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BackgroundTo ensure equity and accessibility of public health care in rural areas, the Chinese central government has launched a series of policies to motivate village doctors to provide basic public health services. Using chronic disease management and prevention as an example, this study aims to identify factors associated with village doctors’ basic public health services provision and to formulate targeted interventions in rural China.MethodsData was obtained from a survey of village doctors in three provinces in China in 2014. Using a multistage sampling process, data was collected through the self-administered questionnaire. The data was then analyzed using multilevel logistic regression models.ResultsThe high-level basic public health services for chronic diseases (BPHS) provision rate was 85.2 % among the 1149 village doctors whom were included in the analysis. Among individual level variables, more education, more training opportunities, receiving more public health care subsidy (OR = 3.856, 95 % CI: 1.937–7.678, and OR = 4.027, 95 % CI: 1.722–9.420), being under integrated management (OR = 1.978, 95 % CI: 1.132–3.458), and being a New Cooperative Medical Scheme insurance program-contracted provider (OR = 2.099, 95 % CI: 1.187–3.712) were associated with the higher BPHS provision by village doctors. Among county level factors, Foreign Direct Investment Index showed a significant negative correlation with BPHS provision, while the government funding for BPHS showed no correlation (P > 0.100).ConclusionIncreasing public health care subsidies received by individual village doctors, availability and attendance of training opportunities, and integrated management and NCMS contracting of village clinics are important factors in increasing BPHS provision in rural areas.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1276-y) contains supplementary material, which is available to authorized users.

BackgroundTo strengthen rural health workforce, the Chinese government has launched a series of policies to promote the job satisfaction of village doctors since the health sector reform. The purpose of this mixed-method study is to describe village doctors’ job satisfaction under the context of health sector reform and investigate the associated factors.MethodsData was obtained from a survey of village doctors across three Chinese provinces in 2014. Using a multistage sampling process, quantitative data was collected from village doctors through the self-administered questionnaire and analyzed by multilevel logistic regression models. Qualitative data was collected through face-to-face semi-structured interviews on both village doctors and health managers. Theoretical coding was then conducted to analyze qualitative data.ResultsAmong the 1221 respondents, 48.6% felt satisfied with their job. Older village doctors with less of a workload and under high-level integrated management were more likely to feel satisfied with their job. Village doctors who earned the top level of monthly income felt more satisfied, while on the county level, those who lived in counties with the highest GDP felt less satisfied. However, enrollment in a pension plan showed no significant difference in regards to village doctors’ job satisfaction.Among 34 participants of qualitative interviews, most believed that age, income, and integrated management had a positive influence on the job satisfaction, while pension plan and basic public health care policies exhibited negative effects. Also, the increasing in availability of healthcare and health resources along with local economic development had negative effects on village doctors’ job satisfaction.ConclusionVillage doctors’ job satisfaction was quite low in regards to several determinants including age, income, workload, enrollment in a pension plan, integrated management, and county economic and medical availability development.

BackgroundInfluenza continues to have a major impact on vulnerable populations worldwide, particularly among the elderly (≥60 years of age). Vaccination for targeted groups is recommended by the WHO as the most effective way to control influenza infections. Since 2009, the Beijing municipal government has provided influenza vaccination to the elderly at no out-of-pocket cost to reduce influenza threats and improve related health equality. The study aims to evaluate the equality of the policy, and to analyze factors that bring influences to equality.MethodsBased on data from a household survey, concentration index (CI) was calculated to measure the socioeconomic inequality in influenza vaccination. A Logit regression model was used to decompose CI, in which the contribution of each determinant was calculated and the percentages of these contribution were obtained.ResultsFree influenza vaccination at point of use shows significant pro-poor distribution among the elderly in Beijing (CI = −0.115). After the decomposition of CI, the elderly with lower income, higher education, and living in rural areas were more likely to get the influenza vaccination, in which place of residence (contribution percentage = 57 %) held the most contribution of variance.ConclusionsBeijing’s free influenza vaccination strategy at point of use could provide the poor elderly with equal opportunities to receive preventive health service, showing a significant pro-poor distribution. The poor elderly, who live in rural areas with high education, benefit most from the policy. Further policy interventions should target the population living in urban areas in order to improve the utilization of public health services and health equality.