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This paper systematically reviewed the process of primary health care development of China over the past 45 years, and summarized the achievements of primary health care based on data related to primary health care draw from 2010-2012 China Health Statistics Year book, 2013-2017 China Health and Family Planning Statistical Yearbook and 2018-2022 China Health Statistics Year book. Data of the infant mortality rate, maternal mortality rate, and average life expectancy were from the World Bank in China and upper middle income countries in 2023. The development of primary health care of China was summarized into four phases, and the achievements included the improvement of the primary health care network, coverage expansion of basic health insurance, the increase of funding and coverage of basic public health services, the steady improvement of family doctor contracts, and the continuous improvement of women's and children's health, with major health indicators ranking among the top upper middle-income countries. The current challenges include the unbalanced development of infrastructure construction in the primary medical and health system, the decline in the proportion of medical insurance funds, the lack of vitality of the management system, the low level of remuneration and imperfect incentive system. This paper summarizes the enlightenment of international experience for China's primary health care, and puts forward the future development directions and strategies.

Background The county-level medical community has helped improve the capacity of primary care institutions and the quality of primary care services, and promoted the operational efficiency of primary care institutions through various "strengthening primary healthcare" measures. Objective To evaluate the efficiency of service delivery and the total factor productivity (TFP) of member township hospitals in county-level medical communities constructed in typical national pilot areas in China. Methods We collected the annual monitoring data and annual health statistics reports during 2018 to 2019 of county-level medical communities (involving 143 member township hospitals) in eight counties (cities) of four regions in central and western China (Anhui Province, Jiangxi Province, Guangxi Zhuang Autonomous Region and Xinjiang Uygur Autonomous Region). We used data envelopment analysis (DEA) and Malmquist inde (MI) to analyze the change in TFP of the township health hospitals before and after the pilot construction of county medical communities. Results Taking the county as the decision-making unit, compared with 2018, the technical efficiency change, technological progress change, pure technical efficiency change, scale efficiency change and TFP change of township hospitals in the typical areas in 2019 were 0.977, 1.037, 0.995, 0.982 and 1.013, respectively, and the TFP of township hospitals increased by 1.3% on average. Taking township health centers as the decision-making unit, compared with 2018, the TFP of township hospitals increased by 4.5% in 2019. Specifically, the TFP of township hospitals increased by 47.83% in Anhui's A1 county, 66.67% in Anhui's A2 county, 54.84% in Jiangxi's B1 county, 59.26% in Jiangxi's B2 county, 70.00% in Guangxi's C1 county, 90.91% in Guangxi's C2 county, 78.57% in Xinjiang's D1 county, and 55.56% in Xinjiang's D2 county. Conclusion The "strengthening primary health care" measures implemented during the reform of county-level medical communities have played a role in elevating the efficiency of township hospitals. The continuous improvement in the efficiency of township hospitals relies on both the leading hospital providing targeted assistance and mobilizing the productivities and enthusiasm of the township hospitals.

There is an error in the affiliation for authors Jiangmei Qin, Yanchun Zhang, Lifang Zhang, and Chunmei Lin. The correct affiliation is: China National Health Development Research Center, Beijing, China.By Jiangmei Qin; Yanchun Zhang; Masha Fridman; Kim Sweeny; Lifang Zhang; Chunmei Lin and Lu MaoReported by Author; Author; Author; Author; Author; Author; Author [Extracted from the article]

In 2002, the Chinese leadership announced a change in national welfare policy: Voluntary medical schemes at county level, called the "New Rural Co-operative Medical System" should cover all counties by 2010. This article addresses the main characteristics of this system, analyses the introduction of local schemes based on our own field studies in one Kazak county of the Xinjiang Uyghur Autonomous Region since 2006, and argues that the fast progressing of the local scheme and the flexibility shown by local administrators in considering structural and procedural adjustments are not the result of central directives but of local initiatives. Recentralization from the township governments to functional departments in the provincial and the central state administration is only one aspect of current rural governance. Complementary forms of locally embedded responsiveness to the needs of health care recipients are crucial in restructuring the administration and discharge of health care. These new modes of governance are different from the hierarchical control and institutionalized representation of interests of the local population. [ABSTRACT FROM AUTHOR]

To evaluate the prevalence, influencing factors, and behavior rules of self-medication in children. Articles on self-medication in children from various electronic databases (PubMed, Cochrane Library, Web of Science, the WHO website (https://www.who.int/), ABI, CNKI, and Wanfang), were searched to August 2022. The single-group meta-analyses of the prevalence, influencing factors, and behavior rules of self-medication in children were performed using Revman 5.3 and Stata 16.0. The overall pooled prevalence of self-medication in children was 57% (95% CI: 0.39-0.75, I²  = 100%, P  < .00001 Z  = 6.22). The pooled prevalence for main influencing factors, in terms of caregivers, was: 73% (95% CI: 0.72-0.75, I²  = 100%, P  < .00001, Z  = 111.18) for those in rural areas; 55% (95% CI: 0.51-0.59, P  = .04, Z  = 26.92, I²  = 68%, P  < .00001) for females; 75% (95% CI: 0.74-0.76, I²  = 68%, P  < .00001, Z  = 106.66) for those whose income was less than 716 dollars; 77% (95% CI: 0.75-0.79, I²  = 99%, P  < .000001, Z  = 92.59) for the middle-aged and elderly; and 72% (95% CI: 0.58-87, I²  = 99%, P  < .00001, Z  = 9.82) for those with a degree below bachelor. In the process of self-medication for children, 19% (95% CI: 0.06-0.32, I²  = 99%, P  < .00001, Z  = 2.82) of the caregivers did not read the instructions, 28% (95% CI: -0.03-0.60, I²  = 100%, P  < .000001, Z  = 1.77) neglected adverse effects, 49% (95% CI: 0.11-0.87, I²  = 100%, P  = .01, Z  = 2.51) spontaneously increased or decreased the dosages, 49% (95% CI: 0.48-0.55, I²  = 65%, P  < .00001, Z  = 16.51) had an awareness of over-the-counter (OTC) drugs, and 41% (95% CI: 0.18-0.64, I²  = 99%, P  < .00001, Z  = 3.49) misrecognized the antibiotics. Self-medication for children was common, although the overall prevalence was not very high. The prevalence of self-medication in children was relatively higher among those caregivers who were female, rural, had low-income, were elder, or had a degree below bachelor. Common behaviors during self-medication in children included spontaneous dose increase or decrease, a lack of awareness of OTC drugs, and misconception of antibiotics. Government departments should formulate corresponding policies to provide quality health education resources for the caregivers of children.