One of China's great successes during the period of the command economy was to provide a large majority of its population with access to basic health services at an affordable price. This contributed to major improvements in the life of rural people. This issue of the IDS Bulletin asks whether China will be able to maintain cost-effective rural health services as it transforms itself into a market economy The answer to this question is of immediate concern to the hundreds of millions of people living in the rural areas of China. It is also relevant to those interested in the health services of low and middle income countries and of countries in transition to a market economy.

This issue is an output of a collaboration between the Shanghai Medical University (SMU) and the IDS.' Researchers from these institutions have been studying the impact of economic and institutional reform on China's rural health services for several years. The article by Tang et al. describes case studies they have undertaken in three poor counties. Several articles in this issue use the study findings as illustrative examples. Several of the articles in this issue were written while its author was an IDS Visiting Fellow. Early drafts of the articles were presented to a two-day workshop held in March 1996.