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People's Republic of China: Toward Establishing A Rural Health Protection System

E-mail or fax the Publications Unit at + 632 636 2648 to order the printed version of this publication. Applicable shipping cost will be charged. View Document  Books, Periodicals, Studies, and Reports ISSN: 0090909-5 Publication Date: September 2002 In stock

ADB has financed several technical assistance projects to help the People’s Republic of China (PRC) in reforming its social security policies and strengthening the institutional capabilities to manage social security.

The technical assistance study examined options and strategies for introducing unified pension and medical insurance schemes in rural areas. The studies were conducted during March - July 2001.

This report on rural health protection systems draws information from an earlier survey of 10 rural counties conducted by the Harvard School of Public Health for UNICEF. Although rural pension is a relatively new concept, PRC has had a successful rural cooperative medical scheme from the 1950s to 1980s. This contributed to significant improvement in public health.

The report

• recommends a decentralized approach due to different levels of economic development in rural areas
• suggests that Government provide financial support for medical assistance programs in the western low-income region
• suggests the reinstatement of the rural cooperative medical system in the central middle-income region so as to improve financial sustainability and operational efficiency of basic health care

This report is being published at the request of the PRC Government to disseminate the findings of the study to a wider audience – government officials, academics, bilateral and multilateral development agencies.

View the document [ PDF: 678kb | 91 pages ]. To read, you need Acrobat.

Contents

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Foreword [ PDF: 63kb | 1 page ]

Executive Summary [ PDF: 633kb | 5 pages ]

1. Introduction [ PDF: 73kb | 12 pages ]

   1. Background and Issues
   2. Historical Development of the Health System
   
   

2. The Need for Health Protection System for the Rural Population [ PDF: 119kb | 17 pages ]

   1. Health Systems and Health Protection Systems
   2. Financial Burden of Medical Costs
   3. Health Protection System and Health Care Utilization
   4. Health Protection System and Provision of Primary Health Care Services
   
   

3. Major Issues Underlying Development of the PRC's Rural Health Protection Systems [ PDF: 114kb | 17 pages ]

   1. Existing Rural Health Protection Schemes
   2. Socioeconomic Context for Rural Health Protection Systems
   3. People’s Willingness to Participate in Rural Health Protection Systems
   4. Organization and Management
   5. Government Support and Rural Health Protection Systems
   
   

4. Conclusions and Policy Recommendations [ PDF: 58kb | 9 pages ]

   1. The “Three Worlds” and Three Models
   2. Critical Policy Areas for Developing Rural Health Protection Systems
   
   

Appendixes [ PDF: 90kb | 16 pages ]

1. The Cooperative Medical System and Primary Health Care Supply
2. China's Community Financing Schemes
3. Demand for Community Payment Schemes
4. Participants at the High-Level Forum on Poverty Analysis

Tables [ PDF: 24kb | 5 pages ]

References [ PDF: 31kb | 5 pages ]