China's fertility policy
The Central Committee and the State Council’s Decision on Optimising Fertility Policy and Facilitating Long-term Balanced Population Development
The Central Committee and the State Council jointly issued the Decision on Optimising Fertility Policy and Facilitating Long-term Balanced Population Development (hereafter “the Decision”) on June 26. The full text of this decision was made public via Xinhua on July 20. Xinhua also published an explainer in the form of an interview with the head of the Department of Population Monitoring and Family Development, National Health Commission.
Before examining the Decision, some background…
China’s population is ageing fast. According to China’s 2020 national census, 18.7 per cent of China’s population are 60 years or older. In 2010, the figure was 13.3 per cent.
This population ageing is driven by the sharp decline in China’s fertility rates, currently sitting among the lowest in the world. From 1980 to 2021, China’s total fertility rate halved from 2.6 to 1.3 children per woman. Socioeconomic changes and government policy aimed at reducing fertility are behind this decline.
Population ageing and fertility decline pose serious social and economic challenges for China. A shrinking working-age population could constrain China’s economic development, reshape social relations, and put upward pressure on public spending. Internationally, a shrinking population may reduce China’s influence over the long run.
Low fertility (coupled with higher life expectancy) is a worldwide phenomenon. The experiences of countries such as Japan, South Korea and Spain illustrate some of the challenges faced by China. For these countries, low fertility rates have persisted for long periods despite pro-natalist policies.
Indeed, for China, fertility continued falling despite the relaxation of the ‘one-child policy’ in 2013 and its termination in 2015. In light of this, population ageing and fertility decline has become a priority issue for the Chinese Government.
In March this year, the Chinese Government released the Outline of the 14th Five-Year Plan for National Economic and Social Development and the Long-Range Objectives Through 2035 (Chinese | English). The 14th Five-Year Plan (14FYP) runs from 2021 to 2025. On population ageing, it commits to the implementation of a national strategy. This strategy include the development of a long-term population development strategy, the optimisation of fertility policy, and the promotion of long-term balanced development of the population. The 14FYP states that the Chinese Government will attempt to lift fertility levels, improve infant and child development policies, and improve elder care service systems.
The Decision is the central directive on the implementation of the ‘three-child policy’ and supporting measures. You can read my full translation of the Decision in the next section.
I translated the Decision because it tells us about Beijing’s fertility policy, and how China’s leadership views population development and ageing, fertility, and the role of the state in individuals’ fertility choices. These are all important for China’s future.
On a personal level, late last year Katharina and I became first-time parents with the birth of our daughter Eli. Parenthood has prompted me to think about a whole range of child-rearing issues. It has also made me reflect on my own upbringing, including the effects of ‘one-child policy’ on me personally. I grew up in Shanghai in the 1980s/1990s - at times I wonder what it would be like to grow up with siblings…
In any case, back to the Decision…
The Decision does three key things. First, it emphasises the importance of optimising fertility policy and promoting long-term balanced population development for China’s socioeconomic development.
Second, it sets objectives for 2025 and 2035. By 2025, Beijing aims to have a system in place to elevate the fertility level. By 2035, it aims to have elevated fertility to an appropriate level and substantially improved the population structure.
Third, in order to achieve the above objectives, the Decision outlines measures to implement the ‘three-child policy’, improve childbirth and upbringing services, develop an inclusive childcare service system, and reduce the cost of childbirth, parenting and education.
In the coming months and years, we will likely see more pro-natalist policies coming out of Beijing. While the Chinese Government can try to reduce the burden and cost associated with having more kids, its unclear that it policies will be able to counteract trends driving fertility lower, such as changing social norms, gender roles and relations, and personal choices.
Population development is a major issue concerning the development of the Chinese nation. The following decision has been made in order to implement the spirit of the 19th Communist Party of China (CPC) National Congress and the 2nd, 3rd, 4th and 5th Plenary Sessions of the 19th CPC Central Committee, and to facilitate the long-term balanced development of the population. This decision pertains to the optimisation of fertility policy; the implementation of the [new] policy allowing each couple to have three children; the abolition of restrictive measures, such as the Social Support Fee [fines for excess births], and other relevant penalties; and the implementation of supporting measures to encourage fertility (hereinafter collectively referred to as “the implementation of the three-child birth policy and supporting measures”).
I. Fully recognise the significance of optimising fertility policy and promoting long-term balanced population development
The Party and the state have always adhered to population-development integrated decision-making. We have laid a solid foundation for building a moderately prosperous society [Xiaokang] in all aspects through economic development and social progress, which has been actively facilitated by the scientific grasping of the laws of population development, and adherence to the basic national policy of family planning.
