title: A model for community health service development in depressed rural areas in China.
abstract: BACKGROUND
  To introduce a model of community health service organization (as implemented in urban areas) to less developed rural areas in China and evaluate the impact of this model on health care utilization.
  
  
  METHODS
  The intervention involved developing leadership at county level, training rural health practitioners, providing clinical management guidelines and standards, encouraging clinic improvements and providing access to subsidies for public health work. We chose 7 townships and 49 administrative villages in Chongyi County as the intervention sites; 3 townships and 9 administrative villages in Luxi County as the comparison sites. Officers from county health bureaus and postgraduates from School of Public Health, Nanchang University visited each township hospital and village clinic in field together and made observations and interviewed clinic staff.
  
  
  RESULTS
  There was little change in health facilities or workforce in the two areas. However, there was an increase in the use of public health services at township and village level in the intervention sites in Chongyi. In these, the proportion of clinics which had developed a child health (under the age of 3) management system, maternal postpartum visit and chronic disease management increased from 53%, 51% and 47% to 78%, 73%, and 71% respectively. There was no significant change in the comparison sites.
  
  
  CONCLUSIONS
  The trial demonstrated that it was feasible to implement a model of community health service delivery that was adapted to depressed rural areas because it required little organizational change, additional funding or personnel. The model had a positive impact on the provision of public health programs, a finding which has implications for efforts to improve access to primary health care in rural China.
authors.affiliation: School of Public Health, Nanchang University, 461 Baiyi Road, Nanchang, Jiangxi, 330006, China. Yuanzhaokang@126.com
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhaokang
authors.forename: Liu
authors.initials: L
authors.lastname: Yuxi
authors.forename: Liu
authors.initials: L
authors.lastname: Yong
authors.forename: Xiao
authors.initials: X
authors.lastname: Yunchang
authors.forename: Guo
authors.initials: G
authors.lastname: Yuanjun
authors.forename: Mark
authors.initials: M
authors.lastname: Harris
mesh_terms: D002681:China; D003153:Community Health Services / Q000458:organization & administration*; D006285:Health Planning / Q000458:organization & administration* / Q000592:standards; D007857:Leadership; D017146:Models, Organizational; D011204:Poverty Areas; D011320:Primary Health Care; D011634:Public Health; D012424:Rural Population; D011795:Surveys and Questionnaires