Chinese health authorities offer clear-eyed analysis of birthrate forecast

China's three-child policy won't have obvious effects in the short term

On Jan. 20 the National Health Commission held a press conference on how China is following through on a prior policy promoting birth rate.

The policy, Decision on optimizing birth policies and promoting long-term balanced population growth, was drafted before June and released to the public on July 20, 2021

The press conference was held exactly on the 6-month marker since the policy was published, a befitting time to review how the policy is implemented, and offer an analysis of the challenges China is facing.

(Incidentally, the Zhengzhou flood probe report, detail-filled and a must-read, was released on Jan. 21, also at the 6-month marker.)

I Measures taken

Here’s a Xinhua story painting in broad strokes the main measures of various levels of gov’t have taken since the policy was announced.

Let’s take a look at what was said exactly by officials at the press conference.

Yang Jinrui, deputy director, office of population and family, NHC (国家卫生健康委人口家庭司副司长 杨金瑞) summarized the measures in three categories:

一是取消社会抚养费等制约措施，国家卫生健康委会同相关部门做好有关行政法规、规章、规范性文件清理工作。二是各部门积极出台一系列配套措施，包括教育“双减”、3岁以下婴幼儿照护服务费用纳入个税专项扣除、三孩生育保险待遇、普惠托育服务、优生优育服务、提高特殊家庭扶助金标准等。三是各地依法组织实施三孩生育政策，积极出台支持措施。目前25个省份完成条例修订，部分省份已制定实施方案。从现有情况看，各地普遍延长产假30-90天，增加普惠托育服务发展、计划生育家庭权益保障等条款。

First, the abolition of social support fees and other constraints. The NHC, in conjunction with relevant agencies, is revoking relevant administrative regulations, rules and regulatory documents. Second, various departments are actively introducing supporting measures, including the "double reduction", making the childcare service expense for toddlers under 3 tax deductible, three-child maternity insurance treatment, universal child care services, ob-gyn services, raising financial support standard for families in with special needs. Third, local governments are adopting localized policies to support the three-child birth policy. At present, 25 provinces have completed the revision of regulations, and some provinces have formulated implementation plans. Most places extended maternity leave by 30-90 days, invested further in universal childcare services, and offered more support for families.

Three local health officials were also invited to share what measures their localities have implemented. Your host assumes they are picked as examples of places where most progress has been made.

Here’s Sheng Le, Director and party chief of the health commission of Suzhou city, Jiangsu province. 江苏省苏州市卫生健康委党组书记、主任盛乐

一是要解决机构与载体的问题。在土地利用、规划引领上给予更多支持。二是供给。把普惠托育服务的供给进一步拓宽渠道。三是加大财政扶持力度。四是强化托育人才的培养与培训。五是示范性机构的建设，以及相应的模式创新。六是加强对托育服务的监管。

1. Offer more support for child care institutions in land planning; 2, Increase supplies of child care services; 3, Raising fiscal support for child care services; 4, Enhancing training for child care professionals; 5, Promoting innovative child care models and establishing exemplary child care institutions; 6, Increase supervision for child care services.

具体的方式和工作中，我们提出三优先，主要是拓宽普惠托育的供给渠道，要优先支持社区，把最后一公里打通；优先支持单位提供普惠托育；优先支持幼儿园。通过这三个优先来推动我们的工作。同时对已经备案的社会办普惠托育机构给予每个托位一万元建设资金补助和300-800元/月的运营补助。

In practice, our support is targeted primarily at communities, organizations that provide child care services, and kindergartens. For registered public child care service providers, we are providing a 10,000 yuan/child financial support, and a 300-800/month operation support.

通过去年的努力，普惠托育机构明显上升，目前整个苏州市有3.2万个托位，缓解了之前供需紧张的情况。

After our efforts in 2021, we are seeing a dramatic rise in numbers of child care services providers. Suzhou is now able to offer care service for 32,000 children, ending a shortage of supply.

