Version classiqueVersion mobile

Gender discriminations among young children in Asia

 | 
Isabelle Attané
, 
Jacques Véron

Part III - Gender discriminations among young children in Korea, Taiwan and Pakistan

10. Sex Preference and Determinants of Child Well-Being in Taiwan

Wen Shan Yang et Likwang Chen

Résumé

Au fur et à mesure de la baisse de la fécondité qui s’est opérée à Taiwan au cours des vingt-cinq dernières années, le rapport de masculinité des naissances a augmenté rapidement à Taiwan, témoignant d’interventions humaines sur le sexe de l’enfant à naître. Dans cette étude, les auteurs présentent tout d’abord les tendances récentes de la fécondité, de même que les facteurs affectant la rapport de masculinité des naissances. Puis ils décrivent les tendances du rapport de masculinité des naissances au niveau national et régional depuis 1990.
A partir de données micro, ils explorent ensuite les conséquences des changements démographiques et sociaux et celles du déséquilibre du rapport de masculinité des naissances sur les ménages, eu égard aux valeurs régissant les comportements des parents en matière d’éducation et de santé des enfants. Enfin, les auteurs énoncent les implications que pourraient avoir certaines décisions politiques sur le bien-être des enfants.

Texte intégral

Introduction

1Over the past several decades, Taiwan has been transformed from a developing society to a semi-developed one. With the concomitant advance of socio-economic indices, many demographic measures of the general population have reached the level of Japan and industrialized societies in Europe and North America. One of these demographic measures is the fertility rate. In 1970, Taiwan’s crude birth rate (CBR) was 27.2 per thousand, but the same measure declined to 23.3 in 1980, 15.4 in 1990 and 11.7 in 2001. This reflects a reduction of more than 40 per cent from 1970 to 2001. The total fertility rate (TFR), another measure of fertility, has correspondingly dropped from 4.0 in 1970, to 2.52 in 1980, 1.81 in 1990 and 1.40 in 2001. In spite of the traditional emphasis in Chinese culture on having at least one son to continue the family lineage, fertility in Taiwan has continued to decline sharply over recent years. Whether the cultural tradition of son preference in Taiwan will affect the trend of declining fertility and the number of children a couple have is a question that remains to be explored.

2As far as sex preference and fertility behaviour are concerned, many demographers have observed a trend to have unbalanced sex ratios at birth (SRB) in several East Asian societies, especially in China, Taiwan and Korea (Hull 1990, Park and Cho 1995, Poston et al. 1997). If one defines the true sex ratio at birth as a biological universal of around 105 to 106 male births for every 100 female births, then a SRB higher than biologically expected indicates an abnormal SRB, i.e., an imbalanced sex ratio at birth. In Taiwan, Poston and associates have reported that since the 1980s, the SRB has been between 108 and 110, a change from a more normal SRB in 1970 (Poston et al. 2001). Since the SRB is higher than biologically expected, it may reflect the influence of various kinds of human intervention on the sex ratio of birth cohorts in Taiwanese society. As a consequence, a SRB higher than expected can cause a marriage squeeze for males, i.e., men in societies with unbalanced sex ratios will have difficulty finding marital partners in the future (Das Gupta and Li 1999, Poston 2002). The consequences of higher SRBs in Taiwan and other East Asian societies deserve our attention and more detailed analyses.

3In this paper we first discuss the fertility trends in Taiwan, and the reason why the SRB is skewed. We describe the trends of the SRB in Taiwan as a whole and the patterns of the SRB for various geographic regions in Taiwan since 1990. We then use micro-level data to explore the consequences of demographic and social changes and the consequences of the SRB within the households with respect to the values and attitudes toward raising children and parental investment in child health. Finally, we probe implications for possible policy interventions to enhance the wellbeing of children in Taiwan and other high SRB societies.

