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the collective ownership. Private practice serves as a supplement to the state and collective-run institutions.
The present systems of medical care in China are: government-paid medical service for the state functionaries and university/college students, labor insur. ance medical service for the employees of industrial, communication and other enterprises, and various forms have been adopted on a voluntary basis for rural popultations to ensure the availability of doctors and medicine for disease preven. tion and treatment. According to local situations, various regions will continue to implement different forms of comprehensive or unitary medical insurance schemes covering different items of services with different premiums, such as health insurance, cooperative medical service, contractual services for prevention, perinatal care and child immunization.
Rural Medical and Health Services
The Government has all along attached great importance to the rural medical and health services. With initiatives from the state, the collectivity and the community and through the combined efforts of health professionals and part- time health workers, the rural health services have been considerably developed, A three-tier medical and health network embracing county, township and village has been basically built up, providing improved medical and health services to the rural people.
There are 1986 counties in the whole country. In 1989, at the county level there are 9654 general hospitals, 3591 health and epidemic prevention stations, 2796 MCH centres and 1958 hopitals of traditional Chinese medicine. A number of counties have established county health schools, vocational medical schools, laboratories for the control of pharmaceuticals as well as specialized institutions for the control of certain diseases. As the centres of disease prevention and control for the whole county, the county level medical and health instiutions have played a significant role in the control of diseases, in the training of health personnel and in the strengthening of medical and health services at the township and village levels by way of giving technical guidance.
Health centres have been set up at the township level, one-third of which are state-owned and the remaining collectively-owned. The township health centre is a multifunctional health institution taking care of health administration and management, medical practice. prevention and control of diseases and family planning. There are 47523 township health centres with 723000 beds averaging 15. 3 for each centre and 877000 professional health workers averaging 18.6 for each.
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A number of township...alth centres with higher technical skills, better equip. ment and facilities, easy communication and transportation and appropria situated; have been selected in each county as key health centres for specul reinforcement. There are 10000 key health centres making up 22 per cent of the total and each with an average of 29.1 beds and 32,7 health personnel.
At present, 87.9 percent of villages have set up health units in diverse forms which are mainly owned by the village community, village doctors perform functions of medical care, disease prevention and control, MCH, technical guid ance on family planning and community health. The number of village doctors and health aids (used to be called barefoot doctors), has reached 1.278 million, of which 724000village doctors have through training acquired a level equivalent to that of an intermediate medical school graduate.
Since 80 percent of China's population live in the rural areas, disease preven tion and control for the 800 million rural population constitute a major priority in our medical and health services. At present, one of the objectives for social development included in the Government agenda at all levels is to implement primary health care, improve rural health conditions and upgrade the quality of health of farmers so as to achieve the strategic goal of health for all by the year 2000 set forth by WHO. The reorganization of county-level medical and health Institutions and key health centres is being implemented according to plan, by stage and in groups. The consolidation and development programme has been extended to township health centres and village health units, improving the facilities for medical and health services.
Disease Prevention and Control
Before 1949, the Chinese people were poverty-stricken and their health was extremely poor because there were few health institutions and pestilence and diseases were rampant. After the founding of the People's Republic of China, we have put into implementation the principle of prevention first, concentrated the forces on prevention and control of the infectious diseases which endangered the people's health, launched with vast efforts the patriotic health campaign centred on preventing and controlling the infectious diseases and strengthened our work on occupational health, food hygiene, school health, radiation protection, disease prevention and control and building of health infrastructure. As a result, the health altuation in both town and countryside has taken on a new look and the people's health has been improved greatly.
As early as in 1950s, smallpox, plague, kala—aza, typhoid.recurrent fever and
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