Improving Local-Level Healthcare in China

Everyone has the right to access quality healthcare. Yet, many are still deprived of it, especially in remote and rural areas. This gap also exists in China, despite having among the world’s largest healthcare systems. How can we bridge the gap and improve local-level healthcare in China?

The Gap of Local-Level Healthcare in China

China has expanded its healthcare system to have over 1 million facilities nationwide. Among these, more than 900,000 are local-level primary healthcare institutions that include clinics and community health centers. These institutions are the first point of contact of care that treats common illnesses and offer preventive services like vaccination or routine health needs. This development is the result of the 2009 healthcare reform that had invested heavily in healthcare infrastructure.

However, this increase in number does not directly translate into quality. Local-level healthcare facilities still face challenges like knowledge-practice gap, disparities in healthcare workforce, or insufficient equipment. Consequently, these factors have led to public distrust. A survey with nationally representative respondents showed that distrust was high in local-level primary healthcare clinics, and respondents often opted for further, better, and higher-level healthcare institutions.

Primary healthcare facilities are necessary to treat common illnesses in order not to overwhelm hospitals, as well as to provide accessible, timely, and quality healthcare at the local level. Without quality local-level healthcare, people might be burdened by higher costs, longer travel, and delayed care.

The Medical Consortia System

Measures are being taken to tackle issues in local-level healthcare in China. Among them is creating a County-level Integrated Healthcare Organizations (CIHOs) or “Medical Consortia”. It aims to reorganize resources and improve the capacity of health facilities at the local level. Primarily, Medical Consortia brings together village and township healthcare facilities into a connected system.

The system provides a team of at least three experts from high-level hospitals to be sent to county-level medical centers, bringing them closer to local residents. They shall improve the quality of local clinics through guidance in pharmacy, nursery, and management. The aim is to ensure that common illnesses are treated at the county level, and routine health checks or concerns are done properly at the local level. These should increase visits to local clinics and reduce hospital load.

More than 2,180 counties and districts have joined the program by 2025, resulting in the establishment of resource-sharing centers for medical testing, electrocardiography, and more. Additionally, 80% of village-level clinics are now medical insurance points, further easing patients’ access to healthcare reimbursement. This approach is expected to reach full coverage by 2027, in which all patients should be able to reach quality healthcare facilities within 15 minutes.

Safeguarding Health by Ensuring Access

Quality healthcare for all is among the pillars of sustainable development. This ensures public health and community resiliency. With the increasing demand for care, attributed to an ageing population and the growing threat of climate change, improving local-level healthcare is a priority.

In this light, governments must design a tailored pathway for local-level healthcare to address the unique context of each locality. With improved capacity, expertise, and affordability, residents will be able to access quality healthcare closer to their home. Beyond the facility itself, improving other supporting infrastructure, from road access to disaster risk management, is also crucial to ensure the facility’s accessibility and resilience.

Furthermore, investment in healthcare workers’ wellbeing, staff training, modern equipment, and community-based healthcare is vital to strengthen and build trust in local health centers. All in all, the key step towards a sustainable future begins with safeguarding the health of our current and future generations for a healthier and fairer world for all.

Editor: Nazalea Kusuma & Kresentia Madina