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Child public health is described by Kohler as “ …the organised efforts of society to develop healthy public health policies to promote child and young people’s health, to prevent disease in children and young people and to foster equity for children and young people, within a framework of sustainable development”.1 China has the second largest population under the age of 5 in the world and faces complex challenges resulting from legislation, such as the one child policy, as well as the problem of increasing inequity, as demonstrated by trends in infant mortality in urban and rural China.2–4 While many reports have pointed out recent health improvements in children, few have highlighted the need to address the growing health disparities among Chinese children. This paper examines China’s child health post millennium and suggests there should be a new emphasis on child health systems which focus on the need for, access to and supply of services.
Overall, improvements in China’s child health are broadly in line with the Millennium Development Goals (MDGs).5 Between 1991 and 2001, infant mortality rates (IMR) fell from 50.2 to 30.0 per 1000 live births, while overall maternal mortality rates (MMR) decreased from 8.0 to 5.0 per 1000 live births. Better nutrition was reflected in improvements in child health: during the past decade, the proportion of underweight children fell from 18.1% to 7.8% and the average height of children between 3 and 18 years of age increased by 3 cm.6 These improvements correlated with increasing affluence but were unevenly distributed across the country, reflecting variable economic development in different regions in China as identified in the 2000 rankings by the World Health Organization (WHO) which placed China 188th among its 191 member states for health equality experienced by its population.7