The central government strategic decision to develop west China has profound implications for population development in the region: population control, improvement of population quality, optimizing population structure, ameliorating population distribution, and the development of human resources. Family planners face a historic opportunity to incorporate population development into overall socio-economic development.

Human resource is the key to socio-economic development. Currently, however, western China is being bogged down by a fast-growing population, an incompetent work force and an irrational population structure. To achieve sustainable development, the issue of population development and family planning must be addressed first.

Compared with the eastern and central regions, western China is disadvantaged by the following:

Adverse natural conditions: The vast region of western China is located on an inland stretch of land with high altitudes and complicated topographical conditions. Accounting for over two-thirds of the country's total landmass, west China consists primarily of mountains and plateaus with an elevation of at least 1,000 meters. With an arid and semi-arid climate, this region is badly short of water in the northwest and soil in the southwest.

A fragile eco-system: Almost all the 1.49 million square kilometers of China's deserts and desertified land -- 15.5% of the country's landmass -- are located in the west. What is worse is that the eco-system is still deteriorating. This is largely a result of over-exploitation of resources and decreasing plantation.

Socio-economic underdevelopment: According to the State Statistical Bureau (SSB), all the 12 provinces in west China in 1998 registered a per capita GDP lower than the national average, with some such as Guizhou even less than half of the national average. Except for urban households in Chongqing and Yunnan, average income of both urban and rural residents in the western region is also lower than the national average. The level of urbanization is low. In addition, this region is home to the majority of the country's impoverished population. Furthermore, the level of education is far below the national average, and medical conditions are pitiful, resulting in high incidences of epidemic diseases and infant mortality rate. Across the region, average life expectancy is shorter than the national average.

Compared with other parts of China, the western region bears the following features:

A. A young population and high fertility rate. By the end of 1998, 27.1% of the population in this region were aged 0-14, compared with the national average of 24.3%, according to SSB statistics (see table 2). The fourth population census in 1990 showed that total fertility rate was 2.70 for the western region, compared with the national average of 2.31.

B. A low level of education. The average length of education in Qinghai, Tibet, Guizhou, Yunnan, Gansu and Ningxia is less than five years, far less than the national average (see table 3). Moreover, the percentages of illiterates and semi-literates are significantly higher than the national average. For example, in Yunnan, Guizhou and Ningxia, the illiterate and semi-literate accounted for more than 25% of the adult population (aged 15 and over); in Qinghai and Tibet, in particular, that percentage was as high as 43% and 60% respectively (see table 4). In stark contrast, the percentage of people receiving secondary and higher education is remarkably lower than the national average. In Qinghai, only 10.55% of the population have received senior middle school education and over, compared to 41.03% in Beijing.

C. Poor medical and health care facilities. Average life expectancy in this region is around 65, compared with over 70 for the eastern provinces (excluding Fujian). For Shanghai, it is even higher (75 years). In MCH and reproductive health, the west lags even farther behind the east. Infant mortality rate across the 12 western provinces, for example, is higher than the

national average. In Guizhou, Yunnan, Tibet, Qinghai and Xinjiang, in particular, that rate is over 50 per

Source: China State Statistical Bureau.

Source: China State Statistical Bureau, China Statistical Yearbook, 1999.

thousand, almost twice the national average level (see table 6).

D. A high percentage of poverty-stricken population. This is evident in the fact that 366 (61.8%) of the country's 592 officially designated impoverished counties, which are eligible for government funds for poverty alleviation, are located in this region (see table 7).

E. A high percentage of ethnic population. Out of the 12 western provinces, seven are heavily populated by minority ethnic groups ?in fact, the ethnic population accounts for over one-third of their total population. In Xinjiang and Tibet, it is over 60% (see table 8).

Source: China State Statistical Bureau, China Population Statistical Yearbook, 1998.

F. A low level of urbanization. By the end of 1998, about 30% of China’s population lived in urban areas, lower than the world's average of 44%. In west China, that percentage is even lower. A 1% sampling survey conducted by SSB in 1995 showed that only about one quarter of the population in west China lived in urban areas, compared with 28.85% for the whole country in the same year (see table 10).

G. Low FP level and poor grassroots service facilities. Generally speaking, the average ages at first marriage and first childbirth of women in the western region are lower than the national average. Furthermore, the percentage of women having three or more children (over 20% in Tibet and Xinjiang and

Source: The fourth population census in 1990.

over 15% in Qinghai and Ningxia) is considerably higher than the national level (see table 9). This is partly due to a slack fertility policy (which is different from that applied in the central and eastern regions in that ethnic families are allowed to have three or more children), and partly due to the ineffectiveness of the FP program. In addition, a weak FP infrastructure has also contributed to the rapid population growth in the region.

Source: China State Statistical Bureau, China Statistical Yearbook, 1999; Office of the Leading Group of the State Council for Poverty Alleviation and Development.

Undoubtedly, human welfare should be the central objective of socio-economic development. However, to ensure sustainable development, it is essential to implement the family planning program to balance population development against resources and the environment. This entails the following:

A. Control the population size to provide a sound population environment for economic development. While the last resort, this has proved the most effective means in easing bottlenecks for economic development.

According to basic population-economics theory, a 1% increase of population will need at least 3% increase of economic growth to support. If economic development fails to keep pace with population growth, the newly added population will eat up the newly produced GNP, thus depleting resources to improve the living standard of the population at large. Experiences in some regions of China and in many other developing nations have proved that controlled population growth is the key for economic takeoff.

B. Improve population quality to ensure ample supply of high quality human resources. The western region is abundant in human resources. However, multitudes of people with no education or skills are not a privilege. In developed nations, knowledge contributes to over two-thirds of their economic growth. Compared with material input and labor force supply, knowledge is playing an increasingly important role in economic development.

Source: 1% national population sampling survey in 1995, China State Statistical Bureau.

Population control and family planning programs can help improve the educational and physical quality of the population in direct and indirect ways. By disseminating scientific knowledge about pregnancy, childbirth and childrearing, providing pre- and postnatal health examinations and counseling, family planners help reduce the infant mortality rate, the incidences of birth deformities and reproductive system diseases. Meanwhile, the FP program has prompted parents to pay more attention to the quality rather than the quantity of children.

C. Optimize population structure so as to provide a stable societal environment for western development. The implementation of the FP program prevents the occurrence of a situation where the young and old populations increase simultaneously, a situation that will strain a society’s resources. In the long run, fewer newborns today mean fewer elderly people in the future. In addition, improvement of the FP program will also help to balance the sex ratio at birth.

Given the experience in eastern China, the government should take proactive measures to forestall population-related problems that have proved detrimental to sustainable development. These include an unbalanced sex ratio at birth, poor management of migrant population, premature population aging and inadequate FP/RH services. Failure to do that will result in costly economic, social, cultural and political consequences.

In our opinion, the central government needs to take the following measures to ensure the smooth unfolding of the western development program:

• Strictly control the population growth
• Increase public spending in human resources
• Strengthen FP infrastructures in western China
• Implement a government-subsidized free FP package service program for ethnic population
• Initiate an old-age support program for households that have implemented family planning.
• Integrate family planning with poverty alleviation.