CPC Committee of NHC: Write a New Chapter of Population Work in the New Era

On August 1st, QIUSHITHEORY.CN published Issue 15, 2022 of QIUSHI magazine, which includes an article, Write a New Chapter of Population Work in the New Era, signed by the CPC Committee of National Health Commission of the People’s Republic of China (NHC). The article wrote that population development is among the fundamental interests of our country. In June, 2021, the CPC Central Committee and the State Council established the Decision on Improving Birth Policies to Promote Long-Term and Balanced Development of Population (hereinafter referred to as the Decision), making comprehensive arrangements for the population work in the new era. The CPC Committee of NHC pointed out in the article that in the new era, China’s population development is faced with profound and complex changes, ‘population ageing with low fertility’ will become a norm with negative growth of the population. This could be demonstrated in five aspects. Firstly, with negative growth momentum of the population further released, the growth of the total population obvious slow down, and will enter the stage of negative growth during the 14th Five-Year Plan period. Secondly, the fertility rate continues to fall. The total fertility rate in recent years below 1.3% and low fertility rate has become the top risk for balanced development of China’s population. Thirdly, population ageing has been deepening. It is estimated that around 2035, China will enter the stage of severe ageing (with more than 30 of the population aged 60 and above). Fourthly, families show the tendency to a smaller size. In 2020, the average size of a family falls to 2.26 people, down 0.48 people from 2010, with elderly and childcare capability being weakened. Fifthly, there are imbalances among different regions. In some regions with vulnerable ecology and resource shortages, the imbalance between population and development is still acute. The development of population is among the fundamental interests of our country. In June 2021, the CPC Central Committee and the State Council established the Decision on Improving Birth Policies to Promote Long-Term and Balanced Development of Population (hereinafter referred to as the Decision), making comprehensive arrangements for the population work in the new era. This major decision is made by the CPC Central Committee with Comrade Xi Jinping at its core from the strategic height of national rejuvenation, grounding their efforts in the new development stage to implement the new development philosophy, foster the new development paradigm and scientifically follow the law of population development, while coordinating multiple aims of the policies. With the Resolution being established for more than a year, relevant regions and departments have actively engaged, improved leadership mechanism, launch supportive measures, and promote the implementation of birth improving policies, achieving positive progress on relevant work. To promote the long-term and balanced development of the population, we need to take steady efforts with an unyielding spirit. We should further study and understand General Secretary Xi Jinping’s major expositions on population work and follow the principle of the Decision, and unite better our minds and actions to the decisions and arrangements made by the CPC Central Committee with Comrade Xi Jinping at its core. We should shoulder responsibilities and make concrete deeds, striving to promote the high-quality development of population work in a new era.

Ⅰ. Gain a thorough understanding of General Secretary Xi Jinping’s expositions on population work

Since the 18th CPC National Congress, the CPC Central Committee with Comrade Xi Jinping at its core, being farsighted and with grand wisdom, has made a series of scientific judgement and major arrangements on population work in a new era, bringing China’s population work to a new stage. General Secretary Xi Jinping’s expositions on population work fully demonstrate his profound understanding of the population issue and its development law, manifesting his farsighted strategic mindset, strong sense of responsibility and sincere love for the people, which point out the right direction and provide the guideline for population work in the new era. The development of population is a major issue concerning the development of the Chinese nation. General Secretary Xi Jinping stressed that, the population issue has always been an overall, long-term and strategic issue faced by China. China’s modernization features a huge population, common prosperity for all, coordination between material civilization and spiritual civilization, harmony between human and Nature, and peaceful development. The Decision pointed out that the establishment of the three-child policy and relevant supportive policies is conducive to improving population structure and implementing the national strategy for addressing population ageing. The policies are also conducive to maintaining our advantages in human resources in response to the world’s profound changes unseen in a century; conducive to flattening the decline of total fertility rate and promoting the realization of an appropriate birth rate; conducive to consolidating the outcomes of building a moderately prosperous society in all respects and promoting peaceful coexistence between human and Nature. Looking back on the hundred-year journey travelled by the Party, the major development problems it faced with in every historical stage are almost all closely related to the population issue. After the founding of the People’s Republic of China, bearing the heavy pressure brought by rapid population growth, the Party explored tenaciously for a development path that accords with our national conditions, during which the family planning policy started to take shape. At the beginning of the 1970s, the family planning policy was promoted comprehensively in urban and rural areas, and after tens of years of efforts, China’s population reproduction has successfully transformed from ‘high birth rate, low mortality rate, high growth rate’ to ‘low birth rate, low mortality rate, low growth rate’. These efforts strongly propped up the courses of reform and opening up as well as socialist modernization, and pronouncedly improved the living and development conditions of the people, laying a solid foundation for our victory in the poverty alleviation fight and for building a moderately prosperous society in all respects. In August 2021, in order to improve the treatment level for pregnant and lying-in women as well as new-born babies to earnestly protect the safety of mothers and infants, Health Commission and relevant departments of Wannian County, Shangrao City, Jiangxi Province organized medical institutions of the county to carry out maternal-infant safety skill competitions.  

