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Urban pluvial flooding in China has become one of the major challenges for sustainable development. This paper analyzes the impact of climate change, urbanization, and integrated disaster drivers on urban pluvial flooding hazards, starting from the disaster-causing mechanisms of urban pluvial flooding in China. This paper then analyzes the main features and progress of urban pluvial flooding governance in China. In particular, this paper describes the progress of sponge cities in China. On the basis of the above contents, this paper describes three manifestations of the fragmentation dilemma at the level of governance, namely, fragmentation in value integration due to conflicting management orders and service values, fragmentation in resource and power allocation due to the lack of vertical top-level design and blurred horizontal departmental management boundaries, and fragmentation in policy formulation and implementation due to outdated urban flood control standards and interdepartmental information compartmentalization. In response to the fragmentation dilemma in urban pluvial flooding management in China, this paper introduces the concept of holistic governance and clarifies the path of urban waterlogging management, i.e., forming a collaborative and diversified governance subjects, deeply optimizing the organizational structure of urban waterlogging management, creating a mature information-based governance platform, and improving the legal and rule of law construction model. This paper is informative for understanding the governance of urban pluvial flooding in China from a government-led management level. [ABSTRACT FROM AUTHOR]

In this paper, the evolution of the ethics committees for health research, their history, membership, and function in China and Australia is described. Investigators in each country compared the history and governance of their ethical systems based on the published evidence rather than personal opinions. Similarly, examples of challenges were selected from the literature. In both countries, the aim was to maximize the social benefits of research and minimize the risk imposed on the participants. Common challenges include maintaining independence, funding and delivering timely ethical reviews of the research projects. These challenges can be difficult where research ethics committees rely on voluntary contributions and lack a strong resource base. They must adapt to the increasingly rapid pace of research as well as the technological sophistication. Population health research can challenge the conventional views of consent and privacy. The principles of the sound ethical review are common in both countries; governance arrangements and operational procedures, however, can differ, reflecting the cultural values and norms of their host countries and in respect of legal environments. By studying the evolution and function of ethics committees in the two countries, we established the differences in the governance and health systems, while similar ethical objectives helped sustain collaborative research. [ABSTRACT FROM AUTHOR]

Background: Research on the relationships between economic development, energy consumption, environmental pollution, and human health has tended to focus on the relationships between economic growth and air pollution, energy and air pollution, or the impact of air pollution on human health. However, there has been little past research focused on all the above associations. Methods: The few studies that have examined the interconnections between the economy, energy consumption, environmental pollution and health have tended to employ regression analyses, DEA (Data Envelopment Analysis), or DEA efficiency analyses; however, as these are static analysis tools, the analyses did not fully reveal the sustainable economic, energy, environmental or health developments over time, did not consider the regional differences, and most often ignored community health factors. To go some way to filling this gap, this paper developed a modified two stage Undesirable Meta Dynamic Network model to jointly analyze energy consumption, economic growth, air pollution and health treatment data in 31 Chinese high-income and upper-middle income cities from 2013–2016, for which the overall efficiency, production efficiency, healthcare resource utilization efficiency and technology gap ratio (TGR) for all input and output variables were calculated. Results: It was found that: (1) the annual average overall efficiency in China's eastern region was the highest; (2) the production stage efficiencies were higher than the healthcare resource utilization stage efficiencies in most cities; (3) the high-income cities had lower TGRs than the upper–middle income cities; (4) the high-income cities had higher average energy consumption efficiencies than the upper-middle income cities; (5) the health expenditure efficiencies were the lowest of all inputs; (6) the high-income cities' respiratory disease and mortality rate efficiencies were higher than in the upper–middle income cities, which had improving mortality rate efficiencies; and (7) there were significant regional differences in the annual average input and output indicator efficiencies. Conclusions: First, the high-income cities had higher average efficiencies than the upper-middle income cities. Of the ten eastern region high-income cities, Guangzhou and Shanghai had average efficiencies of 1, with the least efficient being Shijiazhuang. In the other regions, the upper-middle income cities required greater technology and health treatment investments. Second, Guangzhou, Lhasa, Nanning, and Shanghai had production efficiencies of 1, and Guangzhou, Lhasa, Nanning, Shanghai and Fuzhou had healthcare resource utilization efficiencies of 1. As the average production stage efficiencies in most cities were higher than the healthcare resource utilization stage efficiencies, greater efforts are needed to improve the healthcare resource utilization. Third, the technology gap ratios (TGRs) in the high-income cities were slightly higher than in the upper-middle income cities. Therefore, the upper-middle income cities need to learn from the high-income cities to improve their general health treatment TGRs. Fourth, while the high-income cities had higher energy consumption efficiencies than the upper-middle income cities, these were decreasing in most cities. There were few respiratory disease efficiency differences between the high-income and upper-middle income cities, the high-income cities had falling mortality rate efficiencies, and the upper-middle income cities had increasing mortality rate efficiencies. Overall, therefore, most cities needed to strengthen their health governance to balance economic growth and urban expansion. Fifth, the average AQI efficiencies in both the high-income and upper-middle income cities were higher than the average CO2 efficiencies. However, the high-income cities had lower average CO2 emissions and AQI efficiencies than the upper-middle income cities, with the AQI efficiency differences between the two city groups expanding. As most cities were focusing more on air pollution controls than carbon dioxide emissions, greater efforts were needed in coordinating the air pollution and carbon dioxide emissions treatments. Therefore, the following suggestions are given. (1) The government should reform the hospital and medical systems. (2) Local governments need to strengthen their air pollution and disease education. (3) High-income cities need to improve their healthcare governance to reduce the incidence of respiratory diseases and the associated mortality. (4) Healthcare governance efficiency needs to be prioritized in 17 upper-middle income cities, such as Hangzhou, Changchun, Harbin, Chengdu, Guiyang, Kunming and Xi'an, by establishing sound medical management systems and emergency environmental pollution treatments, and by increasing capital asset medical investments. (5) Upper-middle income cities need to adapt their treatment controls to local conditions and design medium to long-term development strategies. (6) Upper-middle income cities need to actively learn from the technological and governance experiences in the more efficient higher-income cities. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has wreaked havoc on global economy and human communities. Promoting the accessibility and affordability of vaccine via diplomacy is the key to mitigating the pandemic crisis. China has been accused of seeking geopolitical objectives by launching vaccine diplomacy. The definition of vaccine diplomacy is neutral by nature. China's vaccine diplomacy is based on its holistic approach to national security and the importance China attaches to the "Belt and Road" Initiative. With a whole-of-government approach on both the bilateral and multilateral levels and marketization of vaccines, China's vaccine diplomacy has immense implications for global health governance, in that it helps to narrow the global immunization vaccination gap and to promote human-right-based approach to global health governance. However, the sustainability of China's vaccine diplomacy is questionable because of the Sino-American geopolitical competition and doubts over the efficacy of China's vaccines. The escalation of power rivalry between China and the U.S. and the concerns over the efficacy of China's vaccines forebode the gloomy future of China's vaccine diplomacy. [ABSTRACT FROM AUTHOR]