Fertility trends and sex preference in Taiwan

4Taiwan, as well as China and Korea, is a strong patriarchal society (Poston et al. 2002, Larsen et al. 1998). In order to keep the family lineage and ancestor-worship rituals, sons are preferred to daughters when a fertility decision is to be made. Because there is no formal financial and social security in Taiwanese society, another good reason for parents to have a son is to receive financial and emotional support from the son in old age. Although Taiwanese society has been exposed to major economic and social changes over the past several decades, the traditional practice to have a son or sons is still strongly rooted in many segments of the population. In 1964, when the national family planning programme was first implemented, the TFR was 5.10 and the net reproduction rate (NRR) was 2.27. In 1983, almost 20 years after the initiation of the intensive family planning programme, Taiwan had completed the fertility aspect of the demographic transition, with the TFR declining to 2.16, and the NRR falling to 1.0 (Chang 2002). Table 1 reports the crude birth rate, total fertility rate and sex ratio in Taiwan from 1970 to 2001. As shown in this table, the TFR has continued from the previous trends to decline even further under the replacement level. It fluctuated within a narrow range, between 1.56 and 1.81, from 1990 to 2000, and then declined to the record low of 1.40 in 2001. In particular, the pace of fertility decline started to accelerate after 1997. For instance, the TFR was 1.77 in 1997, but turned into 1.47, 1.56, 1.68, and 1.40 in 1998, 1999, 2000 and 2001, respectively. At the same time, the CBR also declined from 15.1 in 1997 to 12.4, 12.9, and 13.9 in 1998, 1999 and 2000, and hit a low of 11.7 in 2001.

Table 1: Crude birth rate (CBR), total fertility rate (TFR) and sex ratio, Taiwan, 1970-2001

Year

CBR

TFR

Sex Ratio

1970

27.2

4.00

106

1980

23.3

2.52

106

1990

15.4

1.81

110

1992

15.5

1.73

110

1993

15.6

1.76

109

1994

15.3

1.76

109

1995

15.5

1.78

108

1996

15.2

1.76

109

1997

15.1

1.77

109

1998

12.4

1.47

109

1999

12.9

1.56

109

2000

13.9

1.68

110

2001

11.7

1.40

109

Source: Ministry of Internal Affairs, Taiwan (1971-2002).

5With fertility continuing to decline in the 1980s, Taiwanese society gradually had to face a tremendously distorted sex ratio at birth (Poston et al. 2001 and 2002). In the 1970s and 1980s, there was no evidence on wide distortion in the sex ratio at birth. This might be because sex-selective abortion technology was not widely available at that time, and most abortions were thus for unwanted births, but not gender-specific (Freedman, Sun and Chang 1994). While fertility continued to decline in the latter half of 1980s, the male to female sex ratio at birth in Taiwan started to rise. The sex ratio at birth has oscillated between 110 and 108 since 1990. Although the sex ratio at birth in Taiwan during this period was not as elevated as Korea’s (Park and Cho 1995, Arnold 1997) or China’s (Zeng et al. 1993, Poston 2001), a sex ratio at birth beyond the biological universal could not take place without artificial interruption of conception and/or childbirth (Poston et al. 2002). The abnormally high SRBs in Taiwan during this period of time are mainly for higher parities, and this pattern is very similar to Korea’s. Gu and Roy (1995) report that the SRBs in Taiwan for the third and fourth parities rose to 110, and the fourth and fifth SRBs were even around 130 and above. Since most women stop bearing children after they have their ideal numbers of children and sons, most higher parity births are born to couples who are desperate to have the desired number of sons.

Table 2: Sex ratios of children under five years of age, Taiwan, 1990-2002

Table 2: Sex ratios of children under five years of age, Taiwan, 1990-2002

Source: Ministry of Interior Affairs, Taiwan (1991-2003).

6Table 2 reports sex ratios by age in Taiwan from 1990 to 2002 up to the age of four. Park and Cho (1995) presented similar results regarding sex ratios for children under five years of age in Taiwan from 1981 to 1990. Compared to Park and Cho’s findings, the SRBs in 1990 and thereafter have followed the pattern of sex ratios in the 1980s, and stayed within the range of 109 and 110 for all age groups. Table 3 presents Taiwan’s SRBs by administrative areas from 1990 to 2002 to further demonstrate the trend. A consistent pattern of high SRBs, similar to that in the late 1980s, is observed in Table 3, irrespective of the size of administrative area. Furthermore, an interesting pattern emerges: sex ratios are higher for age 0 in two greater metropolitan areas than in other smaller cities and units each year. For example, both the Taipei and Kaohsiung greater metropolitan areas recorded higher sex ratios in 1995, ranging from 112 to 115. This abnormality of higher sex ratios in larger cities in Taiwan may be due to migration flows of young couples moving from rural areas to cities to find better job opportunities, and at the same time starting to build their families and bearing children (Park and Cho 1995).

