Le delta du sénégal est un espace relais entre le sénégal et la mauritanie. Il fait partie d'un hydrosystème, la vallée du sénégal, qui prend sa source dans la zone guinéenne à pluviométrie très importante. cette ressource partagée par plusieurs états (sénégal, mauritanie, mali, guinée) assure une alimentation pérenne en eau douce d'un espace situé entre le sahel, le ferlo et l'océan atlantique, où la présence de l'eau a toujours constitué une opportunité de développement. ainsi, depuis l'aof (afrique occidentale française)jusqu'à la mise en place de l'omvs (organisation pour la mise en valeur du fleuve sénégal), les projets de développement s'y sont multipliés.historiquement, le delta du sénégal a été la cible prioritaire de tentative de développement qui se sont soldées, la plupart du temps, par des échecs, car la mise en valeur ne pouvait se faire que dans le cadre d'une domestication complète de l'eau, acquise seulement à partir de 1985 (barrage de diama)et de 1987 (barrage de manantali). ces grands ouvrages hydraulique ont permis une régulation annuelle de l'eau douce, en modifiant le rythme naturel de crue et de décrue qui animait l'hydrosystème et les activités socio-économiques. aussi,de par ses potentialités (eau, tourisme, débouché vers la vallée du sénégal, terre rizicultivables, etc.), le delta du sénégal est-il devenu un espace convoité, autant par les états qui se le partagent (mauritanie et sénégal) que par les collectivités locales (commune de saint-louis, ross béthio, richard toll, communautés rurales de mpal, gandon, ronq) qui l'animent. pour l'état du sénégal, le delta est donc un espace essentiel au développement du pays qui passe par la réduction des importations de riz (autosuffisance alimentaire). c'est aujourd'hui une tête de pont d'un développement endogène de l'afrique de l'ouest.dans ce contexte, cette thèse vise d'abord à montrer que le cadre de gestion actuelle du delta n'est pas favorable à un développement économique homogène et maîtrisé, prenant en charge toutes les structures (approche structurale) en présence (ethniques, politiques - inter et intra étatiques-, sociales etc.). aussi, une nouvelle approche est à déployer dans le bas delta à travers l'opérationnalisation de la gestion intégrée des ressources en eau (gire) ainsi que la mise en place dune plate-forme de connaissances pour la gestion de l'eau (s.i.g., chorèmes, indicateurs, benchmarking, etc.). cette approche d'essence systèmique et multiscalaire (la gire) devrait permettre une meilleure exploitation/répartition des ressources hydrauliques, une meilleure productivité économique pour la sécurité en eau et, par extension, la sécurité alimentaire du sénégal (pour l'alimentation en eau potable, l'agriculture, l'élevage, la pêche, l'hydro- éléctricité, l'ouverture vers le marché mondial, etc.) ainsi qu'une meilleure articulation du global et du local dans la gouvernance de cet espace. le début de domestication a entraîné de profonds changements dans le bas delta. le territoire se recompose (arrivées de nouvelles populations pour sa mise en valeur). les pratiques agropastorales se modifient : passage d'une exploitation extensive par plusieurs ethnies - wolof, peulhs, toucouleurs, maures - et une pluri activité - agriculture, élevage, pêche -, à une exploitation intensive des ressources naturelles (agriculture irriguée, etc.) et à une urbanisation mal contrôlée, etc. dans ce cadre, cette thèse vise à montrer que pour bien gérer les ressources naturelles (eau, terre, biomasse), il faut considérer les structures ethnologiques et anthropologiques traditionnel qui ont construit un territoire (le bas delta) sur un modèle intégré. en effet, un modèle de gestion collective de l'espace et des ressources naturelles a été anciennement développé. ce modèle prenait en compte autant les organisations internes des différents groupes ethniques en présence que leurs projections territoriales. / The Senegal delta is between the Sahel, Sahara and the Atlantic Ocean. Its position on the Senegal-Mauritania border, the amount of fresh water available throughout the year and the importance of its agricultural potential irrigable areas and have made this a vital wetland area (agriculture, livestock, tourism, fishing, etc.). However, if different from the colonization rural development programs have been