Therese Hesketh, One Child Policy: impacts on reproductive health and attitudes
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Since its introduction in 1979, the one child policy has had a direct impact on the lives of over one-fifth of the world’s population. The policy has influenced reproductive choice, preferred family size and access to abortion. In a country where preference for male offspring is common, and where there is easy access to abortion, it has also contributed to an excess of male births. Some relaxation of the policy has started, and this is expected to continue. Therese Hesketh is Professor of Global Health at the UCL Centre for International Health and Development. She trained in paediatrics and public health in the UK and has extensive experience as a clinician and health researcher in Asia. She has taken the lead on a number of large collaborative population studies in China: in health system reform, the health needs of rural-urban migrants, reproductive health, and the demographic, health and social effects of the one child policy.
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Therese Hesketh, One Child Policy: impacts on reproductive health and attitudes
- 1. One Child Policy: impacts on reproductive health and attitudes Therese Hesketh UCL Centre for International Health and Development
- 7. Provincial Policies XINJIANG QINGHAI NEI MONGOL GANSU NINGXIA SHAANXI XIZANG SICHUAN CHONGQING YUNNAN GUIZHOU GUANGXI HAINAN TAIWAN HUNAN JIANGXI ZHEJIANG FUJIAN GUANGD ONG HONG KONG MACAU Shanghai SHANGHAI SHI Guangzhou Chengdu JIAN GSU ANHUI HUBEI HENAN SHANXI SHANDONG Beijiing Shenyang HEBEI BEIJING SHI TIA NJIN LIAONING JILIN HEILONGJIANG Relaxed 1 Child Policy Medium 1 Child Policy Strict 1 Child Policy
- 8. Policy underpinned by easy access to contraception and abortion
- 11. Has reduced Total Fertility Rate Late, Long, Few One Child Policy Great Leap Forward
- 12. Source: World Bank And compared to other nations
- 18. Sex Ratio at birth in China since onset of Policy Sex-selective Abortion
- 19. Sex ratio in 1-4 age band XINJIANG QINGHAI NEI MONGOL GANSU NINGXIA SHAANXI XIZANG SICHUAN CHONGQING YUNNAN GUIZHOU GUANGXI HAINAN TAIWAN HUNAN JIANGXI ZHEJIANG FUJIAN GUANGD ONG HONG KONG MACAU Shanghai SHANGHAI SHI Guangzhou JIAN GSU ANHUI HUBEI HENAN SHANXI SHANDONG Shenyang HEBEI BEIJING SHI TIA NJIN LIAONING JILIN HEILONGJIANG 110 - 120 120 - 130 > 130 < 110
- 20. Provincial Policies XINJIANG QINGHAI NEI MONGOL GANSU NINGXIA SHAANXI XIZANG SICHUAN CHONGQING YUNNAN GUIZHOU GUANGXI HAINAN TAIWAN HUNAN JIANGXI ZHEJIANG FUJIAN GUANGD ONG HONG KONG MACAU Shanghai SHANGHAI SHI Guangzhou Chengdu JIAN GSU ANHUI HUBEI HENAN SHANXI SHANDONG Beijiing Shenyang HEBEI BEIJING SHI TIA NJIN LIAONING JILIN HEILONGJIANG Relaxed 1 Child Policy Medium 1 Child Policy Strict 1 Child Policy
- 21. SRB by birth order rises dramatically in some provinces Source: 2005 1% survey 142 138 111 Hainan 167 146 108 Guangdong 176 166 104 Henan 206 178 108 Jiangxi 227 190 107 Anhui Third Second First
- 27. Attitudes to family size Source Ding & Hesketh 2006
- 31. END
Notas do Editor
- Includes attitudes
- Assume all know about the policy how it works etc Caveat: what changes are attributable to the Policy?
- Has created mostly one-child urban families, mostly two-child rural families, third and higher order births 9% Rural popualtion around 70%
- One and a half polcvy
- Long term contraception
- PUBLIC HEALTH DILEMMAS - CHOICE VS POPULATION BENEFIT Feels very oppressive/ Dracnonian. Today’s world of carbon footp[rints – world should be grateful.
- Tantalising question: would the decline have continued? Population still growing because 0.65% 148 in the world
- Just some perspective – look at other countries with no policy.
- How to make people accept restriction of choice in something so fundamental as reproduction
- How did the Chinese achieve this? Winning hearts and minds-Propaganda and carrots and sticks Too many people in China
- Quality, not quantity
- Example of extreme choice which has been influenced by the Policy. Normal sex ratio at birth 103-107 males to 100 females SSA illegal
- It was high in the 1930s and 40s, then declined after the Communist Revolution Many other Asian countries have high sex ratios: Taiwan 1.19, South Korea 1.12, parts of India 1.2 (Sen, 2002) Increase in sex ratio on China coincided with cheap, accessible ultrasound in rural and suburban areas
- Highest sex ratio in medium strict provinces 7 normal provinces have sex ratios of <110 only 8% of the population % high provinces have 25% of the population
- One and a half polcvy
- Reproductive Choice to go for sex selective abortion being made with second births
- 19% of People’s congress female. Women’s status increased paradoxically
- BUT did they mind….?
- Dramatic change in South Korea with enforcement of the law and publicity campaigns. But IS THIS because of the Policy??
- Graduate unemployement concerns When allowed to have more they choose not to
- People said thay knew others who hadn’t wanted an abortion but were pressurised into getting on e