Table 3: Sex ratios of children under five years of age by administrative areas, Taiwan, 1990-2002

Table 3: Sex ratios of children under five years of age by administrative areas, Taiwan, 1990-2002

Source: Ministry of Interior Affairs, Taiwan (1991-2003).

7We next examine sex-ratio distribution by birth order and family size in Taiwan in 1992. In order to compare with Park and Cho’s (1995) findings on sex preference in Korea, Hsieh and Cheng (1998) have utilized the 1992 Survey of Knowledge, Attitude and Practices of Fertility Behaviour, which was conducted by the Taiwan Provincial Institute of Family Planning, to calculate the sex-ratio at birth by birth order and family size to demonstrate the combined preference for sons and desire for small family size among the couples. Table 4 reports SRBs by birth order and family size in Taiwan. Clearly there is a negative relationship between sex ratio and family size in each birth order, and the sex ratio is extremely skewed for the last-born children, regardless of family size from the data. As shown in Table 4, the diagonal represents the sex ratio of the last-born children, which is very high at every birth order as compared with the sex ratio of the column that is the total number of children born. Among the Taiwanese couples with completed family size, the sex ratio of the first child is 116.4, while that of the second-born child is 132.7; the higher sex ratio by birth order suggests that, if the first-born or second-born child was a son, women tend to stop bearing children. Table 4 further shows that among women who cannot have the desired number of sons, they will continue to have children until birth order 5, at which point there is a significantly higher-than-normal sex ratio at 271. But there exists a clear pattern of negative correlation between sex ratios and family size in every birth order in Taiwan. In 1991, fewer than 3 per cent of women had 5 or more children, while more than 50 per cent of women with completed fertility had only one or two births. This is a product of two underlying forces: the implementation of very successful family planning programmes to reduce the desired family size and, at the same time, a preference for sons in Taiwanese culture. The high sex ratios at lower birth orders for small families may exert a strong influence on the overall sex ratios in Taiwan, the same pattern as that detected in Korea in the 1990s (Park and Cho 1995).

Table 4: Sex ratio at birth by order and family size, Taiwan, 1992, and Korea, 1991

Table 4: Sex ratio at birth by order and family size, Taiwan, 1992, and Korea, 1991

Sources: a 1992 Taiwan Fertility Survey (adapted from Shih and Cheng 1998).
b 1991 Fertility and Family Health Survey (adapted from Park and Cho 1995).

8We use Table 5, presented by Hsieh and Cheng (1998), to further demonstrate the disparity in sex ratios between last-born and earlier born children. This table reports sex ratios of last born-children and earlier children. The size of the family is related to the difference of sex ratios: the smaller the family size, the smaller the difference between the sex ratios across parities. Evidently couples in Taiwan tend to stop bearing more children only when they have their desired number of sons. The high sex ratio at birth may be due to a strong cultural preference for sons in Taiwanese culture. Although most couples in Taiwan have a tendency to have small families because of the very successful family planning programmes in recent years, the preference for sons still exerts a strong influence on fertility decisions when each couple comes to a decision to have an additional child.

Table 5: Sex ratios of last-born children and earlier children: Taiwan, 1992, and Korea, 1991

Table 5: Sex ratios of last-born children and earlier children: Taiwan, 1992, and Korea, 1991

Sources: a 1992 Taiwan Fertility Survey (adapted from Shih and Cheng 1998).
b 1991 Fertility and Family Health Survey (adapted from Park and Cho 1995).

9The cultural tradition of son preference in Chinese society is still persistent in Taiwan, which has recently undergone the transformation from a traditional agriculture-based to an industrialized society, and a higher sex ratio at birth than the biologically expected level is observed at higher parities. Although Taiwan has a fertility rate below the replacement level and the total fertility is at an all-time low at the present time, sons are still very highly desired by couples of child-bearing age because sons can perform family rituals and render financial as well as emotional support to their parents in their old age.

