Community Healthcare’s Future in China: An American Student’s Perspective

Raymond Guo

Raymond Guo,1 Hao Zhang,2 Xuemei Zhen,2 Yuhang Zeng,2 Hengjin Dong2
1Center for Health and Wellbeing, Princeton University, Princeton, NJ, USA
2Center of Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China


The objective of this study was to investigate, in Chinese counties differing in economic development, the extent of the improvement in community healthcare since the 2009 Health Sector Reform and to explore the legacy of the historical barefoot doctors, who were non-profit, government-funded physicians who successfully served the primary healthcare needs of the Chinese rural population of the 1960s and 1970s. For this investigation, ten personal interviews were conducted in each of two different counties in Zhejiang province. Interviewees were primary care doctors, some of whom were also barefoot doctors. The findings revealed that in both counties, doctors reported that the majority of their work was dedicated to public health services, with very little time spent on clinical services, as a result of the implications of the 2009 Health Sector Reform. Many physicians also reported not having adequate medicine provided by the National Essential Medicine List. In this way, the 2009 reforms created a new manifestation of the well-known Chinese saying that criticizes community healthcare, “Lack of clinical doctors, shortage of medicine.” In conclusion, looking ahead to the future of community healthcare and reflecting on the practices of the barefoot doctors, policy should be implemented to increase the provision of clinical services by community doctors, who could then incorporate their public health responsibilities into their medical services.

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