The History, Current Status, and Future Prospects of Barefoot Doctors in China China Rural Health Association Dr. Wang Shucheng

Author synopsis Author synopsis Education experience: Education experience: March In 1982, student of Bethune Medical University in Changchun City of clinical study March In 1982, student of Bethune Medical University in Changchun City of clinical study San Diego State University of United States San Diego State University of United States Work experience: Work experience: In Head of PHC Division in Ministry of Health In Head of PHC Division in Ministry of Health 2000 – present China Deputy Director of Rural Health 2000 – present China Deputy Director of Rural Health Association

The definition of barefoot doctors The definition of barefoot doctors

The main contents of the report The main contents of the report Formation and Development of Barefoot Doctors in China Current Situation The Future of Village Doctors in China Case study Experience

Formation and Development of Barefoot Doctors in China

First stage － 1949 to 1965

Formation and Development of Barefoot Doctors in China First stage － 1949 to 1965 Second stage － 1966 to 1978

Formation and Development of Barefoot Doctors in China First stage － 1949 to 1965 Second stage － 1966 to 1978 Third stage － 1978 to present

Current Situation

Village Doctors and Clinics in China

Table1: Number of Village Clinics and Their Health Workers (1) Number of Villages (2) Villages with Clinic % ((2)/(1)) Number of Village Clinics Set-up by villages Joint-venture Branch of Township Health Center Private Others Licensed Assistant Doctors—— Village Doctors& Assistants of which ： Village Doctors Village Doctors& Assistants Per village Village Doctors& Assistants Per 1000 Rural Population Note: （ 1 ） Number of Villages means number of villager committees. （ 2 ） 2005 agriculture population is estimated.

Table 2: No. of Village Clinics and Their Health Workers by Region in 2006 RegionNo. of VillageNo. of Village Clinics% of Villages with Clinic Village Doctors & Assistants Total East Middle West Beijing Tianjing Heibei Shanxi Inner Mongolia Liaoning Jilin Heilongjiang

Table 2: No. of Village Clinics and Their Health Workers by Region in 2006 RegionNo. of VillageNo. of Village Clinics% of Villages with Clinic Village Doctors & Assistants Shanghai Jiangsu Zhejiang Anhui Fujian Jiangxi Shandong Henan Hubei Hunan Guangdong Guangxi

Table 2: No. of Village Clinics and Their Health Workers by Region in 2006 RegionNo. of VillageNo. of Village Clinics% of Villages with Clinic Village Doctors & Assistants Hainan Chongqing Sichuan Guizhou Yunan Tibet Shaanxi Gansu Qinghai Ningxia Xinjiang

Current Situation Village Doctors and Clinics in China Preparation and Qualification of Village Health Workers

Current Situation Village Doctors and Clinics in China Preparation and Qualification of Village Health Workers Responsibilities and Tasks of Village Health Workers

Current Situation Village Doctors and Clinics in China Preparation and Qualification of Village Health Workers Responsibilities and Tasks of Village Health Workers Infrastructure of Village Clinics

Current Situation Village Doctors and Clinics in China Preparation and Qualification of Village Health Workers Responsibilities and Tasks of Village Health Workers Infrastructure of Village Clinics Management of Village Clinics

The Future of Village Doctors in China

Policy Supports

The Future of Village Doctors in China Policy Supports Financial Supports

The Future of Village Doctors in China Policy Supports Financial Supports Education and Technical Support

Case study——Village Clinics in Shenyang City Shenyang city has 8 counties and districts (rural areas) with 1932 villages. In 2001, we randomly selected and surveyed 66 villages at different economic levels. There were 26,460 households in these villages, an average of 401 households with 1,436 persons per village. Total population was 94,754 at these villages. Annual per capita income for peasants in 2001 was 2,637 RMB. There were 123 village clinics at these villages, 1.68 per village, a lower density than the average in the province of 1.74 but higher than that of the country of The average room space of each village clinics was square meter. Capital asserts per village clinic was 7,480 RMB. There were 135 village doctors, 2.05 per village, much higher than that of province and country. 80 village doctors were trained in the past 2 years. The cumulative training time for each doctor was 3.5 months. On average, each doctor served 734 patients. The survey showed that when residents became sick, percent of residents went to village clinics, percent to township health centers, and 1.6 percent to county hospitals and above.

