Inequities in the allocation of medical resources in China’s Township Health Centers

2016 ◽  
Vol 8 (4) ◽  
pp. 637-646 ◽  
Author(s):  
Yue Ma ◽  
Linxiu Zhang ◽  
Matthew Boswell
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Rural China ◽  
Health Centers ◽  
Content Type ◽  
Representative Study ◽  
Use Of Data ◽  
Fixed Assets ◽  
Nationally Representative ◽  
Academy Of Sciences

Purpose The purpose of this paper is to produce a high-quality measure of the nature of healthcare resources available in China’s Township Health Centers (THCs), paying particular attention to equity between high- and low-income areas. Design/methodology/approach This study makes use of data from a nearly nationally representative survey in rural China conducted by the Center for Chinese Agricultural Policy at the Chinese Academy of Sciences in 2011. The samples of towns were selected randomly from 25 counties located in five provinces from different regions of China. Data were collected through questionnaires and direct observation. Findings The THCs located in rich areas have higher levels of human resources than poor areas. THCs in rich areas also have more fixed assets than those in poor areas. In fact, even though the Chinese Ministry of Health mandates that all THCs have certain basic levels of medical equipment and facilities, many THCs in poor areas do not have them. The allocation of mandated equipment is unequal. Practical implications These findings suggest that China’s government should pay more attention to THCs located in poor areas, especially in light of new initiatives to improve health care in poor rural areas. Originality/value This is the first nationally representative study to employ rigorous empirics to investigate the extent of inequality in allocation of resources within THCs across China.

The impact of investment on drinking water quality in rural China

2017 ◽  
Vol 9 (2) ◽  
pp. 255-269
Author(s):  
Ai Yue ◽  
Yaojiang Shi ◽  
Renfu Luo ◽  
Linxiu Zhang ◽  
Natalie Johnson ◽  
...  
Keyword(s):  
Water Quality ◽  
Drinking Water ◽  
Rural Areas ◽  
Tap Water ◽  
Rural China ◽  
Ordinary Least Squares ◽  
Content Type ◽  
Representative Data ◽  
Nationally Representative ◽  
The Impact

Purpose Although access to safe drinking water is one of the most important health-related infrastructure programs in the world, drinking water remains a large problem in China today, especially in rural areas. Despite increased government investment in water resource protection and management, there is still an absence of academic studies that are able to document what path the investment has taken and whether it has had any tangible impact. The purpose of this paper is to analyze the impact of drinking water investment on drinking water in China. Design/methodology/approach The authors make use of nationally representative data from 2005 and 2012 to measure the impact of drinking water investment among 2,028 rural households in 101 villages across five provinces. Both ordinary least squares regression and probit regression are used to analyze the correlates and the impact of drinking water investment. Findings The authors demonstrate that water quality was likely a significant problem in 2004 but that China’s investment into drinking water appears to have resulted in initial improvements during the study period. The authors show that the most significant change came about in terms of hardware: villages that received more drinking water investment now have more piped tap water and more access to water treatment infrastructure (disinfecting and filtering facilities). High rates of rural resident satisfaction with drinking water suggest the effects of drinking water investment are being felt at the village level. Originality/value To the authors’ knowledge, this is the first empirical study on drinking water investment over time in rural China using nationally representative data.

scholarly journals 1535. Impact of Defunding Family Planning Health Centers on Gonorrhea and Chlamydia Cases in Iowa: A Spatiotemporal Analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S768-S768
Author(s):  
Megan L Srinivas ◽  
Eileen Yang ◽  
Weiming Tang ◽  
Joseph Tucker
Keyword(s):  
Family Planning ◽  
Low Income ◽  
Rural Areas ◽  
Spatiotemporal Analysis ◽  
Incidence Rates ◽  
Health Centers ◽  
Transmitted Infection ◽  
Missed Opportunities ◽  
Linear Regression Modeling ◽  
The Impact

