I Significance of equalizing health and family planning service for migrant population
The Third Plenary Session of the 18th CPC Central Committee and the 12th five-year national basic public service plan for 2011-2015 made it clear that the equalization of basic public service, including health and family planning service, is important. At the moment, the migrant population is on the rise. It reached 236 million in 2012, accounting for one-sixth of the whole population. Although the mass population migration played a role in promoting economic growth, narrowing inter-regional gaps and changing population distribution patterns, it imposed huge pressure and challenges on the government’s public service and social management work. Studies showed that the migrant population didn’t take full advantage of the health and family planning service, which made them a weak link in the public service chain. The equalization work is an important move by the National Health and Family Planning Commission to carry out the spirit of the Third Plenary Session of the 18th CPC Central Committee. It will help promote urbanization of the rural population, integrate urban and rural development, shift government functions, innovate the social governance system, strengthen health and family planning service management and improve the health status of the whole nation.
II Background of the pilot work
In 2009, the former Ministry of Health, the Ministry of Finance and the former National Population and Family Planning Commission came up with the goal and major tasks of the equalization work, which asked for substantial improvement in equalizing basic public health service by 2020, effective control of major diseases and health risks, and health status improvement for urban and rural residents. To meet the goal, major work has been done in recent years as follows:
Since the new round of healthcare reform beginning in 2009, the Ministry of Health has taken active measures to implement basic and major public health service projects. After years’ efforts, project management measures have been improving, funds are secured and the quantity and quality of services are rising steadily, producing significant results.
In October 2010, the former National Population and Family Planning Commission joined hands with the Office of the Central Committee for Comprehensive Management of the Public, the Ministry of Finance, and the Ministry of Human Resources and Social Security to improve the migrant population’s service management system and promote equalization of basic family planning services in 49 pilot cities. The main tasks were to build a comprehensive management and decision-making mechanism for the migrant population, improve the family planning service network and management information system, and enable the migrant population to enjoy equal public services in prenatal care and reproductive health. The efforts yielded positive results.
After the National Health and Family Planning Commission was set up in 2013, it decided to integrate the equalization of health and family planning services for the migrant population. It laid out work goals, key reform areas and main tasks, and conducted special studies on health and family planning services for the migrant population. It decided to add basic public health services to the previous pilot work on basic family planning services, and initiated a new round of pilot projects in 40 cities with large migrant populations. The pilot projects are people-oriented, ensure individual’s basic needs and took steps to explore effective ways to serve migrant population. The projects aim to increase the accessibility and quality of the public services for migrant population, and pave the way for future policy making.
III Ideology of the pilot projects
1. Stress Key points
The migrant population as a whole has their own characteristics. For example, they are generally young, in the prime of reproductive maturity, weak in health consciousness, and enjoy less favorable residential and working conditions. So they need more public services in health education, women and children’s healthcare, planned immunization, family planning and communicable disease prevention, and are less likely to need help in chronic disease control and elderly care. Therefore, under the framework of the national basic public health standards and family planning service requirements, the pilot projects give priority to what they need most . At the same time, we have set out concrete requirements in health education, women and children’s healthcare, planned immunization, family planning and communicable disease prevention, based on previous studies, to ensure they are easily operated at primary level.
2. Integrate resources
At the moment, health and family planning authorities and affiliated agencies below provincial level are merging . Health institutions at various levels have strong technical strength, while the family planning sectors have a strong service management network at the grassroots level. Solid work has been done in gathering statistics and dynamic monitoring of the migrant population, enabling a firm grasp of the migrant population base number. Integration of the two systems will not only help basic public health services cover more of the migrant population, but also improve the quality of family planning services.
3. Rolling out pilot project
Considering the ongoing institutional reform at provincial level and work progress at various levels, the equalization of basic public health and family planning services will be carried out in two steps. This year, it will be piloted in 40 cities to explore the work model and effective measures , and then rolled out nationwide when conditions allow.
IV Main points of pilot work plan
The pilot work plan covers mainly three aspects:
First, clearly define the guiding idea of pilot work and come up with a goal for it: explore work model and effective measures for migrant population’s basic public health and family planning services during 2011-2015; boost relevant information sharing and application ; raise the accessibility and quality of public services; accumulate experience for future establishment of the migrant population’s basic public health and family planning service system.
Second, settle on seven major work areas based on the characteristics of the migrant population: i, set up health records for the migrant population; ii, conduct health education; iii, expand migrant children’s vaccination; iv, carry out disease prevention and control measures tailored to migrant population; v, enhance migrant pregnant and lying-in women and children’s healthcare management; vi, carry out basic family planning services; vii, explore new migrant population service management mechanism.
Third, raise clear requirements for pilot work, including clarifying responsibilities; increasing funding to offer fiscal guarantees; conducting studies to grasp accurate information; integrating information to promote sharing; enhancing supervision and evaluation.