Since the 18th Party Congress [in November 2012], the Party Central Committee has attached great importance to population issues. On the basis of our nation’s demographic changes, it made the major decision to gradually adjust and improve fertility policy and facilitate long-term balanced population development. This work has shown significant progress.
At present, the implementation of the three-child birth policy and supporting measures is of great significance for further adapting to the new changes in the demographic situation and the new requirements for promoting high-quality development.
(1) The implementation of the three-child birth policy and supporting measures is conducive to improving the demographic structure and for actively carrying out the national strategy responding to an ageing population. Population ageing is a major global demographic trend and a major challenge for China’s development. The ageing of China's population is expected to enter a moderate stage during the 14th Five-Year Plan period [2021-2025] and a severe stage around 2035. This will have a profound and long-term impact on all areas of economic operation, social construction and societal culture. The implementation will help to unlock fertility potential, slow down the process of population ageing, promote inter-generational harmony, and enhance the overall vitality of society.
(2) The implementation of the three-child birth policy and supporting measures is conducive to maintaining China’s human resource endowment advantages and for responding to a world undergoing great transformations unseen in a century. The population is critical to social development as well as a key variable affecting sustainable economic development. The implementation is conducive to maintaining an appropriate total population and labour force size into the future. It is also conducive to the better utilisation of the fundamental, broad, and strategic role of population factors, and provides effective human capital and domestic demand support for high-quality development.
(3) The implementation of the three-child birth policy and supporting measures is conducive to moderating the trend of declining overall fertility rate and promoting an appropriate level of fertility. The public's attitude towards fertility has in general shifted towards having fewer children and directing more resources to their upbringing. Financial burdens, childcare, and women's concerns about career development, etc have become the main constraints on fertility. The implementation will advance fertility policy and, together with related economic and social policies, work to better meet the fertility wishes of more families and boost fertility levels.
(4) The implementation of the three-child birth policy and supporting measures is conducive to consolidating the achievements from building a moderately prosperous society in all aspects, and promoting the harmonious coexistence of human beings and nature. In the near future, the basic fact of China with a large population will not change; population and the carrying capability of environmental resources are still in a tight balance; and the contradictions between population and development in areas emerging from poverty and in some ecologically fragile and resource-poor areas are still prominent. The implementation is conducive to further consolidating the achievements from poverty eradication and building a moderately prosperous society. It will also be conducive to guiding the reasonable regional distribution of population and promoting the coordinated and sustainable development of population as well as the economy, society, resources, and the environment.
II. Guiding thoughts, key principles and objectives
(5) Guiding thoughts:
adhere to the guidance of Xi Jinping Thought on Socialism with Chinese Characteristics in the New Era;
base on the New Development Stage, implement the New Development Concept and build the New Development Pattern;
implement the national strategy to actively respond to population ageing;
implement the three-child birth policy and supporting measures;
reform the service management system;
enhance the capacity of families to develop;
promote the realisation of an appropriate level of fertility;
promote the long-term balanced development of the population; and
provide a solid foundation and enduring momentum for building a wealthy, strong, democratic, civilised and beautiful modern socialist nation that is powerful, and for realising the China Dream of the great rejuvenation of the Chinese nation.
(6) Key principles
Put people at the centre. In conformity with the expectations of the people, we must actively and steadily promote the optimisation of fertility policy; promote a coordinated and equitable fertility policy; meet the diversified fertility needs of the public; consider marriage, childbirth, upbringing and education together as parts of an integrated whole; effectively address the concerns of the public with regards to post-birth issues; and release the fertility potential, and promote family harmony and happiness.
Take balance as the main direction and theme [for policy]. We must place the promotion of long-term balanced population development within the broader context of the work of the Party and nation as a whole, and as a part of the planning of, and deployment for, modernisation construction; balance multiple policy objectives; consider issues, including population size, quality, structure and distribution, in an integrated manner; promote the coordinated and sustainable development of population as well as the economy, society, resources and the environment; and promotes the all-round development of human beings.
Take reform as the driving force. We must focus on the outstanding contradictions and problems facing China's population development; focus on the [nation’s] strategic arrangements for modernisation; deepen reform; eliminate the concepts, policies and regulations, institutional mechanisms and other constraints that [negatively] affect the long-term balanced development of the population; and improve the capacity and standard of population governance.
Use the rule of law as the guarantee. We must insist that major reforms are legal and implemented in accordance with the law; turn into law the innovative ideas, reform achievements and practical experience of the Party in leading the people in planning and resolving population-related issues; safeguard the legal rights and interests of the people; guarantee the steady progress of population work in the new era; and ensure the successful realisation of the population development strategic objectives.
