of single children, the government also launched a program to upgrade maternal and child health (MCH). In some rural areas and among certain minority groups, the 1-child restriction is not applied. Family size goals will vary with time. These variations will reflect the need to maintain a balance between economic growth and population growth. A variety of incentives are used to promote the 1-child family. For example, single children receive medical and educational benefits, and in some rural areas, the parents of single children can obtain additional land contracts. Economic disincentives are also used. The government seeks to obtain compliance with the policy primarily through educating the public about the consequences of uncontrolled population growth. All channels of the mass media are used to deliver the messages, and the publicity campaign is especially intensive in rural areas. A comprehensive plan to provided family planning and population education for middle school students is currently being implemented. Each local area develops its own fertility control plan. This plan is then incorporated into the nation's overall plan and the overall plan is implemented from above. Family planning workers bring free contraceptives directly to the people, and family planning motivators are found in almost all villages, neighborhood committees, factories, and military units. As a result of these efforts, China made great strides in controlling population growth and improving MCH during the last decade. The birth rate declined from 27.93 to 18.62, and the total fertility rate declined from 4.01 to 2.48. 124 million couples were practicing contraception by the end of 1983. 41% used IUDs, 37.4% relied on tubal ligation, 12.9% relied on vasectomy, 5.1% on oral contraceptives, and 1% on other methods. The quality of maternal and child care also improved. 92.7% of all deliveries are now performed by trained midwifes. Infant and maternal mortality rates declined considerablely in recent years. Currently the respective rates are 35.68/1000 live births and 0.5/1000 live births. In 1983 alone, the gross national agricultural and industrial output increased by 46.1%. Since 1979 per capita income increased annually by 18.3% among rural residents and by 10.7% among urban workers. China controls and operates its own population program, but in recent years, it increased its cooperation with UN Fund for Population Activities, other UN agencies, and nongovernment agencies. China recently completed its 3rd national census, and demographic research institutes have been established in 10 universities.     

On China's family planning policy

The birthrate in China in 1985, according to Li Honggui, Deputy Director of the General Office, the State Family Planning Commission, was 17.8/1000 with a death rate of 6.57/1000 and a natural growth rate of 11.23/1000. The number of births in 1985 was 18,520,000; 59.1% of these births were 1st births, 24% 2nd births, and 16.9% 3rd or more births. Women of childbearing age who pledged to have only 1 child accounted for 15.6% but only for 10% in rural areas. The peak fertility age of Chinese women was 24. Due to the age structure, a birth boom will begin in 1986 and will last for a decade. It is projected that the natural population growth rate will rise to 12.4/1000 in the 1986-96 period. The Chinese government has advocated a "1 child for 1 couple" policy since 1979. Couples who have difficulties can have a 2nd child with approval. Minority nationalities are permitted to have 3 children. The strategy of China's family planning program is to combine the guidance of the government with the motivation of the population. Consequently, communication and education have been emphasized. The situation is reported to be improving. At this time, women are advised to terminate unplanned pregnancies as early as possible. Individuals who refuse to consider the advice will be taxed.     

Irrational international economic order is an obstacle

China is a socialist and developing country. As the most populous country in the world, China has a population now of over 1 billion, making up more than 1/5 of the total world population. However, China has a rather poor economic and educational foundation to start with. This is particularly true in the rural areas, where 80% of the total population lives. The problem of population increase and decrease in arable land has grown more acute. Hence, the Chinese Government has been promoting family planning since the 1970s. The Constitution of the People's Republic of China explicitly stipulates that "the state promotes family planning so that population growth may fit the plan for economic and social development." Thanks to the implementation of the basic state policy of family planning, the blind population growth is turning into a planned one. It is estimated by the fertility rate of the 1970s that 200 million births have been averted during the last 16 years. Thus, China has made contributions to the stability of the world's population. Were China to allow its population to grow blindly instead of having practiced family planning over the past 10 years, the world population would be substantially over 5 billion by the middle of this year.     

The family planning law should be issued as soon as possible]

China is facing a baby boom in the next ten years. Now is a perfect time to formulate legislature on family planning (FP) to strengthen the current policy and regulations in order to slow the momentum of excessive population growth. As a result of current economic reform and implementation of the rural household responsibility system, the migrant population has increased tremendously. The fact that millions of rural farmers are shifting to non-agricultural areas created new challenges to the effectiveness of traditional measures of the FP program. Promulgating laws and legislature will facilitate the job of FP. The law should stress the restriction of population growth and encouraging one child per couple. In the rural area it is not feasible to implement the one child policy indiscriminately. Under the policy of one child for a majority of the couples, no third birth is permitted. Local governments should be given the authorization to grant permission for second births for special cases within the birth planning quota. Allowing people living in poor and less developed areas to have more children and granting mothers of handicapped children permission to have an additional child were in fact facilitating the deterioration of the quality of the population. Some current policy in rural income distribution and social welfare was beneficial to large-sized family. Such policies should be changed to give incentives to small-sized families.     

