Primary care and health in rural China (1960s–1970s)


This paper employs micro data to examine the effects of primary care expansion in rural China from the 1960s to 1970s. The data reveal a steady increase in the presence of midwives in rural China, reflecting China’s efforts to train primary care workers. By adopting an event study approach, I find the presence of midwives significantly reduced infant mortality in a commune. Economically advantaged communes experienced greater improvement in terms of primary care and a larger reduction in infant mortality rates. These beneficial health effects could not be explained by midwife delivery per se. Moreover, the age-2 mortality of children with poor health was reduced by the presence of midwives, indicating that other primary care interventions in addition to reproductive health services also helped improve health.