Obstacles to the Integrated Care of Children Aged 6 to 59 Months Suffering from Acute and Severe Malnutrition at the Chu-Me and HATC of N’Djamena/Chad

Introduction: the problem of Severe Acute Malnutrition (SAM) and its consequences concern and challenge all social actors worldwide. The objective of the study was to identify the real obstacles that actors face in the integrated management of children aged 6 - 59 months suffering from SAM at the University Hospital of Mother and Child (CHUME) and the Chad-China Friendship Hospital (HATC) of N’Djamena. Methodology: this is a cross-sectional descriptive and interpretative study conducted from January to October 2023 at the CHUME and HATC of N’Djamena. It is based on questionnaires and direct observation of two hundred and thirty-six (236) parents or guardians of malnourished children admitted to these health facilities. All 236 agreed to participate freely in this study. Results: it appears from this study that the obstacles to the integrated management of malnourished children were: poor care-care relationship (26.7%) permanent product breaks (22.9%), the direct costs of services ranged from 30,000 to 60,000 FCFA (41.53%), drugs used for the treatment of patients came from the street (66.10%), malaria and anemia occupy an important place (27.5%), 57.2% respondents had monthly income below 60,000 CFAF. Conclusion: the present study carried out has identified the real bottlenecks to the integrated management of children suffering from SAM in the therapeutic nutritional units of the city of N’Djamena. .

Comments by opponents on the British Medical Association’s guidance on non-therapeutic male circumcision of children seem one-sided and may undermine public health

The British Medical Association(BMA)guidance on non-therapeutic circumcision(NTMC)of male children is limited to ethical,legal and religious issues.Here we evaluate criticisms of the BMA’s guidance by Lempert et al.While their arguments promoting autonomy and consent might be superficially appealing,their claim of high procedural risks and negligible benefits seem one-sided and contrast with high quality evidence of low risk and lifelong benefits.Extensive literature reviews by the American Academy of Pediatrics and the United States Centers for Disease Control and Prevention in developing evidence-based policies,as well as risk-benefit analyses,have found that the medical benefits of infant NTMC greatly exceed the risks,and there is no reduction in sexual function and pleasure.The BMA’s failure to consider the medical benefits of early childhood NTMC may partly explain why this prophylactic intervention is discouraged in the United Kingdom.The consequence is higher prevalence of preventable infections,adverse medical conditions,suffering and net costs to the UK’s National Health Service for treatment of these.Many of the issues and contradictions in the BMA guidance identified by Lempert et al stem from the BMA’s guidance not being sufficiently evidence-based.Indeed,that document called for a review by others of the medical issues surrounding NTMC.While societal factors apply,ultimately,NTMC can only be justified rationally on scientific,evidence-based grounds.Parents are entitled to an accurate presentation of the medical evidence so that they can make an informed decision.Their decision either for or against NTMC should then be respected.

Improving the Use of Insecticide-Treated Nets among Children under Five Years Old in Benin, West Africa

Background: In Benin, malaria represents the first cause of consultation and hospitalization (48% for children under 5 years old) in health units. It also accounts for 23.1% of deaths recorded in health facilities (MoH, 2019). Between the two main components of vector control adopted by Benin government, the mass distribution campaigns of Insecticide-Treated Nets (ITNs) remained the only proven cost-effective way to rapidly achieve high and equitable coverage (WHO, 2017). After the fourth mass distribution campaign conducted in 2017, the Demographic and Health Survey (DHS) data indicated that the percentage of children who slept under an ITN has increased from 20% in 2006 to 70% in 2011-2012 and to 76% in 2017-2018 while the incidence of malaria (tested positive) is increasing rapidly among children under 5 years old, growing from 36.5% in 2009 to 28.8% in 2012 and then to 51.4% in 2019. This study aims to understand this contrast by identifying the origin of the increase in ITN use over time among children under five years old and the factors which determine this use. Methods: Data from the Demographic and Health Survey (DHS) conducted in Benin respectively in 2006 and in 20018 were used during the analysis, which covered 13,445 children under five years old from 2006 DHS and 12,255 children from 2017-2018 DHS. Firstly, the data were analyzed using decomposition method to highlight the origin of the increase of ITN use over time among children under five years old. Secondly, the chi-square test analysis estimated the association between ITN use and some characteristics (wealth index, maternal or caregiver education level and child age). Finally, the logistic regression model was used to identify the main factors, which influence the net use over the study period. Results: This study shows that the improvement of basic conditions is the main origin of behavior change in the use of ITNs among children under five years old. This improvement of the basic conditions consists of making ITNs available in households and informing household members about the benefits of ITN use. So, the free ITN distribution campaigns, routine distribution, awareness campaigns about the benefits of ITN use are the strategies, which increase the household capacities and knowledge, allowing household members to make their children sleep under net. The analysis also shows that region of residence, wealth index of household, household size, religion, and child age continue to determine the ITN use among children under age 5 years old and MNCP will integrate the factors in malaria prevention strategies in order to achieve universal use of ITNs. Conclusions: Although, sleeping under ITN behavior has indeed spread among children under 5 years old, policymakers and other stakeholders should design strategies to maintain and improve the current level of ITN use to reach the collective protection threshold (80% according to WHO). Therefore, to address the challenges of universal use of ITN, the study recommends expanding the routine distribution system to private sector health centers;discussing issues related to health service utilization (particularly ITN use) within a consultation framework at the communal level. In addition, collecting qualitative and quantitative data in the Oueme region will allow better understanding of all aspects of the ITN use gap among children under 5 years.

