Evaluating Family Planning Organizations Under China’s Two-Child Policy in Shandong Province

Abstract

Background: The 2015 two-child policy was the most important institutional change in China’s family planning since the 1978 one-child policy. To implement the two-child policy, China merged the former health departments and family planning departments into the new Health and Family Planning Commission organization. We collected and analyzed funding and expenditure data, providing a novel approach to assessing the family planning outcomes under China’s two-child policy. The paper shows how the management structure and funding levels and streams shifted with the new two-child policy and assesses the new management structure in terms of the ability to carry out tasks under the new family planning policy. Methods: We collected data on the funding, structure of expenditure and social compensation fee in Shandong province from 2011 to 2016, to evaluate how resources were allocated to family planning before and after the organizational change. We also collected interview data from family planning administrators. Results: While total family planning government financing was reduced after the organizational change, expenditures were shifted away from management to family planning work. Funding (80%) was allocated to the grass-root county and township levels, where family planning services were provided. The overlapping work practices, bureaucracy, and inefficiencies were curbed and information flows were improved. Conclusions: The new Health and Family Planning Commissions shifted resources to carry out the new family planning policy. The aims of the two-child policy to reduce inefficiencies, overlapping authorities and excessive management were achieved and expenditures on family planning work was enhanced and made more efficient.

The Turnover Intention among Grassroots Family Planning Staff in the Context of China’s Universal Two-Child Policy: A Case Study of the Xi’an City

“…The policy was implemented rather strictly in urban areas, but couples in rural areas were allowed to have two or more children under some conditions—e.g., the first child was a girl or the couples were of minority ethnic groups—in most provinces. The policy displayed dual effects: On the one hand, it played an important role in promoting China’s economic development and reducing the pressure of population on resources and the environment; on the other hand, it also brought some undesirable problems for a balanced development of population such as very low fertility, labor-force shortage, and quick population ageing [ 19 , 23 , 24 ]. Thus, the Central Committee of the Communist Party of China (CPC) made a decision to implement a selective two-child family planning policy on 12 November 2013 [ 25 ].…”

“…), most of the previous studies on turnover in grassroots family planning workers in China have only qualitatively discussed the topic [ 4 ]. Among those few survey-based analyses, the focus was actually not directly on turnover, but on the salary of grassroots staff or operating expense for family planning work [ 19 , 20 , 21 ]. The situation changed somewhat in recent years, partly due to the necessity of satisfying the requirements of the universal two-child policy.…”

Retracted: Family planning services use: A shared responsibility between men and women of reproductive age in Hubei province, China

“…The unmet needs in term of SRH among the Chinese population are under-studied and may deeply affect individuals thriving. 13,16,[18][19][20][21][22][23][24][25][26][27][28][29][30] Although a range of female contraceptive methods are available, 6,31 male contraceptive methods in FP services are limited. This observation is commonly found in China compared with many countries such as the USA and European countries, 4,6,10,31,32 where both male and female contraceptive methods are widely available and currently well accepted irrespective of an individual's gender.…”

“…Previously revised for ethnic minorities, the current one-to-two-child policy relaxation is implemented nationwide and should be supported by the whole population regardless of its previous and future predicted critical outcomes. 1,12,27,28,33,34 Although Chinese FP is well documented locally, little is known of it overseas.…”

Impact of the Universal Two-Child Policy on the Workload of Community-Based Basic Public Health Services in Zhejiang Province, China

“…A substantial reduction in sex-selective abortions will be seen in the future, but a reduction in the sex ratio at birth is unlikely to completely normalize for many years. The undesirable trend of increasing numbers of childless families will substantially decline under the universal two-child policy due to a reduction in the bribery of officials for permission to have more than one child and a merging of family planning organizations into the National Health and Family Planning Commission [4], all of which will help to create a more harmonious society.…”