China

Impact of the universal birth registration campaign

There have been no statistics on birth registration since the fifth national census, which showed that, in the years 1991 to 1999, only 60% to 80% of children were registered within a year of their birth. Plan succeeded in ensuring that UBR has been put into the strategic plan of the national government programme and vast improvements are expected   

Government policy and practice on birth registration 

Laws and regulations 

From 1953 to 2006, township governments were responsible for rural birth registration and the public security departments for urban registration. Under the law, a child had to be registered within 30 days of their birth at the registry office for their permanent residence by household heads, relatives, foster carers or neighbours.  Currently, every birth in China has to be registered in the police station covering the parents' household. Registration requires:

• a medical birth certificate; since 1996, this has been issued by the Ministry of Public Health through the hospital or facility where the child is born
• a family planning service booklet or bearing certificate; these are given to women after their check up by family planning departments
• the parent’s household booklet or resident identity card, issued by public security departments.

Operation and implementation

• China is highly centralised and local governments act in line with the central government.
• The procedure for birth registration is complex: acquiring the relevant documentation to register a birth is complex and strict; and three departments are involved, each with its own  rules and routines. There are also special procedures for adopted children and those born to floating populations. However, the procedure of registration is simple during the census.

The government is open to UBR and supportive of Plan's UBR project, as well as the partnership of Xi’an Jiaotong University. After data-based research and a pilot in Shaanxi province, and advocacy activities at regional and national levels, the government recognised the UBR project and included it in strategic planning for the national programme, “Caring for Girls”.  The inclusion in “Caring for Girls” helped to raise awareness of birth registration rapidly, and some provinces (such as Hainan) have taken action to improve local regulations and procedures for birth registration.  However, we lack the relevant national data to show the changes. 

Universal birth rights campaign strategy

Plan China in partnership with Xi’an Jiaotong University developed a systematic project strategy. This included an exploratory study and pilot project in one county in North West China, and advocacy and dissemination of information at different levels. 

Aim of campaign

To improve birth registration in China by providing support to strengthen the existing system and services, and to undertake mass registration of children denied the right to register at birth and have a birth certificate.   

Activities

• National exploratory research by May 2005.
• Pilot intervention completed by December 2006. 
• Advocacy and dissemination of information by June 2008.  

Strategy

The theoretical research, dissemination of the research results and interventions on birth registration were addressed simultaneously.

• The theoretical research was at both macro and micro level to obtain a comprehensive understanding of the actual birth registration situation, and to find out the problems and the barriers. 
• Interventions on birth registration were based on the research results. A pilot took place in one county to gain experience and help design an intervention framework for future application.
• As birth registration has not received enough attention from most people, and because it is a sensitive topic in China, the dissemination of the research results and experience from the pilot was very important for raising awareness, especially of decision makers. The main activities of advocacy and dissemination were to produce publications, organise conferences, and hold experts’ workshops. 

Expenditure 

Project budget – US$ 111,689.

Outcomes

Policy and legislation changes

After the national research and pilot project, as well as the advocacy activities, the government recognised the UBR project and included it in strategic planning for “Caring for Girls”. In some “Caring for Girls” programme areas, local governments improved their policies and procedures for birth registration, and awareness of birth registration rose rapidly during the programme.

Government capacity and practice

During 2005 and 2006, Plan China and Xi’an Jiaotong University, in partnership with QiShan county in the west of Shaanxi province, carried out a comprehensive and multiagency intervention. The main approach was to set up a good environment for birth registration and to improve the service of registry and other relevant departments. Following the project, the county government changed its local policy on birth registration to make it more simple and easy. The experience of the QiShan project was one of taking different interventions for different areas - strengthening management and the service, public awareness raising, advocating and implementing an interests-oriented policy, monitoring and evaluation etc.  At national level, the best practice of the pilot intervention project was recognised by the experts committee of “Caring for Girls”, and UBR was taken into account in the strategic plan for this national government campaign. 

Monitoring and ensuring the implementation of policy and legislation related to UBR

During the pilot intervention, Plan monitored not only the project but also the implementation of policy and legislation at the county level. As UBR has now been recognised by the national government and put into the strategic plan for “Caring for Girls”, we need to monitor the implementation of the new strategic plan.

Creating incentives to increase the demand for birth registration  

In the pilot project area, such incentives were created through the interests-oriented policy. The national rural insurance policy is also encouraging people to register births in time in order to benefit from the policy. 

Partnerships, coordination, cooperation, alliances and coalitions

Xi’an Jiaotong University was Plan China’s strategic partner, providing the technical support while Plan China took on the monitoring of evaluation. Nationally, there is an alliance made up of UNICEF, All-China Women’s Federation, All-China Lawyers' Association and other academic institutions and NGOs. 

