The one-child policy in China
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The public impact
- Stakeholder engagement Weak
- Political commitment Strong
- Public confidence Fair
- Clarity of objectives Good
- Strength of evidence Fair
- Feasibility Good
- Management Good
- Measurement Weak
- Alignment Fair
The Chinese central government officially established the "one-child policy" in 1979 , although several initiatives for birth control had already been in place since the early 1970s and had already achieved significant reductions in the national birth rate. It aimed to control population growth, which the government began to see as a threat to the country's economic ambitions. Its basis was that a couple was allowed to have only one child. Initial efforts began in the 1960s as a critical response to the famine facing the population. "A push under the slogan 'Late, Long and Few' was successful: China's population growth dropped by half from 1970 to 1976. But it soon levelled off, prompting officials to seek more drastic measures. In 1979 they introduced a policy requiring couples from China's ethnic Han majority to have only one child (the law has largely exempted ethnic minorities)." 
To enforce this, the government granted certain benefits to those who complied (increased access to education for all, plus childcare and healthcare offered to families that followed this rule) and other measures which penalised those who did not comply, e.g., fines and no access to these benefits.  Similarly, the policy increased the legal age for marriage to 22 years for men and 20 years for women in a bid to prevent population growth. 
The birth control policies implemented varied at the national and local level. National policies, such as the one-child policy, were applicable throughout the whole country, but local policies, such as penalties for above-quota births, varied between regions, such as rural and urban, or between provinces. 
China had been actively influencing its population growth for several years, beginning after the establishment of the People's Republic of China in 1949, when Mao Zedong encouraged the population to grow in order to increase manpower. Although there was no official policy at the time, government propaganda condemned contraceptives and introduced other measures that led to the population doubling over the next few years.
This led to unexpected challenges as food supply became scarce, and from 1959 to 1961, the Great Chinese Famine killed an estimated 15 to 30 million people. As a result, the government started to reverse its campaign. "In 1979, the government introduced the one-child policy, under which most couples are allowed to have only one child or else face the possibility of fines, sterilisations, and abortions." 
The aggressive implementation of the one-child policy in China had significant impact on the growth of the birth rate and population in the country. The birth rate in China fell from 1979 onwards, and the rate of population growth dropped to 0.7%.
This caused unexpected imbalances in the demographic development of the country. Due to a traditional preference for boys, large numbers of female babies ended up homeless or in orphanages, and in some cases were killed. "In 2000, it was reported that 90 percent of foetuses aborted in China were female. As a result, the gender balance of the Chinese population has become distorted. Today it is thought that men outnumber women by more than 60 million." 
Another unintended long-term effect of this policy was that low birth rates also led to a rapid change in the population age pyramid. A study conducted before the end of the policy predicted that "the number of Chinese citizens over the age of 65 will soar to 219 million in 2030 and grow to make up a quarter of China's entire population by 2050. This means a significant portion of residents will age out of the labour force." 
The main stakeholder behind this initiative was the central government, which was very concerned that uncontrolled growth in the population could threaten the country's ambitions for prosperity. There is no evidence of consultations with stakeholders at the local or institutional level before this policy was implemented. However, there were incentives put in place to ensure the compliance of local officials, in the form of fiscal and career rewards for achieving birth targets, and penalties for falling short. Officials could even be demoted for allowing too many above-quota births in their community, which meant that they would lose all future income and other benefits associated with their roles. 
The radical nature of the policy and the risk of non-compliance opened up many opportunities for corruption. "A number of anti-corruption drives have taken place over the years, and recent reports indicate that in some areas Chinese officials themselves are among the greatest violators of family planning policies." 
Curbing population growth became a major priority for the Chinese government. "Family planning is accorded an extremely high priority by the Chinese government, which is worried that China's immense and growing population could offset the gains made by economic reforms."  Deng Xiaoping, who led the country from 1978 to 1989, made this clear in a statement on the perceived necessity of the one-child policy. "In order for China to achieve the four modernisations, it must overcome at least two important roadblocks. The first one is weak economic standing. The second one is a large population with limited arable land. Now the population is more than 900 million, 80 percent of which are farmers. The coin of a large population has two sides. Under the condition of insufficient development, all the problems related to food, education and employment are severe ones. We should deepen the implementation of the family planning policy, and even if the population does not increase in the following years, the problem of population will still exist over a long period of time." 