Values and attitudes toward raising children in Taiwan

10While a preference to have a desired number of sons in a patriarchal society is a major barrier to reducing fertility levels, Taiwan, Korea and Mainland China have nonetheless achieved below replacement level fertility in the past several decades. Despite this, the tradition of son preference may cause some undesirable consequences in such societies at the family level. Among them is the sex distribution of children within a family, which may raise the total number of children and cause a sex imbalance of the children in such a family. According to Park and Cho (1995), if a couple decides to have a desired number of sons before they stop having additional children, the sex ratio and birth-order level within a family may be inversely related to the size of the family. A strong sex preference tradition may cause small families to include mainly boys, while the children in large families will mainly constitute girls until the desired number of sons is born. As a result, the composition and size of the family will affect the resource distribution within the family. Children raised in a larger family tend to receive less childcare, education, medical care and other social resources while they are growing up, and therefore become less competitive and less successful compared with children growing up in small families.

11The relationship between the well-being of children and both their family size and sex balance in Taiwan, Korea and Mainland China has not warranted enough interest among social scientists in those societies (Li and Zhu 2001). As for Taiwan, if socio-economic development has been so successful in the past decades as to reduce social inequality and at the same time raise household income in the general population, will the higher than expected sex ratio still induce unfavourable treatments of daughters within a sex-imbalanced, large family? Furthermore, to what extent will the sex preference practice affect the medical care or general well-being of children within such a family? To respond to the above questions, the first step is to examine the values and attitudes toward having children in such a society, and the special case we examine here is Taiwan.

12An approach to parental values and attitudes toward investment in the quality of children is based on gender-specific intra-household resource allocation (Greenhalgh 1985). The ‘intra-household resource allocation’ argument is based on the rules of exchange existing in all cultures. It is assumed that family members will receive unequal resources from the total resources a family has. When a particular member receives more resources, it will affect the other members of the family. The decisions of resource allocation within the family are made within an informal system of rules governing exchange between individuals in social relationships. There are several allocation rules within the analytic framework of exchange. Among them, a popular one is the ‘contribution rule,’ which is based on equity theory. The notion is that “human beings believe that rewards and punishments should be distributed in accordance with recipients’ inputs or contributions” (Leventhal 1980). This concept has been supported by some empirical research findings. For instance, empirical results have shown that intra-household resource allocation is based on the income-earning abilities and potentials of household members. In order to maximize benefits from children, parents consciously or unconsciously allocate resources unevenly to children in the family, and children’s attributes may affect parental decisions with regard to investment in them. These attributes include birth order, gender, and disability status, to name a few (Li and Zhu 2001). With respect to this argument, previous research has demonstrated that sons are regarded as more valuable than daughters in a society where sons are expected to find urban jobs and send money home, while daughters are expected to marry a man in another family and pay a dowry (Safilios-Rothschild 1980). Differences between perceived long-term benefits from male and female children result in different parental feeding and care practices for sons and daughters when family resources are limited.

13Greenhalgh’s research on intergenerational contracts in Taiwan also furnishes very interesting findings with respect to how intra-household resource allocation works. Based on longitudinal data from Taiwan, Greenhalgh (1985) argues that parents use different child-rearing strategies for sons and daughters so as to maximize their own long-term benefits. In general, parents expect a long-term relationship with children and flows of material and non-material goods from their children. The expectation of parent-child contacts usually varies by gender. The prevailing patriarchal family practice in Taiwan favours sons over daughters when making decisions on investment in children. This is because sons are regarded as life-long members of the family who will continue the family lineage, while daughters are viewed as just temporary members of the family who will become members of another family after marrying into another household. Since parents’ long-term well-being and old-age security depend on their sons, parents tend to invest as much as they can in their sons’ education, skills, and the like. It is apparent that for parents with limited resources, a strategy for greater investment in the son’s well-being is even more attractive. In the same vein as Greenhalgh’s contact hypothesis, Lin and Lee (1999) also find that parental resource investment in their sons has a higher priority over their daughters because sons are obliged to support their ageing parents in a patriarchal culture.