Community awareness

The awareness of birth registration was raised in the pilot area, and the publication of the research and intervention experience has made more organisations and governments realise the importance of child birth registration.

Ownership and sustainability (Have the duty-bearers, the state, taken responsibility? How have rights-holders, communities, and civil society been involved to ensure sustainability?)

In China, a project is sustainable if it is taken into account in the daily work of government. The UBR project is gradually coming into national action through "Caring for Girl”, which will turn into the daily work of different government levels.  

The integration of the issue of birth registration with other programmes, such as maternal health

Plan China has always considered integration with other programmes since the beginning of the UBR project. In fact, we had included different government departments, such as the police and health departments, in the intervention phase. Other Plan China programmes provided very important suggestions for the UBR project.  

Involving children in the UBR campaign

During the community awareness-raising phase, children were involved in child-led activities, such as drama and arts, and were also involved in the national advocacy workshops though giving presentations. 

Good practice

• The partnership between an academic institution, government and NGO is a good model for cooperation in which each party contributes its strengths.
• The involvement of leaders is key. During the project's first stage, regulation and supervision were not very good because the leaders at all levels and in each department had not paid it enough attention, and the project made little progress. After further awareness-raising with local government, the project's second stage saw much more change because of greater attention from the leader of the family planning department, who was in charge in the project. 
• Unity of understanding by the relevant departments is important to achieving success. Many departments are involved in birth registration - family planning, health, public security, civil affairs and village committee, etc. There was a potential for conflict because each department had its own interests. After the project started, these departments gradually unified their understanding under the leadership of the county government leader, and then discussed and issued their "Rules on birth registration". 
• Activity at the grassroots is also important to achieving success. Workers at the grassroots can promote the campaign through their work and their social environments. They can do this through displays and questionnaires, at traditional festival days, and through their work. For example, the police can promote the campaign while they go to the countryside; the hospital can raise it with lying-in women; village cadres can fill in relevant material and supervise parents to register in time. 
• Every department and project township can hold regular meetings to share experience and good practice, guaranteeing the harmony of the project. 
• Monitoring and evaluating the project regularly is effective for its success, with feedback to the local department to help improve the scheme.
• Institutionalising the responsibility of each department in the project. The "Rules on birth registration”, issued at the beginning of the project, confirmed the procedures for registration and the evidence needed, and also defined the responsibility of each department. This laid the basis for the future of the project, and dispelled the unfavourable factors.

Challenges, gaps and barriers

• To influence the government to take UBR as its priority.
• More departments need to be involved in birth registration, and how best to engage all relevant departments is still a challenge. During the pilot project, the participation of the health sector, public security and other relevant departments was still low.

National level recommendations

Although UBR is now included in the "Care for Girls" campaign, this is still just a strategic plan. Plan needs to monitor its implementation.

Future activities 

As UBR has been put into the strategic plan of the national government programme, Plan might not invest as much in the future.

Do you have any high-profile supporters of Plan’s UBR campaign?

Professor Li Shuzhuo, Director, Institute of Population and Development Studies, Xi’an Jiaotong University. 

Case study – one child's story

On 3 November 2005, Gao Penghui and Li Huafan gave birth to a baby girl, Gao Xiaoli. They decided not to register their daughter’s birth, as they believed this was expensive and of little use. 

Gao Xiaoli suffered from chronic respiratory infections. Her medical treatment was expensive, and the family got into debt.  Mr Gao and Mrs Li thought that the new collective medical system – which provides partial medical coverage to residents in rural areas - would save them from this debt. But when the couple attempted to join, they discovered that without birth registration documents, their daughter would not be eligible for cover.  

Fortunately, soon after the family found this out, a birth registration awareness campaign was beginning in their county, QiShan.  

Plan China and Xi’an Jiaotong University held a joint birth registration campaign in QiShan county in cooperation with the local government. For the first time, the government encouraged registration for every child at birth, whether or not the family had money to pay the fine usually levied if parents do not register their child at the public security bureau within three months of birth.  

The campaign included education about birth registration as a child’s basic right. Parents were encouraged to register their child immediately after birth. Mr Gao and Mrs Li were able to register their daughter and subsequently entered her into the new collective medical system. 

Soon after Gao Xiaoli received her birth registration documents, the local township government announced that the family’s land would be reclaimed to build a new government office. Because their daughter had registration documents, she received RMB 5,000 in compensation for the land. 

The couple happily said: “The [birth registration] policy is good, but we didn’t know and created an obstacle for our daughter. If this project had not taken place, we wouldn’t know what to do. We didn’t know that the lack of birth registration could have such a big effect on a child.”  

Before the birth registration campaign in their village, only 1% of children were registered at birth. Less than one year later, birth registration reached 66.7%. In other villages, registration reached over 98%.