Study On Reforming And Improving Nantong Rural Health Service System Under The Socialist Market Economy

Objective This study focuses on Nantong rural health reform and effects with an integrative analysis to explore the strategies and ways to improve and innovate rural health sytem and ensure rural people's health demands, so as to put forward some policy recommendations for government to convert its function and improve rural health policy making.Methodologies The literature study and a combination of quantitative and qualitative methods are adopted to survey all township health centers (THC), township public health centers (TPHC), community health stations (CHST) and the grassroot health personnel and rural residents in Rugao, Tongzhou and Rudong cities (counties). Results Nantong rebuilt the new rural health system by taking various measures, such as government-run independent TPHCs or purchasing services from private THCs to provide public health services, established village CHSTs absorbing a comprehensive range of investment, enhanced the new rural cooperative medical system. The new rural health service system has been rebuilt. The study finds some advantages and successful experiences with the reform. THCs are totally getting better operation and independent TPHCs work better than government purchasing services in public health services provision and rural health administration. However, several defects are detected in the study. Government deficient investment in rural health services and poor health resources in rural public health services restrain rural health service provision. Preventive services integrated in THCs could share more resources with THCs, which would be helpful for public service provision. Without community health centers, the rural community health system couldn't run well. Rural people welcome current village CHSTs but are not familiar to community services of "six-in-one".Conclusions To improve rural health service system at the new situation of market economic development, the policy options should put priorities to following areas: to strengthen government responsibility for people's health, to optimize rural health system, and to ensure the adequate public health provision, so as to protect rural people's rights in health and health service utilization.