Towards strengthened primary care in China: achievements and obstacles

Stream: Chinese social policy: health policy
Date: Wednesday, 11 September 2019
Time: 10.45 am – 12.25 pm


Since the early 2000s, the Chinese government has significantly stepped up its efforts to improve its health care system. A key priority among the different areas of the system has been the strengthening of primary care facilities, including nearly one million health centres, health stations and clinics throughout China. Within the government’s blueprint, primary care facilities will eventually become the cornerstone of its health care system, providing first contact, comprehensive, longitudinal and coordinative care. The strengthening of primary care has been an essential component of the government’s plan to provide “essential health care for all by 2020”, an ambitious goal proposed at the launch of health care reforms in 2009. This study systematically evaluated the Chinese government’s efforts to strengthen primary care between 2003 and 2015. To achieve this, it drew on data from China Health Yearbooks, China Health Statistical Yearbooks, policy documents, and relevant scholarly publications. Fieldwork was conducted between October 2016 and March 2017, to collect primary data from interviews and observations. The results of this research show that the government has been successful in meeting its own quantitative targets. However, much less is known about the true costs of government projects and their benefits. This paper argues that the government’s efforts have been persistently undermined by a mismatch between targets and funding, a poor data foundation, and weak monitoring and evaluation. These factors are mutually reinforcing, presenting significant obstacles to the effective evaluation of primary care reforms in China, and suggesting that significant changes are unlikely.


Xiao Tan (Presenter), The University of Melbourne
Xiao Tan is a PhD candidate at the Centre for Contemporary Chinese Studies at the University of Melbourne. Her doctoral research examines the Chinese government’s role in the health care system, with a particular focus on the primary care sector.