03/26/2010, 00.00
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Child mortality varies along urban-rural divide

A study by The Lancet shows that children in rural areas under the age of five are “three to six times” more likely to die than in urban areas. The government injects fresh cash into health care, but in cities. About 70 per cent of farmers never see a doctor.
Beijing (AsiaNews/Agencies) – Children born in China’s rural areas are three to six times more likely to die before the age of five than those who are born in urban areas. Such stark differences highlight the wide geographic gulf that exists in China’s healthcare system, The Lancet said citing a recent paper by Igor Rudan at the Croatian Centre for Global Health.

According to the study, child mortality in the mainland declined by 71 per cent between 1990 and 2008, dropping from 64.6 deaths to 18.5 per 1,000 live births. However, the geographic disparity between booming cities and the poor countryside remained due to asymmetrical socioeconomic development.

The researchers searched public databases containing information, including 206 long-term studies on causes of death in children under the age of five, with pneumonia, birth asphyxia, and pre-term birth complications as the leading causes of death in children.

The Chinese government is aware of the situation and has been working to address this inequity since 2003, putting in place a modest healthcare insurance system, which it hopes will help the poorest meet basic medical needs.

Last year, Beijing launched a new reform, pledging US$ 123 billion over the next three years to provide universal and affordable basic healthcare for its 1.3 billion-strong population.

In a recent interview, Chinese Health Minister Chen Zhu said the insurance scheme has been extended to much of the population. However, “Some 100 million are not covered; these are migrants, elderly people and children in cities and people in small enterprises,” he noted. “I hope that next year, a part of these 100 million people who are still uninsured . . . will be brought in.” Yet, these major (on paper) outlays may not be enough.

In fact, Health Ministry data show that more than half of rural residents cannot afford medical care. According to former Deputy Health Minister Zhu Qingsheng, anywhere between 40 to 60 per cent of farmers cannot afford medical care, whilst 60 to 80 per cent of Chinese died at home because they could not pay for health care. His ministry was allocated only 1.6 per cent of government's annual budget and most of that went to the cities.

“Only 30 per cent of medical expenditure is spent on farmers, who comprise 70 per cent of the population. The urban population, which makes up 30 per cent, enjoys 70 per cent of the medical resources," Zhu said.

According to the 2004 World Health Report, China's health care system was among the worst in the world coming in at the 189th place in a list of 191 countries.

In order to address rising frustration and possible epidemics, the government has decided to set up a new system of health coops in 310 rural countries. Each would provide basic medical care to seriously ill rural residents who had no health care.

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