FINANCING CHANGES OF SCHISTOSOMIASIS CONTROL PROGRAMS IN CHINA 1980-1995 - A CASE-STUDY IN SONGZI COUNTY

To assess the financing changes of schistosomiasis control programmes in China and estimate the impact of these changes on patients' treatme nt-seeking behaviour and control of schistosomiasis, a survey was cond ucted in five schistosomiasis-endemic areas of the lake regions, Hubei province, in 1996. This paper reports financing changes and their imp act on the incidence and prevalence of schistosomiasis from one of the five areas as a case study By examining the surveillance and financia l data from 1980 to 1995, and through focus group discussions we found that the schistosomiasis control programmes in People's Republic of C hina have gone through dramatic financing changes from 1980 to 1995, w hen the transitions of China's social, economic, and political systems happened. The proportions of funding to schistosomiasis control progr ammes from high level governmental agencies, county budgets, and servi ces revenue changed from 60%, 23%, and 17%, respectively, in 1980-1987 to 0.7%, 22.3%, and 72% in 1995. The percentageages of expenditure of schistosomiasis control activities, salaries and bonuses, and other a ctivities unrelated to schistosomiasis control, were 53.5%, 14.4, and 17.2% in 1980, These percentageages changed to 7.7%, 33.3%, and 53.3%, respectively, in 1995. The preponderant role of the state in organizi ng, financing, and delivery of the services was replaced with the new system which is more influenced by the market economy. The incidence a nd the prevalence of schistosomiasis in the study area have increased lear by year from 1980 to 1990. although there has been a tendency to decrease after 1991 but not to the low pre1980 levels. The collapse of the community-based medical system in rural areas and the dramatic fi nancing changes of schistosomiasis control programmes have created maj or difficulties For schistosomiasis control in China.