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[Increasing infant mortality and tuberculosis in China. A dark picture of public health and health care in China].

Authors
  • Lundberg, S
Type
Published Article
Journal
Läkartidningen
Publication Date
Feb 10, 1999
Volume
96
Issue
6
Pages
642–646
Identifiers
PMID: 10087814
Source
Medline
Keywords
License
Unknown

Abstract

Lennart Bogg, a prominent researcher at the Karolinska Institute, has been monitoring the development of public health in China since 1984. According to Bogg, the increase in the infant mortality rate in China (from 34.7/1000 children in 1981 to 37.0/1000 children in 1992) and the increase in the number of cases of tuberculosis and schistosomiasis are signs of deteriorating public health. Infant mortality has reached 72/1000 in the interior, but it is only 15/1000 in the large cities: this is indicative of a gap in health care delivery in the country. The number of cases of tuberculosis has increased significantly in recent years, and the disease causes 360,000 deaths per year. In the meantime, though, average life expectancy rose between 1949 and 1982, from 39 to 69 years. In the mid 1960s, collective health insurance and the so-called barefoot doctors system were introduced in the rural areas, with 90% of the villages being served by the system. Simple preventive health care and basic care was financed by this system. Subsequent to the reforms introduced in the late 1970s, the collectives were replaced by an individual contract system for each household, and the health insurance system was dismantled without there being anything else to replace it. Nowadays it is estimated that 10-15% of people are insured; these are mainly people who work in cities. The fee-for- service scheme boosted health care costs eight times between 1983 and 1990. Quality of maternal and child health care has declined in the rural areas, and most deliveries take place in the home with the assistance of untrained personnel. In the countryside even the one-child policy seems to have collapsed. In 1994 a project that aimed at resurrecting cooperative health insurance was initiated

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