Public Health Services and Migrant Workers in Shenzhen, China

Background

In early 2009, the Chinese government embarked on a primary care reform, which was designed to provide a public service called six-in-one comprehensive care package via community health centers (CHCs). In Shenzhen, migrants accounted for around 60% of overall population. The objectives of this study were to describe the current state of public health services by focusing on key inputs (human resources and finance) and outputs (scope of primary care services), as well as better understand the impact of public service on migrant workers.

Method

Mixed methods were employed for this study. Policy documents and relevant reports were collected from local health authorities. Institution based questionnaires and in-depth interviews with providers, managers and patients in selected CHCs were carried out so as to collect information about the population situation in the district where the CHCs locate, human resources, financing and services provision.

Results

 

Two CHCs in this study covered a catchment area of 50,130 and 56,000 residents respectively including local residents and migrant workers. Amongst migrants, there were 9,000 and 9,433 temporary residents. Public health services are offered to local residents and permanent residents who registered the residence in Shenzhen. Only one service in this package, which is health education and promotion, can be provided to transient residents. However, this was not well serviced due to limited human resources and insufficient financial support. The capacity of health service providers was low, with 51.35% having bachelor’s degrees. Furthermore, charging for services remains the major source of revenue for CHCs due to insufficient subsidy from government.

Conclusion

Our results suggest that the current performance of public health services remains poor, and some migrants still cannot get access to public health services. Increasing funding is needed for CHCs so as to provide a strong public service, outreach all people in the community and reduce social inequity.