This paper seeks to describe the overall state of Rural Solid Waste Management (RSWM) in China in three main areas: waste collection services, waste transportation services and waste disposal services. Given China’s urbanization, industrialization, and the subsequent improvement of household living standards, the amount of solid waste generated in rural China has increased rapidly. Based on primary data collected in 2016 from 100 villages across five provinces in China, we find that the proportion of villages with waste collection, waste transportation, and waste disposal services in 2015 is 80%, 55% and 22%, respectively. The differences in shares of villages with these services across provinces are statistically significant. Using descriptive and econometric analyses, the authors show that richer villages are more likely to provide rural solid waste (RSW) collection and transportation services. Villages with new (newly elected or appointed) village leaders are more likely to supply RSW disposal services. While the majority of villages report that they offer waste collection services (installing waste collection facilities and employing waste collection workers), the vast majority of villages do not transport their waste to treatment plants. Even fewer villages report using centralized disposal methods to dispose of waste, as required by law or regulation. This study represents the first effort to describe the state and determinants of waste management services in rural China in the wake of increased investment in and new policies regarding RSWM released in 2015. Additionally, we provide evidence-based suggestions that might be useful for policy makers interested in improving RSWM in China. These suggestions include increasing investments in waste collection facilities and worker services; encouraging local residents to classify and recycle waste; designing optimal waste transportation networks and routes; and improving on-site waste disposal technology.

Chronic diseases can be controlled through effective self-management. The purpose of this study is to explore the regularity of clinical visits and medication adherence of patients with hypertension or diabetes (PWHD), and its association with the first experience with care and individual factors in rural Southwestern China. This cross-sectional study was carried out in Yunnan province in 2018 and recruited 292 PWHD and 122 village clinics from 122 villages in 10 counties. Participants were interviewed using a structured questionnaire. Results show around 39% of hypertensive and 25% of diabetic patients neither visited physicians nor took medicine regularly during the preceding three months of the interview date. The regression results further indicated that individual characteristics of the PWHD, including patient age, health status, and economic level, as well as their first experience with care, were significantly associated with their regular healthcare behavior. In addition to providing medical services, on average each sample village clinic, with around two physicians, simultaneously managed 180 hypertensive and 45 diabetic patients. This study revealed the need for further reforms in terms of improving self-management and thus recommends an increase in the quantity and the quality of human resources in the primary healthcare realm in rural China.

Objective Chronic diseases can be controlled through effective self-management. The purpose of this study is to explore the regularity of clinical visits and medication adherence of patients with hypertension or diabetes (PDH), and its association with the first experience with care and individual factors in rural Southwestern China.Methods The authors draw on a dataset which comprised of 292 PDH and 122 village clinics selected from 122 villages in 10 counties in the rural areas of Yunnan province. Data was gathered through interviews with these patients and the directors of the village clinics in January 2018. Logistic regression models were performed using STATA 15.0.Results The data shows around 31% of hypertensive and 25% of diabetic patients neither visited physicians nor took medicine regularly during the preceding three months of the interview date. We also documented PDH first experience with care and found that a proportion of them did not initially choose to seek care from health facilities. The logistic regression results indicated that individual characteristics of the PDH, including patient age, health status, and economic level, as well as their first experience with care were significantly associated with their regular healthcare behavior. Moreover, in addition to providing medical services, on average each sample village clinic with around two physicians simultaneously managed 180 hypertensive and 45 diabetic patients.Conclusions Our paper shows how current self-management trends among PDH in the sample area was unsatisfactory, threatening the effective control of hypertension and diabetes in China. Even though healthcare reforms in China have been launched since 2009, this study revealed the need for further reforms in terms of improving self-management. The authors recommend an increase in the quantity and the quality of human resources in the primary healthcare realm in rural China, which should help provide better education and supervision services for self-management.