China Report

China Report; 56 (3)

An Introductory Note for the Articles

Demographic debates in the decades following the 1960s have shaped much of the discourse on population ageing across the world. This paper by Kavita Sivaramakrishnan traces these discourses and research agendas that led to the understanding of demographic transitions in the developed and developing world. The policies were mostly articulated by demographers from the US and ageing was seen more as a challenge for the West. The questions addressed in this paper are that apart from the predictable and unchanging vulnerabilities of ageing voiced earlier by anthropologists and social workers in the 1940–1950s, what were the new risks being articulated by development experts? Once a diffused ‘world’ agenda was articulated and largely left adrift without resources, what were its afterlives? How did experts in various parts of the world redeploy the global ageing agenda and plan to assert various other alignments? Where did China and India figure in this?

In this article, Madhurima Nundy and Rama V. Baru, look at the arrangements for the care of the elderly in Shanghai through the conceptual framework of the ‘care diamond’ and ‘continuum of care’. The findings, that are based on fieldwork conducted by the authors in Shanghai, delineate what constitutes care diamond in the city for the elderly population. This is mapped through the levels of care from home-based to tertiary-level end-of-life services that are needed by the elderly population. It also looks at the emerging markets of care in this sector and discusses whether multiple actors providing a range of services achieve a continuum of care for Shanghai’s elderly population.

This study by Zhu Bifan, Li Fen, Wang Linan, Wang Changying and Jin Chunlin, aims to summarise the characteristics of the elderly care system and analyse expenditures of healthcare for the elderly in Shanghai. The authors use medical records of 2015 and health account results of 2014 based on the System of Health Accounts 2011 to describe the pattern of care expenditures for the elderly. Individuals aged 60 years and above account for 19.5 per cent of Shanghai’s population but utilise 52.2 per cent of all outpatient visits and 45.3 per cent of all hospitalisations. Almost two-thirds of their medical expenditures occur in hospitals and 16 per cent in community health centres, corresponding to the status of resource allocation. The out-of-pocket payment ratio of the elderly is lower than that of the younger adults, which is attributable to the preferential reimbursement policies set by the insurance schemes. The leading causes of expenditures are cardiovascular disease, neoplasms and respiratory diseases. Care for the elderly costs more, and the elderly use more services than other age groups. The article recommends the monitoring of irrational utilisation of services, strengthening of primary level care and integration of services across different facilities to streamline care for the elderly in Shanghai.

This article by S. Irudaya Rajan, Aneeta Shajan and S. Sunitha presents an overview of the elderly in Kerala and describes various dimensions of elderly care and concerns, based on data from the Kerala Ageing Survey (KAS) 2013, conducted by the Centre for Development Studies (CDS), Thiruvananthapuram, Kerala. The article looks into the main issues, policies and programmes related to ageing and elderly care practices in Kerala and also addresses the basic care response at three levels: household, institutional and society. The ageing process in Kerala is witnessing an increase in the ratio of elderly population along with fundamental changes in families and communities. Hence, in order to accommodate the needs of the ageing population in society, various systems need to be reconstructed. The concerns and issues surrounding the ageing population require long-term attentiveness and forward planning, where policies must be adopted with consideration for cultural and social contexts. Care for the elderly should focus on a holistic combination of health care, socio-economic protection and provision of a suitable environment for a better quality of life.

The COVID-19 pandemic has dented China’s image as an efficient party-state, given how an effort to cover up the outbreak and the resulting delays in reporting led to the virus spreading beyond its origins in Wuhan in Hubei province to the rest of the country as well as rapidly across the world. This article by Jabin T. Jacob examines China’s massive external propaganda effort launched as part of the effort to repair the damage to its global image and interests. It notes how China has not let the situation stop it from pursuing its traditional foreign policy and security interests, including, of competition with the USA. The article also argues that it is the ruling Communist Party of China’s concerns about its legitimacy at home that have determined the nature and scale of Chinese responses to the pandemic outside its borders.

China’s automobile industry has succeeded remarkably since the 1980s. The Chinese government welcomed foreign automobile companies to form joint ventures. The local automobile companies began to enter the market in the late 1990s. To compete with foreign rivals, they needed to acquire advanced technologies. Meanwhile, technology transfer through foreign direct investment (FDI) inflows were not so successful. Some of the local automobile producers developed their technologies through FDI outflows. The large local automobile producers have paid much attention to their own research and development (R&D) activities. China has tried hard to build its human capital. Acquiring intellectual property rights from foreign manufacturers has been another way for local producers to acquire advanced technologies. They have also tried to establish partnerships with local technology groups. In this article Jinglin Dong and Jai S. Mah describe the ways in which the local automobile companies acquired advanced technologies may provide meaningful policy implications for the other technology-intensive industries and developing countries trying to develop the automobile industry.


I Articles


  • Making Age a Global Agenda: India, China and Beyond
    Kavita Sivaramakrishnan
  • ‚ÄčArrangements for the Care of Elderly in Shanghai
    Madhurima Nundy, Rama V. Baru
  • Patterns of Expenditure in Healthcare for Elderly Care in Shanghai
    Zhu Bifan, Li Fen, Wang Linan, Wang Changying, Jin Chunlin
  • Ageing and Elderly Care in Kerala
    S. Irudaya Rajan, Aneeta Shajan, S. Sunitha
  •  ‘To Tell China’s Story Well’: China’s International Messaging during the COVID-19 Pandemic
    Jabin T. Jacob
  • Technology Acquisition in China’s Automobile Industry: Focusing on the Local Producers
    Jinglin Dong, Jai S. Mah


II Book Reviews

  • Book Review: Rory Medcalf, Indo – Pacific Empire: China, America and the Contest for the World’s Pivotal Regions
    Adveetya Kachiar
  • Book Review: Jean A. Berlie (Ed.), China’s Globalization and the Belt and Road Initiative
    Punsara Amarsinghe, Sanjay Kumar Rajhans
  • Book Review: Els Van Dongen, Realistic Revolution: Contesting Chinese History, Culture, and Politics after 1989
    Brij Tankha




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