While it is widely accepted that a decentralised system can enhance policy learning and the spread of best practices, an under-researched question is where that learning process takes place, and another more important and intriguing question is what supports and sustains that learning. As a highly decentralised country, China has experienced a transition from a command to a social market economy and rapid socio-economic development in the past four decades. Last year the communist country celebrated its 70th birthday. How did the communist country achieve high-speed development whilst maintaining long term stability? With recent political enthusiasm in summarizing experiences since the opening up and reform period in late 1970s, learning has become a hot word both in policy document and in research papers in China. It is seen as the main capability of both the rank-and-file communist party member and policy maker.;A national strategy on improving learning capabilities has been released recently, defining learning contents, methods, and the role of the thinktank. All these raise the interest in another question concerning the policy learning: is there a high-level of learning that sustains policy learning and making in China? Considered as a main avenue for improving the people's livelihood through government action, the health sector has undergone radical reforms and development to adapt to disease and demographic changes brought by the rapid socio-economic transitions. With its highly decentralised mode of service provision, the health system has managed to provide equal and universal access to essential medical care and public health services, in a hope of achieving Universal Health Coverage (UHC). One important strategy for achieving this has been to encourage implementation units (local governments or other organizations) to experiment and then incorporate lessons from successful interventions into national plans and policies. The thinktank and research institutions have played an important role in supporting learning and diffusion of best practices.;With latest central policy on improving the policy learning capabilities and thinktank development, China is purposefully targeting to improve governance and the learning ability of the government with assistance of thinktanks. Using case studies in the health sector, the thesis identifies the underlying methodologies supporting learning in China and how learning capability has been enhanced in order to manage changes and seek innovations in supporting UHC. The results show that a meta learning approach has developed with the support of the national thinktank, for supporting and sustaining the distinctive policy learning process. The story of the thesis closes at the time of the COVID-19 pandemic crisis. China has impressed the world with its quick and determined actions and successful containment of an unknown disease within 3 months. This further shows the relevance of the topic to the other countries, especially low- and middle-income countries (LMICs) which need to learn and innovate local health service in the complex environment.
|Date of Award||2 Feb 2021|
- University Of Strathclyde