• China
• demography
• one child family policy
• population aging
• sex ratio at birth

Praised for saving China from a demographic catastrophe or blamed as a violation of a basic human right, the one child family policy (OCFP) is reaching its 25th year and a recent law¹ has confirmed this demographic strategy for the future. The government decision to limit the number of children to one per couple, taken in 1979, was a response to the threat that the country’s massive demographic growth cast on the future of economic development and of living conditions of the Chinese people. The goal set was to limit the total population to about 1.2 billion for the year 2000 and to significantly reduce the natural increase rate.² The OCFP has been implemented—with some exceptions to the rule and a varying severity^3,4—mainly through economic incentives and aids for families with a single child, and taxes, fines, and various social disadvantages for the families who do not abide by the rule,⁵ together with a strong social pressure on women not to have a second pregnancy. The acceptance of the OCFP on the part of the people has been sometimes reported as difficult⁵ as the rule seems to conflict with the deep rooted Confucian tradition that emphasises the importance of numerous offspring, in order to pass on the responsibility of supporting the old people and of perpetuating traditions. Coercion to oblige women to sterilisation, abortion, or insertion of IUDs has also been reported.^5,6

A quarter century after its introduction the OCFP has achieved most of its objectives. The birth of 250–300 million Chinese has been prevented and the rate of natural increase dropped from 11.6 per thousand in 1979 to 8 per thousand in 2001. The population of China was 1273 million in the 2000 census and the …