Newborn Screening and the Relaxation of One Child Policy in Mainland China

Newborn screening for a number of disorders including phenylketonuria (PKU) and congenital hypothyroidism (CH) is widely used as a measure of public health.The Chinese Ministry of Health implements the recommendations of neonatal screenings at the provinces level. With the relaxation of one-child policy approved later in 2013, China is expected to at least have a total population of 13.5 billion by 2021, which is about 10 times the population in 2011. With such a large population and additional births in the years to come, challenges in China's neonatal screening programs, such as capacity, costs and delivery of care will need to be revisited. In light of the relaxation of this policy, the Chinese government would need to be ready to cover screening costs for potentially a 400 million newborns in the next 30 years. The aims of the current study are 1) to discuss the reasons for the past low neonatal screening coverage rate in China, and 2) to explore the potential challenges of China’s neonatal screening programs after the relaxation of one-child policy. Barriers to the success of the program could be identified so that benefits of increasing neonatal screening coverage rate in China could be optimal. This paper will help raise government’s awareness of prompt preparations to meet the neonatal screening service needs of more babies in the near future. Our recommendation for the government is to build one entity that is responsible for making recommendations of screening programs, supervising quality control, conducting evidence-based research.