A Study on Child Development in Contemporary China (Research Series on the Chinese Dream and China’s Development Path) [1st ed. 2023] 9811989583, 9789811989582

Citation preview

Research Series on the Chinese Dream and China’s Development Path

Xiuping Wang

A Study on Child Development in Contemporary China

Research Series on the Chinese Dream and China’s Development Path Series Editors Yang Li, Chinese Academy of Social Sciences, Beijing, China Peilin Li, Chinese Academy of Social Sciences, Beijing, China

Drawing on a large body of empirical studies done over the last two decades, this Series provides its readers with in-depth analyses of the past and present and forecasts for the future course of China’s development. It contains the latest research results made by members of the Chinese Academy of Social Sciences. This series is an invaluable companion to every researcher who is trying to gain a deeper understanding of the development model, path and experience unique to China. Thanks to the adoption of Socialism with Chinese characteristics, and the implementation of comprehensive reform and opening-up, China has made tremendous achievements in areas such as political reform, economic development, and social construction, and is making great strides towards the realization of the Chinese dream of national rejuvenation. In addition to presenting a detailed account of many of these achievements, the authors also discuss what lessons other countries can learn from China’s experience. Project Director Shouguang Xie, President, Social Sciences Academic Press Academic Advisors Fang Cai, Peiyong Gao, Lin Li, Qiang Li, Huaide Ma, Jiahua Pan, Changhong Pei, Ye Qi, Lei Wang, Ming Wang, Yuyan Zhang, Yongnian Zheng, Hong Zhou

Xiuping Wang

A Study on Child Development in Contemporary China

Xiuping Wang Zhejiang Normal University Jinhua, Zhejiang, China Translated by Simin TAN Contributed by ZHANG Xiaoqin

ISSN 2363-6866 ISSN 2363-6874 (electronic) Research Series on the Chinese Dream and China’s Development Path ISBN 978-981-19-8958-2 ISBN 978-981-19-8959-9 (eBook) https://doi.org/10.1007/978-981-19-8959-9 Jointly published with Social Sciences Academic Press The print edition is not for sale in the Mainland of China. Customers from the Mainland of China please order the print book from: Social Sciences Academic Press. © Social Sciences Academic Press 2023 This work is subject to copyright. All rights are reserved by the Publishers, whether the whole or part of the material is concerned, specifically the rights of reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publishers, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publishers nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publishers remain neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd. The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore

Series Preface

Since China’s reform and opening began in 1978, the country has come a long way on the path of Socialism with Chinese characteristics, under the leadership of the Communist Party of China. Over 30 years of reform, efforts and sustained spectacular economic growth have turned China into the world’s second largest economy, and wrought many profound changes in the Chinese society. These historically significant developments have been garnering increasing attention from scholars, governments, and the general public alike around the world since the 1990s, when the newest wave of China studies began to gather steam. Some of the hottest topics have included the so-called “China miracle”, “Chinese phenomenon”, “Chinese experience”, “Chinese path”, and the “Chinese model”. Homegrown researchers have soon followed suit. Already hugely productive, this vibrant field is putting out a large number of books each year, with Social Sciences Academic Press alone having published hundreds of titles on a wide range of subjects. Because most of these books have been written and published in Chinese, however, readership has been limited outside China—even among many who study China—for whom English is still the lingua franca. This language barrier has been an impediment to efforts by academia, business communities, and policy-makers in other countries to form a thorough understanding of contemporary China, of what is distinct about China’s past and present may mean not only for her future but also for the future of the world. The need to remove such an impediment is both real and urgent, and the Research Series on the Chinese Dream and China’s Development Path is my answer to the call. This series features some of the most notable achievements from the last 20 years by scholars in China in a variety of research topics related to reform and opening. They include both theoretical explorations and empirical studies, and cover economy, society, politics, law, culture, and ecology, the six areas in which reform and opening policies have had the deepest impact and farthest-reaching consequences for the country. Authors for the series have also tried to articulate their visions of the “Chinese Dream” and how the country can realize it in these fields and beyond. All of the editors and authors for the Research Series on the Chinese Dream and China’s Development Path are both longtime students of reform and opening and v

vi

Series Preface

recognized authorities in their respective academic fields. Their credentials and expertise lend credibility to these books, each of which having been subject to a rigorous peer review process for inclusion in the series. As part of the Reform and Development Program under the State Administration of Press, Publication, Radio, Film, and Television of the People’s Republic of China, the series is published by Springer, a Germany-based academic publisher of international repute, and distributed overseas. I am confident that it will help fill a lacuna in studies of China in the era of reform and opening. Shouguang Xie

Contents

1

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.1 The Social, Economic, and Cultural Contexts of Child Development in Contemporary China . . . . . . . . . . . . . . . . . . . . . . . 1.2 Definitions and Research Approach . . . . . . . . . . . . . . . . . . . . . . . . . 1.3 Research Methods and Framework . . . . . . . . . . . . . . . . . . . . . . . . . .

Part I

1 1 22 24

Child Population, Survival, and Health

2

Size and Structure of Child Population . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1 Population Size and Structure Over Multiple Censuses . . . . . . . . . 2.2 Changes in Population Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . .

31 31 38

3

Child Survival and Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.1 Policy and Action: The History of the Child Health Sector . . . . . 3.2 Data and Outcomes: The State of Child Survival and Health . . . . 3.3 Summary and Prospects: Discussion on the State of Child Survival and Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

43 44 54

Part II 4

5

59

Education and Development of Children

Preschool Education and the Development of Children Aged 0–5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1 Policy and Action: The Reform and Development of Preschool Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.2 Data and Outcomes: The State of Education for Children Aged 0–5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.3 Summary and Prospects: Discussion on Policies and Outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

67 67 87 99

Compulsory Education and the Development of Children Aged 6–14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 5.1 Policy and Action: The Development of Nine-Year Compulsory Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 vii

viii

Contents

5.2 5.3 6

7

Data and Outcomes: The State of Education for Children Aged 6–14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Summary and Prospects: Discussion on the State of Education for Children Aged 6–14 . . . . . . . . . . . . . . . . . . . . . . . 154

Senior High Education and the Development of Children Aged 15–17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.1 Policy and Action: The Reform and Development of Senior High Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.2 Data and Outcomes: The State of Education for Children Aged 15–17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.3 Summary and Prospects: Discussion on the State of Education for Children Aged 15–17 . . . . . . . . . . . . . . . . . . . . . . Education and Development of Children with Special Needs and Those from Disadvantaged Backgrounds . . . . . . . . . . . . . . . . . . . . 7.1 Policy and Action: The History of Education for Children with Special Needs and Those from Disadvantaged Backgrounds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.2 Data and Outcomes: The State of Education for Children with Special Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.3 Summary and Prospects: Discussion on the State of Education for Children with Special Needs and Those from Disadvantaged Backgrounds . . . . . . . . . . . . . . . . . . . . . . . . . .

157 157 175 194 199

199 212

221

Part III Child Protection 8

9

Child Welfare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.1 Policy and Action: The Birth and Development of the Child-Welfare System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.2 Data and Outcomes: The State of Child Welfare . . . . . . . . . . . . . . 8.3 Summary and Prospects: Discussion on the State of Child Welfare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

229

The Environment for Child Survival and Development . . . . . . . . . . . 9.1 Policy and Action: Environmental Management for Child Survival and Improvement of the Environment for Child Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.2 Data and Outcomes: The State of the Environment for Child Survival and Development . . . . . . . . . . . . . . . . . . . . . . . . 9.3 Summary and Prospects: Discussion on the State of the Environment for Child Survival and Development . . . . . . .

249

229 242 245

249 257 265

10 Legal Protection for Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273 10.1 Policy and Action: The Establishment and Development of the System of Legal Protection for Children . . . . . . . . . . . . . . . . 273

Contents

ix

10.2 Data and Outcomes: The State of Legal Protection for Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280 10.3 Summary and Prospects: Discussion on the State of Legal Protection for Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280 Part IV Children’s Cultures 11 Cultural Content Created by Children . . . . . . . . . . . . . . . . . . . . . . . . . . 285 11.1 Children’s Games . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285 11.2 Children’s Emotions and Attitudes . . . . . . . . . . . . . . . . . . . . . . . . . . 294 12 Cultural Content Created for Children . . . . . . . . . . . . . . . . . . . . . . . . . . 297 12.1 Music for Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297 12.2 Animations for Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 304 13 Future Trends in Children’s Cultures . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.1 Extensive Convergence Between Chinese Children’s Cultures and the World . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.2 Children’s and Adult Cultures in “Symbiosis” . . . . . . . . . . . . . . . . 13.3 A Return to the Child Qua Subject . . . . . . . . . . . . . . . . . . . . . . . . . . 13.4 Integration with Modern Technologies . . . . . . . . . . . . . . . . . . . . . . .

311 311 312 313 314

Chapter 1

Introduction

Historically in China, children have always played a secondary role to adults and have largely played supplementary roles in literature written for, and by, adults. They have been—by design or inadvertently—forgotten in history. Can children in contemporary China finally become full subjects in contemporary society and in the history that is unfolding, just like their adult counterparts? One of the objectives of this study is to provide an answer to this question. The child is the subject of this entire volume, which seeks to shine a light on the Chinese government’s attention to, and investment in, issues pertaining to child survival and development in contemporary times. To this end, we look at policy developments and data over time, which also tell us how far contemporary China has come in terms of protecting the rights of children and in terms of other child-related developments.

1.1 The Social, Economic, and Cultural Contexts of Child Development in Contemporary China How children develop is related to the future and destiny of the family, the nation, and the country, and its importance has been increasingly valued in contemporary times. Similarly, the development of the family, the nation, and the country also affects the development of children at all times. As described by Urie Bronfenbrenner in his theory of the “ecology of human development”,1 the development of the individual and the surrounding environment are interconnected and together form a large ecosystem. That is, microscopic systems, intermediary systems, external systems, as well as macroscopic systems (such as existing political, economic, cultural, and social states) must all undergo the passage of time and the long-term development

1

Bronfenbrenner, U. (1979). The ecology of human development: Experiences by nature and design. Boston: Harvard University Press.

© Social Sciences Academic Press 2023 X. Wang, A Study on Child Development in Contemporary China, Research Series on the Chinese Dream and China’s Development Path, https://doi.org/10.1007/978-981-19-8959-9_1

1

2

1 Introduction

of society.2 All these factors come together to constitute the broader environment of child development and exert a strong influence on the child qua individual as well as a member of a broader group of children. (i) The social context of child development in contemporary China 1. The state of society prior to the reform and opening-up of China: tentative moment in times of turmoil With the founding of the People’s Republic of China, the Chinese nation that had experienced long-term oppression and exploitation became firmly on an independent road to socialist development. The People’s Republic of China’s first Constitution was established at the inaugural National People’s Congress held in Beijing in 1954. The Constitution outlined clearly principles about the state, the leadership of the Communist Party, the guiding ideology of the country, the road to socialism, and democratic centralism, etc., and provided descriptions of the political characteristics of China that distinguish it from Western countries. Further, the Constitution also provided the basic framework of China’s political system by bringing into force political systems such as the People’s Congress system, the political consultation system, the ethnic and regional autonomy system, the administrative system, the judicial system, and the electoral system.3 As such the promulgation of the Constitution was a moment in which a strong political foundation for the subsequent development of Chinese society was laid. Regrettably, from 1957 on, the scope of the anti-rightist struggle was dramatically expanded, and a large number of intellectuals, patriots, and revolutionary cadres were mistakenly labeled as rightists. Conflicts between people had turned into conflicts between enemies. The unprecedented tension in the national political atmosphere severely dampened the enthusiasm of the people to participate in politics, and functional departments and institutions were also distorted or weakened. The democratic and the legal systems began to suffer setbacks. The Cultural Revolution, which began in 1966, replaced nearly all of the administrative agencies provided for by the Constitution with “revolutionary committees”. The national administration lacked the necessary legal protections, and the conference system of the Party and the state’s leading institutions was undermined by unprecedented circumstances. The Cultural Revolution had exaggerated the role of political mobilization and political participation as well as a dogmatic understanding of political theory,4 leading to constrained political thinking and the stultified implementation of socialist principles in practice. In general, during this period China’s political system had existed only in name, and there was a lack of legal protection for the state’s authority. Social decision-making processes were less than democratic, and the prevailing ideology was dogmatic. The turmoil in the general social environment had caused the state’s 2

Che, G. J. et al. (2007). On building a moral education system that integrates school, family and social education. Journal of Northeast Normal University (Philosophy and Social Sciences), 4, p. 155. 3 Xiong, G. Q. (2009). Comparative analysis of political development in contemporary China over 30 years: the perspective of systemic change. Social Science Research, 4. 4 Guan, H.T. The Cultural Revolution and political development in contemporary China.

1.1 The Social, Economic, and Cultural Contexts of Child Development …

3

education efforts to be shelved and severe impediments to children’s development in this period. Fortunately, after experiencing a long “low” in 1978 China finally ushered in a new dawn in its social stability. 2. The state of society thirty years after the reform and opening-up of China: in pursuit of reform and innovation amidst stability General Secretary Xi Jinping has pointed out that “We may not use the historical period after the reform and opening-up to negate the historical period before, and nor can we use the historical period before the reform and opening-up to negate the historical period after.”5 The concept of dialectical development enables us to review history with a more rigorous attitude, and the political party’s errors in the period before reforms and opening-up are undeniable. However, it is precisely the attitude of “learning from history” that has allowed China to always ensure the basic line of socialism with Chinese characteristics with various guidelines and policies and to make great strides forward in continuous reforms in the morethan-thirty years since reform and opening-up. When we look back on the morethan-thirty years since the commencement of reform and opening-up of China, we see that there are stages to the development of Chinese society: reorganization, deepening of reform, and development in a scientific way. These developmental trends have provided us with an increasingly stable social foundation for the development of the children of today. (a) 1978–1990: Recognizing the facts, reorganization, and improvement The Chinese society that had just emerged from the shadow of the Great Cultural Revolution in the later 1970s had urgently needed a development path that was clear and correct. The Third Plenary Session of the 11th Party Central Committee held in Beijing in 1978 was a great turning point in history since the founding of the People’s Republic of China. Some of the major political events that took place in the Cultural Revolution and legacy issues were discussed earnestly during the Session. Further, the following were also restored: intraParty democracy, a focus on seeking truth from facts, the emphasis on the mass line, and the value of criticism and self-criticism. The Marxist ideological line, “political line”, and “organizational line” of the Party were also restored at the Session.6 More importantly at the Session, it was emphasized that the focus of the entire Party’s work and the attention of the people shift from the class struggle to reform, opening-up, and socialist modernization. In addition, in order to meet the needs of the shifting work focus, it was also decided at the Plenary to strengthen democracy in the life of the Party and in the political life of

5

Party History Research Center of the CPC Central Committee. (2014). The correct understanding of the two historical periods prior to, and after, the commencement of reforms and “opening-up”. People’s Daily, Nov. 8. 6 Third Plenary Session of the 11th Central Committee of the CPC Opens a New Chapter of Reform and Opening-up. People.com.cn. http://cpc.people.com.cn/GB/67481/94156/105719/105723/106 451/6464267.html.

