Paying for family planning in China

Abstract

Due to its success, China's family planning programme has attracted attention from other countries seeking to replicate its strategies. Much is known about the organization and operation of China's family planning education and service delivery programmes, yet relatively little is known about costs and programme-financing methods. The authors present information about China's family planning pro gramme from a family and county level administrator perspective, drawing extensively on unpublished recent information to provide insights into costs and methods of financing. A case history illustrates various family planning options available as well as the payment mechanisms for programme incentives. Financial responsibility for the vast majority of the national family planning effort belongs to work units such as factories, educational organizations, stores and cooperatives. Translating the cost of family planning into US dollars and comparing with comparable costs in other developing countries and translating into terms relative to average unskilled Chinese worker salaries reveals the substantial investment made per capita on behalf of the family planning programme. Factors of political will, comprehensive administra tive support, effective organization, an all encompassing motivational programme and extensive service delivery covering the entire country together with generous decentralized financing are presented as important to programme success. Implications for transfer to other countries and the associated costs of doing so are discussed.