14We apply the statistical method of the logit model to analyse whether certain characteristics with regard to parental values and attitudes toward raising children affect the probability that the parents of a child utilize preventive health care for this child. Data used in the following analyses are from a survey entitled ‘Preventive Care and Child Health’, conducted by Taiwan’s National Health Research Institute in 2001. The sample is representative for three districts of the city of Taichung, and consists of 1130 children who were aged 4 and resided in these three districts at the time their parents were interviewed.

15With regard to dependent variables for this research, we consider three types of children’s preventive care: children’s preventive services provided by national health insurance (NHI), children’s preventive eyesight checks paid by out-of-pocket money, and children’s preventive oral check-ups paid by out-of-pocket money, as indicators of child well-being for this study. Measures for these three types of preventive care are binary variables whose value is 1 if the child had at least one wellness visit for the selected type of preventive care at age 3, and 0 if a child did not have any wellness care at age 3.

16We use three sets of variables to capture the potential effects of the major explanatory variables: parental values and attitudes toward raising children. These variables include the most wanted characteristic for children, the major reason for raising children, and expectations regarding major sources of living expenses in parental old age. Various kinds of most wanted characteristics for children are categorized into four types: filial obedience, achievements or popularity, health, and happiness. Various major reasons for raising children are grouped into five types: following the natural route of human life, wanting a child of one’s own, wanting to have children as a symbolic way to extend life, liking children’s loveliness, and others. As to expectations regarding major sources for living expenses in old age, a dummy variable is created to contrast parents who regard children’s support as a major source with those who do not.

17In addition to these major explanatory factors, we also control selected child features, maternal characteristics, and the demographic and socioeconomic status of the family in the multivariate analysis with respect to the relationships of parental values and attitudes toward raising children with their utilization of children’s preventive services. The selected child features include the gender and the birth order of a child. The selected maternal characteristics include current maternal age, maternal educational level, and whether the mother works. The selected types of demographic and socioeconomic status of the family include parental marital status and family income level.

18Analysis for this study consists of two major parts. First, we describe the distributions of the major explanatory variables to depict parent values and attitudes toward raising children in current Taiwanese society, where fertility has declined to below the replacement level. To offer additional information on the relationships of parental values and attitudes with parental utilization of children’s preventive health care, we also calculate the point estimates of the utilization rates of children’s preventive services corresponding to various parental values and attitudes. The second part of the analysis is the multivariate analysis with respect to the relationships of parental values and attitudes toward raising children with their utilization of children’s preventive services. To shed light on the potential effects of various parental values and attitudes toward raising children on their investment in children’s preventive health care, we calculate the three sets of explanatory factors mentioned earlier, with the potential of birth order and gender of the children within the family and effects of covariates held constant.

Results

19Table 6 reports selected characteristics regarding values or attitudes toward raising children in Taiwan. As shown in Table 6, most parents state that “health” (78%) is their most wanted characteristic for children. Regarding attitudes toward raising children, parents who raise children just to follow the natural route of human life (43%) still constitute a large group. Only around ten per cent of parents regard children’s support (10%) as a potential major source of living expenses in old age.

20As to the corresponding utilization rates of children’s preventive health care, parents who regard children’s happiness as the most important quality of children seem to utilize more preventive services for children (21%), compared to parents who prefer other types of children’s qualities. Parents who raise children just to follow the natural route of human life (15%) seem to invest less in children’s preventive care, compared to parents who raise children for other reasons. In contrast, parents who raise children because of children’s loveliness or as a symbolic way to extend their lives (20%) may utilize more preventive health care for children. Results related to expectations regarding major sources of living expenses in old age are somewhat ambiguous, although they appear to demonstrate that parents who deem children’s support to be old-age security (35%) use more children’s preventive oral checks paid with out-of-pocket money. A point worthy of note (or “worth noting”) is that the pattern of the effects of parental values and attitudes for children’s preventive services by NHI is somewhat different from those for children’s preventive services paid by out-of-pocket money. These preliminary results are based on direct and rough contrasts between related point estimates, and need further exploration. In this regard, results from the multivariate analysis offer a clearer picture with respect to the potential effects of parental values and attitudes toward raising children on their investment in children’s preventive care. Below we describe results from the multivariate analysis shown in Table 5 to further scrutinize the links of parental values and attitudes toward raising children with their utilization of children’s preventive services. Results pertaining to other control variables are not included in the report because they are not the focus of our discussion. The point estimates of the three sets of odds ratios mentioned earlier are shown in the table along with the 95% confidence intervals.

