This practice paper is one of a series, in which development practitioners reflect on their own experiences. Its aim is to contribute to efforts to understand China’s successful management of very rapid change and development.
It explores the relationship between central and local governments in the implementation of change and the role of partnerships between the Chinese government and international and bilateral organisations. It focuses on the health sector, which has experienced major challenges in adapting to the many changes associated with the transition to a market economy.
By the mid-1990s, policymakers had recognised the need to address these challenges, but they did not have a clear understanding of a practical way forward. One government strategy to build this understanding was to collaborate with the World Bank and the Department of International Development of the UK in the design and implementation of a project which encouraged a large number of poor rural counties to test strategies for strengthening their health service.
The end-of-project evaluations documented the many changes they had put into place and the contribution this project made to national policy processes.