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    Building institutions for an effective health system: lessons from China's experience with rural health reform

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    Bloom -Building institutions for an effective health system- Lessons from China's experience with rural health reform- post-print.pdf (650.1Kb)
    Date
    2011-04-27
    Author
    Bloom, Gerry
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    Abstract
    This paper is concerned with the management of health system changes aimed at substantially increasing the access to safe and effective health services. It argues that an effective health sector relies on trust-based relationships between users, providers and funders of health services, and that one of the major challenges governments face is to construct institutional arrangements within which these relationships can be embedded. It presents the case of China, which is implementing an ambitious health reform, drawing on a series of visits to rural counties by the author over a 10-year period. It illustrates how the development of reform strategies has been a response both to the challenges arising from the transition to a market economy and the result of actions by different actors, which have led to the gradual creation of increasingly complex institutions. The overall direction of change has been strongly influenced by the efforts made by the political leadership to manage a transition to a modern economy which provides at least some basic benefits to all. The paper concludes that the key lessons for other countries from China’s experience with health system reform are less about the detailed design of specific interventions than about its approach to the management of institution-building in a context of complexity and rapid change.
    URI
    https://opendocs.ids.ac.uk/opendocs/handle/20.500.12413/3886
    Citation
    Bloom, Gerald. "Building institutions for an effective health system: Lessons from China’s experience with rural health reform." Social Science & Medicine 72.8 (2011): 1302-1309.
    More details
    http://dx.doi.org/10.1016/j.socscimed.2011.02.017
    Rights holder
    Elsevier
    Rights details
    http://www.ids.ac.uk/files/dmfile/IDSOpenDocsStandardTermsOfUse.pdf
    Sponsor
    ESRC
    Collections
    • ESRC STEPS Centre [205]
    • Future Health Systems [92]

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