Scaling up the Quality of Care Project in China

Quality of Care Project History:

In 1995 the National Population and Family Planning Commission (NPFPC) of China began to reorient its family planning program towards greater quality of care. Between 1995-2000 quality-of-care pilot projects were initiated in 11 counties. The package of innovations introduced included: broadening informed choice in contraceptive decision making; changing the content of information, education and communication (IEC) materials; improving provider-patient relationships and technical competence; and expanding family planning services to include other aspects of reproductive health care.

Scaling-up efforts:

In 2000 the National Population and Family Planning Commission began to scale up quality-of-care innovations to the whole country. In 2002 the Family Planning Law was passed which affirms the principle of informed choice and criminalizes coercion in family planning. Since 2002 the Commission annually selects a number of “advanced counties” which meet its 33 quality-of-care indicators. The scaling-up efforts receives technical support from the Operational Office of the Quality Project which is located at the China Population and Development Research Center funded by the Ford Foundation.

In March 2005 a workshop organized by the Operational Office held in the Changping District of Beijing, concluded that a guide on quality of care was needed. The purpose of this guide would be to assist new counties in carrying out quality-of-care improvements and to serve as a training resource for staff of the Operational Office. Key staff members from pilot counties had the opportunity to provide input during the guide's development. To complement the guide a two-day training curriculum was developed.

In 2005 and 2006 the guide and training curriculum were pre-tested with approximately 260 county and prefecture participants in Jiu Jiang Prefecture of Jianxi Province, and Anshun Prefecture of Guizhou Province. Participants found the training and guide useful; valued learning from the experiences of the pilot counties and felt the guide provided new information about the concept of quality-of–care.

Future Efforts:

The Operational Office hopes to create a group of master trainers at the provincial level who are committed to (1) implement cascade training for all counties in the province (2) provide a copy of the guide to all counties/townships in the province, (3) conduct a systematic review of what changes are needed to enhance quality of care and, (4) provide periodic reports on what progress has been made to the Operational Office.

The Operational Office also hopes to (1) advocate at the national level for additional measures to institutionalize quality-of-care and facilitate its implementation at the provincial and county level, (2) follow-up and disseminate results from scaling-up initiatives; and (3) participate in the design of future innovations in the areas of gender, sexuality, adolescents, men, and violence against women.

At right is a short video clip of the Director of the Quality Project Operational Office conveying the content of a poster in a county-level family planning clinic that describes key points about quality of care.


Please click the arrow to play.


Further reading:

Kaufman, Joan, Zhang Erli, Xie Zhenming. Forthcoming. "Quality of care in China: from pilot project to national programme" In: Simmons R, Fajans P, Ghiron L, eds. Scaling-up health service delivery: from pilot innovations to policies and programmes. Geneva, World Health Organization. (Book available in PDF by clicking title)

"Quality of Care in Family Planning: Pilot Experiences in China". 2007. National Population and Family Planning Commission, Quality of Care Project Operational Office.

Website of the Quality of Care Project at


Click the images below for descriptions

County clinic Director with Quality of Care Guide


Team member interviewing local woman about services


Grandmother with grandchild


Team leader discusses quality of care framework

click the images above for descriptions