ABSTRACT
Primary health care (PHC) is a key component of the health system. It acts as a hub from which patients are guided through the health system (WHO 2008). Having a wellfunctioning PHC system contributes to equity in health and health care, better service quality, and efficient use of health resources. Although PHC has been extensively studied in a well-resourced context, misunderstandings and challenges in PHC are still prevalent in low-and middle-income countries. PHC is often considered as low-tech nonprofessional care for the rural poor. It is often isolated from secondary and tertiary health care (WHO 2008). China has a good historical record of PHC development, especially in rural areas. But along with social and economic development, the PHC system has been considerably weakened. Since 2003, the Chinese government has been trying to re-establish the PHC system through an overall health reform plan. This article is a review of the progress of PHC reform since then by analysing data mainly collected from three provinces in eastern, central, and western China. It found that PHC has made impressive progress in China since the beginning of the health system reform. However, shortages and low quality of health professionals are the main barriers for PHC development. This study sheds light on the key challenges of China’s health system reform. The policy recommendations that emerged from this study are to promote HRH development to improve rural PHC in China.
