China is the world’s most populous country with a total population of 1.354 billion people by the end of 2012. China’s population continues steadily even as the population growth rate has decreased by 4.95 per 1000 people in 2012. Concurrent with China’s ever-increasing population is a fast growing economy, accompanied by rapid socioeconomic changes that bring in a host of challenged in ensuring comprehensive sexual and reproductive health information.
Demographic trends in China have experienced significant shifts over the past 50 years in terms of declining fertility rate, imbalance in the sex ratio of newborns, population aging, and increasing migration. The total fertility rate of women in China fell below the replacement level in the early 1900s and kept declining to about 1.6 at present, an indication that China has transitioned into the group of low fertility countries. At the same time, the sex ratio of the population has been increasing, from 104.51 to 106.74 in 2000. The imbalanced sex ratio is due to the country’s One Child policy and culture of preference for having sons.
Source: extracted from China Country Profile
Sexual and Reproductive Health
Key findings from the China Country Profile on the situation of SRHR in China are as follows:
- The maternal mortality ratio in the Eastern, Central, and Western parts of China are 17.8/100,000, 29.1/100,000, and 45.1/100,000 respectively.
- Despite progress, there still exists a disparity between rural and urban areas.
- Maternal mortality among migrant workers is relatively higher.
- 6% of births are attended by skilled birth attendants.
- The percentage of antenatal care coverage with at least one visit is 95.0%.
- 6% of births had postpartum/postnatal care within 48 hours of delivery by a skilled health provider.
- The total fertility rate is 1.47, an indication that China has transitioned into the group of low fertility countries.
- During the time of exponential population growth, almost every married woman must adopt one kind of long-active contraceptive method after delivering one or two babies.
- By 2010, the overall prevalence rate of long-term contraception reached 79.85% nationwide.
- The IUD and female sterilization account for about 80% of contraceptive use.
- Condoms made up less than 10% of contraceptive usage.
- The national rate for unmet need for contraception is very low, at less than 2.3%.
- Abortion is legal on all grounds in China.
- Since the 1980s, abortion services are available on request for women.
- However, sex-selective abortion for nonmedical purposes is prohibited by the Population and Family Planning Law, which came into effect in 2002.
- Assistance centers/institutions have been set up in 16 cities to support young girls experiencing unintended pregnancies.
HIV & AIDS:
- The percentage of young students aged 15-24 living with HIV significantly increased from 0.9% in 2008 to 1.7% in 2012.
- The percentage of sex workers living with HIV has generally remained at 0.3%.
- 1% of reported cases of pregnant living with HIV have received antiretroviral treatment to prevent mother-to-child transmission.
- Over 75% eligible AIDS outpatients were able to receive free treatment from nearby hospitals in 2011.
Sexual and Reproductive Rights
Child Early & Forced Marriage (CEFM):
- The rate of early marriage for young women aged 15-19 years fell from 4.6% in 1990 to 1.2% in 2000.
- The legal minimum age of marriage is 22 years for men and 20 years for women.
Violence Against Women (VAW):
- 7% of women aged 18-64 have suffered domestic violence and human rights violations from their husbands, including insult and abuse, hitting, restricting freedom, economic control, and forced sex during their marriage.
- The prevalence of spousal violence against women is 64.8% in a lifetime.
- Psychological violence is the most common form at 58.1%, followed by physical and sexual abuse at 29.7% and 16.7% respectively.
- 8% have suffered sexual harassment during work and study.
- 5% of female adolescents aged 15-22 reported forced first sex when visiting hospitals for abortion services.
- 7% female students have experienced unwanted sex before the age of 16 years.