Are school uniforms associated with gender inequalities in physical activity? A pooled analysis of population-level data from 135 countries/regions

Purpose:It is aimed to assess whether school uniforms are associated with population-level gender inequalities in physical activity,and whether associations differ by school level,country/region income,and assessment method.Methods:An ecological study design was employed.We collected data about global uniform practices using an online survey.We searched for country/region-level estimates of school-aged youth meeting physical activity guidelines from international surveillance studies.Study selection was conducted in duplicate using a systematic process,and a random sample of all data was checked to ensure extraction and pooling processes were accurate.We calculated absolute and relative gender inequalities in physical activity for each country.Linear regression examined associations between country/region-level uniform practices(binary yes/no exposure variable) and country/region-level gender inequalities in physical activity guideline compliance(absolute and relative inequalities).We investigated moderation by school level,stratified analyses by income group,and repeated primary analyses using device-measured data.Results:Pooling data from 135 countries/regions(n=1,089,852),we found no association between population-level uniform practices and gender inequalities in physical activity across all ages(absolute:β=-0.2;95% confidence interval(95%CI):-1.7 to 1.3,p=0.74;relative:β=0.1;95%CI:-0.1 to 0.2,p=0.51).Subgroup analysis suggested a positive association in primary school settings(absolute:β=4.3;95%CI:-0.0 to 8.6,p=0.05).Among high-income countries,absolute inequalities were significantly greater in countries/regions with uniform practices(N=37) compared to those without(N=48)(9.1(SD=3.6) vs.7.8 percentage points(SD=4.3)).Repeating analyses using device-measured data(n=32,130;N=24) did not alter our primary finding.From initial descriptive statistics,we found that in countries/regions where a maj ority of schools(>50%) reportedly use uniforms,there was lower compliance with physical activity guidelines among all genders(median:16.0%,interquartile range:13.2%-19.9%,N=103) compared to generally non-uniform countries/regions(median:19.5%,interquartile range:16.4%-23.5 %,N=32)(z=3.04,p=0.002).(N=countries,regions and studies repre sented;n=sample size or participants included).Conclusion:School uniforms are associated with greater gender inequalities in physical activity in primary school settings and in high-income countries.Our population-level findings warrant testing using individual-level data across contexts.

Fertility Values among Women of Childbearing Age in Hunan Province, China: A Cross-Sectional Study

Background: China is facing with a crisis of the aging population. After the implementation of the latest fertility policy, the research on fertility related issues is urgent. Objective: The objective of this study is to explore the fertility values among women of childbearing age and the socio-demographic factors associated with it under the background of three-child policy, which is helpful to cope with the aging of the population. Methods: This study was conducted among 383 women of childbearing age who met the inclusion criteria using a general information questionnaire and the fertility values questionnaire from May to August 2021 in Hunan Province, China. Data were collected on the women’s socio-demographic characteristics and fertility values. The descriptive statistics, t-test and analysis of variance were used for data analysis. Results: The total mean score of the positive values was 43.55 ± 10.10, and that of the negative values was 50.87 ± 13.85. There were significant differences in the scores of the overall positive and negative values, as well as scores of each dimension (p The item mean score of the overall negative values (3.38 ± 0.93) was higher than that of the overall positive values (2.90 ± 0.67). Among the positive values, “emotional value” (4.26 ± 0.93) scored the highest, while “worrying about life changes” (3.88 ± 1.10) scored the highest among the negative values. There were significant differences in both the positive and negative values in terms of age, marital status, and “only-child” women or not (p Conclusion: The fertility values among women of childbearing age in Hunan Province were relatively negative, especially, excessive worries about life change since having a child, which may lead to further declines in fertility levels. Relevant support measures are urgently needed from the government to adapt to the three-child policy.