4

1 Introduction

the country and to strengthen the building of a socialist legal system.7 At the Third Plenary Session of the 11th Party Central Committee, restorations and rectifications were conducted with the “ideological line”, the “political line”, and “organizational line”, etc. Not only did the Session clearly stipulate the leading and core position of the Communist Party of China (CPC) with China’s socialist cause and determine the overall direction of Chinese society in the future, it also emphasized the key position of the people and fully mobilized the people’s enthusiasm for joining the socialist modernization drive, thus fostering a positive environment of stability and unity for the further development of Chinese society to a large extent. Following deep reflection on the mistakes that had occurred and a quick shifting on the focus of its work, the Party correctly identified the positioning of China’s social development based on its national conditions and also outlined the goals of the socialist modernization drive in all aspects. The 12th CPC National Congress was held in Beijing in 1982, where Deng Xiaoping first proposed the concept of “building socialism with Chinese characteristics”.8 It was also at this event that a new, comprehensive program for a new chapter in socialist modernization—in the form of the “Report of the 12th National Congress of the Communist Party of China”—was introduced. The “Report” clearly defined the overall mission of this new historical period, placed economic building as the overall goal, and stressed the importance of striving to build an advanced socialist spiritual civilization and an advanced socialist democracy. The “Report” had closely tied together socialist democracy and the building-up of the socialist legal system construction closely.9 The 13th CPC National Congress, which was convened in 1987, expounded the basic lines of the theory of the primary stage of socialism for both society and Party. At the event, the basic tasks and goals of reforms to the political and economic systems were also formulated. In the ten years covered by the 6th Five-Year Plan and the 7th Five-Year Plan, Chinese society laid a solid foundation and accumulated strength at the same time under the guidance of the “adjustment, reform, rectification, and improvement” policy, and gradually emerged from its predicament and began to embark on the right track of rapid socialist development. This can be seen specifically in the following three aspects: first, the social situation began to stabilize, and the general direction of the development of socialist modernization became the common effort of the people throughout the country. Second, attention to socialist democracy increased, the legal system gradually improved. Third, with the deepening of the reform and opening-up policy, the degree of openness in China’s society also improved. 7

Bulletin of the Third Plenary Session of the 11th Central Committee of the Communist Party of China. People.com.cn. http://cpc.people.com.cn/GB/64162/64168/64563/65371/4441902.html. 8 12th National Congress of the Communist Party of China. People.com.cn. http://dangshi.people. com.cn/n/2012/0912/c348858-18989527.html. 9 Ushering in a New Stage of Socialist Modernization in a Comprehensive Manner: report at the 12th National Congress of the Communist Party of China. Website of the 13th CPC Central Committee. http://www.xjbz.gov.cn/zwgk/hyzl/ddh/communist/newfiles/l1030.html.

1.1 The Social, Economic, and Cultural Contexts of Child Development …

5

(b) 1991–2000: a broader opening-up, comprehensive reform The successful completion of the 6th Five-Year Plan and the 7th Five-Year Plan in the 1980s accumulated tremendous power for the subsequent development of the Chinese society, as well as laid a solid foundation for further reform and opening-up.10 In 1992, Deng Xiaoping visited the South and delivered an important speech, in which he stressed that the purpose of reform is to liberate the force of production and that China must accelerate the pace of reform and opening-up. He named three criteria for whether efforts are “conducive” to reform and opening-up, and asked that the basic line of the “one center and two basic points” of the Party be upheld for a hundred years and that the Party adhere to the belief in socialism.11 The address further underlined the deep significance of reform and opening-up, and enhanced the people’s confidence in carrying out such efforts, thus creating a stable social situation for these efforts. At the 14th CPC National Congress held in the same year, it was decided that the basic line of building socialism with Chinese characteristics and the concept of the Party’s initial stage of socialism be written into the Party constitution. At this juncture, with Deng’s “Southern Tour Speech” in 1992 and the Party’s 14th CPC National Congress as the symbols, China entered a new stage of socialist reform and opening-up and modernization.12 The overall development of Chinese society also reached a new level as a result. Society was presented with the basic theory and “basic line” for a new stage at the 14th CPC National Congress. To facilitate the implementation of the tasks set forth at the 14th National Congress, and to meet the challenges posed by the new era, new tasks and new challenges to the Party’s own building efforts, the Fourth Plenary Session of the 14th CPC Central Committee focused on the issue of Party building, and passed its Decision of the Central Committee of the Communist Party of China on Several Major Issues Concerning the Strengthening of Party-Building Efforts. Party members were called to uphold and improve democratic centralism, and to work to strengthen and improve the building-up of the Party’s communitylevel organizations.13 It can be said that to a large extent, a vanguard core leadership is critical in ensuring the long-term stability of society and politics, and that correct leadership by the Party has kept Chinese society on a correct and steady path in general. There have invariably been obstacles in the nearly two decades since the advent of reform and opening-up, and there is an urgent need for the Party and the state 10

Outline of the 8th Five-Year Plan for National Economic and Social Development of the People’s Republic of China (1991–1995). 11 Deng Xiaoping’s “Southern Tour Speech” during His Inspection of Southern China. People.com.cn. http://dangshi.people.com.cn/GB/221024/221026/221624/15018896.html. 12 14th National Congress of the Communist Party of China. People.com.cn. http://dangshi.people. com.cn/n/2012/0912/c348858-18989665.html. 13 Decision of the Central Committee of the Communist Party of China on Several Major Issues Concerning the Strengthening of Party-Building Efforts. People.com.cn. http://www.people.com. cn/item/20years/newfiles/b1090.html.

6

1 Introduction

to make comprehensive deployments in order to build up the socialist economy, the political system, in the area of culture, and in terms of Party building, all with Chinese characteristics. Doing so will point to the road ahead for Chinese society and for the people of China. In 1997, the 15th CPC National Congress established Deng Xiaoping Theory as the Party’s guiding ideology, put forward and discussed the basic program of the Party in the primary stage of socialism, and summarized the basic objectives and policies for the construction of socialism with Chinese characteristics in the areas of economy, politics, and culture.14 Judging simply from the impact of such a move on Chinese society, the determination of the basic program as well as basic political goals and policies have further consolidated national unity and social stability in our country and also strengthened efforts to build up a socialist democracy and the legal system. This decade was a decade in which Chinese society worked hard to weigh the relations between reform, development, and stability. While drastic reforms were undertaken for the sake of better development, they have also inevitably caused the intensification of certain contradictions. Stability has thus become the prerequisite and guarantee for reform and development. In the 1990s, the pace of comprehensive reform and opening-up accelerated within Chinese society, and under the correct leadership of the Communist Party of China, not only did this phenomenon not cause social turmoil, it also allowed society to courageously move forward in change and provided a stronger foundation for social stability. Society became increasingly open, and the legal system for society was continuously improved with the advancement of socialist democracy and the legal system. These developments laid the foundation for the stable development of China and deepened reforms, as well as provided a fertile ground for child development for children of the era. (c) 2001–2010: the promotion of development in a scientific way and social harmony China was amply rewarded during this decade of growing openness and comprehensive reform. At the turn of the century, China obtained victories with its achieving of the first two steps toward its strategic goal of modernization: the allround development of economy and society, and moderate prosperity in terms of living standards in general. The successful completion of the 8th and 9th Five-Year Plans during this period not only enhanced China’s overall national strength, but more critically also improved the lives of the people, thus allowing China to stride confidently into the twenty-first century. In the new century, China has continued to adhere to its goals of building a moderately prosperous society in a comprehensive manner and accelerating the progress of socialist modernization, been committed to solving the problems that have arisen during the course of development, and emphasized the centrality of development in its efforts. However, at the same time China has also attached great importance to 14

Holding high the great banner of Deng Xiaoping Theory and pushing the cause of building socialism with Chinese characteristics into the twenty-first century. People.com.cn. http://cpc.peo ple.com.cn/GB/67481/69242/69323/4694542.html.

1.1 The Social, Economic, and Cultural Contexts of Child Development …

7

various contradictions that have emerged over the course of development. The 10th Five-Year Plan approved at the 2001 National People’s Congress underscored the importance attached to efforts to promote positive and rapid social development: on the one hand, it affirmed the crucial role of development in social progress, and on the other it also recognized the importance of the people’s livelihoods and social justice. The Congress called the task of raising people’s living standards “the fundamental starting point” for future efforts, and called for efforts to increase the income of urban and rural residents, particularly for farmers and low-income urban residents, as well as to advance socialist cultural and ethical progress and the efforts to build up democracy and the legal system in China.15 The 16th CPC National Congress held in 2003 established various objectives for the building of a moderately prosperous society on all fronts. In terms of socialist democracy, the Congress called for the upholding and improvement of the socialist democratic system, guarantees for a wide range of rights and freedoms for the people, the strengthening of efforts to build up the socialist legal system, and the reforming and improving of the Party’s leadership and governance methods. The Congress also called for the maintenance of social stability and harmonious and stable social environment over the long term.16 This important text has further promoted the development of society in the direction of democracy, fairness, and stability. In the twenty-first century, there have been drastic changes in the international situation, posing both opportunities for, and challenges to, the development of Chinese society. Only by correctly handling the relationship between reform, development, and stability, can we ensure the long-term, harmonious and stable development of society. In 2003 and 2004, the Party put forward the key strategic ideas of establishing a scientific outlook on development and the building of a socialist harmonious society in order to better handle the relationship between the three, and the amount of attention paid to the matter of “social development” increased steadily. In October 2005, the idea of building a harmonious socialist society was incorporated into the 11th Five-Year Plan with the adoption of the “Proposal on the Formulation of the 11th Five-Year Plan for National Economic and Social Development by the Fifth Plenary Session of the 16th CPC Central Committee”. At the Session, it was stressed that China must strengthen its efforts at building a harmonious society in the following five years and resolve the practical problems that concern the vital interests of the people through a people-centered approach.17 In October 2006, the first special discussion on the theme of “social progress” was held at the Sixth Plenary Session of the 16th CPC Central Committee, where the Decision on Several Major Issues in the Building of a Harmonious Socialist Society was also released. The Session resulted in the deployment of plans for the building of a harmonious socialist society in terms of both theory and practice. Under the guidance of the key strategic ideas for the building 15

Outline of the 10th Five-Year Plan. http://govinfo.nlc.gov.cn/nxfz/xxgk/plxrmzfzwgkw/201204/ t20120429_1433434.html. 16 The 16th National Congress of the Communist Party of China. http://www.ce.cn/ztpd/xwzt/guo nei/2003/sljsanzh/szqhbj/t20031009_1763196.shtml. 17 Outline of the 11th Five-Year Plan for National Economic and Social Development.

8

1 Introduction

of a harmonious society, efforts to build up the social security system were further strengthened, continuous improvements were made to the public health system and basic medical services, gradual advancements were made with social management, and greater social stability was seen.18 In 2007, the 17th CPC National Congress held high the great banner of socialism with Chinese characteristics, stressing the guiding power of Deng Xiaoping Theory and the important thought of Three Represents and also expounding on the Scientific Outlook on Development. The Congress laid out the roadmap to the development of Chinese society through continued emancipation of the mind, adherence to the agenda of reform and opening-up, the pursuit of development in a scientific way, and efforts toward greater social harmony.19 The development trends in the first decade of the twenty-first century can be summed up with the idea of “development in a scientific way”. This is both an affirmation of development and a relentless pursuit of a harmonious socialist society. We are looking at the social background of contemporary China through the lens of historical developments as the formation of a social background occurs cumulatively over time. If we want to thoroughly understand the social background of contemporary China, we will have to trace the various lines of social development over time. From rectification and improvement to reform-deepening and then to harmonious development, we have witnessed the rapid development, as well as foreseen the future development, of Chinese society. Social factors that have had an important impact on child development in China are simply stability and development. Throughout the history of child development in China and abroad, such development has often been unsatisfactory in times of war or social unrest. In the more-than-thirty years since the advent of reforms and opening-up in China, Chinese society has withstood multiple challenges, and even crises, along the way and has advanced toward the direction of socialist modernization under the correct leadership of the CPC. The general trajectory of social development has never changed, and social stability has never been compromised. For more than thirty years, Chinese society has shown continued development through openingup, reforms, and stability, and a series of bold reforms have provided much energy for social development. With the continuous development of socialist democracy, the People’s Congress system, the multiparty cooperation and political consultation system, as well as the Party’s policies concerning ethnic groups, and freedom of religious beliefs have also been gradually improved, ensuring that people throughout the country enjoy a wide range of rights and freedoms. This is a reflection of the advanced nature of the ruling party as well as a guarantee of social stability and fairness, and a strengthening of the patriotic united front and national cohesion. Together, the right leadership of the Party, the soundness of the social and democratic legal system, greater social openness, and emphasis on the value of social harmony have provided a stable, open, and evolving social background for the development of children today. 18

17th CPC National Congress. Website of the People Electric Group. http://www.chinapeople. com/peopleele/pqrty/pqrtyinfo.aspx?pid=4044. 19 17th CPC National Congress.

1.1 The Social, Economic, and Cultural Contexts of Child Development …

9

(ii) The economic context of child development in contemporary China There is a well-known saying in Marxist philosophy that the economic base determines the superstructure. The development of the national economy is not only a reflection of the state of development with Chinese society; it also determines China’s international status. It also affects China’s social ideology and the corresponding political and legal systems and institutions. If we focus on the impact of the national economy on our children, we see that the state of development with the national economy may have a direct impact on education and child development. 1. The state of the economy prior to the advent of reform and opening-up: backwardness and stagnation Before the advent of reform and opening-up, China lagged far behind the Western developed countries in terms of economic development. China was closed off from the rest of the world in the late Ming Dynasty and early Qing Dynasty. This was also a time when the Industrial Revolution had occurred in countries such as those in Europe, as a result of which European economies reached their heyday. In addition, China had also suffered foreign occupation for a long period of time in its modern history. This historical factor also caused China to lag behind before its economic liberation. After liberation, although China had become independent, it still faced barricades put up by imperialism and social imperialism. It lacked effective ways of learning from advanced foreign economic models and from operational and management experience. Not only that, in the early years after the founding of the People’s Republic of China, there was also a “veering toward the left” in the guiding ideology of economic development. In 1958, the reckless Great Leap Forward campaign, which ignored the laws of socialist economic development, failed to promote the rapid development of China’s economy and more gravely, also caused serious national economic losses. Faced with a national economy that continued to struggle, the CPC Central Committee decided to completely rectify the mistakes committed in the Great Leap Forward campaign. In January 1961, at the Eighth Plenary Session of the 8th CPC Central Committee, the policy of the “adjustment, consolidation, enrichment, and improvement” of the national economy was formally established. This marked the beginning of a phase of adjustment for the national economy, and under this policy, the national economy began to gradually improve. Just as the adjustment of the national economy was basically completed, what was to be a decade-long “Cultural Revolution” broke out in 1966. This politically charged campaign based on class struggle severely impeded economic development and construction, and caused major disasters to the Party and the lives of the people. “The industrial, product, technology, enterprise, and organizational structures and the industrial and economic configurations of the country before reform and opening-up were not very reasonable”,20 and there were also a number of problems in the management of the 20

1981 Report on the Work of the Government. http://www.gov.cn/test/2006-02/16/content_2 00802.htm.

10

1 Introduction

economy. A number of factors had caused China’s economy to be backward, and the pace of progress also stagnant, prior to the advent of reform and opening-up. 2. The state of the economy, thirty years into reform and opening-up: great increase in economic strength and continued deepening of reform and opening-up (a) 1981–1990: Economic recovery and the beginning of reform and opening-up The Third Plenary Session of the 11th CPC Central Committee held in 1978 was a moment in the Party’s history where efforts were made to set things right: the erroneous theories and practices centered on class struggle were resolutely rejected, and all work focus was shifted to socialist modernization and building. The Session began to implement the program for the adjustment, reform, rectification, and improvement of the national economy. The national economy began to recover with guidance from this leading ideology, and adjustments to the national economy were made in all aspects. Officially, China was on the road to socialist modernization by means of internal reforms and opening-up to the outside world. The 6th Five-Year Plan adopted by the Fifth National People’s Congress in 1982 laid out a clear direction for the Chinese economy that had just emerged from difficulty. The Plan stated that the basic tasks for the coming five years were: “… to further solve various legacy issues hindering economic development in the past, to achieve a decisive victory by achieving a fundamental turn for the better in financial and economic terms, and to lay a better foundation and create better conditions for the national economy and for social development during the 7th Five-Year Plan”.21 In the five years between 1981 and 1985, there were substantial increases in the production of several products important to the people’s livelihood, and China’s overall economic strength was also significantly enhanced. The breadth and depth of opening-up to the outside world was historically unprecedented. Most of the targets specified in the 6th Five-Year Plan were met ahead of schedule, or were exceeded.22 The successful completion of the 6th Five-Year Plan laid a strong material foundation for China to continue its socialist modernization drive. In order for China to fully harness favorable conditions and to further implement the policy of reform and opening-up, the Decision on the Reform of the Economic System was adopted at the Third Plenary Session of the 12th CPC Central Committee. The outlines of a socialist economic system with Chinese characteristics had become increasingly clear. In this Party document, the socialist economy was defined as a “planned commodity economy based on public ownership”. The document also promoted reforms of the planned economic system, affirmed the importance of collectively owned and privately owned enterprises within the socialist economy, and encouraged the development of various types of ownership at the same time. The focus of reform was also shifted from the rural areas to the cities with a focus on the enhancement of enterprise vitality. Internal reforms and efforts toward the “opening-up” of China were greatly accelerated by this document. 21 22

6th Five-Year Plan. 1986 Report on the Work of the Government.

