Virginia C. Li

Community-Based Trial to Prevent Drug Use Among Youths in Yunnan, China

OBJECTIVES This study evaluated a community-based program in China to prevent initiation of drug use in young men. METHODS Similar intervention and control areas were selected. Village leaders, teachers, and women and youth leaders were recruited to participate in the program. Community activities were organized and intervention activities in schools were implemented. Incidence of new drug users was estimated. RESULTS There was a 2.7-fold greater reduction in drug use initiation in the intervention area (1.59% vs 0.60%). Reduction was highest among males aged 15 to 19, single men, illiterate men, and the Jingpo minority. HIV/AIDS knowledge and attitudes and recognition of drug problems were all significantly better in the intervention area. CONCLUSIONS Community-based intervention programs to prevent drug use can be successful in rural areas of China.

Seeking women's voices: Setting the context for women's health interventions in two rural counties in Yunnan, China

If interventions to improve health are truly to benefit women, they must be developed from the start with a critical understanding of womens own perceptions of their health problems and needs, and how these concerns are linked to other facets of womens lives. To obtain such understanding, it is crucial for health planners to seek out women in the communities where they live, to encourage them to speak in their own voices about their health and lives, and to be genuinely committed to listening to what the women have to say. This paper presents results of focus group discussions with village women in two rural counties in Yunnan, China. The data are derived from 28 focus group discussions conducted by the Womens Reproductive Health and Development Program in Yunnan as part of a comprehensive assessment of reproductive health needs in poorer, more remote areas of the two counties. The discussions were held to ascertain what village women themselves feel to be their most pressing health problems, and how these relate to work, family, social status and their use of health services. Results show how womens health and their use of health services are rightly intertwined with their labor roles, harsh environmental conditions and oppressive poverty. Widespread breakdowns in the village-level primary health care network lead village women to express a profound lack of confidence in local health services. The findings have several implications for planning and implementation. Demands on womens scarce time need to be explicitly considered when designing health education activities and health service delivery.(ABSTRACT TRUNCATED AT 250 WORDS)

Capacity building to improve women's health in rural China

The Womens Reproductive Health and Development Program (WRDHP) is an ambitious attempt to operationalize two important tenets of health development thinking within a rural reproductive health context. First, it is important for communities to participate in decisions about the services and programs that affect them. Secondly, the complex nature of healthcare is best addressed by intervention processes which call for a multi-functional approach to planning and coordination. In both planning and intervention approach, the WRHDP recognizes the social, cultural and economic realities that affect womens efforts to secure the health and well-being of themselves and their families. The focus of the WRHDP is on capacity-building within a rural reproductive health environment, in this case Yunnan Province in rural China. Rather than using international donor funding to provide a specific intervention, the WRDHP used Ford Foundation funding as a lever to encourage community investment in environmental resources that affect health, to improve the technical skills of individuals within the existing health bureaucracies, and to promote structural changes within existing health and development bureaucracies to support interagency collaboration and community empowerment within the regions health and development agencies. This article describes how the WRHDP created new methods for provincial and local agencies to overcome obstacles and work with one another to improve womens health. It also describes the processes used in the rural areas of Chengjiang and Luliang counties to assess local conditions and needs, and the supported and expanded local efforts in improving womans reproductive and family health that resulted from the processes.

Characteristics of women having abortion in China

A pre-coded, closed response questionnaire was administered to women at abortion clinic sites in August 1985. The convenience sample was comprised of 1200 women, 200 samples in both Chengdu and the Lianshan Yi Autonomous Region in Sichuan Province, 400 in Nanjing and Jiangsu Province, and 400 in the municipality of Shanghai. The women were interviewed by physicians as part of the womens intake medical history. The sample yielded 574 respondents who were urban and 624 who were rural. The number of previous abortions reported ranged from 0 to 5. Nearly half of the abortion recipients had had at least one prior abortion and 18% had had two or more prior abortions. Education, age, marriage duration and residence have apparent effect on abortion order. The urban respondents reported an average of 1.08 children vs 1.60 children for the rural respondents. Approximately 72% of the respondents claimed to have been using a contraceptive method at the time they became pregnant. The most commonly used method was the IUD (41.6%), followed by the pill (21.3%) and the condom only (16.5%). Residence appeared to be the greatest factor determining the type of contraceptive methods. The data presented here are limited and cannot be generalized to the larger population. However, they do shed some light on the contraception characteristics of a group of women who undergo abortion procedures in China. Their response to questions to contracepting behavior prior to abortion suggests that the problem, in part, is behavioral. For example after the expulsion of the IUD, no other method was substituted to avert pregnancy. In order to alleviate the problem of contraceptive failure, and subsequent abortion, there are policy as well as training and education implications for the state.

