ArticleInternational health2026
Equity of opportunity in China's essential public health services: influencing factors and moderating mechanisms.
Article in International health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChina's progress toward universal health coverage (UHC) faces persistent equity gaps in basic public health services. This study quantifies the equity of opportunity in mainland China's national essential public health services (NEPHS) from 2015 to 2020 and analyses its influencing factors through the lens of UHC dimensions to inform policy design aimed at advancing health equity and sustainable development.
methodsUsing panel data from 31 provinces, an evaluation index system was constructed. The entropy-weight method was applied to quantify the equity of opportunity in NEPHS across mainland China. A two-way fixedeffects model was employed to examine the impact mechanisms of factors across different UHC dimensions.
resultsThe equity of opportunity in NEPHS showed an overall upward trend, with eastern and central regions demonstrating higher equity levels than western regions. Financial investment and central transfer payments significantly positively related to equity, whereas higher fiscal self-sufficiency attenuated the positive effect of transfers. An increase in the number of participants in basic medical insurance also positively related to equity. In contrast, a higher registration rate for antenatal care was negatively related to equity of opportunity.
conclusionsLocal governments should adjust the structure of public fiscal expenditures, appropriately increase investment in NEPHS and continue expanding basic medical insurance coverage to advance equalization of NEPHS.
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