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

3. Author synopsis Author synopsis Education experience: Education experience: March 1978 - In 1982, student of Bethune Medical University in Changchun City of clinical study March 1978 - In 1982, student of Bethune Medical University in Changchun City of clinical study 1988 - 1990 San Diego State University of United States 1988 - 1990 San Diego State University of United States Work experience: Work experience: In 1983 - 1999 Head of PHC Division in Ministry of Health In 1983 - 1999 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

4. The definition of barefoot doctors The definition of barefoot doctors

5. 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

6. Formation and Development of Barefoot Doctors in China

7. First stage － 1949 to 1965

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

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

16. Current Situation

17. Village Doctors and Clinics in China

18. Table1: Number of Village Clinics and Their Health Workers 19851990199520002005 (1) Number of Villages940617743278740150734715652718 (2) Villages with Clinic625992646529655105652923583209 % ((2)/(1))66.687.088.589.883.7 Number of Village Clinics777674803956804352709458583209 Set-up by villages305537266137297462300846313633 Joint-venture880387149906818982838561 Branch of Township Health Center2976929963363884710132396 Private323904381844354981255179180403 Others2966138863248401648618216 Licensed Assistant Doctors—— 103863 Village Doctors& Assistants1293094123151013310171319359916532 of which ： Village Doctors 6430227768599559331019845864168 Village Doctors& Assistants Per village 1.801.641.81 1.40 Village Doctors& Assistants Per 1000 Rural Population 1.551.381.481.441.05 Note: （ 1 ） Number of Villages means number of villager committees. （ 2 ） 2005 agriculture population is estimated.

19. 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 Total62468060912888.1957479 East23857721129779.5328778 Middle20248821223592.9349354 West18361518559694.0279347 Beijing3957276269.84019 Tianjing3825238062.25178 Heibei4911552907100.073038 Shanxi281722212378.546318 Inner Mongolia 1121913066100.017731 Liaoning1176821345100.025854 Jilin9211859493.313188 Heilongjiang905512548100.022482

20. 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 Shanghai1862164288.21919 Jiangsu173031265673.136720 Zhejiang329311643849.915561 Anhui2001922372100.046271 Fujian1448517470100.029452 Jiangxi 17571 22089100.0 35280 Shandong 8128356779 69.9 101813 Henan 4836261336100.0 104788 Hubei 2582824226 93.8 41200 Hunan44270 38227 86.339827 Guangdong 1950524810100.0 32753 Guangxi 1436322367100.035407

21. 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 Hainan2543 210882.9 2471 Chongqing 972210539100.0 21299 Sichuan 50299 51247100.0 73707 Guizhou 19669 19660100.0 26072 Yunan 12882 13608100.0 35478 Tibet 5746 3473 60.4 3167 Shaanxi 27537 25280 91.8 32679 Gansu16823 13781 81.9 17448 Qinghai 4163 4180 100.0 4804 Ningxia2376 2793 100.0 4149 Xinjiang 88165332 60.5 7406

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

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

24. 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

25. 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

37. The Future of Village Doctors in China

38. Policy Supports

39. The Future of Village Doctors in China Policy Supports Financial Supports

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

41. 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 0.98. The average room space of each village clinics was 46.83 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, 76.67 percent of residents went to village clinics, 14.63 percent to township health centers, and 1.6 percent to county hospitals and above.

42. Experience

43. 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.

44. 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.

45. 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.

46. 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.

47. 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.