Significant funds were allocated to the initiative through the budget for family planning, which was increased by approximately 18% per year throughout the 1980s, and after 1991 was doubled to USD1.1 billion. 
The Chinese government rewarded those who complied with the one-child policy in numerous ways, such as preferential housing, food subsidies, medical care, education, a monthly health allowance, job promotions, and special bonuses for volunteering for sterilisation.  However, the inflexibility and swiftness with which the government implemented the one-child policy also generated significant opposition from the public, exacerbated by reports of forced abortions and other human rights issues. "Although the one-child policy — and the accompanying mass campaign of sterilisation and induced abortion — led to a decline in fertility, it also caused a popular uproar and ignited strong resistance, especially in China's vast rural areas." 
The number of forced abortions and sterilisations caused widespread bitterness and resentment. "'I support the family planning policy, but not their methods,' said Ji Shuqiang, 42, working behind the cash register at the village store. 'If they find a woman who's pregnant, no matter how far along, they'll make you have an abortion.' An older man, who despite the urging of the others was afraid to give his name, said his wife had been sterilised 34 years ago after the birth of their only child, a daughter. He was still furious. 'We hate family planning more than anything else. We don't agree with the government's policy on this.'" 
Clarity of objectives
There were several growth targets established by the government through their initial campaigns before the one-child policy was put in place: the fourth five-year plan in 1970 was the first to include targets for the population growth rate, and the target set for 1980 was a growth rate of 1%. However, as the government realised that their targets were unrealistic, most population growth rate targets were abandoned in the early 1980s. When the one-child policy was implemented, the official policy was to aim for a population of around 1.2 billion in 2000. 
Regulations included restrictions on family size, late marriage and childbearing, and the spacing of children (in cases in which second children were permitted). There were also a number of exceptions, including: families in which the first child had a disability or both parents worked in high-risk occupations (such as mining) or were themselves from one-child families (in some areas). In rural areas (where around 70% of the population lived), a second child was normally allowed after five years, but this sometimes only applied if the first child were a girl — a clear acknowledgment of the traditional preference for boys. A third child could also be allowed among some ethnic minorities and in underpopulated areas. 
Apart form the overall population target, there is no evidence of clearer objectives allowing to track the policy. This, coupled with the variability of guidelines explained above, made the policy extremely difficult to monitor.
Strength of evidence
There was a range of initiatives put in place and significant resources allocated to the implementation of the one-child policy. Family planning was coordinated at the federal level by the State Family Planning Commission (SFPC), which had approximately 520,000 full time cadres, and the Birth Planning Association, which assisted government in enforcement and implementation, had over 83 million part-time employees working at 1 million locations throughout China.  In addition, some 900,000 family planning associations had an estimated membership of between 36 and 50 million volunteers.  The government also increased the family planning budget by approximately 18% per year throughout the 1980s, and doubled it after 1991. 
The Communist Party published the new Marriage Law in 1980, mandating that couples were obliged to practise family planning, with a limit of one child for each family. This gave legal force to the policy.  However, clear communication was limited, and its interpretation and implementation were generally left to local officials to define in response to local conditions. "Sources indicate that implementation of family planning regulations differs from region to region and even within specific localities". 
The central government led the policy at the national level, with the State Family Planning Bureau setting targets and policy direction. Family planning committees at provincial and county levels were responsible of developing local strategies for implementation.  Similarly, Population and Family Planning Commissions at the national, provincial and local levels were expected to promote the policy, register births, and carry out family inspections. Provincial governments enforced the policy through a mix of rewards and penalties enforced at the discretion of local officials. “They include economic incentives for compliance and substantial fines, confiscation of belongings, and dismissal from work for non-compliance.” 
The evaluation of officials was tied to the ability to meet birth quotas within their jurisdictions. “The leaders of units who meet these birth quotas are more likely to get promotions and bonuses. If a particular area does not meet its birth quota, meaning that the number of children born is in excess of the number the government allows, the leaders of the local population control units would be held responsible for this failure and be disqualified from promotions or bonuses."  The establishment of unreasonable targets led to widespread corruption and meddling in the reporting of official figures, which is one of the most significant negative effects of the management method that was used.