implemented, it must be admitted that the failures were also numerous.The construction of dams on the upper valley Manatali (1987) and Diama in the Delta (1985) has opened new possibilities for agricultural development. The aim is, in particular, to irrigate 350,000 ha of land, causing massive arrivals populations and substantial private investment (rice, agribusiness), but from a profound effect on the traditional management of these living areas (eg land ownership.) and production (flood recession cultivation, pastoralism, freshwater fishing, etc.). specific part for each ethnic group. Anthropological structures and social representations are different depending on the people who inhabit the delta (Wolof, Fulani, Tukulor, Maure, etc..) Not only affect them specifically on land organization, local politics, but in addition they help define, by their number and their spatial distribution, a particularly complex area in its relations to space, its development, etc.. we analyzeThis thesis shows that the socio-anthropological and spatial dynamics are impacted by the integrated management of water that goes up through the State of Senegal and the institutions of governance at the watershed scale. In terms of space, agricultural activity is to the detriment of traditional spaces. On the socio-anthropological terms, people equate modern tech through the filter of local realities, which is the basis of a hybrid system which is the heart of the technological transition in the irrigation schemes.The land issue remains a key operation of all rice-growing land in 2025 (target set by the Master Plan for the Development and Water Management). Achieving this goal will go through a land reform taking into account the hybrid systems that develop in the Senegal River delta.

Les enjeux alimentaires liés aux mutations de l’aménagement du territoire sont une question d’actualité, mais aussi source de polémique. C’est notamment le cas du bassin versant du fleuve Gianh, situé dans la Région Centre au Vietnam. En effet, depuis 1986, ce delta de zone littorale connait des mutations. La riziculture, qui emploie une grande partie de la population, constitue une soupape de sécurité contre la pénurie alimentaire. Cette région connait une croissance démographique, urbaine et économique rapides. Cela entraîne une augmentation de la demande alimentaire, alors que les zones agricoles ont tendance à disparaître. Une autre conséquence de ce changement est l’accentuation des conséquences des typhons avec la conjonction entre tempêtes, marées et crues du fleuve. Le risque s’accroît à cause de la concentration démographique dans des zones fragiles, et de la bétonisation liée à l’extension de la ville. Un problème d’insécurité alimentaire est susceptible d’apparaître dans le bassin si des densités trop fortes sont combinées avec la réduction des surfaces rizicoles et le risque. C’est pourquoi des solutions sur la gestion, la prévention et protection de l’inondation sont proposés afin d’aider les aménageurs au Vietnam pour la réduction les risques. / Food shortage related to the changes in land which is used for planning are a current issue, but also a source of controversy. This, particularly, is the case of the Gianh River watershed, located in the Central Region of Vietnam. Indeed, since 1986, this delta of littoral zone has been known for mutations. Rice farming helps to bring job to a large number of the population, is a safety valve against the food shortage because the more farmers, the more food would be produced.This region, on the other hand, is experiencing rapid demographic, urban and economic growth, as a result, it leads to an increase in the demand for food while the agricultural areas tend to be reduced and disappeared. Another effect of this change is the accentuation of the consequences of typhoons with the conjunction of storms, tides and floods of the river. The risk increases because of the demographic concentration in fragile areas, and the concreteization linked to the extension of the city. A problem of food insecurity is likely to appear in the basin if too high densities are combined with the reduction of farming areas and risks. That's why flood management, prevention and protection solutions are proposed to help developers in Vietnam to reduce mentioned risks.

No description available.

