'Hybrid' top down bottom up health system innovation in rural China: A qualitative analysis.

ABSTRACT:

Introduction

China has made considerable progress with health system reforms in recent years. Rural China, however, has lagged behind as the diversity of needs of China's 3,000 rural counties were not always well addressed by national top-down reforms. China's Rural Health Reform Project Health XI (HXI) piloted a hybrid process of top down and bottom up implementation of health system reforms which were tailored to rural county level needs and covered a population of more than 21 million. Different studies provide evidence that HXI counties have achieved substantial benefits given the relatively limited investment. The Effectiveness of HXI subsequently raises the question how the hybrid approach may have resulted in effective implementation of interventions. We answer this question

SUBMITTER: Klundert JV 

PROVIDER: S-EPMC7540887 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature