Primary health care in the People's Republic of China: a march backward?
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Biomedical subjects
Publications and source records attributed to P K New.
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This paper deals with the encounter between the Chinese and Western medical missionaries in early twentieth century China. Based on data of two Canadian Protestant missions in China before 1937, this study reveals that medical missionaries were generally ignorant of Chinese medicine, and they regarded Chinese medicine as part of an inferior, heathen culture. Such a 'mission-centric' perspective prevented the missionary doctors from creating an effective doctor-patient relationship with the Chinese patients. To the Chinese, missionary health care provided an additional health care pathway. The functional complementarity of Western medicine to the pluralistic Chinese medical structure enabled missionary medicine to gain increasing credibility from the Chinese, although few Chinese actually understood the basic principles of Western medicine. Implications of this missionary doctor-Chinese patient relationship in China are discussed.
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The paper reports the findings of a study of the neighborhood health center (NHC) program which was initiated by the Office of Economic Opportunity (OEO) in 1965. The study focuses on the structure of the NHC system (funding agency, operating agency, and community board), analyzes the goals of the different sets of actors, and argues that the conflicts which evolved within the system were the natural outcome of the divergence in the goals of the different actors. Based on a series of 88 in-depth interviews with key health officials in OEO as well as project officers in NHCs throughout the country, the study suggests a framework for a more comprehensive analysis of the outcome of the NHC program and notes the implications of these findings for some current health legislation.
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