Salinity intrusion, caused by global sea-level rise, is a major threat to paddy cultivation in the Mekong Delta of Vietnam (MKD). Salinity exposure reduces crop yields, increases soil salinity, and exacerbates fresh water scarcity, resulting in altered land use decisions and decreased paddy farming profitability. This study evaluates the effects of salinity intrusion on paddy yields and planted acreage, using a 21-year district-level panel dataset from the 13 provinces in the MKD. Specifically, we analyze the relationship between current salinity levels and paddy yield, as well as the relationship between lagged salinity levels and the paddy planted area. We examine these relationships across all districts, as well as for salinity-prone and non-salinity-prone districts and by proximity to the coast (20 km, 20-60 km, and 60+ km). The results indicate that salinity intrusion poses a significant challenge to paddy production in salinity-prone and coastal regions. Salinity level significantly and adversely affects paddy yields in salinity-prone and coastal districts. Similarly, high salinity levels in the past five years significantly reduce planted paddy acreage in these same regions. We also find that paddy yields in the MKD peaked in 2015 and have been declining since. The study highlights the regional differences in challenges associated with salinity intrusion in paddy production. Policymakers and agricultural managers need to take a region-specific approach to ensure that interventions are tailored to the specific needs and challenges faced by farmers. This entails supporting intensified paddy production in less salinity-prone areas and facilitating transitions to economically profitable alternatives to paddy in more salinity-prone areas. / Master of Science / Salinity intrusion, resulting from rising sea levels worldwide, poses a significant threat to paddy cultivation in the Lower Mekong Delta, Vietnam (MKD). The increased exposure to salinity adversely affects crop yields, exacerbates soil salinity levels, and contributes to freshwater scarcity. Consequently, this study aims to assess the effects of salinity intrusion on paddy yields and planted acreage in the MKD. By using a 21-year dataset covering thirteen provinces within the MKD, this study examines the relationship between current salinity levels and paddy yield, as well as the association between lagged salinity levels and the planted area of paddy crops. The analysis considers all districts within the region, distinguishing between salinity-prone and non-salinity-prone districts, as well as the proximity to the coast (20 km, 20-60 km, and 60+ km). The findings indicate that salinity intrusion presents a significant challenge to paddy production in both salinity-prone and coastal regions. High salinity levels substantially and adversely affect paddy yields in these districts. Furthermore, elevated salinity levels within the past five years significantly reduce the planted acreage of paddy crops in the same regions. Notably, paddy yields in the MKD reached their peak in 2015 and have been declining since. This study highlights the need for tailored strategies to address the diverse challenges faced by farmers in different regions. Policymakers and agricultural managers must support intensified rice production in areas that are less prone to salinity, while also promoting alternative crops in regions more vulnerable to salinity. By doing so, we can help sustain agricultural productivity and livelihoods in Vietnam's Mekong Delta, even in the face of salinity intrusion.

目前，中國大陸最熱門的兩大經濟區域為長江三角洲與珠江三角洲，此兩地吸引眾多外商至當地投資。究竟此兩區域具有何區位優勢能吸引眾多外資，以及此兩地區的優勢有何差異，成為本論文重心所在。本論文主要探討三個主題： 一﹑這兩區域自改革開放以來，區位優勢的消長如何，才造成今日長江三角洲吸引外商投資金額超越珠江三角洲。 二﹑這兩區域有何區位優勢，才能吸引眾多外商至當地投資。 三﹑這兩區域與中國大陸整體平均水準的區位優勢作比較，究竟這兩區域相較於中國大陸整體平均水準具有何優勢，使外商特別關注此兩大地區。 以上問題運用中國統計年鑑的數據資料，以複回歸模型分析各地區的外商投資數據，以得出各項主題的結果。 / Yangtze River Delta and Pearl River Delta are both the most famous economic areas in Mainland China nowadays, attracting many foreign capitals to invest. The purpose of this thesis is to investigate what are the advantages in these two areas that attract foreign direct investment, and what are the differences between them. Three subjects are discussed in the present study. First, how did the location advantages rise and fall between Yangtze River Delta and Pearl River Delta, thus now there are more foreign investment enterprises located in Yangtze River Delta than in Pearl River Delta since the beginning of China’s ‘Open Door’ Policy. Second, what are the location advantages in these two areas that attract so many foreign investment enterprises to locate in these two areas. Third, what are the unique location advantages in these two areas compared with the average level of Mainland China, so that many foreign investment enterprises pay especially high attention to this two areas. Data of Statistical Yearbook of China are used in the present study, and multiple regression model is adopted to analyze the data in order to obtain the results.

