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Underreporting of Births and Infant Deaths in Rural China: Evidence from Field Research in One County of Northern China*

Published online by Cambridge University Press:  12 February 2009

Abstract

Between the beginning of the 1950s and the early 1970s, China, like many other countries in Asia, Africa and Latin America, experienced rapid population growth. This was due mainly to a dramatic mortality decline not offset by any decline in the birth rate. In 1970, China had a crude birth rate of 33.43 (per 1,000), a crude death rate of 7.60 (per 1,000) and a rate of natural increase of 25.83. “Population growth” was identified as a fundamental obstacle to economic development, and the stage was set for large-scale state interventions in the process of human reproduction. The apotheosis of this intervention was the introduction, in 1979, of the One Child Policy, which was successfully implemented in the urban areas. In rural areas, policies promoting later marriage, one child – maximum two – per couple, and greater spacing of those births that are permitted contributed to the swift fertility decline witnessed over the last three decades. In 1996 China's birth and death rates were reported at 16.98 per 1,000 and 6.56 per 1,000 respectively and the population was growing at 10.42 per 1,000.

Type
Research Note
Copyright
Copyright © The China Quarterly 1998

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References

* Thanks to Herbert Smith, William Lavely, Stevan Harrell and Samuel Preston for their valuable suggestions and constructive comments.

1. State Statistical Bureau, China Statistical Yearbook 1997 (Beijing: China Statistical Publishing House, 1997), p. 69.Google Scholar

2.Hua, Guofeng, “Economic and social policy in China: a report by Hua Guofeng,” Population and Development Review, Vol. 4 (1998), pp. 167179.Google Scholar

3.Croll, E., Davin, D., and Kane, P., China's One Child Family Policy (New York: St. Martin's Press, 1985)CrossRefGoogle Scholar; Banister, J., China's Changing Population (Stanford: Stanford University Press, 1987)Google Scholar; Hardee-Cleveland, K. and Banister, J., “Fertility policy and implementation in China, 1986–1988,” Population and Development Review, Vol. 14 (1988), pp. 245286Google Scholar; Greenhalgh, S., “The evolution of the one-child policy in Shaanxi, 1979–1988,” The China Quarterly, No. 121 (1990), pp. 191229.CrossRefGoogle Scholar

4.Lavely, W. R. and Freedman, R., “The origins of the Chinese fertility decline,” Demography, Vol. 27 (1990), pp. 357367CrossRefGoogle Scholar; Feeney, G. and Feng, Wang, “Parity progression and birth intervals in China: the influence of policy in hastening fertility decline,” Population and Development Review, Vol. 19 (1993), pp. 61101CrossRefGoogle Scholar; Thomas, N., “The ethics of population control in rural China, 1979–1992,” International Journal of Population Geography, Vol. 1 (1995), pp. 318.CrossRefGoogle Scholar

5. State Statistical Bureau, China Statistical Yearbook 1997, p. 69.Google Scholar

6. See inter alia Banister, J. and Preston, S. H., “Mortality in China,” Population and Development Review, Vol. 7 (1981), pp. 98110CrossRefGoogle Scholar; Lavely, W. R., “China's rural population statistics at the local level,” Population Index, Vol. 48 (1982), pp. 665677CrossRefGoogle Scholar; Banister, China's Changing Population; Xingyuan, Gu, “Infant and child mortality of eight provinces of China,” paper presented at the International Seminar on China's In-depth Fertility Survey, Beijing, 1990Google Scholar; Tu, Ping and Zai, Liang, “An evaluation of the quality of enumeration of infant deaths and births in China's 1990 census,” paper presented at the International Seminar on China's 1990 Population Census, Beijing, 1992Google Scholar; Sun, Fubing, Li, Shuzhuo and Nan, Li, “Zhongguo disi ci renkou pucha quanguo ji bufen shengqu siwang loubao yanjiu” (“Study of the nonreported deaths for the whole country and for some provinces in China's Fourth Population Census”), Zhongguo renkou kexue (China Population Science), No. 2 (1993), pp. 2025.Google Scholar