Table 6: Selected characteristics regarding values or attitudes toward raising children

Table 6: Selected characteristics regarding values or attitudes toward raising children

Notes: 1. The number of observations is 1130.
2. The corresponding utilization rate of children’s preventive care refers to the utilization rate for the group of parents with that specific characteristic.

Table 7: Selected results regarding the relationships of parental values and attitudes toward raising children with their utilization of children’s preventive services

Table 7: Selected results regarding the relationships of parental values and attitudes toward raising children with their utilization of children’s preventive services

* indicates significance at the 5 per cent level.
** indicates significance at the 1 per cent level.

21As indicated in Table 7, parents who regard the fact that their children are symbols of extending their own lives as the most important reason for them to raise children are more likely to utilize children’s visual preventive services paid by out-of-pocket money. Parents who think that their children’s happiness is the most important quality of children or that children’s loveliness is the most important reason for them to raise children are more likely to utilize children’s oral preventive services paid by out-of-pocket money. Parents who think that children have to support them in old age are also more likely to use children’s oral preventive services paid by out-of-pocket money. Somewhat surprisingly, parental values and attitudes toward raising children that we examine in the study do not affect the probability that parents utilize preventive services provided to children for free by NHI in Taiwan.

Discussion

22Taiwan and many East Asian countries have accomplished the demographic transition from high to low mortality and fertility in the past several decades. At the present time, the total fertility rates (TFR) of Taiwan, Korea and Mainland China are well under the replacement level. Although the traditional cultural preference to have sons in the family in order to continue the family lineage has gradually declined in recent years, the imbalance of the sex ratio at birth remains high in these societies. Some important questions to explore here with respect to son preference are: (1) what are the dominant values and attitudes of the parents toward raising children, and (2) to what extent will sex preference affect the well-being of children within the families? In several studies, it has been demonstrated that sex imbalance within a family will influence the resource allocations within the family, and as a result will affect the well-being of the children in such families. In the present study, we are using the most recent Taiwan data to answer these questions.

23In this paper we first examine the fertility trends of Taiwan for the past several decades. It is obvious that Taiwan has fallen below the replacement level of fertility since the 1980s, and the level of fertility still continues to fall, up to the present time. The links between parental attitudes toward raising child with their decisions on bearing and educating children have not been empirically investigated comprehensively with respect to reducing family size in Taiwan and in other Asian societies with the same fertility levels. With small family size as a prevailing societal norm, Taiwanese society presently pays much more attention to children’s quality than before. In Taiwan’s current society, because each household has fewer children, children have opportunities to seek much higher education than their previous cohorts. They also have access to more and better health care. The introduction of national health insurance (NHI), in particular, has brought about an advance in access to health care for children. In spite of this amelioration, more needs to be done in order to effectively improve children’s utilization of health care. For example, children rely on their parents for utilizing access to health care, and it is thus important to understand parental behaviour with respect to investment in child health in order to ensure the adequate utilization of children’s health care, especially in light of the fact that son preference still prevails in Taiwan. To furnish knowledge in this regard, this study empirically examines the relationships of parental values and attitudes in raising children with their behaviours related to children’s health, and especially with respect to children’s well-being.

24The results indicate links between parental values and attitudes toward raising children and their investment in child health in Taiwanese society, where small family size is now the norm. However, certain legacies of traditional patriarchal family practices still play an important role in Taiwan. In particular, they show that parents who expect more monetary transfers from children in the future tend to use more preventive care for children. These findings also show that parents who pay more attention to children’s loveliness and see them as symbols of extending life or emphasize children’s happiness are also more likely to utilize children’s preventive care. Such findings are consistent with wealth flow between parents and children in society (Caldwell 1976, Caldwell and Caldwell 1987) and with anthropological research on gender-specific intra-household resource allocation (Greenhalgh 1985, Preiffer, Gloyd, and Li 2001).

