The development and reform of public health in China from 1949 to 2019
Identifieur interne : 000A80 ( Main/Exploration ); précédent : 000A79; suivant : 000A81The development and reform of public health in China from 1949 to 2019
Auteurs : Li Wang ; Zhihao Wang ; Qinglian Ma ; Guixia Fang ; Jinxia YangSource :
- Globalization and Health [ 1744-8603 ] ; 2019.
Abstract
Public health system plays a vital role in the development of health sector in China and protects the health of Chinese people. However, there are few comprehensive reviews and studies focusing on its evolution and reform. It is worthwhile to pay attention to the public health development in China, given that the history and structure of public health system have their own characteristics in China.
The study is a retrospective review of the development public health over seven decades in China. It presents the findings from some national or provincial survey data, interviews with key informants, reviews of relevant published papers and policy contents.
This study identified four key stages that public health experienced in China: the initial stage centering on prevention, the stage of deviation with more attention to treatment but little to prevention, the recovery stage after SARS(Severe Acute Respiratory Syndromes) Crisis, and the new stage to an equitable and people-centered system. In the latest stage, the National Basic Public Health Service Program (NBPHSP) is implemented to respond the threat of noncommunicable diseases (NCDs) and has achieved some initial results, while there are still many challenges including service quality, poor integration among service items and IT system, lack of quality professionals and insufficient intersectoral endeavor.
There are unique Chinese wisdom and remarkable achievements as well as twists and turns on the development of China’s public health. Prevention-first, flexible structure of the system, multi-agency collaboration and mass mobilization and society participation are the main experience of public health in early stage. Despite twists and turns since 1980s, public health system in China shows substantial resilience which may be from the government’s continuous commitment to social development and people’s livelihoods and its flexible governance. In 2010s, in order to achieve the well-off society, Chinese government pays unprecedented attention to health sector, which bring a new wave of opportunities to public health such as remaining the NBPHSP for priority. The evolution and reform of China’s public health is based on its national condition, accumulates rich experience but also faces many common worldwide challenges. Getting this development and reform right is important to China’s social and economic development in future, and China’s experience in public health may provide many lessons for other countries.
Public health in China needs to focus on prevention, strengthen multi-agency coordination mechanism, improve the quality of public health services in the future.
Url:
DOI: 10.1186/s12992-019-0486-6
PubMed: 31266514
PubMed Central: 6604346
Affiliations:
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Management,</institution><institution>Anhui Medical University,</institution></institution-wrap>81 Meishan Road, Hefei, 230032 Anhui People’s Republic of China</nlm:aff><wicri:noCountry code="subfield">230032 Anhui People’s Republic of China</wicri:noCountry></affiliation></author><author><name sortKey="Wang, Zhihao" sort="Wang, Zhihao" uniqKey="Wang Z" first="Zhihao" last="Wang">Zhihao Wang</name><affiliation><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="ISNI">0000000121679639</institution-id><institution-id institution-id-type="GRID">grid.59053.3a</institution-id><institution>The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China,</institution></institution-wrap>17 Lushan Road, Hefei, Anhui 230001 People’s Republic of China</nlm:aff><wicri:noCountry code="subfield">Anhui 230001 People’s Republic of China</wicri:noCountry></affiliation></author><author><name sortKey="Ma, Qinglian" sort="Ma, Qinglian" uniqKey="Ma Q" first="Qinglian" last="Ma">Qinglian Ma</name><affiliation><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9490 772X</institution-id><institution-id institution-id-type="GRID">grid.186775.a</institution-id><institution>Department of Medical Law,</institution><institution>Anhui Medical University,</institution></institution-wrap>81 Meishan Road, Hefei, 230032 Anhui People’s Republic of China</nlm:aff><wicri:noCountry code="subfield">230032 Anhui People’s Republic of China</wicri:noCountry></affiliation></author><author><name sortKey="Fang, Guixia" sort="Fang, Guixia" uniqKey="Fang G" first="Guixia" last="Fang">Guixia Fang</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9490 772X</institution-id><institution-id institution-id-type="GRID">grid.186775.a</institution-id><institution>School of Health Services Management,</institution><institution>Anhui Medical University,</institution></institution-wrap>81 Meishan Road, Hefei, 230032 Anhui People’s Republic of China</nlm:aff><wicri:noCountry code="subfield">230032 Anhui People’s Republic of China</wicri:noCountry></affiliation></author><author><name sortKey="Yang, Jinxia" sort="Yang, Jinxia" uniqKey="Yang J" first="Jinxia" last="Yang">Jinxia Yang</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 9490 772X</institution-id><institution-id institution-id-type="GRID">grid.186775.a</institution-id><institution>School of Health Services Management,</institution><institution>Anhui Medical University,</institution></institution-wrap>81 Meishan Road, Hefei, 230032 Anhui People’s Republic of China</nlm:aff><wicri:noCountry code="subfield">230032 Anhui People’s Republic of China</wicri:noCountry></affiliation></author></analytic><series><title level="j">Globalization and Health</title><idno type="eISSN">1744-8603</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p id="Par1">Public health system plays a vital role in the development of health sector in China and protects the health of Chinese people. However, there are few comprehensive reviews and studies focusing on its evolution and reform. It is worthwhile to pay attention to the public health development in China, given that the history and structure of public health system have their own characteristics in China.