published_or_final_version / Geography and Geology / Master / Master of Arts

Salt marshes provide critical ecosystem services, such as shoreline stabilization, biogeochemical cycling and habitat for wildlife, to much of the world's population living on the coasts. Emergent vascular plants are a critical component of these ecosystems. This study was a comprehensive effort to gain a better understanding of the ecology of salt marsh plants in the Nueces River delta on the south Texas coast. This knowledge is essential to understand the potential anthropogenic impacts on salt marshes, including sea-level rise, global warming, reduced freshwater inflow and coastal erosion. A combination of remote sensing analysis, field studies and experiments were used to allow analysis across spatial scales ranging from landscape patterns of vegetation to leaf level measurements of the dominant species. A novel method of image classification was developed using high-resolution multi-spectral imagery integrated with ancillary data to map the major plant communities at a landscape scale. This included a high marsh assemblage composed primarily of Spartina spartinae and a low marsh community dominated by Borrichia frutescens and Salicornia virginica. Geospatial analysis determined that the location of these plant communities was related to the distance from the tidal creek network and elevation. The B. frutescens and S. virginica assemblage was more abundant at lower elevations along the waters edge, making it vulnerable to loss from shoreline erosion. At a finer spatial scale, gradient analysis was utilized to examine the relationship between elevation, which creates environmental gradients in salt marshes, and species distribution. I discovered that elevation differences of less than 5 cm can influence both individual species and plant community distribution. One interesting finding was that the two dominant species, B. frutescens and S. virginica, share similar responses along an elevation gradient yet are observed growing in monotypic adjacent zones. I constructed a large reciprocal transplant experiment, using 160 plants at 4 sites throughout the marsh, to determine what causes the zonation between these two species. The results of this study found that S. virginica fared well wherever it was transplanted but was a weak competitor. B. frutescens survival was significantly lower in the S. virginica zone than in its own zone suggesting that abiotic factors are important in determining the zonation of this species. However, high spatial and temporal variability existed in environmental parameters such as salinity. This variability may have been caused by the semi-arid climate and irregular flooding typical in the Nueces Marsh. Therefore, I utilized a greenhouse experiment to directly test the importance of the two dominant physical factors in salt marshes, flooding and salinity. The results found that for B. frutescens the effects of flooding were not significant, however salinity at 30% reduced growth. Salinity did not influence growth of S. virginica. The greater ability of S. virginica to tolerate salinity stress has important implications because reduced freshwater inflow or climate change can increase porewater salinity, thus favoring the expansion of S. virginica, and altering the plant community structure. / text

Four modern shoals on the Louisiana continental shelf are proposed to have formed through transgression, marine reworking, and submergence of Mississippi River deltaic lobes. However, one of these shoals, the St. Bernard Shoals, is dissimilar to the other shoals in morphology and stratigraphy. Understanding the processes that lead to these differences resulted in the development of a wholly new model for subaqueous shoal evolution. The results of this study suggest that the St. Bernard Shoals are transgressive remnants of a near shelf-edge delta lobe that was transgressed and truncated by marine processes after fluvial abandonment. Subsequent to truncation, the shoals formed through subaqueous excavation and reworking of coarse grained sediment contained within underlying distributary channels by hurricane related marine currents. As a result the shoals are bound at their base by a ravinement surface and lie directly upon progradational facies associated with previously unrecognized southern progradation of the La Loutre distributary network.

