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PubMed1999

International child care practices study: methods and study population.

The study set out to document child care practices in as many different countries and cultures as possible with the aim of providing baseline child care data and stimulating new hypotheses to explain persisting differences in sudden infant death syndrome (SIDS) rates between countries. The protocol, piloted in four countries in 1992, was distributed to 80 potential centres in 1995. Data from 19 centres were received. This paper describes the demographic characteristics of the data from the different centres. Comparison showed significant differences for a number of variables including mean age of completion of the study, response rate, mean gestation, mean birth weight, method of delivery and incidence of admission to neonatal intensive care units. High caesarean section rates identified in the Chinese samples (44 and 40%) were unexpected and have important public health implications. This finding warrants further study but may be related to China's one child policy. We consider that international comparison of child care practice is possible using standardised data collection methods that also allow some individual variation according to local circumstances. However, in view of the heterogeneity of the samples, it will be important to avoid over-interpreting differences identified and to view any differences within the qualitative context of each individual sample. Provided there is acknowledgement of limitations, such ecological studies have potential to produce useful information especially for hypothesis generation.

Birth Weight↗
PubMed2002

Son preference and fertility in China.

This paper examines the effect of son preference on the hazards of having a second and a third birth. With data from the Two-per-thousand National Sample Survey on Fertility and Contraception conducted in 1988 by the State Family Planning Commission of China, the hazard of having a second birth among 62+ thousand married women who have had a first birth, and the hazard of having a third birth among 43+ thousand married women who have had two births was examined. These two hazards (i.e. the hazard of moving from the first to the second birth, and the hazard of moving from the second to the third birth) were analysed by estimating Cox proportional hazard models. The major covariate in the first analysis is whether or not the first-born was a daughter. In the second analysis the main covariate is whether both of the first two children were girls. In both models seven covariates known to have independent effects on the transition to a second (or third) birth are controlled for, namely, whether the woman is a Han, whether she is a farmer, her age at the birth of the first (or second) child, whether she had her first (or second) birth prior to the initiation in 1979 of the one-child policy, and three dummy variables reflecting her level of education. The results show the important influence of son preference on the hazard of having another birth.

China↗
PubMed2002

Gender selection in China: its meanings and implications.

With the advancement of assisted reproduction technologies, people are offered wider choices to choose the gender of their offspring and to construct 'ideal-typed' families with specific gender structure. Gender selection is welcomed by many societies with gender-specific preference, especially those patriarchal societies such as Chinese communities. It is not only a medical procedure but also a social orientation, which reveals much of the underlying preference towards gender. This paper explores the cultural dimensions to gender selection and its psychosocial meanings and implications in Chinese societies, especially after the establishment of One Child Policy in China. Problems associated with son preference in the culture with strong gender stereotyping are addressed. We believe that gender selection for social reasons should not be allowed since undesirable outcomes will be resulted under such strict population control program.

China↗
PubMed2004

Factors affecting adoption in China, 1950-87.

Though adoption in China is known to have increased as more girls were abandoned and became available for adoption following the introduction of the country's one-child policy in the 1980s, little is known about Chinese adoption practices. This paper investigates the factors affecting adoption in China in the period 1950-87 using data from the National Two-Per-Thousand Sample Survey on Fertility and Contraception of 1988. The results show that the national adoption rate was 2.3 per cent. Childless women were more likely than women with children to adopt and did not show a sex preference. Women with children by birth used adoption to secure a child of the 'missing' sex. Women who had experienced the death of a child were more likely to adopt than those who had not. Women with children may have used adoption as a strategy to circumvent the strict family planning policies.

Adolescent↗
PubMedDate not supplied

The influence of age at menarche on the fertility of Chinese women.