25The results also furnish evidence that parents invest more in child health if they expect more monetary rewards or obtain more psychological satisfaction from children. Nevertheless, these findings only help answer part of the relevant questions, while many puzzles remain. For example, it is interesting that many parents express that they regard children’s health as the most wanted characteristic of children for them. But parents who express that they deem children’s happiness to be the most important quality of children invest more in children’s preventive care than other parents, including those expressing that they deem children’s health to be the most important quality of children. More research is needed to explore whether such a phenomenon implies that many parents choose ‘health’ as their answer in the field survey because it is a more socially acceptable answer and comes to mind easily. But parents who choose ‘happiness’ as the answer actually tend to deliberate the meaning of raising children more deeply. It also calls for more research on the reasons why the pattern of the effects of parental values and attitudes for children’s preventive services are somewhat different for different types of children’s preventive care.

26Finally, two additional phenomena are worthy of more attention and research. First, the utilization rate of children’s preventive care in Taiwan appears to be quite low, regardless of a child’s birth rank and sex. How to interpret such a phenomenon requires more careful investigation. If seems unreasonable to conclude that Taiwanese parents tend to under-invest in children’s human capital. In contrast, this may imply that the value of children’s preventive care is quite low in the minds of Taiwanese parents. Second, the fact that parental values and attitudes toward raising children do not seem to affect the probability of using preventive services provided by NHI suggests that parents may not view preventive care provided by NHI as a good investment tool for child health. This tends to indicate a necessity to improve the quality of such health care offered by the government, and this is an issue that deserves more attention from the government agencies.

Bibliographie

References

Caldwell, J.C. (1976), ‘Toward a Restatement of Demographic Transition Theory’, Population and Development Review, No. 2, pp. 321-66.

Caldwell, J.C. and Caldwell, P. (1990), ‘High Fertility in Sub-Saharan Africa’, Scientific American, No. 262, pp. 118-25.

Chang, M.C. (2002), ‘Demographic Transition in Taiwan’, Journal of Population and Social Security (Population), Supplement to Vol. 1, pp. 611-28.

Das Gupta, M. and LI, S. (1999), ‘Gender Bias and Marriage Squeeze in China, South Korea and India 1920-1990: The Effects of War, Famine and Fertility Decline’, Development and Change, No. 30, pp. 619-52.

Freedman, R., Chang, M.C. and Sun, T.H. (1994), ‘Taiwan Transition from High Fertility to Below-Replacement Levels’, Studies in Family Planning, No. 25, pp. 316-31.

Greenhalgh, S. (1985), ‘Sexual Stratification: The Other Side of “Growth with Equity” in East Asia’, Population and Development Review, No. 11, pp. 265-314.

Hull, T.H. (1990), ‘Recent Trends in Sex Ratios at Birth in China’, Population and Development Review, No. 16, pp. 63-83.

Leventhal, G.S. (1980), ‘What Should Be Done with Equity Theory? New Approaches to the Study of Fairness in Social Relationships’, in Gergen K.J., Greenbers M.S. and Willis R.H. (eds.), Social Exchange: Advances in Theory and Research, New York: Plenum, pp. 27-53.

Li, S. and Zhu, C.Z. (2001), Research and Community Practice on Gender: Difference in Child Survival in China. Beijing: China Population Publishing House.

Lin, H. and Lee, H.C. (1999), ‘The Crossroads of Ethnicity and Gender: Intergenerational Household Resource Allocation Strategies in Taiwan’, Journal of Social Science and Philosophy, No. 11, pp. 475-528 (In Chinese).

Park, C.B. and Cho, N.H. (1995), ‘Consequences of Son Preference in a Low-Fertility Society: Imbalance of the Sex Ratio at Birth in Korea’, Population and Development Review, No. 21, pp. 59-84.

Poston, D.L. Jr. (2000), ‘Social and Economic Development and Fertility Transition in Mainland China and Taiwan’, Population and Development Review, No. 26 (Supplement), pp. 40-60.

Poston, D.L. Jr., Gu, B., Liu, P. and McDaniel, T. (1997), ‘Son Preference and the Sex Ratio at Birth in China: A Provincial Level Analysis’, Social Biology, No. 44 (1-2), pp. 55-76.