7. Demographers have attempted to explain the proximate causes of high sex ratios at birth. These include excess female infant mortality (J. Banister, “China: recent mortality levels and trends,” presented at the Annual Meeting of the Population Association of America (1992)); recording of female early infant deaths as stillbirths (Coale, A. J. and Banister, J., “Five decades of missing females in China,” Demography, Vol. 31 (1994), pp. 459479)CrossRefGoogle Scholar; out-adoption of female infants (Johansson, S. and Nygren, O., “The missing girls of China: a new demographic account,” Population and Development Review, Vol. 17 (1991), pp. 3551)CrossRefGoogle Scholar; underreporting of female births (Hull, T. H., “Recent trends in sex ratios at birth in China,” Population and Development Review, Vol. 16 (1990), pp. 6383)CrossRefGoogle Scholar, and sex-selective abortion (Zeng, Yi, Tu, Ping, Gu, Baochang, Xu, Yi, Bohua, Li and Yongping, Li, “Causes and implications of the increase in China's reported sex ratio at birth,” Population and Development Review, Vol. 19 (1993), pp. 283302).Google Scholar

8.Duncan, O. D., Notes on Social Measurement: Historical and Critical (New York: Russell Sage, 1984) quoted on pp. 289290Google Scholar in Smith, H. L., Ping, Tu, Merli, M. G. and Hereward, M., “Implementation of a demographic and contraceptive surveillance system in four counties in north China,” Population Research and Policy Review, Vol. 16 (1997), pp. 289314.CrossRefGoogle Scholar

9.Orleans, L. A., “Chinese statistics: the impossible dream,” The American Statistician, Vol. 28 (1974), pp. 4752.Google Scholar

10. The interaction of political and statistical systems was first addressed in White, T., “Implementation of the one-child-per-couple policy in rural China: national goals and local politics,” in Lampton, D. M. (ed.), Policy Implementation in Post-Mao China (Berkeley: University of California Press, 1987), pp. 284317Google Scholar, and White, T., “Birth planning between plan and market: the impact of reform on China's one-child policy,” in Joint Economic Committee, Congress of the United States, China's Economic Dilemmas in the 1990s: The Problems of Reforms, Modernization, and Interdependence, Vol. I (Washington, DC: U.S. Government Printing Office, 1991)Google Scholar. Demographers have proposed that pregnancies and births are systematically omitted from retrospective fertility surveys and official records and that the implementation of family planning policies may have to do with the occurrence of this phenomenon (see Smith, H. L., “Nonreporting of births and nonreporting of pregnancies? Some evidence from four rural counties in north China,” Demography, Vol. 31 (1994), pp. 481–86CrossRefGoogle Scholar; Feeney, G. and Yuan, Jianhua“Below replacement fertility in China? A close look at recent evidence,” Population Studies, Vol. 48 (1994), pp. 381394). Zeng Yi also links underreporting of most recent out-of-plan births in a 1992CrossRefGoogle Scholar national fertility survey with the strictures of the birth planning programme (see Zeng, Yi, “Is fertility in China in 1991–1992 far below replacement level?” Population Studies, Vol. 50 (1996), pp. 2734).Google Scholar

11. Ciqixian (a pseudonym), formerly a county (xian), was recently redefined as a city district (shixiaqu) with the former county boundaries. Because of its former administrative status, Ciqixian has a mostly rural population. The district was selected with three other counties in Shandong and Hebei provinces for participation in the project “Introducing new contraceptives in rural China” (INCRC). For details about this project, see Smith et al. “Implementation of a demographic and contraceptive surveillance system”; and Merli, M. G., Smith, H. L., Hereward, M. and Qian, Zhenchao,“Demographic research in rural China: field observations from work in four counties in north China,” paper presented at the Population Association of America Annual Meeting, New Orleans, 1996.Google Scholar

12.Coale, and Banister, , “Five decades,” pp. 466–67.Google Scholar

13.Lee, J. Z. and Campbell, C. D., Fate and Fortune in Rural China, (Cambridge: Cambridge University Press, 1997), p. 70.CrossRefGoogle Scholar

