A Chinese-style one-child policy for India
Authors: Jianghong Li
Journal: The Lancet (2005)

In response to Patralekha Chatterjee's World Report (May 7, p 1609),1Chatterjee P Doctors' group proposes a one-child policy for India.Lancet. 2005; 365: 1609Summary Full Text Full Text PDF PubMed Scopus (4) Google Scholar it is important to note that China's one-child policy does not apply to all of its regions and ethnic groups. Couples in poor rural regions are permitted to have two children, and national minority groups of a small population size have no birth restrictions. Even so, China's achievement of rapid fertility declines has incurred high social, demographic, and health costs.2Li J Lavely W Village context, women's status and son preference among rural Chinese women.Rural Sociology. 2003; 68: 87-108Crossref Scopus (63) Google Scholar, 3Coale A Banister J Five decades of missing females in China.Demography. 1994; 31: 459-480Crossref PubMed Scopus (238) Google Scholar North and Central India share one main feature of the patrilineal family system found in rural China (where 75% of the population resides), namely son preference.2Li J Lavely W Village context, women's status and son preference among rural Chinese women.Rural Sociology. 2003; 68: 87-108Crossref Scopus (63) Google Scholar, 4Mutharayappa R Choe MK Arnold F Roy TK Is son preference slowing down India's transition to low fertility?.Nat Family Health Survey Bull. 1997; 4: 1-4PubMed Google Scholar Son preference in such family systems implies that at least one son is wanted to continue the patrilineal family line and to perform religious, social, economic, and reproductive functions for the family. This imperative poses a formidable challenge to population policies that impose birth restrictions on rural families, as occurred in rural China.2Li J Lavely W Village context, women's status and son preference among rural Chinese women.Rural Sociology. 2003; 68: 87-108Crossref Scopus (63) Google Scholar India's sex imbalances are already very high. A forced family planning programme would further exacerbate them. Parents' preferences for male offspring are intimately connected with women's status in the larger society and are an indicator of sex inequality.2Li J Lavely W Village context, women's status and son preference among rural Chinese women.Rural Sociology. 2003; 68: 87-108Crossref Scopus (63) Google Scholar In societies where men and women have relatively equal roles in social, economic, and political spheres, parents tend to value sons and daughters more equally than in settings where sex differentiation is more pronounced. The effects of son preference on mortality and fertility are well documented. It is no coincidence that the southern Indian state of Kerala has achieved remarkable population control and this is also a state where son preference is the weakest in India.4Mutharayappa R Choe MK Arnold F Roy TK Is son preference slowing down India's transition to low fertility?.Nat Family Health Survey Bull. 1997; 4: 1-4PubMed Google Scholar Women's status (eg, literacy, mass media exposure, domestic decision-making power, and social economic opportunity in the public domain) affects fertility through two mechanisms. It stops the cycle of high infant mortality and high fertility by improving infant survival chances, and it provides women with other social alternatives to early childbearing and motherhood, thus ultimately contributing to low fertility. The demographic experiences of other Asian countries show multiple pathways to low fertility and that broad social and economic development and, in particular, the elevation of women's social position are the driving force for low birth rates in the absence of mandatory family planning programmes.5Freedman R Asia's recent fertility decline and prospects for future demographic change.Asia-Pacific Pop Res Rep. 1995; 1: 1-27Google Scholar Chinese history has proven that wars, natural disasters, diseases, and non-functional social and economic systems, rather than population size itself, are the main causes of famines. The Great Leap Forward campaign in the late 1950s that led to large-scale starvation in rural China is a prime example. I declare that I have no conflict of interest.