To embark on a new journey to build China into a modern socialist country in all respects, we should focus on implementing the national rejuvenation strategy within the context of once-in-a-century global changes. The population issue remains a top strategic issue requiring high attention and proper dealing. We must follow the guidance of Xi Jinping Thoughts on Socialism with Chinese Characteristics in a New Era and analyze and address the population issue with Marxist Theories on population, fully recognize the historical contribution and great achievements made by our population work and stay committed to the Chinese path on addressing population issue, striving to achieve the strategic goal of promoting the long-term and balanced population development. We should be firmly aware of national conditions and strategies, stick to the decision coordinating population and development, and take the population issue as an underpin to promote reform, make development plans and improve people’s livelihood. We should bear in mind the worst scenarios, and clearly recognize that population is a key variable influencing economic and social development, and a key factor concerning China’s overall national strength and national security. We should strengthen our sense of urgency, responsibility and mission, be brave to shoulder responsibilities and be adept at tackling challenges, so as to make well conduct in population work in the new era. The strategic aim of population work is to promote the long-term and balanced development of population. General Secretary Xi Jinping pointed out that in recent years, pronounced changes have taken place in China’s population development. We are faced with the pressure of a huge population, as well as the challenges brought by the transfer of population structure. The Decision stressed that we are required to take balance as the mainstay and properly balance the issues of number, quality, structure and distribution of the population, so as to promote coordinated and sustainable development of population, economy, society, resources and environment, and promote people’s well-rounded development. In the new era, China’s population development is faced with profound and complicated dynamic changes, with ‘population ageing with low fertility’ under negative growth of population becoming our norm. Firstly, with the long-accumulated momentum of population’s negative growth being further released, the growth rate of the total population has significantly slowed down, and population will enter its stage of negative growth during the 14th Five-Year period. Secondly, the birth rate continues to fall, with the total fertility rate in recent years below 1.3%, and a low birth rate has become the most significant risk influencing the balanced development of China’s population. Thirdly, with populating ageing deepening, it is estimated that we will enter the stage of severe population ageing around 2035 (with the population aged 60 and above exceeding 30%). Fourthly, families show the tendency to a smaller size. In 2020, the average size of family falls to 2.26 people, down 0.48 people from 2010, with elderly and childcare capability being weakened. Fifthly, there are imbalances among different regions. In some regions with vulnerable ecology and resource shortages, the imbalance between population and development is still acute. Considering these trends, our missions are heavier and tougher with higher requirements in improving birth policies and promoting long-term and balanced population development, which needs our prolonged and tenacious efforts. We must strengthen strategic awareness, and be keenly aware that population development is related to the overall and long-term development of the economy and society. We should always coordinately integrate population development into the strategic arrangements of the two stages of modernization building, and fully display the proactive role of the population factor, and lay a solid foundation of human capital and domestic demand for the great Chinese Dream of national rejuvenation. We should uphold a systematic approach to coordinate multiple targets, and properly deal with the relations between short-term and long-term interests, volume and structure, population and resource environment, etc., striving to reach a balanced development condition of population with an appropriate amount, respectively high quality, upgraded structure and reasonable distribution. We should attach priority to regional coordination, and in regions with respectively sharp imbalances between population and development, we should accurately provide management services, guide the orderly flow and reasonable distribution of population and safeguard the stability and security in ethnic minority and border areas, so as to further consolidate the results achieved in poverty alleviation fight and in building a moderately prosperous society. We should address the need for care for infants aged 0-3, and promote long-term and balanced development of population. In recent years, from the central government to local governments, relevant policies have been established to support and encourage the development of infant care services. Currently, the focus of our work is to improve the policy system of birth encouragement. General Secretary Xi Jinping stressed that, on the journey in the new era, all the Party members must focus on issues most directly and realistically related to people’s interests and concerns. The issues of concern to the people, be they big or small, should be handled with utmost care and attention. We must start with addressing issues of public concern, do more to improve the lives and address the concerns of the people, continuously achieve new progress in access to childcare, education, employment, medical services, elderly care, housing and social assistance. We should keep promoting social fairness and justice, people’s well-rounded development and common prosperity for all. The Decision proposed that we should respond to people’s aspirations, actively and steadily advance birth policies to promote coordination and fairness, and fulfil people’s diversified birth needs. We should attach a holistic approach to marriage, birth, childcare and education, so as to free people from worries, tap the birth potential and promote family