Gender equity, caregiving, and the 1-2-3-child policy in China

Abstract

The Lancet Commission on 70 years of women's reproductive, maternal, newborn, child, and adolescent health in China by Jie Qiao and colleagues1Qiao J Wang Y Li X et al.A Lancet Commission on 70 years of women's reproductive, maternal, newborn, child, and adolescent health in China.Lancet. 2021; 397: 2497-2536Summary Full Text Full Text PDF PubMed Scopus (14) Google Scholar clearly describes a roadmap for universal coverage by 2030. However, the gendered role of caregiving2Langer A Meleis A Knaul FM et al.Women and health: the key for sustainable development.Lancet. 2015; 386: 1165-1210Summary Full Text Full Text PDF PubMed Scopus (172) Google Scholar is overlooked in the narrow definition of maternal health.3Knaul FM Langer A Atun R Rodin D Frenk J Bonita R Rethinking maternal health.Lancet Glob Health. 2016; 4: e227-e228Summary Full Text Full Text PDF PubMed Scopus (18) Google Scholar Women at a reproductive age face unique challenges as mothers, daughters, and granddaughters of the one-child policy. Although grandparents might offer child-rearing support,4Chen F Liu G Mair CA Intergenerational ties in context: grandparents caring for grandchildren in China.Soc Forces. 2011; 90: 571-594Crossref PubMed Scopus (209) Google Scholar they might also require care in a 4-2-1 family structure. The couple, each with a single child, have to take care of four older family members and at least one child, and the caregiving responsibility most likely falls solely or largely, five to one, on the woman in the couple.5Cook S Dong XY Harsh choices: Chinese women's paid work and unpaid care responsibilities under economic reform.Dev Change. 2011; 42: 947-965Crossref PubMed Scopus (130) Google Scholar With increasing longevity and the new three-child policy,6Qiu L The three child policy is here.http://www.xinhuanet.com/2021-05/31/c_1127513067.htmDate: 2021Date accessed: June 6, 2021Google Scholar the family structure might become 8-4-2-2 or more; with two working adults potentially caring for 12 older family members and up to three children. One woman can become the main caregiver of up to 15 people. In follow-up to the Lancet Commission on women and health, we are researching this generational change in caregiving responsibility. Many women were raised as so-called substitute sons, benefiting from increased access to education and salaried employment, reducing their caregiving time and possibly their preferred number of children.7Huang W Lei X Sun A When fewer means more: impact of one-child policy on education of girls.http://scholar.harvard.edu/files/weihuang/files/ocp_education_201605.pdfDate: May 1, 2016Date accessed: September 30, 2019Google Scholar, 8Fong VL China's one-child policy and the empowerment of urban daughters.Am Anthropol. 2002; 104: 1098-1109Crossref Scopus (192) Google Scholar National strategies aimed at increasing China's birth rate should be accompanied by policies that ensure accountability to women and value their myriad contributions to human, social, and economic development. Gender proactive policy-making should encourage the full participation of men in caregiving, public education, and advocacy to avoid labour market discrimination against working mothers,9Stevenson A Chen E In China, working mothers say they are fired or sidelined.https://www.nytimes.com/2019/11/01/business/china-mothers-discrimination-working-.htmlDate: Nov 1, 2019Date accessed: June 6, 2021Google Scholar and full access to high quality, affordable care for older family members and children. FMK reports two research grants from EMD Serono and Merck KGaA related to measuring the economic value of women's paid and unpaid contributions to the health sector. XK reports research grants from EMD Serono and Merck KGaA via the University of Miami Institute for the Advanced Studies of the Americas. BME reports research grants from EMD Serono and Merck KGaA via the Universiy of Miami Institute for the Advanced Studies of the Americas. AL declares no competing interests. A Lancet Commission on 70 years of women's reproductive, maternal, newborn, child, and adolescent health in ChinaWomen's reproductive, maternal, newborn, child, and adolescent health (RMNCAH) is a cornerstone for the healthy development of the next generation and a driving force for the progress of population and society in the future, especially in this era of population ageing and low fertility in China. In past decades, China's RMNCAH has made remarkable achievements in development goals related to reducing maternal and child mortality. However, as China moves towards a thriving goal—namely, towards ensuring health and wellbeing—the country faces emerging problems and new challenges in RMNCAH. Full-Text PDF Gender equity, caregiving, and the 1-2-3-child policy in China – Authors' replyXiaoxiao Kwete and colleagues note the challenge of population ageing and low fertility that is happening not only in China but also in many other countries. With increasing longevity and a relaxing population policy, young couples are shouldering a growing burden of caregiving for their older family members and children. This burden is the main reason for the decreased fertility desire among young Chinese couples. Additionally, increased independence and more opportunities have empowered women to pursue their personal development, which inevitably results in a low fertility rate and the postponement of childbearing. Full-Text PDF