Women's health in rural China

Abstract

China's sheer size, along with its ongoing economic and cultural metamorphosis, creates enormous challenges in health care. Cervical cancer and breast cancer are major threats to women's health, with the 100 000 new cervical cancer cases recorded in China every year accounting for 29% of the world's total. Worryingly, cervical cancer incidence is greater in women younger than 30 years in China than it is in developed countries, and the disease is over-represented in rural areas—owing to lack of education, poverty, and inability to pay for health care.China's Government has now put the health of rural women firmly on their domestic agenda. From July 6, 2009, free cervical cancer screening examinations have been available for women between 35 years and 59 years under a government-sponsored programme proposed by the All-China Women's Federation. Over the next 3 years, 10 million rural women will be able to access this service, and 1·2 million women will get free breast cancer screening. In the first 5 months, this programme is set to cost 77 million RMB (US$11·3 million), part of the country's ambitious 850 billion RMB ($124 billion) health reform plan. The plan will concentrate on China's less developed central and western regions, and cover broad preventive and screening efforts, ranging from vaccination drives to improved cooking and sanitation facilities in rural areas.The new government-sponsored programme is a step towards provision of universal breast and cervical cancer screening nationwide, although with an estimated 500 million women in rural China the public health challenge is substantial. This is the first time China's Government has proposed to gradually widen access to public health services so that women in rural China are included. This admirable step needs to be followed by development of more appropriate health-care policies to achieve access to health-care services for all.The success of this health-care programme will need to be evaluated carefully over a sustained period, and could provide a good model for other middle-income countries to follow. China's sheer size, along with its ongoing economic and cultural metamorphosis, creates enormous challenges in health care. Cervical cancer and breast cancer are major threats to women's health, with the 100 000 new cervical cancer cases recorded in China every year accounting for 29% of the world's total. Worryingly, cervical cancer incidence is greater in women younger than 30 years in China than it is in developed countries, and the disease is over-represented in rural areas—owing to lack of education, poverty, and inability to pay for health care. China's Government has now put the health of rural women firmly on their domestic agenda. From July 6, 2009, free cervical cancer screening examinations have been available for women between 35 years and 59 years under a government-sponsored programme proposed by the All-China Women's Federation. Over the next 3 years, 10 million rural women will be able to access this service, and 1·2 million women will get free breast cancer screening. In the first 5 months, this programme is set to cost 77 million RMB (US$11·3 million), part of the country's ambitious 850 billion RMB ($124 billion) health reform plan. The plan will concentrate on China's less developed central and western regions, and cover broad preventive and screening efforts, ranging from vaccination drives to improved cooking and sanitation facilities in rural areas. The new government-sponsored programme is a step towards provision of universal breast and cervical cancer screening nationwide, although with an estimated 500 million women in rural China the public health challenge is substantial. This is the first time China's Government has proposed to gradually widen access to public health services so that women in rural China are included. This admirable step needs to be followed by development of more appropriate health-care policies to achieve access to health-care services for all. The success of this health-care programme will need to be evaluated carefully over a sustained period, and could provide a good model for other middle-income countries to follow.