Poston, D.L. Jr., Wu, J.J., Yuan, M.M. and Glover, K.S. (2000), ‘Patterns and Variations in the Sex Ratio at Birth in China and Taiwan’, Paper presented at the Annual Meeting of The North American Chinese Sociologists Association, Washington, D. C., USA, August 11.

Poston, D.L. Jr. (2002), ‘Taiwan’s Demographic Destiny: Marriage Market and Aged Dependency Implications for the 21st Century’, Paper presented at the International Conference on Allocation of Social and Family Resources in Changing Societies, Taipei, Taiwan, December 4-6.

Preiffer, J., Gloyd, S. and Li, L.R. (2001), ‘Intra-household Resource Allocation and Child Growth in Mozambique: An Ethnographic Case-Control Study’, Social Science & Medicine, No. 53, pp. 83-97.

Safilios-Rothschild, C. (1980), ‘The Role of the Family in Development’, Finance and Development, No. 12, pp. 44-47.

Hsieh, Y.S. and Cheng, C.C. (1998), ‘Children Sex Preference and Fertility Behavior of the Family in Taiwan’, Paper presented at the Annual Population Association Meeting of Taiwan, Taipei, Taiwan, December (In Chinese).

Zeng, Y., Tu, P., Gu, B., Xu, Y., Li, B. and Li, Y. (1993), ‘Causes and Implications of the Recent Increase in the reported Sex Ratio at Birth in China’, Population and Development Review, No. 19, pp. 283-302.

Table des illustrations

Titre Table 2: Sex ratios of children under five years of age, Taiwan, 1990-2002
Légende Source: Ministry of Interior Affairs, Taiwan (1991-2003).
URL http://books.openedition.org/ifp/docannexe/image/4552/img-1.jpg
Fichier image/jpeg, 56k
Titre Table 3: Sex ratios of children under five years of age by administrative areas, Taiwan, 1990-2002
Légende Source: Ministry of Interior Affairs, Taiwan (1991-2003).
URL http://books.openedition.org/ifp/docannexe/image/4552/img-2.jpg
Fichier image/jpeg, 188k
Titre Table 4: Sex ratio at birth by order and family size, Taiwan, 1992, and Korea, 1991
Légende Sources: a 1992 Taiwan Fertility Survey (adapted from Shih and Cheng 1998).b 1991 Fertility and Family Health Survey (adapted from Park and Cho 1995).
URL http://books.openedition.org/ifp/docannexe/image/4552/img-3.jpg
Fichier image/jpeg, 116k
Titre Table 5: Sex ratios of last-born children and earlier children: Taiwan, 1992, and Korea, 1991
Légende Sources: a 1992 Taiwan Fertility Survey (adapted from Shih and Cheng 1998).b 1991 Fertility and Family Health Survey (adapted from Park and Cho 1995).
URL http://books.openedition.org/ifp/docannexe/image/4552/img-4.jpg
Fichier image/jpeg, 60k
Titre Table 6: Selected characteristics regarding values or attitudes toward raising children
Légende Notes: 1. The number of observations is 1130.2. The corresponding utilization rate of children’s preventive care refers to the utilization rate for the group of parents with that specific characteristic.
URL http://books.openedition.org/ifp/docannexe/image/4552/img-5.jpg
Fichier image/jpeg, 116k
Titre Table 7: Selected results regarding the relationships of parental values and attitudes toward raising children with their utilization of children’s preventive services
Légende * indicates significance at the 5 per cent level. ** indicates significance at the 1 per cent level.
URL http://books.openedition.org/ifp/docannexe/image/4552/img-6.jpg
Fichier image/jpeg, 180k

Auteurs

Sun Yat-Sen Institute for Social Sciences and Philosophy,
Academia Sinica
128 Yen-Chiu-Yuan Road, Sec. 2, Taipei, 115, TAIWAN
yang@ccvax.sinica.edu.tw

Division of Health Policy Research,
National Health Research Institutes
2F, 109 Ming-Chuan East Road,
Sec. 6, Taipei 114, TAIWAN

© Institut Français de Pondichéry, 2005

Conditions d’utilisation : http://www.openedition.org/6540

Acheter

Rechercher dans OpenEdition Search

Vous allez être redirigé vers OpenEdition Search