Tackling China’s Pension Fund Payment Crisis:Will the “Two-Child Policy” Be the Answer?——An example with the basic pension insurance program for urban employees

Based on the reality that 29 Chinese provinces have already implemented the policy allowing a couple to raise a second child if either parent is an only child, this paper provides an empirical study on the effect of this policy on the financial status of the social pooling fund of basic pension insurance for urban employees. Our study suggests the followings. First, under the previous unchanged family planning policy, current deficits and cumulative deficits will occur in the social pooling fund in the year 2047 and 2063 respectively. Second, if lO% to 50% of qualified couples choose to raise a second child, the financial status of the social pooling fund will improve; relative to the previous unchanged family planning policy, the contribution ratio can decrease from 20% to the range between 18.06% and 19.57% without causing any changes to the original financial status of income and expenditure. Third, if the percentage of couples choosing to raise a second child rises to 60% to 100%, the contribution ratio can even decrease to the range between 16.55% and 17. 7% without causing any changes to the financial status as under the previous unchanged family planning policy. The above conclusions have all passed the sensitivity test. Therefore, the ＂two-child policy＂ for qualified couples is favorable to alleviating the payment pressures of pension insurance but the policy effectiveness is subject to fertility desire and the intensity of government implementation.

China's Universal Second-Child Policy: Grounds, Effects and Strategies

The 13 th Five-Year Plan(2016─2020), with the balanced development of population being the core element, is crucial for China. The superimposed effect of an aging population and low birthrate leading to a reduction in the labor supply would have a fundamental influence on the long term balanced development of China's population, implying that China's population policy must be adjusted. This paper argues that a gradual relaxation of the family-planning policy adjustments accords with the original intention of the population policy design and development direction. The universal second-child policy is the logical results of the adjustment and improvement of China's family-planning policy, and is designed to bring about positive effects on future demographic and economic development, particularly in sustaining the long term balanced development of China's population, easing the marriage squeeze, extending the demographic dividend, and delaying the population aging process. China needs to develop and improve support and governance systems for fully implementing the universal second-child policy, realizing the policy transition from rewarding one-child families to population security and the modern transition of governance systems and capacity to a universal second-child policy.

血清对氧磷酯酶-1活性与肝硬化Child-Pugh分级的关系

目的探讨血清对氧磷酯酶-1(PON1)酶活性与肝硬化Child-Pugh分级的关系。方法以对氧磷(paraoxon)为底物测定76例正常、26例急性肝炎、45例慢性肝炎和72例肝硬化患者血清基础PON-1活性和1mol/L NaCl刺激后PON1活性;PCR扩增PON1基因,Alw I酶切PCR产物,对PON1基因192位多态性进行分型。结果正常对照组、急性肝炎、慢性肝炎和肝硬化患者血清PON-1基础活性水平分别为403±145,312±83,201±114,137±99 U/ml;1mol/L NaCl刺激后PON-1活性分别为673±232,509±139,335±151,233±162 U/ml。与正常对照比较,急性肝炎、慢性肝炎和肝硬化患者血清PON-1活性基础水平和1mol/LNaCl刺激后PON1活性均显著下降(P<0.01),肝硬化组下降最明显。肝硬化Child A,Child B和Child C组患者血清PON-1活性基础水平分别为185.5±98.6,141.6±93.6,86.7±51.2 U/ml;1mol/L NaCl刺激后PON-1活性分别为308.9±161.3,227.1±116.3,124.9±78.1 U/ml。Child B组比A组PON1酶活性显著下降(P<0.05),而Child C组又比B组PON1酶活性显著下降(P<0.01)。在肝硬化Child A,Child B和Child C组患者PON1的192位R-Q多态性分布频率无显著性差异(P>0.05)。结论血清PON1活性下降与肝硬化Child-Pugh分级相关,可反应肝硬化的严重程度,且PON1基因192位多态性不影响肝硬化各组的PON1酶活性。

Comparison of nutrition education policies and programs for children in China and other selected developed countries