by François Soulard. / Thesis (Ph.D.)--Chinese University of Hong Kong, 1993. / Includes bibliographical references (leaves 225-253). / Abstract --- p.ii / List of maps --- p.vi / List of tables --- p.vii / List of charts --- p.ix / List of appendices --- p.xi / References and acronyms --- p.xii / Acknowledgements --- p.xiii / Chapter Chapter 1 ： I --- Introduction --- p.1 / Introduction --- p.1 / Research area --- p.2 / Modernization in China --- p.3 / Zhujiang Delta： a definition --- p.5 / Hong Kong: bonded with Zhujiang --- p.11 / Research issues --- p.15 / Research objectives --- p.20 / Research axioms --- p.20 / Research methodology --- p.23 / Chapter Chapter 2: --- Industrial restructuring --- p.24 / The capitalist production model --- p.24 / The production model --- p.25 / Capital accumulation --- p.29 / Crisis construct --- p.36 / The restructuring of industrial capitalism --- p.41 / Manufacturing development --- p.41 / From rigidity to flexibility --- p.45 / Division of labour --- p.50 / Spatial division of labour --- p.52 / International division of labour --- p.57 / The cost factor of labour --- p.61 / Industrial restructuring --- p.64 / Conclusion： Restructuring modelled --- p.66 / Chapter Chapter 3： --- Restructuring analysis --- p.70 / Introduction --- p.70 / Restructuring tendencies --- p.71 / Scale analysis --- p.71 / Sectoral analysis --- p.86 / Restructuring analysis --- p.105 / Conclusion --- p.135 / Chapter Chapter 4： --- Urbanization in Zhujiang Delta --- p.138 / Introduction --- p.138 / City-based urbanization --- p.138 / Region-based urbanization --- p.141 / Zhujiang Development --- p.145 / Rural agricultural reform --- p.145 / Rural industrial reform --- p.155 / Foreign invested development --- p.162 / Zhujiang Delta region-based urbanization --- p.173 / Designated towns development --- p.175 / Functional capital and industrialization --- p.183 / Zhujiang megapole --- p.191 / Conclusion --- p.197 / Chapter Chapter 5: --- Conclusion： industrial restructuring and territorial development --- p.199 / Transplantation and rural reforms --- p.199 / Transplant --- p.201 / Hong Kong industries and rural reforms in China --- p.205 / Economic diversification in Hong Kong --- p.207 / The collapse of the production/exchange divide --- p.208 / The development of the Zhujiang megapole --- p.211 / The significance for development in China --- p.213 / The value of compensation trade --- p.214 / A regional secondary circuit of capital --- p.217 / Concluding remarks and prospects --- p.218 / Research agenda --- p.222 / Bibliography --- p.225 / Cited references: --- p.225 / Other readings: --- p.236

背景：中國在發展城市社區衞生服務/基層醫療的過程中，基於當地經濟社會發展情況和特點，主要形成了政府辦政府管、院辦院管、以及私營三種模式。近年來中國學者對大陸社區衞生服務/基層醫療的研究主要關注于服務的基本現狀與功能的描述性研究，以及患者主觀層面的滿意度調查等，對城市社區衞生/基層醫療組織形式與服務模式建設的研究相對缺乏。初級衞生評價工具( Primary Care Assessment Tool, PCAT) 由美國約翰霍普金斯大學初級衞生保健政策中心開發，將初級醫療的五個核心方面進行量化，從患者對社區衞生服務/層醫療服務的客觀體驗角度出發，客觀評價醫療服務品質。本研究關注於基層醫療服務的過程層面，作為珠江三角洲六城市基層醫療研究項目的一部分，聯合廣州醫學院公共衛生與全科醫學學院，在廣東省衞生署以及香港智經研究中心的大力支持下，其他學者將研究基層醫療服務的結構和結果層面。 / 目的：本研究關注從病人體驗角度出發，在城市社區衞生/基層醫療服務的過程層面，評價和比較三種不同的社區衞生服務/基層醫療模式，以及不同地區在實施國家初級衞生政策時的不同策略所導致的在初級醫療五個核心方面的差異。 / 方法：首先，本研究進行了全面的文獻檢索，回顧了PCAT工具在全球和地區的應用。其次，本研究根據國際上認可的跨文化翻譯過程將PCAT（成人簡化版）翻譯成中文官方語言（普通話）並使其與中國國情相適應，並通過問卷的信度和效度分析，證明中文PCAT成人簡化版在評價社區衞生服務/基層醫療的過程層面方面具有較高的可靠性和有效性。進而，本研究採用多階段整群抽樣方法，在珠江三角洲六個城市的社區衞生中心，由訓練有素的調查員進行現場訪談。最後，本研究採用多元線性回歸和多元方差分析統計分析，評估和比較了不同城市和不同模式下，社區衞生服務/基層醫療服務五個核心方面的PCAT分數的差異。 / 結果：中文PCAT（成人簡化版）包含了九個不同維度，從五個方面評價初級保健服務過程，具有良好的結構效度。克隆巴赫係數反映了問卷具有良好的內部一致性。本研究共調查了3,360名在社區衞生服務中心接受基層醫療服務的成人患者，問卷整體回收率達86.1。本研究基於PCAT 分數從不同城市和不同服務模式角度分別評價和比較了社區衞生服務/基層醫療服務的過程。