China's one child family policy

British Medical Journal, Oct 9, 1999 by Ching Y Choi, Penny Kane

Summary points

The one child family policy was developed and implemented in response to concerns about the social and economic consequences of continued rapid population growth

Implementation was more successful in urban areas than rural areas

Social and economic reforms have made rigorous implementation of the policy more difficult

The main criticism of the policy is its stimulus to discrimination against females, who may be aborted, abandoned, or unregistered

The policy has eased some of the pressures of rapid population increase on communities, reducing the population by at least 250 million

China's one child family policy, which was first announced in 1979, has remained in place despite the extraordinary political and social changes that have occurred over the past two decades. It emerged from the belief that development would be compromised by rapid population growth' and that the sheer size of China's population together with its young age structure presented a unique challenge.

Methods

This article is based on experience from frequent field visits to China over the past 25 years and the authors' collections of relevant Chinese and Western documents from the 1950s onwards. We also used references from the major demographic journals.

Population growth since 1953

Government family planning services became available as a contribution to maternal and child health in China from 1953. As the result of falling death rates, the population growth rate rose to 2.8%, leading to some 250 million additional people by 1970. After a century of rebellions, wars, epidemics, and the collapse of imperial authority, during which the annual population growth was probably no more than 0.3%, such an expansion was initially seen as part of China's new strength. Mao Zedong quoted a traditional saying: "Of all things in the world, people are the most precious."[1]

Rapid growth, however, put considerable strain on the government's efforts to meet the needs of its people. The fourth five year plan in 1970 included, for the first time, targets for population growth rate. Contraceptive and abortion services were extended into the rural areas, and there was extensive promotion of later marriage, longer intervals between births, and smaller families.

Within five years the population growth rate fell to around 1.8%, and the target set for 1980 was a growth rate of 1%. To achieve this, each administrative unit introduced its own target and discussed and, when necessary, attempted to modify its population's fertility behaviour. At local level, collective incomes and allocation of funds--for health care, welfare, and schools, for example--made it possible for couples to understand the effect of their personal family choices on the community. They also made it possible for the community to exercise pressure on those who wished to have children outside the agreed plans.

Origins of one child policy

But even the 1980 target, let alone the more ambitious aim of reaching zero growth by the year 2000, was unattainable through a "later, longer, fewer" campaign. Population studies had been discontinued in China in the late 1950s in line with Marxist doctrine. Only in 1975 did new university departments begin to be established, staffed largely by statisticians. They quickly realised that with half of the population under the age of 21, further growth was inevitable even if each family was quite small.[2] By the time of the 1982 census there were already more than 1 billion people in China, and if current In-ends persisted, there could be 1.4 billion by the end of the century. Most population growth rate targets were abandoned in the early 1980s, and from 1985 the official goal was to keep the population at around 1.2 billion by 2000.[3]

Elements of the policy

Details of what the one child policy involved and how it was to be implemented have varied at different times.[4] The essential elements are clear. The aim was to curtail population growth, perhaps to 1.1 billion and certainly to 1.2 billion, by the year 2000. It was hoped that third and higher order births could be eliminated and that about 30% of couples might agree to forgo a second child. The ideal of a one child family implied that the majority would probably never meet it. It was argued that the sacrifice of second or third children was necessary for the sake of future generations. People were to be encouraged to have only one child through a package of financial and other incentives, such as preferential access to housing, schools, and health services. Discouragement of larger families included financial levies on each additional child and sanctions which ranged from social pressure to curtailed career prospects for those in government jobs. Specific measures varied from province to province.[5] Minorities were excluded from the policy.

Early implementation

In some of the largest and most advanced cities like Shanghai, sizeable proportions of couples already chose to have only one child. Both adults worked full time with long hours; the housing allocation was only 3.6 [m.sub.2] per person in 1977; without conveniences such as refrigerators tasks like shopping and cooking were time consuming daily efforts. In most families, at least one member would be employed in the state sector and susceptible to government direction. As a result, it was not long before 90% of couples in urban areas were persuaded to restrict their families to a single child.