With rigorous economic research and practical policy solutions, we focus on the issues and institutions that are critical to global development. Explore our core themes and topics to learn more about our work.
In timely and incisive analysis, our experts parse the latest development news and devise practical solutions to new and emerging challenges. Our events convene the top thinkers and doers in global development.
As more countries rise out of poverty, CGD’s work in this area focuses on the inequities and emerging problems that jeopardize global health progress.
As more countries rise out of poverty, CGD is focusing on the inequities and emerging problems that jeopardize global health progress: How should governments allocate scarce health budgets rationally and equitably? How can the world advance global health security and fight infectious diseases? What can be done to address treatment inequalities between developed and developing countries? What are the benefits of, mechanisms for, and threats to, greater family planning provision? CGD research helps policymakers build sustainable health systems, respond to shifting realities, and deliver value for money.
Jeremy Gaines, Center for Global Development, firstname.lastname@example.org
Colin Bowyer, Stanford University email@example.com
Stanford, CA – An estimated 210,000 girls may have “gone missing” due to China’s “Later, Longer, Fewer” campaign, a birth planning policy predating the One Child Policy, according to a new study from the Center for Global Development. The study looked at hundreds of thousands of births occurring before and during the “Later, Longer, Fewer” policy to measure its effect on marriage, fertility, and sex selection behavior.
The researchers found that China’s “Longer, Later, Fewer” population control policy—which began in the 1970s and preceded China’s One-Child Policy—reduced total fertility rates by 0.9 births per woman and was directly responsible for an estimated 210,000 missing girls countrywide. Importantly, the study emphasizes that because this policy existed before ultrasound technology was widely available—and therefore before selective abortion was an option—these missing girls must have been due to postnatal neglect of infant girls, or in the extreme, infanticide. The phenomenon of “missing girls” widely recognized in later years under the One Child Policy is largely thought due to sex-selective abortion after ultrasound technology spread across China.
“Prior research has shown that sex ratios rose dramatically under China's One-Child Policy, leading to stark imbalances in the numbers of men and women. But we’re finding that girls went missing earlier than previously thought, which can in part be directly attributed to the birth planning policy that predates the One-Child Policy.” said Grant Miller, Director of the Stanford Center on Global Poverty and Development, a Non-Resident Fellow at the Center for Global Development, and one of the authors of the study.
The top findings of the study include:
The birth planning policy reduced fertility by 0.9 births per woman, explaining 28% of the overall decline during this period.
The Later, Longer, Fewer policy is responsible for a roughly twofold increase in the use of “fertility stopping rules,” the practice of continuing to have children until the desired number of sons is achieved.
The Later, Longer, Fewer policy is also responsible for an increase in postnatal neglect, from none to 0.3% of all female births in China during this period.
Sex selection behavior was concentrated among couples with the highest demand for sons (couples that have more children but no sons), with sex ratios reaching 117 males per 100 female births among these couples.
“Population control strategies can have unforeseen consequences and human costs,” Miller said. “At the same time, as China debates the future of birth planning policies, it’s also important to note that family planning policy does not appear to be the largest driver of fertility.”
You can read the full study at https://www.cgdev.org/publication/limits-and-human-costs-population-policy-fertility-decline-and-sex-selection-china.
Most of China’s fertility decline predates the famous One Child Policy—and instead occurred under its predecessor, the Later, Longer, Fewer (LLF) policy. Studying LLF’s contribution to fertility and sex selection behavior, we find that it i) reduced China’s total fertility rate by 0.9 births per woman (explaining 28% of China’s modern fertility decline), ii) doubled the use of male-biased fertility stopping rules, and iii) promoted postnatal neglect (implying 210,000 previously unrecognized missing girls). Considering Chinese population policy to be extreme in global experience, our paper demonstrates the limits of population policy—and its potential human costs.
In this note, we explore some of the challenges facing Gavi-eligible countries. We then propose procedural improvements or adaptations to Gavi’s operations to better support the needs of country governments and other partners.
In this note, we highlight the results of Gavi HSS evaluations, how Gavi has responded to identified challenges and limitations in the HSS proposal and implementation process, and what options are available to enhance the effectiveness of HSS support for Gavi’s core mandate. We also discuss the importance of 4G (Gavi, the Global Fund, the Global Financing Facility, and the World Bank Group) collaboration.
In this note, we summarize the changing context and its relevance for Gavi, exploring the specific issues relevant to transitioning countries, never-eligible MICs, and countries dealing with complex emergencies or large-scale protracted displacement. We then offer four recommendations to increase Gavi’s relevance and effectiveness in a changing world.