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Guiding Opinions on Further Improving and Implementing Measures to Support Stimulation of Childbirth



To the people's governments of all provinces, autonomous regions, and directly-governed municipalities, all State Council ministries and commissions and subordinate institutions, and all relevant units of the military:

After approval by the State Council, the following opinions are hereby put forward in order to thoroughly implement the "Decision of the Central Committee of the Communist Party of China and the State Council on Optimizing the Birth Policy and Promoting the Long-term Balanced Development of the Population", to implement the Population and Family Planning Law, and to further improve and implement the support measures for stimulating births:

I. General Requirements

Persist in the guidance of Xi Jinping Thought on Socialism with Chinese Characteristics for the New Era, earnestly implement the Party Central Commission and State Council's decisions and deployments, thoroughly implement the policy of allowing each couple to have 3 children and accompanying support measures; consider marriage, childbirth, parenting, and education together; try one's hardest and do all one can; address causes and symptoms to take well-focused steps; improve and implement support measures for stimulating childbirth such as for government finance, tax collection, insurance, education, housing, and employment; implement the responsibility of multiple parties such as government, employers, and individuals; continue to optimize the supply of services, continuously increase the level of services, actively create a marriage-friendly social environment, accelerate the establishment of a system of supports for stimulating childbirth, complete service management systems, and provide effective support for realizing appropriate birth levels and promoting the longterm balanced development of the population.

II. Raise the level of prenatal and postnatal care services

(1) Improve full-cycle prenatal and postnatal care services. Implement the action promotion plan on maternal and child safety, and fully implement the five systems for maternal and child safety. Advance capacity building in maternal and child health care institutions, with a government-organized, standardized maternal and child health care institution set up at each province, city, and county level. Strengthen the establishment of high-quality obstetrics and comprehensively improve hospital delivery conditions. Promote the implementation of the three-level prevention and control strategy for birth defects, complete the birth defect prevention and control network of "county-level screening, city-level diagnosis, provincial-level guidance, and regional radiation"; increase the service level for premarital healthcare, preconception healthcare, prenatal screenings, and prenatal diagnoses; promote integrated perinatal, prenatal and postnatal management services and multidisciplinary cooperation in diagnosis and treatment for key diseases; and strengthen the screening and diagnosis of neonatal genetic metabolic diseases, hearing impairment, and congenital heart disease.

(2) Raise the quality of children's health services. Implement the Healthy Children Action and Enhancement Plan. Strengthen the health management services for children aged 0-6 and pregnant and lying-in women, and raise the quality of services and the efficiency of funds usage. Strengthen the establishment of the basic-level network of children's healthcare services. Promote the standardized establishment of children's healthcare clinics (or children's healthcare rooms) in basic-level medical institutions, and raise the staffing allocation levels of doctors specialized in child health care and basic medical services at township health establishments and community health service centers. During the period of the "14th Five-Year Plan", the central budget is to include investment and support for the development of about 10 state regional pediatric medical center construction projects, promote the construction of pediatric medical associations, and promote the downward and balanced allocation of high-quality pediatric medical resources. Develop the establishment of hospitals that are mother and infant-friendly and child-friendly. Complete efforts on newborns' participation in resident health insurance service administration.

(3) Strengthen reproductive health services. Expand pilot projects on labor analgesia, regulate related diagnostic and treatment conduct, and raise the level of labor analgesia. Guide and promote medical establishments' provision of targeted services to the public through health education, psychological counseling, traditional Chinese medicine services, pharmaceutical treatments, surgical treatments, assisted reproductive technology, and other means to increase the level of prevention and treatment of infertility. Advance the establishment of assisted reproductive technology systems, complete quality control networks, and strengthen service monitoring and digitalized management. Carry out actions to promote reproductive health, enhancing the public's healthcare awareness and ability. Strengthen publicity, education, and services for reproductive health, prevent unintended pregnancies, and reduce abortions that are not medically necessary.

(4) Increase families' ability to care for infants and young children. Establish and improve the popular health science expert and resource databases, and popularize scientific parenting knowledge and skills through various channels such as radio, television, newspapers, the Internet, and new media. Encourage localities to employ active measures to support care models such as intergenerational care and mutual family assistance. Expand the supply of domestic service enterprises with at home and residential infant care services. Encourage childcare institutions that have the capacity to cooperate with domestic services enterprises to provide at-home or residential infant care services. Encourage qualified service bodies, industry associations, and professionals to support basic-level forces such as village (or resident) committees in increasing capacity for infant and childcare through methods such as parenting classes, group activities on childcare, and in-home guidance. Give full play to the active role of social forces such as public interest and charitable social organizations, to increase support for infant and childcare services in rural and underdeveloped areas.