14.Taylor, J. R. and Banister, J., “Statistical reliability in China,” (Center for International Research, Washington, DC: U.S. Bureau of the Census, 1989)Google Scholar; Banister, , China's Changing Population, p. 102Google Scholar; Luo, Sheng, “Reconstruction of life tables and age distribution for the population of China by year,” PhD dissertation (University of Pennsylvania, 1988)Google Scholar; Ji, Meifang, “Jihua shengyu tongji baobiao shuifen wenti yuanyin ji duice” (“Reasons and countermeasures pertaining to the problem of underreporting in family planning statistics”), Renkou yanjiu (Population Research), Vol. 3 (1991), pp. 5961.Google Scholar

15.Luo, Sheng, “Reconstruction of life tables,” pp. 3334Google Scholar; Wang, Changling, “Yinger chusheng siwang renshu bumennei hengxiang bijiao” (“A cross-sectional comparison of birth and infant deaths records collected by health stations”), Zhongguo weisheng tongji (China Health Statistics), No. 10 (1993), p. 29Google Scholar; Zhang, Qingdong, “Yangzhong xian yinger siwang loubao de kongzhi” (“The control of underreporting of infant deaths in Yangzhong county”), Zhongguo weisheng tongji, (China Health Statistics), No. 10 (1993), p. 22.Google Scholar

16. Banister, China's Changing Population; Hardee-Cleveland and Banister, “Fertility policy and implementation in China.”Google Scholar

17. White, “Birth planning between plan and market.”Google Scholar

18.Qian, ZhenchaoReport of field research in rural China,” unpublished manuscript, (Philadelphia: Population Studies Center, University of Pennsylvania, 1992)Google Scholar; Zhenchao, Qian, “Revisiting Zunhua and Leting,” unpublished manuscript (Philadelphia: Population Studies Center, University of Pennsylvania 1994).Google Scholar

19. See Feng, Guoping and Hao, Linna, “Zhongguo de ershiba ge difang jihua shengyu tiaoli zongshu” (“Summary of 28 Chinese birth planning regulations”), Renkou yanjiu (Population Research), No. 4 (1992), pp. 2833Google Scholar. Out-of-plan (jihuawai) births are births not in conformity with family planning regulations. These are (a) early births, resulting from early marriages (zaohun zaoyu), i.e. marriages taking place at an earlier age than the legal minimum (20 for females and 22 for males) (see Fifth National People's Congress, China's new marriage law,Population and Development Review, Vol. 7 (1981), pp. 369372), or out-of-wedlock births (feihun zaoyu), and (b) above quota (chaosheng) births, or births in excess of the individual or the village birth quota.Google Scholar

20. White, “Implementing the one-child-per-couple policy in rural China”; Cui, Sixing, “Guanyu renkou tongji wenti de tantao” (“An inquiry into the quality of population statistics”), Renkou yu jingji (Population and Economics), Vol. 2 (1990), pp. 3132Google Scholar, 41; Greenhalgh, S., “The peasantization of population policy in Shaanxi: cadre mediation of the state-society conflict,” in Davis, D. and Harrell, S. (eds.), Chinese Families in the Post-Mao Era (Berkeley: University of California Press, 1993), pp. 219250;Google ScholarWang, Huide, “Qiantan yingxiang chusheng tongji baobiao zhiliang de yuanyin he duice” (“Factors affecting the quality of birth statistics and countermeasures”), Renkou yanjiu (Population Research), No. 5 (1994), pp. 5859.Google Scholar

