演題番号：4
テーマ 2：UHC（ユニバーサルヘルスカバレッジ）
Research on the Supply of Primary Healthcare Services in Minority Rural Areas in China:
evidence from Xiangxi Tujia and Miao Autonomous Prefecture.
Han Wu1,2,3, Bing Li3, Jia Chen3, Hirotaka Onishi1
1

Laboratory of International Research Center for Medical Education,
Graduate School of Medicine, The University of Tokyo
2
Department of International Health, Graduate School of Medicine,
The University of Tokyo
3
Xiangya Nursing School, Central South University, Changsha, China【Introduction/Objective】 Improving access to primary healthcare in rural areas is crucial for
preventing disease progression and promoting population health. However, minority rural regions
in central China face challenges in providing basic medical services. This study aims to investigate
the supply of primary healthcare services in 13 administrative villages in Xichehe Town, Xiangxi
Tujia and Miao Autonomous Prefecture, through questionnaire surveys and interviews.
【Methods】 From June to October 2020, primary data on healthcare services in Xichehe Town
were collected using questionnaires and interviews. The number of rural healthcare institutions
was recorded, and surveys were conducted with village clinic staff (n=31) and ordinary villagers(n=120). Interviews with clinic staff focused on their information, training, infrastructure, services
provided, challenges, and suggestions. Villagers were randomly selected to gather information on
medical expenditure, difficulties in accessing healthcare, and improvement suggestions.
【Results】 In Xichehe Town, there were 3 township health centers and 6 village clinics, with ahealthcare institution-to-population ratio of 0.02%. Among the township health centers, thedoctor-to-nurse ratio was 1:0.70. 83.4% of village clinics lacked nursing professionals, and 65%of healthcare workers in these clinics did not possess the required qualifications. 85.7% of
healthcare workers in village clinics had a high school education or below. The clinics sufferedfrom disorganized spatial arrangements and a severe shortage of medical equipment supply. The
services provided by the village clinics were limited, lacking specialized nursing, chronic disease
prevention and treatment, and health education. 70.8% of villagers expressed difficulties inaccessing medical care, and only 30% of villagers expressed satisfaction or high satisfaction withthe village clinics.
【Conclusions】 The results of this study underscore the significant challenges in providing
primary healthcare services in minority rural areas. The low institution-to-population ratio,
shortage of nursing professionals, inadequate infrastructure, and limited services offered byvillage clinics highlight the disparities in healthcare access and quality. To address these issues,
there is a need for targeted interventions such as improving infrastructure, recruiting, andtraining qualified healthcare personnel, and expanding services to include specialized care andhealth education. By implementing these improvements, the overall accessibility andeffectiveness of primary healthcare can be enhanced, leading to improved health outcomes forminority populations in rural areas.