Here’s Cao Qifeng, deputy director, Health Commission of Zhejiang province 浙江省卫生健康委副主任 曹启峰

“七普”数据显示，我省总和生育率在1.0左右，低于全国1.3的水平。我们清醒地认识到出生人口下降的严峻性，解决不好，会对我省经济社会持续健康发展产生重大影响。

The 7th consensus showed that the total fertility rate in Zhejiang is about 1.0, lower than the national average of 1.3. We are soberly aware of the seriousness of the decline in births. If it’s not properly addressed, Zhejiang's economic and social development will be significantly impacted.

女性在享受国家规定产假的基础上，一孩延长产假六十天，二孩、三孩延长产假九十天；在子女三周岁内，夫妻双方每年各享受十天育儿假；除产假待遇由生育基金保障外，其他假期的工资、奖金和其他福利待遇照发。照顾两孩及以上家庭子女在同一所幼儿园、小学、初中就学（入园）。在社区、乡村规划建设中全面植入托管服务功能。优化保障性住房配给机制，对多孩家庭予以倾斜，提高三孩家庭住房公积金贷款额度并予优先放款。

In addition to maternity leaves as provided for by national regulations, mothers in Zhejiang enjoy 60 more days of maternity leave after the first baby, and 90 more days after 2nd and 3rd babies; Both mother and father enjoy 10 days of parental leave every year before the child reaches 3 while enjoying full salary and benefits during the leave; Offer the opportunity for families with more than one child to send all their children to the same kindergarten/elementary school/middle school. Fully implant child care services in community and village planning and construction; Optimize the rationing of affordable housing with priority given to multi-child families; Raise mortgage cap for multi-child families and expedite their mortgage application.

女性因无业、失业、灵活就业以及其他非应保未保原因未能享受产假和生育津贴待遇的，由县（市、区）人民政府结合当地实际以及经济社会发展水平给予适当经济补助，具体对象和标准由县（市、区）人民政府规定。对三周岁以下的婴幼儿家庭给予育儿津贴、托育费用补助。推动将3岁以下婴幼儿照护服务费用纳入个人所得税专项附加扣除。省人民政府可以根据需要，决定延长产假、护理假、育儿假和独生子女陪护假的期限。

The Regulations provide that women who are not entitled to maternity leave and maternity benefits due to joblessness, unemployment, or unconventional forms of employment and other non-insured reasons, the governments shall offer appropriate financial assistance in accordance with the local level of economic and social development, the qualifying standards set by the county-level governments; Families with children under 3 shall be given childcare allowances and subsidies for childcare expenses; making the childcare service expense for toddlers under 3 tax deductible. The provincial government may decide to extend the length of maternity leave, nursing leave, parental leave and paternity leave for only one child, as needed.

An official from Panzhihua city, Sichuan province, also briefed the media about the policy his city has carried out. Aside from noting Panzhihua’s weather is “cool in the summer and warm in the winter”, has an abundance of fruits around the year, and boasts high air quality, therefore “very pregnancy-friendly”, his remarks are similar to the other two officials so your host won’t expand on his words.

II Assessment

In the press conference, Yang Jinrui of the NHC and an expert Song Jian, deputy director of the center for population and growth, the Renmin University of China, illustrated the population landscape China is in.

Here are Song Jian’s remarks.

*Continuous remarks are quoted together.

的确，近几年中国的出生人口数持续下降，这主要是受到育龄妇女总数、育龄妇女内部年龄结构以及生育率多重因素的影响。判断未来的走势是需要综合上述因素来看的。 育龄妇女数量取决于以往的出生队列规模，1962-1975年以及1981-1997年我国出生人口规模均超过2000万人，在死亡水平缓慢变化的条件下，不同规模出生队列人口进入育龄期将影响育龄妇女总数。

Indeed, the number of births in China has continued to decline in recent years, driven by multiple factors including the total number of women of childbearing age, the age structure within women of childbearing age, and the fertility rate. Judging the future trend should be based on all of these factors. The number of women of childbearing age depends on the size of the previous birth cohorts. The size of China's birth cohort exceeded 20 million in both periods of 1962-1975 and 1981-1997, and under the condition of slow changes in mortality levels, the entry of people of different birth cohorts into childbearing age will affect the total number of women of childbearing age.

