Teaching Comparative Government and Politics

Thursday, July 31, 2014

Following on the barefoot doctors

Public health has been a priority in China since the revolution. Some efforts have been more productive than others, but progress is undeniable.

Congratulations! Inoculations!

FANS of the China model frequently say that, for all the disadvantages of a one-party state, there are also benefits. Enforcing basic health care is one—and by no means a small one. Last year China’s mortality rate for children under five years old was just one-fifth the rate it was in 1991, down from 61 deaths per 1,000 live births to 12. The maternal mortality rate has also dropped substantially—by 71%—since 1991. In 1992, one in ten Chinese children under five contracted hepatitis B. Today fewer than one in 100 of them carry the disease.

A cost of public health

China’s advances have not gone unnoticed. Last month a group of four international bodies, including the World Health Organisation (WHO) and the World Bank, said China was one of ten countries to have made exceptional progress in reducing infant and maternal mortality…

China’s improvement lies in two basic, connected areas: better care at birth and countrywide immunisation. Since 2000 the government has offered subsidies to mothers who give birth in hospitals…

Margaret Chan, the WHO’s director-general, this month said that China’s regulatory system for vaccines had passed the WHO’s evaluation with outstanding results…. China and the WHO claim that about 95% of children are vaccinated for measles, rubella and polio. In 2008 the government added eight new vaccines, including hepatitis A and meningitis, to its national programme. All are administered to children free of charge. Just as important has been the mobilisation of a network of health-care workers, at provincial, county and township levels…

That does not guarantee effectiveness…

Part of the problem is the growing number of rural migrant children. They are tied to their hometown through the household-registration, or hukou, system and do not qualify for free health services, such as routine immunisation, outside it. Another hurdle is the complexity of administering so many vaccines in such a large, developing country…

That China is now at a stage where it needs a more sophisticated and targeted immunisation programme is testimony to its success, however. It is a sign that 1.4 billion people have taken another step up the ladder of good health.