A double burden of overweight/obesity and malnutrition during childhood is a major concern in China.Dietary intakes in this critical period affect children’s physical and cognitive development,and also have health consequences in later life.Therefore,establishing healthy eating habits that will endure is crucial for children.Nutrition education is an effective way in improving nutrition knowledge and attitudes,and healthy eating behaviors.Diverse forms of nutrition improvement programs that targeting children,family,teachers,and school settings have been conducted in many developed countries.However,due to the differences of genetic background,household environment as well as dietary patterns between Chinese children and children from other countries,the existing nutrition education programs for children abroad might not be appropriate for children in China.Thus,nutrition education programs that consider Chinese nutrition-related policies and food supply as well as the local educational resources are required for Chinese children.This review summarized nutrition-related policies and legislations in China and developed countries.A series of evidence-based nutrition education programs that combined educational strategies and environmental supports conducted in the Southwest China Childhood Nutrition and Growth Study were presented.These programs can serve as example models for adopting nutrition interventions to improve nutrition and health status of children in different regions of China.

已婚女性流动人口生育两孩的影响因素分析--基于江浙沪的数据分析

2016年全面二孩政策推行后,我国经历了短暂的二孩生育潜能释放期,而后多项生育支持政策遇冷,对提升总和生育率收效甚微。对家庭经济状况影响生育二孩的机制进行理论分析,发现存在高收入女性因高“生育代价”而减少生育二孩的“生存-生育冲突”机制以及女性因乡城流动和家庭化流动同时发生压力更大而减少生育二孩的“双重迁移”机制。为探究已婚女性流动人口生育两孩的影响因素及影响机制,选取2018年全国流动人口卫生计生动态监测调查数据中流入江浙沪地区的已婚育龄女性(15~49岁),构建核心解释变量为家庭月收入、周工作时间以及亲属幼儿照料的Probit模型。为解决生育二孩与家庭收入之间的内生性问题,将正规就业、长期居留作为工具变量建立IVProbit模型。对全体样本回归后,发现如果忽视内生性问题,将低估高家庭月收入、低女性周工作时长对生育二孩的激励作用,同时也高估了亲属提供幼儿照料变量的正向作用。从生育旺盛期与非生育旺盛期、乡城与城城流动的分组回归结果来看,发现影响机制存在显著差异。分别在引入女性个人月收入与家庭月收入交互项和家庭化迁移与家庭月收入交互项后,发现生育旺盛期女性“生存-生育冲突机制”显著、乡城流动女性“双重迁移机制”显著。由于上述机制的存在,仅仅通过调节家庭收入对生育二孩的激励效果并不明显。需要在此基础上出台更多降低“生育代价”以及家庭化迁移压力的配套政策,探索建立普惠式、社会性别平等式的生育政策支持体系。

生育文化、生育制度与生育率——兼论三孩生育政策及其配套支持措施的可能效果

随着中国少子老龄化程度的不断加深,如何促使生育率回升至适度水平成为政府和学界重点关注的议题,其中以三孩生育政策及其配套支持措施为代表的鼓励型生育制度和以“多子多福”为核心的传统生育文化被寄予厚望,希望借此帮助中国摆脱“低生育率陷阱”。然而,研究发现:中华文化圈国家或地区的生育率远低于其他国家与地区,而海外华人则是所在国生育率最低的族群之一,传统生育文化在现代社会已然发生了嬗变,对促使低生育率回升的作用已十分有限,取而代之的是“晚婚晚育少生优生甚至不婚不育”的现代生育文化,并形塑起一种内生性的低生育率机制。与此同时,欧洲和东亚国家通过构建鼓励型生育制度后依然深陷低生育率陷阱,无法有效刺激低生育率回升至适度水平。中国三孩生育政策及其配套支持措施的预期效果同样不容乐观,而生育文化、生育制度和生育率之间存在着十分复杂的互构关系,亟需从结构性和内生性的“文化—制度”视角去重新审视我国生育率转变的形成机制。

