Health Service and Social Integration for Migrant Population : lessons from China

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Health Service and Social Integration for Migrant Population : lessons from China WANG Qian Director, Department of Services and Management of Migrant Population, National Health and Family Planning Commission of the PRC 29 November, 2017China

Contents 1. Characteristic of China's Migrant Population 2. China s Migrant-Sensitive Policy and Programs 3. Social Integration of Migrant Population

Characteristic of China's Migrant Population Migrant Population in China 245 million at the end of 2016 18% 70%~80% Migrant Population Others Migrate from the rural area to urban.

Characteristic of China's Migrant Population 300 migrant population size (100 million) 250 200 150 100 50 0 7 18 21 71 121 147 221 230 236 245 253 247 245 1982 1987 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015 2016

person Characteristic of China's Migrant Population The trend of migrating with the family is getting obvious Migrating with family members: 81.9% 3.00 2.90 2.80 2.70 2.60 2.50 2.40 2.97 Household size Average household size of China 2.61 Average household size of migrant population

Characteristic of China's Migrant Population The percentage of long-term residency is going up The average living time of migrants at residence place is 6.1 years. About half of the migrant population live more than 4.3 years.

Characteristic of China's Migrant Population The migration of population is becoming one of the most important motive force of urbanization. The key factors of China's population development trend in the future will not be the natural growth of the population, but the migration of population.

Characteristic of China's Migrant Population The total population of China at the end of the year(2000/2010) Region 2000 2010 Growth Rate(%) Nationwide 126743 134091 5.80 Beijing 1357 1962 44.58 Tianjin 1001 1299 29.80 Shanghai 1641 2303 40.32 Zhejiang 4596 5447 18.51 Anhui 6286 5957-5.24 Henan 9488 9405-0.87 Hubei 5960 5728-3.89 Hunan 6562 6570 0.12 Guangdong 7707 10441 35.47 Guangxi 4750 4610-2.95 Chongqing 3092 2885-6.71 Sichuan 8602 8045-6.48 Guizhou 3756 3479-7.38 Xinjiang 1849 2185 18.18

Characteristic of China's Migrant Population Jilin Gansu Beijing Tianjing Sichuan Henan Hubei Anhui Jiangsu Shanghai Yunnan Hunan Guizhou Guangxi Guangzhou Zhejiang

Characteristic of China's Migrant Population High fertility High mortality Low growth rate High fertility Low mortality High growth rate Low fertility Low mortality Low growth rate Mortality dominates 1950 s-1960 s Fertility dominates 1970 s-1990 s

Characteristic of China's Migrant Population Focus on population issues: Geographical Distribution instead of the Total Size Regional population changes: Migration Dominant instead of Fertility Dominant

China s migrant-sensitive policy and programs National Documents for Migration National Plan on New Urbanization (2014-2020) Opinions on Further Promoting the Reform of the Household Registration System

China s migrant-sensitive policy and programs The Chinese government is committed to pushing forward people-oriented urbanization, and to providing primary public services to all permanent residents, especially for the population from rural to urban.

China s migrant-sensitive policy and programs The National Health and Family Planning Commission(NHFPC) developed migrant-sensitive policies and programs to ensure equal access to primary public healthcare services for all migrants.

China s migrant-sensitive policy and programs Promote the primary public health service for all migrants Strengthen the work of disease prevention and control for migrant population Improve the level of medical security for migrants Conduct health education and promotion among migrants

1. Promotion of the primary public healthcare services for all migrants National primary public healthcare service program

1. Promotion of the primary public healthcare service for all migrants 12 items of Services Establishment of health records Chronic disease health management Traditional Chinese Medicine health management Sanitation supervision & subcooperation Health education Maternal health care Child health care Vaccination Elderly health care Health management for TB Patients Health management for patients with serious mental disorders Infectious diseases & public health emergencies reporting & handling

1. Promotion of the primary public healthcare service for all migrants Health Education Maternal Health Care Child Health Care Vaccination

Promotion of the primary public healthcare service for all migrants Screening for Cervical Cancer and Breast Cancer Primary Public Health Service for pregnant woman

Strengthen disease prevention and control for migrant population Carry out health education on HIV/AIDS HIV TB Free access to TB diagnosis and treatment. Make sure migrant workers are entitled to equality and HIV TB the proportion of migrant workers with successful continuous access to treatment in TB keeps HIV/AIDS services higher than 80%.

Improve the level of medical security for migrants Health Insurance 91.4% 91.4% of the migrant population participated in at least one type of medical insurance.

Improve the level of medical security for migrants The measures we are taking

Health education and promotion among migrants Develop core messages for migrants health Promote health literacy of young migrant workers

Experience and perception Health is the cornerstone of all-round human development and happiness Primary Public Healthcare Services are indispensable to all people Social Integration should starts from where it is most needed Primary Public Healthcare Services Social Integration

Social Integration of Migrant Population Work in cities Become urban residents Integrate into the city life

Migrants Population Dynamic Monitoring Survey Sample size: 170,000 respondents (2017) Questionnaire :About 260 questions Family Members Information, Income and Expense Employment and Mobility Residency and Settlement Willingness Health and Family Planning Services Health Literacy

Migrants Population Dynamic Monitoring Survey Outcomes based on the data New trends of population migration Migration and urbanization Equalization of basic public health service Population migration in border areas Left behind population Annual Report on China s Migrant Population Development (The Government White Book).

Social Integration of Migrant Population Economic Integration Cultural communication Social Acceptance Identification Assimilation

Social Integration of Migrant Population

Social Integration of Migrant Population Chinese Experiences Multi-sector government linkage --- Zhongshan as an example Established the joint conference system on health work. Putting more attention on occupational health education and pre-service training.

Social Integration of Migrant Population Chinese Experiences Promote family harmony ---- Dalian as an example well-designed service projects, passing "home" concept. Provide comprehensive health and family planning services conrtonraned about the migrant families and provide needed services of different ages.

Social Integration of Migrant Population Chinese Experiences Internet + new ways of working ----- Guiyang as an example A net: database for demand and service Two Lines: Online and Offline Three circles: the grid members, communities, neighborhood committees

Population Development High fertility High mortality Low growth rate High fertility Low mortality High growth rate Low fertility Low mortality Low growth rate Mortality dominates Fertility dominates Migration dominates New eta

THANK YOU