Training sufficient and adequate general practitioners for universal health coverage in China

China introduced national health system reforms in 2009 with the aim of achieving universal health coverage by 2020, and to address growing inequalities in access to healthcare across urban and rural areas.12 Strengthening primary healthcare is considered essential for universal health coverage, which is a key target of sustainable development goal 3 (SDG3) as it provides financial protection against catastrophic healthcare expenses and ensures accessibility to necessary health services.3

The reforms have achieved substantial progress in service delivery, including nearly universal insurance coverage.2 However, China now faces rapidly rising health needs associated with population ageing, with chronic diseases already accounting for over 80% of all deaths.4 China’s health system also remains hospital centric, resulting in spiralling health expenditure.4Figure 1 summarises how a shift to primary healthcare could help achieve universal coverage and meet health needs, specifically by emphasising disease prevention and a person centred approach.5 Through gatekeeping, primary healthcare also has the potential to achieve long term health savings equivalent to 3% of gross domestic product.4