The impact of public health service on rural children's health: Quasi-experimental evidence from China.

OBJECTIVES

This study evaluates the impact of a major maternal and child health service program on the health outcomes of children in rural China.

STUDY

DESIGN

Quasi-experimental study.

METHODS

We utilize data from the China Family Panel Studies (CFPS) spanning 2012 to 2018, leveraging a regression discontinuity (RD) design with March 2006 as the cutoff to identify the program's causal effects. Our empirical strategy includes a series of robustness checks, such as RD validity tests, alternative bandwidths and functional forms, placebo cutoffs, exclusion of a confounding policy, and a combined RD-DID approach.

RESULTS

The program yields significant improvements in rural children's health. We find a 5% reduction in hospitalization rates and a 53.7% increase in hospital delivery rates, accompanied by improvements in nutritional status, as reflected by a 0.082 increase in BMI Z-scores. Placebo test results show no significant effects, supporting our identification strategy and suggesting a narrowing of the urban-rural health gap. Additional analysis indicates that the program significantly reduces out-of-pocket medical expenditures for rural households, with particularly pronounced benefits for low-income families.

CONCLUSIONS

The maternal and child health service program has proven to be an effective intervention for improving child health and reducing health disparities, particularly between urban and rural areas as well as within rural communities. These findings underscore the program's critical role in promoting health equity and accelerating progress toward universal health coverage.