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The University of Southampton
Economic, Social and Political Sciences

Improving China's reproductive health and family planning

Analysis by demographers and social statisticians at the University of Southampton is helping a United Nations’ Population Fund (UNFPA) programme to improve the reproductive health and family planning of millions of young people in China. They have been monitoring and evaluating the large-scale programmes that the UNFPA has run across eastern, central and western China over the last 13 years.

Research challenge

The UNFPA Reproductive Health and Family Planning Country Programmes were designed to enhance the reproductive and sexual well-being by empowering women and couples in China with informed contraceptive choices and reproductive rights. The Sixth Country Programme (CP6) built on the previous programmes (CP4 and CP5) primarily aimed at improving access to quality reproductive health services, promoting awareness and reducing social stigma related to HIV/AIDS, changing attitudes towards young people’s risky sexual behaviour, and focusing on improving women’s status and gender equity.

Context

After years of enforcing a rigorous family planning policy that restricted couples especially in urban areas to only one child, China adopted a policy strategy to enable its people to make informed reproductive health and family planning choices through a bottom-up client-centred services without any discrimination or influence from health authorities. They responded to the United Nations’ recommendations and Plan of Actions outlined in the proceedings of the 1994 International Conference on Population and Development placing emphasis on meeting the reproductive needs of individuals within the framework of universally recognised human rights standards instead of merely meeting demographic goals, and, together with the United Nationals Population Fund UNFPA, they put in place a series of programmes to improve Chinese people’s access to quality reproductive health and family planning services. However, no systematic method of evaluating the impact of these programmes was in place and member states, including the UK, insisted on a comprehensive evaluation before committing further resources.

Our solution

Southampton researchers from Social Statistics and Demography were invited to lead an independent research programme working with the Chinese ministries to scientifically evaluate the impact of the UN programme in China. The team first analysed the CP4 and CP5 programmes and were invited to evaluate the CP6 programme. Their research involved gathering high quality data through statistically robust population surveys and field research in areas included in the intervention and non-intervention areas. The field based research included face-to-face interviews, focus group discussions with service providers, provincial authorities and stakeholders, as well as assessment of client-centred service outreach in local communities and how they were communicating these services to the public. Their research identified gaps in service standards that were able to be addressed in future programmes. Analysis of all three programmes revealed a clear shift in attitudes among health providers, an improved knowledge of reproductive health and family planning among men and women and significant improvements in contraceptive choices.

What was the impact?

The Southampton team’s analysis over the past decade have benefited millions of Chinese people by generating robust scientific evidence to inform significant policy changes by Chinese government ministries and the UN FPA. These included sstrategies aimed at reorienting service delivery and grassroots level client-provider interactions, revising in-service training modules to include gender-based reproductive health and family planning information, counselling, referral and treatment services for HIV/AIDS and other STDs, and amending post-abortion care guidelines to consider the needs of women and couples to ensure that they were provided with a better service without coercion or discrimination. The UN programme has been extended nationwide giving 754 million Chinese men and women of reproductive age access to family planning methods of their choice without coercion or discrimination from service providers. The research tools developed by the team are also being extended further afield. They have already been replicated in a similar programme in North Korea and members of the team have been in discussions about whether lessons from China could be adopted in Africa, particularly in conflict regions such as Sierra Leone and Rwanda.

Improving China's reproductive health and family planning
Improving China's family planning

Related Staff Member

Our research over the past decade was critically influential in boosting the credibility of the UN programme in China and shaping significant policy changes by the Chinese government, which in turn had a direct impact facilitating the client-oriented informed choices service environment, and more importantly, enhancing the quality of life and reproductive wellbeing of millions of Chinese men and women.

Sabu Padmadas - Professor of Demography and Global Health

Key Publications

List of all staff members in
Staff MemberPrimary Position
Sabu S PadmadasAssociate Dean (International) and Professor of Demography and Global Health
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