研究發現，與院辦院管及私營模式相比，政府主導模式下的社區衞生服務/基層醫療服務使用者具有更好的病人體驗，主要是因為政府主導模式下，社區衞生服務在首診利用及基層醫療服務協調統籌維度層面達到更高的水準。 / 結論：本博士論文研究確立了中文PCAT（成人簡化版）在評價社區衞生服務/基層醫療服務過程的可靠性和有效性。本研究率先在中國大陸採用PCAT 工具對廣東省珠江三角洲地區城市社區衞生服務/基層醫療模式開展了大規模調查。該項研究可以填補目前中國大陸在PCAT應用以及城市社區衞生服務/基層醫療模式研究方面的空白，探索適合中國國情的社區衞生/基層醫療服務發展道路，為中國大陸進一步發展及完善初級衞生體系提供翔實的政策依據。 / Backgrounds: China’s current healthcare reform has an overall goal towards re-strengthening primary care. Establishment and expansion of primary care network based on community health centres (CHCs) in urban areas has been prioritized. Due to various socio-economic status of local population and policy context across urban areas in mainland China, primary care is delivered by three main organisational models: government-owned CHCs, hospital-owned CHCs, and privately-owned CHCs with each model being adopted in various localities. This PhD study focuses on studying the process of primary care provided under different CHC models in the six cities of Pearl River Delta (PRD) and it is part of a larger study entitled “A Study of Comparing Primary Care Services among Six Cities in the Pearl River Delta funded by Bauhinia Foundation Research Centre, in which other co-investigators have studied the structure and outcome of the primary care. / Objectives: This PhD study aims to use the Primary Care Assessment Tool (PCAT) within Donabedian’s framework of structure, process and outcome to measure and compare the quality attributes of primary care from patient’s perspective under different CHC models in the six cities of PRD where each city has different responses to the national policy for delivering primary care services. / Methods: A comprehensive literature search was conducted to review the utilization of PCAT both globally and locally. The PCAT - Adult Edition (short version) was translated into Mandarin Chinese following an internationally recognized procedure and was cross-culturally adapted into Chinese context. The reliability and validity of the PCAT instrument were evaluated through test-retest approach, exploratory factor analysis, and internal consistency reliability analysis. Multistage cluster sampling method was adopted to select CHCs in the six cities of PRD. All interviews were conducted on-site by trained interviewers. Statistical analysis including multiple linear regression and multivariate analysis of covariance were used to assess and compare the quality attributes of primary care (PCAT scores) provided by different organisational models of CHCs in the six cities of PRD. / Results: The Mandarin Chinese version of PCAT-AE (short version) contains nine primary care scales with good construct validity. Cronbach’s alpha within all the nine primary care scales achieved moderate to high internal consistency reliability. A total number of 3,360 adult primary care service users were surveyed on-site at CHCs with an overall response rate of 86.1%. Descriptive city-by-city analysis based on the PCAT scores was conducted to depict primary care process in each of the six cities. Primary care service users under government-owned CHC model reported receiving better primary care experiences than those under privately-owned CHC model and hospital-owned CHC model, largely because of the greater achievements in first contact utilization and better score in the coordination domain (information system). / Conclusions: The Mandarin Chinese version of PCAT-AE (short version) was found to be reliable and valid as a measure of primary care in mainland China from patients’ perspective. The study suggested that the government-owned CHCs had better quality attributes than other organisational models, and offered a direction for quality improvement in the five domains of primary care. