Ensuring Health Care for the Rural Poor: alternative approaches in China and Vietnam
A comparative study of rural health care services undertaken in collaboration with partners in Vietnam and China.
Economic reforms in China and Vietnam have resulted in strong economic growth and in both countries most people are enjoying rising incomes. However, for a sizeable minority of the populations benefits have been limited, inequalities in income have increased between both regions and households and many people still live in poverty.
In the context of economic transition, the health sector has been liberalised in the two countries and households face fees within and without the public health service. The poor, especially in low income rural areas, now find health care much less accessible and affordable, and illness related costs contribute significantly to impoverishment. At the same time rural health workers respond to market incentives by over using drugs and other medical interventions and by moonlighting, to the detriment of the delivery of basic preventive and curative care. In this environment rural health authorities have difficulty in exercising effective supervisory and regulatory control on both public and private health care and in ensuring the efficient provision of essential health services of acceptable quality and responsiveness. These problems are of current concern to the governments of both China and Vietnam.
This comparative study is intended to encourage greater collaboration between researchers and policy makers from the two countries, allow lessons to be learnt by both parties and make a substantial contribution to the formulation of pro-poor health sector policies. The conclusions may have general applicability in transitional economies, as well as in developing market economies of the region and wider afield.
The initial phase, starting in April 2003, focuses on an investigation of the Chinese rural health care system by a team of Vietnamese researchers.
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