REPRODUCTIVE HEALTH FINANCING, SERVICE AVAILABILITY AND NEEDS IN RURAL CHINA

Changes in the health financing system have had a detrimental effect o n the provision and utilisation of reproductive health services for po or rural women. Studies in Yunnan province suggest many women do not s eek medical advice for reproductive health problems. The shortage of f emale doctors is a constraint on service utilisation by women, and man y staff an not appropriately trained to provide key services. Provisio n of preventive sen-ices, such as health education and screening, has been adversely affected by increased reliance on user fees for cost re covery. Some insurance schemes, established to improve utilisation, do not provide adequate coverage, but are used to sen-e the needs of und erfunded health facilities, The authors conclude that women's reproduc tive hearth needs require increased attention, so that provision of se rvices is closely matched to needs and not determined by market forces alone.