Experience

As the social-economic condition is still under-developed in rural area, government and the people should pay more attention to rural health problems and strive to keep peasants healthy. Due to limited funds, governments should bring up more rural health workers—village doctors, who are suitable to rural situation. As the social-economic condition is still under-developed in rural area, government and the people should pay more attention to rural health problems and strive to keep peasants healthy. Due to limited funds, governments should bring up more rural health workers—village doctors, who are suitable to rural situation.

Experience As the social-economic condition is still under-developed in rural area, government and the people should pay more attention to rural health problems and strive to keep peasants healthy. Due to limited funds, governments should bring up more rural health workers—village doctors, who are suitable to rural situation. As the social-economic condition is still under-developed in rural area, government and the people should pay more attention to rural health problems and strive to keep peasants healthy. Due to limited funds, governments should bring up more rural health workers—village doctors, who are suitable to rural situation. Governments should provide funds and teachers for village doctors’ continuous education so that skill mix of village doctors could meet the increasing medical needs of village residents. Governments should provide funds and teachers for village doctors’ continuous education so that skill mix of village doctors could meet the increasing medical needs of village residents.

Experience As the social-economic condition is still under-developed in rural area, government and the people should pay more attention to rural health problems and strive to keep peasants healthy. Due to limited funds, governments should bring up more rural health workers—village doctors, who are suitable to rural situation. As the social-economic condition is still under-developed in rural area, government and the people should pay more attention to rural health problems and strive to keep peasants healthy. Due to limited funds, governments should bring up more rural health workers—village doctors, who are suitable to rural situation. Governments should provide funds and teachers for village doctors’ continuous education so that skill mix of village doctors could meet the increasing medical needs of village residents. Governments should provide funds and teachers for village doctors’ continuous education so that skill mix of village doctors could meet the increasing medical needs of village residents. In China, township health centers and village clinics are nonprofit health organizations. Keeping their public characteristics would maximally protect health right of peasants. In China, township health centers and village clinics are nonprofit health organizations. Keeping their public characteristics would maximally protect health right of peasants.

Experience As the social-economic condition is still under-developed in rural area, government and the people should pay more attention to rural health problems and strive to keep peasants healthy. Due to limited funds, governments should bring up more rural health workers—village doctors, who are suitable to rural situation. As the social-economic condition is still under-developed in rural area, government and the people should pay more attention to rural health problems and strive to keep peasants healthy. Due to limited funds, governments should bring up more rural health workers—village doctors, who are suitable to rural situation. Governments should provide funds and teachers for village doctors’ continuous education so that skill mix of village doctors could meet the increasing medical needs of village residents. Governments should provide funds and teachers for village doctors’ continuous education so that skill mix of village doctors could meet the increasing medical needs of village residents. In China, township health centers and village clinics are nonprofit health organizations. Keeping their public characteristics would maximally protect health right of peasants. In China, township health centers and village clinics are nonprofit health organizations. Keeping their public characteristics would maximally protect health right of peasants. Village doctors should be supervised and monitored in order to improve their professional competency and prevent wastage and abuse of drugs and supplies. Village doctors should be supervised and monitored in order to improve their professional competency and prevent wastage and abuse of drugs and supplies.

Experience As the social-economic condition is still under-developed in rural area, government and the people should pay more attention to rural health problems and strive to keep peasants healthy. Due to limited funds, governments should bring up more rural health workers—village doctors, who are suitable to rural situation. As the social-economic condition is still under-developed in rural area, government and the people should pay more attention to rural health problems and strive to keep peasants healthy. Due to limited funds, governments should bring up more rural health workers—village doctors, who are suitable to rural situation. Governments should provide funds and teachers for village doctors’ continuous education so that skill mix of village doctors could meet the increasing medical needs of village residents. Governments should provide funds and teachers for village doctors’ continuous education so that skill mix of village doctors could meet the increasing medical needs of village residents. In China, township health centers and village clinics are nonprofit health organizations. Keeping their public characteristics would maximally protect health right of peasants. In China, township health centers and village clinics are nonprofit health organizations. Keeping their public characteristics would maximally protect health right of peasants. Village doctors should be supervised and monitored in order to improve their professional competency and prevent wastage and abuse of drugs and supplies. Village doctors should be supervised and monitored in order to improve their professional competency and prevent wastage and abuse of drugs and supplies. Village doctors could fulfill their responsibility in disease prevention and control by making fuller use of villager committee to carry out the health education and promotion programs. Village doctors could fulfill their responsibility in disease prevention and control by making fuller use of villager committee to carry out the health education and promotion programs.