harmony and happiness. The essence of population work is to pursue all-rounded human development as well as family harmony and happiness. Now China’s industrialization, urbanization and modernization processes have been accelerated, education level been advanced, medical service conditions been improved, social security system been promoted, people’s living standards been significantly raised, and the idea of birth in total turned to bearing fewer and raising better. According to the research by NHC in 2021, the willingness of women of childbearing age to give birth continues to fall, with an average preferred number of children being 1.64, lower than 1.76 in 2017 and 1.73 in 2019. For youths born after the 1990s and 2000s who are the majority of fertility, their preferred numbers of children are only 1.54 and 1.48 respectively. Features including heavy economic burden, lack of childcare and female development worries have become the main barriers restricting fertility. Employment of population is related to everyone and every household, yet currently, our birth supportive policy system is not complete, and there is a large gap between the policy system and the population development trend as well as people’s eager aspiration, which urgently needs to be filled. We must stay committed to the people-centred development philosophy, respond to people’s aspirations for a better life, and focus on addressing the problems related to birth and childcare that are of strong concern to the people. We must respect grassroots practices while referring to international experiences, take actions based on China’s national situations, and do everything within our capacity to address the problems arising through earnest study and research. We must keep remedying our deficiencies and strengthening our weak links, so as to improve people’s sense of gain, happiness and security. We should well deliver the effect of a combination of policies and keep up efforts to support birth and family development, coordinate birth policies and relevant economic and social policies to achieve better effects, and properly adjust the policies of housing, education, medical services, employment, tax and social security to address the needs of families with children, so as to foster a reasonable birth-cost sharing mechanism and a supportive policy system that is birth friendly, earnestly relieving birth and childcare burdens on families, thus taping their birth potential. We should orderly dovetail relevant policies, and make sure that people’s interests are fulfilled and their concrete needs addressed. We should safeguard the legitimate rights and interests of families covered by family planning policies, establish and improve the comprehensive supportive and securing system to help families covered by family planning policies, so as to make sure that for the people who have responded to the call of the Party and the government,  their interests are not injured and they can feel the warmth of the socialist system. We should continue to promote modernization of population governance capacity driven by deepened reform. General Secretary Xi Jinping has pointed out that we should coordinate our efforts to promote reform with the overall situation of serving the Party and the country, and we should conduct creative and guiding reforms by focusing on the new development philosophy, the new development paradigm, and the strategic targets of advancing high-quality development. The Decision stressed that we should keep our eye on the prominent conflicts and problems in the country’s population development, as well as the strategic arrangements of modernization, deepen reforms to break the factors impeding the long-term and balanced population development including thinking and ideas, policies and legislation, institutions and mechanisms, etc., so as to enhance the capacity and level of population governance. The improvement of birth policies is a major reform in our population work. The series of thinking, methods and means of work must be transformed according to the requirements of new situations and missions in a resolute and thorough manner. In the past, we used to focus on controlling the population, and now we should take keen efforts to promote appropriate birth level and population quality, improve population structure and distribution, so as to enhance the long-term and balanced development of population. Our basic state policy now bears renewed connotations: in the past, our priority is attached to management, but now we should abolish relevant restriction measures, strengthen the inclusiveness of birth policies, improve comprehensive services of birth and childcare and establish supportive measures, so as to lighten the burdens of our people and improve the development capability of families. In the past, we used to rely mainly on the strength of the government, but now we attach more importance to the coordinated governance of the government and the society, respecting and fully leveraging the enthusiasm of all sectors of society, and building a birth friendly social atmosphere. We should step up modernization of population governance capacity, stick to comprehensive governance and implement the primary responsibilities of Party Committees and government departments in their leadership and guidance, strengthen administration featuring coordination of relevant departments and participation of the whole society, so as to foster synergy for population work and actively respond to the severe challenges brought by low birth rate. We should enhance dynamics analysis and closely follow the evolving trends and features of population changes, stick to the problem-oriented approach and make timely response suggestions, keep improving the strategy and policy plan on population development so as to keep the initiative of work firmly in our hands. We should uphold the rule of law, and make sure that major reforms have their legal basis and are conducted according to the law. We need to transfer the long-term achievements made by the Party leading the people including innovative philosophies, reform results and practical experiences into laws, so as to ensure every mission is implemented, people’s legitimate rights and interests are safeguarded, and our population work in a new era runs in a steady and sustained manner.

