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Development of village doctors in China: financial compensation and health system support

Overview of attention for article published in International Journal for Equity in Health, July 2017
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (93rd percentile)
  • High Attention Score compared to outputs of the same age and source (88th percentile)

Mentioned by

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3 news outlets
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11 X users
facebook
1 Facebook page
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3 Wikipedia pages

Citations

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54 Dimensions

Readers on

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131 Mendeley
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Title
Development of village doctors in China: financial compensation and health system support
Published in
International Journal for Equity in Health, July 2017
DOI 10.1186/s12939-016-0505-7
Pubmed ID
Authors

Dan Hu, Weiming Zhu, Yaqun Fu, Minmin Zhang, Yang Zhao, Kara Hanson, Melisa Martinez-Alvarez, Xiaoyun Liu

Abstract

Since 1968, China has trained about 1.5 million barefoot doctors in a few years' time to provide basic health services to 0.8 billion rural population. China's Ministry of Health stopped using the term of barefoot doctor in 1985, and changed policy to develop village doctors. Since then, village doctors have kept on playing an irreplaceable role in China's rural health, even though the number of village doctors has fluctuated over the years and they face serious challenges. United Nations declared Sustainable Development Goals in 2015 to achieve universal health coverage by 2030. Under this context, development of Community Health workers (CHWs) has become an emerging policy priority in many resource-poor developing countries. China's experiences and lessons learnt in developing and maintaining village doctors may be useful for these developing countries. This paper aims to synthesis lessons learnt from the Chinese CHW experiences. It summarizes China's experiences in exploring and using strategic partnership between the community and the formal health system to develop CHWs in the two stages, the barefoot doctor stage (1968 -1985) and the village doctor stage (1985-now). Chinese and English literature were searched from PubMed, CNKI and Wanfang. The information extracted from the selected articles were synthesized according to the four partnership strategies for communities and health system to support CHW development, namely 1) joint ownership and design of CHW programmes; 2) collaborative supervision and constructive feedback; 3) a balanced package of incentives, both financial and non-financial; and 4) a practical monitoring system incorporating data from the health system and community. The study found that the townships and villages provided an institutional basis for barefoot doctor policy, while the formal health system, including urban hospitals, county health schools, township health centers, and mobile medical teams provided training to the barefoot doctors. But After 1985, the formal health system played a more dominant role in the CHW system including both selection and training of village doctors. China applied various mechanisms to compensate village doctors in different stages. During 1960s and 1970s, the main income source of barefoot doctors was from their villages' collective economy. After 1985 when the rural collective economy collapsed and barefoot doctors were transformed to village doctors, they depended on user fees, especially from drug sale revenues. In the new century, especially after the new round of health system reform in 2009, government subsidy has become an increasing source of village doctors' income. The barefoot doctor policy has played a significant role in providing basic human resources for health and basic health services to rural populations when rural area had great shortages of health resources. The key experiences for this great achievement are the intersection between the community and the formal health system, and sustained and stable financial compensation to the community health workers.

X Demographics

X Demographics

The data shown below were collected from the profiles of 11 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 131 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 131 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 16 12%
Student > Master 16 12%
Student > Bachelor 14 11%
Researcher 12 9%
Student > Doctoral Student 11 8%
Other 28 21%
Unknown 34 26%
Readers by discipline Count As %
Social Sciences 21 16%
Medicine and Dentistry 19 15%
Nursing and Health Professions 16 12%
Business, Management and Accounting 5 4%
Environmental Science 5 4%
Other 25 19%
Unknown 40 31%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 41. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 January 2024.
All research outputs
#917,819
of 23,979,951 outputs
Outputs from International Journal for Equity in Health
#109
of 2,038 outputs
Outputs of similar age
#19,624
of 317,161 outputs
Outputs of similar age from International Journal for Equity in Health
#7
of 51 outputs
Altmetric has tracked 23,979,951 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,038 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.5. This one has done particularly well, scoring higher than 94% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 317,161 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 93% of its contemporaries.
We're also able to compare this research output to 51 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 88% of its contemporaries.