Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jan 31:15:38.
doi: 10.1186/s12889-015-1364-7.

China's three-year health reform program and equity in sanitation improvement: a panel analysis

Xiaolong Li  1 , Yanqing Miao  2 , Wenjing Chen  3
Affiliations

China's three-year health reform program and equity in sanitation improvement: a panel analysis

Xiaolong Li et al. BMC Public Health. .

Abstract

Background: Accessible improved sanitation is critical to child health, and inequities in improved sanitation can be interpreted as health inequities across socio-economic groups. From 2009 to 2011, the Chinese government invested 4.448 billion yuan for rural sanitation improvement through a 3-year health reform program. This study assesses the inequity of sanitation improvement in rural China from 2003 to 2011 and examines whether the 3-year health reform program promoted equity in sanitation improvement.

Methods: Data from the China Health Statistics Yearbooks of 2004 to 2012 and the National Bureau of Statistics of China were used to create the concentration curve (CC), concentration index (CI), and absolute concentration index (ACI) of improved sanitation. Data of central investment for sanitation improvement in each province of China for 2009, 2010, and 2011 was gained through correspondence and used to create the CC and CI for investment.

Results: Although the CIs of improved sanitation are lower than the CIs of the net income of rural residents, the latter have an obvious downtrend. The CIs of improved sanitation increased from 2003 until 2008 and started to drop in 2009. As a result, by 2011, the CIs of improved sanitation had reached their 2003 levels. The ACI of improved sanitation decreased slightly from 2003 to 2008, but declined sharply from 2009 to 2011. The CIs of central investment for 2009, 2010, and 2011 are negative and the CCs of central investment are above the line of absolute equality, indicating that investments had been concentrated more on poorer provinces and regions.

Conclusions: The equality of rural residents' net income has been improving each year, whereas equity in sanitation improvement deteriorated from 2003 to 2008. However, equity in sanitation improvement has increased since 2009 due to central investment in sanitation improvement during the 3-year health reform program that benefits low-income areas more. It is clear that the 3-year health reform program played an important role in promoting the level and equity of sanitation improvement.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Coverage rate of improved sanitation in rural China from 2003 to 2011.
Figure 2
Figure 2
Concentration curves for 2005.
Figure 3
Figure 3
Concentration curves for 2010.
Figure 4
Figure 4
CIs and ACI from 2003 to 2011.
Figure 5
Figure 5
Coverage of improved sanitation in different regions of China.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Prüss-Üstün A, Bos R, Gore F, Bartram J. Safer water, better health: costs, benefits and sustainability of interventions to protect and promote health. Geneva: World Health Organization; 2008.
    1. Boschi-Pinto C, Velebit L, Shibuya K. Estimating child mortality due to diarrhoea in developing countries. Bull World Health Organ. 2008;86(9):710–7. doi: 10.2471/BLT.07.050054. - DOI - PMC - PubMed
    1. Bartram J, Cairncross S. Hygiene, sanitation, and water: forgotten foundations of health. PLoS Med. 2010;7(11):e1000367. doi: 10.1371/journal.pmed.1000367. - DOI - PMC - PubMed
    1. Pardey PG, Alston JM, Piggott R. Agricultural R&D in the developing world: Too little, too late? Washington, D.C: Intl Food Policy Res Inst; 2006.
    1. Carlton EJ, Liang S, McDowell JZ, Li H, Luo W, Remais JV. Regional disparities in the burden of disease attributable to unsafe water and poor sanitation in China. Bull World Health Organ. 2012;90(8):578–87. doi: 10.2471/BLT.11.098343. - DOI - PMC - PubMed

Publication types

MeSH terms