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Wang, Haoxiang. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references. / Abstract also in Chinese; some appendixes also in Chinese. / ABSTRACT --- p.i / ABSTRACT (IN CHINESE) 摘要 --- p.iii / ACKNOWLEDGEMENTS --- p.v / TABLE OF CONTENTS --- p.viii / LIST OF APPENDICES --- p.xii / LISTS OF TABLES --- p.xiii / LISTS OF FIGURES --- p.xv / ABBREVIATIONS --- p.xvi / PREFACE --- p.xvii / Chapter CHAPTER 1: --- BACKGROUND --- p.1 / Chapter 1.1 --- What is Primary Care? --- p.1 / Chapter 1.2 --- Why Primary Care? --- p.2 / Chapter 1.3 --- Healthcare Reform in mainland China --- p.3 / Chapter 1.4 --- Primary Care in Mainland China: A Brief History and Current Status --- p.8 / Chapter 1.5 --- Three CHC models of primary care delivery in urban areas --- p.13 / Chapter 1.5.1 --- Hospital and Hospital-owned CHCs --- p.13 / Chapter 1.5.2 --- Government and Government-owned CHCs --- p.14 / Chapter 1.5.3 --- Private sector and Privately-owned CHCs --- p.15 / Chapter 1.6 --- Pearl River Delta: an open window for primary care research --- p.16 / Chapter 1.7 --- Primary Care Assessment Tool: assessment of primary care from an international perspective --- p.21 / Chapter SUMMARY OF CHAPTER 1 --- p.23 / Chapter CHAPTER 2: --- LITERATURE REVIEW OF PRIMARY CARE ASSESSMENT TOOL --- p.25 / Chapter 2.1 --- Introduction --- p.25 / Chapter 2.2 --- Criteria for review and search strategy --- p.26 / Chapter 2.3 --- Key messages from the literature review --- p.28 / Chapter 2.4 --- Research gaps in the literature --- p.33 / Chapter 2.5 --- Conclusion --- p.34 / Chapter SUMMARY OF CHAPTER 2 --- p.36 / Chapter CHAPTER 3: --- ADAPTION OF PRIMARY CARE ASSESSMENT TOOL IN MAINLAND CHINA --- p.38 / Chapter 3.1 --- Introduction --- p.38 / Chapter 3.2 --- Methods --- p.39 / Chapter 3.2.1 --- Translation of PCAT --- p.39 / Chapter 3.2.2 --- Validation of the translation --- p.40 / Chapter 3.2.3 --- Face validity and peer evaluation --- p.40 / Chapter 3.2.4 --- Pilot test and test-retest reliability --- p.41 / Chapter 3.3 --- Results --- p.43 / Chapter 3.3.1 --- Translation of PCAT into Mandarin Chinese and validation of the translation --- p.43 / Chapter 3.3.2 --- Face validity --- p.46 / Chapter 3.3.3 --- Demographic characteristics of the survey sample in the pilot test --- p.46 / Chapter 3.3.4 --- Test-retest reliability --- p.48 / Chapter 3.4 --- Discussion --- p.48 / Chapter SUMMARY OF CHAPTER 3 --- p.51 / Chapter CHAPTER 4: --- VALIDATION OF MANDARIN CHINESE VERSION OF PRIMARY CARE ASSESSMENT TOOL --- p.53 / Chapter 4.1 --- Introduction --- p.53 / Chapter 4.2 --- Methods --- p.54 / Chapter 4.2.1 --- Study design and study subjects --- p.54 / Chapter 4.2.2 --- Scoring --- p.55 / Chapter 4.2.3 --- Factor analysis and construct validity --- p.57 / Chapter 4.2.4 --- Item analysis and internal reliability --- p.61 / Chapter 4.3 --- Results --- p.62 / Chapter 4.3.1 --- Demographic profile --- p.62 / Chapter 4.3.2 --- Analysis of the correlation matrix --- p.63 / Chapter 4.3.3 --- Factor analysis and construct validity --- p.63 / Chapter 4.3.4 --- Item analysis --- p.66 / Chapter 4.3.5 --- Internal reliability of the primary care scales --- p.67 / Chapter 4.4 --- Discussion --- p.68 / Chapter SUMMARY OF CHAPTER 4 --- p.70 / Chapter CHAPTER 5: --- PRIMARY CARE PROFILES IN SIX CITIES OF PEARL RIVER DELTA --- p.72 / Chapter 5.1 --- Introduction --- p.72 / Chapter 5.2 --- Methods --- p.73 / Chapter 5.2.1 --- The instrument to assess primary care --- p.73 / Chapter 5.2.2 --- Training of the interviewers and the assessment of inter-rater reliability --- p.74 / Chapter 5.2.3 --- Study location and sampling framework --- p.75 / Chapter 5.2.4 --- Target population --- p.76 / Chapter 5.2.5 --- Identification of primary care source --- p.76 / Chapter 5.2.6 --- Data collection --- p.77 / Chapter 5.2.7 --- Statistical analysis --- p.78 / Chapter 5.3 --- Results --- p.79 / Chapter 5.3.1 --- Inter-rater reliability, response rate, and demographic characteristics --- p.79 / Chapter 5.3.2 --- Comparison of primary care assessment scores in the six cities (city-by-city analysis) --- p.80 / Chapter 5.3.2.1 --- Primary care service users and primary care quality attributes in City A --- p.83 / Chapter 5.3.2.2 --- Primary care service users and primary care quality attributes in City B --- p.89 / Chapter 5.3.2.3 --- Primary care service users and primary care quality attributes in City C --- p.94 / Chapter 5.3.2.4: --- Primary care service users and primary care quality attributes in City D --- p.99 / Chapter 5.3.2.5 --- Primary care service users and primary care quality attributes in City E --- p.105 / Chapter 5.3.2.6 --- Primary care service users and primary care quality attributes in City F --- p.110 / Chapter 5.2.3 --- Factors associated with overall primary care experience --- p.115 / Chapter 5.2.4 --- Comparison of primary care assessment scores among the three CHC organisational models --- p.116 / Chapter 5.2.4.1 --- Presence of ‘hukou’ registry and primary care experience --- p.118 / Chapter 5.2.4.2 --- Presence of medical insurance and primary care experience --- p.119 / Chapter 5.2.4.3 --- Presence of chronic disease and primary care experience --- p.122 / Chapter 5.4 --- Discussion --- p.124 / Chapter 5.4.1 --- Patient characteristics and primary care profiles in the six cities --- p.124 / Chapter 5.4.1.1 --- Ageing --- p.126 / Chapter 5.4.1.2 --- Household registry --- p.126 / Chapter 5.4.1.3 --- Medical insurance --- p.127 / Chapter 5.4.2 --- Factors significantly associated with primary care assessment scores --- p.128 / Chapter 5.4.2.1 --- Healthcare utilization and health characteristics --- p.128 / Chapter 5.4.2.2 --- Socio-demographic characteristics --- p.129 / Chapter 5.4.3 --- Primary care experience in the government-owned CHC --- p.130 / Chapter 5.4.3.1 --- Separation between revenue and expenditure --- p.130 / Chapter 5.4.3.2 --- Central planning and multi-sectoral collaboration --- p.130 / Chapter 5.4.3.3 --- Towards health equality --- p.131 / Chapter 5.4.3.4 --- First contact --- p.132 / Chapter 5.4.3.5 --- Suboptimal service capacity --- p.132 / Chapter 5.4.4 --- Primary care experience in the privately-owned CHC --- p.133 / Chapter 5.4.4.1 --- Lower healthcare utilization --- p.133 / Chapter 5.4.4.2 --- Insufficient funding support --- p.134 / Chapter 5.4.5 --- Primary care experience in the hospital-owned CHC --- p.135 / Chapter 5.4.5.1 --- Large service capacity --- p.135 / Chapter 5.4.5.2 --- Tackling aging population with chronic diseases --- p.136 / Chapter 5.4.5.3 --- CHCs in the less socio-economic developed urban area --- p.136 / Chapter 5.4.5.4 --- Disparities due to socio-demographic status --- p.137 / Chapter 5.4.6 --- Study limitations --- p.137 / Chapter 5.4.7 --- What is already known and what this study adds --- p.139 / Chapter SUMMARY OF CHAPTER 5 --- p.141 / Chapter CHAPTER 6: --- CONCLUSION AND POLICY IMPLICATIONS --- p.144 / Chapter 6.1 --- Conclusion --- p.144 / Chapter 6.2 --- Policy implications for mainland China --- p.146 / REFERENCES --- p.150 / APPENDICES --- p.161