Family Planning in China, White Paper, 1995

Foreword

Excessive population growth is an extremely serious problem facing the contemporary world. Each minute, the earth's population is increased by 160 people. In face of this problem, the UN Population Fund sounded a warning to the international community: Lacking prompt and determined moves to control population and maintain a balance between consumption and development, the world population would be 12.5 billion people by the middle of the next century and humanity be unable to develop further.

The global emergence of the population question poses a serious challenge to many countries and regions. For a populous developing country like China the challenge posed by the population question not only has a bearing on the survival and development of the Chinese nation but also affects the stability and prosperity of all human society.

How is China taking up the challenge to deal with this problem? Why has China adopted the strategic policy of carrying out family planning? What policies and measures has it taken to implement its family planning programme and what results has it achieved? We shall introduce the problem and provide some answers.

I. A Strategic Policy That Suits National Conditions

The population problem is an important question that touches upon the survival and development of the Chinese nation, the success or failure of China's modernization drive as well as the coordinated and sustained development between the population on one hand, and the economy, society, resources and environment on the other. It is a natural choice that the Chinese government has made to implement family planning, control population growth and improve the life quality of the population a basic state policy on the basis of a wish to make the state strong and powerful, the nation prosperous and the people happy.

After the founding of the People's Republic of China, due to the stability of the society, the development of production and the improvement of medical and health care conditions, the people lived and worked in peace and happiness. The death rate was reduced markedly, while the population increased rapidly, thus the situation then was characterized by more births, fewer deaths and high growth. It should be pointed out that this was an inevitable phenomenon at that time. But, just as the international community then was not responding promptly to the question of swelling global population, China lost the chance to solve the problem of over-rapid population growth in the first birth peak period after the founding of New China.

In the 1960s, China's population entered its second peak birth period. From 1962 to 1972, the annual number of births in China averaged 26.69 million, totalling 300 million. In 1969, China's population exceeded 800 million. Beginning from the 1960s, the contradiction between the population on one hand, and the economy, society, resources and environment on the other had become gradually apparent. In view of the situation, the Chinese government issued a call for family planning and advocated the use of contraceptives. However, as there was still the lack of a deep understanding of the seriousness of the population problem and the government still had not worked out a clear population policy, family planning was not effectively carried out throughout the country.

From the early 1970s, the Chinese government had become increasingly deeply aware that the over-rapid growth of population was unfavourable to economic and social development and decided to energetically carry out family planning in both urban and rural areas and integrated the plan for population development into the plan of national economic and social development. Consequently, family planning work entered a new phase of development.

At the end of the 1970s, Deng Xiaoping, the chief architect of China's reform and opening to the outside world, made an in-depth analysis of China's basic national conditions on the basis of the experience and lessons of socialist construction since the founding of the People's Republic, pointing out that, to accomplish the goal of the four modernizations in China, it was imperative to take into consideration the basic features of the Chinese environment, that is, the vast scale of the country, its weak foundation, its massive population and the low ratio of cultivated land, and this demonstrated the objective need for the development of population to be coordinated with the development of the economy, society, resources and environment. The major contribution Deng Xiaoping made to the solution of China's population problem is: To study and deal with the population problem in the overall context of the national economic and social development and clearly point out that China's population policy is an important policy of strategic significance. In accordance with Deng Xiaoping's thinking, the Chinese government has made it a basic state policy to carry out family planning and population control and to improve the life quality of the population, and has clearly incorporated it in the Constitution of the People's Republic of China, thus establishing the important position of family planning programme in China's overall task of national economic and social development.

By February 15, 1995, China's population had reached 1.2 billion. Over the past few years, the annual births have averaged about 21 million, with a net annual increase of 14 million. Such massive total population and annual population growth constitutes a heavy burden for China, a country that has a weak foundation and little cultivated land, whose economic and cultural level is rather backward and where development is regionally imbalanced. The negative impact of China's overabundance of population has permeated all aspects of social and economic life; in fact, many difficulties China has encountered in its economic and social development are directly related to the problem of population.

Over the vast territory of China, the space suited for people to live and engage in economic activities is limited and population distribution is extremely uneven. Plains and hilly land account for 12.0 percent and 9.9 percent respectively of China's total land area, totalling only 21.9 percent, while basins, mountains and plateaus account for 18.8 percent, 33.3 percent and 26.0 percent each, adding up to 78.1 percent. Many of the mountain, plateau, hilly and basin areas are unsuited for living. China's humid and semi-humid areas, appropriate for living, account for only 47 percent of the total land mass, while the arid and semi-arid areas account for 53 percent. Now, 94 percent of China's population live in the eastern part, which accounts for 46 percent of the country's territory, particularly in the southeastern region where the natural environment is better and the economy is relatively developed. The State Statistical Bureau estimates, on the basis of data collected in the third national census in 1982, that 20.3 percent of China's population live in areas over 500 metres above sea level, whereas in the world's population as a whole, only 10 percent live in areas over 400 metres above sea level. At present, there are still 70 million people in China living below the poverty level, of which the majority live in the western region where the geographic environment is harsher. Obviously, the poverty of the population is closely related to their poor living conditions. Besides this, China's per-capita average of forested land, grassland and freshwater resources amounts to only one-ninth, one-third and one-fourth of the respective world averages. "Food is the first necessity of the people." To solve the problem of feeding a population of 1.2 billion is a big challenge to China. Now, cultivated area in China accounts for only onetenth of its territory. In contrast, cultivated land in India accounts for 55 percent of its territory, with a per-capita average twice that of China. Although cultivated land in the United States makes up for only 20 percent of its territory, still its per-capita average is nine times that of China. The greatest pressure on China's agriculture, particularly grain production, is the continuous growth of the population and incessant shrinkage of the cultivated land. The United States and India, as well as China, are all major grain-producing nations in the world. Though its cultivated land is less than the United States and India, China ranks the first in the world in terms of grain output; its per-unit grain yield is much higher than the world average. But, as China's population is almost five times that of the United States, its per-capita share of grain is less than one-fourth of the latter. In 1993, despite a bumper harvest witnessed in China's grain production, the per-capita share of grain was only 387.3 kilogrammes. Forecasts show that China's per-capita share of grain will remain at the low level of less than 400 kilogrammes of crude grain for a long time due to the continued growth of the population size in the future. If China fails to effectively check the over-rapid growth of the population and alleviate the great pressure wrought by the population growth on cultivated land, forests and water resources, an ecological and environmental deterioration will become inevitable in the coming decades, profoundly endangering the minimum living conditions of the overwhelming majority of the Chinese people as well as the sustainable development of their society and economy.

