Publication: Stakeholder Participation Targets the Rural Poor : China Basic Health Project
Date
2001-03
ISSN
Published
2001-03
Author(s)
Kuehnast, Kathleen
Abstract
The past 20 years have witnessed a
growing disparity in health status indicators between urban
and rural populations in China. The economic and social
reforms that have accelerated the growth in GDP and personal
income levels of the urban population have not trickled down
to the rural areas. Declining government support of public
health programs and the collapse of community financing of
health services have meant that health services in poor
rural areas have deteriorated in general. Services have
declined in coverage, quality, efficiency, utilization, and
financial viability. To address this disparity, the World
Bank-supported Basic Health Project in China introduced a
systematic but rapid process of consultation and feedback
among selected beneficiary communities. The project was
prepared using guidelines prepared by national and
international experts. The social assessment confirmed
impressions gained from less structured consultations and
provided additional support for project design. Stakeholder
involvement was extensive, including consultations with
governmental departments of planning, finance, poverty
alleviation, personnel, and education, as well as civil
society groups such as the All China Women's Federation
and the Red Cross. Field visits included focus group
discussions with local government representatives, village
officials, and householders. The rural poor, including
minority nationalities, figured prominently in such
consultations. This note concludes that responsive social
development has its risks. Even in such an innovative and
comprehensive project, maintaining a balance between
improvement of health facilities versus population-based
health care remains a challenge. Without adequate technical
support and supervision, or without adequate funds in the
county poverty fund to reimburse health care providers for
their services given to the poor, this balance could
ultimately break down and erode the lines of communication
and trust established by the project.
Citation
“Kuehnast, Kathleen. 2001. Stakeholder Participation Targets the Rural Poor : China Basic Health Project. Social Development Notes; No. 53. © World Bank, Washington, DC. http://openknowledge.worldbank.org/entities/publication/b33aa343-a6cf-547f-b025-47647e2ab652 License: CC BY 3.0 IGO.”