Ⅱ. China’s population work has achieved significant outcomes since the 18th CPC National Congress

Since the 18th CPC National Congress, the CPC Central Committee with Comrade Xi Jinping at its core has attached high importance to the population issue, scientifically followed the law of population development, focused on the overall condition of modernization building and made the strategic decision to gradually adjust and improve the birth policy to promote the long-term and balanced development of population. Historical changes have taken place in the philosophy and method of population work, with birth policies gradually improved, service management and reform coordinatedly advanced, and supportive methods strengthened. The series of decisions and arrangements on population work made by the CPC Central Committee has received warm response from society, and was called the ‘heartful bag of presents’ from the CPC Central Committee. People regard them as good policies ‘implemented with a human touch’, and the policies have been sincerely supported by the people. Our population work has been keeping breaking new ground while achieving new outcomes. The development trend of population has improved. The data of the 7th National Census showed that the percentage of the total population taken by children aged 0-14 has raised from 16.60% in 2010 to 17.95 in 2020. Among the newborn population, the second child or above has taken up more than 55% in recent years, up from around 35% before the policy adjustments. The sex ratio at birth has been falling from 118 in 2010 to 111 in 2020, gradually reaching the normal level. People’s average life expectancy has grown from 74.83 years in 2010 to 77.93 years in 2020, and the average education years of people aged 15 and above have grown from 9.08 years in 2010 to 9.91 years in 2020.  Urbanization rate of permanent population has grown from 49.68% in 2010 to 63.89% in 2020. Sound bearing and rearing of children have been significantly improved. We have comprehensively implemented the five systems on infant and mother security, promoted pregnancy risk assessment and special management of high-risk pregnant women, and established a treatment net for critically pregnant and lying-in women as well as newborn babies with statewide coverage. Up until now, we have established around the country 3364 treatment centres for critically pregnant and lying-in women and 3070 treatment centres for critically ill newborn babies. We have implemented health care services for pregnant and puer-peral periods and comprehensive prevention and treatment of birth defects, while providing assisted reproductive technology services in a well-regulated manner. These efforts have proactively improved children’s early development. In 2021, China’s mortality rate of pregnant and lying-in women has dropped to 16.1/1 billion, and that of infants and children below 5 years old dropped respectively to 5.0% and 7.1%, ranking among top of global high-income countries. Compared with the year 2011, the mortality rate of pregnant and lying-in women in 2021 has decreased by 38%, while that of infants dropped by 58% and children below 5 years old dropped by 54%. The moderately inclusive child care services have witnessed a well beginning. We have established a series of normative documents and service guides on setting standards for child care institutions, management norms, record methods, fire safety, injury prevention and control and nutrition and feeding, etc. We have set child care majors in secondary vocational schools, senior vocational colleges and senior vocational universities. We have established the National Standard on Childcare Worker Skills, listing the number of childcare positions per thousand population as one of the major indicators of the national 14th Five-Year Plan. We have carried out the special action on moderately inclusive childcare services, and built 200,000 moderately inclusive childcare positions within the support of the central budget. We have vigorously developed moderately inclusive childcare services of multiple forms to advance the healthy development of community and home childcare services. By the end of 2021, the number of childcare positions per thousand population reaches 2.03. We have made solid steps in developing supportive policies. Care expenses for children under three are made part of the special additional deductions for individual income tax, and some local governments have made positive explorations to provide birth subsidies and childcare allowances, etc. Maternity leave has been generally extended to more than 60 days, with relevant paternity leave of around 15 days and parents childcare leave of 5-30 days. We have explored ways to improve housing security policies including public rental housing, while weighting them to qualified multiple-child families. Large public places have generally been equipped with mother and infant facilities, making overall achievements in our targets of full coverage for places in need. We have continued to improve the coverage rate of moderately inclusive kindergartens and launched policies to ease students’ homework load and reduce after-school training, so as to promote the high-quality and balanced as well as urban-rural integrated development for compulsory education. Subsidy standard for special families covered by family planning has been unified in urban and rural areas. We have set up a dynamic adjustment mechanism, steadily improved old-age and medical insurance levels, and thoroughly carried out social care activities.    