On one hand, China's abundant labour force is of course conducive to development. On the other, however, it will be considerably difficult to tackle the problem of employment of a continuously growing labour force under the shortage of funds and the relative insufficiency of resources. Now, nearly 20 million young people reach working age in China every year, and most of them need jobs. The surplus labour force in China's rural areas has reached 120 million, and by the year 2000 the rural surplus labour force will exceed the 200 million mark. Although the state has adopted various measures to open up channels for employment and satisfactory results have been achieved, there are still considerably large amounts of people who are in the plight of job-waiting or recessive unemployment. Only by resolutely controlling the population growth while making energetic efforts to develop the economy and create new employment opportunities can it be possible to make the growth of the work force fall in step with the demand of the economic development for the work force. Despite the rapid pace of economic development, continuous improvements in China's overall national strength, and the leap of China to the world's front rank in gross national product since the adoption of reform and opening to the outside world, the country's per-capita gross national product still lags behind in the world and remains lower than the average level of the developing countries because of its huge population. Owing to the excessively rapid population growth, the state's accumulation has become relatively less, funds that can be invested in educational, medical and health care and other social services are limited, and there are significant difficulties in further improving the people's cultural quality and health level, particularly the life quality of the massive rural population and the population living in areas haunted by poverty.

It is precisely for bringing about a sustained economic growth and sustainable development, satisfying the daily increasing material and cultural demands of the whole people, and guaranteeing the fundamental and long-term interests of the current generation and their posterity, that the Chinese government has chosen the strategic policy of family planning. Facts have proved and will continue to prove that, while making energetic efforts to develop the economy, the comprehensive promotion of family planning was the correct policy decision, taken in China since the latter half of the 20th century, which bring benefits to the present and constitutes a meritorious service for the future.

II. A Social Undertaking That Benefits the People

China's reform and opening to the outside world as well as its economic development have created a favourable socioeconomic environment for family planning, while the achievements of family planning have in turn created a favourable population environment for the continuous development of the economy, the improvement of the people's living standards as well as the overall progress of society.

1. Family planning has effectively checked the trend of over-rapid population growth.

In the 15 years from the founding of the People's Republic to 1964, China's population increased from 500 million to 700 million, and on average 7.5 years were needed for the population to increase by 100 million. The 1964-74 period was one of high-speed growth where China's population increased from 700 million to 900 million in ten years, and the time needed for the population to increase by 100 million was shortened to five years. In 1973, China began to promote family planning throughout the country. China's population increased from 900 million to 1.2 billion in the period from 1973 to February 1995, and the time needed for the population to increase by 100 million was again lengthened to around seven years. China has been through the third post-1949 peak period of births from the beginning of the 1990s, the community of women in their prime of fertility (aged 20 to 29) has exceeded 100 million each year on average, and such a huge child-bearing community has a great birth potential still. But, because China's current population and family planning programmes and policies have won understanding and support from the people, the fertility level of the population has steadily reduced and the trend of overrapid population growth has been effectively checked along with the country's economic and social development. Compared with 1970, in 1994 the birth rate dropped from 33.43 per thousand to 17.7 per thousand; the natural growth rate, from 25.83 per thousand to 11.21 per thousand; and the total fertility rate of women, from 5.81 to around 2. Now, China's urban population has basically accomplished the change-over to the population reproduction pattern characterized by low birth rate, low death rate and low growth; and the rural population is currently in this process of change-over. According to statistics supplied by the United Nations, China's population growth rate has already been markedly lower than the average level of other developing countries. According to calculation by experts, if China had not implemented family planning but had all along kept the birth rate at the level of the early 1970s, its population would possibly have passed the 1.5 billion mark by now. Over the past two decades and more, China's promotion of family planning has created a population environment conducive to reform and opening to the outside world and socioeconomic development as well as the population conditions for safeguarding the survival and development of China.

2. Family planning has promoted the change of people's concepts regarding marriage, birth and family.

Since the implementation of the policy of family planning in China, profound changes have been taking place in people's concepts of marriage, birth and family along with the reform and opening to the outside world as well as socio-economic development; the traditional ideas of "early marriage and early births," "more children, greater happiness," and "looking up on men and down on women" are being discarded by more and more people at the child-bearing ages. Late marriage and late births, fewer and healthier births, viewing male and female children as the same, establishing happy, perfect and harmonious small families and seeking a modern, scientific and civilized way of life have become an irresistible trend of the times. The rate of early marriage for women has come down and their average age at first marriage has gone up. In 1992, the proportion of women entering first marriage before the age of 20 dropped to 12.9 percent of the total number of firstmarriage women. In 1970, women's average age at first marriage was 20.2 years, while in 1993 it was 22.67 years, up 2.47 years. The family size has become gradually smaller and nucleus family is becoming the major form of modern Chinese families. According to China's fourth national census, the average size of families in 1990 was 3.96 persons, 0.88 person less than the 4.84 persons in 1971. The major reason for the reduction of family size is a reduction in the number of births. Compared with 1970, of the babies born in 1993 the first-birth rate and second-birth rate increased from 20.7 percent and 17.1 percent to 61.3 percent and 27.5 percent respectively, and the multiple-birth rate dropped from 62.2 percent to 11.2 percent. By 1994, a total of 46.76 million couples had volunteered to give birth to only one child throughout the country, accounting for 20.3 percent of the total married women at child-bearing age. At the current level of economic development and living standards in China, the reduction of family size and fewer children to support have obviously reduced the economic burden and the burden of family chores on the families and improved their quality of life.