The policy required restrictions on family sizes and birth figures at the local and national levels, and Population and Family Planning Commissions were responsible for implementing this mandate. “This policy stated that citizens must obtain a birth certificate before the birth of their children. In 1980, the birth-quota system was established to monitor population growth. Under this system, the government set target goals for each region. Local officials were mainly held responsible for making sure that population growth totals did not exceed target goals. If target goals were not met, the local officials were punished by law or by loss of privileges.” 
However, it not clear whether a consistent methodology was used for this, or appropriate measurements actually took place, as both the public and enforcement officials had strong incentives to conceal the real numbers. The rigour and penalties applied when enforcing the policy led people to avoid reporting for fear of repercussions, and this also affected the accurate monitoring of outcomes. "The 1995 population survey reported average male:female ratios of 108:100 in rural areas. But this is not just because of sex-selective abortion (which is now illegal, though undoubtedly still occurs), but also because of failure to report female births." 
The main driver for the central government in curtailing growth of the population was that it perceived its increase as detrimental to the growth of the economy. At the local level, however, these issues were not so relevant, so there was a need to provide a motivation for local officials to enforce the one-child policy. It used a quota reward system for Planning Officials who carried out the birth control policies. If they did not meet quotas, they were either punished or would lose the opportunity to earn promotions. 
For the population at large, the government applied incentives and sanctions to encourage compliance with the policy's goals. "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 other sanctions which ranged from social pressure to curtailed career prospects for those in government jobs. Specific measures varied from province to province.” 
An Evaluation of 30 Years of the One-Child Policy in China , 10 November 2009, The Tom Lantos Human Rights Commission
Challenging Myths About China's One-Child Policy, Martin King Whyte et al, 2015, The China Journal
China: Family planning laws, enforcement and exceptions in the provinces of Guangdong and Fujian (2010-September 2012), Immigration and Refugee Board of Canada
China one-child policy leads to forced abortions, mothers' deaths, Barbara Demick, 15 June 2012, Los Angeles Times
China One-Child Policy: Some unintended Consequences, David Howden and Yang Zhou, 2014, Institute of Economic Affairs
China's One-Child Policy, Laura Fitzpatrick, 27 July 2009, Time
China's one child family policy, Penny Kane and Ching Y Choi, 9 October 1999, US National Library of Medicine
Couples must wait for law to catch up with China's ‘second-child' policy, 31 October 2015, The Inquirer: China Daily/Asia News Network
History of the Chinese Family Planning Program: 1970-2010, Cuntong Wang, October 2011, Contraception
Managing population change - Case study: China, BBC
One-Child Policy Update, January 1995, Immigration and Refugee Board of Canada
Population Control and Consequences in China, Jamie Cook, 5 December 1999, University of Nebraska
Prepared Statement for Harry Wu, 5 November 2009, Director of Laogai Research Foundation, Human Rights Commission in Washington, DC
See How the One-Child Policy Changed China, Aileen Clarke, 13 November 2015, National Geographic
The Effect of China's One-Child Family Policy after 25 Years, Therese Hesketh, et al, 15 September 2005, The New England Journal of Medicine
The Effect of the One-Child Policy on Fertility in China: Identification Based on the Differences-in-Differences, Hongbin Li et al, 11 August 2005, The Chinese University of Hong Kong
The One Child Family Policy, W X Zhu, US National Library of Medicine
When a Son is Born: The Impact of Fertility Patterns on Family Finance in Rural China, Weili Ding and Yuan Zhang, March 2011, Queens University
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Case Study: China
The Chinese government introduced the ‘One Child Policy’ in 1979. The aim of this policy was to attempt to control population growth. The policy limited couples to one child. Under this policy couples have to gain permission from family planning officials for each birth.
If families followed this policy they received free education, health care, pensions and family benefits. These are taken away if the couple have more than one child.
The benefits of this policy are that the growth rate of China’s population has declined. Without the policy it is estimated that there would be an extra 320 million more people in a country whose population is estimated to be 1.3 billion.