This paper examines the effect of age at menarche on children ever born (CEB). We use data from the 1997 Sample Survey of Population and Reproductive Health conducted by the China Population Information and Research Center and the State Family Planning Commission. Poisson regression models are estimated for 10,919 ever married Chinese Han women. The influence of a woman's age at menarche on her CEB is examined while controlling for the social effects of rural/urban residency, education, her number of fecund years, whether her first birth occurred before or after the initiation of China's one child policy, and her age at first marriage. The results support our hypothesized positive association between age at menarche and CEB. That is, the later a woman's age at menarche, the greater her number of children ever born. Holding the other five independent variables constant, we show that for every additional month in age at menarche, a Chinese Han woman's mean number of children ever born increases by 0.5 percent. Some of the implications of these results are explored.

Adolescent↗
PubMed1993

The academic, personality, and physical outcomes of only children in China.

Representative samples of 1,000 schoolchildren from 4 Chinese provinces were surveyed to compare the outcomes of only children to those of firstborn and later-born children. The children's ages ranged from 8 to 17 years, with half of the sample in the third grade and the other half in the sixth grade. 3 types of outcomes were considered. In terms of academics, differences between only children and others were found in 3 of the 4 provincial samples, with onlies being most likely to outscore others in verbal tests. In terms of personality evaluations, very few only-child effects were found. In 2 of the 4 provincial samples, only children were found to be taller or to weigh more than others. Taken together, these results suggest that the one-child policy in China is not producing a generation of "little emperors."

Achievement↗
PubMed2003

Perinatal mortality in rural China: retrospective cohort study.

OBJECTIVES: To explore the use of local civil registration data to assess the perinatal mortality in a typical rural county in a less developed province in China, 1999-2000. DESIGN: Retrospective cohort study. Pregnancies in a cohort of women followed from registration of pregnancy to outcome of infant seven days after birth. SETTING: Routine family planning records in 20 rural townships in eastern China. SUBJECTS: 3697 pregnancies registered by the local family planning system during 1999. MAIN OUTCOME MEASURES: Abortions, stillbirths, early neonatal mortality, perinatal mortality. RESULTS: Only three cases were lost to follow up. The average age of the women at pregnancy was 25.9 years. Three hundred and twelve pregnancies were aborted and 240 ended in miscarriage (total 552, 15%). The perinatal mortality rate was 69 per 1000 births, the rate of stillbirth was 24 per 1000 births, and the early neonatal mortality was 46 per 1000 live births. The early neonatal mortality was 29 in boys and 69 in girls per 1000 live births. The perinatal mortality rate increased notably with parity and was higher in townships having lower income per capita. CONCLUSIONS: The family planning system at the most local level is a useful data source for studying perinatal mortality in rural China. The perinatal mortality rate in the study county was higher than previously reported for both rural and urban areas in China. The results by parity and sex of the infant raise concern over the impact of the one child policy.

Adult↗
PubMed2006

The HIV related risks among men having sex with men in rural Yunnan, China: a qualitative study.

OBJECTIVES: To explore the characteristics and issues specific to HIV related risk behaviours among men who have sex with men (MSM) in rural China. METHOD: Qualitative study using semistructured in-depth interviews in Dali prefecture, Yunnan. 24 informants recruited through a local MSM network, snowballing and by word of mouth. The main outcome measures were themes identified as increased exposures and risks to HIV. RESULTS: Risk behaviour, social stigma, one child policy and concepts of traditional Chinese medicine (TCM) had significant roles in the spread of HIV in rural China. Many MSM lead a life with double identities in China and condom use was found to be variable with attempts to "rationalise" the risky behaviour being its major determining factor. Health seeking behaviours of genitourinary problems were infrequent and illogical, which were further held back by the existing healthcare system and lack of sensitivity expressed by the health professionals. CONCLUSIONS: Clear education messages to the general public while raising awareness among health professionals of the health risks and needs in MSM are essential in the prevention of the current HIV epidemic.

Adult↗
PubMed2003

Giving birth. Voices of Chinese women.

