From Barefoot Doctor to Village Doctor in Rural China

摘要

The paper recalls the impressive results of the Chinese model of primary health care achieved in the past three decades and reviews the evolution of the barefoot doctor of the 1960's and 70's to the village doctor of the 80's who is the major health care provider in rural areas. Using data from a 1990 nationwide sample survey, the demographic characteristics, income, working patterns, general education and professional training, and training preferences of the current village doctors are presented. Two key issues in rural health care in China are discussed: quality of health services and their financial sustainability. The paper suggests alternative ways to train village doctors in order to improve their technical competence and alternative ways to pay for their services. The policy implications of the on-going privatization of rural health care and policy choices are discussed, a redefinition of the role and functions of the village doctor is recommended, and a networking strategy for integrating rural health services functionally and financially is suggested. (Copyright (c) 1992 The International Bank for Reconstruction and Development/The World Bank.)