1.1 The Social, Economic, and Cultural Contexts of Child Development …

11

The successful completion of the 6th Five-Year Plan boosted China’s confidence in continuing to implement the policy of reform and opening-up. Then, the 7th Five-Year Plan called for “adherence to the general policy of injecting vitality into the economy and opening-up to the outside world, and the continued promotion of the strategy of economic development and the transformation of the economic management system from the old model to the new model”.23 On the one hand, China was to carry out economic development in a down-to-earth manner, strive to maintain a basic balance between overall demand and supply in society, persist in opening-up to the outside world, and grow China’s national economy more quickly by studying the technical and management experience of advanced foreign players. Doing so would ensure sustained and steady economic growth and create strong material conditions for economic restructuring. On the other hand, China was also to actively promote the reform of the economic system, encourage the development of various types of ownership within the economy, shift the economic system from a fossilized centrally planned system to a new system with planned development of the commodity economy on the basis of public ownership, and fully harness the vitality of the market. The idea was to inject vitality into the development of the socialist economic system through the reform of the parts of the economic system that were not appropriate for the existing state of economic development.24 The scientific conclusion of China in the primary stage of socialism and the basic line of the Party in the primary stage of socialism was expounded upon at the 13th CPC National Congress in 1987. This “basic line” was: “to lead and unite the people of all ethnic groups in the country, to take economic development as the central task, to adhere to the Four Basic Principles, to persist in reform and openingup, to develop self-reliance, and to work hard to fight for the country’s goal of building China into a prosperous, strong, democratic, and culturally advanced modern socialist country”.25 This “basic line” further established the centrality of the task that is economic development, and helped to accelerate and deepen economic system reform, cultivate persistence in efforts to open up to the outside world, and enhanced the depth and breadth of economic and technological exchanges and cooperation with foreign partners with the aim of ensuring the sustainable development of the national economy at a quicker rate. A series of policy documents issued by the central government in the 1980s provided analyses of the contemporaneous situation and indicated the direction of economic development for the country. These documents helped China’s national economy to move onto the right track and achieve leapfrog development. By the end-1990, the gross national product and the gross output value of industry and agriculture had surpassed the requirements of the original five-year plan, and the country as a whole had gradually become open to the outside world.26

23

7th Five-Year Plan. See Footnote 23. 25 Report at the 13th CPC National Congress. 26 8th Five-Year Plan. 24

12

1 Introduction

The 1980s can be said to be a decade of stability and change for the Chinese economy. The implementation of the policy of reform and opening-up greatly accelerated the pace of economic growth, injected energy into the economy, significantly enhanced the country’s economic strength, and laid a solid material foundation for further economy-building and economic reforms. At the same time, the reform of the economic system as a whole was also well underway, with the first strategic goal of modernization successfully achieved. With the sustained and stable development of the national economy, the thinking on the raison d’être for economic development also went deeper. People became increasingly aware of the importance of the development of science and technology and education for rapid economic development, and that scientific and technological progress and improving the quality of workers is the key to ensuring sustained and stable economic development. Overall, the rapid development of the national economy in the 1980s not only provided a solid material foundation for national education and child development but also provided room for ideological development. (b) 1991–2000: deepening reform of the economic system, further opening-up In response to the overheating of the economy in the second half of the 1980s, the Decision of the CPC Central Committee on Further Governance Improvement and the Deepening of Reform was passed at the Fifth Plenary Session of the 13th CPC Central Committee. The Decision called for a gradual reduction of the inflation rate, efforts to achieve balanced national fiscal accounts, improvements to the industrial structure, and the deepening of, and improvements to, various reform measures, etc.27 By 1991, the task of governance improvement had been basically completed, and the national economy was once again on the right track. This created a positive beginning for the realization of the 8th Five-Year Plan. The guiding principles of the 8th Five-Year Plan of 1991 were stronger governance, rectification, and the deepening of reforms, and China’s goal for the following decade was to achieve the first strategic goal of China’s socialist modernization drive and to raise the overall quality of the national economy to a new level. Under the plan, it was also stressed that in the following five years, China must correctly handle the relationship between rectification, deepening reform, and economic development, and clearly maintain the speed of economic growth while keeping inflation under control. China was also to perform basic tasks such as more adjustments to the industrial structure and work on the problem of fiscal imbalances.28 The plan became a “beacon” for China in the 1990s as it sought continued development of the national economy and to promote economic restructuring. Deng Xiaoping’s Southern Tour Speech in 1992 also revisited the matter of planning and markets. He emphasized that development was the absolute focus and stated that a difference along the central planning/marketization spectrum by degrees did not connote an essential difference 27

Decision of the CPC Central Committee on Further Governance Improvement and the Deepening of Reform. 28 See Footnote 26.

1.1 The Social, Economic, and Cultural Contexts of Child Development …

13

between socialism and capitalism.29 In the same year, the Party made two important decisions at its 14th National Congress: first, it affirmed that the “basic line” of the Party in the primary stage of socialism was “unshakable“, and that the Party ought to seize available opportunities to accelerate development; second, the Party made it clear that the goal of China’s economic restructuring was to establish a socialist market economy.30 The Southern Tour Speech and the CPC’s 14th National Congress in 1992 underscored the Party’s determination to establish a socialist market economy and also made it clear that the goal of China’s economic restructuring in the future was to establish a socialist market economy. Since then, the establishment of a market economy and the introduction of market adjustment mechanisms have become the focus of China’s economic reforms. In order to effectively implement the goals of China’s economic restructuring, in 1993, the CPC convened the Third Plenary Session of the 14th Central Committee, and at the event the Decision on Several Issues Concerning the Establishment of a Socialist Market Economic System was adopted. This text laid out clearly specific goals of economic reform and also proposed a series of concrete measures including: the establishment of a modern enterprise system, the establishment and improvement of macroeconomic controls, the cultivation and development of a market system, the establishment of a rational personal income distribution and social security system, and the deepening of reforms for the rural economy.31 The average economic growth rate per annum over the entire 8th Five-Year Plan period stood at around 11%.32 The national economy continued to grow rapidly, and breakthroughs were made in efforts to establish a socialist market economy. The Chinese economy had more or less taken on the drive to open up to the outside world and the living standards of urban and rural residents continued to improve. The 9th Five-Year Plan introduced in 1996 continued the general line of “grasping opportunities, deepening reforms, broadening opening-up, promoting development, and maintaining stability”. The plan called for China to maintain the sustained, rapid and healthy development of the national economy; promote the transformation of the model of economic growth, and to place the enhancement of economic efficiency at the center of economic efforts; place the strengthening of agriculture as a top priority for the national economy; regard the reform of state-owned enterprises as the central link within economic restructuring; and unswervingly implement reform and opening-up efforts, etc., in the following five years.33 The Plan facilitated strong preparations for the building-up of the socialist cause with Chinese characteristics into the twenty-first century. At its 15th National Congress in 1997, the Party further elaborated on the main tasks leading to the goal of building a “socialist economy 29

Deng Xiaoping’s Southern Tour Speech. 14th CPC National Congress. 31 Decision of the Central Committee of the Communist Party of China on Several Issues Concerning the Establishment of a Socialist Market Economic System. http://news.eastday.com/eastday/13n ews/auto/news/china/u7ai1035396_K4.html. 32 http://news.hexun.com/2009-09-29/121241317.html. 33 9th Five-Year Plan. 30

14

1 Introduction

with Chinese characteristics”. With close attention paid by the Party and the nation as well as unceasing efforts by both, by the turn of the century, China had victoriously achieved the first two strategic steps toward the goal of socialist modernization. Not only were there continued efforts to carry out in-depth reforms within the economic system in the 1990s, at the same time there was also unceasing attention paid to a series of issues that had emerged in the course of reform and opening-up, as well as efforts to resolve these issues. Strenuous efforts were made to achieve a balance between reform, development, and stability. In particular, the strategy of rejuvenating the country through science and education proposed as well as enhanced understanding of the relationship between the economy, science and technology and education in this period greatly promoted the development of education as well as individual child development. (c) 2001–2010: adjustments to the economic structure, stronger macroeconomic control China entered the twenty-first century with two victories in the form of the achievement of two strategic steps toward the goal of modernization. These victories provided China with ample preparation for the task of building a moderately prosperous society in the new century. In order to continue to preserve the economic achievements that had been made to date and to properly resolve outstanding issues in economic development, the CPC Central Committee formulated a program of action for the entire population that would come together and work together toward said goals. This was the Outline of the 10th Five-Year Plan. According to the Outline, the main goals for the economy during the 10th Five-Year Plan period were: to maintain a relatively rapid economic development; to promote the strategic adjustment of the economic structure; to work toward the alignment of the speed and quality of economic growth; to deepen reforms of state-owned enterprises; to achieve substantial progress in the establishment of a modern enterprise system; to further improve upon the socialist market economy system; and for China to participate in international economic cooperation and competition on a larger scale and to a greater degree.34 In order to fully prepare for the third strategic step toward the achievement of socialist modernization, in 2002 the CPC held its first National Congress (the 16th National Congress) in the new century, where the important thought of Three Represents and the goal of building a moderately prosperous society were fully established. Further, at the event, it was also stated that the main tasks of economic development and reform in the first two decades of the twenty-first century were: improvements to the socialist market economy system; strategic adjustments to the economic structure; and continued comprehensive adjustments to the industrial structure, urban–rural structure and regional structure.35 The Report delivered at the Congress also stressed that in terms of adjustments to the industrial structure, on the one hand vigorous efforts must be made to implement the strategy of rejuvenating the country through science and education (by 34 35

10th Five-Year Plan. 16th CPC National Congress.

1.1 The Social, Economic, and Cultural Contexts of Child Development …

15

relying on advancements in science and technology and high-quality workers to improve the face of national economic growth and thus taking the path to a new type of industrialization and to industrialization by means of information technology) while on the other hand, there should be adherence to the strategy of sustainable development (through reforms of certain energy-hungry and highly polluting traditional industries and by promoting the optimization and upgrading of the industrial structure). In terms of adjustments to the urban and rural structure, the Report called for efforts to make the rural economy prosperous and to increase the income of rural residents while also working toward a quicker pace of urbanization and committed efforts toward to the coordinated development of cities and towns of various scales. In terms of adjustments to regional structures, the Report called for the implementation of the development strategy for western China, for support to be provided to the western regions in areas such as science and technology and capital, and for efforts to promote the coordinated development of regional economies.36 Although during the 10th Five-Year Plan period, the national economy was impacted by the changes brought forth by accession to the World Trade Organization and major natural disasters, with the joint efforts of people of all nationalities across the country, the major development goals identified in the 10th Five-Year Plan were still achieved ahead of schedule. In accordance with the important strategic thought on the establishment of the concept of development in a scientific way and the building of a harmonious socialist society proposed by the CPC Central Committee, the Outline of the 11th Five-Year Plan called for economic development to continue at its prior sustained and rapid rate as well as for coordinated and healthy economic development in the country. The “Outline” also called for consistently upholding the strategies of rejuvenating the country through science and education, and of strengthening the country through a quality talent pool, for strengthened capabilities in independent innovation, for an acceleration in the transformation of the model of economic growth mode, for more coordinated development between town and country, and for continued deepening of reforms and greater opening-up.37 At the CPC’s 17th National Congress in 2007, the achievements made in terms of China’s economy and society during the three decades of reform and opening-up were affirmed, and there was also an elaborate exposition of the concept of development in a scientific way in order to lay the ideological foundation for the sound and rapid development of China’s economy. In the first decade of the twenty-first century, China was mainly committed to solving the outstanding issues that had emerged during the process of rapid economic development. Active efforts were made to promote the strategic adjustment of the economic structure and to speed up the transformation of the model of economic development; to, when necessary, strengthen macroeconomic regulation and controls; and to further improve the socialist market economy system in order to achieve the sound and rapid development of the Chinese economy. 36 37

See Footnote 35. 11th Five-Year Plan.

16

1 Introduction

The development of the Chinese economy between the implementation of the reform and opening-up policy from 1978 to the completion of the 11th Five-Year Plan can be described as “leapfrog”. As Comrade Hu Jintao once pointed out: “The fundamental reason for all our achievements and progress in efforts towards reform and opening-up is that we have opened up the path of socialism with Chinese characteristics”.38 China’s economic achievements are rooted in the correct direction obtained by objective analysis of actual conditions, and internal reforms have promoted the comprehensive reform of the economic system and activated the national economy by means of improved systems and institutions, while opening-up to the outside world has brought to China advanced technologies and management experience and promoted better economic development. The positive impact of rapid economic development on child development is undeniable: a strong economy provides the material basis for child development, and moreover continued and rapid development of the economy and efforts to make strategic adjustments to the economic structure have also brought the importance of worker-related elements and qualities that would promote the healthy and stable development of the economy over the long term, such the level of science and technology and the ability to innovate independently, into greater focus. This [confluence of factors] has created a positive atmosphere for national education and child development. (iii) The cultural context of child development in contemporary China Culture is a hidden but powerful force in overall national strength. More specifically, the “culture” that we refer to here is culture in its narrow sense and includes elements such as education, technology, and the cultural industries. The aim here is to provide a full representation of the intellectual and cultural features of Chinese society. 1. The cultural landscape prior to reform and opening-up: lack of diversity in content, general conservatism and stagnation The Chinese civilization, which had shone for millennia, saw its light fade in the period prior to the advent of the reform and opening-up policy. With the devastating impact of the Cultural Revolution, China’s outstanding historical and cultural heritage was crippled, and the status of Chinese intellectuals was continually degraded. More critically, scientific, cultural, and educational undertakings were not given due attention but were instead extinguished, causing a cultural discontinuity in Chinese society. The quality of the Chinese people declined severely, and the spiritual and cultural life of the people became gravely constrained. In the field of culture and education, due to criticisms of ideas such as “respecting teachers and the importance of education” and “intellectual education is the number one priority” during the Cultural Revolution, education becomes increasingly regarded as useless. During the ten-year-long Cultural Revolution, educational institutions at all levels were devastatingly damaged to varying degrees. Teachers, scholars, and other intellectuals were either humiliated or “sent down” for manual 38

http://cpc.people.com.cn/GB/104019/104098/6378274.html.

1.1 The Social, Economic, and Cultural Contexts of Child Development …

17

labor, and teaching and scientific research work was halted. Schools at all levels stopped operating one after another. The frequent “sending down” of educated youths to the countryside did not have significant impact in terms of promoting rural development; instead, the cultural education of these youth was interrupted. As such, a true improvement in the quality of the Chinese people was hindered. In the area of ideology and belief, due to the “mistaken veering toward the left”, the Chinese people found themselves seriously constrained in terms of freedom of thought and belief in that era. In the field of traditional Chinese culture, a 1966 People’s Daily editorial titled “Sweep Away All Monsters and Demons” called for the destruction of “the old ideology, old culture, old customs, and old habits belonging to the exploitative classes that have caused harm to people for thousands of years”. In an instant, China’s outstanding cultural heritage that had lasted several millennia became the subject of the “Breaking the Four Olds” drive and suffered a devastating blow. The erroneous ideological line of the era caused a major cultural decline in a China that was at that time free from foreign invasion. The loss of a strong foundation in outstanding traditional culture was accompanied by the lack of a free and relaxed environment needed for the development of culture itself. The result: Chinese culture prior to the advent of the reform and opening-up policy was highly stagnant. The policy of reform and opening-up instituted in 1978 removed the shackles that had been on Chinese culture for a number of years, and injected new vitality in this culture that has since embarked on a path of blossoming. 2. The cultural landscape after the beginning of reform and opening-up: freedom, diversity, and the “blooming of a hundred flowers” (a) 1981–1990: a period of reversals and swift rises The National Science Conference held in Beijing in 1978 was an important moment in the history of science and culture: at the event, Comrade Deng Xiaoping put forward an important statement that “science and technology are productive forces”, making it clear that intellectuals are part of the working class. This move completely eliminated the obstacles created by the Cultural Revolution in the field of science and culture, and following this historic milestone Chinese culture has been on the path of recovery and ascendancy. The 6th Five-Year Plan set out as basic tasks “mobilizing resources across the country to make scientific and technological breakthroughs and promote the application of scientific and technological achievements and developing education, science, and culture to promote socialist cultural and ethical progress and material progress”.39 To ensure that these tasks could be achieved smoothly, during the 6th Five-Year Plan period, government spending on education, science, culture, health, and sports were increased compared to the previous Five-Year Plan period, with the spending on education, science and culture accounting for 15.9% of total government expenditure during the period and 16.8% specifically in 1985.40 The 12th CPC National Congress put forward the scientific thesis of “taking our own path and building socialism with 39 40

6th Five-Year Plan. 1982 Report on the Work of the Government.