The scheme has caused a number of problems in China. This is particularly the case for hundreds of thousands of young females. Many thousands of young girls have been abandoned by their parents as the result of the one child policy. Many parents in China prefer to have a boy to carry on the family name. As a result large numbers of girls have either ended up in orphanages, homeless or in some cases killed. Also, 90% of foetuses aborted in China are female.
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Case Study: China’s One Child Policy
Anti-natalist policy – A policy that tries to reduce birth rates through better education on family planning and better provision of contraception or a more rigid forced policy.
The one-child policy ran from 1979 to 2016.
- China is the 3rd largest country in the world, but only 10% of its area is good for arable farming – with much of the west covered in mountains and the north deserts.
- After Japanese occupation in World War II, the newly established Communist Party of China vowed to never allow this to happen again.
- As a result, population growth was encouraged in order to create a large and powerful army.
- These pro-natalist policies were successful to the extent that the population grew far too large to be supported by food reserves.
- By the early 1960s, over 20 million people had died from famine.
- This prompted the Chairman Mao led government to start a new anti-natalist campaign, called ‘Late, Sparse, Few’.
- A couple of years later in 1979 the One Child policy was introduced.
- Families with one child were given benefits by the government, such as free education and healthcare.
- Some argue that the policy has encouraged forced abortions and sterilizations.
- Families with more than one child paid heavily fines and taxes.
- Towards the end of the policy, rules were relaxed and families in rural areas were allowed up to two children to help with farm work.
- Since 1979, fertility rates have fallen from 6 to 1.7 (Average number of live births per 1000 women of child-bearing age per year).
- Population growth have dropped by almost 2% in 40 years.
- An estimated 250 million births have been prevented since the scheme was first adopted.
- The family planning industry has created over 300,000 jobs, and heavy fines have provided a stable income for local governments.
- Female infanticide – due to only being allowed one child, boys are preferred in order to carry on the family name. This has led to a gender imbalance in the country, there are 117 males to every 100 females. This is worst in rural areas.
- Ageing population – the 4:2:1 effect (grandparents:parents:child) has been observed as a result of the policy.
- China is still the most populated country in the world at 1.3 billion.
- Fines – Heavy fines are handed out to those that choose to have multiple children, this can often be much more than rural families can afford. If the family has no more money left, the government will take the goods the produce instead, pushing people into poverty.
- There are 6 million undocumented people in China.
- The enforcement of the policy is spatially uneven, rules in urban areas are much more strict.
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- v.319(7215); 1999 Oct 9
China’s one child family policy
a Office for Gender and Health, Department of Psychiatry, University of Melbourne, Carlton, Vic 2053, Australia, b Welfare Division, Australian Institute of Health and Welfare, 6A Traeger Court, Bruce, ACT 2617, Australia
Ching Y Choi
Competing interests: None declared.
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.
- 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
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 trends 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.
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 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.
Rural families, however, were more difficult to convince. Peasants with limited savings and without pensions needed children to support them in old age. As married daughters moved into their husbands’ families, a son was essential—and preferably more than one. Infant mortality had fallen greatly, but in 1980 it was still around 53 per 1000 live births nationally and higher than that in rural areas. 6
Years of political upheaval had left many peasants cynical about government policies and their likely duration; it also left them adept at avoiding unpopular prescriptions. Local authorities were forced to rely on fines for higher order births. They also turned to stringent birth control campaigns, which in the policy’s earlier years resulted in considerable numbers of women being bullied into abortions and sterilisation. Village level family planning workers were caught between the state’s demands and the determination of their friends and neighbours. Gradually villagers developed a process of negotiation and compromise 7 which allowed a degree of flexibility within the policy. As a result, irrespective of the particular directives at any given time, the proportion of women with one child who went on to have a second (almost universal behaviour in the late 1970s) fell only to 90% by 1990. 8
Effect of reform process on implementation
The economic reforms of recent years in China had many—often unintended—consequences for the one child family policy. Possibly the most important has been the growth of internal migration. Tight restrictions on movement, especially rural-urban movement, were relaxed as the demand for labour in the towns and cities grew. Government efforts to regulate the migrants, or even to identify their numbers, have been only partially successful. Recent estimates suggest that up to 150 million Chinese—most of them adults in their 20s and 30s—form a floating population who leave their villages for longer or shorter periods. 9 Earning cash wages, living in makeshift accommodation, moving between jobs and between cities and their home villages, these people are seldom eligible for state provided services and see no reason to draw official attention through temporary registration.
