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China's Rural Public Health System Performance: A Cross-Sectional Study

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  • Miaomiao Tian
  • Da Feng
  • Xi Chen
  • Yingchun Chen
  • Xi Sun
  • Yuanxi Xiang
  • Fang Yuan
  • Zhanchun Feng

Abstract

Background: In the past three years, the Government of China initiated health reform with rural public health system construction to achieve equal access to public health services for rural residents. The study assessed trends of public health services accessibility in rural China from 2008 to 2010, as well as the current situation about the China's rural public health system performance. Methods: The data were collected from a cross-sectional survey conducted in 2011, which used a multistage stratified random sampling method to select 12 counties and 118 villages from China. Three sets of indicators were chosen to measure the trends in access to coverage, equality and effectiveness of rural public health services. Data were disaggregated by provinces and by participants: hypertension patients, children, elderly and women. We examined the changes in equality across and within region. Results: China's rural public health system did well in safe drinking water, children vaccinations and women hospital delivery. But more hypertension patients with low income could not receive regular healthcare from primary health institutions than those with middle and high income. In 2010, hypertension treatment rate of Qinghai in Western China was just 53.22% which was much lower than that of Zhejiang in Eastern China (97.27%). Meanwhile, low performance was showed in effectiveness of rural public health services. The rate of effective treatment for controlling their blood pressure within normal range was just 39.7%. Conclusions: The implementation of health reform since 2009 has led the public health development towards the right direction. Physical access to public health services had increased from 2008 to 2010. But, inter- and intra-regional inequalities in public health system coverage still exist. Strategies to improve the quality and equality of public health services in rural China need to be considered.

Suggested Citation

  • Miaomiao Tian & Da Feng & Xi Chen & Yingchun Chen & Xi Sun & Yuanxi Xiang & Fang Yuan & Zhanchun Feng, 2013. "China's Rural Public Health System Performance: A Cross-Sectional Study," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-10, December.
    • Handle: RePEc:plo:pone00:0083822
    DOI: 10.1371/journal.pone.0083822
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    References listed on IDEAS

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    1. Handler, A. & Issel, M. & Turnock, B., 2001. "A conceptual framework to measure performance of the public health system," American Journal of Public Health, American Public Health Association, vol. 91(8), pages 1235-1239.
    2. Mays, G.P. & McHugh, M.C. & Shim, K. & Perry, N. & Lenaway, D. & Halverson, P.K. & Moonesinghe, R., 2006. "Institutional and economic determinants of public health system performance," American Journal of Public Health, American Public Health Association, vol. 96(3), pages 523-531.
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    Cited by:

    1. Heyuan You & Deshao Zhou & Shenyan Wu & Xiaowei Hu & Chenmeng Bie, 2020. "Social Deprivation and Rural Public Health in China: Exploring the Relationship Using Spatial Regression," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 147(3), pages 843-864, February.
    2. Zheng Xie & Adrienne N Poon & Zhijun Wu & Weiyan Jian & Kit Yee Chan, 2015. "Is Occupation a Good Predictor of Self-Rated Health in China?," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-18, May.

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