Indian .7,. Pediatr. 44 : 78, 1977
FAMILY PLANNING IN CHINA* Wax WEN Peking
Against the background of two striking posters on family planning hung up on the wall (Plate 1, Fig. 1) K u a n Chih-chin, woman director of the health centre run by tile Tunchuan Lane Residents' Committee in Peking, was carefully keeping records on a card. The entries were about a 36-year-old woman worker, mother of a six-year-old, who recently had a sterilization operation after giving birth to her second child, a boy. For the six years previously she had been practising birth control under the health centre's guidance and coming here regularly to get contraceptives free of charge. Apart from giving advice on disease prevention and treating minor complaints and injuries for more than 600 households, this health centre is also in charge of birth control in this lane. It keeps a set of cards on which are entered the age, number of chi!d-births, contraceptive methods used etc, concerning all the 364 women in the childbearing age group. The centre has a staff of six, helped by a group of sparetime family planning workers elected by the residents. They pay regular visits to couples in the child-bearing age group, giving publicity to the significance of family planning and supplying them with free contraceptives. As neighbonrs, the visitors and tile hosts talk together lightly and freely. Only 12 babies were born in 1976 in this lane. *From China Features, P.O. Box 522, Peking.
There are 800 or more neighbourhoodrun health centres like this one in Peking. They are a component of the city's family-planning service network which covers state-run hospitals and clinics of government offices and factories. The family-planning work of these medical organizations is conducted under the guidance of the leading bodies in charge of birth control set up by the revolutionary committees at all levels. Family planning in Peking is directeed by a special group set up under the municipal administration. Family planning in China is carried out on a voluntary basis under state guiddance. Consequently, the rate of population growth of the country has been declining year by year, with remarkable results achieved in many areas. In Kiangsu province, east China, the population growth decreased to around 11 per thousand in 1976 as against 27.4 per thousand in 1965. China follows the policy of regulating the population increase in a planned way not because of there being such problems as "surplus population" or "population exp]osion". As a developing socialist state, she develops her national economv in a planned way and proportionately, and this calls tbr planned population growth. Since the founding of the People's Republic, the annual pooulation growth has averaged around two per cent but the annual increase of grain output has averaged nearly four per cent. W h h only a little over 10 per cent
~,VEI X~,rEN--FAMILY P I . A N N I N G IN C H I N A
of her land area under the plough and tile per-hectare grain yield and the level of mechanization not high, the country has a vast potential for raising grain output. Family planning in China is carried out in accordance with the existing conditions in different areas. In densely populated areas with a high birth rate, late marriage and birth control are advocated; in sparselypopulated areas, the national minority areas in particular, appropriate measures are adopted to facilitate population growth. Urban and rural hospitals and clinics offer regular services to give advice on contraception. Urban medical workers are organized in groups to tour rural people's communes to disseminate information on contraception and help rural health workers raise their technical level in this field. Quite a number of commune-run clinics are able to apply such contraceptive techniques as setting in place and taking out the intrauterine ring, and tying up Fallopian tubes or spermatic ducts. Barefoot doctors in many production brigades have also learned how to handle the intrauterine ring. With medicine kits shmg across their shoulders, they make rounds of peasant homes to give the needed services. The state supplies contraceptive drugs and devices free of charge. In both countryside and city, cadres in charge of women's work, midwives, barefoot doctors, sparetime health and family-planning workers in rural communes, factories, government organizations and other set-ups distribute contraceptives to the people who need them. Many trading stores have special counters supplying free contraceptives. Operations, including sterilization and abortion, are given without any charge for medicine
79 used, surgery and medical examinations. The in-patients have to pay only for their meals. Sick leave is granted to those under-. going such operations with the duration determined in the light ot the operation involved. During such leave, office and factory workers draw full pay and members 0 f p e o p l e ' s communes receive a subsidy in work-points. Planned parenthood protects the health of both women and children and frees more women for work. Along with encouraging success achieved in birth control, attention is paid to maternity and child care to ensure the highest possible rate of survival and healthy growth of new-born babies. Experience in many places shows that this helps with the success in family planning as parents are assured that the few children they already have will survive and grow up in health. To drive home the significance of family planning to the masses, great attention is paid to publicity work, which is carried out mainly by the people themselves. Apart from millions of voluntary spare-time family planning workers among the masses, special publicity groups have been organized in many places to work at grossroots units. They publicize the need and methods of birth control through the media of exhibitions, the press, pamphlets, broadcast programmes, slide shows or art performances. In general, married women are advised to have no more than two children, spaced out three or four years apart. Late marriage is encouraged. Before nationwide liberation in 1949, it was common in the rural areas for people to get married at 15 or 16. Today, rural men and women are encouraged not to marry before
80
INDIAN JOURNAL OF PEDIATRICS
25 and 23 years of age, respectively. Urban dwellers are advised to marry at still older 9ages. By marrying late, people may be in a better position to concentrate their energy on political study and professional training. Nevertheless, marriage registrations are granted to those who insist on getting married at the marriageable ages stipulated in the Marriage Law instead of at those advocated. The movement criticizing Lin Piao and Confucius which started in 1974 has greatly
V o L 44, No. 350 promoted planned parenthood. This movement helps people get rid of such old ideas as " m e n are superior to w o m e n " and "treasuring a man while looking down upon a w o m a n " , preached by Confucius over 2,000 years ago. In the past, many couples indoctrinated with such ideas looked forward to a boy even after giving birth to a number of girls. Now, even in the countryside, there are many couples who do not want to give birth to a boy after having two girls.
