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Globalization and Health
Published in: Globalization and Health 1/2019

Open Access 01-12-2019 | Public Health | Research

The development and reform of public health in China from 1949 to 2019

Authors: Li Wang, Zhihao Wang, Qinglian Ma, Guixia Fang, Jinxia Yang

Published in: Globalization and Health | Issue 1/2019

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Abstract

Background

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.

Methods

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.

Results

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.

Discussion

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.

Conclusion

Public health in China needs to focus on prevention, strengthen multi-agency coordination mechanism, improve the quality of public health services in the future.
Footnotes
1
The data of “Xinjiang Production and Construction Corp”was collected separately from those of Xinjiang Vigor Autonomous Region. the autonomous region. “Xinjiang Production and Construction Corp” is an important component of Xinjiang Vigor Autonomous Region and responsible for both national government and the autonomous region. The Corp has its own administrative and judicial system.
 
2
Calculated with the data from China’s Statistic Yearbook of Health and Family Planning 2017.
 
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Metadata
Title
The development and reform of public health in China from 1949 to 2019
Authors
Li Wang
Zhihao Wang
Qinglian Ma
Guixia Fang
Jinxia Yang
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Public Health
Published in
Globalization and Health / Issue 1/2019
Electronic ISSN: 1744-8603
DOI
https://doi.org/10.1186/s12992-019-0486-6

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