title: Factors influencing the provision of public health services by village doctors in Hubei and Jiangxi provinces, China.
abstract: OBJECTIVE
  The Chinese central government launched the Health System Reform Plan in 2009 to strengthen disease control and health promotion and provide a package of basic public health services. Village doctors receive a modest subsidy for providing public health services associated with the package. Their beliefs about this subsidy and providing public health services could influence the quality and effectiveness of preventive health services and disease surveillance.
  
  
  METHODS
  To understand village doctors' perspectives on the subsidy and their experiences of delivering public health services, we performed 10 focus group discussions with village doctors, 12 in-depth interviews with directors of township health centres and 4 in-depth interviews with directors of county-level Centers for Disease Control and Prevention.
  
  
  METHODS
  The study was conducted in four counties in central China, two in Hubei province and two in Jiangxi province.
  
  
  RESULTS
  Village doctors prioritize medical services but they do their best to manage their time to include public health services. The willingness of township health centre directors and village doctors to provide public health services has improved since the introduction of the package and a minimum subsidy, but village doctors do not find the subsidy to be sufficient remuneration for their efforts.
  
  
  CONCLUSIONS
  Improving the delivery of public health services by village doctors is likely to require an increase in the subsidy, improvement in the supervisory relationship between village clinics and township health centres and the creation of a government pension for village doctors.
authors: Institute of Public Health, Heidelberg University, Heidelberg, Germany.
authors: Yan
authors: Y
authors: Ding
authors: Helen J
authors: HJ
authors: Smith
authors: Yang
authors: Y
authors: Fei
authors: Biao
authors: B
authors: Xu
authors: Shaofa
authors: S
authors: Nie
authors: Weirong
authors: W
authors: Yan
authors: Vinod K
authors: VK
authors: Diwan
authors: Rainer
authors: R
authors: Sauerborn
authors: Hengjin
authors: H
authors: Dong
mesh_terms: D002681:China; D003150:Community Health Workers / Q000191:economics / Q000193:education / Q000458:organization & administration / Q000600:supply & distribution; D017144:Focus Groups; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D011314:Preventive Health Services; D015980:Public Health Practice; D036301:Qualitative Research; D019035:Rural Health Services / Q000600:supply & distribution*
references: Lancet. 2012 Mar 3;379(9818):833-42
references: 22386036
references: Nature. 2003 Sep 25;425(6956):333
references: 14508448
references: BMC Med Inform Decis Mak. 2012 Feb 03;12:4
references: 22305256
references: Lancet. 2009 Apr 18;373(9672):1322-4
references: 19376436
references: Health Aff (Millwood). 2008 Jul-Aug;27(4):952-63
references: 18607028
references: Soc Sci Med. 1997 Aug;45(3):351-60
references: 9232730
references: BMC Med Res Methodol. 2008 Jul 10;8:44
references: 18616812
references: Hum Resour Health. 2009 Mar 17;7:24
references: 19292911
references: Fam Pract. 2000 Feb;17(1):71-5
references: 10673494
references: Bull World Health Organ. 2004 Jul;82(7):532-8
references: 15500285
references: Soc Sci Med. 1995 Oct;41(8):1085-93
references: 8578331