The meaning of the childbirth experience for Chinese women living in the People's Republic of China is described in this phenomenological study. Ten primiparous women participated in audiotaped interviews within 5 months of giving birth, 9 from Beijing and 1 from Chongqing. The interviews were translated by a bilingual native Chinese speaker and transcribed by the researcher. Themes were identified from the rich narrative data, including the One Child Policy's influence on childbearing, the transition to motherhood, and the influence of the cultural practice of "doing the month" (zuo yue zi). The findings provide insights into how nurses can provide better nursing care by learning about and validating specific cultural practices related to childbearing. The rising number of Chinese immigrants to the United States reflects the increasing need for more culturally competent care by nurses to ensure positive perinatal health outcomes.

Adaptation, Psychological↗
PubMed1997

A Baby-Friendly Hospital initiative in northern China.

In the People's Republic of China, an approach has been adopted to ensure that all children born as a result of the one-child policy are healthy. The World Health Organization/United Nations Children's Fund (WHO/UNICEF) has encouraged the Chinese Government to embrace this philosophy. Part of this approach has resulted in an attempt to increase the breastfeeding rates. This report describes a visit by two nursing faculty members of a Canadian university to an urban hospital maternity unit in the northeast of China, where the staff were attempting to incorporate this philosophy into their maternity care with the assistance of nursing faculty members from the local university. The method chosen to integrate this philosophy was the Baby-Friendly Hospital Initiative initiated by WHO/UNICEF.

Breast Feeding↗
PubMedDate not supplied

Comparison of breast-feeding and nurturance practices in the Peoples Republic of China and the United States of America.

Comparison of breast-feeding and nurturance practices between the Peoples Republic of China and the United States of America revealed many similarities. Some differences did exist, especially regarding use of antiseptic solutions for cleansing nipples, use of herbal teas for treatment of engorgement and the concern of "over nurtu-rance" due to China's One-Child Policy.

Breast Feeding↗
PubMed1993

Caregiving and long-term health care in the People's Republic of China.

The growing proportion of frail elderly in the People's Republic of China has necessitated policy of the state toward their long-term care. In this decade, there has been an increase in the amount of data available on the care and needs of Chinese frail elders. This article synthesizes these data and traces the patterns of care of frail elders. It distinguishes between urban and rural patterns, and identifies the increasing role of the family and community in the caregiving of elders. State policy, evident from the data, suggests that the state's role in direct care of elders is minor but that it continues to influence and support eldercare as part of its policy of promoting the one-child per couple policy. This process can be seen in support programs for the childless elder, who symbolizes the expected condition of a large number of future elders under the one-child policy. The article identifies four factors that are influencing the changing patterns of long-term care of elders in China: (1) economic reform programs; (2) the political agenda of the Chinese Communist Party; (3) differences in urban and rural economic conditions; and (4) policy directed at long-term investment in health care technology.

Aged↗
PubMed2005

A sense of autonomy is preserved under Chinese reproductive policies.

China has had a one-child family policy since 1979 and a National Family Planning Law since 2002. This paper presents analysis of comments from members of the general public and experts in China on the question of reproductive autonomy. The Chinese concept of 'Yousheng' (healthy birth) is more appropriate than eugenics as an expression of Chinese social policy and public attitudes. The widespread support for healthy birth has policy implications. None of the persons interviewed said that they had ever used ultrasound to choose the gender of their child nor had an abortion for the reason of a fetus's gender. Despite the bad impression of abortion from their experience, most would abort a fetus with a genetic disease. Respondents in rural areas were less likely to use prenatal care, pointing to more important social problems in reproduction in China. The impressions given from the survey stands in contrast to the implications of the majority of Western papers on the Chinese situation, and indicate that people are generally satisfied with the ethical balance towards the societal needs over individual autonomy, but they still have a sense of reproductive autonomy. There needs to be further study into these issues with larger surveys and interview studies.

Abortion, Induced↗
PubMed1988

Establishment of life insurance benefits, 1986.

In 1986, Nanjing County in Fujian Province, China, established life insurance policies for only children. Families with only one child paying insurance premiums of 40 yuan will be refunded medical expenses exceeding 200 yuan incurred in caring for the child from birth to age 16.

Asia↗