Maximising the potential of the National Compulsory Service Programme in rural China: a mixed methods study

Area of Science:

• Public Health
• Healthcare Management
• Rural Medicine

Background:

• China faces a physician shortage in rural areas.
• The National Compulsory Service Programme (NCSP) trains medical students for rural service.
• NCSP general practitioners (GPs) are assigned to township health centers (THCs).

Purpose of the Study:

• Evaluate the impact of NCSP GPs on healthcare quality in THCs.
• Identify the specific contributions of NCSP GPs to patient care.
• Understand the factors influencing NCSP GP effectiveness.

Main Methods:

• Explanatory sequential mixed-methods study design.
• Quantitative survey of 2815 THC leaders across nine provinces.
• Qualitative semi-structured interviews with 33 NCSP GPs.

Main Results:

• 68% of THC leaders reported significant quality improvements due to NCSP GPs.
• NCSP GP contribution positively correlated with their performance and THC remoteness.
• Contribution negatively associated with licensed physician percentage and NCSP GP turnover.

Conclusions:

• NCSP GPs positively impact rural healthcare quality.
• Their contributions extend beyond clinical practice to influencing others and management.
• Recommendations include curriculum adjustments, support, and improved allocation for the NCSP.