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Country Report to
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24 March 1998 Source: State Family Planning Commission Subject: population and development, ICPD
Text: I. China's Population: Current Situation and Future Trend China is a vast country with a huge population and an inadequate base for development. Its population is characterized by a large size, excessive amount of growth and an unbalanced regional development. Among its population, the impoverished, illiterate and semi-literate take a high percentage. All in all, population has become a crucial factor restraining China's social and economic development. With a view to improving people's living standard, in the process of developing the national economy, the Chinese government started to advocate the practice of family planning in the 1970s. In the 1980s, family planning has become one of the fundamental national policies. Accordingly, population program was integrated into China's overall national program for economic and social development. The success of China's population program in the control of its population especially after the International Conference on Population and Development is shown from the following figures. The population birth rate has been reduced to 16.57 ‰ in 1997, comparing with 17.70 ‰ in 1994. The population death rate has remained around 6 – 7 ‰ since 1980s. The natural growth rate has been reduced from 11.21 ‰ in 1994 to 10.06 ‰ in 1997 and below 10 ‰ in 20 out of China's 30 provinces. Total fertility rate dropped from 5.81 in 1970 to below 2 in 1997. However, China's large population base and excessive growth is still challenging its-limited resources, socio-economic development, people's living standard and the environment. Its total population by the end of 1997 has reached 1,236.26 million (not including Taiwan, Hong Kong and Marco ), which is estimated to reach 1.4 billion in 2020 and stabilize around 1.6 billion, with the current annual net increase of 13 million. Besides, the fast population aging and the large number of aging population will become a severe challenge to the current social security system. It is estimated that by the year 2025, 18.40 percent of the population (around 280 million) will age 60 and above. Other challenges include the migrant population, the redundant workers, early marriage and pre-marital pregnancy and in certain areas the unbalanced sex ratio at birth. But the biggest challenge is how to meet people's increased need for reproductive health with the deepening of the economic reform.
II. China's Population and Development: Policy and Strategy Family planning and environmental protection are the two of China's fundamental national policies for sustainable development. In his famous statement entitled "Some Crucial Relationships to be Properly Dealt with in the Course of China's Socialist Modernization Drive" delivered in September 1995, President Jiang Zemin pointed out that sustainable development must be taken as an important strategy in the modernization drive and high priority is to be given to the control of population, saving of resources and protection of the environment so as to achieve a coordinated development between population growth on the one hand and the productivity, resources and environment on the other. The goal set by the Government for the development into the next century includes: to quadruple the 1980 per capita GNP and guarantee its people a moderately good life by the year 2000 when the population will be 300 million more than the 1980 figure; to double the year 2000 level of per capita GNP and guarantee a much better life for the Chinese people by the year 2010 and to catch up with the moderately developed countries by the middle of next century. The population target of the government is to maintain a population figure of 1.3 billion for the year 2000 and 1.4 billion for the year 2010 through a gradual decline of the natural growth rate. The family planning program of China includes: to advocate late marriage and child bearing and later, fewer but healthier births; while couples are encouraged to have one child, those rural couples who want to have the second one will have to do so with proper spacing, the minority nationalities are also to practice family planning, with specific practice subject to the local autonomous government. Generally speaking, in terms of the number of children a couple can have, the program is more favorable to the countryside than to the city and more to the national minorities than to the Han nationality - the majority nationality. For some national minorities, no limit is set to the number of children a couple can have. Besides, every province can formulate their own provincial regulations in light of the national policy and on the basis of the local situation. In 1995, the government made it clear that fundamental changes will be made to the approach and practice of the family planning program. The changes refer to: the change from the approach of "family planning for the sake of family planning" to an integrated approach of family planning with socio-economic development and addressing the population issue in a holistic manner; the change from relying mostly on social constraint to the gradual establishment of a mechanism which includes the integration of social constraint with interest orientation, IEC, the provision of service and scientific administration. To elaborate on this, the family planning program will aim to meet the ever-increasing needs of the people in reproductive health and family planning; it will be integrated with poverty alleviation, the development of rural economy and the effort to help the farmers to increase family income and to build happy and civilized families; it is to show more concern for the vital interests of the people; to improve physical and mental health of women and to motivate the public to take an active part in the program so as to make family planning their voluntary practice.
