Amartya Sen on Population: Delusion and Reality

China's Population Policies

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China's Population Policies

The difficulties with this "solution" are of several kinds. First, if freedom is valued at all, the lack of freedom associated with this approach must be seen to be a social loss in itself. The importance of reproductive freedom has been persuasively emphasized by women's groups throughout the world.(31)

The loss of freedom is often dismissed on the grounds that because of cultural differences, authoritarian policies that would not be tolerated in the West are acceptable to Asians. While we often hear references to "despotic" Oriental traditions, such arguments are no more convincing than a claim that compulsion in the West is justified by the traditions of the Spanish Inquisition or of the Nazi concentration camps. Frequent references are also made to the emphasis on discipline in the "Confucian tradition"; but that is not the only tradition in the "East," nor is it easy to assess the implications of that tradition for modern Asia (even if we were able to show that discipline is more important for Confucius than it is for, say, Plato or Saint Augustine).

Only a democratic expression of opinion could reveal whether citizens would find a compulsory system acceptable. While such a test has not occurred in China, one did in fact take place in India during "the emergency period" in the 1970s, when Indira Gandhi's government imposed compulsory birth control and suspended various legal freedoms. In the general elections that followed, the politicians favoring the policy of coercion were overwhelmingly defeated. Furthermore, family planning experts in India have observed how the briefly applied programs of compulsory sterilization tended to discredit voluntary birth control programs generally, since people became deeply suspicious of the entire movement to control fertility.

Second, apart from the fundamental issue of whether people are willing to accept compulsory birth control, its specific consequences must also be considered. Insofar as coercion is effective, it works by making people do things they would not freely do. The social consequences of such compulsion, including the ways in which an unwilling population tends to react when it is coerced, can be appalling. For example, the demands of a "one-child family" can lead to the neglect—or worse—of a second child, thereby increasing the infant mortality rate. Moreover, in a country with a strong preference for male children—a preference shared by China and many other countries in Asia and North Africa—a policy of allowing only one child per family can easily lead to the fatal neglect of a female child. There is much evidence that this is fairly widespread in China, with very adverse effects on infant mortality rates. There are reports that female children have been severely neglected as well as suggestions that female infanticide occurs with considerable frequency. Such consequences are hard to tolerate morally, and perhaps politically also, in the long run.

Third, what is also not clear is exactly how much additional reduction in the birth rate has been achieved through these coercive methods. Many of China's longstanding social and economic programs have been valuable in reducing fertility, including those that have expanded education for women as well as men, made health care more generally available, provided more job opportunities for women, and stimulated rapid economic growth. These factors would themselves have reduced the birth rates, and it is not clear how much "extra lowering" of fertility rates has been achieved in China through compulsion.

For example, we can determine whether many of the countries that match (or outmatch) China in life expectancy, female literacy rates, and female participation in the labor force actually have a higher fertility rate than China. Of all the countries in the world for which data are given in the World Development Report 1994, there are only three such countries: Jamaica (2.7), Thailand (2.2), and Sweden (2.1)—and the fertility rates of two of these are close to China's (2.0). Thus the additional contribution of coercion to reducing fertility in China is by no means clear, since compulsion was superimposed on a society that was already reducing its birth rate and in which education and jobs outside the home were available to large numbers of women. In some regions of China the compulsory program needed little enforcement, whereas in other—more backward—regions, it had to be applied with much severity, with terrible consequences in infant mortality and discrimination against female children. While China may get too much credit for its authoritarian measures, it gets far too little credit for the other, more collaborative and participatory, policies it has followed, which have themselves helped to cut down the birth rate.

China and India

A useful contrast can be drawn between China and India, the two most populous countries in the world. If we look only at the national averages, it is easy to see that China with its low fertility rate of 2.0 has achieved much more than India has with its average fertility rate of 3.6. To what extent this contrast can be attributed to the effectiveness of the coercive policies used in China is not clear, since we would expect the fertility rate to be much lower in China in view of its higher percentage of female literacy (almost twice as high), higher life expectancy (almost ten years more), larger female involvement (by three quarters) in the labor force, and so on. But India is a country of great diversity, whose different states have very unequal achievements in literacy, health care, and economic and social development. Most states in India are far behind the Chinese provinces in educational achievement (with the exception of Tibet, which has the lowest literacy rate of any Chinese or Indian state), and the same applies to other factors that affect fertility. However, the state of Kerala in southern India provides an interesting comparison with China, since it too has high levels of basic education, health care, and so on. Kerala is a state within a country, but with its 29 million people, it is larger than most countries in the world (including Canada). Kerala's birth rate of 18 per 1,000 is actually lower than China's 19 per 1,000, and its fertility rate is 1.8 for 1991, compared with China's 2.0 for 1992. These low rates have been achieved without any state coercion.(32)

The roots of Kerala's success are to be found in the kinds of social progress Condorcet hoped for, including among others, a high female literacy rate (86 percent, which is substantially higher than China's 68 percent). The rural literacy rate is in fact higher in Kerala—for women as well as men—than in every single province in China. Male and female life expectancies at birth in China are respectively 67 and 71 years; the provisional 1991 figures for men and women in Kerala are 71 and 74 years. Women have been active in Kerala's economic and political life for a long time. A high proportion do skilled and semi-skilled work and a large number have taken part in educational movements.(33) It is perhaps of symbolic importance that the first public pronouncement of the need for widespread elementary education in any part of India was made in 1817 by Rani Gouri Parvathi Bai, the young queen of the princely state of Travancore, which makes up a substantial part of modern Kerala. For a long time public discussions in Kerala have centered on women's rights and the undesirability of couples marrying when very young.

This political process has been voluntary and collaborative, rather than coercive, and the adverse reactions that have been observed in China, such as infant mortality, have not occurred in Kerala. Kerala's low fertility rate has been achieved along with an infant mortality rate of 16.5 per 1,000 live births (17 for boys and 16 for girls), compared with China's 31 (28 for boys and 33 for girls). And as a result of greater gender equality in Kerala, women have not suffered from higher mortality rates than men in Kerala, as they have in the rest of India and in China. Even the ratio of females to males in the total population in Kerala (above 1.03) is quite close to that of the current ratios in Europe and America (reflecting the usual pattern of lower female mortality whenever women and men receive similar care). By contrast, the average female to male ratio in China is 0.94 and in India as a whole 0.93.(34) Anyone drawn to the Chinese experience of compulsory birth control must take note of these facts.

The temptation to use the "override" approach arises at least partly from impatience with the allegedly slow process of fertility reduction through collaborative, rather than coercive, attempts. Yet Kerala's birth rate has fallen from 44 per 1,000 in the 1950s to 18 by 1991—not a sluggish decline. Nor is Kerala unique in this respect. Other societies, such as those of Sri Lanka, South Korea, and Thailand, which have relied on expanding education and reducing mortality rates—instead of on coercion—have also achieved sharp declines in fertility and birth rates.

It is also interesting to compare the time required for reducing fertility in China with that in the two states in India, Kerala and Tamil Nadu, which have done most to encourage voluntary and collaborative reduction in birth rates (even though Tamil Nadu is well behind Kerala in each respect).(35) Table 2* shows the fertility rates both in 1979, when the one-child policy and related programs were introduced in China, and in 1991. Despite China's one-child policy and other coercive measures, its fertility rate seems to have fallen much less sharply than those of Kerala and Tamil Nadu. The "override" view is very hard to defend on the basis of the Chinese experience, the only systematic and sustained attempt to impose such a policy that has so far been made.

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