Resources needed for rural health

Chinese authorities laid out a roadmap for improving the health of the nation's rural residents in a policy document released recently.

The document, jointly released by the National Health Commission and 13 other government departments, said that comprehensive measures will be taken, ranging from upgrading infrastructure and cultivating healthcare professionals in rural areas, to ramping up healthcare services and boosting health awareness among rural residents.

The goal is to achieve "marked improvements" in healthcare service capabilities and ensure convenient and affordable access to medical services in rural areas by 2030. In the meantime, major health threats and risk factors, such as cancer and heart disease, and negative lifestyles involving smoking or heavy alcohol use, should be reined in by then.

By 2035, the gap in the development of the healthcare industry and the health levels between city dwellers and rural residents should be narrowed markedly, the document said.

According to the national census in 2020, the proportion of people aged 60 and above in rural areas was 23.8 percent, nearly 8 percent points higher than that in urban areas.

Thanks to a nationwide campaign that lifted 100 million rural residents out of poverty from 2012 to 2021, those living in the countryside are now able to receive prompt diagnoses and treatment for common diseases, the commission said in a statement explaining the policy document.

Since 2021, the nation has been focusing on recalibrating a series of poverty alleviation measures to fit the new mission of rural vitalization and consolidating the provision of basic healthcare in rural areas.

However, the commission said that existing healthcare services still do not meet the demands of rural residents and it remains urgent to construct a healthy living environment and promote healthy lifestyles among them.

"Resolving these challenges will not only bolster the nation's drive to build a healthy China, but also lay a solid foundation for advancing rural vitalization," it said.

Highlighted among the key tasks outlined in the document are cultivating rural healthcare professionals and widening the use of remote, digital healthcare tools in the countryside.

The document said it will gradually expand tuition-free training for vocational medical students who agree to be assigned to the countryside upon graduation, as well as encourage suitable college-educated medical students to practice in rural clinics.

"Efforts will be made to improve the capabilities and age structure of rural healthcare workers, as well as guarantee their income and treatment, and resolve elderly care and medical insurance concerns," it said.

Fu Wei, director of the commission's primary health department, said that since the commission, along with four other government departments, launched a plan in April last year to nurture college-educated rural doctors, nearly 7,500 graduates have been hired as rural doctors.

"Students admitted into the program last year have an average age of 24 years old and 97 percent of them are aged 35 or under," she said, adding that about 12.5 percent of them have a bachelor's degree or higher and the remaining have vocational college diplomas.

"We can tell from these numbers that the plan has injected fresh vigor into rural healthcare and improved the academic levels and age structures of rural doctors," she said.

Konchok Tsepak, from the Yushu Tibetan autonomous prefecture in Northwest China's Qinghai province, graduated from a vocational college's medical school in 2022 and became a rural doctor in Sichuan province through the program this year.

He provides healthcare services for residents in Luoxu village, located at an average altitude of 4,200 meters and 82 kilometers away from the county seat. The village, covering an area of 700 square kilometers, only has about 521 residents and nearly one-third of them are elderly.

Despite the harsh natural environment, Konchok Tsepak said he has gained a sense of achievement from his work.

"On average, I see about 10 patients a day seeking help for headache, fever and other ailments. I also provide basic public health services such as routine examinations for the elderly suffering chronic diseases, pregnant women and infants and toddlers aged 6 and under," he said.

"For some seniors and people with disabilities, I also offer door-to-door services.

"Because I can speak both the Tibetan language and Mandarin, I am able to communicate easily with local villagers and gradually earn their trust," he added.

The local authorities have provided accommodation, enrolled him in training programs that teach skills needed by a general physician, and guaranteed him an adequate salary along with other supportive policies, he said.

Lei Haichao, head of the National Health Commission, said in an article released last month that China has some 4.95 million grassroots healthcare workers, including 1.1 million rural doctors.

"We are now working on offering better treatment for college-educated rural doctors, adding village clinics into the national healthcare insurance program and nurturing more medical students destined for central and western parts of the country," he said.

Lei added that by the end of last year, nearly 90 percent of counties had dispatched county-level hospital workers to lower-level health clinics and about 67 percent of county-level or village-level health clinics could provide medical imaging services themselves or through partnerships with larger hospitals.

"Information technologies and remote medical service platforms should be improved and utilized to support different levels of hospitals so that they can offer online services for common and chronic diseases," he said.

The significant role of remote diagnosis technologies is also highlighted in the policy document. It said that the infrastructure of rural healthcare should be ramped up, and remote imaging, electrocardiogram and consultation centers should be set up in the countryside.

Isolated communities

Nestled deep in the mountains in East China's Zhejiang province, the Jingning She autonomous county is sparsely populated. With a population density of less than 50 people per sq km, it was difficult to guarantee convenient access to quality medical services.

To address the issue, the county has deployed mobile medical clinics and online platforms, said Weng Zhihong, Party chief of Jingning county.

"Such mobile clinics target 67 far-flung villages and consolidate functions including examinations, drug distribution and reimbursement, remote diagnosis and first aid," he said. "In the past five years, these vehicles have traveled over 210,000 km and provided 84,000 consultations."

The county's online diagnosis platform has provided 1,500 consultations in the past two years.

"A patient surnamed Lan who lives in Shawan township in Jingning county used to spend a day traveling back and forth from a major hospital in the provincial capital of Zhejiang to receive follow-up checks after a major surgery. Now, it only takes him half an hour to see a doctor online," Weng said.

The policy document also stressed that a vital part in preventing a relapse into impoverishment in the countryside, was for it to be able to prevent, diagnose and treat severe illnesses.

To this end, a mechanism aimed at monitoring families at risk of falling into poverty and offering targeted assistance for them should be set up. Favorable healthcare insurance policies and social assistance measures should be fully implemented while the nonprofit sector should be guided to play a role in helping them as well, it said.