China continues to face the challenge of declining birth rates, leading to adjustments in education and healthcare institutions in many county towns. In Inner Mongolia’s Jiuyuan District, it was announced that Zhaonan Primary School would stop enrolling first-grade students starting from the autumn of 2025, with the original catchment area students being merged into the central school. Similarly, in the Pingchuan District of Baiyin, Gansu Province, a hospital announced months ago that it would cease outpatient services and no longer accept new patients. Recently, there have been announcements of school consolidation, enrollment freezes, and healthcare institutions discontinuing services in various locations.
The government of Jiuyuan District in Hohhot, Inner Mongolia, recently announced adjustments to the enrollment of Zhaonan Primary School. Starting from the autumn of 2025, the first grade will no longer accept new students, and students from the original school district will be transferred to Machi Central School. Following the announcement, parents of nearby students told reporters that admission arrangements would be communicated to them again during the summer break.
An anonymous Mongolian teacher in Hohhot mentioned that many schools in the area are downsizing due to the difficulty in attracting students. Schools that are unable to enroll enough students have to reduce the number of classes, leading some teachers to opt for early retirement. The situation is particularly prominent in Hohhot due to its high population density and the abundance of schools. Following the halt in enrollment at primary schools, students are required to transfer to central schools. Some parents expressed concerns about the need to rearrange their children’s commuting arrangements, which would incur additional transportation expenses.
The teacher also pointed out that with a decrease in the number of newborns, some hospitals have consolidated their obstetrics and gynecology departments into larger medical facilities.
According to media reports, a county-level hospital in Ganzhou City, Jiangxi Province, stopped providing inpatient delivery services for obstetrics since September 8, 2024, citing business integration as the reason. Local residents commented online that delivery services would need to be redirected to another hospital campus.
On October 28, the Health Commission of Shishou City, Hubei Province, announced that starting from September 29, 2025, the clinical obstetrics and neonatology services at the People’s Hospital, Traditional Chinese Medicine Hospital, and various township health centers would be consolidated at the Maternal and Child Health Hospital of the city. In April, Guangdong province announced the consolidation of 50 birthing-related procedures into 30.
Ms. Lin, an industry insider in the Xiamen healthcare system, explained to reporters that the reduction in obstetrics services across hospitals is associated with the trend of declining birth rates. She noted that the number of deliveries has been decreasing annually, resulting in numerous midwives struggling to secure employment. Some hospitals have integrated obstetrics into their maternal and child healthcare system, a trend that has become particularly noticeable in the past two years.
The Chinese Communist Party’s civil affairs and health departments have released the latest population data indicating a decline in the number of newborns. As a response, some kindergarten classes in county towns have been downsized, with private institutions announcing plans to cease operations. A kindergarten teacher named Qiu Xiuli (pseudonym) from Zhengzhou, Henan Province, disclosed that multiple classes have been merged into the same classroom this semester. The issue of insufficient enrollment in kindergartens has been prevalent for the past five years, becoming more pronounced in the last year.
Documents from the Chinese Communist Party’s Ministry of Education suggest that rural primary schools and township schools are adjusting their configurations based on local conditions, with many focusing on consolidating small-scale schools under central schools’ leadership. A recent report by “Nanfang Renwu Zhoukan” highlighted the case of a primary school in Hengshan County, Hunan Province, where there were 43 students in the sixth grade last academic year but only 2 enrolled in the first grade this year. Some township schools have a teacher-student ratio approaching 1:5, making it unsustainable to maintain standalone classes for certain grades. Research in Jiangxi Province indicates a projected reduction of over 15% in primary school enrollment from 2023 to 2027.
A teacher in Hunan informed reporters that the integration of central schools is expanding, resulting in widening gaps between schools. The teacher mentioned that as students consolidate into central schools, it becomes increasingly challenging for township schools to maintain class sizes.
Statistics from the National Bureau of Statistics of China released on January 17, 2024, revealed a continued decline in the country’s population due to the number of deaths surpassing births, marking the third consecutive year of decrease in mainland China’s population.
Data indicates that China’s total population in 2024 was approximately 1.408 billion, reduced by 1.39 million from 2023’s 1.409 billion. Considering the Communist Party’s consistent data falsification, the actual population in China is likely less than reported.
Official figures from the Chinese government showed a slight increase in the number of births in 2024, rising from 9.02 million in 2023 to 9.54 million. However, experts believe that this upward trend is unlikely to be sustained.
By the end of this century, the number of childbearing women in China (defined by the United Nations as aged 15 to 49) is expected to decrease by over two-thirds, falling to less than 100 million. Zhao Litao, a senior researcher at the East Asia Institute of the National University of Singapore, noted that the recent increase in births in 2024 is unlikely to continue given the anticipated sharp decline in the population of childbearing women in the coming decades.
“Long-term trends indicate a decline in birth rates, overall population contraction, and a faster pace of aging,” Zhao said.
Local statistics show that the population of several provinces’ county towns is lower than that recorded in the previous census round. Job postings in parts of Sichuan and Jilin mentioned a shortage of applicants. A local enterprise leader in Sichuan mentioned that after a decline in local labor force, the placement rate of workers needs to be reevaluated.
Scholar Mr. Qian highlighted that the continuous decline in the number of newborns is reshaping the scale of grassroots public services. He emphasized that the recent announcements of enrollment freezes, class consolidations, and facility adjustments across different regions indicate that these changes are taking effect. Many county towns are reconfiguring their educational and healthcare infrastructure, a trend that is expected to persist in the short term.
Mr. Qian expressed that if the population continues to decline, some regions may witness further consolidation of schools and hospitals. Local authorities need to anticipate these shifts in advance to prevent service gaps.
Currently, adjustment notices released by the Chinese government continue to demonstrate the extension of education and healthcare services to grassroots levels. County-level departments have mentioned in public data that they will promote school consolidation and facility layout based on existing plans. Several teachers and industry professionals believe that similar arrangements may continue into the next academic year. Localities will update notifications according to changes in population and service demand, with different regions likely to announce further enrollment freezes, class consolidations, and facility adjustments.