Rapid Responses to:

PAPERS: Zhuochun Wu, Kirsi Viisainen, Ying Wang, and Elina Hemminki Perinatal mortality in rural China: retrospective cohort study BMJ 2003; 327: 1319 [Abstract] [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Mortality from family planning statistics needs to be validated

Therese Hesketh, Guo Guang Ping, Zhang Jun, Dong Jia Qiang   (18 December 2003)

Mortality from family planning statistics needs to be validated 18 December 2003
Therese Hesketh, Senior Lecturer Institute of Child Health London WC1N 1EH, Guo Guang Ping, Zhang Jun, Dong Jia Qiang Send response to journal: Re: Mortality from family planning statistics needs to be validated	Editor, We are surprised at Wu et al’s belief in the superiority of family planning sources for perinatal mortality rates in rural China. (1) One of the main tasks of the family planning authorities is to meet population control targets or at least to appear to be. (2) Therefore some of the girls (and disabled children) who are abandoned, are recorded as deaths in family planning statistics, because this allows couples to have another pregnancy to get the boy or “normal” child they want. Few will admit to abandoning a child, an act which is illegal, although numbers are estimated in the tens of thousands every year. (3) However, like Wu et al we are sceptical about the official child mortality figures in parts of rural China. Under-reporting is very common because of a highly pervasive target culture which means that local officials, and especially family planning officials, are required to meet targets which sometimes necessitates manipulation of the figures. (3) To explore this further we are investigating the “true” child mortality rate in an area of rural China on the China-Myanmar border. Using a stratified sampling method we are surveying women aged 25 to 35 years. Women are asked for details of all pregnancies with the outcomes. We are comparing their reponses with the official mortality rates over the past five years. (see Table) Although clearly not directly comparable, the data do suggest much higher mortality rates than reported by the local health bureau. Table: Mortality rates per 1000 per year: official and extrapolated from survey results Official figures Figures from survey Stillbirth rate 12 28 Neonatal mortality rate 21 33 IMR 35 61 U5MR 44 81 From questioning mothers it appears that much of the difference may be explained by failure to report deaths.. We think that in rural China such surveys are a more reliable way of obtaining accurate demographic data than reliance on “official” figures, especially those emanating from the family planning system. 1. Wu Z, Viisainen K, Wang Y, Hemminki E. Perinatal mortality in rural China: retrospectoive cohort study BMJ2003;327:1319-22 2. Merli MG, Raftery AE. Are births underreported in rural China? Manipulation of statistical records in response to China’s population policies. Demography 2000; 37(1):109-26 3. Walfish D. A billion and counting: China’s tricky census. Science 2000; 290(5945):1288-9 However, like Wu et al we are sceptical about the official child nortlaity Competing interests: None declared