One result has been declines in the reliability of population statistics, already compromised by the reluctance of family planning workers to admit their inability to achieve the results demanded of them. In 1991-2, perhaps a quarter of all births were missed. 10 As a result, although China’s official total fertility rate for 1990-5 was 1.92 children, 11 it may be more realistic to assume total fertility around the replacement level—that is, a little over two children per couple.
Although both male and female births are underreported, the birth of a girl is twice as likely to be ignored. 12 Underreporting is believed to account for about half to two thirds of the difference in infant sex ratios, which by the early 1990s had risen to 114 boys for every 100 girls. Unrecorded daughters may be left with relatives, adopted out, or abandoned to orphanages, 13 which are increasingly unable to cope with the influx. Sex ratios are further skewed by widespread abortion, after the illegal but lucrative use of ultrasound to identify fetal sex.
In many rural areas rising incomes make it possible to see the fine for an additional child as a feasible investment strategy. At the same time peasants are increasingly saving for old age through a variety of retirement schemes, some offered through non-government family planning associations. These family planning associations, besides promoting family planning and the one child policy, offer various social welfare benefits including training and income generating loans for rural women and basic maternal and child health screening and care. 14
The introduction of fees for health services has had severe consequences for poorer peasants, and many women are unable to access reproductive health services, including maternity care or even follow up for contraceptive problems. One recent provincial survey found that over 70% of diagnosed women in a random sample had at least one reproductive tract infection. 15
A long standing challenge to effective family planning had been the poor quality and limited choice of contraceptives, especially in rural areas reliant largely on intrauterine devices and sterilisation. With support from international agencies, especially the UN Population Fund, quality has been improved (manufacture of the unreliable steel ring intrauterine device ceased in 1994). A wider range of methods is becoming available, and despite the extra cost to the individual they are proving popular.
Urban dependence on the state for employment, housing, education, and other benefits, which facilitated compliance with the one child policy, is being progressively reduced. However, although some in lucrative private work may choose to ignore the policy, for most people the increased costs and greater insecurity which they now face probably contribute to caution in family building. Instead, incomes are channelled into buying better health care and education for the sole child and providing the desirable brand name toys and clothes now available. Concerns over spoilt “little emperors” are widespread, and some family planning associations now run parent education classes to counter parents’ overprotective behaviour.
Outcomes of one child policy
The one child policy has unquestionably imposed great costs on individuals, even if (as has been suggested 16 ) these costs have to be seen in the context of a Chinese tradition in which demographic decisions have never been individual. Most Chinese people seem prepared to make such a sacrifice if the pain is generally shared. 17 , 18 In 1993, the family planning associations were officially given a supervisory role in monitoring coercion and other abuses in implementing the policy. The complaints they receive almost invariably relate to unfair favourable treatment of cadres or other favoured individuals.
The main criticism of the policy, though, is undoubtedly its stimulus to sex discrimination. Faced with hard choices about overall numbers, the Chinese girl child has once again become expendable. Too many girls, if not aborted, face orphanages or second class lives concealed from the world and with reduced chances of schooling and health care. China has one of the world’s highest rates of suicide of women in the reproductive years. 19 Increased pressure to produce the desired child, and a perceived reduction in the value of females, can only have exacerbated the problems of rural women.
At the same time, the successes of the policy should not be underrated. In the context of rising costs and rising aspirations throughout China, there is increasing recognition among the four fifths of the population that is rural of the burden to the family of having a third child, and some are even willing to avoid a second. 20 Moreover, since its inception reductions in Chinese fertility have reduced the country’s (and the world’s) population growth by some 250 million. These reductions in fertility have eased at least some of the pressures on communities, state, and the environment in a country which still carries one fifth of the world’s people.
From A Collection of Cartoons on Marriage and Children (Hun yu bai tai man hua ji) by NING Changhui, 1989.
One is ideal, said Mao