18

1 Introduction

Chinese characteristics”, and also made it clear that China must, while making material progress, also strive to advance socialist cultural and ethical progress. The 7th Five-Year Plan continued to stress the need for vigorous efforts to promote socialist cultural and ethical progress while making material progress. Under the plan, the development of science and education was an important strategic focus, with the aim being to promote the rapid development of science and technology and to improve the cultural qualities of the people. In 1988, Deng Xiaoping put forward the assertion that “science and technology are primary productive forces”, and this statement became an important driving force for the development of China’s social, scientific, and cultural undertakings. After ten years of unceasing efforts, China began to stir from near-stagnancy in the areas of education, science and culture and began to prosper in these areas. The country saw a significant amount of important scientific research output as well as rapid improvements on education. As the country became even more open to the outside world, the cultural aspect of people’s lives became richer over time, and the level of scientific and cultural knowledge among the people gradually increased. Since the introduction of the reform and opening-up policy in 1978, China’s cultural undertakings gradually began to shift from a state of desolation and stagnation in the Cultural Revolution period to a new state of vigorous development. The shackles placed on Chinese culture by the mistaken veer toward the left were removed in the 1980s, and further, Chinese culture began to see thriving development. In the area of education, systemic reforms were actively implemented, and with the implementation of the Compulsory Education Law, the enrollment rate of schoolage students in primary and secondary schools improved greatly. Moreover, campus conditions and standards of education also improved while vocational and technical education developed rapidly, nurturing large numbers of workers with more advanced professional skills and literacy for the building of socialism with Chinese characteristics. There was also a stream of reforms made in higher education, helping to cultivate for the country intellectual talents with scientific knowledge and also significantly promoting the development of teaching and science and technology research in China. In the field of science, the idea that “science and technology are productive forces “ reshaped the people’s understanding of science and technology and, to some extent, cleared the way for the development of science and technology. In addition, reform of the science and technology sector opened up scientific research to players other than state-run institutions, allowing various scientific and technological enterprises and privately-run research institutions to also enter the field. Such competition has injected vitality into the development of the field, and great achievements have been made. In the field of people’s culture, products such as literature, art, film, television, radio, and news became increasingly abundant and diverse, and content became increasingly intellectual, scientific, and artistic in nature.41 The social and cultural backdrop is directly related to how people see the role of education and to the quality of individual citizens. It can be said that it has the greatest direct impact on child development. In the decade between 1981 and 1990, 41

1988 Report on the Work of the Government.

1.1 The Social, Economic, and Cultural Contexts of Child Development …

19

not only were the prior erroneous approaches taken toward intellectuals and science and technology reversed, various cultural undertakings also developed rapidly, thus providing a positive cultural background for child development in the era. It also laid a more solid cultural foundation for child development in the future. (b) 1991–2000: rapid development and a bounty of achievements As a result of ten years of reform and opening-up beginning in 1978, Chinese culture entered a period of rapid development in the final decade of the twentieth century. A central task of the 8th Five-Year Plan formulated at the beginning of the 1990s was “to continue to place the development of science, technology, and education in an important strategic position, and to gradually shift China’s economic growth to a path that mainly depends on scientific and technological progress and that improves the quality of workers”. Efforts were made to continue the implementation of the Torch Program and the 863 Program, and to promote the rapid development of high-tech industries. The 8th FiveYear Plan attached great importance to the development of science, technology and education, and to a large extent the Plan accelerated the development of China’s scientific, educational and other cultural undertakings. In order to fully and effectively implement the dictum that “science and technology are primary productive forces”, in 1995 the CPC Central Committee and the State Council released a Decision document centered on means to accelerate scientific and technological advancement in the country. The document, which put forward for the first time the strategy of implementing science and education as a means of rejuvenating China, called for adherence to a strong focus on education and for science and technology and education to be placed in an important position within economic and social development as a means of improving the scientific and cultural standards of the entire nation.42 The strong emphasis on science, technology and education continued with the 9th Five-Year Plan, which stated that prioritizing the development of education and improving the quality of the people was part of a century-long plan for China’s modernization.43 In addition to an emphasis on the development of science, technology and education, the CPC and the Chinese government also attached great importance to the enriching of the spiritual and cultural life of the people in this new period, calling for, in the 9th Five-Year Plan, adherence to the principle of “in service of the people and of socialism” and the program of “letting a hundred flowers bloom, and a hundred schools of thought contend”. Cultural products should not highlight the central theme of the times but also promote diversity, stay close to the ground, as well as promote the development of socialist cultural undertakings. Even as the Party and the government strived to promote material progress, there was also much emphasis on efforts to advance cultural and ethical progress at the same time. In the 1990s, great progress was made not just with the former but also 42

Decision of the CPC Central Committee and the State Council on the Acceleration of Scientific and Technological Progress. 43 9th Five-Year Plan.

20

1 Introduction

in the case of the latter. In the field of science and technology, the rapid development of higher education resulted in the emergence of top-notch talents in the field of science and technology who have in turn made great achievements in fields such as aeronautical science, information technology, new materials, and biology. A constant stream of scientific and technological output has been applied to actual production to promote further economic development. In the field of education, continued reforms resulted in the development of education at all levels and of various types on all fronts, and the goal of implementing a mandatory education regime was more or less achieved. Enrollment in colleges and universities increased, and the comprehensive development of education greatly improved the cultural standards of the people while the illiteracy among young and middle-aged people was basically eliminated. As for the culture of people, with the advancement of the opening-up policy, the thinking of people gradually opened up to a free and active state. At the same time, an evergrowing array of mass media options also led to increasingly diverse offerings of cultural products, both in form and content. In the creation of cultural products, not only did Chinese society absorb the essence of traditional culture, it also absorbed the outstanding parts of advanced culture from abroad, and the culture of the people gradually blossomed in turn. (c) 2001–2010: more reforms, push for innovation In the new century, culture, politics, and economics are no longer mutually exclusive fields but have been gradually integrating. The status and role of culture within national strength have become increasingly prominent. Thus, cultural development has also received the attention it deserves within the process of national development. The 10th Five-Year Plan formulated in 2001 focused on the strategy of rejuvenating the country by means of science and education, on the vigorous development of talent resources. The aim was to improve the quality of national culture and cultivate high-quality talents through the acceleration of reforms in the science and technology sector, the education sector, and the system of education management.44 In the face of increasingly fierce technological competition on a global scale, in 2002 the CPC Central Committee and the State Council formulated the Outline of the National Talent Development Plan 2002–2005, proposing for the first time the Strategy of Strengthening China through Talents. In the same year, the 16th CPC National Congress opened up a new situation for China’s socialist cause in what was a new era by setting out comprehensive goals for the building of a moderately prosperous society. The Congress called for the more rapid cultural development and deeper cultural restructuring; a firm grasp of the trajectories of advanced cultures; persistence in the promotion and cultivation of the national spirit; feasible approaches toward morality-building; the vigorous development of education and scientific undertakings; active development of cultural undertakings and cultural industries; and efforts to build up a comparatively complete system of modern national education, science and technology, and cultural innovation.45 To ensure the 44 45

10th Five-Year Plan. 16th CPC National Congress.

1.1 The Social, Economic, and Cultural Contexts of Child Development …

21

full implementation of the concept of development in a scientific way and the in-depth implementation of the strategy of rejuvenating the country through science and education and the strategy of strengthening the country through talents, a group of entities led by the State Council formulated the Outline of National Medium- and Long-Term Scientific and Technological Development Plan in 2006. The objective of the document was to provide encouragement to the relevant personnel so that they might work hard in the field of science and technology and achieve even more brilliant results. Into the twenty-first century, a series of national policy documents have guided the full implementation of the strategy of rejuvenating the country through science and education, and the strategy of strengthening the country through talents. These documents have also helped to strengthen cultural development, facilitate deeper reform of the cultural system, and promote the development and prosperity of culture in China. In the field of education, the central government has increased spending on education; more or less implemented free compulsory education throughout the country in rural and urban areas; vigorously developed vocational education; trained a group of high-quality skilled personnel; improved the quality of higher education; and focused on the building-up of a number of key subjects and high-level universities, thereby making gratifying progress in increasing access to and improving education for all and laying the foundation for the modernization of China. In the field of science, China has continually implemented the strategy of rejuvenating the country through science and education, encouraged scientific and technological innovation, and made important progress with major science- and technology-related projects in the areas of aerospace engineering, mobile communications, and integrated circuit chip design. In the field of culture, deepen the reform of the cultural system, China has actively carried out pilot work on the reform of the cultural system, correctly handled attitudes toward traditional Chinese culture and foreign culture, promoted the development of the cultural industries, promoted the diversification of cultural products, and enriched the intellectual life of the people. The development path of Chinese cultural development since the introduction of the reform and opening-up policy can be described as “prosperous”. Since the rectification of errors and the implementation of the reform and opening-up policy in 1978, China have gradually shaken off the dilemma of development stagnation and have taken the smooth road to development in terms of cultural undertakings. The Party’s understanding of the importance of the country’s cultural undertaking has directly promoted the long-term development of China’s cultural undertakings. The rapid development of the education sector has not only improved the quality of the people, but also trained a group of skilled and educated individuals for the country’s construction. The advancement of science and technology has been transformed into productive forces and accelerated the process of economic development in China. The popularization of the cultural industries has enriched the intellectual and cultural lives of the people. In terms of child development, the Chinese cultural landscape that has developed over the past thirty years has created a positive development

22

1 Introduction

environment, and society’s emphasis on education, technology, and culture has been important for fostering the awareness needed. In the fierce competition between countries today, the comprehensive national strength of a country cannot be determined by the state of social development or economic level or the level of cultural development alone. Instead, the three are intertwined in a comprehensive measure of national strength. In the same way, the social background, economic background and cultural background can come together to form a broader environment that has an impact on child development. The stable, open, and developing social landscape of contemporary China has provided a stable social foundation for child development; high-speed and sustained economic development has provided a solid material foundation for child development; and the liberal and open culture of contemporary China and its emphasis on science and education has provide a good ideological foundation for child development. All three are indispensable in this regard. As part of a bigger system that has an impact on child development, together these three elements determine the future direction and development momentum of child development in China.

1.2 Definitions and Research Approach (i) Definitions 1. Defining “contemporary China” In the context of this volume, by “contemporary China” we mean the Chinese society in the period beginning from the introduction of the reform and openingup policy in 1978 to end-2010. 2. Defining “child” or “children” in terms of age As of 2010, China’s demographic and medical sectors define the “child” as an individual aged between zero and fourteen years old. This age range was also used in the 2010 national census. The medical field has also continued to use this definition in its research.46 The United Nations General Assembly adopted the Convention on the Rights of the Child (UNCRC) on November 20, 1989. It was the first text in the history of the UN that outlined the specifics of child protection laws with concrete and detailed description of children’s rights and provisions for protection. This document has served as an important guide for efforts to protect the rights of children in all countries around the world, including China. According to Article 1 of the UNCRC, a child means every human being below the age of eighteen years. On September 4, 1991, the 21st Session of the Standing Committee of the 7th National People’s Congress of China passed the Law of the People’s Republic of China on the Protection of Minors. The Law defines minors as children aged between zero and eighteen (not including 46

Su, S.F. & Ding, Y. (2015). Recommendations based on the structure of China’s child population and education policies: based on data analysis of the results of the 6th national census. Journal of Hebei Normal University (Education Edition), 2015 (1).

1.2 Definitions and Research Approach

23

the latter). Thereafter, this definition has been used in a number of policies relating to children put out by the government of China. In this volume, we define “child” as an individual aged between zero and seventeen (calendar) years. This is consistent with international standards as well as the standard used in Chinese government policy documents. More specifically, preschool children are defined as children aged zero and five years old, children of mandatory schooling age aged six to fourteen years old, and children of senior-high-school age at age fifteen to seventeen. 3. The definition and scope of the term “policy” The term “policy” originated from the term “polities” or politics in tandem with the emergence and rise of the modern capitalist state and political party. The definition of “policy” is: an expression of the actions to be taken by organizations such as political parties or governments to accomplish specific goals. On the one hand, policies are related to politics and strategies. It is a type of political behavior and the expression of the government’s will. It indicates what the government wishes to do, how it intends to carry out its will, what the government does not wish to do, and why the government does not wish to undertake said action, etc. On the other hand, the policy is also a concept of process. The process aspect is expressed in the fact that the policy comprises a series of actionable moves undertaken to reach a specific goal.47 “Policy” as described in this volume only refers to policy at the national level and does not include policies introduced by various local governments (e.g., at the provincial, municipal and other levels). Policy can be categorized into one of three groups depending on the organization involved in its formulation: laws are promulgated and implemented by China’s legislative bodies, the National People’s Congress and the Standing Committee of the NPC; regulations are policies put in place and implemented by China’s highest administrative authority, the State Council; sectoral rules are policies put in place and implemented by the various departments of the State Council. In this volume, these three categories are generally regarded as under the umbrella term of “policy” instead as “laws”, “regulations”, and “sectoral rules”. They are, however, distinguished in this regard by the specified organization that issues the policy. (i) Research approach The factor with a direct and constraining impact on child development within a certain country is the suite of child development-related policies formulated and implemented by the government and political parties of the country. Child development-related policies formulated by the national government serve as programs or guidelines for the promotion of child development and determine the trajectory of child development in the country. The World Declaration on the Survival, Protection and Development of Children stated that “the wellbeing of children requires political action at the highest level”. A basic system 47

Hu, J. (2011). Study on the development of mandatory education in China since the advent of the policy of reforms and opening-up. Master’s dissertation at Southwest University, June 2011.

24

1 Introduction

of institutions and mechanisms for the protection of child rights can only be established in a certain country through actions by government and by those in society, and when the government of said country places pays attention to the issues of child survival, child’s health, and child development and is constantly working to improve child-related policies. At the same time, forward-looking policies will promote the child-development cause while passivity will only lead the cause to be dragged along by society and suffer retrogression. Therefore, the top-level design of policy has a positive relationship with child development. As such, we have adopted the following approach in our research on child development in contemporary China in this volume: first of all, we take the historical approach and present the child-related policies that have been formulated and implemented by the government. These policies are examined to see if they were forward-looking or passive in nature as well as for other characteristics, such as whether they were grounded in scientific thinking, whether they were put in place to rectify previous errors, and if they were targeted, etc. Second, we take the realistic perspective and examine quantitative data on child survival and development status to see if policy implementation has made a positive difference as a means of testing the relationship between policy investment and child development. Finally, we use factual materials based on policies and data, to summarize the current situation of child development in contemporary China and try to describe future trends in this area. In this volume, the study structure is presented through the section headings, which are: 1. Policy and action 2. Data and outcomes 3. Summary and prospects.

1.3 Research Methods and Framework (i) Research methods 1. The historical method Rather than a mere description of specific historical events or the activities of historical figures, the essence of the historical research method lies in the search for the development process of the subject of research itself and the development of human knowledge over time.48 In this study, we have applied the historical research method and gone through the evolutionary path of China’s child-related over thirty-two years by means of textual analysis and qualitative discussion. With this approach, we were able to determine the evolution and characteristics of child-related development under policy guidance in various areas. At the same time, through the collection and processing of data on 48

Pei, D.N. (1995). Introduction to research methods in education. Hefei: Anhui Education Publishing House.

1.3 Research Methods and Framework

25

the survival and development of children in China over thirty-two years, we have also be able to quantitatively analyze the impact of policies on child development. For this study, we have divided this period of thirty-two years into three periods of roughly ten years long each: 1978–1990, 1991–2000, and 2001–2010. However, for certain areas of child-related development such as education and welfare, the trajectory and milestones of development have in turn come from major policies or major events, and therefore the historical stages of certain areas of child-related development have been divided according to these key moments. 2. The quantitative method The quantitative method is a method uses data collected as fact to come up with value judgments, and explanations, and assessments. As such, the objectivity, authority, and validity of data used in the quantitative method are particularly important. How data used in this study have been collected and obtained. The data used for quantitative research in this study were all collected and published in China, and no unofficial data has been used. Below are our data sources and descriptions of the types of data collected: • Data on the child population. Obtained from four of the six censuses that have been conducted since the founding of the People’s Republic of China: the 1982, 1990, 2000, and 2010 censuses. These four censuses fall into the scope of “contemporary China” as defined in this volume, i.e., between the advent of reform and openingup in 1978 and end-2010. • Data on the state of education for children. From the China Education Yearbook (1949–2011) and the Educational Statistics Yearbook of China (1987–2011). • Data on child survival and health. From the China Yearbook of Health Statistics (1990–2011) and the Statistical Bulletin on the Development of Healthcare in China (1996–2011) on the Ministry of Health website. • Data on the natural and social environment impacting child survival. From the China Publisher’s Yearbook (1997–2011), the China Yearbook of Culture and Cultural Relics (1990–2011), the Compilation of the Final Monitoring and Assessment Report for the “Child Development Outline of China for the 1990s” and the Compilation of Statistical Reports on the Child Development Outline of China (2001–2010). • Data on child welfare. From the China Civil Affairs Statistical Yearbook (1990– 2011). • Data on legal protections for children. From the Law Yearbook of China (1990– 2011). 3 Literature review The literature review method is a method used to retrieve existing literature in order to obtain a comprehensive and systematic review of the subject at hand and understanding of the issues to be studied.