III. China's Population Program: Its New Progress After the 1994 International Conference on Population and Development, the Chinese government has made some new decisions pertaining to population and family planning and has adopted a series of new measures in light of the ICPD Program of Action and China's own national situation, and through drawing on China's own lessons and other countries' successful practices. All this has yielded notable results in fertility reduction and socio-economic development. 1. The integration of family planning with social and economic development China's family planning program is focused on the rural area, because 70 percent of China's population is in the countryside. Since the 1990s, households which practice family planning are organized in one way or another by the local government. Various assistance from agricultural production, family life to reproduction as well as favorable treatment in terms of policy, project, funding, technology and information are given to these households. As a result, each household gets one or two income - generating projects which give these households a family income higher than the local average level. This in turn becomes an internal motivation for a voluntary practice of family planning among these households, which at the same time sets a good example for the other households in 1995, the State Council sponsored a meeting to provide a forum for the participants to exchange their experiences in this practice. It is also at the meeting that the practice was fully recognized. As a result, relevant government departments formulated many favorable policies and measures in support of those families who practice family planning to enable them to become economically better - off. All this has led to a situation of addressing the population issue in a holistic way. There are still several million impoverished population in China. It has always been the government ' s policy to adopt a holistic approach in addressing population and development in the poor areas, including the integration of poverty alleviation with family planning in 1996, a joint meeting between the State Family Planning Commission and the State Council's Poverty Alleviation Leading Group was organized to document and disseminate the experiences in the integration of poverty alleviation with family planning. It is required by the State Council that local government and all departments give favorable treatment in terms of projects, funding and technology to those counties, townships, villages and poor households which have done a good job in family planning. This is intended to help them eradicate poverty so that others will follow suit. This practice strengthens both the family planning program and the poverty alleviation effort. 2. The provision of quality service to the eligible couples Following the ICPD and 4th World Conference on Women, the focus of China's family planning program has been reoriented towards the improvement of the quality of service, with a view to the improvement of the quality of service, with a view to the improvement of women's reproductive health. In 1995, the State Family Planning Commission of China started a pilot project on quality service in II counties. The project is aimed to expand the family planning service. The expanded services include IEC in terms of contraception, healthy child- bearing and child - rearing and reproductive health; inter personal counseling and informed choice of contraceptive methods and follow - up visits; counseling on pre-marriage, post-marriage, pregnancy, post-natal care and the treatment of infertility. The pilot project has now been expanded to around 100 counties. Throughout the country, 94 percent of the counties and 70 percent of the townships have family planning service centers. In the meantime, a new evaluation system is being set up which uses the clients' degree of satisfaction as the most important indicator in evaluating the quality of service. 3. Training of family planning workers The key to the improvement of family planning performance lies in upgrading the qualifications of the family planning workers. In response to this, starting from 1994, SFPC compiled standardized textbooks to provide in-service training to family planning service providers. As many as 70,000 persons have attended the training and have obtained their certificates. The training particularly emphasize that family planning workers should improve their attitude while providing service and show care and concern for their clients, they should safeguard the clients' legal right and interests and do away with any form of coercion. 4. The protection of women's reproductive health right and their participation in social development The Constitution of the People's Republic of China has made it clear that women enjoy equal right with men in political, economic, cultural, social as well as family affairs. Any forms of discrimination. violence against women and children are prohibited by the government. After the ICPD, the government formulated the Maternal and Child health Care Law and Program for Women's Development, apart from the already existed Marriage Law, the Heritage Law, Voting Law and Law for the Protection of Women's Right and Interest to provide a legal basis for the improvement of women's status and their participation in social development. Accordingly, a series of measures are taken to ensure women's role in sustainable development. In both rural and urban areas, various activities are carried out to bring women's potentials into full play: The "Project Happiness--an Initiative to Help Poor Mothers" organized jointly by China Population Nelfare Foundation, China Family Planning Association and China Population News has set up many project sites in most of the provinces, municipalities and autonomous regions. By providing rotating micro-credit loan with low or free interest directly to the households, the project helps poor mothers not only economically, but also in education and health. The project has so far yielded notable result in relieving women of poverty, improving their status and making family planning a voluntary practice. 5. The promotion of male participation in family planning and adolescent sexual health While certain progress has been achieved in some areas due to much IEC effort, male participation in family planning is still insignificant compared with that of female and contraceptive methods are still targeted mostly towards women. This is due partly to the traditional preference for sons. Men, according to tradition, are the bread winners of the family whereas women's responsibility is child bearing and child rearing. Therefore, contraception is seen as women's business. In response to this, the government as well as the State Family Planning Commission and Ministry of Health have made much effort to ensure more male participation in reproductive health and contraception. Despite the intolerance of the traditional culture, adolescent sexual behavior and pre-marital sex tend to increase over recent years. As a result, there has been a change of social attitude towards this behavior. However, the government's reproductive health/family planning IEC are targeted mostly towards married couples, though population and family planning have been included in the curriculum of high schools. Counseling and reproductive health service from both the government and non- governmental organizations, therefore, have an very inadequate coverage of this population. As a result, this group are more likely to get pregnant, have abortions and even sexually transmitted diseases. One survey shows that in one place, 23 percent of abortions are done with young girls, 20 percent of the students in one university have sexual experiences. One explanation for this is the intolerance of the mainstream culture with premarital sex which leads to the concern that reproductive counseling and service to the young might encourage more adolescents to have sex. The second explanation is the government's limited funding which naturally go first to married couples for reproductive health and family planning service. 6. Monitoring and evaluation: the indicators Crucial indicators in population and family planning can be obtained on a timely and valid basis. This is ensured by various sources of data: the population census conducted every ten years, the population sampling survey of every five years, the annual sampling survey on population change, the routine record forms from family planning department and the household registration of the public security department. Apart from these, irregular surveys on specific subjects are conducted when needed, such as the nationwide sampling survey on reproductive health conducted in 1997. Besides, an annual evaluation is conducted by different levels of government on reproductive health/family planning as well as on the reliability and validity of the data obtained. Major reliable indicators attainable include natural population change, contraceptive prevalence rate, contraceptive methods, contraceptive effectiveness and availability, informed choice, women's knowledge on reproductive health/family planning and STDs/AIDS, reproductive/family planning service (including pre- marital counseling and check-up, contraceptive counseling and follow-up visit) and couples' satisfaction with the service. Additional information on reproductive health can be obtained from health department, civil affairs department and women's federations. All these are important indicators in monitoring and evaluating China's population and family planning program in the implementation of ICPD Program of Action.