Preliminary achievements of China's national economy development and family planning]

A preliminary view of the population control policies of the People's Republic of China is the subject of this report. The report maintains that population control policies are closely linked to economic growth and indicates that criticism by the West of these policies is unfounded. According to an investigation of 1000 married women of child-bearing age carried out in 1981, 19.1% of them have 1 child, 21.4% of them have 2, 49.5% have 3 and only 9.9% of them have no children. This would seem to refute the West's idea of the "1 child only" policy as strict and clear-cut. The report maintains that economic growth and family planning are functions of one another. Although China has made marked progress in population control, its population problem is still far from being resolved as population growth is still relatively high compared to productivity. The marriageable population is extremely high and increase in population create a burden on education, employment, transportation, welfare, housing and medicine each year. The trend in rural areas (which make up 80% of China's population) to have larger families to produce more labor must be reversed in order to make population control objectives feasible. Thus, the need for China to continue its efforts to promote rural economy and family planning must continue. The needs for improvement in promotion and family planning education as well as for improved medical conditions are also evident.     

On the situation and tasks of current birth planning work]

This is the text of the closing speech delivered by the author at the 2nd Chinese National Symposium on Population Theories held on December 13, 1979. The meeting had been successful for several reasons, including the concern, support, and leadership of the State Council, provincial, and revolutionary committees. Under the leadership of the State Council, targets of natural population growth rates were established for 1980 and 1981. Financial rewards for couples producing only 1 child had been planned. Contraception, adequate child care, and eugenics were stressed. Attendants were urged to learn from Sichuan's successful experience. During 1979, a policy was established that advocates 1 child/couple and penalizes couples producing 3 children. Agreements were signed with the UN whereby China would receive US $50 million during 1980-1983 for equipment upgrading, education, and other related purposes. The goal for a 1% growth rate could not be achieved in 1979; the actual rate was probably about 1.2%. The major reasons for this failure could be attributed to traditional feudal concepts still prevalent among many Chinese as well as to organizational problems among birth planning units and technical problems in birth control. With goals of population growth set for 1980, and 1985 and zero growth at 2000, China would encounter tremendous difficulties in its efforts to achieve them. However, under the determination and leadership of the central government coupled with valuable experience over the past 30 years, these goals would be attainable.     

Publicity and education are fundamental to China's family planning programme

This article summarizes and discusses the documents concerning family planning promulgated by the Communist Party, National People's Congress and the Government of China since the start of China's family planning program. In 1955 a document was issued entitled the Directive Concerning Population Control pointing out that the public should be made aware of birth control. In 1965 the summary of the 2nd Conference on Urban Work discussed ways of explaining the significance of family planning, to make it a voluntary action of the people. In 1980 the necessity of 1 child per couple was pointed out and policies were formulated regarding ideological and political education. During the 80's several documents were issued which stressed the voluntariness and initiative of the people in practicing birth control, and that any type of coercion was prohibited. For 30 years the fundamental practice of strengthening publicity and education and opposing coercion has remained unchanged no matter how birth policies have been scored in population control since 1979.     

The present task of family planning as suggested by the findings of the National Sample Survey of Fertility]

Results from the 1982 census show great progress has been made in the field of family planning because of close cooperation between the people and the government. Under the influence of the high birth rate in the 1950s and 1960s, a large number of youths are reaching the age for marriage each year, and they are bringing heavy pressure on the population growth. As a result of this situation, family planning work is still urgently needed. A great difference exists between cities and rural areas in family planning work. Economic conditions, cultural and educational levels, occupational characteristics, living environments, and concepts of population growth have contributed to this difference. Henceforth, special emphasis should be placed on family planning work in rural areas, so that the large scale population groth in the countryside may be brought under control. In areas of scientific management, propaganda and education, and technical measures for family planning, modern and and progressive methods should be used in order to reach the national goal of controlling population growth.     