FAMILY PLANNING IN CHINA* Wax WEN Peking
Against the background of two striking posters on family planning hung up on the wall (Plate 1, Fig. 1) K u a n Chih-chin, woman director of the health centre run by tile Tunchuan Lane Residents' Committee in Peking, was carefully keeping records on a card. The entries were about a 36-year-old woman worker, mother of a six-year-old, who recently had a sterilization operation after giving birth to her second child, a boy. For the six years previously she had been practising birth control under the health centre's guidance and coming here regularly to get contraceptives free of charge. Apart from giving advice on disease prevention and treating minor complaints and injuries for more than 600 households, this health centre is also in charge of birth control in this lane. It keeps a set of cards on which are entered the age, number of chi!d-births, contraceptive methods used etc, concerning all the 364 women in the childbearing age group. The centre has a staff of six, helped by a group of sparetime family planning workers elected by the residents. They pay regular visits to couples in the child-bearing age group, giving publicity to the significance of family planning and supplying them with free contraceptives. As neighbonrs, the visitors and tile hosts talk together lightly and freely. Only 12 babies were born in 1976 in this lane. *From China Features, P.O. Box 522, Peking.
There are 800 or more neighbourhoodrun health centres like this one in Peking. They are a component of the city's family-planning service network which covers state-run hospitals and clinics of government offices and factories. The family-planning work of these medical organizations is conducted under the guidance of the leading bodies in charge of birth control set up by the revolutionary committees at all levels. Family planning in Peking is directeed by a special group set up under the municipal administration. Family planning in China is carried out on a voluntary basis under state guiddance. Consequently, the rate of population growth of the country has been declining year by year, with remarkable results achieved in many areas. In Kiangsu province, east China, the population growth decreased to around 11 per thousand in 1976 as against 27.4 per thousand in 1965. China follows the policy of regulating the population increase in a planned way not because of there being such problems as "surplus population" or "population exp]osion". As a developing socialist state, she develops her national economv in a planned way and proportionately, and this calls tbr planned population growth. Since the founding of the People's Republic, the annual pooulation growth has averaged around two per cent but the annual increase of grain output has averaged nearly four per cent. W h h only a little over 10 per cent
~,VEI X~,rEN--FAMILY P I . A N N I N G IN C H I N A
of her land area under the plough and tile per-hectare grain yield and the level of mechanization not high, the country has a vast potential for raising grain output. Family planning in China is carried out in accordance with the existing conditions in different areas. In densely populated areas with a high birth rate, late marriage and birth control are advocated; in sparselypopulated areas, the national minority areas in particular, appropriate measures are adopted to facilitate population growth. Urban and rural hospitals and clinics offer regular services to give advice on contraception. Urban medical workers are organized in groups to tour rural people's communes to disseminate information on contraception and help rural health workers raise their technical level in this field. Quite a number of commune-run clinics are able to apply such contraceptive techniques as setting in place and taking out the intrauterine ring, and tying up Fallopian tubes or spermatic ducts. Barefoot doctors in many production brigades have also learned how to handle the intrauterine ring. With medicine kits shmg across their shoulders, they make rounds of peasant homes to give the needed services. The state supplies contraceptive drugs and devices free of charge. In both countryside and city, cadres in charge of women's work, midwives, barefoot doctors, sparetime health and family-planning workers in rural communes, factories, government organizations and other set-ups distribute contraceptives to the people who need them. Many trading stores have special counters supplying free contraceptives. Operations, including sterilization and abortion, are given without any charge for medicine
79 used, surgery and medical examinations. The in-patients have to pay only for their meals. Sick leave is granted to those under-. going such operations with the duration determined in the light ot the operation involved. During such leave, office and factory workers draw full pay and members 0 f p e o p l e ' s communes receive a subsidy in work-points. Planned parenthood protects the health of both women and children and frees more women for work. Along with encouraging success achieved in birth control, attention is paid to maternity and child care to ensure the highest possible rate of survival and healthy growth of new-born babies. Experience in many places shows that this helps with the success in family planning as parents are assured that the few children they already have will survive and grow up in health. To drive home the significance of family planning to the masses, great attention is paid to publicity work, which is carried out mainly by the people themselves. Apart from millions of voluntary spare-time family planning workers among the masses, special publicity groups have been organized in many places to work at grossroots units. They publicize the need and methods of birth control through the media of exhibitions, the press, pamphlets, broadcast programmes, slide shows or art performances. In general, married women are advised to have no more than two children, spaced out three or four years apart. Late marriage is encouraged. Before nationwide liberation in 1949, it was common in the rural areas for people to get married at 15 or 16. Today, rural men and women are encouraged not to marry before
80
INDIAN JOURNAL OF PEDIATRICS
25 and 23 years of age, respectively. Urban dwellers are advised to marry at still older 9ages. By marrying late, people may be in a better position to concentrate their energy on political study and professional training. Nevertheless, marriage registrations are granted to those who insist on getting married at the marriageable ages stipulated in the Marriage Law instead of at those advocated. The movement criticizing Lin Piao and Confucius which started in 1974 has greatly
V o L 44, No. 350 promoted planned parenthood. This movement helps people get rid of such old ideas as " m e n are superior to w o m e n " and "treasuring a man while looking down upon a w o m a n " , preached by Confucius over 2,000 years ago. In the past, many couples indoctrinated with such ideas looked forward to a boy even after giving birth to a number of girls. Now, even in the countryside, there are many couples who do not want to give birth to a boy after having two girls.
