A Lancet Commission on 70 years of women's reproductive, maternal, newborn, child, and adolescent health in China

Women's reproductive, maternal, newborn, child, and adolescent health (RMNCAH) is a cornerstone for the healthy development of the next generation and a driving force for the progress of population and society in the future, especially in this era of population ageing and low fertility in China. In past decades, China's RMNCAH has made remarkable achievements in development goals related to reducing maternal and child mortality. However, as China moves towards a thriving goal—namely, towards ensuring health and wellbeing—the country faces emerging problems and new challenges in RMNCAH. These problems and challenges relate to the rapid and continuous improvement in social and economic conditions along with changes in demographics, lifestyles, the environment, and innovations in medical and therapeutic technologies, as well as an increasing threat of emerging infectious diseases such as COVID-19. The UN Sustainable Development Goals (SDGs) have also extended the focus from maternal and child survival to improvement of health across the life span. This focus is integrated in the visions of both the SDGs and the Healthy China 2030 agenda. The years 2021–30 are crucial in ensuring that China is able to meet the goal of universal RMNCAH coverage, which is embodied by access, quality, and equity. This Lancet RMNCAH Commission aims to review past achievements and lessons, to analyse current problems and challenges, and then to prioritise steps towards the achievements of the SDGs and Healthy China 2030. Time of transition: lessons from China's progress in reproductive, maternal, newborn, child, and adolescent healthThe report of the Lancet Commission on 70 years of reproductive, maternal, newborn, child, and adolescent health (RMNCAH) in China1 describes the country's achievements and discusses policy and socioeconomic transitions, and their impact on epidemiological and demographic transitions. Current challenges are identified by the Commission, including low fertility, the ageing population, undernutrition and overnutrition, and emerging diseases as China moves towards its final stage of ending preventable maternal2 and neonatal deaths. Full-Text PDF Gender equity, caregiving, and the 1-2-3-child policy in ChinaThe Lancet Commission on 70 years of women's reproductive, maternal, newborn, child, and adolescent health in China by Jie Qiao and colleagues1 clearly describes a roadmap for universal coverage by 2030. However, the gendered role of caregiving2 is overlooked in the narrow definition of maternal health.3 Full-Text PDF Gender equity, caregiving, and the 1-2-3-child policy in China – Authors' replyXiaoxiao Kwete and colleagues note the challenge of population ageing and low fertility that is happening not only in China but also in many other countries. With increasing longevity and a relaxing population policy, young couples are shouldering a growing burden of caregiving for their older family members and children. This burden is the main reason for the decreased fertility desire among young Chinese couples. Additionally, increased independence and more opportunities have empowered women to pursue their personal development, which inevitably results in a low fertility rate and the postponement of childbearing. Full-Text PDF