fbpx 53023-001: Strengthening the Rural Health System in Guangxi Zhuang Autonomous Region | Asian Development Bank

China, People's Republic of: Strengthening the Rural Health System in Guangxi Zhuang Autonomous Region

Sovereign (Public) Project | 53023-001 Status: Active

The knowledge and support technical assistance (TA) will provide research-based solutions in the health sector to support inclusive growth in the People's Republic of China (PRC). It will (i) address institutional challenges, and (ii) promote digital technology and eventually generate regional public goods. The TA will reduce the rural-urban disparity in health service delivery, and support the achievement of Sustainable Development Goal 3 (to ensure healthy lives and promote well-being for all at all ages) and attainment of universal health coverage.

Project Details

Project Officer
Eisuke Tajima East Asia Department Request for information
Country
  • China, People's Republic of
Sector
  • Health
 
Project Name Strengthening the Rural Health System in Guangxi Zhuang Autonomous Region
Project Number 53023-001
Country China, People's Republic of
Project Status Active
Project Type / Modality of Assistance Technical Assistance
Source of Funding / Amount
TA 9886-PRC: Strengthening the Rural Health System in Guangxi Zhuang Autonomous Region
Technical Assistance Special Fund US$ 400,000.00
Strategic Agendas Inclusive economic growth
Regional integration
Drivers of Change Gender Equity and Mainstreaming
Governance and capacity development
Knowledge solutions
Sector / Subsector

Health / Health system development

Gender Equity and Mainstreaming Effective gender mainstreaming
Description The knowledge and support technical assistance (TA) will provide research-based solutions in the health sector to support inclusive growth in the People's Republic of China (PRC). It will (i) address institutional challenges, and (ii) promote digital technology and eventually generate regional public goods. The TA will reduce the rural-urban disparity in health service delivery, and support the achievement of Sustainable Development Goal 3 (to ensure healthy lives and promote well-being for all at all ages) and attainment of universal health coverage.
Project Rationale and Linkage to Country/Regional Strategy

The Government of the Guangxi Zhuang Autonomous Region (GZAR) is committed to the PRC's national rural revitalization strategy as it aims to reinvigorate rural areas to reduce poverty, promote equity, improve rural development, and support green and inclusive growth. Improving access to health services is critical to achieving this goal, particularly in rural areas.

The PRC's health sector has undergone a series of reforms since 2009. These included shifting resources to primary health care (PHC), which has supported the PRC's high level of health coverage and the New Rural Cooperative Medical Scheme, which has become a nationwide comprehensive insurance scheme providing outpatient benefits that target the rural population. The Healthy China 2030 plan-a national strategy approved by the State Council-further guides all provinces and regions, including GZAR, to prioritize improvement of rural PHC quality, through the use of innovations and health system efficiencies, to reduce the burden on hospitals and secondary health facilities. However, there is still a significant gap across the PRC in terms of health care service quality between urban and rural areas. The quality of clinical processes is often left to the discretion of providers, while the quality of health care services is highly dependent on provider capacity. Providers in urban areas typically have more resources and capacity than those in rural areas. GZAR has a rural population of 3 million people in 54 poor counties, and faces considerable challenges in improving rural health care quality, and in implementing Healthy GZAR 2030.

In addition to gaps in quality between urban and rural health services, GZAR also faces health risks stemming from the significant volume of cross border trade with and migration from Viet Nam. Controlling outbreaks and cross border health threats can be a major challenge; in GZAR, animal trade and human migration have the potential to spread communicable diseases across borders. PHC service providers are the first point of contact for early disease detection, treatment, and surveillance. Ensuring high-quality PHC services, especially in rural border areas, can control potential epidemics and protect the health of the population, including vulnerable groups such as internal and cross border migrants. PHC facilities should be strengthened, particularly in rural underserved areas, by improving the quality and capacity of the facilities, as these are the closest diagnostic facilities on the ground and serve as important surveillance points.

GZAR provides free basic public health services to migrants, focusing mainly on maternal and child health and family planning services. Services include immunization, prenatal and postnatal checkups for pregnant women, prevention and control of communicable diseases, and family planning and health education. While basic health care needs are covered, services related to noncommunicable diseases (NCDs) and other clinical services, occupational health, rehabilitation, and palliative care (i.e., inpatient and outpatient services) are not covered for migrants. Such services should be extended to migrants to reduce inequality and improve the overall health of the migrant population.