21. Cui Sixing, “An inquiry into the quality of population statistics.”Google Scholar

22. John Aird was the first author to emphasize and document “alternating escalations and remissions” of the Chinese family planning policy. See Aird, J. S., “Coercion in family planning: causes, methods, and consequences,” in Joint Economic Committee, Congress of the United States, China's Economy Looks Toward the Year 2000: The Four Modernizations, Vol. I (Washington, DC: Government Printing Office, 1986), pp. 184221Google Scholar. Also see Hardee-Cleveland and Banister, “Fertility policy implementation in China”; Greenhalgh, “The evolution of the one-child policy”; Greenhalgh, S., Zhu, Chuzhu and Li, Nan, “Restraining population growth in three Chinese villages, 1988–1993,Population and Development Review, Vol. 20 (1994), pp. 365395CrossRefGoogle Scholar; Greenhalgh, S., and Li, Jiali, “Engendering reproductive policy and practice in peasant China: for a feminist demography of reproduction,Signs: Journal of Women in Culture and Society, Vol. 20 (1995), pp. 601641.CrossRefGoogle Scholar

23. Feng Guoping and Hao Linna, “Summary of 28 Chinese birth planning regulations”; Zeng, Yi, “Is the Chinese family planning program tightening up?” Population and Development Review, Vol. 15 (1989), pp. 333–37.Google Scholar

24.Greenhalgh, S., “Negotiating birth control in village China,” in Gilmartin, C., Hershatter, G., Rofel, L. and White, T. (eds.), Engendering China: Women, Culture and the State (Cambridge, MA: Harvard University Press, 1994); Greenhalgh, “The peasantization of population policy in Shaanxi.”Google Scholar

25.Freedman, R. and Guo, S., “Response of a traditional fishing community to China's family planning program: a case study,International Family Planning Perspectives, Vol. 14 (1988), pp. 2833Google Scholar; Wang, Huide, “Factors affecting the quality of birth statistics,” p. 58.Google Scholar

26.White, , “Birth planning between plan and market,” p. 253.Google Scholar

27.Greenhalgh, et al., “Restraining population growth,” p. 376.Google Scholar

28. By 1991, 18 provinces had enforced this stated policy. See Feng Guoping and Hao Linna, “Summary of 28 Chinese birth planning regulations.”Google Scholar

29.Tu, Ping, “Contraceptive use patterns among young rural women in four counties of China,” paper presented at the conference on INCRC, Honolulu, 06 1993, p. 1.Google Scholar

30.Smith, H. L. and Tian, Linzhu, “Variation in sex ratios for first births in four counties: where does the variation begin?” paper presented at the conference on INCRC, Honolulu, 06 1993Google Scholar. The biologically normal sex ratios should be around 106 male births per 100 female birth plus or minus variability due to chance (see Johansson, and Nygren, , “The missing girls of China,” p. 35)Google Scholar. However, it should be noted that the sex ratio of Chinese births in the U.S. appears to be higher. James estimated a sex ratio for 1960–1982 births of Chinese origin in the U.S. of 107.1 (James, W. H., “The sex ratio of oriental births,Annals of Human Biology, Vol. 12 (1985), pp. 485–87). Sex ratios significantly higher than 106 males per 100 female births are considered abnormal. As noted in footnote 7, elevated sex ratios at birth suggest underreporting of births, sex selective abortions, excess female infant mortality or all of these in some combination. There is no evidence of excess female mortality in Ciqixian, nor of its most direct cause, infanticide. Sex selective abortion and underreporting of female births are more plausible explanations of high sex ratio at birth. Yet, because ultrasound machines enabling detection of the sex in utero became available in Ciqixian only in the late 1980s, sex selective abortion may only partially explain Ciqixian's high sex ratios in the period 1981–1991.CrossRefGoogle Scholar

31.Tu, Ping, “The sex ratio at birth in China: results from the 1990 census,” (Beijing: Institute of Population Research, Beijing University, 1992).Google Scholar

32.Qian, Zhenchao, “Progression to second births in China: a study of four rural counties,Population Studies, Vol. 51 (1997), pp. 221–28.CrossRefGoogle Scholar

33.Tu, Ping, “The sex ratio at birth in China.Google Scholar

34. The survey was conducted as the baseline for the INCRC project.Google Scholar

35. According to World Bank estimates, Japan recorded an IMR of 5 (per 1,000) in 1991, while Sweden, Finland and Singapore recorded IMRs around 6 (per 1,000) (see World Bank, World Development Report 1993: Investing in Health (Washington, DC: The World Bank, 1993))Google Scholar. It should be noted, however, that Japan systematically underreports infant mortality by recording early infant deaths as stillbirths (Coale, and Banister, , “Five decades,” pp. 466–67.Google Scholar