3. Family planning has created favourable conditions for the development of China's economy and the improvement of people's living standards.

In vigorously promoting family planning, China strives to make the speed of population growth much lower than the speed of growth in the gross national product, thus gradually raising the per-capita level. A part from the reform and opening to the outside world, family planning has been a factor for the sustained economic development of China and the steady improvement of its people's living standards over the past ten years and more. From 1952 to 1978, China's gross domestic product (GDP) increased 4.7-fold. The per-capita GDP, however, increased by only 2.8-fold. From 1978 to 1994, while upholding reform and opening to the outside world and making great efforts to develop the economy, China persisted in doing a good job in family planning. In this period, the GDP went up 4.2-fold and the per-capita GDP increased 3.4-fold. During the same period, thanks to improvements in the quality of people's lives and the rise in their purchasing power, China's consumer goods market expanded 13.7-fold, and the total retail sales volume of consumer goods increased by an annual average of 17.2 percent. In 1994, the total volume of retail sales of consumer goods in China was 1,605.3 billion yuan. China has become a market with the greatest potential in the world. Compared with 1978, living standards have markedly improved, the urban people's per-capita incomes for living expenses increased 10-fold, at an annual increase of 15.5 percent; the per-capita net incomes for rural families went up 9-fold, at an annual increase of 14.8 percent. In Chinese cities and towns, the per-capita housing increased from 3.6 square metres to 7.5 square metres, and in the rural areas it increased from 8.1 square metres to 20.8 square metres. For the overwhelming majority of families, the basic needs of living, such as food, clothing, daily-use articles and housing, were met. The possession rate of durable goods, such as TV sets, cassette tape recorders, refrigerators and washing machines, approached the level of the moderately developed countries.

4. Family planning has promoted the improvement of the quality of the Chinese population in terms of education and health as well as the overall development of the people.

China's family planning has always included the two aspects of controlling the population size and improving the population quality in terms of education and health. While making efforts to control the population at an appropriate size, the Chinese government has devoted great attention to developing educational, medical and other services in order continuously to improve the quality of the population in terms of education and health. Prior to 1949, the mortality rate was as high as 20 per thousand, while by the end of the 1970s it had dropped to below 7 per thousand. From 1949 to 1990, the life expectancy rose from 35 years to 68.55 years--66.84 years for males and 70.47 years for females, making China a country where the life expectancy increased the most rapidly. Great improvements have been witnessed in the basic facilities for public health in China. Throughout the country, the average number of hospital beds for every 10,000 people increased from 13.3 in 1970 to 23.6 in 1994, and the average number of professional medical workers and technical workers in the field of medicine for every 10,000 people went up from 17.5 in 1970 to 35 in 1994. The incidence of various contagious diseases has markedly dropped. The diet of urban and rural people throughout the country has greatly improved, the per-capita daily calorie intake has reached 2,600 Kcal. and that of protein has reached 75 grammes, having reached or approaching the world average levels. Health care for women and children has continuously expanded. Now, family planning as well as maternity and child care networks have been basically formed in China's urban and rural areas. The mortality rate for babies dropped from 200 per thousand prior to the founding of the People's Republic to 35 per thousand in 1990, the death rate of expectant and new mothers was 94.7 per 100,000, and the rate of planned immunity for new-born babies reached 85 percent. The major indexes of people's medical care and health have already far outstripped countries at the same level of economic development, and the gap with the developed countries is being gradually narrowed.

The Chinese government has taken education as a strategic key for the country's development, and great progress has been made in this field. China is now accomplishing the goal of nine-year compulsory education in a planned and systematic way. In 1994, the enrolment at schools, at various levels and of various kinds throughout the country, already reached 270 million, the schooling rate of school-age children reached 98.4 percent, the illiteracy rate of young and middle-aged people dropped to 7 percent, primary education was made universal in areas with 91 percent of the country's population, the major cities and some of the developed regions basically popularized junior middle school education, and infant education as well as the special education for handicapped children developed steadily. Secondary vocational and technical education developed quickly, and enrolment has reached 8.446 million, accounting for 56 percent of the total number of students at the level of senior middle school. Countrywide, over 200 million farmers have received various kinds of education in general knowledge and practical skills.

5. Family planning has further liberated the female productive forces and helped improve the status of women.

Family planning in China has extricated women from frequent births after marriage and the heavy family burden, further liberated and expanded the social productive forces latent in women, and provided them with more opportunities to learn science and general knowledge and take part in economic and social development activities, hence greatly promoted the improvement of the Chinese women's status in economic and social affairs as well as in their families.

