The development and reform of public health in China from 1949 to 2019

Abstract

Background Public health system plays a vital role in the development of health sector in China and protects the health of Chinese people. However, there are few comprehensive reviews and studies focusing on its evolution and reform. It is worthwhile to pay attention to the public health development in China, given that the history and structure of public health system have their own characteristics in China. Methods The study is a retrospective review of the development public health over seven decades in China. It presents the findings from some national or provincial survey data, interviews with key informants, reviews of relevant published papers and policy contents. Results This study identified four key stages that public health experienced in China: the initial stage centering on prevention, the stage of deviation with more attention to treatment but little to prevention, the recovery stage after SARS(Severe Acute Respiratory Syndromes) Crisis, and the new stage to an equitable and people-centered system. In the latest stage, the National Basic Public Health Service Program (NBPHSP) is implemented to respond the threat of noncommunicable diseases (NCDs) and has achieved some initial results, while there are still many challenges including service quality, poor integration among service items and IT system, lack of quality professionals and insufficient intersectoral endeavor. Discussion There are unique Chinese wisdom and remarkable achievements as well as twists and turns on the development of China’s public health. Prevention-first, flexible structure of the system, multi-agency collaboration and mass mobilization and society participation are the main experience of public health in early stage. Despite twists and turns since 1980s, public health system in China shows substantial resilience which may be from the government’s continuous commitment to social development and people’s livelihoods and its flexible governance. In 2010s, in order to achieve the well-off society, Chinese government pays unprecedented attention to health sector, which bring a new wave of opportunities to public health such as remaining the NBPHSP for priority. The evolution and reform of China’s public health is based on its national condition, accumulates rich experience but also faces many common worldwide challenges. Getting this development and reform right is important to China’s social and economic development in future, and China’s experience in public health may provide many lessons for other countries. Conclusion Public health in China needs to focus on prevention, strengthen multi-agency coordination mechanism, improve the quality of public health services in the future.

Factors Influencing Resilience of Medical Workers from Other Provinces to Wuhan Fighting Against 2019 Novel Coronavirus Pneumonia

“…scoring higher for resilience than medical workers of other published Chinese study (59.50 ± 12.77) [26]. Since the outbreak of SARS in 2003 and the Wenchuan earthquake in 2008, Chinese government pays unprecedented attention to health sector [27]. Substantial resources have been devoted to improving disaster resilience in China, with a particular emphasis on mitigating the impact of wide-spread infectious diseases and mass casualty incident.…”

Declining Public Health Protections within Autocratic Regimes: Impact on Global Public Health Security, Infectious Disease Outbreaks, Epidemics, and Pandemics

“…Public health was never given the same priority and failed to catch up with changes that required timely updating and adjustment of services. 28 While it took time to recognize that China was on a path to also politically and economically redefine public health protections, infrastructure, and development, warnings directed at China's new regional Centers for Disease Control (CDC; Beijing, China) fell on deaf ears. That same lack of coordination and collaboration remains evident today, placing China under a different microscope, one of greater scrutiny and judgment from the global community who sees their many poor health outcomes.…”

Investigation the differences between the medical personnel’s and general population’s view on the doctor-patient relationship in China by a cross-sectional survey

“…To offer better health care, since the 2010s, the Chinese government has adopted a series of effective reforms that include expansion of the social health insurance, reform of the public hospitals, and strengthening of primary care. These reforms have succeeded in reducing mortality, increasing life expectancy, and providing better primary health care [4,5]. However, as the aging population continues to increase, China's limited medical resources will face huge challenges in the future [6].…”