26

1 Introduction

The literature review method has been employed in this study with all policy documents, laws, regulations, and agency regulations concerning child survival and development. In general, the original source of the policy document as well as the full name, date, promulgating agency, and text of the policy document as well as any attachments have been obtained through online searches and searches in the relevant databases. (ii) Research framework There are four parts to this study: child survival and health; education for children; the protection of children; and children’s cultures. Each part is then further divided into small sections. The logical structure of this volume revolves around these four areas of child development, which more or less reflect the logical sequence of the growth of the child from biological entity to human. The specific framework of this volume is as follows: Introduction: description of the social, economic and cultural contexts of child development in contemporary China; defining and explaining the core concepts and research methods used in the study; description of the basic framework of the study. Part I: Child population, survival and health. Chapters 2 and 3 make up Part I of the volume. Chapter 2: Size and structure of child population. First, establish the number of children and their age, gender and geographical distribution in census years using data from the four censuses of 1982, 1990, 2000, and 2010. Then, establish trends in the size of the child population in contemporary China as well as age, gender and geographical distribution over time based on the aforementioned census data. Chapter 3: Child survival and health. First: description of the Chinese government’s policy interventions and action with regard to child health. Second: presentation of the achievements China has made in child survival and health as understood through data analysis. Part II: Education and development of children. Chapters 4–7 make up Part II of the volume. Chapter 4: Preschool education and the development of children aged 0–5. First of all, describe the reform and development of preschool education that have taken place in terms of the preschool education system, funding, curriculum and human resource management. Then, present data on the state of education for children zero to five years old. Chapter 5: Compulsory education and the development of children aged 6–14. First: describe the establishment and development of China’s compulsory nine-year education system in terms of system management, funding, curriculum and human resource development, etc. Second, describe the outcome of efforts to implement the compulsory education requirement. Chapter 6: Senior-high-school education and the development of children aged 15–17. First: description of the overall development history of high school education as well as of the development history of ordinary high school education and vocational high school education. Then: description of changes over time and achievements due to structural reform of the senior-high-school education system based on data analysis. Chapter 7: Education and development of special and disadvantaged children. First: descriptions of the changes that have occurred over time in education for special and

1.3 Research Methods and Framework

27

disadvantaged children respectively. Then: description of the outcomes of development in the area of special education and education for disadvantaged children, based on data analysis. Part III: Child protection. There are three chapters (Chapters 8–10). Chapter 8: Child welfare. First: description of how the child-welfare system came out, and changes in this system over time. Then: description of the achievements made by programs designed to assist children in difficult in China, based on data analysis. Chapter 9: The environment for child survival and development. First: historical description of the Chinese government’s policy formulation and behavioral investment in efforts to management the living environment and optimize the developmental environment for children. Then: description of the achievements made by the Chinese government in terms of management of the living environment and the optimization of the developmental environment for children. Chapter 10: Legal protection for children. First: description of how the system of legal protections for children was formed and developed over time. Then: description of the state of judicial protection and assistance, based on available data. Part IV: Children’s cultures. Chapters 11–13 make up Part IV of this volume. Chapter 11: Cultural content created by children. This chapter provides a description of the characteristics of children’s cultures over time as well as the reasons for the formation of such cultures through two lenses: children’s games, and children’s emotions and attitudes. Chapter 12: Cultural content created for children. This chapter provides a description of the characteristics of cultural content created for children over time, and the reasons for the formation of such content through two lenses: music for children and animated content for children. Chapter 13: Future development trends for cultural content pertaining to children. This chapter predicts that the future development of children’s cultures in China will take on the following forms: convergence with global trends; symbiosis with adult cultures; and the return of the child qua subject.

Part I

Child Population, Survival, and Health

Chapter 2

Size and Structure of Child Population

To understand the size and structure of the child population in contemporary China is a prerequisite to understanding child development in contemporary China. A total of six population censuses have been conducted since the founding of the People’s Republic of China. The results of these six censuses provide us with a rich trove of information needed for an accurate understanding of basic indicators for the child population and for a description of the child population in general as well as the structure and characteristics of various subgroups. The four censuses that fall into the “contemporary” period as described in this volume (in the period of thirty-two years between 1978 and end-2010) are the last four censuses that were completed in 1982, 1990, 2000, and 2010. The description of the child population in China in this chapter is based on the data obtained from these four censuses.

2.1 Population Size and Structure Over Multiple Censuses Population structure is a certain way of looking at international relationships within population. It reflects various category attributes of population composition as seen through the prism of various measurement labels.1 The structure or distribution of a population can take various forms depending on the labels used. Briefly speaking, various population distributions can take one of the following forms: by age, by sex, geographical location, by social class, and by other qualities. Our analytic focus with the child population is on the age structure, gender structure, and geographical structure.

1

Li, D.Z. (2014). Study of the impact of changes in the Chinese population on the life insurance market. Master’s degree dissertation at Hebei University, June 2014.

© Social Sciences Academic Press 2023 X. Wang, A Study on Child Development in Contemporary China, Research Series on the Chinese Dream and China’s Development Path, https://doi.org/10.1007/978-981-19-8959-9_2

31

32

2 Size and Structure of Child Population

2.1.1 Population Size and Structure According to the 1982 Census The size of the child population as well as its age and sex distribution based on data from the third national census of 19822 is shown in Table 2.1. In terms of age, as of July 1, 1982, the size of China’s population was 1,031,887,961, an increase of 312,722,424 or 31.02% over the 1964 figure. The size of the child population (those aged zero to seventeen) was 410,106,529 or around 40.68% of the total population. Children of preschooling age (zero to five) numbered 114,125,661, those of mandatory schooling age (six to fourteen) numbered 223,125,528, and those seniorhigh-school age (fifteen to seventeen) numbered 72,855,340. In terms of sex, males in the general Chinese population numbered 515,277,505 or 51.11% of the total while females numbered 488,636,422 (48.89% of the total). The male-to-female ratio was 105.45 (size of female population as base of one hundred). Among children aged zero—seventeen years old, male children numbered 211,256,571 or 51.51% of the child population while female children numbered 198,849,958 (48.49% of the child population). There were 12,406,613 more males than females, with the male-to-female ratio standing at 106.24. The geographical distribution of the child population (by city, town, county) based on data from the third national census of 19823 is shown in Table 2.2. A total of 46,513,307 children (aged zero to seventeen) or 11.34% of the child population lived in urban areas, while 21,398,909 children or 5.22% of the population lived in towns. Around 342,194,313 children or 83.44% of the total child population were found to be living at the county level. The state of population development differed widely across various regions, indicating the presence of obvious regional differences.

2.1.2 Population Size and Structure According to the 1990 Census The size of the child population as well as its age and sex distributions according to data from the fourth national census of 19904 is shown in Table 2.3. The size of China’s total population in 1990 was 1,133,709,738, an increase of 125,529,189 or 12.45% over 1982 numbers. The size of the child population (those aged zero to seventeen) was 382,769,811 or around 33.76% of the total population. Children of preschooling age (zero to five) numbered 136,420,709, while those of mandatory 2

Data covers the population of active servicemen and the populations of Kinmen and Matsu islands, but do not cover the populations of Taiwan Province and Hong Kong and Macau Special Administrative Regions. 3 See Footnote 2. 4 Data covers the population of active servicemen but not the populations of Kinmen and Matsu islands, Taiwan Province and Hong Kong and Macau Special Administrative Regions.

2.1 Population Size and Structure Over Multiple Censuses

33

Table 2.1 Child population by age and sex Age

Size of child population Subtotal

Percentage of total pop.

Male

Female

Subtotal

Male

Female

0

20,809,347

10,787,028

10,022,319

2.06

1.07

0.99

1

17,375,778

9,015,023

8,360,755

1.72

0.89

0.83

2

18,273,841

9,460,846

8,812,995

1.81

0.94

0.87

3

19,625,509

10,131,309

9,494,200

1.95

1.00

0.94

4

18,619,886

9,589,607

9,030,279

1.85

0.95

0.90

5

19,421,300

10,005,985

9,415,315

1.93

0.99

0.93

6

20,432,542

10,528,882

9,903,660

2.03

1.04

0.98

7

21,779,429

11,215,966

10,563,463

2.16

1.11

1.05

8

24,032,967

12,373,188

11,659,779

2.38

1.23

1.16

9

25,069,633

12,902,275

12,167,358

2.49

1.28

1.21

10

25,222,513

12,990,403

12,232,110

2.50

1.29

1.21

11

27,323,306

14,071,874

13,251,432

2.71

1.40

1.31

12

26,487,340

13,614,655

12,872,685

2.63

1.35

1.28

13

28,239,541

14,522,190

13,717,351

2.80

1.44

1.36

14

24,538,257

12,638,810

11,899,447

2.43

1.25

1.18

15

22,750,897

11,710,874

11,040,023

2.26

1.16

1.10

16

25,686,509

13,189,846

12,496,663

2.55

1.31

1.24

17

24,417,934

12,507,810

11,910,124

2.42

1.24

1.18

410,106,529

211,256,571

198,849,958

40.68

20.95

19.72

Total

Source State Council Population Census Office and Department of Population Statistics, National Bureau of Statistics (1985). 1982 China census data. Beijing: China Statistics Press Note Percentage statistics obtained by means of calculation Table 2.2 Distribution by city, town, and county Age

Cities Size of child population

Towns % of total child pop.

Size of child population

Counties % of total child pop.

0–4

10,848,531

2.65

4,892,024

1.19

5–9

11,612,876

2.83

5,454,751

10–14

15,321,774

3.74

6,943,453

15–17

8,730,126

2.13

Total

46,513,307

11.34

Size of child population

% of total child pop.

78,963,806

19.25

1.33

93,668,244

22.84

1.69

109,545,730

26.71

4,108,681

1.00

60,016,533

14.63

21,398,909

5.22

342,194,313

83.44

Source State Council Population Census Office and Department of Population Statistics, National Bureau of Statistics (1985). 1982 China census data. Beijing: China Statistics Press Note Percentage statistics obtained by means of calculation

34

2 Size and Structure of Child Population

Table 2.3 Child population by age and sex Age

Size of child population Subtotal

Male

Percentage of total pop. Female

Subtotal

Male

Female

0

23,220,851

12,254,905

10,965,046

2.05

1.08

0.97

1

23,331,877

12,304,824

11,027,953

2.06

1.09

0.97

2

24,180,595

12,672,092

11,508,503

2.13

1.12

1.02

3

24,294,365

12,676,790

11,617,575

2.14

1.12

1.02

4

21,410,731

11,140,519

10,270,212

1.89

0.98

0.91

5

19,982,290

10,405,433

9,576,857

1.76

0.92

0.84

6

19,067,078

9,922,498

9,133,580

1.68

0.88

0.81

7

20,196,487

10,518,627

9,677,860

1.78

0.93

0.85

8

22,015,342

11,419,500

10,595,842

1.94

1.01

0.93

9

18,086,546

9,264,817

8,721,729

1.60

0.82

0.77

10

19,224,062

9,956,298

9,267,764

1.70

0.88

0.82

11

19,310,091

9,974,473

9,335,618

1.70

0.88

0.82

12

18,864,678

9,727,202

9,137,476

1.66

0.86

0.81

13

19,367,292

9,987,990

9,379,302

1.71

0.88

0.83

14

20,460,569

10,537,630

9,922,939

1.80

0.93

0.88

15

21,643,791

11,123,627

10,520,164

1.91

0.98

0.93

16

23,487,567

12,043,876

11,443,691

2.07

1.06

1.01

17

24,536,599

12,581,345

11,955,254

2.16

1.11

1.05

382,769,811

198,612,446

184,057,365

33.76

17.52

16.23

Total

Source State Council Population Census Office and Department of Population Statistics, National Bureau of Statistics (1993). 1990 China census data (Vol. I-IV). Beijing: China Statistics Press Note Percentage statistics obtained by means of calculation

schooling age (six to fourteen) numbered 176,592,145. Another 69,767,957 were of senior-high-school age (fifteen to seventeen). The number of males within the general population numbered 581,820,407 or 51.32% of the total population while females numbered 548,690,231 or 48.68% of the total population, with the sex gender at 106.04 (female population as base of 100). Among children aged zero to seventeen, male children numbered 198,612,446 or 51.89% of the child population while female children numbered 184,057,365 (48.11% of the child population). There were 14,555,081 more male children than female children, with the sex ratio at 107.91. The fourth national census of 1990 delineated geographical locations into three groups: cities, towns, and counties. The geographical distribution of the child population based on data from the 1990 census5 is shown in Table 2.4. The number of children living in the cities numbered 98,285,580 or 25.68% of the total child population, while children living in towns numbered 92,568,118 or 24.18% of the child 5

See Footnote 4.

2.1 Population Size and Structure Over Multiple Censuses

35

Table 2.4 Distribution by city, town, and county Age

Cities Size of child population

Towns % of total child pop.

Size of child population

Counties % of total child pop.

Size of child population

% of total child pop.

0–4

29,693,540

7.76

28,559,879

7.46

58,185,000

15.20

5–9

25,696,164

6.71

24,567,924

6.42

49,072,655

12.82

10–14

24,803,060

6.48

23,267,220

6.08

49,156,412

12.84

15–17

18,092,816

4.73

16,173,095

4.23

35,402,046

9.25

Total

98,285,580

25.68

92,568,118

24.18

191,816,113

50.11

Source State Council Population Census Office and Department of Population Statistics, National Bureau of Statistics (1993). 1990 China census data (Vol. I-IV). Beijing: China Statistics Press Note Percentage statistics obtained by means of calculation

population. The number of children living at the county level totaled 191,816,113 or 50.11% of the total child population. Similarly, the state of population development varied widely across various regions, and it was clear that there were obvious regional differences. However, these differences had been narrowed compared to 1982.

2.1.3 Population Size and Structure According to the 2000 Census The size of the child population as well as the age and sex distribution of the population based on data from the fifth national census of 20006 is shown in Table 2.5. According to the National Bureau of Statistics, as of November 1, 2000, the population of the Chinese mainland stood at 1,265,825,048 across thirty-one mainland provinces, autonomous regions, and municipalities directly under the Central Government (including active servicemen). This number marked an increase of 132,115,310 or 11.65% from 1990 figures. The Chinese population had changed from a growing one to a shrinking one. The size of the child population (those aged zero–seventeen years old) was 345,335,394 or around 27.28% of the total population. Children of preschooling age (zero to five) numbered 85,911,933, while those of mandatory schooling age (six to fourteen) numbered 198,615,661. Another 60,807,800 were of senior-high-school age (fifteen to seventeen). The total number of males across the country stood at 640,275,969 or 50.58% of the total population, while females numbered 602,336,257 (49.42% of the total population), with the sex ratio standing at 106.30. Among children aged zero–seventeen, male children numbered 182,638,979 or 52.89% of the child population, while female children numbered 162,696,415 or 47.11% of the child population. There

6

See Footnote 4.