The employment rate of women has steadily increased and sphere of employment has continuously expanded. By the end of 1992, the number of female staff and workers had reached 56 million in China, accounting for 38 percent of the national total of staff and workers and representing a 24.1 percent increase over the 45 million in 1985. In the 1979-88 period, the growth rate of employment for urban women had always been higher than that for men, with the average annual increase standing at 4.9 percent, 1.27 percentage point higher than the average annual increase of all staff and workers countrywide. The overwhelming majority of Chinese women are located in the countryside, and they are the major force of the agricultural production and diversified economy in the country. They are that part of the population to benefit most from the policy of family planning. In 1989, a move of "double learnings" (of general knowledge and techniques) and "double competitions" (in achievements and contributions) was launched in China's rural areas, appealing to 120 million rural women. Of this total, more than 90 million received training in practical techniques, over 15,000 were cited as model women workers at and above the provincial level, more than 510,000 were given the title of farmer technician, and 1.067 million scientific and technological demonstration households, with women as the major body, came to the fore. In China's rural areas, some 40 million women are employed in township enterprises, accounting for 47 percent of the total work force in these enterprises.

Family planning has provided women with more opportunities to receive education and is conducive to raising their educational qualities. At present, the average schooling for adult women in China's urban areas totals 9.97 years. Of these women, those who have received education of senior middle school or higher account for 56.3 percent; those who have received junior middle school education account for 33.3 percent; those who have received primary school education account for 8.3 percent; and those who are illiterate and semi-illiterate account for only 2.1 percent. For the previous generation, however, those with senior middle school education and higher account for only 9.1 percent; those with junior middle school education, 11.1 percent; those with primary school education, 24.5 percent; and illiterates and semi-illiterates, 55.3 percent. For adult women in the rural areas, those with senior middle school education or higher make up 8.9 percent; those with junior middle school education, 26.6 percent; those with primary school education, 27.9 percent; and illiterates and semi-illiterates, 36.6 percent. For the previous generation, those with senior middle school education or higher account for only 0.5 percent; those with junior middle school education, 1.9 percent; those with primary school education, 9.0 percent; and illiterates and semi-illiterates, 88.6 percent.

6. Family planning has accelerated the process of eradicating poverty in rural China.

In China's poor areas, economic and cultural backwardness and too many births often interact as both cause and effect. The Chinese government has taken an important step in giving support to the development of poor areas to alleviate poverty by promoting family planning, holding population growth under control, and raising the life quality of the population in those areas. Since 1978, the state has adopted a series of measures to make those living below the poverty line drop from 250 million to 70 million in 1995. The Chinese government has combined the solution of the problem of the portion of society living under the poverty level with family planning to free families from the vicious cycle of "the poorer they are, the more children they give birth to, and the more children they give birth to, the poorer they become." In this respect, marked achievements have been obtained. In the community that have extricated themselves from poverty, farming households that have implemented family planning are often in a clearly advantageous position.

The positive impact produced by family planning on Chinese society is wide and profound. With the passing of time, the benefits of family planning, for the people and for posterity, are bound to be more apparent.

III. Combination of State Guidance with Voluntary Participation by the Masses

Due to its vast territory, large population and the great differences between regions, urban and rural areas and ethnic groups, the promotion of family planning in China is a highly complicated task. When working out the policies of population and family planning, and the objectives of population control in accordance with the actual conditions in the country, the Chinese government took into consideration the needs of the social and economic development of the state and its longrange interests, as well as the actual conditions of different regions, ethnic groups and social strata, the people's wishes and attitudes, to combine state guidance with voluntary participation by the masses.

The combination of state guidance with voluntary participation is an important principle China has always followed since the implementation of the family planning policy, and is the fundamental guarantee of success for the family planning programme as well. The main manifestations of state guidance include: The central and local governments, in accordance with the national conditions and people's will, and through legislative procedures, have formulated the policies, laws and regulations concerning the control of population growth, the improvement of the life quality of population and the optimization of the population structure; worked out the macro population development plan, and integrated it in the overall plan for national economic and social development; placed population control and family planning in the government's major agenda, organized and coordinated all relevant departments and mass organizations to draw up and implement the programmes on population and family planning, and provided necessary funds and conditions to guarantee the needs of both causes; and, through extensive and in-depth publicity and education all over the country, provided guidance and services to all couples and individuals in terms of reproductive health care, contraception and birth control, healthy child birth and rearing to help them in proper arrangement of family planning.

Voluntary participation is mainly manifested in the fact that, under the guidance of the state's relevant policies and legislation, the right of all couples and individuals to carry out family planning is protected and respected. While exercising their right of child bearing, couples and individuals must take into account their responsibilities and duties to the state and community, and the health and happiness of the family and all its members. On the basis of effective information, advice and services and in accordance with the age, health, work and family economic conditions, couples and individuals can arrange for pregnancy and child bearing in a responsible and planned way, and select proper contraceptive methods so as to have healthy children and happy, progressive families.

A family planning policy that conforms to the state's actual conditions and embodies classified guidance is an important component part of exercising state guidance. The main contents of the current family planning policy in China are: Advocating delayed marriage and delayed child bearing, fewer and healthier births; and advocating one child for one couple. Some rural couples with actual difficulties are allowed to give birth to a second child a few years after the birth of the first child. The national minorities are also required to practise family planning, and concrete demands and approaches to the policy are decided by each autonomous region or the province in which the national minorities live. There are practical differences in the family planning policy between urban and rural areas, and between the Han and the ethnic minorities, i.e., the policy for rural areas is more flexible than for urban areas; for national minorities more flexible than for the Han people. Each province (autonomous region or municipality) will formulate the corresponding policy and regulations in accordance with the state's policy and the actual local conditions and form its local legislation through legal procedures.

One child for one couple is a necessary choice made under China's special historical conditions to alleviate the grim population situation. One child for one couple does not mean to "have one child" under all circumstances, but rather, while encouraging couples to have only one child, to plan arrangements for couples who have real difficulties and need to have a second child to do so. In China's cities and towns where family planning was introduced earlier and the economic, cultural, educational, public health and social security conditions are better, the overwhelming majority of couples of child-bearing age who are pleased with a small family have responded to the government's call and volunteered to have only one child. In 1990, of the non-agricultural population in China's urban localities, the total fertility rate of women dropped to 1.26, or 1.05 lower than the nation's average figure. In the countryside, the total fertility birth rate of women was 2.8.

