When seeking to build high quality and cost-effective infrastructure in rural villages, a fundamental question is: Who is better at doing so? Should the village leadership or a government agency above the village finance and/or manage the construction of the infrastructure project? To answer this question, we surveyed all rural road projects in 101 villages in rural China between 2003 and 2007 and measured the quality and per kilometer cost of each road. According to our analysis, road quality was higher when more of the project funds came from the government agency above. Moreover, projects had lower cost per kilometer when the village leaders managed the road construction. Overall, our findings suggest that to build high quality and cost-effective rural roads village leaders and government agencies should collaborate and each specialize in a specific project role.

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Abstract: The overall goal of this article is to understand the progress in implementing the New Cooperative Medical Scheme, while seeking to assess the strengths and weaknesses of the programme and, in particular, to understand its effects on the incidence of catastrophic medical payment. The study is based on two rounds of nationally representative household survey data collected in 2005 and 2008. The study found that the programme has a very high level of participation, and has increased farmers’ use of medical services. However, despite efforts by both central and local governments and high household participation, the programme is only partially achieving its policy objectives. In particular, it has been able to extend to almost all of the rural population, but has failed to cover expenses for catastrophic illness, due to insufficient funds.

Abstract The overall goal of this article is to understand the progress in implementing the New Cooperative

Medical Scheme, while seeking to assess the strengths and weaknesses of the programme and, in particular,

to understand its effects on the incidence of catastrophic medical payment. The study is based on two

rounds of nationally representative household survey data collected in 2005 and 2008. The study found that

the programme has a very high level of participation, and has increased farmers’ use of medical services.

However, despite efforts by both central and local governments and high household participation, the

programme is only partially achieving its policy objectives. In particular, it has been able to extend to almost

all of the rural population, but has failed to cover expenses for catastrophic illness, due to insufficient funds.

Purpose

Purpose: The need for a universal rural pension system has been heightened by demographic changes in rural China, including the rapid aging of the nation’s rural population and a dramatic decline in fertility. In response to these changes, China’s Government introduced the New Rural Social Pension Program (NRSPP) in 2009, a voluntary and highly subsidized pension scheme. The purpose of this paper is to assess the participation of rural farmers in the NRSPP. Furthermore, the authors examine whether the NRSPP affects the labor supply of the elderly population in China.

The lost decades for China in the 1950s, 1960s and 1970s look remarkably like the lost decades of Africa in the 1980s an 1990s.  Poor land rights, weak incentives, incomplete markets and inappropriate investment portfolios.  However, China burst out of its stagnation in the 1980s and has enjoyed three decades of remarkable growth.  In this paper we examine the record of the development of China's food economy and identify the policies that helped generate the growth and transformation of agriculture.  Incentives, markets and strategic investments by the state were key.  Equally important, however, is what the state did not do.  Policies that worked and those that failed (or those that were ignored) are addressed.  Most importantly, we try to take an objective, nuanced look at the lessons that might be learned and those that are not relevant for Africa.  Many parts of Africa have experienced positive growth during the past decade.  We examine if there are any lessons that might be helpful in turning ten positive years into several more decades of transformation.

New research on the political economy of policy-induced distortions to incentives for optimal resource use in agriculture and insights from the study of the dramatic reforms in former state-controlled economy has led to enhanced insights on the role of governance structures on policy making in agricultural and natural resources. This paper reviews these research developments and key new insights.

Researchers typically explain inequalities in access to elite high schools by looking at gaps that appear before the high school admissions process. However, even when disadvantaged students reach the stage of high school admissions with identical qualifications as advantaged students, mechanisms particular to the high school admissions process may prevent disadvantaged students from accessing elite high schools. The overall goal of this paper is to examine the degree to which the high school admissions process deters disadvantaged students from accessing elite high schools. To fulfill this goal, we analyze longitudinal, administrative data on approximately 24,000 students in one region of China. In this setting, according to our data, the rural-urban gap in elite high school attendance can be larger than 50 percentage points (even though rural students comprise well more than half of the high school student population). Our results show that the five subject exams of the high school entrance exam (HSEE) are biased against rural students. If the HSEE dropped two of the most biased subject exams from the HSEE, access to elite high schools among rural students would increase by 4 percentage points (or 8 percent). Furthermore, conditional on HSEE scores, rural students are 13 percentage points less likely than urban students to apply for elite high schools. Finally, conditional on HSEE scores and application choices, the existence of an alternative admissions channel that charges extra admissions fees further reduces rural access by 18 percentage points.

This paper studies women’s participation in village elections. It focuses on the impact of voting rights training on women’s knowledge, and their voting behaviors in Ningxia, China, a Hui nationality autonomous region with a conservative cultural environment for women. A randomized controlled trial has been used in the study.

Objectives: To determine whether China's New Rural Cooperative Medical Scheme (NCMS), which aims to provide health insurance to 800 million rural citizens and to correct distortions in rural primary care, and the individual policy attributes have affected the operation and use of village health clinics.

Design: We performed a difference-in-difference analysis using multivariate linear regressions, controlling for clinic and individual attributes as well as village and year effects.

Setting: 100 villages within 25 rural counties across five Chinese provinces in 2004 and 2007.

Participants: 160 village primary care clinics and 8339 individuals.

Main outcome measures: Clinic outcomes were log average weekly patient flow, log average monthly gross income, log total annual net income, and the proportion of monthly gross income from medicine sales. Individual outcomes were probability of seeking medical care, log annual "out of pocket" health expenditure, and two measures of exposure to financial risk (probability of incurring out of pocket health expenditure above the 90th percentile of spending among the uninsured and probability of financing medical care by borrowing or selling assets).

Results: For village clinics, we found that NCMS was associated with a 26% increase in weekly patient flow and a 29% increase in monthly gross income, but no change in annual net revenue or the proportion of monthly income from drug revenue. For individuals, participation in NCMS was associated with a 5% increase in village clinic use, but no change in overall medical care use. Also, out of pocket medical spending fell by 19% and the two measures of exposure to financial risk declined by 24-63%. These changes occurred across heterogeneous county programmes, even in those with minimal benefit packages.

Conclusions: NCMS provides some financial risk protection for individuals in rural China and has partly corrected distortions in Chinese rural healthcare (reducing the oversupply of specialty services and prescription drugs). However, the scheme may have also shifted uncompensated new responsibilities to village clinics. Given renewed interest among Chinese policy makers in strengthening primary care, the effect of NCMS deserves greater attention.