未来一段时期，1981-1997年间高出生队列仍是我国育龄妇女的主体，但后续进入育龄期的妇女数量在缩减，由此导致育龄妇女总数持续下降，内部年龄结构趋于老化，尤其是20-34岁生育旺盛期育龄女性规模在2030年前下降明显，这将给出生人口带来较大下行压力。

In the coming period, the high birth cohort during 1981-1997 is still the main body of women of reproductive age in China, but the number of women who subsequently enter reproductive age is shrinking, which leads to a continuous decline in the total number of women of reproductive age, and the age structure of women of reproductive age continues to rise, especially the number of women at the peak of fertility between 20-34 years old will decline significantly before 2030, which will bring greater downward pressure on the birth population.

近年来，我国的生育率下降也比较迅速，特别是一孩总和生育率下降抵消了二孩总和生育率上升的效果，这是群众生育意愿走低、婚育年龄推迟、新冠肺炎疫情冲击等因素共同影响的结果。未来能否平缓出生人口下降趋势，关键在于生育率能否有所提升。这就需加快生育支持政策体系建设，缓解群众面临的压力，推动适龄婚育，提振生育水平。

In recent years, China's fertility rate has also declined relatively rapidly, especially the decline in the total fertility rate of the first child offset the effect of the rise in the total fertility rate of two children. This is the result of the combined effect of low fertility intentions of the population, the delay in the age of marriage and childbearing, and the impact of Covid. The key to deaccelerate the decline of births in the future lies in whether the fertility rate can be improved. This will require accelerating the establishment of a fertility support policy system to ease the pressure faced by the general public, promote marriage and childbearing at the appropriate age, and boost fertility levels.

如何来判断未来的走势？我们现在的出生人口下降，实际上在0-14岁少儿人口这块比例还会继续下降，同时我们的老年人口比例上升迅速。中国目前仍然处在人口红利的机会窗口期，但是这个窗口期即将关闭。

How can we determine the future trend? We have a declining birth population, and in fact, the proportion of children aged 0-14 will continue to decline, while the proportion of our elderly population is rising rapidly. China is still in the window of opportunity of the so-called demographic dividend, but this window is about to close.

我们可以发现，推进性别平等的、平衡工作家庭冲突的以及促进家庭发展的这些政策，对于生育水平的提升都有所助益。

We conclude that policies that advance gender equality, balance work-family conflict, and promote family development have all contributed to the increase in fertility levels.

出生人口的规模下降，受到多种因素的影响。其中有一个因素也是和新冠肺炎疫情是有关系的，我们初步判断，疫情的影响主要是直接的和间接的两个方面。比如对未来的不安全感和不确定性的增加，就使得家庭对未来的生育可能会很犹豫，也会降低人们的生育意愿。新冠肺炎疫情会直接或间接减少家庭成员的收入，使得育儿成本对于生育的影响更加突出。

The decline in birth is influenced by a number of factors. One of these factors is also related to Covid, and our preliminary finding is that the impact of the epidemic is both direct and indirect. For example, increased insecurity and uncertainty about the future may make families hesitant to have children and may reduce people's willingness to have children. Covid can directly or indirectly reduce the income of household members, making the impact of childcare costs on fertility even more pronounced.

