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With the largest population in the world, China is managing major health system reforms against a background of rapid economic and institutional change. This has posed a serious challenge in increasing access to health services, especially for poor people living in both rural areas and as internal migrants.

FHS Phase 1

In the first phase of FHS China, the focus was on the merger of the New Rural Cooperative Medical Scheme (NCMS) with the Medical Financial Assistance Scheme (MFA) for improve the rural poor’s access to essential health services, to reduce their economic burden of disease and to prevent the vicious circle of "disease caused by poverty and poverty caused by disease."

 There was a big gap in the integration process of NCMS and MFA because the two schemes that target rural residents were administered by different government departments, the Ministry of Health and the Ministry of Civil Affairs, respectively. After years of work, the official policy was issued by the Ministry of Health and the Ministry of Civil Affairs was in 2009, which is an important milestone in the development of NCMS and MFA system.


FHS Phase 2

In addition to insurance schemes, one of the five priorities on China's health reform agenda is to build a national essential drug system that ensures the rational use and effective delivery of essential drugs and that reduces the financial burden of drug cost.

FHS China will shift its work to this key area. The aim is to identify existing and impeding problems emerging during the reform on drug delivery system in rural areas, and to find out the linkage and conflicts between the drug delivery system and other functions of health system. With this knowledge we will propose suggestions from the perspective of strengthening the whole health system on how to eliminate technical and institutional obstacles and improve the access to clinical preferred, essential, safe and effective, affordable and rational drugs for rural residents.

FHS Partners in China

News and announcements from FHS China


On 25 March, the China National Health Development Research Center (CNHDRC) hosted a seminar to mark the launch of an FHS research project examining the impact of payment system reform on the delivery of health care services in rural healthcare facilities in China. The seminar took place in Yubei county, Chongqing city. Over 40 delegates attended the meeting, including a number of local and national government officials and grassroots policy makers.

Recent FHS China Publications


Wang L, Zhang X, Liang X and Bloom G (2016) Addressing antimicrobial resistance in China: policy implementation in a complex context, Globalization and Health, 12:30, DOI: 10.1186/s12992-016-0167-7

The effectiveness of antibiotics in treating bacterial infections is decreasing in China because of the widespread development of resistant organisms. Although China has enacted a number of regulations to address this problem, but the impact is very limited. This paper investigates the implementation of these regulations through the lens of complex adaptive systems (CAS).

Husain, L (2016) Looking for ‘New Ideas That Work’: county innovation in China’s health system reforms—the case of the New Cooperative Medical Scheme, Journal of Contemporary China, Volume 25, Issue 99, pages 438-452, DOI: 10.1080/10670564.2015.1104911

The article presents a case study of a low tech and ‘second best’ reimbursement mechanism developed sub-nationally under the New Cooperative Medical Scheme, China’s rural health insurance framework, and its spread and incorporation into national policy. It argues for the importance of local government development of ‘appropriate’ policy mechanisms (jizhi) as underpinning central reforms and system adaptation.

Pan Y, Chen S, Chen M, Zhang P, Long Q, Xiang L, and Lucas H (2016) Disparity in reimbursement for tuberculosis care among different health insurance schemes: evidence from three counties in central China, Infect Dis Poverty. 2016; 5: 7. doi: 10.1186/s40249-016-0102-4

Health inequity is an important issue all around the world. The Chinese basic medical security system comprises three major insurance schemes, namely the Urban Employee Basic Medical Insurance (UEBMI), the Urban Resident Basic Medical Insurance (URBMI), and the New Cooperative Medical Scheme (NCMS). Little research has been conducted to look into the disparity in payments among the health insurance schemes in China. In this study, the authors aimed to evaluate the disparity in reimbursements for tuberculosis (TB) care among the abovementioned health insurance schemes.

Zhou C, Long Q, Chen J, Xiang L, Li Q, Tang S, Huang F, Sun Q, and Lucas H (2016) Factors that determine catastrophic expenditure for tuberculosis care: a patient survey in China, Infect Dis Poverty. 2016; 5: 6. doi:  10.1186/s40249-016-0100-6

Tuberculosis (TB) often causes catastrophic economic effects on both the individual suffering the disease and their households. A number of studies have analyzed patient and household expenditure on TB care, but there does not appear to be any that have assessed the incidence, intensity and determinants of catastrophic health expenditure (CHE) relating to TB care in China. That will be the objective of this paper.

Li Q, Jiang W, Wang Q, Shen Y, Gao J, Sato KD, Long Q, and Lucas H (2016) Non-medical financial burden in tuberculosis care: a cross-sectional survey in rural China, Infect Dis Poverty. 2016; 5: 5. doi:  10.1186/s40249-016-0101-5

Treatment of tuberculosis (TB) in China is partially covered by national programs and health insurance schemes, though TB patients often face considerable medical expenditures. For some, especially those from poorer households, non-medical costs, such as transport, accommodation, and nutritional supplementation may be a substantial additional burden. In this article the authors aim to evaluate these non-medical costs induced by seeking TB care using data from a large scale cross-sectional survey.