Abstract Background Fifteen states have defunded family planning health centers (FPHCs), causing thousands to be left without health services. This has accelerated in the COVID-19 era. FPHCs provide low-income individuals in rural areas with essential primary care services, including sexually transmitted infection prevention, testing, and treatment. The purpose of this analysis is to use spatiotemporal methods to examine the impact of FPHC closures in Iowa on the reported number of gonorrhea and chlamydia cases at the county level. Methods This analysis investigates the association between FPHC closures and changes in the number of gonorrhea and chlamydia cases between 2016 and 2018. Iowa implemented defunding policies for family planning clinics, resulting in four FPHC closures in June 2017. 2016 pre-closure STI incidence rates were compared to 2018 post-closure rates. Gonorrhea and chlamydia rates in the four Iowa counties with clinic closures were compared to the 95 Iowa counties without closures. T tests were used to compare changes in reported gonorrhea and chlamydia rates in the two settings. Linear regression modeling was used to determine the relationship between clinic closures and changes in gonorrhea and chlamydia cases. Results The gonorrhea burden in Iowa increased from 83 cases per 100,000 people in 2016 to 153.8 cases per 100,000 people in 2018. The four counties with clinic closures experienced a significantly larger increase (absolute 217 cases per 100,000 population) in their gonorrhea rate compared to counties without FPHC closures (absolute 121 cases per 100,000 population). There was also a significant relationship between clinic closures and increasing gonorrhea rates (p = 0.0015). Over the three-year period, there was no change in chlamydia rates (p = 0.1182). However, there was a trend towards counties with more FPHC closures having a higher number of chlamydia cases (p = 0.057). Conclusion Despite the fact that many STI diagnoses are made and reported by FPHCs, our data suggest that clinic closures may have contributed to an increase in gonorrhea and chlamydia cases. This is consistent with delayed diagnoses and missed opportunities for providing essential STI services to vulnerable and under-served rural residents. Legislative action is urgently needed to curtail this trend. Disclosures All Authors: No reported disclosures

Do institutions matter?

2019 ◽  
Vol 13 (3) ◽  
pp. 319-332
Author(s):  
Habiba Ibrahim
Keyword(s):  
Social Networks ◽  
Low Income ◽  
Qualitative Interviews ◽  
Community Support ◽  
Institutional Perspective ◽  
Content Type ◽  
Credit Line ◽  
Institutional Determinants ◽  
The Usa ◽  
Nationally Representative

Purpose Guided by the institutional theory of savings, the purpose of this study is to assess the institutional elements of rotating, savings and credit associations (ROSCAs) that enable participants to save. Design/methodology/approach The study used data from in-depth qualitative interviews (N = 10) conducted among the ROSCA group leaders from African immigrant communities in the USA. Findings The primary goal for joining the ROSCA group among participants is to achieve economic stability. The results of the study postulate that, through institutional mechanisms and social networks, ROSCAs create an environment for families to save and invest. The emphasis on the concept of “you cannot save alone” underscores the importance of supportive structures to enable low-income households to save. Although “alternative savings programs” such as ROSCAs are imagined as something that less well-to-do persons use, the findings from this study demonstrate that such strategies also appeal to some people with higher socioeconomic status. This appeal and utility speaks to the importance of ROSCAs as an institutional response, rather than just an informal arrangement among persons known to each other. Research limitations/implications It is prudent to bear in mind that the study sample is not nationally representative, and therefore, the results presented cannot be generalized to immigrants across the country. However, as one of the few ROSCA studies in the USA, the findings from this study make generous contributions to the immigrants’ savings and ROSCA practices literature. Practical implications ROSCAs could be used as a bridge to the formal financial institutions. Non-profit agencies working with these communities could work with these groups to report ROSCA payments to the major credit bureaus, to help them build a credit line in their new country. Originality/value Previous studies of ROSCAs have assessed ROSCAs as community support systems and social networks. The current study has analyzed ROSCAs from an institutional perspective by examining the institutional characteristics of ROSCAs comparable to the institutional determinants of savings that enable savings among the participants.

scholarly journals Assessing clinical quality performance and staffing capacity differences between urban and rural Health Resources and Services Administration-funded health centers in the United States: A cross sectional study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242844
Author(s):  
Nadereh Pourat ◽  
Xiao Chen ◽  
Connie Lu ◽  
Weihao Zhou ◽  
Hank Hoang ◽  
...  
Keyword(s):  
United States ◽  
Low Income ◽  
Rural Areas ◽  
Health Resources ◽  
Quality Measures ◽  
The United States ◽  
Health Centers ◽  
Quality Performance ◽  
Clinical Quality

Background In the United States, there are nearly 1,400 Health Resources and Services Administration-funded health centers (HCs) serving low-income and underserved populations and more than 600 of these HCs are located in rural areas. Disparities in quality of medical care in urban vs. rural areas exist but data on such differences between urban and rural HCs is limited in the literature. We examined whether urban and rural HCs differed in their performance on clinical quality measures before and after controlling for patient, organizational, and contextual characteristics. Methods and findings We used the 2017 Uniform Data System to examine performance on clinical quality measures between urban and rural HCs (n = 1,373). We used generalized linear regression models with the logit link function and binomial distribution, controlling for confounding factors. After adjusting for potential confounders, we found on par performance between urban and rural HCs in all but one clinical quality measure. Rural HCs had lower rates of linking patients newly diagnosed with HIV to care (74% [95% CI: 69%, 80%] vs. 83% [95% CI: 80%, 86%]). We identified control variables that systematically accounted for eliminating urban vs. rural differences in performance on clinical quality measures. We also found that both urban and rural HCs had some clinical quality performance measures that were lower than available national benchmarks. Main limitations included potential discrepancy of urban or rural designation across all HC sites within a HC organization. Conclusions Findings highlight HCs’ contributions in addressing rural disparities in quality of care and identify opportunities for improvement. Performance in both rural and urban HCs may be improved by supporting programs that increase the availability of providers, training, and provision of technical resources.