III. Develop an inclusive childcare service system

(5) Increase the supply of inclusive childcare services. In 2022, all of the nation's prefectures and cities are to issue and implement the overall "one old and one small".solution plan. Through the investment support in the central budget and guidance, carry out projects to build the capacity of public childcare services and special actions on inclusive childcare services to drive local government infrastructure investment and societal investment. Local governments are to formulate fee collection standards for public childcare establishments, strengthening regulation of inclusive childcare establishments' fee collection. Expand the functions of community childcare services and improve basic public service facilities such as for infant and child care. Support employers that have the capacity in providing welfare childcare services for employees. Accelerate the formulation and issuance of management measures for family childcare stations. On the foundation of satisfying the popularization of preschool education, encourage and support qualified kindergartens that have the capacity to accept 2-3 year olds.

(6) Reduce the operating costs of childcare establishments. During the period of the "14th Five-Year Plan", the scope of applications for projects to establish childcare is expanded, and central budget investment increases the extent of support for construction subsidies. Scientifically arrange comprehensive community service facilities, and implement preferential tax and fee policies for the development of community childcare services. Improve policies on land, housing, government funds, finance, and talent, to encourage local governments to support inclusive childcare institutions. Resident livelihood pricing is to be implemented for childcare establishments' water, electricity, gas, and heat. Encourage private capital to set up a fund for the development of childcare services, providing credit enhancement support for the childcare industry. All localities should establish emergency response mechanisms for special situations such as the closure of childcare institutions, and implement bailout policies for childcare enterprises during the epidemic.

(7) Improve the quality of childcare services. Thoroughly carry out activities on constructing national demonstration cities for infant care services to form a group of example experiences that can be replicated and promoted. Research and formulate institutional norms related to childcare services, and vigorously develop diverse forms of childcare services. Encourage regular schools of higher learning and vocational colleges that have the capacity to open majors related to childcare services, to accelerate the cultivation of professional talent. Gradually implement an entry qualification system for childcare workers in accordance with law. Thoroughly implement a vocational skills training plan for health care, strengthening skills training for personnel in childcare positions. All levels of Medical health establishments, disease prevention and control bodies, and so forth, should strengthen operational guidance, consulting services, and oversight inspections on the healthcare efforts of childcare establishments; to prevent and control infectious diseases, reduce the incidence of common illnesses, and protect the physical and mental health of infants and young children. Strictly implement a series of normative documents such as fire safety guidelines for childcare institutions, strengthen comprehensive departmental oversight, and strictly prevent safety incidents. Strengthen societal oversight and promote industry self-discipline.

IV. improve maternity leave and benefits safeguard mechanisms

(8) Optimize the maternity leave system. All localities should improve maternity leave policies, starting from the functional orientation of safeguarding workers’ maternity rights and protecting the right to health of childbearing workers, embodying the process of protecting childbirth and parenting, helping workers balance work and family relationships, and promoting fair employment and career development. Actual conditions should be considered in improving mechanisms for reasonably sharing the burden of maternity leave costs, clarifying the responsibilities of relevant parties, and employing effective measures to safeguard employees' leave and benefits.

(9) Improve maternity insurance and other relevant social insurance systems. The state is to uniformly regulate and formulate improved policies for maternity insurance and maternity allowance payments, strengthen the role of maternity insurance in guaranteeing benefits such as childbirth medical expenses and maternity allowances for insured female employees, and ensure the safety of maternity insurance funds. Areas with the capacity may explore having flexibly employed personnel who participate in the basic health insurance also participate in maternity insurance. Unemployed women enjoy maternity medical treatment through participation in the basic medical insurance for urban and rural residents. The required funds are to be drawn from the unemployment insurance fund to pay employees' basic medical insurance premiums (including maternity insurance fees) for personnel who receive unemployment insurance benefits and ensure their childbirth rights, Guide localities to comprehensively consider factors such as the affordability of medical insurance (including maternity insurance) funds and relevant technical specifications, to gradually incorporate appropriate analgesia for childbirth and assisted reproductive technology projects into the scope of fund payments in accordance with procedures.