Demography in China: from zero to now

After 20 years of neglect the study of population and demography in China have come to be considered imperative. China has even accepted $50 million from the UN Fund for Population Activities to defray the cost of the 1982 census and help pay for action, training, and research programs. Institutions directed toward population studies have been established in many provinces during the 1970s. The principal types are population training and research institutes and offices within institutions of higher learning. In addition institutes outside the system of higher education and special units of population studies in various medical colleges were initiated. Between 1957-77 the large increase in population began to cause economic problems which were not admitted until the late 1970s. Since 1979 the country's efforts to lower the level of fertility have been organized in major policy statements calling for 1 child/couple and a rate of natural increase causing zero population growth by the year 2000. The Institute of Population Research was created in 1974 and it has provided population projections that have helped form population policy with a major focus on historical stages of growth in China as well as counteracting the lopsided population optimism which existed earlier. In 1978 a conference was held on the science of population theory which identified areas for study such as: 1) population and economics, 2) capitalist population theories, 3) population policies, 4) family planning and economics, and 5) population problems in foreign countries. The author describes some of the literature which was published after the 1978 conference and the reappearance of academic journals in 1979 as well as the 1979 conference. 1980 and 1981 studies dealt with such topics as debates on Malthusian theory, zero population growth, urban and rural populations, historical demography, housing, employment, health improvement of the population, minorities, and fertility determinants. Chinese scholars have also begun to cooperate with their foreign colleagues in a variety of studies. In order to illustrate the wide variety of directions which Chinese population studies are taking the author provides a bibliography of population studies from 1977-81.     

Some problems about the policy of controlling population growth in China]

This discussion of some problems regarding the policy of controlling population growth in China focuses on the formation and the development of the policies of planned population growth control, how demands of modernization require a policy of only 1 child for each couple, and the need for ideological education as well as essential economical and administrative measures. The process of forming and developing the population control policies of China can be divided into 3 phases: the mid-50s to the early 1970s; the early 1970s to March 5, 1978 -- the date the new constitution became effective; and March 5, 1978 to the present. The 1st formal policy on planned popultion control emerged in 1956 at the 8th national meeting of the Communist party. The necessity for propagating planned birth control and advocating planned birth was recognized at this time. During the 2nd phase, the planned birth program was almost stopped by interference from an anti-revolutionary group. The maladjustment between population development and economic development were getting worse during the 1966-1971 period. Health services in both rural and urban areas were developed, and maternal and child health care services were reinforced in order to lower the death rate and to increase the practice of birth planning. The objective was to adjust the birth rate by improving production development and the living coinditions of the people. The new constitution indicated that the country should advocate and practice planned birth. The special committee on planned birth of the State Council, meeting in June 1978, established guidelines for the national planned birth program. The population policy of only 1 child for each couple was proposed for the longterm benefit of China and its people and because of the urgent demand of the 4 modernizations. The indication of the achievement of the 4 modernizations by the end of the 20th century is a per capita income of 1000 United States dollars. To reach the $1000 figure, the per capita income needs to be increased 3-fold. This is a difficult task, and to realize it effort must be placed on both material production and population control. Problems that may result from the advocation of only 1 child for each couple are reviewed. The way to promote the exeuction of the policy of planned control of population growth is to apply ideological education as the major method and to integrate it with economical and administrative measures.     

Advocating "one couple with one child" being an optimal choice]

Zero population growth within the next 5 years in China would be reached only if many couples were not allowed to have their own child. On the other hand, if every couple were allowed to have 2 children China's population would reach 1500 million within the next 50 years. It seems advisable to advocate the "1 couple 1 child" idea; couples will have to keep in mind both the national interest and the communist ideology; social welfare to assure good living conditions for the old people will relieve the worries of parents with 1 child only. Most people are willing to follow this decision made by the Communist Party; many people declare their willingness to stick by this rule during their wedding ceremony; many couples send back their permit to have a second child, and many women choose abortion when pregnant with a second permitted pregnancy. By the end of 1979 the proportion of "1 couple 1 child" couples was 90% in many large cities; people realize that the practice of "1 couple 1 child" is the best assurance for the future of the country and of their children. This policy will not result in aging of the population, lack of manpower and shortage of soldiers; even if birth rate were 1% in 1985 the proportion of older people for the next 25 years will still be lower than that in European countries. The problem of aging of the population will not occur in this century, and population policies can always be adjusted when needed. Today's problem is to control population through the "1 couple 1 child" policy, even if it may result in many lonely old people, which is a lesser problem than too many people. Even if China has reduced its population growth by 10 million births each year from 1970 to 1979, the necessity to control population growth is still present, in the interest of the country and economic development.     

