China - Health



A revamping of China's health system is under way to manage serious diseases. The Ministry of Public Heath's ninth five-year plan on the control of serious diseases outlined major reforms to be reached by the year 2000. These include strengthening epidemic prevention management systems and facilities. National health practices, including the provision of both Western and traditional Chinese health services are under the supervision of the Ministry of Health. The ministry has emphasized preventive medicine and general improvement of sanitary conditions.

Since the early 1950s, mass campaigns have been mounted to deal with major public health problems. These have included nationwide cleanup campaigns and mass educational programs in the sanitary preparation of food, the treatment of drinking water, personal hygiene, and waste disposal. The entire population was mobilized to eradicate the four pests—rats, sparrows, flies, and mosquitoes—with mixed results. Epidemic prevention centers were established to carry out massive immunizations, while parasitic diseases, affecting hundreds of millions in China, were also attacked. As a result, schistosomiasis, malaria, kala-azar, and hookworm are thought to have been largely brought under control. The country's 1991–1995 five-year plan was instituted to upgrade services yet again. The prevalence of infectious diseases was to be lowered by 20% by 1990; all provinces were to provide primary medical care to citizens; there were plans to add 450,000 hospital beds and 500,000 technical health workers; and the availability of health insurance was forecast to increase. From 1985 to 1992, 90% of inhabitants had access to health care services. In 2000, 75% of the population had access to safe drinking water and 38% had adequate sanitation.

There were 62,000 hospitals at the end of 1990 (a rise of 3,000 over 1985) and total beds numbered 2.6 million (up by 370,000), a rate of 2.33 per 1,000. As of 1999, there were an estimated 1.7 physicians and 2.4 hospital beds per 1,000 people. During the Cultural Revolution, in an effort to even out the disparity between rural and urban health services, medical personnel from hospitals (as much as 30–50% of a hospital's medical staff) were included in groups of people sent down to the countryside and the number of locally trained paramedical personnel, called barefoot doctors, expanded. An increasingly important medical factor since the Cultural Revolution, these young peasants or middle-school graduates have been trained on the job by township doctors or in two-month courses at township health clinics. Barefoot doctors and production teams and brigade health stations are still the major deliverers of health care in the countryside.

As of 2000, an estimated 83% of married women (ages 15 to 49) used contraception. The infant mortality rate was reduced from as high as 200 per 1,000 live births before 1949 to an estimated 32 per 1,000 in 2000. The maternal mortality rate was estimated at 55 per 100,000 live births in 1998. In the mid-1990s, China vaccinated a high percentage of its children up to one year of age: tuberculosis, 94%; diphtheria, pertussis, and tetanus, 93%; polio, 94%; and measles, 89%. Despite the high immunization rates, diseases still persist. China had the greatest number of tuberculosis cases of any UN member state. In 1999, there were 103 cases of tuberculosis per 100,000 people. According to the World Health Organization, cholera was reported in 10,344 individuals in 1995. In China, which accounts for 20% of the world's tetanus cases, over 90,000 a year die from neonatal tetanus. In the mid-1990s, only 10% of pregnant women were immunized against tetanus.

Average life expectancy in 2000 was 70 years, up from an average of 45 years in 1950. From 1985 to 1990, major causes of death were recorded as: communicable diseases and maternal/perinatal causes (117 per 100,000), noncommunicable diseases (696 per 100,000), and injuries (88 per 100,000). In an effort to prevent the spread of AIDS, the government (in 1987) required the testing of all foreigners for the HIV virus. HIV prevalence in 1999 was 0.1 per 100 adults. At the end of 2001 the number of people living with HIV/AIDS was estimated at 1.25 million and deaths from AIDS that year were estimated at 17,000.

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