在新冠肺炎疫情暴发期间有很多企业，特别是小微企业单位的效益不好，不光影响到家庭成员收入，也会增加家庭中的工作和家庭冲突，增加了生育的恐慌或者是畏惧。当然还有一些人会担心在疫情期间母婴保健、孕产检查等等这些常规的服务会受到影响。这些因素都会促使群众选择推迟甚至是取消生育计划。

There are many businesses, especially micro and small business units, which did not do well during the Covid epidemic, which not only affects the income of family members but also increases work and family conflicts in the household, increasing the fear or trepidation about childbearing. And of course, there are those who will worry that during the epidemic maternal and child health care, maternity checkups, and other such routine services will be affected. All of these factors can prompt people to choose to delay or even cancel their childbearing plans.

去年以来，国际上也有很多的研究，关注到新冠肺炎疫情对于死亡率、生育率等的相关影响，中国的学者也一直在关注这方面的影响。目前大多数的研究表明，新冠肺炎疫情对出生产生的影响是负面的，新冠肺炎疫情对于中国的出生人口的影响还有待进一步观察。

Since last year, there have been many international studies that have focused on the impact of the Covid epidemic on mortality and fertility rates, and Chinese scholars have also been concerned about the impact. Most studies so far suggest that the impact of the Covid epidemic on births has been negative, and the impact of the Covid epidemic on China's birth population remains to be seen.

但是为什么人们还是有这个顾虑，觉得产假延长了，反倒是心事重重，关键就在于能不能够带薪产假真正落地，特别是要明确假期的成本分担机制。因为假期不是事，带薪产假可能才是事，能不能在假期期间保障女性的收入，能不能女性在休完产假之后顺利返回到原岗位，她的职位和她原来的收入不受到影响。

But why do people still have this concern even when maternity leave is extended? They worry that these policies cannot be properly implemented, especially before a burden-sharing scheme (between the government, employer, and family) is devised. Because taking leave is the easy part, whether mothers’ pay during paid maternity leaves whether they can have a smooth transition back into their career and whether their position and income are affected by the paid leaves are harder issues to solve.

所以我们认为育儿分担机制是必须要明确的，否则可能就会影响女性的收入保障，甚至是加重女性的就业歧视。刚才浙江的领导在介绍时，各地目前进一步明确生育相关假期成本分担机制，生育成本要由国家、企业和家庭共同分担，要利用多种措施，比如政府的补贴，税收减免手段，也要适当分担一下用人单位的成本，这样就能减轻家庭，特别是育龄女性的后顾之忧。

So we think the childcare burden-sharing mechanism is necessary to clarify, otherwise, it may affect the income security of women, and even aggravate the employment discrimination of women. Just now the Zhejiang official made clear that localities are experimenting with a burden-sharing mechanism, with the consensus that the childbirth burden needs to be shared among the government, enterprises, and families. We need to adopt a variety of measures, such as government subsidies and tax deductions to take some burden off of the employers, so as to alleviate the worries of families and especially women of childbearing age.

Here are some additional remarks from Yang Jinrui of the NHC.

出生人口下降是多重因素综合影响的结果。 一是育龄妇女特别是生育旺盛期育龄妇女规模下降。“十三五”时期20-34岁生育旺盛期妇女年均减少340万，2021年相比2020年减少了473万。这是带动出生人口数量下降的重要因素。 二是年轻人婚育观念显著变化。当前，90后、00后作为新的婚育主体，绝大部分成长和工作在城镇，受教育年限更长，面临的就业竞争压力更大，婚育推迟现象十分突出。婚姻推迟增加了女性终身不婚的可能性，进一步抑制了生育水平。

The decline in the birth population is the result of a combination of factors. First, the number of women of childbearing age, especially women of childbearing age in their prime, is declining. During the 13th Five-Year Plan period, the average annual decrease of the number of women aged 20-34 is 3.4 million, and by 4.73 million in 2021 yoy. This is an important factor driving the decline in the number of births. Second, the concept of marriage and childbirth among young people has changed significantly. Currently, the post-90s and post-00s as the new main body of marriage and childbirth, the vast majority of them grow up and work in urban areas, have longer years of education, face more competitive pressure for employment, and the phenomenon of delayed marriage and childbirth is very prominent. The postponement of marriage increases the possibility of women not marrying for life, which further suppresses the fertility level.

