资源描述：
《the political economy of public health in rural China》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。
1、JournalofContemporaryChina(2004),13(39),May,367–390BringingtheLocalStateBackIn:thepoliticaleconomyofpublichealthinruralChinaYANZHONGHUANG*Contrarytowhatmostalarmistreportswouldimply,Chinahasnotwitnessedameasurabledeclineintheoverallpublichealthstatus.Whatexpl
2、ainsthecontinuousimprovementinsomeimportantdomainsofpublichealthdespitethepertinaciouspricing,financingandinstitutional-behavioralproblemsinChinashealthsystemchange?ThisstudyprovidesapoliticaleconomyanalysisoftherolethelocalChinesestateplayedinruralpublichealt
3、hprovisionduringthereformera.Throughcomparativecasestudies,statisticalanalysis,andformalmodeling,thestudyshowsthatstatecapacityisaprincipalfactorsettingtheparametersforruralpublichealthinChina.Italsosuggeststhatthepost-Maoreforms,whilegeneratingstrongdisincen
4、tivesfortheprovisionofpublicservices,unleashedforcesthatlaydowntheinstitutionalbasesforsustainedstateengagementinthehealthsector.IntroductionImprovingoverallpublichealthstandardsisanythingbuteasyforaformercentrallyplannedeconomy(CPE),wherepricing,financingandi
5、nstitutional-behavioralproblemspresentpertinaciousobstaclestohealthsystemreform.ThistaskisparticularlydifficultforChina,wheremostofthe850millionruralresidentsarepeasants,claimingamajorityofthecountry’sabsolutepoorandilliteratepopulation.Itentailshugeinvestment
6、tohaveneededhealthservicesreachthissegmentofthepopulation,becausesimplytransferringsmallamountsofincome1wouldcreaterelativelylittleadditionaldemandforhealthcare.Underthepre-reformsystem,ruralpatientssoughttreatmentfrom‘barefootdoctors’(BFDs)atthevillage(briga
7、de)healthstations,and,ifnecessary,werereferredtohigher-levelhealthunits,suchastownshiphealthcentersandcountyhospitals.ThecommunesorbrigadespaidtheBFDsworkpointstodeliverfreepreventativeandprimarycareservicesatthevillagelevel,andofferedcollective*YanzhongHuang
8、isDirectoroftheCenterforGlobalHealthStudiesandAssistantProfessorattheJohnC.WhiteheadSchoolofDiplomacyandInternationalRelationsofSetonHallUniversity.Hiscurrentresearchfocusesonthehealthpol