China is a multi-ethnic country, the population of the national minorities making up about 8 percent of the country's total. To raise the economic and educational levels of the national minority areas and improve the life quality of the population, since the early 1980s the Chinese government has also advocated family planning in the areas inhabited by national minorities, except for Tibet and sparsely populated minority areas. The concrete policies are worked out by the national minority autonomous areas and the relevant provinces and autonomous regions according to specific local conditions. In general, a couple in agricultural and pastoral areas is allowed to have two children; and a more flexible policy is adopted to farmers and herdsmen with actual difficulties. Since the founding of New China, the population growth rate of the national minorities has been not only higher than that before Liberation, but also higher than that of the Han people in the corresponding period. The total population of the national minorities increased from 35 million in 1953 to 91.32 million in 1990. Between 1982 and 1990 after the practice of family planning in the areas inhabited by minority people, the population of the national minorities increased by 35.81 percent, or 3.27 times the growth of the Han population in the same period.

The state has imposed no specific requirements on Tibet in family planning. In 1985, the People's Government of the Tibet Autonomous Region, in view of the actual population growth there, began to advocate family planning among Tibetan cadres, workers and staff, encouraging each couple to voluntarily space two births at reasonable intervals. Among the broad masses of farmers and herdsmen, the government has mainly educated them in child-bearing knowledge, advocated healthier birth and child-rearing practices, improved health care for women and children, and provided contraceptives and birth control technical services to those who volunteer to practise birth control. No policy restrictions have ever been imposed on the number of births in the agricultural and pastoral areas. The fourth national population census in 1990 revealed that Tibetan people in the Tibet Autonomous Region numbered 2.0967 million, making up 95.48 percent of the total population in Tibet.

China encourages fertile married couples to select contraceptive methods of their own accord under the guidance of the state; and offers various preferential treatments in daily life, work and many other aspects to families who volunteer to have only one child, helps them to solve difficulties in their lives and work and creates conditions for them to become better off as soon as possible. Assessments are imposed on multi-birth families to enable society to bring up their children. This represents both a restriction on having too many childbirths and an obligation of those responsible to pay a certain compensation to society. Assessments for this purpose are made according to local legislation, but the amounts thus collected must in no way affect the family's basic livelihood and their needs in keeping up production and management. All funds so collected will be used to further family planning.

Practice has proved that China's current policy on family planning conforms to the fundamental interests of the people throughout the country; meanwhile it also takes into account part of the people's wishes and attitudes. Hence the policy has won understanding and support from the people of the whole country and has guaranteed the success of the family planning work.

IV. Bringing the People to a Common Level of Understanding

The traditional child-bearing viewpoints formed in long years of Chinese history still profoundly affect people's attitudes to child-bearing; in particular a certain distance still exists between the viewpoints and will of a number of rural people and the state's demands for controlling population growth. Without the people's awareness, family planning can hardly be practised. Therefore, the Chinese government attaches great importance to educating the people to practise family planning of their own free will and strives to create the economic and cultural conditions for people to change their child-bearing viewpoints.

The publicity and education of family planning conducted in China according to its actual conditions and the population situation have made the whole society see that to control the rapid population growth is its responsibility and its urgent task. From the 1980s, all regions of China began one after another the activity of "doing accounts and making contrasts," during which people were organized to do accounts and make contrasts of the national and local changes after the founding of New China in terms of the population growth, per-capita cultivated land, grain supply and income, education, employment, housing and transportation, the differences in living standards between the families with more children and those with fewer children, and the benefits of family planning to the state and people. The activity has played an active role in helping people see clearly the nation's actual situation and practise family planning of their own accord.

Since 1987, China has put into practice the plan on popularizing the basic knowledge of population and family planning, with the rural areas as the key points. At present, a number of villages and neighbourhoods have set up population or marriage education schools. The people at different childbearing ages and those in different situations may obtain scientific knowledge of population, childbirth, contraception and birth control, maternity and child care through the lectures or advice given by doctors, teachers and cadres. Then they may practise family planning more conscientiously. For instance, in Tieling City located in the northern mountain areas of Liaoning Province, whose agricultural population makes up 80 percent of the total, more than 700,000, or 95 percent, of the couples of child-bearing age received education from 1987 to 1991. In the past, of the city's annual newly born babies, about 10 percent were born to parents who married early and had children early; and the rate of births with genetic defects reached nearly 15 per thousand because of the marriage between close relatives, or hereditary and endemic diseases. After education, the percentage of the people who married early and had children early dropped to below 1 percent and the birth defect rate, to below 8 per thousand in 1991. Now 92 percent of the couples of child-bearing age in the city have adopted birth control measures of their own accord.

Cadres at all levels taking the lead in practising family planning has exerted great influences among the people all over the country. For instance, each of over 50,000 cadres and Party members in Rudong County, Jiangsu Province has exemplarily implemented the state's family planning policy. Under their influence, the broad masses of the people actively respond to the government's call and practise family planning of their own free will.

The activities of family planning associations in all areas have also played an important role in publicity and education. Consisting of people from all walks of life who are interested in family planning, these associations are mass organizations with an extensive social basis. Up to now, all 30 provinces, autonomous regions and centrally administered municipalities as well as the overwhelming majority of the cities, counties and grass-roots units have set up their family planning associations, totalling more than one million with approximately 80 million members. Their members keep in close touch with the broad masses of the couples of child-bearing age. A family planning work situation with self-education and self-management as the mainstay is being formed step by step.