How to carry out work on family planning after adopting production responsibility systems in rural areas]

After the Third Meeting of the Eleventh People's Congress, the entire responsibility for agricultural production was transferred to a lower level. Peasants in various areas have adopted the so called production responsibility system, and the phenomenon of an increased population rate has also appeared in some areas. In this article, the author discusses how to solve these problems created by the new situation. The 1st step is try to control population growth through socialist propaganda education, administrative measures, economic incentives and punishments, and family planning work. The 2nd step is to popularize the practice of having only 1 child per household in the rural areas. The 2nd and 3rd child in each family should be controlled and prohibited. This policy formulated by the Central Government should be carried out thoroughly. Families which follow the policy and have only 1 child should be encouraged with economic rewards, and those families which have 2 or more children should be punished economically. The 3rd step is to establish a national work team to be in charge of family planning and birth control. There should be an ideological unity among the nation's leadership. Party members and cadres should establish themselves as good examples for the people so that the population control work may become successful.     

A better future is ahead of us

China's family planning program is implemented under the unified leadership of the Chinese government. The main responsibilities under this program are to set up and strengthen family planning offices at all levels, formulate relevent laws and regulations, work out programs, principles, and policies for population growth, carry out intensive publicity and education, speed up scientific and technological research on family planning, and mobilize all the people and related departments to support the work of family planning. Family planning in China is practised on a voluntary basis. Education on patriotism is conducted among the people to enable them to see that strict control of population growth and conscious practice of family planning according to policy have a crucial bearing on China's prosperity and well being. As shown in practice, China has not only succeeded in maintaining sustained and steady economic growth, but has also succeeded in drastically reducing the population birth rate, death rate, infant mortality rate, and in extending average life expectancy. This demonstrates the superiority of China's socialist system. To control the growth of the population is an extremely arduous task. However, as long as China keeps to a practical and effective policy, the goal of keeping the total population at around 1.2 billion by the end of the century can be attained.     

Five recommendations for controlling population growth in China]

The rapid population growth rate (2% annually from 1949 to 1978) caused great difficulties for China's national economy because it increased the burden of families, communities, and government. It caused employment problems and slowed increases in living standards and educational levels. The best way to control population growth is based on a combination of political education and effective economic measures. The recommendations are: 1) coordinate employment, food rationing, salaries, bonuses, health treatment, age and condition of retirement, preschool care and education with family planning programs, maintain the elderly's living standard, and give preference to childless and single child families; 2) educate people about family planning and incorporate population growth and family planning into political and economics courses in high school and college; 3) incorporate population control into national economic plans; 4) prohibit families with 3 children and advocate 1 child per couple; and 5) establish a permanent population committee to plan, develop, and implement population policies and related research.     

Thinking about several problems of the research of our family planning strategy]

On the basis of 1982 census data, it is estimated that from 1987-1997 13 million women will enter the age of marriage and child-bearing each year. The tasks of keeping the population size around 1.2 billion by the year 2000 is arduous. Great efforts have to be made to continue encouraging one child/couple, and to pursue the current plans and policies and maintain strict control over fertility. Keeping population growth in pace with economic growth, environment, ecological balance, availability of per capita resources, education programs, employment capability, health services, maternal and child care, social welfare and social security should be a component of the long term development strategy of the country. Family planning is a comprehensive program which involves long cycles and complicated factors, viewpoints of expediency in guiding policy and program formulation for short term benefits are inappropriate. The emphasis of family planning program strategy should be placed on the rural areas where the majority of population reside. Specifically, the major aspects of strategic thrusts should be the linkage between policy implementation and reception, between family planning publicity and changes of ideation on fertility; the integrated urban and rural program management relating to migration and differentiation of policy towards minority population and areas in different economic development stages. In order to achieve the above strategies, several measures are proposed. (1) strengthening family planning program and organization structure; (2) providing information on population and contraception; (3) establishing family planning program network for infiltration effects; (4) using government financing, taxation, loan, social welfare and penalty to regulate fertility motivations; (5) improving the system of target allocation and data reporting to facilitate program implementation; (6) strengthening population projection and policy research; (7) and strengthening training of family planning personnel to improve program efficiency.     