36

2 Size and Structure of Child Population

Table 2.5 Child population by age and sex Age

Size of child population Subtotal

Male

Percentage of total pop. Female

Subtotal

Male

Female

0

13,793,799

7,460,206

6,333,593

1.09

0.59

0.50

1

11,495,247

6,332,425

5,162,822

0.91

0.50

0.41

2

14,010,711

7,701,684

6,309,027

1.11

0.61

0.50

3

14,454,335

7,897,234

6,557,101

1.14

0.62

0.52

4

15,224,282

8,257,145

6,967,137

1.20

0.65

0.55

5

16,933,559

9,157,597

7,775,962

1.34

0.72

0.61

6

16,470,140

8,866,012

7,604,128

1.30

0.70

0.60

7

17,914,756

9,590,414

8,324,342

1.42

0.76

0.66

8

18,752,106

10,014,222

8,737,884

1.48

0.79

0.69

9

20,082,026

10,674,963

9,407,063

1.59

0.84

0.74

10

26,210,044

13,811,030

12,399,014

2.07

1.09

0.98

11

25,137,678

13,110,848

12,026,830

1.99

1.04

0.95

12

24,576,191

12,779,621

11,796,570

1.94

1.01

0.93

13

26,282,644

13,619,530

12,663,114

2.08

1.08

1.00

14

23,190,076

12,023,710

11,166,366

1.83

0.95

0.88

15

20,429,326

10,598,460

9,830,866

1.61

0.84

0.78

16

20,313,426

10,468,201

9,845,225

1.60

0.83

0.78

17

20,065,048

10,275,677

9,789,371

1.59

0.81

0.77

345,335,394

182,638,979

162,696,415

27.28

14.43

12.85

Total

Source State Council Population Census Office and Department of Population Statistics, National Bureau of Statistics. 2000 China census data Note Percentage statistics obtained by means of calculation

were 19,942,564 more male children than female children, and the sex ratio in this population was 112.26. In the fifth national census of 2000, geographically speaking, the country was divided into the following geographic categories: cities, towns, and villages. The geographic distribution of the child population according to data from the 2000 census7 is shown in Table 2.6. The number of children living in cities stood at 62,789,044 or 18.18% of the child population, while the number of children living in towns stood at 44,627,109 (12.92% of the child population). The number of children living in villages totaled 237,919,241 or 68.90% of the child population. Similarly, the development of the population in each region is very different, and children living in rural areas accounted for the majority of the population.

7

See Footnote 4.

2.1 Population Size and Structure Over Multiple Censuses

37

Table 2.6 Distribution by city, town, and village Age

Cities Size of child population

Towns % of total child pop

Size of child population

Villages % of total child pop

Size of child population

% of total child pop

0–4

13,077,563

3.79

9,041,154

2.62

46,859,657

13.57

5–9

15,139,090

4.38

11,449,273

3.32

63,564,224

18.41

10–14

20,312,108

5.88

15,490,776

4.49

89,593,749

25.94

15–17

14,260,283

4.13

8,645,906

2.50

37,901,611

10.98

Total

62,789,044

18.18

44,627,109

12.92

237,919,241

68.90

Source State Council Population Census Office and Department of Population Statistics, National Bureau of Statistics. 2000 China census data Note Percentage statistics obtained by means of calculation

2.1.3.1

Population Size and Structure According to the 2010 Census

The size of the child population as well as the age and sex distribution according to data from the sixth national census of 20108 are shown in Table 2.7. In 2010, the total population across thirty-one provinces, municipalities, autonomous regions and municipalities directly under the Central Government (including active servicemen) stood at 1,339,724,852, an increase of 73,899,804 or 5.52% over 2000 figures. The size of the child population (those aged zero to seventeen) was 278,912,995 or around 20.82% of the total population. This figure was already lower than the normal proportion for this age range. The swift decline in the total number of children is a reflection of the tremendous impact of the stringent policy of family planning. The number of children of preschooling age (zero to five) stood at 90,264,747 while those of mandatory schooling age (six to fourteen) numbered 131,057,874. Another 57,590,374 were of senior-high-school age (fifteen to seventeen). Nationwide, the total number of males stood at 682,329,104 or 50.93% of the total population, while females numbered 650,481,765 (49.07% of the population), with the sex ratio standing at 104.90. Within the child population (aged zero to seventeen), male children numbered 149,875,415 or 53.74% of the total child population, and female children numbered 129,037,580 (46.27% of the child population). There were 20,837,835 more male children than female children, with the sex ratio standing at 116.15 within this population. The sixth national census of 2010 divided the nation geographically into cities, towns, and villages. The geographic distribution of the child population according to data from the 2010 census9 is shown in Table 2.8. The number of children living in cities stood at 65,467,663 or 23.47% of the child population, while the number of children living in towns stood at 59,009,941 (21.16% of the child population). The number of children living in villages totaled 154,435,391 or 55.37% of the child population. Similarly, the development of the population in each region is 8 9

See Footnote 4. See Footnote 4.

38

2 Size and Structure of Child Population

Table 2.7 Child population by age and sex Age

Size of child population Subtotal

Male

Percentage of total pop. Female

Subtotal

Male

Female

0

13,786,434

7,461,199

6,325,235

1.03

0.56

0.47

1

15,657,955

8,574,973

7,082,982

1.17

0.64

0.53

2

15,617,375

8,507,697

7,109,678

1.17

0.64

0.53

3

15,250,805

8,272,491

6,978,314

1.14

0.62

0.52

4

15,220,041

8,246,206

6,973,835

1.14

0.62

0.52

5

14,732,137

7,988,151

6,743,986

1.10

0.60

0.50

6

14,804,470

8,034,452

6,770,018

1.11

0.60

0.51

7

13,429,161

7,292,300

6,136,861

1.00

0.54

0.46

8

13,666,956

7,423,559

6,243,397

1.02

0.55

0.47

9

14,248,825

7,726,203

6,522,622

1.06

0.58

0.49

10

14,454,357

7,830,808

6,623,549

1.08

0.58

0.49

11

13,935,714

7,522,558

6,413,156

1.04

0.56

0.48

12

15,399,559

8,288,987

7,110,572

1.15

0.62

0.53

13

15,225,032

8,161,000

7,064,032

1.14

0.61

0.53

14

15,893,800

8,463,924

7,429,876

1.19

0.63

0.55

15

18,024,484

9,524,898

8,499,586

1.35

0.71

0.63

16

18,790,521

9,795,181

8,995,340

1.40

0.73

0.67

17

20,775,369

10,760,828

10,014,541

1.55

0.80

0.75

278,912,995

149,875,415

129,037,580

20.82

11.19

9.63

Total

Source State Council Population Census Office and Department of Population Statistics, National Bureau of Statistics. 2010 China census data Note Percentage statistics obtained by means of calculation

very different, and children living in rural areas accounted for the majority of the population.

2.2 Changes in Population Structure Calculations using data from the four censuses show us clearly the changes in the size and structure of the child population in contemporary China.

2.2 Changes in Population Structure

39

Table 2.8 Distribution by city, town, and village Age

Cities

Towns

Size of child population

% of total child pop.

Villages

Size of child population

% of total child pop.

Size of child population

% of total child pop.

0–4

16,360,447

5.87

14,576,023

5.23

44,596,140

15.99

5–9

15,903,218

5.70

14,662,441

5.26

40,315,890

14.45

10–14

17,121,336

6.14

15,686,190

5.62

42,100,936

15.09

15–17

16,082,662

5.77

14,085,287

5.05

27,422,425

9.83

Total

65,467,663

23.47

59,009,941

21.16

154,435,391

55.37

Source State Council Population Census Office and Department of Population Statistics, National Bureau of Statistics. 2010 China census data Note Percentage statistics obtained by means of calculation

2.2.1 Changes in the Size and Age Distribution of the Child Population Table 2.9 shows that the size of the child population (aged zero to seventeen) declined from 410,106,529 in 1982 to 278,912,995 in 2010, with the proportion of the child population within the general population dropping from 40.68% to 20.82% or around 7% every decade. The child population in contemporary China is shrinking. Table 2.9 Size of child population and its percentage of total population over multiple censuses Year 1982

2000

Age

Size of child population

Percentage of total pop.

0–2

56,458,966

5.59

3–5

57,666,695

5.73

Year 1990

Age

Size of child population

Percentage of total pop.

0–2

70,733,323

6.24

3–5

65,687,386

5.79 10.40

6–11

143,860,390

14.27

6 –11

117,899,606

12–14

79,265,138

7.86

12–14

58,692,539

5.17

15–17

72,855,340

7.23

15–17

69,667,957

6.14 33.76

Total

410,106,529

40.68

0–2

39,299,757

3.11

3–5

46,612,176

3.68

2010

Total

382,769,811

0–2

45,061,764

3.37

3–5

45,202,983

3.38

6–11

124,566,750

9.85

6–11

84,539,483

6.31

12–14

74,048,911

5.85

12–14

46,518,391

3.48

15–17

60,807,800

4.80

15–17

57,590,374

4.30

Total

345,335,394

27.28

Total

278,912,995

20.82

Source State Council Population Census Office and Department of Population Statistics, National Bureau of Statistics, census data for the 1982, 1990, 2000 and 2010 censuses

40

2 Size and Structure of Child Population

Table 2.10 Population sex ratios over multiple censuses (female population = base of 100) Year

1982

1990

2000

2010

National sex ratio

105.45

106.04

106.30

104.90

Sex ratio for children aged 0–17

106.24

107.91

112.26

116.15

Source State Council Population Census Office and Department of Population Statistics, National Bureau of Statistics, census data for the 1982, 1990, 2000 and 2010 censuses

2.2.2 Changes in the Sex Distribution of the Child Population Table 2.10 shows that changes in this regard are not very significant. However, the sex ratio for the child population (aged zero to seventeen) rose from 106.24 in 1982 to 116.15 in 2010. Clearly, there is an imbalance between the numbers of male and female children.

2.2.3 Changes in the Geographical Distribution of the Child Population The geographical distribution of the population reflects the results of mankind’s sustained use of various natural resources. The rural–urban distribution is an especially important aspect of population geographical distribution. Within academia in China there is no consensus on definitions of “urban” and “rural”, and various scholars have different standards for differentiating between the two. The urban– rural delineation has also been adjusted a number of times over the course of several population censuses. The 1980 and 1990 censuses divided China geographically into cities, towns, and counties, while the 2000 and 2010 censuses divided China into cities, towns, and townships. In 2008, the National Bureau of Statistics released its “Statistical Regulations on the Delineation of Urban and Rural Areas”. These are the latest delineation standards available in China. The document stipulates that geographically China should be divided into: (a) urban areas; and (b) rural areas. “Urban areas” include cities (residents’ committees and other areas connected to facilities by the local municipal, non-district city, district, and city governments) and towns (residents’ committees and other areas outside of urban areas connected to facilities by the local county people’s and other town governments). The term “rural areas” refers to the areas outside of towns and cities as defined herein and includes market towns and villages. The market town is a non-government-built town that has developed from a marketplace to the economic, culture, and lifestyle services center of a specific rural area and that has been recognized by the local township or ethnic people’s government as well as by the local county government. Clearly, conceptually speaking, the township unit is smaller than the county unit. When the county is rezoned into urban and rural areas, the existing county people’s government is zoned into urban areas with the remaining independent areas zoned as rural areas.

2.2 Changes in Population Structure

41

Table 2.11 Geographic distribution of the child population based on data from the 1982 and 1990 censuses Location

1982 Size of child population

Cities Towns Counties

46,513,307

1990 % of total child pop. Size of child population

% of total child pop.

11.34

98,285,580

25.68

21,398,909

5.22

92,568,118

24.18

342,194,313

83.44

191,816,113

50.11

Source State Council Population Census Office and the Department of Population Statistics, National Bureau of Statistics; China census data for 1982 and 1990

Two types of geographic categorizations were used in the four population censuses: in 1982 and 1990, China was divided into cities, towns, and counties while in 2000 and 2010 China was divided into urban and rural areas. Thus, the results of the 1982 and 1990 censuses can be considered together, just as the results of the 2000 and 2010 censuses can be considered together.

2.2.3.1

Changes in the Distribution of the Child Population in Cities, Towns, and Counties

From Table 2.11 we see that the number of children living at the county level is far higher than the number of children living in towns and cities. At the same time, the proportion of individuals living at the county level has dipped significantly between 1982 and 1990. In this period, there has been a significant shift, with the child population in the counties moving toward the towns and cities.

2.2.3.2

Changes in the Distribution of the Child Distribution in Cities, Towns, and Villages

From Table 2.12 we see that the proportion of children living in villages or rural areas to be significantly higher than the proportion of children living in towns and cities, and that the rural child population is slightly greater than the sum total of the town and city child populations. The proportion of individuals living in towns has significantly increased between 2000 and 2010, indicating that the rural child population is shifting toward the towns. Between 2000 and 2010, there has been a significant shift of the rural population toward the towns and cities. Calculations using data from the four censuses show that the geographic divisions used in these four censuses are not the same. The 1982 and 1990 censuses used the city/town/county classification while the 2000 and 2010 census used the city/town/village classification. For the last two instances, data for the urban and rural populations became available. As of 2010, the rural child population accounted

42

2 Size and Structure of Child Population

Table 2.12 Geographic distribution of the child population based on data from the 2000 and 2010 censuses Location

2000 Size of child population

Cities Towns Villages

2010 % of total child pop. Size of child population

% of total child pop.

62,789,044

18.18

65,467,663

23.47

44,627,109

12.92

59,009,941

21.16

237,919,241

68.90

154,435,391

55.37

Source State Council Population Census Office and the Department of Population Statistics, National Bureau of Statistics; China census data for 2000 and 2010

for 55.37% of the total child population in China, compared to 68.9% in 2000. In the span of ten years there was a significant shift of the rural child population toward the towns and the cities.

Chapter 3

Child Survival and Health

The state of development with regard to child health in modern sovereign states can be measured by the state’s intervention with, and resolution of, three types of issues in the area of child health. The first type of issue is child survival, which includes various issues associated with fertility, childbirth, and immunization. Policies and measures that can be implemented to resolve such issues include: the lowering of neonatal and maternal mortality rates, the eradication of neonatal tetanus, and ensuring safe deliveries and the health and safety of mother and child, etc. The second type of issues concern health, healthcare, and nutrition issues for children, including: the physical health of child and nutrition, health care and family health, campus health and physical activity, and the physical growth and development of children, etc. Policies and measures that can be implemented to mitigate/resolve such issues include: the guaranteeing of breastfeeding, ensuring children receive adequate nutrition, promoting health care for children, and efforts to promote the physical growth of children, etc. The third type of issues pertains to the matter of healthcare services, including: reproductive health and prenatal/postnatal care (sex education), family planning and household welfare, healthcare and health promotion for adolescents, and psychological and mental health, etc. Policies and measures that can be implemented to mitigate/resolve such issues include: guaranteeing conducive conditions for children’s psychological health and sex education for children, etc. Various countries around the world have, as far as their economic, social cultural conditions allow, become gradually more involved in resolving these three types of child-related health issues in turn. In general, states tend to work first on matters pertaining to survival, such as working to reduce neonatal and maternal mortality rate and to eradicate neonatal tetanus in order to ensure the safe delivery of the child and the safety of both mother and child. Then, the state begins to intervene in matters pertaining to health care and nutrition, linking the matters of children’s physical health and nutrition, child health and physical development, and health care for children directly with the future of the country and the future of the nation. The degree to which these issues are resolved also serve as an important indicator of the degree of to which a country has been modernized. Finally, the state looks at the issue © Social Sciences Academic Press 2023 X. Wang, A Study on Child Development in Contemporary China, Research Series on the Chinese Dream and China’s Development Path, https://doi.org/10.1007/978-981-19-8959-9_3

43

44

3 Child Survival and Health

of health services. Such issues are usually a sign of to which a country or society is civilized and a symbol of the quality of children’s health care. The developed nations in the West began to intervene in issues such as household welfare, sex education, and mental health after the Second World War. However, Chinese society has only begun to deal with the third category of issues at the turn of the new century.1

3.1 Policy and Action: The History of the Child Health Sector In contemporary China, we have invariably gone through the three stages of intervention, first with matters pertaining to child survival, then matters pertaining to health care and nutrition for children, and then finally with a focus on healthcare services for children. It was after 1990 that the Chinese government began to consider “children” a subject of policy and worked to develop the child health sector with the principle of “Children First”.

3.1.1 1978–1990: Little Attention Paid to the Child Health Sector In 1978, China began to open up and undergo reforms as it transitioned from a centrally planned economy to a socialist market economy. In this period, economic development was the overriding concern of Chinese society. So, in the first decade after the advent of the reform and opening-up policy, there was almost zero direct policy formulation and action on child health by the Chinese government. On December 6, 1979, the Ministry of Health released its “Draft Interim Provisions for Health Work in Elementary and High Schools”, a document which contained specific requirements and provisions for “campus health work” and “the management of campus health”. It was a policy for the regulation of elementary and high school education and of the management order at a time Chinese society had just entered the era of reform and opening-up, and when rectifications and regulations were needed in the education system. On April 20, 1986, the Ministry of Health issued its “Regulations on Health Work for Mothers and Children”. In Section II (“Tasks”), Article 7 of the Regulations, five tasks pertaining to children’s health care and nutrition were stipulated. They are: (1) Ensure children under seven years of age receive acceptable health care. To implement systematic healthcare management for infants and young children,

1

Liu, J.T. & Guo, Yan (2007). Consolidating children’s health and child welfare: a restructuring of the child welfare policy framework in modern China. Study and Practice, 2007 (2).