Ⅲ. Implementing relevant tasks in the Decision in real earnest

Practices of more than a year have proved that the blueprint of population development mapped out in the Decision conforms to economic and social development needs and people’s aspirations, and has achieved significant effects. We should continue to take the earnest implementation of the Decision as one of our major political tasks and take concrete actions, striving to break new ground for population work in the new era. We should strengthen the Party’s overall leadership on population work. We should fully exert the Party’s core role in providing overall leadership and coordinating the efforts of all sides. Party Committees and governments of all levels must be firm in their political position, strengthen the awareness of national conditions and strategies, and establish and improve a coordinating mechanism to promote long-term and balanced population development. We should advance the target management responsibility system for population work and strengthen overall planning, policy coordination and work implementation. We should focus on elderly care and child care to establish and improve the population service system covering the full life cycle, and enhance elderly care and childcare capability at the grassroots level. We should establish and improve a population monitoring and alerting system that covers the full population and life cycle, and enhance supervision and inspection to ensure that the time-phased targets in the Decision will be completed successfully. Supportive measures should be improved and implemented to encourage birth. We should explore ways to improve cost-sharing mechanisms of holiday employment with the joint participation of the government, employers and individuals. We should expedite the development of government-subsidized rental housing and implement policies weighing towards housing purchase and leasing in a targeted way. Employers are encouraged to consult with employees equally to make flexible arrangements on holidays to provide childcare support and create a family-friendly work environment. We should improve the comprehensive supportive and insurance system for special families covered by family planning, and deliver earnest care and help to relevant families. We should expedite the development of a moderately inclusive childcare service system. While implementing the childcare service development plan during the 14th Five-Year Plan period, we should actively launch the construction project on public childcare service capacity and the special action on moderately inclusive childcare service. We should encourage and support kindergartens to enroll young children aged 2-3 where conditions permit. We should strengthen professional talents cultivation, in-service staff training and materials development, and gradually implement a qualification access system for childcare employees with a basis on the law. We should build national demonstrating cities of childcare services and help achieve the planned targets of 4.5 childcare positions per thousand population by 2025. We should enhance comprehensive supervision, and firmly safeguard the bottom line of security and health. We should deepen our analysis of population development strategy and its evolving dynamics. A high-level think tank on population issue shall be built to deepen our research on major issues including population and economy, society, resources and environment, scientific and technological development, national security, etc. We should build a friendly evaluation indicator system for long-term and balanced development of population and birth, follow up and evaluate the implementation effects of population planning, birth policies and supportive measures, and take proactive steps to address risks and challenges. We should actively participate in global exchanges and cooperation on population and development, and contribute China’s wisdom and solutions. We should earnestly build a birth-friendly social environment. We should attach importance to family education and atmosphere, build new marriage and birth culture, so as to advocate the traditional virtues of the Chinese nation.  We should respect the social value of birth and encourage both sides of parents to jointly shoulder childcare responsibilities, and tell well the Chinese stories of profound love, harmonious family and happy life. We should continue to advance reforms on marriage customs, and break the outmode old customs of high-profile wedding and extravagant betrothal gifts, etc.  

(Source: The QIUSHI Magazine)