China and the 'barefoot doctors'

This is one of the earliest examples of primary health care, from the 1960s. Local people were trained in basic medical care, so that only the more serious cases were referred to central hospitals.

This allowed hospitals to concentrate on the very sick. The 'barefoot doctors' lived and worked part-time in the community who paid for their services; they were understood and trusted by their neighbours.

Because local medicines were used in addition to western drugs, the cost of drugs was reduced.

The health care was very successful in early years at reducing disease/illness/deaths in rural areas, but it also had failures.


  • too few health workers trained to supply all the rural communities
  • lack of funding in the local community to pay for the training
  • lack of volunteers who are willing to do community work rather than work in private practice in wealthier urban areas