Inequality boosts US white death rates

2015 ◽  
Keyword(s):  
Low Income ◽  
Health Care Professionals ◽  
Rural Areas ◽  
Addiction Treatment ◽  
Health Sector ◽  
National Academy Of Sciences ◽  
Mental Strain ◽  
Death Rates ◽  
Content Type ◽  
Criminal Justice Reform

Subject Rising death rates for white US nationals. Significance A recent study published by Anne Case and Angus Deaton in the 'Proceedings of the National Academy of Sciences' (PNAS) has noted a dramatic increase since 1998 in death rates and a decline in many measures of mental and physical health among middle-aged, non-Hispanic white US nationals, particularly men. The uptick in midlife death rates and decline in health passes significant costs onto the health sector, prison system and public finances, as well as the general productivity and social wellbeing of US nationals. Impacts Local and state budgets will feel demographic pressures more acutely than the federal government. Unaffordable housing will place further fiscal and mental strain on low-income US nationals. Shortages of health care professionals in rural areas will constrain addiction treatment efforts. The opioid abuse epidemic will spur criminal justice reform when Congress reconvenes in 2016.

scholarly journals Data-driven decision-making in creating class rosters

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rebecca Wolf ◽  
Joseph M. Reilly ◽  
Steven M. Ross
Keyword(s):  
Decision Making ◽  
Student Learning ◽  
Low Income ◽  
School Leaders ◽  
Data Driven ◽  
Data Driven Decision Making ◽  
Content Type ◽  
Use Of Data ◽  
Using Data ◽  
Rich Data

PurposeThis article informs school leaders and staffs about existing research findings on the use of data-driven decision-making in creating class rosters. Given that teachers are the most important school-based educational resource, decisions regarding the assignment of students to particular classes and teachers are highly impactful for student learning. Classroom compositions of peers can also influence student learning.Design/methodology/approachA literature review was conducted on the use of data-driven decision-making in the rostering process. The review addressed the merits of using various quantitative metrics in the rostering process.FindingsFindings revealed that, despite often being purposeful about rostering, school leaders and staffs have generally not engaged in data-driven decision-making in creating class rosters. Using data-driven rostering may have benefits, such as limiting the questionable practice of assigning the least effective teachers in the school to the youngest or lowest performing students. School leaders and staffs may also work to minimize negative peer effects due to concentrating low-achieving, low-income, or disruptive students in any one class. Any data-driven system used in rostering, however, would need to be adequately complex to account for multiple influences on student learning. Based on the research reviewed, quantitative data alone may not be sufficient for effective rostering decisions.Practical implicationsGiven the rich data available to school leaders and staffs, data-driven decision-making could inform rostering and contribute to more efficacious and equitable classroom assignments.Originality/valueThis article is the first to summarize relevant research across multiple bodies of literature on the opportunities for and challenges of using data-driven decision-making in creating class rosters.

Consequences of post-disaster policies and relocation approaches: two communities from rural China

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Yong Chen ◽  
Lulu He ◽  
Dan Zhou
Keyword(s):  
Rural Areas ◽  
Disaster Recovery ◽  
Rural China ◽  
Critical Role ◽  
Content Type ◽  
Face To Face ◽  
Displaced People ◽  
Questionnaire Surveys ◽  
Post Disaster

PurposePost-disaster population resettlement is a complicated process, during which the restoration of livelihood and lifestyle plays a critical role in achieving a successful resettlement outcome. This paper attempts to examine how recovery policies and relocation approaches influence people's livelihood recovery and perception of wellbeing. It specifically investigates the role of farmland in producing a livelihood and maintaining a rural lifestyle among displaced people.Design/methodology/approachThrough face-to-face questionnaire surveys and in-depth interviews with rural residents displaced from their villages after the Wenchuan earthquake in Sichuan, China, this study presents both quantitative and qualitative evidence to investigate how post-disaster policies and particularly the availability of farmland influence people's recovery and their satisfaction with the post-resettlement life.FindingsData suggest that availability of farmland, in spite of the size, makes big differences in post-disaster recovery because farmland provides resettled people with not only a livelihood to secure basic living but also a guarantee to maintain a rural lifestyle.Research limitations/implicationsMore samples are needed for analyzing factors that significantly influence disaster-displaced farmers' recovery and wellbeing post resettlement.Practical implicationsThis study can be used as an important reference for making plans for post-disaster recovery and population resettlement programs in other disaster-prone countries across the world.Originality/valueLand-based relocation is proposed as a desirable approach to addressing challenges of livelihood restoration amongst the resettled population in rural areas of developing countries.

