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Incorporating Reproductive Health and Gender Concerns into Health Sector Reform in China

Recent health sector reform in China has been driven by fiscal devolution and privatisation and these have disproportionately affected reproductive health services for poor rural women. Reproductive health depends on preventive health services such as education and screening. However, the decrease in financing for health education has resulted in low awareness among rural women for the need to seek prenatal care, screening and treatment for reproductive tract infections or to make use of safe delivery services. The decline in subsidies to local areas has resulted in the deterioration in the quality of local health services.

In 1998, this situation led to a Ford Foundation funded project, Reproductive Health Improvement Project Phase I (RHIP-I), being initiated with the aim of improving the reproductive health of the rural population through provision of essential services and better financing mechanisms. One of the results of RHIP-I was to reveal the complexities involved in improving reproductive health in poor rural communities.

The Chinese Government has become increasingly aware of the importance of community participation in planning processes and Phase II of the project, RHIP-II, will be conducted with a view to testing new planning approaches. Two of the major interventions will centre on a "bottom-up approach" and the involvement of NGOs and women in the health planning process.

The GHEN China Case Study, to be carried out in Dafang County, Guizhou Province, is being undertaken in conjunction with RHIP-II (above). It focuses on promoting women's participation in the planning process through:

  • participatory research with local women to identify legitimate agents to represent their interests to local government and participate in local planning
  • capacity building of local women's groups
  • participatory planning training and practice with local township health centres and women's representatives.

Its goal is to make health planning and service delivery responsive to women's reproductive health needs and problems. It will aim to:

  • enable local women to be involved in the planning process
  • strengthen the capacity of local women's groups to participate in the planning process and be advocates for women's needs
  • improve transparency and accountability to women of the local health planning process
  • improve evidence used and planning methodology.

Leading Team Members
Liu Yunguo, Foreign Loan Office, Ministry of Health, China
Joan Kaufman, Harvard University and Wellesley Center for Research on Women, Wellesley College
Fang Jing, Yunnan Reproductive Health Research Association and Institute of Development Studies, University of Sussex, UK

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