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At least 19 recordsLinked to original sources
PubMed2005

[Evolution of village doctors from the communist regime to contemporary China: reeducation of the "barefoot doctors" in rural communities].

To modernize health care in China, much emphasis is currently being put on the in-service training for the remaining group of its medical paraprofessionals known as the "barefoot doctors". They have functioned differently from the conventional professional physicians. They were farmers, yet they took care of the primary health care needs in their communes even without proper medical education. The manner in which they trained and practiced their profession as barefoot doctors was a unique modality of China's health care system during the Cultural Revolution. When the revolution ended, the economic reforms placed the barefoot doctors in a bad light. They were negatively perceived and their credibility as health care workers continued to be a major health management issue since the barefoot doctors reflected the strong ideals of the revolution. Despite this criticism from central government and the general public, their professional growth has been encouraged because of the insufficiency of local physicians who can 1 provide appropriate health care for the rural peasants. This study describes their historical evolution in the paraprofessional medical manpower development of China, to explore further directions of primary health care in contemporary China.

China↗
PubMed1989

Factors associated with the decline of the Cooperative Medical System and barefoot doctors in rural China.

The Cooperative Medical System (CMS) and its barefoot doctors have been in decline in rural China for nearly a decade. In order to explore the reasons for this, in 1987 we carried out a survey of villagers, barefoot doctors, and local administrators in Fengxian, Shanggoa, and Loaan counties, where incomes are good, fair, and low, respectively. The state of the CMS in these counties was contrasted and the situations which prevailed in 1978, 1982, and 1985, when the system was, respectively, at its peak, had begun to decline, and had declined markedly, were compared. A random sample of villages was selected and all the barefoot doctors and administrators as well as a random sample of households were surveyed. The results indicate that health status (as measured by infant mortality, immunization coverage, and rate of infectious diseases) has decreased in areas where the CMS has declined, while per capita incomes increased. Concomitantly, villager's expenditures on health care have increased. Barefoot doctors and their patients were, however, reasonably happy with the system, and in its absence the doctors are no longer able to obtain ongoing training. The CMS was fiscally sound, and did not decline to the same extent in all areas--it continues to thrive in Fengxian, which is relatively affluent. It is concluded that the system probably declined because many local administrators perceived that it no longer enjoyed the backing of the central government.

China↗
PubMed1982

The Barefoot Doctors of China: from political creation to professionalization.

The Barefoot Doctor policy of the Peoples Republic of China (PRC) has recently been changed. Rather than remaining a permanent corp of paraprofessionals, Barefoot Doctors (BFD) are to be upgraded, certified, and paid wages for full-time medical work in a process of slow professionalization. This article includes a brief historical description of BFD policy evolution and a literature review that notes problems in the equitable implementation of the original policy. An update in information is added based on original material collected in 1979 and 1981, providing a current picture of efforts to implement the new professional focus. While BFDs everywhere are taking the certification examinations, there are almost no signs of other features of the new policy.

China↗
PubMed1975

Training of the barefoot doctor in the People's Republic of China: from prevention to curative service.

Among the changes that have been brought about in health delivery in the People's Republic of China, the introduction of the barefoot doctor has been one of the most important and effective ways that the government has devised to radically alter the concept of health care. Through close identification with the community in terms of recruitment, training, and practice, the barefoot doctor is a concrete manifestation of the ideological principles of following the mass line and being self-reliant. The paper focuses on the building of rural health services, with special reference to the training of the barefoot doctor as the first-level contact person in primary care in the communes. It describes the training programs in a school of public health and the career mobility possible to the barefoot doctor in joining the ranks of medical practitioners.

Adult↗
PubMed1985

The barefoot doctor: Shanghai County revisited.

Since a 1981 review of health status and health services in Shanghai County, there have been considerable social and economic changes in the People's Republic of China. A major question currently is the impact of the new economic "responsibility system," which was introduced in 1982, on the cooperative health structure and the "barefoot doctors" (BFDs). Investigators in other areas of China have reported the collapse of the cooperative systems and a shift in the role of the BFDs as a result of incentives for them to spend more time in agricultural production. In Shanghai County, however, BFDs continue essentially full time as before, salaried by the brigade, with fee-for-service charges prohibited. Recent evidence from Shanghai County shows that the health care system and those who direct it can remain flexible and respond positively to changes in the social, economic, and political structures.

China↗
PubMed1984

'Barefoot doctors' in rural Georgia: the effect of peer selection on the performance of trained volunteers.

Does volunteer selection by peers have a measurable effect on volunteer performance? This paper examines this question in the context of a field experiment which used community organizations as a means to select people to serve as Emergency Medical Coordinators (EMCs). Field sites were 36 rural Georgia communities with populations ranging from 150 to 1850. EMCs were trained in a 40 hour program as first responders to emergency incidents and as organizers of an emergency response system within their communities. Their performance in each of these roles was assessed by composite measures (a first aid performance index and an activity index) developed as part of the study. Each sponsor organization conducted the selection of EMCs for their respective communities. The process was monitored and assessed as either comprehensive, including the evaluation and elimination of candidates, or as unstructured where interested individual self-volunteered. Performance scores were regressed on the selection process variable as well as a set of structural, predisposing and enabling variables. Peer selection was a statistically significant predictor of EMC performance as a first responder but not as a response system organizer. Implications of this result as well as the influence of other independent variables are discussed.

Adolescent↗
PubMed1983

Dental health education by "barefoot doctors".

In an insurance company 18 out of 507 employees were trained as dental health educators. They then informed their fellow workers about prevention of caries and periodontal disease in groups of about 10 persons. Two information meetings were held during a period of 10 months. Eighty-nine percent of the employees were positive to this educational programme. Twenty-two percent said that they had reduced the intake of sucrose after the first meeting. Even more persons reduced their sucrose intake later. Saliva secretion rate and buffer capacity were analyzed and the number of lactobacilli and Streptococcus mutans were determined before and after the information meetings. A significant reduction in the number of lactobacilli was found, confirming the change in carbohydrate intake. The information raised the level of knowledge about dental health among the employees. It was suggested that this type of educational programme should be used in other health areas.

Adult↗