V. Strengthen support measures such as in housing and taxation

(10) Accelerate the improvement of the housing security system. Accelerate the development of subsidized rental housing, and promote the resolution of housing difficulties for new citizens, young people, and other groups. Further improve support measures for public rental housing safeguards to promote childbirth; all localities may give appropriate preferential treatment to eligible families with minor children in terms of apartment type selection based on the number of minor children; optimize rules for public rental housing waitlists and allocation, including family size and composition as factors in waiting list order or comprehensive scoring; housing selections may be directly organized for eligible families that have a larger number of children; improve policies for changing public rental housing, promptly making changes for families that need to change public rental housing for reasons such as adding a family member, employment, or children's schooling, in light of the housing resource situation.

(11) Precisely implement preferential policies in buying and renting houses. Skew housing policies towards families with multiple children; urban families with multiple children who do not own a house but rent a home may withdraw from the housing provident fund according to actual rent payments; and cities with the capacity may grant support policies such as appropriately increasing the value of loans from the housing providence fund for families with multiple children that are buying their first house for their own residency. Accelerate the development of the long-term rental market, increase the supply of long-term rental properties through multiple channels, and promote equal rights for renters and buyers. All localities may further study and formulate preferential policies for implementing differentiating home leasing and purchasing based on the burden of raising minor children in light of the actual situation.

(12) Give play to the supportive role of taxes and financing. Implement the special additional personal income tax deduction policy for expenses in the care of infants and young children under the age of 3. Establish incentive mechanisms for employers to protect employees' reproductive rights and interests in accordance with the law. Increase the extent of financial support for enterprises that provide maternal and infant care, childcare services, and related vocational training or produce related consumer goods.

VI. Strengthen the supply of high-quality educational resources

(13) Raise the level of universal and inclusive preschool education. Continue to implement the "14th Five-Year Plan's" action plan for the development and improvement of preschool education, and strive to compensate for the shortcomings of inclusive resources in rural and urban areas with a high concentration of new populations. Effectively implement the responsibility of all levels of government for the development of preschool education, and complete multi-channel financing mechanisms in which government investment is primary and families reasonably share in the burden. Optimize and improve fiscal subsidy policies, gradually increasing the level of financial investment in preschool education, and ensuring the high-quality and sustainable development of inclusive preschool education. Improve the pre-school education subsidy system, to effectively ensure that children from families with financial difficulties receive inclusive pre-school education.

(14) Raise the level of balanced development of compulsory education. Implement the main responsibility of the government to organize compulsory education in accordance with law, optimize the structure of compulsory education, and ensure that compulsory education degrees are mainly provided by public schools and by the government through purchasing degrees. Continue to implement the "two exemptions and one subsidy" policy to reduce the cost of schooling for students. Further reduce the burdens of homework and extra-curricular training for students in the compulsory education stage, give play to the role of school education as the main front, improve the quality of after-school services, and ensure funding for after-school services in accordance with regulations. Strictly implement the government price guidance management policy for extra-curricular academic training fees at the compulsory education stage. Strengthen the regulation of non-academic extra-curricular training, and regulate fee collection by training institutions. Strengthen the family education guidance for parents and establish a scientific concept of parenting.

(15) Strengthen health education such as on physical hygiene. Focusing on the psychological and physiological characteristics of school-aged children, carry out education on physical hygiene, adolescence, and sexual health education through periodic topical lectures, establishing public elective courses, and so forth, and strengthening the positive guidance of the concepts of marital love and family.

VII. Build a birth-friendly employment environment

(16) Encourage the implementation of flexible methods of working. Employers may consider actual production and work conditions to negotiate with employees and adopt methods such as flexible start and finish times or working from home to facilitate work for employees who need to take their children to and from school, care for sick or stay-at-home children, and so forth, and help employees resolve childcare difficulties.

(17) Promote the creation of family-friendly workplaces. Promote employers' incorporation of measures related to helping employees balance work and family relations into collective contracts and special collective contract clauses for the protection of female employees' rights and interests. Implement actions to promote breastfeeding. Employers with larger numbers of female employees shall establish rooms for pregnant women to rest and nursing rooms, and provide necessary maternal and child service facilities to better satisfy the needs of female employees during pregnancy, childbirth, and lactation. Encourage employers, schools, communities, group organizations, and so forth that have the capacity to carry out winter and summer vacation boarding services.