高学历育龄人群三孩生育意愿研究

文章基于2021年中国综合社会调查(CGSS)数据,采用二元Logit回归模型、门槛效应模型和倾向值匹配(PSM)等方法实证分析高学历育龄人群的三孩生育意愿以及生育支持条件对其的影响。研究结果表明:高学历育龄人群的三孩生育意愿相对较低,平均只有14.1%的高学历育龄人群愿意生育三孩,而低学历育龄人群有18.4%愿意生育三孩。高学历育龄人群愿意生育三孩的比例与已育二孩的性别结构有关。已有两个儿子、两个女儿和一儿一女的高学历育龄人群愿意生育三孩的比例分别为12.3%、16.0%和13.9%。家庭收入水平对高学历育龄人群的三孩生育意愿有显著的正向影响,且存在显著的收入门槛效应。随着家庭收入水平的提高,家庭收入对高学历育龄人群三孩生育意愿的边际影响效应呈现出先增大后减小的倒“U”型关系,家庭收入水平对家庭收入为11万元-36万元的高学历育龄人群三孩生育意愿的影响效应最大,对家庭收入为11万元以下和36万元以上高学历育龄人群三孩生育意愿的影响效应较小。相对于没有托育服务的高学历育龄人群而言,政府而非市场提供低价优质的托育服务能够显著增强高学历育龄人群的三孩生育意愿。政策启示在于:一是提高中国育龄人群的三孩生育水平,不能把过高的期望寄托在高学历育龄人群,尤其是已育有两个孩子的高学历育龄人群;二是提高已育两个孩子高学历育龄人群的三孩生育水平,重点关注已育两个女儿且家庭收入为11万元-36万元的高学历育龄人群;三是降低高学历育龄人群三孩生育的直接成本和机会成本,加强生育支持政策评估,进一步完善高学历育龄人群的生育休假政策和生育三孩家庭的收入补贴政策,优化高学历人群的延迟退休政策,消除高学历育龄女性的就业歧视,仍然是激励高学历人群生育三孩的重要举措;四是政府主动承担婴幼儿的托育服务,为育龄人群提供低价优质的托育服务,能够达到事半功倍的三孩生育激励效应。

构建育儿友好型社会策略探析--以宁波市为例

在阐述构建育儿友好型社会的研究背景、解读构建育儿友好型社会的核心内涵的基础上,指出:面向育儿友好的高质量公共服务供给体系有待完善,育儿友好性设施建设及权益保障尚需补缺,管理职能分散化、碎片化影响育儿友好构建整体合力等。完善育儿友好型公共服务体系、加强育儿友好型城市和社区建设、构建育儿友好型部门综合治理政策体系等,是构建幼儿友好型社会的有效策略。

“三孩”政策背景下婴幼儿家庭养育压力的影响因素探究

为了解“三孩”政策背景下0~6岁婴幼儿家庭养育压力的现状及其影响因素,采用基本信息问卷、简式养育压力量表(PSI-SF)对我国东、中、西部六省3982个婴幼儿家庭所面临的养育压力展开调查,并从个体家庭因素、经济因素和社会区域因素三个方面分析0~6岁婴幼儿家庭养育压力产生的原因。结果显示,在0~6岁婴幼儿家庭中,近五成家庭养育压力超出正常范围,且从养育压力的各个维度来看,育儿愁苦得分高于困难儿童得分高于亲子互动失调得分;家庭结构、社会经济地位以及城乡地区对0~6岁婴幼儿家庭的养育压力有显著影响。基于此,建议关注父亲的养育压力,政府社区家庭合作共育;明确家庭压力来源,缓解家庭养育压力;加大政府投入,降低家庭养育成本;完善社会服务支持,提高家庭养育知识与技能。

育龄夫妻三孩生育意愿分析及对策研究——基于福建龙岩的实地调查

为积极落实三孩生育政策,主动适应人口和计划生育工作转型发展的新要求,调研组基于龙岩市育龄夫妻三孩生育意愿的调查问卷数据及实地调研,得出结论:三孩生育意愿的影响因素主要表现在经济成本、制度保障和生育观念三个方面。为进一步优化生育政策,提高三孩生育政策及配套支持措施的针对性、可操作性,切实减轻群众生育、养育、教育负担,助力生育友好城市建设,建议加强顶层设计提供政策支持,着力提升系统保障功能,多管齐下降低家庭养育成本,营造良好的生育氛围。

生育政策调整对黄河流域城市韧性影响——以二孩政策为例

统筹人口与经济社会、资源环境的关系,对于打造韧性城市,实现区域高质量发展具有重要意义。研究以2013年开始实施的单独二孩政策为准自然实验,综合考虑全面二孩政策的实施效果,建立包含失业人口和老幼人口两条作用路径的分析框架。在使用机器学习算法对黄河流域城市韧性进行测算后,进一步采用双重差分模型对生育政策调整影响城市韧性的效果与机制进行探究和验证。结果表明,生育政策调整会在短期内降低黄河流域城市韧性,且这种负面效应会随着时间的变化呈现出三阶段特征。机制检验表明,生育政策调整并不会使城市的女性失业人口显著增加,但会通过增加老幼人口影响城市韧性。

