ArticleBMC public health2012
Revisiting current "barefoot doctors" in border areas of China: system of services, financial issue and clinical practice prior to introducing integrated management of childhood illness (IMCI).
Article in BMC public health, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed.
- Antibiotic Culture: A History of Antibiotic Use in the Second Half of the 20th and Early 21st Century in the People's Republic of China.Antibiotics (Basel, Switzerland) · 2023Article
- Identifying key influences on antibiotic use in China: a systematic scoping review and narrative synthesis.BMJ open · 2022Article
- Can family doctor contracted services facilitate orderly visits in the referral system? A frontier policy study from Shanghai, China.The International journal of health planning and management · 2022Article
- Observational
- Does exam-targeted training help village doctors pass the certified (assistant) physician exam and improve their practical skills? A cross-sectional analysis of village doctors' perspectives in Changzhou in Eastern China.BMC medical education · 2018Article
- Unmet needs in health training among nurses in rural Chinese township health centers: a cross-sectional hospital-based study.Journal of educational evaluation for health professions · 2017Article
- Financing strategies to improve essential public health equalization and its effects in China.International journal for equity in health · 2016Article
- Elderly suicide trends in the context of transforming China, 1987-2014.Scientific reports · 2016Article
- Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example.BMC health services research · 2016Article
- Is a decentralized continuing medical education program feasible for Chinese rural health professionals?Journal of educational evaluation for health professions · 2016Article
- Health providers' perspectives on delivering public health services under the contract service policy in rural China: evidence from Xinjian County.BMC health services research · 2015Article
- Factors that influence the turnover intention of Chinese village doctors based on the investigation results of Xiangyang City in Hubei Province.International journal for equity in health · 2014Article
- Aging village doctors in five counties in rural China: situation and implications.Human resources for health · 2014Article
- Care-seeking and quality of care for outpatient sick children in rural Hebei, China: a cross-sectional study.Croatian medical journal · 2013Article
- Longitudinal study of rural health workforce in five counties in China: research design and baseline description.Human resources for health · 2013Article
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6 authors.
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Abstract
backgroundUnder-5-years child mortality remains high in rural China. Integrated management of childhood illness (IMCI) was introduced to China in 1998, but only a few rural areas have been included. This study aimed at assessing the current situation of the health system of rural health care and evaluating the clinical competency of village doctors in management of childhood illnesses prior to implementing IMCI programme in remote border rural areas.
methodsThe study was carried out in the border areas of Puer prefecture of Yunnan province. There were 182 village doctors in the list of the health bureau in these border areas. Of these, 154 (84.6%) were recruited into the study. The local health system components were investigated using a qualitative approach and analyzed with triangulation of information from different sources. The clinical component was assessed objectively and quantitatively presented using descriptive statistics.
resultsThe study found that the New Rural Cooperative Medical Scheme (NRCMS) coordinated the health insurance system and the provider service through 3 tiers: village doctor, township and county hospitals. The 30 RMB per person per year premium did not cover the referral cost, and thereby decreased the number of referrals. In contrast to available treatment facilities and drug supply, the level of basic medical education of village doctors and township doctors was low. Discontent among village doctors was common, especially concerning low rates of return from the service, exceptions being procedures such as injections, which in fact may create moral hazards to the patients. Direct observation on the assessment and management of paediatric patients by village doctors revealed inadequate history taking and physical examination, inability to detect potentially serious complications, overprescription of injection and antibiotics, and underprescription of oral rehydration salts and poor quality of counseling.
conclusionThere is a need to improve health finance and clinical competency of the village doctors in the study area.
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