Policy impact on China's rural health system

Village doctors in rural China are increasingly faced with fewer resources and limited knowledge when it comes to dealing with a wide array of communicable and chronic medical problems. The Chinese government has implemented wide-ranging policy changes to address problems of health care access and quality of care, namely the New Cooperative Medical Scheme and the National Essential Medicines Scheme that prevents providers from profiting from pharmaceutical sales. This paper explores the impacts of these 2009 policy reforms on rural clinics in two areas. First, through quantitative analysis, the impact of the 2009 reforms on clinic revenue is examined. Clinic revenue is an important indicator of whether village and township clinic doctors may seek other means of increasing income that may create skewed prescribing and treatment practices. Second, this paper provides a qualitative analysis of village and township health center doctors’ personal opinions of these health policy reforms. This project is significant for public health because the role of village doctors in China is to provide the first level of health care for the more than 600 million rural inhabitants that comprise half of China’s population. The rural poor are overburdened with both non-communicable and communicable diseases throughout China, a disease pattern that is exacerbated by out-migration to cities of the working-age population, leaving behind the elderly and children in rural areas with little source of income. Furthermore, China’s aging population significantly contributes to the rise in non-communicable diseases. The confluence of a complex disease burden, considerable policy shifts, as well as growing patient demands all affect rural village doctors and their ability to provide quality care for their constituents. Ultimately, this research will provide health care workers, government officials, non-governmental organizations, as well as scholars and researchers, a better understanding of the impacts of major policy reforms on both providers and patients