The government has always supported the participation of NGOs in population and family planning program. All China Women's Federation and all its branches initiated various campaigns with the aim to advancing women's social, economic and family status and safeguarding their right and interest in economic and social activities and in reproductive health and family planning. These campaigns include poverty alleviation, vocational training and helping girls to go back to school: China Family Planning Association through its large number of volunteers and by mobilizing various sources conduct IEC campaigns in population and family planning, reproductive health and maternal and child health care. The Association also helps couples, especially women to participate in income - generating activities as part of the effort to combine family planning with the development of rural economy. China Population Association strengthened its demographic research and research on reproductive health/family planning, while continuing to give policy recommendations to the government. Research, IEC and counseling are also conducted by many other NGOs to help the government to meet people's need for reproductive health and family planning. In the meantime, NGOs are encouraged by the government to participate in and monitor the government's family planning program.
V. Resource mobilization: current and future need China's reproductive and family planning program is mainly funded by the government's finance, with an annual input of US $518 million, equivalent to US$0.42 per person. In the meantime, individuals, NGOs and enterprises are also encouraged to support the program, to help impoverished mothers and school drop- outs, especially girls. In response to the central government's call for more input into the program, some local government has channeled part of poverty alleviation fund to help those families which practice family planning in improving both their economic status and reproductive health. China is also seeking international assistance. The United Nations Population Fund (UNFPA), the International Planned Parenthood Federation (IPPF), World Health Organization (WHO), the Japanese Organization for International Cooperation in Family Planning (JOICFP), the Rockfeller Foundation and Ford Foundation are the major organizations which are currently assisting China's population and family planning program UNFPA has just approved a new cycle of China program with 14 million U.S. dollars to support a reproductive health/family planning project to be conducted in 32 counties. Nevertheless, funding still remains a big challenge in the face of an increasing need for reproductive health care and family planning service.
China's reproductive health/family planning program has made some new progress in light of the ICPD Program of Action. By creating a favorable environment for social and economic development, the program reduces the pressure of population growth upon the economy, employment, resources and the environment. Apart from facilitating the poverty alleviation effort, the program also helps in women's empowerment and in improving women's status in social, economic and family affairs and most importantly women's reproductive health conditions. However, much remains to be improved with the program. Financial input needs to be increased, some de facto inequalities still exist between men and women; more attention needs to be paid to adolescent sexuality, especially in terms of information and service; women's educational attainment needs to be improved, especially in rural areas; reproductive health care for the disadvantaged group of laid-off women calls for special attention, and family planning administrators and workers need to improve their skills and working style to better implement the new reproductive/ family planning program. The 21st century will be a bigger challenge for China's population and family planning program. While addressing such new issues as occurred with the fertility decline and the economic reform, the government will stick to the fundamental policy of family planning to curb the excessive population. Population aging during the first half of the next century will be an influential factor for every aspect of the society. To address this issue, a social security system for the aged will be gradually established with the involvement of the state, society, family and the individual. Another challenge will be how to improve the skills of China's labor force to meet the needs of the market economy and the development of science and technology. There has been a closer link between population migration and economic development. Reproductive health and family planning service for the migrant population needs to be strengthened. All these issues are the result of development and call only be resolved in the process of development. The Chinese government is confident that its population and development can be addressed through implementing its population and family planning program in light of the ICPD Program of Action and through developing the economy.
Note: prepared for The High Level Meeting to Review the Implementation of ICPD POA and Bail Declaration on Population and Sustainable Development and Make Recommendations for Further Action |
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