Primary Research Of Guangxi Maternal & Children Health Expenditure Actuality In County Level

PURPOSE OF THIS RESEARCHPurpose of this research,is to obtain the primary information on the actuality of financing,distribution and utilization of MCH expenditure in county level of Guangxi Zhuang Autonomous Region,and to find the main problems existed in county MCH capital flow of Guangxi,by estimating MCH expenditures for the experimental counties,using the Service-Amount Method combined with Financing-Resource Method and Institutional-Flow-Direction Method.This research can provide valuable information as references for the Government on instituting grassroots MCH related policies.Two counties of Guangxi,Ningming(N County)and Luzhai(L County)were selected as experimental counties in this research.WAY OF OUR RESEARCHResearches and estimation analysis were carried out on MCH expenditure resource,investment,distribution and utilization of the two counties in 2004. The surveyed institutions including:County Health Bureau,County Hospital, Traditional Chinese Medical Hospital,MCH Care Center,Family Planning Institution,Township health clinics and Village clinics.Different sampling methods were adopted during our investigation according to specialties of different institutions.Our investigation methods include questionnaire, information/material collection and face to face interview.Data recording and automatic treatment were done by EXCEL and SPSS software.RESEARCH RESULTSThrough estimating the MCH expenditure of the two project counties and after establishing the Matrix Balance,it is obvious that:1)View from composition of MCH health expenditure by source,the total MCH service financing of N County was 32.555 million yuan RMB in 2004,and L County was 72.428 million yuan RMB.Percents in TEH of the two counties were 5.77%and 7.72%.And were 38.97%and 57.20%in percent of their public health expenditure in each county.And personal financing on health dominated MCH expenditure in both counties.Personal cash disbursements on health were 77.29%and 64.31%in percent of MCH expenditure in the two counties. Governmental appropriation took lower percent in MCH expenditure.And all governmental appropriation came from county finance.Governmental MCH appropriation was mostly stressed on Family Planning Institutions.Especially, Family Planning Institution of N County,its expenditure took nearly 50%in total governmental appropriation.View from the direction of governmental and private finance utilization,governmental appropriation mostly went to family planning service.Percent of expenditure on family planning in governmental appropriation separately reached 47.59%and 45.12%in the two counties. Family health capital was mostly used for health care of pregnant and lying-in women.Expenditure of health care for pregnant and lying-in women took over 80%in family MCH expenditure in both counties.Thereinto,expenditures on Delivery in hospital services were 78.40%and 77.03%.2)View from MCH expenditure institutional distribution,MCH expenditure of N and L County mostly went to County Hospital,County MCH Care Centers and Township Health Clinics in 2004.But differences in distribution between the two counties were obvious.According to different source utilization situations of each institution,MCH care expenditure in the two counties,which went to all kinds of health institutions(except Family Planning Institutions), were mostly used for Maternal health care service.Thereinto,Delivery in hospital expenditure were very high in proportion.3)View from the function of MCH care service,in the MCH expenditures of N Count and L Count in 2004,Maternal health care expenditure were 47.771 million yuan RMB and 22.594 million yuan RMB.This expenditure was highest in the MCH expenditure.The percents were 69.40%and 65.96%.And within the Maternal health care expenditure,expenditure of Delivery in hospital separately reached 62.80%and 59.25%.THE CONCLUSIONSA.The structure of MCH financing is not reasonable,and lack of governmental appropriation.B.Imbalanced governmental appropriation and investment on county MCH care institutions and MCH care related activities lead to unsound county MCH care service system and too single MCH service items.C.MCH expenditures mostly went to County Hospitals.And some MCH items which should be belonged to MCH Care Centers are taken by other health institutions.That threatens the survival of many MCH Care Centers.D.Hospital Delivery charges take too high proportion in MCH expenditures. Many MCH Care Centers mainly depend on this charge for surviving.E.Unsound utilization of the actual MCH expenditure in the MCH Care Centers makes some MCH services a mere formality.SUGGESTIONS:A.Increase governmental appropriation and investment. B.Carry out practical researches on criterions of governmental appropriation and the applicable complementary policies.F.Optimize and well distribute the MCH Care and Health resources,soundly distribute the MCH expenditures,and try to accelerate the development of MCH project.G.Actively utilize overseas capitals,and try to search a suitable road of accelerating the development of our grassroots WCH project by proceeding from China's realities.