In addition, GZAR is facing the PRC's broader national challenge of a rapidly aging elderly population. Longer life expectancies are increasing the susceptibility of the elderly to costly prolonged medical issues, particularly NCDs. NCD cases among Chinese people above the age of 40 are predicted to triple over the next 2 decades, while 35% of the PRC's population will be above 60 years of age by 2050. Increasing health care services for major NCDs (asthma, cancer, chronic obstructive pulmonary disease, diabetes, heart disease, hypertension, and stroke) require integration of primary care settings using innovative and cost-effective interventions. ADB has increasingly strengthened its intervention for elderly care in GZAR since 2015. A project approved in September 2019 aims to help GZAR develop a proper integrated health referral system between medical institutions such as hospitals and elderly care institutions, and improve the quality and quantity of elderly care institutions to provide a range of care needs. This effort must be expanded to rural primary health service providers, as they are the first level health care providers in the rural areas.

Although the government has actively promoted the use of digital technology to improve health service delivery and management following the Healthy China 2030 plan, an urban-rural gap remains in terms of the actual use of digital technology in urban and rural health systems. Large hospitals in urban areas are using digital technology to efficiently deliver services and manage overcrowding by queuing patients through online appointment systems, electronic notification of examination results, digital payment systems, and electronic medical records systems. Nevertheless, the use of digital technology in rural health facilities is lagging behind. Online systems to improve family doctor services and remote diagnosis have been designed, but are not fully functional, as rural PHC providers use the system only to settle health insurance claims.

To respond to current gaps in rural health service delivery including the weak adoption of digital technology, rapidly changing needs of the vulnerable rural population, and increasing health risks related to cross border trade and migration; assessments of GZAR's rural health system will be conducted. The TA outputs will help determine interventions that would strengthen GZAR's rural health system.

Impact Rural health system in GZAR strengthened
Project Outcome
Description of Outcome GZAR''s rural primary health system planning and management improved
Progress Toward Outcome
Implementation Progress
Description of Project Outputs

1. Health services in rural areas assessed

2. Application of digital technology for health care services assessed

3. Knowledge on improved rural PHC expanded

Status of Implementation Progress (Outputs, Activities, and Issues)
Geographical Location Guangxi
Summary of Environmental and Social Aspects
Environmental Aspects
Involuntary Resettlement
Indigenous Peoples
Stakeholder Communication, Participation, and Consultation
During Project Design
During Project Implementation
Business Opportunities
Consulting Services The TA will engage both national and international consultants. ADB will engage the consultants and carry out procurement following the ADB Procurement Policy (2017, as amended from time to time) and its associated project administration instructions and/or staff instructions.
Responsible ADB Officer Eisuke Tajima
Responsible ADB Department East Asia Department
Responsible ADB Division Urban and Social Sectors Division, EARD
Executing Agencies
Guangxi Development and Reform Commission
No. 1 Minle Road, Nanning
Guangxi, PRC (Post code: 530012)
Guangxi Zhuang Autonomous Region Health Commission
Minzu Avenue,Nanning,Guangxi Zhuang Autonomous Region
Ministry of Health
Project Management, Foreign Loan Office
Beijing
People's Republic of China
Timetable
Concept Clearance 24 Oct 2019
Fact Finding 16 Sep 2019 to 20 Sep 2019
MRM -
Approval 03 Dec 2019
Last Review Mission -
Last PDS Update 05 Dec 2019

TA 9886-PRC

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
03 Dec 2019 28 Dec 2019 28 Dec 2019 30 Jun 2021 - -
Financing Plan/TA Utilization Cumulative Disbursements
ADB Cofinancing Counterpart Total Date Amount
Gov Beneficiaries Project Sponsor Others
400,000.00 0.00 0.00 0.00 0.00 0.00 400,000.00 03 Dec 2019 0.00

Project Data Sheets (PDS) contain summary information on the project or program. Because the PDS is a work in progress, some information may not be included in its initial version but will be added as it becomes available. Information about proposed projects is tentative and indicative.

The Access to Information Policy (AIP) recognizes that transparency and accountability are essential to development effectiveness. It establishes the disclosure requirements for documents and information ADB produces or requires to be produced.

The Accountability Mechanism provides a forum where people adversely affected by ADB-assisted projects can voice and seek solutions to their problems and report alleged noncompliance of ADB's operational policies and procedures.

In preparing any country program or strategy, financing any project, or by making any designation of, or reference to, a particular territory or geographic area in this document, the Asian Development Bank does not intend to make any judgments as to the legal or other status of any territory or area.

Safeguard Documents See also: Safeguards

Safeguard documents provided at the time of project/facility approval may also be found in the list of linked documents provided with the Report and Recommendation of the President.

None currently available.

Evaluation Documents See also: Independent Evaluation

None currently available.

Related Publications

None currently available.


The Access to Information Policy (AIP) establishes the disclosure requirements for documents and information ADB produces or requires to be produced in its operations to facilitate stakeholder participation in ADB's decision-making. For more information, refer to the Safeguard Policy Statement, Operations Manual F1, and Operations Manual L3.

Requests for information may also be directed to the InfoUnit.

Tenders

No tenders for this project were found.

Contracts Awarded

No contracts awarded for this project were found

Procurement Plan

None currently available.