3.1 Policy and Action: The History of the Child Health Sector

(2)

(3) (4)

(5)

45

to enhance the physical fitness of children, and to reduce levels of neonatal and infant mortality rate. Active prevention and treatment of common/high-occurrence pediatric illnesses, investigation and analysis of disease causes, formulation of prevention and control measures to reduce disease incidence rate, and rising of the cure rate. Provision of strong guidance for the health-related operations in childcare facilities and nursery schools. Promotion of science-based childcare practices, promotion of breastfeeding, and working with relevant agencies to ensure adequacy of care for infants and those in early childhood. Working together with health and disease-control agencies on vaccination and control of infectious diseases.

On November 14, 1986, the Ministry of Health issued its “Health Management Measures for Dietary Nutrition Enhancers”. The Management Measures comprise thirteen articles. In particular, Article 8 deals with the management of foods designed for consumption by infants. Specifically: the fortification of foods designed for consumption by infants must be implemented in accordance with the regulations for the nutrition and hygiene of baby foods promulgated or approved by the Ministry of Health. On April 1, 1987, the State Council released its “Health Management Regulations for Public Spaces”. These regulations were drafted and put in place to protect human health by creating positive health conditions in public spaces and preventing against disease. Neither campus nor child health were mentioned specifically in this set of regulations. On February 21, 1989, the National People’s Congress passed and promulgated the Law of the People’s Republic of China on the Prevention and Treatment of Infectious Diseases. Article 1 of the Law states the aims of drafting and implementing this law: to protect human health by preventing against, controlling, and eradicating the incidence and spread of infectious disease. The Law does not deal specifically with the subject of child health. On April 25, 1990, with the approval of the State Council, the Ministry of Health promulgated the “Regulations on Health Work in Schools”. At the same time, the “Draft Interim Provisions for Health Work in Elementary and High Schools” jointly promulgated by the Ministry of Health and Ministry of Education and the Draft Interim Provisions on Health Work in Colleges and Universities were abolished on December 6, 1979 and August 26, 1980 respectively. The “Regulations on Health Work in Schools”, which applied to campuses of all levels, cover the following five subjects: general principles, requirements for health work on campuses, the management of on-campus health work, the supervision of on-campus health work, and rewards and punishment. Table 3.1 shows the policies pertaining to child health established and implemented by the National People’s Congress, the State Council and the Ministry of Health in the period 1978–1990.

46

3 Child Survival and Health

Table 3.1 Government policies pertaining to child health, 1978–1990 Promulgated on/in

Promulgated by

Policy

1979.12.6

Ministry of Health

Draft Interim Regulations on Health Work in Elementary and High Schools

1986.4.20

Ministry of Health

Regulations on Health Work for Mothers and Children

1986.11.14

Ministry of Health

Health Management Measures for Dietary Nutrition Enhancers

1990.4.25

Ministry of Health

Regulations on Health Work in Schools

3.1.2 1991–2000: Swift Development of the Child Health Sector In 1989, the United Nations made a major legal breakthrough in terms of the protection of children’s rights, one with major impact for countries around the world (including China). This breakthrough was the Convention on the Rights of the Child. The Convention, a follow-up to the 1924 Geneva Declaration on the Rights of the Child, the 1924 Universal Declaration of Human Rights (including child rights), and the 1959 Declaration on the Rights of the Child, was the first instance in which specifics on legal protection of the rights of the child, and ways to perform such protection, were written in a legal document. China, which had been on the path of reform and opening-up for a decade by then, actively participated in the work of the United Nations in the formulation of the Convention and signed the Convention in 1990. Then, the implementation of the Convention was approved by the Standing Committee of the National People’s Congress in 1991.2 Since then, China’s child health sector has become more aligned with the rest of the world, and a system of the protection of child rights has been incorporated. The Chinese government has made solemn promises to work seriously to fulfill its obligations under the Convention. Since then, a series of laws and regulations related to child rights has been introduced in quick session. China’s child health sector had entered a period of rapid development. On September 4, 1991, the National People’s Congress passed, and promulgated, the Law of the People’s Republic of China on the Protection of Minors. The promulgation and implementation of the Law marked a milestone in the history of child survival and development in China: it was the first time in which the basic forms of protection for minors and a framework for social protection had been introduced in the form of state law. The Law, which established the legal rights of minors and respect for the dignity of minors, and the principle of combining education with protection, classified the social protection of minors into four basic types: family protection, on-campus protection, social protection, and judicial protection. The Law stipulates a rehabilitative policy of education and probation for minors found to have 2 State Council National Working Committee on Children and Women (1996). Report on the state of child development in China in the mid-1990s, p. 4.

3.1 Policy and Action: The History of the Child Health Sector

47

committed crimes, with priority to education and punishment serving as a supplementary means.3 This law is a powerful guarantee for the rights of the Chinese child to survival, good health, and development. In this period, the Chinese government formulated and introduced a series of laws, regulations, and agency regulations that directly pertain to the protection and promotion of child survival and health. On February 16, 1992, the State Council approved and promulgated the “Child Development Outline of China for the 1990s” drafted by the National Working Committee on Children and Women. The Outline, which placed child development as a priority area within social development, laid out the main objectives, strategic significance, planning principles, development strategies and policy measures for the survival, protection and development of Chinese children in the 1990s. This was the first Chinese national action plan for child development that was centered on the child and which adhered to the principle of “Children First”. As such, it has strong historical significance.4 The release of the Outline led the opening of a new chapter in the history of child development in China and marked the advent of an era where children were regarded as a subject of development within Chinese society. On the subject of child survival and health, the Outline called for the infant mortality rate and the under-five-year-old child mortality rate to be reduced by one third, the maternal mortality rate to be reduced by half, and the prevalence of malnutrition in children under five years of age to be reduced by half. The Ministry of Health issued its “National Plan for the Control of Respiratory Infections in Children (1992–1995)” and the “Diarrhea Control Plan (1990–1994)” in order to reduce infant and child mortality attributable to pneumonia and diarrhea. Through the promotion of the appropriate technologies, step-by-step training, health education, the deployment of management and monitoring systems, and other measures, there has been a decline in the mortality rate of infants and young children, especially in rural areas. To reach the goal of an 80% breastfeeding rate by 2000 as stipulated in the “Outline of the China Child Development Program” for the 1990s, in 1992 China responded to an initiative by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) and worked vigorously to promote breastfeeding and create baby-friendly hospitals. China also promised to build one thousand baby-friendly hospitals by 1995 (actual number of such hospitals built: three thousand).5 In this vein, in May 1992, the Ministry of Health also issued its “Notice on the Strengthening of Breastfeeding-Related Work” where it advocated for the establishment of baby-friendly hospitals in various provinces as a means of promoting the practice of breastfeeding. In the period 1992–1993, significant achievements were made in a large-scale campaign to promote breastfeeding and to build baby-friendly hospitals

3

See Footnote 1. See Footnote 1. 5 Sun, Y.X. et al. (2008). Report on the state of the rights of minors in China. China Youth Study [sic.], 2008 (11). 4

48

3 Child Survival and Health

due to the ministry’s vigorous efforts. On April 9, 1994, in order to better implement the “1994–1995 Promotion of Breastfeeding and Building of Baby-Friendly Hospitals” project jointly run by China and UNICEF, the Ministry of Health issued its “Notice on Continuation of Efforts to Promote Breastfeeding and to Establish Baby-Friendly Hospitals”, thus reiterating its focus on young children through the building of baby-friendly hospitals. These pro-baby campaigns laid the foundation for the introduction of the Law of the People’s Republic of China on Maternal and Infant Health. On October 27, 1994, the National People’s Congress passed and promulgated the Law of the People’s Republic of China on Maternal and Infant Health, the text of which covered seven areas: general provisions, premarital health care, maternity health care, technical appraisal, administrative management, legal responsibilities, and supplementary provisions. To ensure the full and proper implementation of this law, in June 1995, the Ministry of Health issued a series of supporting regulations and measures: the “Management Measures for Maternal and Child Health Care Supervisors”, the “Measures for the Management of Special Technical Services for Maternal and Child Health Care and Personnel Qualifications”, the “Measures for the Management of Medical Technologies for Maternal and Child Healthcare”, and the “Administrative Measures for Maternal and Child Health Care Organizations”. In particular, in conjunction with the “Administrative Measures for Maternal and Child Health Care Organizations”, a three-level maternal and child healthcare network (hospitals, health institutes and health stations catering to maternal and child health) as well as a monitoring system for child (under five years of age) and maternal mortality and birth defects were established. The three-level maternal and child healthcare network has provided a strong guarantee for the realization of the child’s right to survival and good health in China. Since 2000 China has been implementing a project aimed at reducing maternal mortality rate and eliminating neonatal tetanus in the central and western regions. The project, which covers one thousand counties in twenty-two provinces and which has benefited more than three hundred million individuals, has effectively reduced the maternal and child mortality rate in the poorer areas of western China. During this period, the Chinese government has also issued a number of policy documents related to child health, nutrition for children, and health care for children. On December 1, 1994, the Ministry of Health and the State Education Commission jointly issued the “Management Measures for Healthcare in Childcare and Nursery School Facilities”. These Measures, comprise a total of nineteen articles, were issued with the aim of enhancing the quality of health work performed in childcare and nursery school facilities as a means to ensure the physical and mental health of children. On October 30, 1995, the Food Safety Law of the People’s Republic of China (Trial) was passed and promulgated. The aim of the Law is to ensure food safety by preventing food contamination and adulteration detrimental to human health, thereby ensuring the good health and physique of the people. The Law comprises ten sections but does not deal specifically with food for children.

3.1 Policy and Action: The History of the Child Health Sector

49

On July 9, 1996, the Ministry of Construction and the Ministry of Education jointly issued the “Management Measures for the Health Supervision of Drinking Water”. The Measures, which did not deal specifically with the matter of child health, did however tackle the issues of child health in schools, in the community, and in the household. On August 27, 1996, the Ministry of Health issued and implemented the “Measures for the Health Supervision of Collective Meals for Students”. These Measures, which comprise thirteen articles, were issued with the aim of enhancing the management of collective meals for students in order to ensure the safety of collective meals consumed by student and improve student nutrition to ensure the healthy growth of students. On September 28, 1999, the State Council issued its “Regulations on the Minimum Living Standards for Urban Residents”. The aim of these Regulations was to ensure that the minimum living standard system would have a positive effect for urban residents living in difficult circumstances. The implementation of these Regulations had a significant impact on promoting work related to the minimum living standard for urban residents as they served to incorporate the minimum living standard system for urban residents into a legal framework. In terms of the healthy development of the child, the Regulations provided children in impoverished families with basic living security, thus helping them to grow up in a healthy manner. Toward the end of this period, in 1998, Chinese society saw the budding of healthcare services for children. However, such services still fell in the domain of private rather than public practice. Amidst growing globalization, United Nations (UN) organizations, international non-governmental organizations (NGOs), and other international organizations have influenced child survival and development around the world in various ways. China has significantly converged with the rest of the world in the area of child development and protection. In 1998, with funding from the United Nations Population Fund, the China Family Planning Association was able to implement its pilot reproductive health education program for youth, and in 2000, the Association teamed up with PATH, another organization, to implement its program to promote awareness of issues related to reproductive health among Chinese youth. These were the earliest instances of interventional sex education efforts for children in the field of China’s child health sector. The implementation of these programs signaled that Chinese society had begun to conduct interventional efforts with regard to issues relating to child health and healthcare services for children. Table 3.2 shows the policies related to child health established, promulgated and implemented by the National People’s Congress, the State Council and the Ministry of Health between 1991 and 2000.

50

3 Child Survival and Health

Table 3.2 Policies relating to child health, 1991–2000 Promulgated on/in

Promulgated by

Policy

1991.9.4

National People’s Congress

Law of the People’s Republic of China on the Protection of Minors

1992.5

Ministry of Health

Notice on the Strengthening of Breastfeeding-Related Work

1994.4.9

Ministry of Health

Notice on Continuation of Efforts to Promote Breastfeeding and the Creation of Baby-Friendly Hospitals

1994.10.27

National People’s Congress

Law of the People’s Republic of China on Maternal and Infant Health Care

1994.12.1

Ministry of Health

Management Measures for Health Management in Childcare and Nursery School Facilities

1995.6

Ministry of Health

Management Measures for Supervisors of Maternal and Child Health Management Measures for the Licensing of Maternal and Child Technical Services and Personnel Qualifications Management Measures for the Assessment and Management of Maternal and Child Health-Related Medical Technologies Management Measures for Maternal and Child Healthcare Institutions

1995.10.30

National People’s Congress

Food Safety Law of the People’s Republic of China

1996.7.9

Ministry of Health

Management Measures for the Health Supervision of Drinking Water

1996.8.27

Ministry of Health

Measures for the Health Supervision of Collective Meals for Students

1999.9.28

State Council

Regulations on the Minimum Living Standard for Urban Residents

3.1.3 2001–2010: Significant Development of the Child Health Sector In this period, in addition to focusing on issues such as maternal and child health care, vaccination, and safe delivery in rural areas, the Chinese government also faced the daunting task of preventing mother-to-child transmission of HIV (human immunodeficiency virus) infection. On June 20, 2001, the State Council issued and implemented the “Implementation Measures for the Maternal and Child Health Law of the People’s Republic of China”. These Measures comprised eight sections that covered the following areas: general provisions, premarital health care, maternal health care, baby care, technical assessments, supervision and management, penalties, and supplementary

3.1 Policy and Action: The History of the Child Health Sector

51

provisions. The Measures, which also provided detailed operating procedures and measures for maternal and child healthcare institutions at various levels, have had an effect in promoting the regulated development of China’s maternal and child healthcare system. On March 16, 2005, the State Council passed the “Management Regulations for Vaccine Circulation and Vaccination”, which were subsequently issued on Mar 24. The Management Regulations provided detailed stipulations on matters relating to vaccine circulation, vaccination, protection measures, supervision and management, and legal responsibilities, etc., thus providing the legal basis for the work of vaccine circulation and immunization. Traditionally in China, there are four key vaccinations for children: the Bacillus Calmette-Guérin (BCG) vaccine against tuberculosis, the DTP (diphtheria-tetanus-pertussis vaccine), the trivalent oral polio vaccine, and the measles vaccine. The coverage of the Four Vaccines has long been maintained at over 97% in China. Since 2002, the Chinese government has included the Hepatitis B vaccine in the immunization program for newborns. As of end-2000, the Hepatitis B vaccination rate stood at 91.83%, meaning there is still much room for improvement. On December 1, 2008, the Ministry of Health issued its Management Measures for Neonatal Screening, another “safety net” for newborn health in addition to the premarital examination for premarital medical check-up and prenatal check-ups for mothers. The implementation of these Measures is expected to reduce the number of children born with congenital defects by around six thousand each year.6 On September 21, 2009, the Ministry of Health issued its “Management Plan for the Rural Hospital Delivery Subsidy Program”. The aim of the Plan is to ensure maternal and infant safety in rural and remote areas and to lower maternal and infant mortality rates in rural and remote areas in order to minimize the national maternal and infant mortality rates. In conjunction with the release of the Plan, since 2009 the Ministry of Health has implemented a folic-acid supplementation program designed to prevent neural tube defects in infants. Under this program, each year folic-acid supplementation is provided to twelve million women living in rural areas and who are preparing for pregnancy.7 At the end of the twentieth century, the number of people living with HIV in China had begun to increase, and in the twenty-first century, the number of people infected with HIV has grown rapidly. The prevention of the mother-to-child transmission of HIV has become a new and arduous task in the first decade of the new century. In 2004, the Ministry of Health established in succession a number of policy documents: the “Trial Implementation Plan for the Prevention of Mother-to-Child Transmission of HIV”, “Guidance on the Strengthening of Efforts to Prevent the Mother-to-Child Transmission of HIV”, and “Notice on Strengthening the Pilot Program Centered on Preventing the Mother-to-Child Transmission of HIV”. These policy measures were aimed at laying specific implementation requirements for efforts to prevent HIV/AIDS nationwide, to regulate various preventive measures, to establish a service 6

Ministry of Civil Affairs of the People’s Republic of China (2010). 2010 Report on Child Welfare Policies in China, p. 7. 7 See Footnote 6.