</p></sec><sec><title>Methods</title><p id="Par2">The study is a retrospective review of the development public health over seven decades in China. It presents the findings from some national or provincial survey data, interviews with key informants, reviews of relevant published papers and policy contents.</p></sec><sec><title>Results</title><p id="Par3">This study identified four key stages that public health experienced in China: the initial stage centering on prevention, the stage of deviation with more attention to treatment but little to prevention, the recovery stage after SARS(Severe Acute Respiratory Syndromes) Crisis, and the new stage to an equitable and people-centered system. In the latest stage, the National Basic Public Health Service Program (NBPHSP) is implemented to respond the threat of noncommunicable diseases (NCDs) and has achieved some initial results, while there are still many challenges including service quality, poor integration among service items and IT system, lack of quality professionals and insufficient intersectoral endeavor.</p></sec><sec><title>Discussion</title><p id="Par4">There are unique Chinese wisdom and remarkable achievements as well as twists and turns on the development of China’s public health. Prevention-first, flexible structure of the system, multi-agency collaboration and mass mobilization and society participation are the main experience of public health in early stage. Despite twists and turns since 1980s, public health system in China shows substantial resilience which may be from the government’s continuous commitment to social development and people’s livelihoods and its flexible governance. In 2010s, in order to achieve the well-off society, Chinese government pays unprecedented attention to health sector, which bring a new wave of opportunities to public health such as remaining the NBPHSP for priority. The evolution and reform of China’s public health is based on its national condition, accumulates rich experience but also faces many common worldwide challenges. Getting this development and reform right is important to China’s social and economic development in future, and China’s experience in public health may provide many lessons for other countries.</p></sec><sec><title>Conclusion</title><p id="Par5">Public health in China needs to focus on prevention, strengthen multi-agency coordination mechanism, improve the quality of public health services in the future.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Huang, Y" uniqKey="Huang Y">Y Huang</name></author><author><name sortKey="Zeng, L" uniqKey="Zeng L">L Zeng</name></author><author><name sortKey="Li, Y" uniqKey="Li Y">Y Li</name></author><author><name sortKey="Zhou, X" uniqKey="Zhou X">X Zhou</name></author><author><name sortKey="Liu, P" uniqKey="Liu P">P Liu</name></author><author><name sortKey="Zhong, D" uniqKey="Zhong D">D 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Jakovljevic</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Lee, Yr" uniqKey="Lee Y">YR Lee</name></author><author><name sortKey="Kim, Sy" uniqKey="Kim S">SY Kim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jakovljevic, Mm" uniqKey="Jakovljevic M">MM Jakovljevic</name></author><author><name sortKey="Netz, Y" uniqKey="Netz Y">Y Netz</name></author><author><name sortKey="Buttigieg, Sc" uniqKey="Buttigieg S">SC Buttigieg</name></author><author><name sortKey="Adany, R" uniqKey="Adany R">R Adany</name></author><author><name sortKey="Laaser, U" uniqKey="Laaser U">U Laaser</name></author><author><name sortKey="Varjacic, M" uniqKey="Varjacic M">M Varjacic</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rancic, N" uniqKey="Rancic N">N Rancic</name></author><author><name sortKey="Jakovljevic, Mm" uniqKey="Jakovljevic M">MM Jakovljevic</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jakovljevic, Mb" uniqKey="Jakovljevic M">MB Jakovljevic</name></author><author><name sortKey="Milovanovic, O" uniqKey="Milovanovic O">O Milovanovic</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list></list><tree><noCountry><name sortKey="Fang, Guixia" sort="Fang, Guixia" uniqKey="Fang G" first="Guixia" last="Fang">Guixia Fang</name><name sortKey="Ma, Qinglian" sort="Ma, Qinglian" uniqKey="Ma Q" first="Qinglian" last="Ma">Qinglian Ma</name><name sortKey="Wang, Li" sort="Wang, Li" uniqKey="Wang L" first="Li" last="Wang">Li Wang</name><name sortKey="Wang, Zhihao" sort="Wang, Zhihao" uniqKey="Wang Z" first="Zhihao" last="Wang">Zhihao Wang</name><name sortKey="Yang, Jinxia" sort="Yang, Jinxia" uniqKey="Yang J" first="Jinxia" last="Yang">Jinxia Yang</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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