Intergovernmental Fiscal Transfers and County-Level Education Expenditure in China

Purpose The purpose of the paper is to investigate the impact of various types of intergovernmental fiscal transfers on local public education expenditure at the county level in China and to estimate the leakage of categorical subsidies for rural compulsory education. Design/Approach/Methods It is a quantitative study. The paper constructs a quantile regression model and adopt data collected in 2007 for 1,985 counties in China to examine the impact of relevant fiscal transfers. Findings The results reveal that most intergovernmental fiscal transfers exert a substitution effect on the local education expenditure, whereas subsidies for rural compulsory education from the Central Government have a crowding-out effect on education investments from local financial resources. Although the subsidy program generally narrows the education expenditure disparity across counties, there are heterogeneous effects across different regions. Originality/Value The paper estimates and compares the impact of fiscal transfers on both the level and disparity of local public education in different regions, and provides a possible explanation for the crowding-out effect of fiscal transfers in China

The challenge of maintaining microscopist capacity at basic levels for malaria elimination in Jiangsu Province, China

Abstract Background Local malaria transmission has decreased rapidly since the National Malaria Elimination Action Plan was launched in China in 2010. However, imported malaria cases from Africa and Southeast Asia still occur in China due to overseas laborers. Diagnosis by microscopy is the gold standard for malaria and is used in most hospitals in China. However, the current capacity of microscopists to manage malaria cases in hospitals and public health facilities to meet the surveillance needs to eliminate and prevent the reintroduction of malaria is unknown. Methods Malaria diagnoses were assessed by comparing the percentage of first visit and confirmed malaria diagnoses at Centers for Disease Control and Prevention (CDCs) and hospitals. The basic personnel information for public health departments and hospitals at different levels was investigated. The skills of microscopists for blood smear preparation and slide interpretation were also examined at the county and township levels. Results Inaccurate rate with 13.49% and 7.32%, respectively, in 2013 and 2014, from 341 and 355 reported cases from sub-provincial levels in Jiangsu province. Most of the 523 malaria cases reported in Nantong Prefecture from 2000 to 2014 involved patients who first visited county CDCs seeking treatment, however, none of these cases received confirmed diagnosis of malaria in townships or villages.The staff at county CDCs and hospitals with a higher education background performed better at making and interpreting blood smears than staff from townships. Conclusions The network for malaria elimination in an entire province has been well established. However, an insufficient capacity for malaria diagnosis was observed, especially the preparing and reading the blood smears at the township and village levels, which is a challenge to achieving and maintaining malaria elimination