Sum up experience to make continuous progress

Population control in China has been very successful in combatting the extremely rapid growth in population (birth rate: 1960's 33.65/1000; 1970's 24.57/1000; 1980's 18.3/1000). The female mean age for 1st marriage has increased from 19 in the 1950's to 22.63 in the 1980's. Infant mortality has declined substantially from the 1950's to the present (200 deaths/1000 vs. 81.3/1000 (cities)). Most people have embraced family planning and population control and have emphasized quality of childrearing vs. quantity. The goals of China's policy are as follows: economic development of the nation and well-being of individuals; coordination of population growth and socioeconomic development; implementation not only in accordance with state condition, but also according to the wishes of the people; continued success of the population and family planning organization network; integration of state guidance with individual voluntariness; and strengthening the unified leadership of the state. China's 3rd baby boom began in 1986 and will last through 1995. Unplanned children will count as 30% of the annual births. Government action is attempting to strengthen family planning education and research. These measures will help control the expected population boom.     

Grasp the work of family planning by unifying thinking and stabilizing the policy

The China Population Information and Research Center reported that in 1988 the number of childbearing women between 20 and 49 was 4.65 million above 1987, but the population growth rate was 0.19 lower than in 1987. Controlling the population is still a difficult problem. The 3rd baby boom of New China; economic, cultural, social, and other factors; and the uneven progress of family planning are cited as causes of the lack of control. The 13th Party's Congress in 1989 plans to work to reform family planning and control population growth. In particular, late marriages and childbearing will be promoted; in cities, one-child-per- couple will be policy; in rural areas, only girl households will be allowed another child only after several years; local family planning regulations will be supported; and research on family planning and safer, longer acting contraceptives will be financed.     

Sub-Saharan Africa: population pressures on development

The population of sub-Saharan Africa, estimated at 434 million in 1984, is expected to reach 1.4 billion by 2025. The birth rate, currently 48/1000 population, continues to increase, and the death rate, 17/1000, is declining. Rapid population growth has curtailed government efforts to provide adequate nutrition, preserve the land base essential for future development, meet the demand for jobs, education, and health services, and address overcrowding in urban areas. Low education, rural residence, and low incomes are key contributors to the area's high fertility. Other factors include women's restricted roles, early age at marriage, a need for children as a source of security and support in old age, and limited knowledge of and access to modern methods of contraception. Average desired family size, which is higher than actual family size in most countries, is 6-9 children. Although government leaders have expressed ambivalence toward development of population policies and family planning programs as a result of the identification of such programs with Western aid donors, the policy climat is gradually changing. By mid-1984, at least 13 of the 42 countries in the region had indicated that they consider current fertility rates too high and support government and/or private family planning programs to reduce fertility. In addition, 26 countries in the region provide some government family planning services, usually integrated with maternal and child health programs. However, 10 countries in the region do not support family planning services for any reason. Unfortunately, sub-Saharan Africa has not yet produced a family planning program with a measurable effect on fertility that could serve as a model for other countries in the region. Social and economic change is central to any hope of fertility reduction in sub-Saharan Africa. Lower infant and child mortality rates, rising incomes, higher education, greater economic and social opportunities for women, and increased security would provide a climate more conducive to fertility decline. Given the limited demand, great sensitivity must be shown in implementing family planning programs.     

China's first family planning publicity month

China conducted its 1st nationwide Family Planning Publicity Month in 1983, from New Year's Day to Spring Festival (February 13). The campaign emphasized the rural areas and focused on explaining why family planning is a state policy. The most noticeable achievements of this campaign were that every household became familiar with the fact that family planning is a basic state policy. The majority of the population take this policy seriously, realizing that strict control of population growth is both a good and imperative policy. More than 1,830,000 propaganda columns and photo exhibitions were displayed, 5,900,000 radio and television programs broadcast, 2,010,000 theatrical performances, movie and slide showings presented, and 97,000,000 copies of materials published for public dissemination. The activities were varied and interesting, vivid and lively, and purposeful and persuasive. 1 of the most effective methods of publicizing population control has been the presentation of comparative statistics. This aspect of the campaign was a specific and lively form of education in population theory and practice. The presentation of statistics that show the relationship among population, land use, grain produce, and income enabled the population to reason out why population growth needs to match economic and social development. Another important accomplishment of the publicity month was that a large number of couples of reproductive age became convinced of the need to use contraception. According to the incomplete statistics, 8,860,000 people had surgical operations for birth control. The universal promotion of ligations by either partner of a reproductive couple who already had given birth to a 2nd child was an important development of family planning technique promoted simultaneously with the promotion of IUDs. The increase in the number of people doing family planning work was another achievement of the publicity month. More than 15,240,000 publicity personnel and 760,000 medical personnel were trained. The enthusiasm of the Party and the people contributed to the success of the publicity month. The success of the publicity month is inseparable from the achievements and experience gained through China's longterm pursuit of family planning.