52

3 Child Survival and Health

model to prevent the mother-to-child transmission of HIV that suits the specific conditions of China, and to effectively reduce the incidence of mother-to-child transmission of HIV in China in order to improve the quality of life of mothers and babies. At the same time, the Ministry of Health has carried out efforts to prevent such transmission in 271 counties nationwide by combining these efforts with the day-to-day work of maternity and child care through the three-level network of maternity and child care. In other words, services to prevent the mother-to-child transmission of HIV are provided alongside regular maternity care services. In 2008, the central government program to provide subsidies for the prevention of the mother-to-child transmission of HIV at the county level would be extended to 333 counties in the country, and at the same time the AIDS Prevention and Control Information Network Direct Reporting System would also be put into use across China.8 Accidental injury is a key cause of child mortality and disability. In this period, the government introduced the work of preventing accidental injury to its agenda, promulgating a series of policies aimed at such prevention in the process. On March 26, 2002, the Ministry of Education promulgated its “Handling Measures for Incidents Where Injury to Student Has Been Incurred”. The aims of the measures were: to ensure proper handling of incidents where injury to a student has been incurred, and to protect the legal rights of both students and schools. On February 7, 2007, the State Council promulgated its “Guidelines for Public Safety Education for Elementary and High Schools”. The Guidelines stipulate specific requirements for the content and implementation of safety education programs at the elementary and high school levels with the aim of further enhancing such education, cultivate greater awareness of public safety among elementary and high school students, and enhance these students’ ability to keep themselves safe in the event of emergencies. On April 3, 2008, the Ministry of Education, the Ministry of Finance and the China Insurance Regulatory Commission (CIRC) jointly issued the “Notice on the Implementation of School Liability Insurance to Improve the Management Injury Risk”. According to the notice, elementary and high schools across the country were required to implement injury liability insurance schemes (with insurance to be purchased by the government) and to improve risk control for accidental on-campus injury over time. The Central Committee of the Communist Youth League of China (CYLC) and the China Children and Teenagers’ Fund (CCTF) have also acted to prevent accidental injury to children. The CYLC Central Committee has published a number of publications such as the Handbook to Self-Protection for Chinese Youth and PalmSized Guide to Self-Protection for Youth as well as overseen the production of a number of video works mostly focused on educating viewers on the same subject. Since 2004 the CYLC Central Committee has also established and run the “12,355” information platform to help youth protect their rights. The 12,355 hotline has been established more or less nationwide in every city above county level. The CCTF has implemented the “Plan for the Safe and Healthy Growth of the Children and Youth 8

See Footnote 5.

3.1 Policy and Action: The History of the Child Health Sector

53

of China” that seeks to help children to “stay in school, stay healthy, stay crime-free, and stay away from harm”. By the year 2004, the Plan had benefited nearly twenty thousand children and teachers.9 In this period, the Chinese government has also issued a number of policy documents pertaining to the health and nutrition of children. On August 3, 2007, the Ministry of Health promulgated the “Strategy for the Nutrition of Infants and Young Children” that aimed to create even greater awareness of breastfeeding for infants and young children and to raise breastfeeding levels in China. At the same time, the Strategy also had practical significance for efforts to reduce levels of severe malnutrition among children aged under five years old and to raise breastfeeding rates for infants. On December 15, 2008, the Ministry of Health and the Standardization Administration of China jointly issued the General Standards for Supplementary Foods and Dietary Supplementation. These Standards stipulated the implementation of standards for nutrition designed for infants and young children and thus raised the standard of nutrition for infants and young children in China. In the same year, in conjunction with the implementation of the aforementioned Standards, the Ministry of Health’s Department of Disease Control and Prevention worked together with UNICEF to implement a program to improve nutrition for infants and young children in eight provinces including Sichuan, Gansu, and Shaanxi in the wake of the massive Wenchuan earthquake. The program delivered education on infant and child nutrition to local health workers and parents as well as provided supplementary nutrition packs free-of-charge to around 23,000 children aged six to twenty-four months.10 On May 7, 2007, the State Council issued its “Opinions on the Enhancement of Sports among the Young as a Means of Strengthening the Physiques of Adolescents”. The document states clearly that: the physical and mental health of young people are critical to the future of the country and nation, and form the basis for the allround development of children and adolescents’ physical and mental health, physical training and moral, intellectual and aesthetic development. On March 1, 2010, the “Management Measures for Healthcare Management in Childcare and Nursery-School Facilities” were issued by the Ministry of Health with approval by the Ministry of Education. The Measures laid out standards for health and healthcare work to be conducted for zero to five-year-old children within educational institutions, thus aiding the prevention and reduction of diseases and raising standards of work in this area. In this period, community organizations (such as the China Family Planning Association) continued to work on the development of healthcare services. There was still no mention of healthcare services for children in policy documents issued by the government. 9 Sun, Y.X. et al. (2008). Report on the state of rights for China’s minors. China Youth Study, 2008 (11). 10 Ji, C.Y. & Zhu, G.R. (2004). An analysis of China’s reproductive health policies and regulation for its youth. Beijing: UNICEF and China Family Planning Association.

54

3 Child Survival and Health

In 2003, the China Family Planning Association became one of the implementing agencies of the fifth cycle of the joint reproductive health/family planning program headed by the Chinese government and the United Nations Population Fund. The objectives of the 1996–2010 Development Strategy of the China Family Planning Association relating to reproductive health among youth are: to have a better understanding of the needs of youth; to provide knowledge and information on reproductive health, maternal and child health, adolescent health and family planning; and to reduce instances of premarital pregnancies and abortions. In 2004, the China Family Planning Association conducted its first targeted study on China’s adolescent reproductive health policy with the aim of evaluating China’s policies and regulations on adolescent reproductive health. Through the study, the association had hoped to provide advice for improvements and policy recommendations pertaining to policy formulation, strategies, measures, and services based on its understanding existing sexual health education practices in order to aid the promotion adolescent reproductive health.11 Table 3.3 shows the policies relating to child health that were established and promulgated by the National People’s Congress, the State Council, and various State Council departments in the period 2001–2010.

3.2 Data and Outcomes: The State of Child Survival and Health 3.2.1 Mortality Rates for Children Under the Age of Five and the Maternal Mortality Rate Lowering the child and maternal mortality rates is one of the basic ways of protecting child rights, and a mandatory task for modern sovereign nations. Since 1991, the Chinese authorities have provided detailed data for both child (under five years old) and maternal mortality rates. From Table 3.4, we see that nationally the newborn mortality rate has been reduced from 33.1‰ in 1991 to 8.3‰ in 2010, while the infant mortality rate has been reduced from 50.2‰ in 1991 to 15.3‰ in 2010. The mortality rate for children aged under five has been reduced from 61.0‰ in 1991 to 18.1‰ in 2010, while the maternal mortality rate has been reduced from eighty per one hundred thousand in 1991 to 25.2 per one hundred thousand in 2010. In all cases, the reduction has been significant. When we compare urban and rural areas, we see that in all four cases the rural mortality rate stands at multiples of the urban mortality rate. As such, into the future one focus of child health-related work in China would be the reduction of child and maternity mortality rates in rural areas.

11

See Footnote 10.

3.2 Data and Outcomes: The State of Child Survival and Health

55

Table 3.3 Policies relating to child health, 2001–2010 Promulgated on/in

Promulgated by

Policy

2001.6.20

State Council

Implementation Measures for the Maternal and Child Healthcare Law of the People’s Republic of China

2002.3.26

Ministry of Education

Handling Measures for Incidents Where Injury to Student Has Been Incurred

2004

Ministry of Health

Trial Implementation Plan for the Prevention of Mother-to-Child Transmission of HIV Guidance on the Strengthening of Efforts to Prevent the Mother-to-Child Transmission of HIV Notice on Strengthening the Pilot Program Centered on Preventing the Mother-to-Child Transmission of HIV

2005.3.24

State Council

Management Regulations for Vaccine Circulation and Vaccination

2007.2.7

State Council

Guidelines for Public Safety Education for Elementary and High Schools

2007.5.7

State Council

Opinions on the Enhancement of Sports Among the Young as a Means of Strengthening the Physiques of Adolescents

2007.8.3

Ministry of Health

Strategy for the Nutrition of Infants and Young Children

2008.4.3

Ministry of Education and the Ministry of Finance

Notice on the Implementation of School Liability Insurance to Improve the Management Injury Risk

2008.12.1

Ministry of Health

Management Measures for Neonatal Screening

2008.12.15

Ministry of Health

General Standards for Supplementary Foods and Dietary Supplementation

2009.9.21

Ministry of Health

Management Plan for the Rural Hospital Delivery Subsidy Program

2010.3.1

Ministry of Health

Management Measures for Healthcare Management in Childcare and Nursery-School Facilities

3.2.2 The State of Health and Healthcare Services for Children The reduction of child mortality rates goes hand-in-hand with the lowering of the neonatal tetanus incidence rate, malnutrition rates, the neonatal visit rate, child care management rates, and other indicators of children’s health care. The eradication of

56

3 Child Survival and Health

Table 3.4 Maternal and child (aged under 5) mortality rates Year Newborn mortality rate (%)

Infant mortality rate (%)

Mortality of children aged below 5 years (%)

Maternal mortality rate (per 100,000)

Total Urban Rural Total Urban Rural Total Urban Rural Total Urban Rural 1991 33.1

12.5

37.9

50.2

17.3

58.0

61.0

20.9

71.1

80.0

46.3

100.0

1992 32.5

13.9

36.8

46.7

18.4

53.2

57.4

20.7

65.6

76.5

42.7

97.9

1993 31.2

12.9

35.4

43.6

15.9

50.0

53.1

18.3

61.6

67.3

38.5

85.1

1994 28.5

12.2

32.3

39.9

15.5

45.6

49.6

18.0

56.9

64.8

44.1

77.5

1995 27.3

10.6

31.1

36.4

14.2

41.6

44.5

16.4

51.1

61.9

39.2

76.0

1996 24.0

12.2

26.7

36.0

14.8

40.9

45.0

16.9

51.4

63.9

29.2

86.4

1997 24.2

10.3

27.5

33.1

13.1

37.7

42.3

15.5

48.5

63.6

38.3

80.4

1998 22.3

10.0

25.1

33.2

13.5

37.7

42.0

16.2

47.9

56.2

28.6

74.1

1999 22.2

9.5

25.1

33.3

11.9

38.2

41.4

14.3

47.7

58.7

26.2

79.7

2000 22.8

9.5

25.8

32.2

11.8

37.0

39.7

13.8

45.7

53.0

29.3

69.6

2001 21.4

10.6

23.9

30.0

13.6

33.8

35.9

16.3

40.4

50.2

33.1

61.9

2002 20.7

9.7

23.2

29.2

12.2

33.1

34.9

14.6

39.6

43.2

22.3

58.2

2003 18.0

8.9

20.1

25.5

11.3

28.7

29.9

14.8

33.4

51.3

27.6

65.4

2004 15.4

8.4

17.3

21.5

10.1

24.5

25.0

12.0

28.5

48.3

26.1

63.0

2005 13.2

7.5

14.7

19.0

9.1

21.6

22.5

10.7

25.7

47.7

25.0

53.8

2006 12.0

6.8

13.4

17.2

8.0

19.7

20.6

9.6

23.6

41.1

24.8

45.5

2007 10.7

5.5

12.8

15.3

7.7

18.6

18.1

9.0

21.8

36.6

25.2

41.3

2008 10.2

5.0

12.3

14.9

6.5

18.4

18.5

7.9

22.7

34.2

29.2

36.1

2009

9.0

4.5

10.8

13.8

6.2

17.0

17.2

7.6

21.1

31.9

26.6

34.0

2010

8.3

4.1

10.0

13.1

5.8

16.1

16.4

7.3

20.1

30.0

29.7

30.1

Source Website of the Ministry of Health; 2010 China Health Statistics Yearbook

neonatal tetanus, improvements in neonatal visits, and the management of children’s health care are all basic indicators of the child’s right to life and protection of the right to life. From Table 3.5, we see that the proportion of newborns born at a weight of less than 2500 g has stayed more or less the same between 1997 and 2010. However, the perinatal mortality rate has been reduced by half, from 15.14‰ in 1997 to 7.02‰ in 2010. The incidence of neonatal tetanus has decreased significantly from 4.16 per ten thousand in 1997 to 0.17 per ten thousand in 2010, while the mortality rate from neonatal tetanus has dropped from 2.976/10,000 in 1997 to 0.08 per ten thousand in 2010. The problem of mortality from neonatal tetanus has essentially been eradicated. Among children aged under five, the proportion of those found with severe malnutrition has been reduced by more than half from 3.51% in 1997 to 1.55% in 2010. The neonatal visits rate has increased by 7.2% from 82.4% in 1997 to 89.6% in 2010. The healthcare management (within the healthcare system) rate

3.2 Data and Outcomes: The State of Child Survival and Health

57

for children aged under three has risen from 65.7% in 1997 to 81.5% in 2010. There is still significant room for improvement in this regard. The healthcare management rate of children aged under seven has risen from 65.8% in 1997 to 83.4% in 2010. In this instance, there is also a fair bit of room for growth. The coverage of the so-called Four Vaccines, a traditional mainstay of China’s child health program, has always been fairly high. We can see from Table 3.6 that in the five years between 1990 and 1995, there had been a significant decline in the coverage of the “Four Vaccines” while in the five years between 1995 and 2000, the coverage rebounded. By the year 2010, the average coverage of all four vaccines was around 99.5%, meaning coverage is more or less universal. In Fig. 3.1, we see the decline between 1990 and 1995 in terms of the immunization rates of the “Four Vaccines” and a rebound to the peak value in 2010. There also appears to be a case of overlap in terms of the coverage of the four vaccines.

3.2.3 The State of Maternal Health Care The enhancement of maternal health care will have a significant effect in the lowering of child mortality and effectively mitigate the incidence of congenital defects. From Table 3.7, we see that 50.6% of births were performed in hospitals in 1990, and this figure rose to 97.8% in 2010. In urban areas, this figure had risen from 74.2% to 99.2% while in the rural areas the figure had risen from 45.1% to 96.7%. The data shows that in the span of twenty years, the hospital delivery rate for rural mothers has risen by more than 100% while the improvement has also been significant in the urban areas. By the year 2010, almost all babies were delivered by the so-called new method in the cities, while 99.4% of rural babies were also delivered the same way. This shows that the “new method” has become a complete norm in China. Figure 3.2 shows us the gradual rise of the institutional delivery rate among rural mothers between 1990 and 2010. Raising the institutional delivery rate among rural mothers is key to reducing the maternal mortality rate among rural mothers.

3.2.4 The State of Child Nutrition Raising the breastfeeding rate and promoting the consumption of iodized table salt are two basic ways of improving child nutrition. From Fig. 3.3, we see that in the four years between 1994 and 1998, there was a certain increase in the percentage of babies being fully breastfed, although the increase was not significant; between 1998 and 2005 however there has been a significant increase in this figure, from 67% in 1998 to 92.8% in 2005. Post-2005, the rate has more or less stabilized with a small decline. Iodine deficiency in children can be effectively controlled through the consumption of iodized table salt. From Table 3.4, we see that between 1995 and 1997, the

2.34

2010

0.17

0.27

0.34

0.47

0.64

0.77

0.98

1.40

1.33

1.41

1.88

2.24

2.74

4.16

Incidence rate (per 10,000)

Neonatal tetanus

0.08

0.11

0.15

0.20

0.32

0.39

0.51

0.83

0.73

0.84

1.16

1.48

1.86

2.97

Mortality rate (per 10,000)

1.55

1.71

1.92

2.02

2.10

2.34

2.56

2.70

2.83

3.01

3.09

3.29

3.41

3.51

Rate of moderate and severe malnutrition in children under 5 (%)

Source Website of the Ministry of Health; 2010 China Health Statistics Yearbook

7.02

8.74

7.70

2.35

2.40

2008

8.71

2.26

2007

2009

9.68

10.27

2.21

2.22

11.08

2005

2.20

2004

12.47

12.24

2006

2.39

2.26

2002

2003

2.35

2001

13.28

14.22

13.99

2.39

2.40

1999

2000

15.14

14.94

2.31

2.58

1997

Perinatal mortality rate (‰)

1998

% of children with neonatal weight