(18) Effectively safeguard legitimate rights and interests in labor and employment. Promote the improvement of institutional mechanisms for promoting women's employment, and strengthen relevant vocational skills training for female workers, especially those who seek re-employment following childbirth. Continue to carry out efforts on having reprimand discussions on employment gender discrimination, and investigate and punish violations in accordance with law. Urge employers to implement special labor protections for female employees during pregnancy and childbirth and lactation in terms of working hours, wages, labor intensity, etc. in accordance with laws and regulations. Strengthen regulation and law enforcement, complete judicial assistance mechanisms, explore and carry out procuratorial public interest litigation for the protection of women's equal employment rights and interests, and maintain women's labor and social security rights and interests. Strengthen the labor unions' legal supervision of labor, and promote the implementation of laws and regulations on the protection of employees' rights and interests.

VIII. Strengthen publicity, guidance, and service management

(19) Actively create a birth-friendly social atmosphere. Give full play to the role of all types of media and the advantages of group organizations, to actively carry out publicity and education on the basic national population conditions, carry forward the traditional virtues of the Chinese people, advocate age-appropriate marriage and childbirth, prenatal and postnatal care; and advocate respect for the social value of childbirth, respecting parents, putting children first, and having husband and wife sharing parenting responsibilities. Promote the reform of marriage customs and change prevailing customs, breaking outmoded conventions such as big marriages and high-priced gifts, and advocating the concept of positive marriage and childbirth. Organize the creation of a group of positive literary and artistic works, to tell China stories of love, harmonious families, and happy lives for the new era. Promote the construction of child-friendly cities. Carry out activities commending units that with advanced efforts to be childbirth-friendly across the country, select a group of advanced examples with solid work, notable results, and that satisfy the public; encourage and drive active innovation at the basic level, and create a childbirth-friendly social environment.

(20) Establish and improve the population service systems. Emphasizing 'one old, one young", establish and complete a population service system that covers the entire life cycle. Strengthen the collaborative governance by the government and society, and strengthen the establishment of basic-level population management systems and service capacity in towns (neighborhoods), villages (communities), and so forth. Improve the birth registration system, and fully implement the integrated handling of "matters arising from a birth" such as medical birth certificates, child vaccinations, household registration, medical insurance enrolment, and social security card applications. Strengthen responsibility for the management of basic-level population information, promote the integration and sharing of basic information such as on household registration, school enrollment, marriage registration, and health, and scientifically assess the birth situation and population trends. Safeguard the legitimate rights and interests of family planning families, establish and complete work mechanisms to support and care of special family planning families that are led by the government and participated in by social organizations; establish and complete support and safeguard systems for life, senior care, medical care, spiritual comfort, and so forth; and mobilize all levels of family planning associations to thoroughly carry out "Compassion Actions".

The relevant departments of all localities should deeply recognize the importance and urgency of improving and implementing support measures for stimulating childbirth, truly increasing political positions, placing population work on the agenda of important matters, and closely coordinating and cooperating to accelerate the improvement of support measures for stimulating childbirth. All localities should persist in having a person who is personally in charge with overall responsibility; strengthen overall planning, policy coordination, and work implementation; consider actual conditions to promptly improve specific policy measures, better plan organization and implementation, and ensure that responsibilities, measures, investments, and implementation are all in place. All relevant departments should strengthen local guidance, summarize and spread good experience and practices, promptly refine supporting measures, promote the resolution of problems faced in work, and continuously improve service management systems. Based on the national conditions, strengthen evaluation and hearings, and promote the connectivity between birth policies and relevant economic and social policies. Improve mechanisms for interdepartmental coordination, strengthen the planning of research and the urging of implementation of important policies. Improve and optimize the target management responsibility system for birth policies, study and establish an indicator system, and monitor and assess the effectiveness of support measures for stimulating childbirth. Strengthen publicity and exposition of policies, promptly and properly respond to social concern, and create a positive atmosphere. Promptly report important situations.

National Health Commission

National Development and Reform Commission

Publicity Department of CPC Central Committee

Ministry of Education

Ministry of Civil Affairs

Ministry of Finance

Ministry of Human Resources and Social Security

Ministry of Housing and Urban-Rural Development

Bank of China

State-owned Assets Supervision and Administration Commission of the State Council

State Administration of Taxation

National Healthcare Security Administration

China Banking and Insurance Regulatory Commission

All China Federation of Trade Unions

The Central Communist Youth League

China Women's Federation

Logistics Support Department of the Central Military Commission

July 25, 2022


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