Quality of care in China: from pilot project to national program

Zhenming Xie, China Population and Development Research Center (CPDRC)
Joan Kaufman, Harvard University and Brandeis University
Erli Zhang, China Population Information and Research Center (CPIRC)

China’s family planning program ranks as history’s most intensive effort to control national population growth. Although successful in keeping population growth in check, the population policy has also generated much international criticism. A long overdue reform of its approach to implementing the family planning program has begun to re-focus the program on client needs, informed choice of contraceptives, and better quality services. Inspired by the Cairo ICPD conference, the reform program began as a pilot project among six counties and has now become a blueprint for re-orienting the national family planning program. This article reviews the process by which a small innovative pilot project was scaled up into a national reform effort and the key lessons learned about scaling up sensitive but needed innovation in a difficult political environment.