Paper short abstract:

This paper first provides an overview of AMR regulations launched by Chinese national and Provincial health authorities in the past two decades and then examines how and why when these top-down official initiatives are translated into local practices they have not achieved the intended outcomes.

Paper long abstract:

Antimicrobial resistance (AMR) has been identified as an issue of global and national significance in Public Health. In this paper we discuss why AMR policies in China have failed to be effective. We draw on over 60 semi-structured interviews and observations conducted in 3 village clinics and 3 township health centres, examining how rural residents and families access and use antibiotics among other medicines.

This paper has two parts: Part 1 will provide an overview of AMR regulations and policies launched by Chinese national and Provincial health authorities in the past two decades—for example, the List of Essential Medicine, the New Agricultural Co-operative Medical Scheme (NACMS) and other relevant policies.

Part 2 will examine how these top-down official initiatives are translated into local practices in Primary Care rural health facilities and why they have not achieved their intended outcomes. We argue that the infrastructure of modern social-economic life in rural Anhui Province affect residents' health-seeking behaviours, in particular, accessing and consuming antibiotics. Their health-seeking behaviours are closely linked to the values of productivity and time, and the expectation that antibiotic will yield fast and full recovery. Hence, perceptions of the potency of antibiotics is central to both their use and the desired form of administration; particularly the use of "drips" (IV treatment which usually contain antibiotics) for the common cold or flu. The need for a "quick fix" is very much embedded in rural-to-urban migration practices, the intergenerational exchange of care and moral values of reciprocity.