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.W...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.展开更多
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 (Mo...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.展开更多
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 t...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.展开更多
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 co...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.展开更多
Universal two-child policy has been implemented since the end of 2015 in China.This policy is anticipated to bring a significant increase in the total population,with profound influences on the resources and environme...Universal two-child policy has been implemented since the end of 2015 in China.This policy is anticipated to bring a significant increase in the total population,with profound influences on the resources and environment in the future.This paper analyzes the changing dynamics of urban and rural population,and forecasts urban and rural population from 2016 to 2030 at national and provincial scale using a double log linear regression model.Drawing upon the results of these two predictions,the impact of the population policy change on Chinese resources consumption and environmental pollution are predicted quantitatively.Given the future total population maintains current levels on resources consumption and environmental emission,the additional demand of resources and environment demand for the new population is forecasted and compared against the capacity on supply side.The findings are as follows:after implementing the universal two-child policy,China's grain,energy consumption,domestic water demand,and pollutant emissions are projected to increase at different rates across provinces.To meet the needs arising from future population growth,food and energy self-sufficiency rate will be significantly reduced in the future,while relying more on imports.Stability of the water supply needs to be improved,especially in Beijing,Henan,Jiangsu,Qinghai,and Sichuan where the gap in future domestic water demand is comparatively larger.Environmental protection and associated governing capability are in urgent need of upgrade not least due to the increasing pressure of pollution.展开更多
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 i...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.展开更多
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...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.展开更多
文摘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.
文摘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.
基金sponsored by the National Social Sciences Foundation Program,An Evaluation of the Impact of China’s Family Planning Policy Adjustment on the Sustainability of the Social Security Fund and A Study of the Relevant Countermeasures(Grant No.15XRK005,chaired by:Zeng Yi)
文摘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.
基金This work was supported in part by research grants from the New Century Excellent Talents in University Program(NCET-12-0377)Sichuan Outstanding Young Scholars Foundation(2014JQ0005)the National Natural Science Foundation of China(Grant no.81673158).
文摘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.
文摘Universal two-child policy has been implemented since the end of 2015 in China.This policy is anticipated to bring a significant increase in the total population,with profound influences on the resources and environment in the future.This paper analyzes the changing dynamics of urban and rural population,and forecasts urban and rural population from 2016 to 2030 at national and provincial scale using a double log linear regression model.Drawing upon the results of these two predictions,the impact of the population policy change on Chinese resources consumption and environmental pollution are predicted quantitatively.Given the future total population maintains current levels on resources consumption and environmental emission,the additional demand of resources and environment demand for the new population is forecasted and compared against the capacity on supply side.The findings are as follows:after implementing the universal two-child policy,China's grain,energy consumption,domestic water demand,and pollutant emissions are projected to increase at different rates across provinces.To meet the needs arising from future population growth,food and energy self-sufficiency rate will be significantly reduced in the future,while relying more on imports.Stability of the water supply needs to be improved,especially in Beijing,Henan,Jiangsu,Qinghai,and Sichuan where the gap in future domestic water demand is comparatively larger.Environmental protection and associated governing capability are in urgent need of upgrade not least due to the increasing pressure of pollution.
文摘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.
文摘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.