“三孩”政策背景下我国乡村生育政策的创新与完善研究

进入新世纪以来,受长期计划生育政策惯性、生育观念转变和大范围人口流动的影响,我国乡村人口呈现出总量快速下降、人口结构恶化、总和生育率下降、新生儿性别比失调等问题。2021年“三孩”政策推出,提出应对我国生育政策进行综合性设计,以顺应我国乡村人口发展的需求。我国现有生育支持政策对于化解乡村生育问题还存在较多不足,需要秉持科学化和统筹城乡理念,抛弃历史包袱和政策惯性,遵循推进政策普惠化和系统化的思路进行政策调整,并不断完善政策执行体系。

2024—2035年学前教育学龄人口及其对资源需求的预测——基于“三孩”政策的研究

在“三孩”政策全面实施背景下,本文基于第七次全国人口普查数据,使用CPPS2020软件分高、低两种总和生育率方案预测2024—2035年学前教育出生人口、学龄人口和在园幼儿数,进而测算各年份幼儿园机构、专任教师和财政投入需求。结果发现:2035年我国出生人口在高、低方案下较2024年提升99万人、减少6万人;学龄人口和在园幼儿总量整体减少,向城市集聚,到2035年在园幼儿规模为2498—2752万人,其中71%—72%就读于城镇幼儿园。从教育资源现有供给水平来看,城乡学前机构与城镇专任教师可以满足未来需求,乡村专任教师和教育经费存在大量短缺。基于此,需统筹城乡幼儿园的配置;促进城乡教师资源流动;建立各级财政分项目按比例承担学前教育经费的分担机制,加大学前的教育财政投入;财政投入更多用于人员经费和公用经费。

欧洲儿童福利政策:比较及经验借鉴

近年来,随着中国儿童福利需求不断升级,现行的儿童福利政策难以适应新时代发展要求,完善儿童福利政策势在必行。从世界范围看,欧洲国家的儿童福利政策发展较早且较为完备,对现阶段中国儿童福利政策的完善具有十分重要的参考价值。本文以福利体制和社会福利政策分析框架为基础,选取英国、德国和瑞典三个欧洲典型国家进行深入剖析,厘清其儿童福利政策的发展方向和趋势,为中国儿童福利政策的发展提供借鉴。在“三孩政策”的背景下,中国应大力发展适度普惠型儿童福利,完善经济支持、时间和服务政策,建立多元主体共同参与的混合照顾体系,拓宽儿童福利筹资渠道,以设计出适合中国国情的儿童福利政策,通过完善儿童福利政策为生育开启“机会之窗”,并消除儿童福利需求与儿童福利供给之间的现实难题,增进儿童福祉,从而切实解决家庭后顾之忧,提升适龄人群生育意愿。

三孩政策下家庭教育期望及其生育效应

随着经济社会发展和生育观念转变,家庭生育决策进入日益理性化和成本约束的阶段。父母较高的教育期望和激烈的教育竞争影响着家庭生育意愿和行为。通过构建家庭资源约束条件下教育期望、培育策略与生育效应的分析框架,并基于大样本调查数据,考察了教育期望对家庭生育的影响效应。研究发现,家庭教育期望显著提升了生育一孩的概率,但降低了家庭生育二孩的概率,较高的教育期望引致家庭采取“质量替代数量”的生育决策。异质性分析发现,教育期望对不同阶层生育数量和再生育意愿的影响形成分化效应。较高的教育期望显著降低了中低收入阶层家庭二孩和三孩的生育意愿及行为;但在高收入阶层,较高的教育期望并未对家庭二孩和三孩的生育意愿及行为产生挤压效应。进一步研究发现,育龄夫妇受教育程度与家庭教育期望形成替代效应,育龄夫妇受教育程度越低,教育期望对二孩生育的挤压效应越大。机制分析发现,较高的教育期望显著降低了家庭的男孩偏好,说明父母对子女的教育期望越高,越重视孩子的质量而非性别和数量,带来少子化的生育决策。家庭教育期望具有一定程度的不可逆性和不同群体的趋同性,必须降低家庭的养育成本和缓解家庭养育焦虑。通过发展普惠性学前教育和义务教育,提高城乡教育均等化水平,提供多元化的市场养育服务,改善家庭的生育预期,进而提高家庭生育率。