Background: Patient Reported Outcome Measures (PROMs) are widely used in Europe and North America in a variety of areas including research, clinical governance, clinical registries and insurance ascertainment. The aim of this study was to assess commonly used knee and hip PROMs among Chinese surgeons and to gain an insight into their impact on evaluation of clinical outcomes.Methods: 1. A systematic literature search of databases Medline, EMBASE, CINAHL and CNKI was performed from the earliest records to 22/07/2020 for knee instruments and 22/08/2020 for hip instruments, to retrieve Chinese Mandarin cross culturally adapted and validated knee and hip PROMs. 2. An 11-item electronic questionnaire was then designed under four domain categories. The survey was distributed via a ubiquitous online social media platform to orthopaedic surgeons. Responses were collected and analyzed. Output from 1. was used to populate parts of the survey questionnaire.Results: The systematic online search yielded a total of 41 evaluation instruments, (10 hip and 31 knee); all of which were incorporated as response options. 234 viable questionnaires were retrieved with the largest group representing attending surgeons. 59.0% were familiar with the concept of PROMs among which 78.4% reported to have used PROMs themselves. In order of frequency of use, PROMs were purposed for clinical assessment (55.6%), research (40.7%), health regulation policies (18.6%) and insurance service requirements (10.6%). Implementation was prompted by both departmental (43.4%) and institutional policy (34.5%). 89.4% of PROMs users reported difficulties in the use of PROMs, with major barriers including license fees, limited access, inadequate training and burden of fill-out time (all > 40%).Conclusion: There is evidence of limited familiarity with knee and hip PROMs among orthopaedic surgeons. Barriers to their use are significant. Development of a Chinese language PROMs database would be helpful. [ABSTRACT FROM AUTHOR]

Background: Air pollution is an important factor in health outcomes and health-care expenditure. It has become an important issue of global concern. The objective of this study was to explore the influence of air pollution on the economic burden of respiratory diseases using different levels of PM2.5. Methods: Starting from the demand side, we took the 3,546 patients in the Respiratory and Critical Care Department of a tertiary hospital in Beijing between 2013 and 2015 as examples, combining daily air-quality data using a generalized linear regression–analysis model to explore the impact of air pollution on health-care expenditure on a microindividual level. Results: We found that PM2.5 had a significant impact on health-care expenditure on respiratory diseases. It had a positive impact on total health-care expenditure, drug expenditure, and antibiotic expenditure. The impact of different levels of air pollution on the health care–expenditure burden of disease was heterogeneous. As the air-pollution index increased, health care–expenditure burden of respiratory diseases also gradually raised. The impact of PM10 and air-quality index had a positive impact on health-care expenditure for respiratory diseases. Air pollution had a significant impact on health care–expenditure burden of respiratory diseases. The effect of length of stay on various health-care expenditure was significantly positive. Conclusion: The impact of mortality-risk classification on various health-care expenditure is significant. Therefore, policy-making must take into account both the supply side and the demand side of health-care services. Furthermore, the government should strengthen environmental governance, pay attention to the heterogeneity of the health care–expenditure burden affected by environmental pollution, improve the medical insurance system, and improve the health of residents to reduce the health care–expenditure burden. [ABSTRACT FROM AUTHOR]

Background: The family planning program in some countries have not been successful yet because the population is growing rapidly. Currently, all the government is trying to provide family planning access in health facilities through the national health insurance program Aim: To compare the role of universal health coverage in supporting national family planning programs Method: This literature study had been made by data reviewing in four different countries which have large population: China, India, the USA and Indonesia. Using the indicator of involvement of UHC in family planning in several countries, there are advocacy and policy, health service, health financing and governance. It was compared the support of contraceptive policy and highlighted the program as a strategy for developing family planning in the national health insurance era Results: Policies related to the use of national health insurance for supporting family planning in several different countries produced different results. In addition to the aspect of finance, the policy on the number of children, the private and public service systems, the priority of contraception choice and family involvement also played a role in the success of the program Conclusion: The correct target program must be immediately determined by the government so it is important for policymakers to self-introspection related to family planning in this country by using the indicator of involvement of UHC. [ABSTRACT FROM AUTHOR]