China makes full use of newspapers, radio, television, publication, theatre, music, local performances and schools to educate people about family planning. In addition, it has also set up a family planning publicity and education network reaching all parts of the country. In the late 1980s, all provinces, autonomous regions and centrally administered municipalities and the cities with economic planning directly supervised by the State Council (except Tibet Autonomous Region) set up regional family planning publicity and education centres one after another, which produced more than 1,600 television programmes and video tapes, and numerous publicity materials of various kinds. By 1994, two administrative officials' colleges, eight secondary professional schools and 26 provincial training centres had been founded as part of the national family planning system. Each city, county and township has a family planning service station focused on publicity and education; and all residents' and villagers' committees have a member responsible for propagating birth control education. Educational institutions of higher learning and research institutes in China also take an active part in training and research in population and birth control. The China Population Society, the China Population Culture Promotion Society and other organizations have also played an active role in organizing demographers, literary and art workers and people from all walks of life to participate in family planning work.

Publicity and education, which has resulted in the common understanding and conscientious participation of hundreds of millions of people, is the fundamental guarantee of the successful implementation of family planning in China.

V. Satisfying the Reproductive Health Needs of People of Child-bearing Age
     
While advocating family planning, China has mainly focused on contraception. Providing family planning information, consultation and services is an important measure in promoting family planning. The Chinese government attaches great importance to meeting the various and multi-level needs of people of child-bearing age by relying on progress in science and technology, and the study and development of the methods of family planning and contraception. In addition, the government has also established family planning and maternity and child care service networks throughout the country to provide people of child-bearing age with safe, effective and convenient services of family planning and reproductive health care, thus ensuring the smooth expansion of family planning.

Back in the 1960s, China embarked on scientific research on contraception, and soon made a large number of achievements, which were popularized all over the country. In the 1980s, China formulated the programme for the scientific and technological development of family planning, and has formed an initial, geographically rationally distributed system for family planning scientific research and the production of contraceptives. China has produced contraceptive and birth control technological services providing a great variety of methods for people to select as they wish. China leads the world in the research on male contraception techniques, some of which have been listed as the ones to be promoted by the World Association of Voluntary Surgical Contraception (AVSC). China has also made quite a number of important achievements in research of female contraception techniques, some of which have been extensively used in China and abroad. China has been included among those advanced countries in the development of contraceptives. While improving the quality of existing contraceptives, China is sparing no effort to develop safer, more effective, more convenient and cheaper contraceptives. To meet the demands of people of child-bearing age for contraceptives, the state has organized more than 40 factories and invested nearly 200 million yuan in the production of various contraceptives every year. Now the production of contraceptives in China has basically become self-sufficient.

To ensure that people of child-bearing age can receive required services at any time and in any place, China has established countrywide family planning service networks consisting of hospitals, maternity and child care centres and family planning service stations. Following the principle of catering to grass-roots units, going deep into the countryside, offering services to people's doorsteps and providing conveniences to the people, family planning workers provide people of child-bearing age with guidance, advice and services, and help them select favourable contraceptive methods according to their health and needs. In light of the actual conditions in rural areas, women of child-bearing age there with one child are encouraged to use intrauterine device and either the wife or husband of a couple with two children is encouraged to undergo sterilization, which are safe and effective contraceptive measures favourable to the protection of women's health. Therefore they are more easily accepted by rural couples of child-bearing age. As to those couples who are unsuitable or unwilling to accept such measures, family planning workers guide them to select other contraceptive measures according to their needs. At present, more than 200 million married couples of child-bearing age in China have adopted contraceptive measures, making up about 80 percent of the country's total.

Starting from the 1960s, China distributed contraceptives free of charge, and exempted and reduced the fees for birth control technical services. Since 1988, China has implemented the system of combining the supply of free contraceptives with retail sales in the market, thus widening the supply channels, providing conveniences to the people, satisfying their needs and raising the utilization rate of contraceptives. To ensure that people can get contraceptives in time, specialized organs have been set up or special personnel assigned for this purpose from the provincial and city down to the township and village levels.

The Chinese government is against promoting induced abortion as a means of family planning. China allows women who require induced abortion to have such an operation under safe and reliable conditions. Along with the popularization of the scientific knowledge of family planning and the extensive adoption of contraceptive measures, the number of induced abortions has been on the decline in many places. When China's birth rate drops sharply, the annual ratio between the number of newly born babies and that of induced abortions has retained at around 1:0.3, equivalent to the medium level in the world.

To guarantee the health of babies and mothers, China has made efforts to improve medical and health care conditions and strengthen health care services for women and children while doing a job in family planning. Consequently, the improvement of women's and children's health has also promoted family planning. China has set up health care networks for women and children all over the country. Several thousand maternity and child care centres provide various services, including the general survey, prevention and treatment of women's diseases, consultation on hereditary diseases, examination before marriage, health care for pregnant and postpartum women, new delivery methods, health care for babies and young children, etc. The family planning departments in many places have initiated health-care-at-childbirth services for couples of child-bearing age. In spite of their comparatively backward medical and health care conditions, the health care and family planning departments in some economically underdeveloped regions have organized people to provide services to the people at their doorsteps to protect women and children's health, so that they are highly acclaimed by the people.

VI. Optimization Through Reform and Development

Practice has shown that China's population and family planning programme has been crowned with success. But we should also clearly see that there is still imbalance in development in various areas, instability in fertility levels in many regions, and the high birth rate in others. The working style and service level concerning family planning in most rural regions, especially in some economically underdeveloped areas, remain to be improved. In the process of establishing the socialist market economic system, family planning work is faced with new situations and new problems. There are also problems in the quality and structure of population that should not be neglected. These problems include the high sex ratio and the growing population aging. Therefore, China is still confronted with a severe challenge on issues of population and development. To carry out family planning and population control, and improve population quality remain an arduous and urgent task of strategic significance.

