Women Must Have Equal Access to Healthcare

Nurses promote healthcare for women and little children. [Women of China English Monthly]

The Beijing Declaration, passed during the Fourth World Conference on Women in September 1995, urged governments around the world to guarantee that women received the same access – and level of treatment – to health care as received by men. The declaration was also a commitment by the signatories to improve women's sexual and reproductive health. During the past 20 years, the Chinese Government has made women's health a priority as it has promoted gender equality and women's development. For example, the government has implemented various laws, including the Law of the People's Republic of China on Maternal and Infant Health Care, the Population and Family Planning Law of the People's Republic of China, and the Law of the People's Republic of China on the Protection of Rights and Interests of Women. In its national programs for women's development, the government has listed women's health as one of its objectives.

Three Steps

On March 1, 2008, China's then-ministry of Health, the National Working Committee on Children and Women under the State Council, the All-China Women's Federation (ACWF), the World Health Organization, the United Nations Children's Fund (UNICEF) and the United Nations Population Fund (UNFPA) hosted a seminar on Chinese women's health in Beijing.

Liu Qian, then-vice-minister of Health, said there would be three steps taken during implementation of the Action for Chinese Women's Health. First, Liu said, the service system would be improved by 2010, to provide rural and urban women with basic healthcare services; second, the functions and service capacity of the maternal and infant health service system would be improved by 2015, so all pregnant women would give birth in hospitals, the maternal and infant mortality rates would decrease significantly, and China would be one of the top developing countries in terms of the level of women's level of health; and third, urban and rural women would enjoy basic medical and health services by 2020, and the level of women's health in eastern China and some parts of central and western China would be close to or equal to that in moderately developed countries.

Since Liu made those comments, the Chinese Government and related organizations have made continuous efforts to complete the three steps and realize the goals.

In 2013, to evaluate the implementation of the National Program for Women's Development (2011-2020), the officials of the National Bureau of Statistics of China conducted a survey.

Regarding women's health, the survey's results indicated the following:

●The level of maternal care continued to improve. In 2013, some 99.5 percent of women gave birth in a hospital, a 1.7-percent increase over 2010; the prevalence of severe anemia (with harsher symptoms than a regular case of anemia) decreased to 1.64 percent of pregnant and lying-in women, down 0.16 percentage point from 2010; the maternal mortality rate declined, from 30/100,000 in 2010, to 23.2/100,000, and that decrease was close to the program's target; compared with 2010, the rates of prenatal examinations, post-delivery visits and maintaining records of examinations of women and fetuses increased;

●The level of women's reproductive health improved; the rate of screening women for common diseases reached 68.7 percent in 2013, up 7.5 percent over 2010; the rate of incidence of disease among women was 27.4 percent, down 1.4 percentage points; more women had received free gynecological examinations and screening for cervical and/or breast cancer ("two cancers"), and the screening range was expanded from women in rural areas to all women aged 35 to 64;

●Women's right to family planning was basically guaranteed. In 2013, the use of contraceptives by women of childbearing age was 87.3 percent, 1.8 percentage points lower than in 2010. In addition, more men were willing to accept responsibility for contraception; and

●There was a significant increase in the number of women who participated in physical exercise. Statistics issued in 2013 indicated the proportion of women who often participated in physical exercise was 18.9 percent, up 11.4 percentage points compared with 2007, while the proportion of women who never exercised decreased from 70.9 percent to 51.9 percent.

Song Xiuyan, Vice-President and First Member of the Secretariat of the ACWF, delivered a work report during the 11th National Women's Congress of China in October 2013. She noted that some common and frequently occurring diseases that affect women's health had been effectively prevented and controlled. She also explained that women's average life expectancy had reached 77.37 years, that women's social security had been improved, that the percentage of women covered by basic pension and medical insurance finally equaled the percentage of men, and that more than 95 percent of pregnant and lying-in women had maternity insurance.

Preventing 'Two Cancers'

The "two cancers" have become major threats to women's health in recent years, and the rate of incidence has continued to rise. Statistics indicate, in China, there are 132,000 new cases of cervical cancer and 126,000 new cases of breast cancer each year. Of greater concern, the statistics indicate nearly 30,000 women die of cervical cancer and 37,000 women die of breast cancer annually in China.

China for years has attached great importance to the early prevention and treatment of the "two cancers." In 2009, the ACWF and the then-ministry of Health launched the program to provide free screening for the "two cancers" to rural women.

In March 2009, "regular checkups for gynecological diseases are to be given to rural women" was written into the Chinese Government's work report. The checkup program has been included in the new plan for national medical reform and key national public health service programs.

Also, officials of the ACWF and the then-ministry of Health announced 10 million rural women in 221 counties would be screened for cervical cancer between 2009-2011. In addition, 1.2 million rural women in 200 counties would be screened for breast cancer.

During those three years, governments, at all levels, spent a combined 562 million yuan (US $89 million), 11.69 million rural women received free cervical cancer screening, and 1.46 million women received breast cancer screening. Officials of ACWF said the program's objectives had been exceeded.

To help poverty-stricken rural women who suffered from one or both of the "two cancers," ACWF in 2011 established a special fund to pay for the women's treatments. Each year, China's Ministry of Finance allocates 50 million yuan (US $8 million) to the fund. In addition, ACWF conducts various charity events to raise money to add to the fund.

A conference, by video and telephone, to discuss the national "two cancers" screening program was held on July 27, 2012. During the conference, the following tasks were set for the next three years: The program would be expanded from 221 to 1,111 counties; women aged 35-64 would receive free cervical cancer screenings (the previous age group was 35-59); and by 2015, the program would have provided free cervical cancer screening to 50 million women, and free breast cancer screening to 6 million women.

Caring for Disadvantaged Mothers

In remote areas of western China, and in poverty-stricken areas of central and eastern China, the health conditions of rural women, such as pregnancy and birth healthcare, screening for major diseases, emergency aid and the prevention and treatment of gynecological diseases, lag behind the conditions in China's coastal areas. That is due to poor transportation and the lack of medical equipment.

To deal with this issue, and with the support of the ACWF and the National Working Committee on Children and Women under the State Council, the China Women's Development Foundation (CWDF) launched a charity health program, the Health Express for Mothers, in July 2003. Officials of CWDF also called on society to help poverty-stricken areas establish and improve their public health service systems.

As of December 2013, thanks to donations by enterprises and individuals, the project has provided 2,023 vehicles and vehicle-mounted medical equipment, including hundreds of electrocardiographs and b-ultrasonic scanners, to operate the program in 30 provinces, regions or municipalities. The program has benefited 30 million women.

In August 2013, the Center for Social Responsibility and Innovation of Tsinghua University conducted a survey to evaluate the implementation of the Health Express for Mothers project. Data collected from the 779 medical organizations that carried out the project indicated, as of December 2012, the organizations have provided free medical consulting services to 6.645 million women, checkups to 8.958 million women and health training to 3.796 million women. In addition, the data indicated the organizations treated 469,000 patients in critical condition, transported 607,000 pregnant women and 334,000 other patients to hospitals, and distributed 16.597 million yuan (US $2.486 million) worth of medicine and 12.623 million health brochures.

Li Caiyun, head of the project's office, says the Health Express for Mothers project has facilitated checkups for women and children, shared health-related information and raised rural women's awareness of healthcare.

(Source: Women of China English Monthly May 2015 Issue)