The Actuality Investigation About The Impact Of The NCMS On Accessibility Of Rural Healthcare In Five Counties Of Fujian Province

Background: Health for all is a common goal of all national governments in the world. Therefore, the accessibility of health service becomes the key factor to realize this goal. Since the implementation of the new rural cooperatives medical service system(NCMS) in Fujian Province in 2004, it has has been carried out in every county in this province. This study is based on the impact of the NCMS on the availability of hygienic service in Fujian Province, to describe the rural residents'participation and their views on this systerm, to analyze the improved situation of their health service accessibility, particularly economical accessibility aftre participating in the NCMS, and so on. Then contribute reference to government's decision-making and smooth the implementation of the NCMS.Purpose:1. To understanding the different demands on health service among different residents;2. To determine the residents'opinion of how the NCMS impact on the accessibility of rural health service;3. To investigate the perspectives on utilisation changes due to the implementation of the NCMS;4. To require about the residents'priority aims of what the NCMS should be able to provide and in which way they are willing and able to compromise in order to achieve these aims;5. Through the above mentioned purpose, it intends to establish a better systerm for rural residents.Methods:1. A quantitative research in Minqing, Luoyuan, Changle and Jinjiang four counties. Use Epidata 3.0 to type-in the data,and use SPSS15.0 to analyse;2.A mixed method study based on qualitative research including key informant inerviews, semi-structured interviews, focus group discussions, the participatory matrix ranking method in Minqing, Luoyuan, Changle, Jinjiang and Zherong five counties. If neccesary, recording and note during the interviews.Conclusions:1. Rural residents have strong demand on convenience, cheep and high quality health service;2. Accessibility in material: as a result of kinds of reasons, such as the old technical equipment, the low service quality, the lack of financial support and so on, there isn't any county meeting the rural's healthcare;3. Accessibility in economy: the implementation of NCMS indeed played a role in reducing the residents'big sickness burden, but the majority countryside residents still must pay for many common slight illness, many poor farmers are still unable to afford. Moreover, chronic illness's expense is also the heavy burden;4.Utilisation of health service in town-level and county-level hospital mostly increased from 2003 to 2007;5. Rural residents'willingness to improve the NCMS: the government should expand the investment to this systerm. Further more, government should also promote this systerm to be more transparent, more understandable and acceptable to rural residents.