The reform targeted at establishing a socialist market economic system is further promoting the development of social productive forces. At the same time, it has created favourable social and economic conditions for optimizing the family planning work. The Chinese government will unswervingly continue to carry out the basic national policy of family planning, and promote a coordinated development between population on one hand and the economy, society, resources and environment on the other. On one hand, we will adhere to and continually improve the basic experience that suits China's specific conditions and that has proved effective in practice; on the other, we should adapt ourselves to the new situation, emancipate the mind, seek truth from facts and unceasingly deepen the reform, to improve the level of family planning work. The practice of pursuing family planning mainly through administrative means and campaigns in some areas must be resolutely changed. The emphasis should be put on the publicity and education, contraception and regular work. Quality service in family planning should be provided to the people of child-bearing age, particularly the reproductive health care for women, to protect their health. The publicity and education and the management of family planning programme should serve the purpose of serving people's production, livelihood and fertility. With this in mind, the "Programme of China's Family Planning Work (1995-2000)" was formulated by the Chinese government at the end of 1994, setting clear demands on the task, target, principle and measures in deepening the development of family planning work.

The Chinese government holds that the issue of population is fundamentally one of development. Population is closely and inseparably related to economic and social development. Therefore, China always considers population and family planning an important component part of the strategy for the substained national economic and social development, and they are planned and implemented together with economic and social issues.

Since China's reform and opening to the outside world, the development of national economy, science, technology, education, public health and social welfare has played an active and promotive role in changing people's concept of fertility and in lowering the birth rate. This role is particularly evident in areas where the economy has developed rapidly. As economic development and population control promote each other, these areas have seen a transition, in a relatively short period of time, to the modern population reproduction pattern characterized by a low birth rate, low death rate and low natural growth rate. As for poverty-stricken areas where the economy is relatively backward, since the 1980s, the Chinese government has formulated a comprehensive strategy in regard to the overall planning, comprehensive management and coordinated development in population, grain, ecology and resources. It has carried out extensive activities to help the poor in their development and integrated these activities with family planning, vigorously accelerating the economic and social development in these areas.

On the basis of summing up experiences of history and the innovations of the people, the Chinese government in recent years has put forward that the rural areas should combine family planning with developing economy, helping peasants to become better off through hard work, and building progressive and happy families. Through providing service to peasants in production, livelihood and fertility, and above all through helping families practising family planning to become better off, more and more families were guided to have less children and to improve their financial situation as soon as possible. This practice has won warm support from governments at all levels, cadres at grass-roots level and the people. In a relatively short period of time, this work has been implemented in most of the provinces, autonomous regions and municipalities throughout the country. This is not only good for accelerating rural economic development, increasing peasants' income, and improving their living standard, but it can also make them realize from their immediate interests the benefit of having less children, gradually changing their attitudes towards fertility, hightening their awareness of and enthusiasm for carrying out family planning. Rural women not only take an active part in these activities but they also benefit mostly from them. Through these activities, they have enhanced their enthusiasm for production, increased their income from labour, improved their status in both the family and society and obtained greater independence in marriage and childbirth.

In order to fundamentally and comprehensively solve China's population problem, comprehensive measures have to be adopted. Such measures include vigorously developing the economy, getting rid of poverty, protecting the ecological environment, rationally developing and utilizing resources, popularizing education, developing medical service and maternal and child health care, improving the social security system --especially the insurance system for the aged, steadily advancing urbanization, improving women's status, and guaranteeing the legal rights and interests of women. Over the past few years, the Chinese government has formulated plans, policies and measures in these fields, providing a more favourable environment for the implementation of family planning.

The Chinese government and the society as a whole have paid close attention to the recent tendency of the high sex ratio. The problem will be gradually solved through heightened publicity and education, and measures have been taken to guarantee the legal rights and interests of women and children; to severely prohibit, except when called for medically, the technical examination of fetus for determining sex followed by selective abortion; and to improve birth report and statistical system.

The Chinese government strongly believes that the problems that have appeared in the course of implementing China's family planning programme will be solved steadily in the process of reform and development, before it can be gradually improved and perfected.

VII. The Correct Choice for Human Rights Protection

In the practice of carrying out family planning programme, whilst persistently proceeding from its reality and taking into full account and observing principles and regulations concerning population and family planning formulated by international institutions and organizations, the Chinese government has gradually set up guiding principles, policies, measures and methods that reflect the basic interests and various rights and interests of the people, and has continuously improved these as the actual situations change, so as to better safeguard the right to subsistence and development of the Chinese nation.

It has been China's consistent stand and principle in international exchange and cooperation to fully respect the sovereignty of all nations, and not to interfere with the internal affairs of other nations. The "Programme of Action" adopted by the International Conference on Population and Development by that conference in Cairo, 1994, pointed out: "The formulation and implementation of population-related policies is the responsibility of each country and should take into account the economic, social and environmental diversity of conditions in each country, with full respect for the various religious and ethical values, cultural backgrounds and philosophical convictions of its people, as well as the shared but differentiated responsibilities of all the world's people for a common future." Only by proceeding from the reality of the country, independently setting up its population policy and target, as well as plans and measures to realize this target, can the population problem of each country be effectively solved. Positive results of solving population problem through international cooperation can only be achieved under the premise of respecting the sovereignty of each country, and by adopting the attitude of mutual understanding and the seeking of common ground while preserving differences. As the national situation, the degree and pattern of social and economic development, cultural habits and values, and the specific characteristics of the population problem in each country differ, there will be differences in the plan and dynamics of problem solving in each country, which is a normal phenomenon. Not only has China never imposed its ways and ideas of solving its own population problem on anyone else, but it has, instead, always understood and welcomed all good-intentioned criticism and useful suggestions from outside. However, some people, distorting or disregarding the basic facts, have made improper comments on China's family planning programme, criticizing it as a "violation of human rights," and denouncing it as "inhumane." They have even tried to impose their values and ideas on China, using the excuse of "protecting human rights" to put pressure on China and to interfere in China's internal affairs. This is totally unacceptable. Any such practice of interfering in China's internal affairs has not only deviated from the basic principle set up in the field of population by the international community, but it has also violated the established principles of international law, which will neither help promote a healthy development of China's family planning programme nor the stability of the world's population.

