China

Rural township health centres and urban community health centres play a crucial role in the delivery of primary health care in China. The limited availability and low qualifications of human resources in health are among the main challenges facing lower-level health facilities. This paper aims to analyse the mobility of health workers in township and community health centres. [from abstract]

China’s long struggle with rural coverage for health care goes back to the early part of the 20th century. In 1968, the programme of barefoot doctors was introduced by the journal Red Flag as a national policy focused on quickly training paramedics to meet rural needs. Most barefoot doctors, who graduated from secondary school education, practised after training at the county or community hospital for 3—6 months. Hence medical coverage in the countryside rapidly expanded. However, the barefoot doctors, who generated their work points with medical services just like agricultural work (ie, their income was counted by transferring time for medical service to similar time for agricultural work) were not at par with the regularly trained doctors and their incomes were 50% lower. [from author]

The total number of health workers in rural China is currently in severe shortage, especially in short of qualified doctors, nurses and professionals in public health, and the situation has been exacerbated by the unplanned brain drain of health workers. This study will focus on analyzing the status of mobile of health workers and the general competency of those flow health workers at both levels of county hospitals and township health centers through 2001-2005 [adapted from abstract]

This paper analyzes China’s current health workforce in terms of quantity, quality, and distribution. Unlike most countries, China has more doctors than nurses. Doctor density in urban areas was more than twice that in rural areas, with nurse density showing more than a three-fold difference. Over the past decade there has been a massive expansion of medical education, with an excess in the production of health workers over absorption into the health workforce.

This website contains brief country reports on HRH development activities in 2008 from nations belonging to the Asia-Pacific Action Alliance on HRH.

We examined how individual and institutional factors in health care settings affected discrimination toward persons with HIV/AIDS. A representative sample of 1101 Chinese service providers was recruited in 2005, including doctors, nurses, and laboratory technicians. [from abstract]

The purpose of this paper is to examine what is known about the nurse workforce and nursing education in China in order to assess the likely potential for nurse migration from China in the future. [from abstract]

To objective of this article was to determine the prevalence and nature of workplace violence against nurses, how nurses deal with such aggression; and to identify the risk factors related to violence in the hospital environment. [author’s description]

Using a representative sample of 478 doctors, nurses, and lab technicians working with people living with HIV/AIDS (PLWHA), a cross-sectional study was conducted to assess the impact of the AIDS epidemic on medical care systems and service providers in China. The study findings suggest that improved institutional support for AIDS care at the facility level and HIV-related stigma reduction intervention are crucial to maintain a high quality performance by the workforce in the health care system. [from publisher’s description]

This study examines the relationship between medical practice and type of clinic ownership in HeBei province in the People’s Republic of China. The objective was to find out whether the kind of clinic ownership affects health care delivery patterns and access to health care. The study was carried out between 1995 and 2000 by a team of researchers from China, Israel and the Netherlands. [from preface]

This document report on the trends of HRH during past fifty years including the issues of unqualified doctors in rural areas, geographical differences in HRH, and the increase in medical school graduates. It also forecasts HRH needs for fifteen years from 2000 to 2015.

There are four types of health providers at present in China. These are defined in terms of differences in ownership. Private practice in the health sector was reintroduced from 1980, when China began its economic reform from a planned economy to a market economy. Dual practice (DP) is quite common and a major concern from the point of view of health policy-making as little is known about it. The aim of this study was to describe policies and regulations of DP, the current situation, its impact on access to services and physician behaviour, and to provide evidence for future policy decisions. This study was conducted in two provinces, Shandong and Sichuan.

The Chinese government has found it impossible to maintain uniform pay levels, particularly in the face of a radical devolution of its own financial management. Health workers have increasingly resorted to informal methods of earning an income. The government considers this to be unprofessional behavior and has used a combination of moral pressure and loss of professional privileges to discourage it.

With the recognition that public hospitals are often productively inefficient, reforms have taken place worldwide to increase their administrative autonomy and financial responsibility. Reforms in China have been some of the most radical: the government budget for public hospitals was fixed, and hospitals had to rely on charges to fill their financing gap. Accompanying these changes was the widespread introduction of performance-related pay for hospital doctors, termed the “bonus” system. While the policy objective was to improve productivity and cost recovery, it is likely that the incentive to increase the quantity of care provided would operate regardless of whether the care was medically necessary.

Decentralising health workforce management may help local services to coordinate and plan their human resources more effectively to meet health care needs. Health sector decentralisation in China and South Africa is complex, with different forms being implemented within varying timescales and for different purposes. In China decentralisation has taken place alongside the transition to a market economy, whilst post-apartheid South Africa is attempting to establish a new district health system. [author’s description]

The departure of a large proportion of the most competent and innovative individuals from developing nations slows the achievement of the critical mass needed to generate the enabling context in which knowledge creation occurs. To favourably modify the movement and distribution of global talent, developing countries must implement bold and creative strategies that are backed by national policies.