Health sector reform and reproductive health services in poor rural China.

This paper describes and analyses the major reforms and changes that have occurred in the rural health sector of China. Key findings from a number of empirical studies on reproductive health service provision and utilization are summarized in order to assess the implications for reproductive health services of the ongoing health reform. The focus of this paper is what has actually been happening at the ground level, rather than what should have been happening as stated by rural health sector reform policies. It is argued that reproductive health is a missing component of the current health sector reform agenda. It also argued that the rural health sector reform in China is really a passive response to the changed rural socio-economic conditions rather than an active action aimed at improving the health status of the rural population. The ongoing rural health reform has produced both negative and positive implications for reproductive health services and there is a need for both the state, and for women, to play a much stronger role in this reform. Further studies and actions are required, however, to identify the specific type of roles and activities that the state and women need to undertake so as to fulfil the reproductive health goals and objectives set forth by the 1994 International Conference on Population and Development. Copyright 2004 Oxford University Press