36.Ciqixian, qu, 1990 nian renkou pucha ziliao (Data from the 1990 Census of Population of Ciqixian) (Renkou pucha bangongshi, 1991).Google Scholar

37. Personal communication with the director of the Ciqixian Maternal and Child Health Station (17 07 1995).Google Scholar

38.Banister, , “China: recent mortality levels and trends;” World Bank, World Development Report 1993.Google Scholar

39.Lavely, W. R., “Luoping County Yunnan, October–November 1993: field notes and observations,” unpublished manuscript (Seattle: Center for Studies in Demography and Ecology, University of Washington, 1993).Google Scholar

40.Kaufman, J., Zhang, Zhirong, Qiao, Xinjian and Zhang, Yang, “The creation of family planning service stations in China,International Family Planning Perspectives, Vol. 18 (1992), pp. 1823.CrossRefGoogle Scholar

41. Ibid.

42.Lavely, , “Luoping county, Yunnan.”Google Scholar

43.Feeney, and Yuan, Jianhua, “Below replacement fertility in China?”Google Scholar

44.Hereward, M., Smith, H. L. and Tu, Ping, “Consistency and reality, the great divide: evidence of consistency in misreporting in retrospective survey,” unpublished manuscript (Philadelphia: Population Studies Center, University of Pennsylvania, 1995).Google Scholar

45. A detailed description of the demographic and contraceptive surveillance system established for the INCRC project, as well as of the difficulties of ensuring accurate measurement of events, is given by Smith et al., “Implementation of a demographic and contraceptive surveillance system.”Google Scholar

46.Child inoculations guaranteed with card,China Daily, 4 03 1995.Google Scholar

47. Analyses not shown, available from the author on request.Google Scholar

48. Vaccination records were missing for one village in township A for 1993 and for one village in township C for 1994. Therefore, the comparison for these villages and these years was not performed and corresponding values for family planning records were also excluded from the analysis.Google Scholar

49.Lavely, , “Luoping county, Yunnan.Google Scholar

50.Gao, Ersheng et al., Jiceng jihua shengyu pingjia (Family Planning Evaluation at the Grassroots Level) (Beijing: Zhongguo renkou chubanshe, 1990).Google Scholar

51.White, L. T., III, “Deviance, modernization, rations, and household registers in urban China,” in Wilson, A. A., Greenblatt, S. L. and Wilson, R. W. (eds.), Deviance and Social Control in Chinese Society (New York: Praeger, 1977)Google Scholar, cited in Lavely, , “China's rural population statistics,Google Scholar footnote 8; also see Mallee, H., “China's household registration system under reform,Development and Change, Vol. 26 (1995), pp. 129.CrossRefGoogle Scholar

52.Xu, Gailing, “Zai tan woguo renkou yuce de wenti” (“A discussion of the problems pertaining to [China's] population projections”), Renkou yanjiu (Population Research), No. 5 (1988), pp. 3436Google Scholar; Ji, Meifang, “Reasons and counter measures pertaining to the problem of underreporting in family planning statistics;”Google ScholarStoecklin, D., “Note sur la statistique des naissances en Chine,Population, Vol. 47 (1992), pp. 223233.CrossRefGoogle Scholar

53.Qian, ZhenchaoRevisiting Zunhua and Leting,” p. 15.Google Scholar

54. See Trussel, J., and Pebley, A. R., “The potential impact of changes in fertility on infant, child and maternal mortality,Studies in Family Planning, No. 14 (1984), pp. 267280CrossRefGoogle Scholar. For an interesting discussion of the relationship between infant mortality and family planning see Bongaarts, J., “Does family planning reduce infant mortality rates?” Population and Development Review, Vol. 13 (1987), pp. 323334CrossRefGoogle Scholar, and related comments by J. Trussel and J. Potter with a response by Bongaarts, J. in Population and Development Review, Vol. 14 (1988), pp. 171190.Google Scholar