How the new media impacts rural development in China: an empirical study

2017 ◽  
Vol 9 (2) ◽  
pp. 238-254 ◽  
Author(s):  
Dong Zhou ◽  
Benqian Li
Keyword(s):  
New Media ◽  
Rural Areas ◽  
Media Coverage ◽  
Rural China ◽  
General Social Survey ◽  
Probit Model ◽  
Content Type ◽  
Pseudo Panels ◽  
Alternative Measures ◽  
Urban And Rural Areas

Purpose The purpose of this paper is to study a new pathway out of poverty for rural areas through cultivating non-farm employment: the new media utilization. Design/methodology/approach The authors utilize two waves of nationwide micro survey data in China, China General Social Survey 2005 and 2013, to investigate the impacts of new media coverage on non-farm employment and earnings in rural China with the ordered probit model and instrument variables. Findings The authors find that promotion of new media coverage can significantly enhance rural non-farm employment in China by 10-20 percent and ultimately increase earnings for rural residents. The findings provide new evidence for the new media as a potential newly emerging pathway out of poverty for rural areas. The conclusions are robust regarding a variety of controls and model specifications, evaluations with alternative measures, examinations within different subsamples, and estimations with constructed pseudo panels. Social implications Encouragement of new media coverage in rural China not only can improve the rural non-farm employment and living standards but also can contribute toward narrowing the differences between urban and rural areas, thereby balancing regional development. Originality/value It contributes to the existing literature through primarily empirically investigating the economic functions of new media in rural China.

Serving the low-income consumer in a rich economy: Dollar General racks up sales

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Glyn Atwal ◽  
Douglas Bryson
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Business Strategy ◽  
Cultural Context ◽  
Success Factors ◽  
Low Cost ◽  
Well Being ◽  
Content Type ◽  
The Usa

Purpose The conceptualization of the Base of Pyramid (BOP) proposes that low-income markets can lead to profitable opportunities for businesses. The purpose of this study is to identify key success factors of a BOP business strategy based on a case study of the discount retailer, Dollar General, in the USA. Design/methodology/approach The research design used in this research is an in-depth case study of Dollar General in the USA. Qualitative methods are applied in both the primary and secondary data collection and during the follow-on data analysis of Dollar General. Findings Dollar General’s strategic profile is achieved through the combination of the following four actions which are tailored to compete effectively at the BOP in the USA: creating the neighborhood discounter, raising aspirational appeal, reducing service and eliminating internationalization. Research limitations/implications The case is specific to Dollar General in a US cultural context. Practical implications The case of Dollar General demonstrates how a discounter retailer should not only follow a low-cost strategy to compete at the BOP. Its ability to craft a distinctive strategy is coherent with meeting the logistical, rational and emotional needs of the low-income consumer in the USA. Social implications Many businesses have neglected rural areas of the USA as being unprofitable. The ability for businesses such as Dollar General to serve the BOP segment can foster the socio-economic well-being of communities. Originality/value The overwhelming body of the BOP literature is based on emerging markets. To the best of the authors’ knowledge, this is one of the few studies to investigate BOP business strategy in the USA.

scholarly journals Rural residents’ understanding and willingness to pay higher prices for mitigation against global warming in China

2018 ◽  
Vol 10 (5) ◽  
pp. 711-728 ◽  
Author(s):  
Genying Chang
Keyword(s):  
Global Warming ◽  
Willingness To Pay ◽  
Low Income ◽  
Rural Areas ◽  
Multivariate Regression Analysis ◽  
Western China ◽  
Rural Residents ◽  
Content Type ◽  
Climate Policies ◽  
The Cost

Purpose Studies addressing rural residents’ understanding of global warming and their willingness to pay higher prices to mitigate it are very limited. The purpose of this study is to examine the general understanding and attitudes of rural residents in China regarding global warming and their willingness to pay higher prices to mitigate it. Design/methodology/approach This study surveyed 1,185 rural residents in three counties of coastal, middle and western China. Multivariate regression analysis was conducted to reveal the relationships between the willingness to pay higher prices to mitigate global warming and influencing factors. Findings The majority of respondents had heard of global warming; however, their knowledge of the phenomenon and its causes was very limited. Most respondents admitted the likelihood of risks from global warming. Although most respondents thought they had an obligation to mitigate global warming, only a small percentage of them were willing to pay higher prices to address the problem; the unwillingness of respondents to pay higher prices to mitigate global warming may have been associated with their low income and perceived inability to handle the cost, externalisation of responsibility and causes and lack of knowledge of how to affect it. Originality/value This study examines the general understanding and attitudes of rural residents in China regarding global warming and their willingness to pay higher prices to mitigate it. The research is conducive to climate change communications and the implementation of climate policies in China’s rural areas.

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