(7) Key objectives
By 2025, the active fertility support policy system shall be basically established; the service management system shall be basically complete; the standard of services for the birth and upbringing of children shall be significantly improved; the construction of an inclusive childcare service system shall be accelerated; the costs of childbirth, parenting and education shall be significantly reduced; the fertility level shall be appropriately elevated; the sex ratio at birth shall be moving towards normalisation; the population structure shall be gradually optimised; and the quality of the population shall be further improved.
By 2035, the policy and regulatory system for promoting long-term balanced population development shall be even more complete; the service management mechanism shall be functioning efficiently; the fertility level shall be even more appropriate; population structure shall be further improved. The level of services for natal care, prenatal care, and upbringing of children as well as childhood education shall be commensurate with the people's need for the good life; the family capacity for development shall be significantly improved; and more obvious and substantial progress shall be made in the all-round development of people.
III. Effectively organise and implement the three-child birth policy
(8) Implement the three-child birth policy in accordance with the law. Amend the Law of the People's Republic of China on Population and Family Planning; advocate marriage and childbirth at the suitable age, and excellent services for natal care, prenatal care, and upbringing of children; and implement the three-child birth policy. Every province (autonomous region, municipality directly under the Central Government) shall consider local population development trends, conditions for carrying out this work, and risks in policy implementation in their respective regions. They shall make effective and integrated policies, and organise and implement them in accordance with the law.
(9) Abolish the Social Support Fee [fines for excess births] and other restrictions. Abolish the Social Support Fee, and clean up and repeal relevant penalty provisions. Fully de-link an individual’s fertility status with household registration, school enrolment and entry into the labour force, etc. Properly deal with historical legacy issues in accordance with the law and regulations. In regions where the contradictions are more prominent — between population development on the one hand, and the economy, society, resources, and the environment on the other — strengthen publicity and guidance, promote the effective interface between relevant policies that benefit the people and fertility policy, and carry out management service work with precision.
(10) Establish a sound population service system. Focusing on “one senior, one child”, establish and improve a population service system that covers the entire life cycle of a person. Strengthen the management system and capacity of grassroots services, and enhance the functions of childcare and elderly care. Implement a birth registration system and provide guidance on childbirth counselling. Implement an integrated system under which multiple registrations could be made simultaneously, including for medical birth certificate, child vaccination, household registration, medical insurance, and social security card etc.
(11) Strengthen population monitoring and research on population trends. Improve the national life registration management system; complete a population monitoring system that covers the entire population over the whole life cycle; and closely monitor the fertility situation and trends, and changes in the population. Rely on the national population basic information database and other platforms to realise the integration, sharing and dynamic update of information pertaining to population services, including education, public security, civil affairs, health, medical insurance, social welfare etc. Establish a system of indicators for long-term balanced population development and improve the population forecast and early warning system.
IV. Improve the services associated with childbirth and upbringing
(12) Safeguard maternal and infant health. Fully implement the five systems for maternal and infant safety, including pregnancy risk screening and assessment, special case management for high-risk pregnant women, treatment of critical emergencies, reporting of maternal deaths for individuals, and notification for interviews etc. Implement the project to safeguard maternal and infant health; accelerate the standardisation of maternal and infant healthcare systems at all levels of government, and their management; strengthen the capacity for critical maternal and neonatal care and the building of pediatric departments; consolidate the grassroots networks at the county, township and village levels; accelerate the patching up of shortcomings in maternity-related public services. Promote the integration of reproductive health services into the entire process of women's health management. Strengthen the standardisation of child health clinics and their construction; and enhance the screening, diagnosis and intervention among children and youths with respect to health illnesses and risks, such as near-sightedness, nutritional imbalance, dental caries etc. Effectively carry out work to ensure basic medical coverage for children.
(13) Prevent and treat birth defects in an integrated manner. Improve the network for the prevention and treatment of birth defects and implement the three-tiered preventive measures. Strengthen the dissemination of relevant knowledge and consultation on the prevention and treatment of birth defects; enhance premarital healthcare; promote prenatal health check-ups; strengthen prenatal screening and diagnosis; and promote integrated management and services, and medical multidisciplinary collaboration with respect to the perinatal, prenatal and postnatal periods. Expand the scope of screening for newborn illnesses and diseases, and promote early screening, diagnosis and treatment. Effectively carry out the work to provide basic medical assistance and rehabilitation to children with birth defects.
