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BACKGROUND: Access to health care is a major requirement in improving health and fostering socioeconomic development. In the People's Republic of China (P.R. China), considerable changes have occurred in the social, economic, and health systems with a shift from a centrally planned to a socialist market economy. This brought about great benefits and new challenges, particularly for vertical disease control programs, including schistosomiasis. We explored systemic barriers in access to equitable and effective control of schistosomiasis. METHODOLOGY: Between August 2002 and February 2003, 66 interviews with staff from anti-schistosomiasis control stations and six focus group discussions with health personnel were conducted in the Dongting Lake area, Hunan Province. Additionally, 79 patients with advanced schistosomiasis japonica were interviewed. The health access livelihood framework was utilized to examine availability, accessibility, affordability, adequacy, and acceptability of schistosomiasis-related health care. PRINCIPAL FINDINGS: We found sufficient availability of infrastructure and human resources at most control stations. Many patients with advanced schistosomiasis resided in non-endemic or moderately endemic areas, however, with poor accessibility to disease-specific knowledge and specialized health services. Moreover, none of the patients interviewed had any form of health insurance, resulting in high out-of-pocket expenditure or unaffordable care. Reports on the adequacy and acceptability of care were mixed. CONCLUSIONS/SIGNIFICANCE: There is a need to strengthen health awareness and schistosomiasis surveillance in post-transmission control settings, as well as to reduce diagnostic and treatment costs. Further studies are needed to gain a multi-layered, in-depth understanding of remaining barriers, so that the ultimate goal of schistosomiasis elimination in P.R. China can be reached.

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This article is a general review of the evolvement of HIV/AIDS-related public policies in China since 1980's. It tracks the important laws, regulations and other governmental documents in regard to HIV/AIDS prevention mainly at central level.

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This paper discusses an intersectoral health-related intervention, using cartoons and video-recording, print materials and face-to-face educational methods, to increase children's knowledge of schistosomiasis, which in turn might improve the case management of early diagnosis and treatment. The main components of the project were (i) the collaboration between the departments of public health and education and (ii) a randomized, controlled, school-based field trial conducted in the Dongting Lake region, China. Children in the experimental group (n=604) and their parents participated in the educational programme. Control children (n=527) received a 2 hour lecture about the disease. All participants were pre-tested, and retested five months after the conduct of the educational intervention. The results show significant changes among children and their parents in the experimental group related to knowledge about schistosomiasis and beliefs towards screening and treatment of the disease. Children in the experimental group also had better compliance than children in the control group for regular screening for schistosomiasis. These findings indicate that carefully designed education programmes are useful for providing both children and their families with information about the prevention and treatment of schistosomiasis. Intersectoral collaboration holds promise to deliver research-based interventions for enhanced knowledge of schistosomiasis and improved case management.

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OBJECTIVE: To explore factors related to current prevention and treatment of Advanced cases on schistosomiasis. METHODS: In-depth interviews were introduced to the qualitative study on 61 Advenced cases of schistosomiasis in Dongting Lake regions. Sampling was accidentally and judgmentally performed. RESULTS: Related factors on prevention and treatment of Advenced cases of schistosomiasis would include: higher degree of social support for patients (61/61), excessive dependence on the past pattern of schistosomiasis control, lack of the idea that one should be responsible for his/her own health, lack of knowledge about prevention and treatment of schistosomiasis (28/61), older age (57.40 +/- 10.80), lower education (4.70 years), less family income, lack of effective medical insurance system and efficient close-to-client system. CONCLUSION: Active participation from patients, medical institutions and society was needed to control Late Stage Schistosomiasis. Health education campaign should be intensified to improve the health awareness for schistosomiasis among residents in the heavy endemic areas. Medical insurance system should be set up in epidemic areas, while public health and cure systems for important diseases should be intensified in rural areas. The ability of public health system to be responsive and the accessibility of residents to health service system should be improved in rural areas as well.

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