Improving reproductive health knowledge in rural China - a web-based strategy.

In China, one of the major problems in upgrading rural health services is the difficulty of communicating between the rural and urban areas. Enabling local agencies to access the Internet in resource-poor areas can provide an efficient means of diffusing current training and information and will have far-reaching policy implications. To test the feasibility of using the Internet to deliver needed health information to the countryside, the UCLA School of Public Health and the Institute of Health Studies of Kunming Medical College (IHS-KMC) collaborated in an experimental website project to improve the quality of reproductive health services to promote womens health in three rural counties of Yunnan. The project involved the county government and the Bureau of Public Health, the Bureau of Family Planning; the Bureau of Education, Womens Federation, and the Maternal and Child Health Station targeting village health workers and teachers; womens cadres. Three counties, matched on socioeconomic status, participated in the study and were randomized to receive three programs. Nanhua County received computer skill training and logistic support including a planning workshop for information diffusion. Mouding County received computers only. Dayao, the control county, did not receive the full program until the conclusion of the project. The study demonstrated that the use of a website to disseminate health information in remote rural areas is not only feasible but that it also will be enthusiastically adopted by local health workers and interested parties. Moreover, the knowledge was diffused from the primary population of village doctors, family planning workers, womens cadres, and teachers to the secondary population of villagers and students.

China’s New Road for Tobacco Control: Tobacco Crop Substitution

The article explores tobacco control in China as of 2018, focusing on whether or not tobacco crop substitution could aid the cause. Additional topics discussed include how China sets a quota for tobacco leaf production to ensure revenue to the state, the health impact of Chinas transition to a developed country and world economic power, and social conditions for farmers in China. The WHO (World Health Organization) and the United Nations Development Program are also noted.

Family Planning Information, Education and Communication: Current Activities in the People's Republic of China

Based on observation of family planning activities in China in 1989 and 1990, this article takes a close look at education and publicity to promote family planning. Today these activities rely heavily on modern communication technology, especially TV and video, and continue to reflect an urban bias in content. The absence of male involvement in family planning was also noted. Family planning education has been strengthened in certain areas with the “five phases” approach and with the organization of “key households.” The Family Planning Association with is 200,000 grassroots associations throughout the country and its 17,000,000 members has greatly increased the manpower pool for the delivery of educational services. It has also been instrumental in developing insurance schemes for one child families, and in some areas the primary function of Association members is surveillance aimed at detecting unplanned pregnancies. There is a need for improved training in the development of educational materials for family planning and in the provision of contraceptive services in rural areas.

Health Behavior Research toward Health for All: Issues and Schema

Health behavior research is concerned with the social, cultural and psychological determinants of health. Implicit in this is a focus on action that will lead to real-world improvements in health for the individual and in the community. Research in this area should not lose this focus. Programmatic needs must be understood if support is to be gained from policy makers. Along with the relevance of research, staff training is a key part of bridging the gap between the discovery of new knowledge and action to improve health.

China's One Child Family Program: Policies, Barriers and Communication Network.

Chinas experience in the one child family campaign is impeded by forces which are political, economic, cultural and administrative. The infrastructure for family planning can be enhanced by a vigorous communication strategy directed to the citizenry and cadres. The disincentive system created by some provincial and municipal authorities may signify a trend which is crucial to Chinas ability to bring its population growth under control.