(14) Regulate the application of assisted reproductive technology. Strengthen planning and leadership; tighten technical approvals; and build an assisted reproductive technology system that is well laid out and balances supply with demand. Strengthen the supervision of assisted reproductive technology services and strictly regulate the application of related technologies. Undertake targeted research and development to improve fertility, and standardise infertility diagnosis and treatment services.
V. Develop an inclusive childcare service system
(15) Establish a robust system of supporting policies, and standards and specifications. Incorporate infant and child care services into economic and social development planning; strengthen policy guidance; and guide the active participation of social forces through improved support policies on land, housing, finance and human resources. Develop overall solutions, establish working mechanisms, and drive the healthy development of childcare services at the level of municipal and prefectural administrative units. Step up efforts to train professionals and progressively implement a system of professional qualification for practitioners in accordance with the law. Develop new industries such as smart childcare, and foster national brands in childcare and development services, dairy powder and milk, animation design and production, etc.
(16) Vigorously develop various forms of inclusive services. Exert the guiding and leveraging role of investment from the central government budget to promote the construction of a batch of childcare service institutions. They should provide services that are convenient and accessible, reasonably priced, and of guaranteed quality. Support employers who are in a position to do so to provide childcare services for their employees. Encourage state-owned enterprises and other entities to actively participate in the construction of inclusive childcare service systems driven by governments at all levels. Strengthen the construction of community childcare service facilities, and improve activity areas and service facilities for infants and children in residential communities. Develop management methods for family childcare nursery. Support childcare models such as intergenerational care and mutual family support. Support the housework industry expand their childcare services. Encourage and support kindergartens that are in a position to do so to enrol toddlers aged 2 to 3.
(17) Strengthen integrated supervision. All types of institutions carrying out infant and toddler care services must comply with relevant national and local standards and specifications. They must also bear the main responsibility for the safety and health of infants and toddlers. Local governments must assume responsibility for supervision, and establish and improve registration and file-keeping , information disclosure, and evaluation systems. They must strengthen dynamic management, and establish emergency mechanisms for special situations, for example, when [childcare] institutions need to be temporarily or permanently closed.
VI. Reduce the cost of childbirth, parenting and education
(18) Improve the maternity leave and maternity insurance system. Strictly implement the systems, including maternity leave and breastfeeding leave. Support pilot schemes for parental leave in areas where conditions exist and improve the mechanism for sharing the cost of leave. Continue to provide maternity insurance coverage for the medical costs of childbirth and maternity allowance entitlements for insured female workers, and provide coverage for the medical costs of childbirth for urban and rural residents who are participants in medical insurance schemes so as to reduce the burden of medical costs for childbirth.
(19) Strengthen taxation, housing and other support policies. In conjunction with the next revision of the Personal Income Tax Law, studies shall be conducted to promote the inclusion of expenses for the care of infants and children under the age of three as a special additional deduction item for the purpose of personal income tax. When allocating public rental housing, local governments should give appropriate consideration to families with minors that meet local conditions for public rental housing under housing security schemes. They should give appropriate consideration to the housing options etc for these families based on the number of minors in the household. Local governments may study and formulate preferential policies with respect to the differentiated rental and purchase of housing [in terms of pricing and purchase conditions] based on family burden pertaining to minors in the household.
(20) Promote education equity and the supply of quality education resources. We will promote the governance of kindergartens in urban areas; continue to improve the coverage rate of public kindergartens, and appropriately extend the length of possible stay in kindergartens for kids or provide custodial services. We will promote the quality and balanced development of compulsory education and urban-rural integration, and effectively solve the problem of “school choice fever”. Relying on school education resources, and based on the principles of public welfare and inclusiveness, we shall fully implement after-school cultural and sports activities, social practice programmes, and custodial services. This should help align school hours with after-work hours of the parents. We need to improve the quality of in-school teaching and education evaluation and include the frequency and fees for student participation in extra-curricular tuition as issues for the education supervision and guidance system. We must balance the burden of education between families and schools, and strictly regulate extracurricular tuition.
(21) Protect the legitimate rights and interests of women in employment. We must regulate the recruitment and hiring practices of government organs, enterprises and other employers to promote equal employment opportunities for women. We must implement the Special Rules on the Labor Protection of Female Employees, and regularly conduct special inspections on the protection of the rights and interests of female workers with respect to childbirth. We should provide re-employment training as a public service for women whose employment has been interrupted by childbirth. We must make maternity friendliness an important aspect of employers’ social responsibility, and encourage employers to develop measures that facilitate employees’ work-family balance and negotiate in accordance with the law to determine flexible leave and work practices that are beneficial for the caring of infants and toddlers. We should, in due course, amend and improve accordingly the existing policy provisions on leave and working hours.
