World Bank to Support Scaling up of Health Reform Pilots in China

May 9, 2017

WASHINGTON, DC, May 9, 2017 – The World Bank Board of Executive Directors approved a US$600 million loan to China today to help improve the quality and efficiency of healthcare services in Anhui and Fujian provinces, using the Program-for-Results (PforR) instrument that links loan disbursements to tangible results on the ground.

“China has made impressive gains in improving overall health outcomes in past decades, but now faces new challenges: an aging population, an increasing burden of chronic diseases, and fast-rising health expenditures. This program will support China’s efforts to scale up successful health reform pilots and innovations to tackle these challenges,” said Ramesh Govindaraj, World Bank Lead Health Specialist and team leader for the program.

The Health Reform Program-for-Results will be implemented in Anhui and Fujian provinces with policy development and technical support from the State Council National Health Reform Office. The two provinces, which face similar challenges as the country as a whole, have been pioneering innovative health reforms.

The program aims to achieve its objective through three result areas:

  • Improving the quality and efficiency of hospital services by reforming hospital governance and management, controlling the growth of health expenditure, strengthening service quality assurance, and establishing systems for performance monitoring and evaluation;
  • Establishing an effective People Centered Integrated Care model with an emphasis on primary care services, by strengthening the service capacity of primary care facilities, intensifying the training of health-care workers, implementing provider payment reform, and introducing a transformative model for service delivery among different levels of providers, in order to facilitate the integrated management of non-communicable diseases;
  • Creating an enabling policy and institutional environment for health reform by strengthening oversight and stewardship, developing health information systems, building capacity of health providers, and establishing a platform for knowledge-sharing and learning.

“The challenge is not merely one of introducing technical solutions, but also of managing large-scale reform. This program strongly supports and encourages knowledge-sharing to help close the gap between ‘knowing’ and ‘doing’, so that reforms can be scaled up successfully from pilots through continuous learning and adjustment,” said Shuo Zhang, World Bank Senior Health Specialist and the co-team leader.

The program will be implemented from 2017 to 2021 supporting the Health Reform Program of 13th Five-Year development plan of China. The total IBRD financing for the PforR is US$600 million, which is 15 percent of total spending for the program in the two provinces.

“We are pleased to support the Chinese government in the ‘deep water’ phase of its health reform. This PforR is building on our joint study with WHO and the Chinese government on health reform, and will put its recommendations into practice,” said Bert Hofman, World Bank Country Director for China.

The 2016 study, titled Deepening Health Reform in China: Building High-Quality and Value-Based Service Delivery, recommends that China continue to shift from its current hospital-centric model that focuses on patient volume and disease treatment, to a model centered on primary care that delivers greater value for money by focusing on prevention and integrated disease management of chronic conditions.  

“Getting this reform right is crucial for China’s social and economic success in the coming decades. We believe that China’s experience with health service delivery reform can provide valuable lessons for other countries facing similar challenges,” said Tim Evans, Senior Director of World Bank Group’s Health, Nutrition and Population Global Practice.

The World Bank Group has had a long engagement in the health sector in China. Over the past three decades, the Bank has been working with China on more than a dozen projects, ranging from rural health service development and medical education, infectious and endemic diseases, tuberculosis control, maternal and child health, to rural health system strengthening and health system reform.

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