China has always held that concepts of human rights are a product of historical development, closely related to social, political and economic conditions, as well as the individual nation's particular history, culture and concepts. The realization and optimization of human rights is a historical process. A citizen's right of choice in reproduction is also part of this process.

The great changes in the world population situation in the mid-twentieth century, the rapid world population growth and the severe consequence ensuing have aroused increasing attention from the international community and various countries. The contradiction between population on one hand and survival and development on the other is especially sharp in developing countries with a fast population growth. Irrational international economic order, stagnant economic and social development, and the pressure of a large population have continually widened the gap between developed and developing countries in terms of welfare and living conditions, increasing rather than decreasing the number of those living below the poverty line. With recognition of the seriousness of the population problem and the urgent need to control population growth, people's understanding and attitudes towards reproduction and other associated rights have changed, responding to new historical conditions, becoming more comprehensive. The "World Population Plan of Action," approved at the International Population Conference held in Bucharest in 1974, states: "Individual reproductive behaviour and the needs and aspirations of society should be reconciled.... All couples and individuals have the basic right to decide freely and responsibly the number and spacing of their children and to have the information, education and means to do so; the responsibility of couples and individuals in the exercise of this right takes into account the needs of their living and future children, and their responsibilities towards the community." The "Recommendations on Further Implementing the World Population Plan of Action," approved at the 1984 International Population Conference held in Mexico City, again emphasized that "Any recognition of rights also implies responsibilities." Accordingly, when couples and individuals exercise their right to the choice of reproduction, they should "take into consideration their own situation, as well as the implications of their decisions or the balanced development of their children and of the community and society in which they live." The "Recommendations" point out that "governments can do more to assist people in making their reproductive decisions in a responsible way." The "Programme of Action" adopted at the International Conference on Population and Development held in Cairo in 1994 once again points out that "these [reproductive] rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health.... In the exercise of this right, they should take into account the needs of their living and future children and their responsibilities towards the community. The promotion of the responsible exercise of these rights for all people should be the fundamental basis for government- and community-supported policies and programmes in the area of reproductive health, including family planning."

Family planning in China is pursued in complete accordance with the relevant principles and human rights requirements designated by the international community. China's family planning policies and programmes combine citizens' rights and duties, joining the interests of the individual with those of society. These conform to the basic principles outlined at the various international population conferences and have been established on the basis of the relationship of interpersonal interests under socialism. Never in any country are rights and duties absolute, but rather, they are relative. There are no duties apart from rights, or rights apart from duties. When there is conflict between social needs and individual interests, a means has to be sought to mediate it. This is something that the government of every sovereign country is doing. As China has a large population, the Chinese government has to limit the number of births of its citizens. This is a duty incumbent on each citizen as it serves the purpose of making the whole society and whole nation prosperous, and it is not proceeding from the private interest of some individuals. This is wholly justifiable and entirely consistent with the moral concepts of Chinese society. To talk about citizens' rights and duties out of reality in an abstract and absolute way does not hold water either in China or in any other country. In a heavily populated developing country like China, if the reproductive freedom of couples and individuals are unduly emphasized at the expense of their responsibilities to their families, children and societal interests in matters of child bearing, indiscriminate reproduction and unlimited population growth will inevitably ensue. The interests of the majority of the people, including those of new-born infants, will be seriously harmed.

We should see that in China, especially in rural, backward and remote areas, there is a gap between the desire for childbirth of some couples of child-bearing age and the demand of the present family planning policy, and shortcomings of one kind or another are unavoidable in family planning work. However, as the family planning policy fundamentally conforms to the interests of the majority of the Chinese people and, during its actual implementation, the actual difficulties and reasonable demands of some people have been taken into consideration and the legal rights and interests of the citizens are strongly protected, the family planning policy has won understanding and recognition from the broad masses of the people. Through long period of practice, the Chinese people have realized more and more deeply from their practical interests that family planning is a cause that benefits the nation and the people, and they have increasingly come to understand and support this cause. After unremitting efforts, including drawing useful experience from other countries, the management level and service quality of China's family planning programme have continually been improved and the shortcomings and problems in its actual work has been remarkably reduced. We believe that all those who do not seek to hold prejudice will respect this basic fact.

Concluding Remarks

China is home to more than one-fifth of the world's population. It thoroughly understands the responsibility it bears in stabilizing world population growth and the essential role it should play. Family planning as an effective solution to China's population problems is more than just responsibility towards the well-being of the Chinese people and future generations; it is a duty owed to maintaining the stability of the world population. Working for the common interests of all of humanity, at the same time working for individual interests of each nation, the international community and each nation should work together to solve the population problems facing individual nations and the entire world. This will promote development and progress in every country and throughout human society.

Twenty-one years have passed since the First International Population Conference was held in Bucharest in 1974. The government of each nation and the international community as a whole have made new progress in implementing the "World Population Plan of Action" and the "Mexico City Declaration." The rate of increase in world population has been further slowed. Still, world population continues to increase by 90 million per annum, and it will reach 6.25 billion by the end of the century and 8.4 billion by 2025. Control of world population remains an urgent and difficult task. China, as always, will continue to work in concert with all the nations of the world to carry out the "Programme of Action of the International Conference on Population and Development" and make positive contributions to stabilizing world population and ensuring a happier future for mankind.