标题：Evaluating Family Planning Organizations Under China's Two-Child Policy in Shandong Province
作者：Xu, Lizheng; Yang, Fan; Sun, Jingjie; Nicholas, Stephen; Wang, Jian
作者机构：[Xu, Lizheng; Yang, Fan] Shandong Univ, Sch Publ Hlth, Ctr Hlth Econ Expt & Publ Policy, Key Lab Hlth Econ & Policy Res,NHFPC, Jinan 250012, Shandong, 更多
通讯作者：Nicholas, S;Nicholas, S;Nicholas, S;Nicholas, S;Nicholas, S;Wang, J;Wang, J
通讯作者地址：[Nicholas, S]Tianjin Normal Univ, Sch Management, West Bin Shui Ave, Tianjin 300074, Peoples R China;[Nicholas, S]Tianjin Normal Univ, Sch Econ, West 更多
来源：INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
关键词：family planning; government financing; organizational change
摘要：Background: The 2015 two-child policy was the most important institutional change in China's family planning since the 1978 one-child policy. To implement the two-child policy, China merged the former health departments and family planning departments into the new Health and Family Planning Commission organization. We collected and analyzed funding and expenditure data, providing a novel approach to assessing the family planning outcomes under China's two-child policy. The paper shows how the management structure and funding levels and streams shifted with the new two-child policy and assesses the new management structure in terms of the ability to carry out tasks under the new family planning policy. Methods: We collected data on the funding, structure of expenditure and social compensation fee in Shandong province from 2011 to 2016, to evaluate how resources were allocated to family planning before and after the organizational change. We also collected interview data from family planning administrators. Results: While total family planning government financing was reduced after the organizational change, expenditures were shifted away from management to family planning work. Funding (80%) was allocated to the grass-root county and township levels, where family planning services were provided. The overlapping work practices, bureaucracy, and inefficiencies were curbed and information flows were improved. Conclusions: The new Health and Family Planning Commissions shifted resources to carry out the new family planning policy. The aims of the two-child policy to reduce inefficiencies, overlapping authorities and excessive management were achieved and expenditures on family planning work was enhanced and made more efficient.