同时，生育意愿持续走低，育龄妇女平均打算生育子女数，2017年调查为1.76个，2019年调查为1.73个，2021年调查降到1.64个。 三是生育养育教育成本偏高加重了生育顾虑。随着经济社会发展，住房、教育、就业等多重因素影响下的生育养育教育成本居高不下，加大了年轻人生育顾虑。相关配套支持政策不太衔接，托育等公共服务不太健全，让许多年轻人在生育问题上犹豫不决、望而却步。 此外，新冠肺炎疫情也对部分群众婚育安排产生一定影响。

At the same time, fertility intentions continue to be low, the average number of children women of childbearing age intend to have 1.76 in a 2017 survey, 1.73 in a 2019 survey, and down to 1.64 in the 2021 survey. Third, the high cost of childbearing and raising education has increased fertility concerns. With economic and social development, the high cost of childbirth, education, and employment under the influence of multiple factors has increased the concerns of young people about childbirth. Related supporting policies are not well connected, and public services such as childcare are not well developed, making many young people hesitant and discouraged to have children. In addition, the new crown pneumonia epidemic has also had an impact on some people's marriage and childbirth arrangements.

Here your host would like to insert a commentary from official media Guangming Daily that’s received over 2 million likes on Weibo:

90后与00后绝大部分成长在城镇，受教育年限更长，就业竞争压力较之前代更大，导致婚育在人生节奏中后置——这是不分男女都要遇到的问题。但上述“无性别”的压力，最终导致了“女性终生不婚可能性增加”，就很值得注意。这提示我们，同样的压力作用于现有的性别权力结构，女性是首当其冲的承重者。

The majority of the post-90s and post-00s grew up in urban environments, with more years of education and more career pressure than previous generations, resulting in marriage and childbirth taking a back seat in life - a problem that both men and women face. But it is worth noting that the "genderless" pressures eventually led to "an increased likelihood of women not marrying for life". This suggests that under existing gender power structures, women bear the brunt of the pressure.

Back to Yang’s remarks.

人口再生产与物质再生产是不一样的，人口再生产的周期长，影响因素多，生育决策的因素很复杂，而且涉及方方面面。目前，三孩生育政策实施时间还不长，配套的积极生育支持措施也在陆续出台中，短期内很难显现出明显效果。

Population reproduction is not the same as material reproduction. The cycle of population reproduction is long, with many influencing factors, and the factors of fertility decision are complex and involve various aspects. At present, the three-child birth policy has not been implemented for a long time, and the supporting positive birth support measures are being introduced one after another, so it is difficult to show obvious effects in the short term.

While answering a question if the Chinese government is contemplating further ease of restrictions on the number of children allowed, Yang hinted that is not on the immediate agenda.

当前我们的主要任务还是深入贯彻落实中央《决定》，实施好三孩生育政策及配套支持措施，减轻群众生育养育教育方面的负担，更好地满足群众生育意愿，推动实现适度生育水平，促进人口长期均衡发展。

At present, our main task is to thoroughly implement the central government's decision (on optimizing birth policies and promoting long-term balanced population growth), the implementation of three-child birth policy, and supporting measures to reduce the burden of childbirth and education, to better meet the public's desire to have children, to promote the realization of moderate fertility levels, and to promote long-term balanced population development.

This newsletter is written by Yang Liu, founder of Beijing Channel.

Please write to yangliuxh@gmail.com if you have any feedback or tell me if you’d like to see any particular topic featured in future Beijing Channel newsletters.

Disclaimer: translation in this newsletter is done by deepl.com, with editing by your host. It should only serve as a reference, NOT as an official translation of the original text.