VII. Enhance the coordination of policy adjustments
(22) Safeguard the legitimate rights and interests of families under family planning schemes. For families that have only one child and families with two daughters in rural areas before the adjustment of the comprehensive two-child policy, we shall continue to implement the existing incentive and support systems and preferential policies. We will explore and establishment a carer leave system for families with only a single child. We will strengthen legislation to protect the legitimate rights and interests of families that have responded to the call of the Party and the State and practice family planning.
(23) Establish and improve the system of all-round support for special families under family planning. We will dynamically adjust the level of support under the special support system in accordance with the level of socioeconomic development and other factors. For eligible members of special family planning families, policies including these related to basic aged care and basic medical care will be implemented. They will be given priority for admission to public elderly nursing institutions and provided with free or low-cost care services. For those with housing difficulties, they will be prioritised for housing security schemes. Where possible, local government can grant care subsidies to elderly members of special family planning families who are unable to take care of themselves for long periods of time and are in financial difficulty. In order to ensure that the funds required for this support is in place, local governments may explore the establishment of public charity funds or foundations that focus on helping special families under family planning.
(24) Establish a sound mechanism for supporting and caring work which is led by the government with participation from social organisations. Through the method of public tender, we shall support qualified social organisations in providing delegated care with respect to special families under family planning, carry out care and comforting services, and in accordance with the law, take care of such matters as the admission to institutions for the care of the elderly and medical-related support and nusering services. We should carry out “Operation Heartwarming” [with respect to the elderly] in-depth by establishing the regular visits system, and implement the system of “double-post” contact person for special families under family planning, so that the the safety net of support can be firmly woven.
VIII. Strengthen the organisation and implementation of policy
(25) Strengthen the leadership of the Party. Party committees and governments at all levels should raise their political standpoint; enhance their awareness of national conditions and policies; insist that “number ones” [leading cadres] should personally take charge and assume overall responsibility; adhere to and improve the target management responsibility system; strengthen overall planning, policy coordination and work implementation; and promote the introduction of positive fertility support measures; and to ensure that responsibilities are discharged, measures are in place, investment are made and implementation is effective.
(26) Mobilise social forces. We must strengthen collaborative governance from the government and society, and give full play to the important role of trade unions, the Communist Youth League, women's federations, and other mass organisations in promoting population development, family building, and fertility support. We must actively bring into play the role of family planning associations, strengthen grass-roots capacity building, and effectively carry out propaganda and education, reproductive health counselling services, guidance on childbirth and upbringing, support for families under family planning, the protection of rights and interests, family health promotion and other related work. Social organisations should be encouraged to carry out public welfare activities such as health literacy and infant care services. To meet the needs of the elderly and create a healthy environment for infants and toddlers to grow up in, we should support activities aimed at creating vibrancy and urban development.
(27) Deepen strategic research. In order to build a strong modern socialist country and achieve the great rejuvenation of the Chinese nation, we will continue to deepen research on national medium- and long-term population development strategies and regional population development plans, improve the spatial layout of the population and optimise the allocation of human resources. We will strengthen the development of population studies and theoretical systems with Chinese characteristics in the new era, develop high-end think tanks for population research, and promote international exchange and cooperation.
(28) Provide effective propagenda [publicity] and guidance. We must strengthen policy publicity and policy interpretation guidance, unify the thoughts and actions of all regions, authorities and society as a whole and to align them with the major decisions and plans fo the Party Central Committee. We must guide all sectors of society to correctly understand the structural changes in [China’s] population, promote the main theme, gather positive energy, respond to social concerns in a timely and appropriate manner, and create a favourable atmosphere. We will promote the traditional virtues of the Chinese nation, respect the social value of childbirth, advocate marriage and childbirth at appropriate ages, promote good childbirth and upbringing, encourage couples to share responsibility for childcare, and break such outdated customs as the high bride price, so as to build a new culture of marriage and childbirth.
(29) Strengthen supervision of the work. All provinces (autonomous regions and municipalities directly under the central government) should formulate implementation plans in accordance with the requirements of this decision, tackle implementation with vigour, and study and solve problems of an incipient nature and tendency in a timely manner so as to ensure that policies aimed at optimising fertility achieve positive results. The Party committees and governments of each province (autonomous region, municipality directly under the Central Government) shall report annually to the Party Central Committee and the State Council on the population work in the region, and the Centre will carry out supervision and inspection at an appropriate time.