Intended for healthcare professionals

Education And Debate

China's one child family policy

BMJ 1999; 319 doi: (Published 09 October 1999) Cite this as: BMJ 1999;319:992
  1. Penny Kane, associate professora,
  2. Ching Y Choi, headb
  1. a Office for Gender and Health, Department of Psychiatry, University of Melbourne, Carlton, Vic 2053, Australia
  2. b Welfare Division, Australian Institute of Health and Welfare, 6A Traeger Court, Bruce, ACT 2617, Australia
  1. Correspondence to: P Kane

    China's one child family policy, which was first announced in 1979, has remained in place despite the extraordinary political and social changes that have occurred over the past two decades. It emerged from the belief that development would be compromised by rapid population growth and that the sheer size of China's population together with its young age structure presented a unique challenge.

    Summary points

    The one child family policy was developed and implemented in response to concerns about the social and economic consequences of continued rapid population growth

    Implementation was more successful in urban areas than rural areas

    Social and economic reforms have made rigorous implementation of the policy more difficult

    The main criticism of the policy is its stimulus to discrimination against females, who may be aborted, abandoned, or unregistered

    The policy has eased some of the pressures of rapid population increase on communities, reducing the population by at least 250 million


    This article is based on experience from frequent field visits to China over the past 25 years and the authors' collections of relevant Chinese and Western documents from the 1950s onwards. We also used references from the major demographic journals.

    Population growth since 1953

    Government family planning services became available as a contribution to maternal and child health in China from 1953. As the result of falling death rates, the population growth rate rose to 2.8%, leading to some 250 million additional people by 1970. After a century of rebellions, wars, epidemics, and the collapse of imperial authority, during which the annual population growth was probably no more than 0.3%, such an expansion was initially seen as part of China's new strength. Mao Zedong quoted a traditional saying: “Of all things in the world, people are the most precious.”1

    Rapid growth, however, put considerable strain on the government's efforts to meet the …

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