Tobacco crop substitution: pilot effort in China.

In China, approximately 20 million farmers produce the world's largest share of tobacco. Showing that income from crop substitution can exceed that from tobacco growth is essential to persuading farm families to stop planting tobacco, grown abundantly in Yunnan Province. In the Yuxi Municipality, collaborators from the Yuxi Bureau of Agriculture and the University of California at Los Angeles School of Public Health initiated a tobacco crop substitution project. At 3 sites, 458 farm families volunteered to participate in a new, for-profit cooperative model. This project successfully identified an approach engaging farmers in cooperatives to substitute food crops for tobacco, thereby increasing farmers' annual income between 21% and 110% per acre.

Improving reproductive health knowledge in rural China--a web-based strategy.

In China, one of the major problems in upgrading rural health services is the difficulty of communicating between the rural and urban areas. Enabling local agencies to access the Internet in resource-poor areas can provide an efficient means of diffusing current training and information and will have far-reaching policy implications. To test the feasibility of using the Internet to deliver needed health information to the countryside, the UCLA School of Public Health and the Institute of Health Studies of Kunming Medical College (IHS-KMC) collaborated in an experimental website project to improve the quality of reproductive health services to promote women's health in three rural counties of Yunnan. The project involved the county government and the Bureau of Public Health, the Bureau of Family Planning; the Bureau of Education, Women's Federation, and the Maternal and Child Health Station targeting village health workers and teachers; women's cadres. Three counties, matched on socioeconomic status, participated in the study and were randomized to receive three programs. Nanhua County received computer skill training and logistic support including a planning workshop for information diffusion. Mouding County received computers only. Dayao, the control county, did not receive the full program until the conclusion of the project. The study demonstrated that the use of a website to disseminate health information in remote rural areas is not only feasible but that it also will be enthusiastically adopted by local health workers and interested parties. Moreover, the knowledge was diffused from the primary population of village doctors, family planning workers, women's cadres, and teachers to the secondary population of villagers and students.

Reproductive health indicators for China's rural areas.

We report community-based development of reproductive health indicators for China's rural areas. To generate these indicators, we sequenced two participatory techniques known as nominal group process and Delphi survey methodology. Nominal group process entailed grassroots reproductive health workers' generating indicators, followed by refinement and prioritization of these indicators through a consensus-building Delphi process among nationally and internationally known reproductive health experts. Major criteria for the indicators were practicality, feasibility, and measurability within China's rural areas. We explain the importance of establishing these indicators for application in rural China and other developing countries as a complement to the World Health Organization's reproductive health indicators for global monitoring; present the identified indicators; and describe lessons learned from field testing in low-, middle-, and high-income counties of China's countryside.