Improving the Equity and Sustainability of the Social Protection System

The segmentation of the social protection system in China renders the system not only inequitable but inefficient.Those employed in the public sector,particularly civil servants,are＂overprotected＂,while workers in the non-public sector,especially farmers and rural migrant workers,are＂under-protected＂.The segmented pension system impedes labor mobility while increasing administrative costs.Policies aimed at developing the new rural cooperative medical system and new rural old-age insurance scheme,as well as policies aimed at encouraging migrant workers to participate in urban social insurance programs,help improve the equity of social protection.Howere,competition between different local governments to win the ＂welfae crown＂ and the heavy brden placed on local finance caused by welface overspending has been hurting the sustainability of social protection programs.The following measures are suggested to address these problems;First,cease using social insurance coverage as an indicator of work performance for government officials;second,enhance the responsibility of the central government in social expenditure while increasing public transfers to less-developed regions in order to improve social assistance and merit goods provision;third,integrate or reorganized various sgements into one entity under each insurance program,with the purpose of eventually eliminating the segmentation problem in China＇s social protection system.

China's Labor and Social Security Protection under the Globle Financial Crisis

Against the background of economic globalization, the economy of many countries has been inevitably affected by the globle financial crisis. But the impact varies. China, as one of the leading countries in globalization, the direct or indirect impact it suffered can be imagined. The Chinese government adopted a series of measures to deal with the financial crisis.

Can Social Protection Build State Legitimacy？ Perspectives from Post War Sri Lanka

The link between social protection provision and state legitimacy, particularly in post war contexts, has been suggested theoretically （Babajanian, 2012）. However, there is little empirical evidence to support this view. Sri Lanka＇s long history in social welfare provision and the post war context provides an opportunity to explore this relationship. This study was conceptualized to address the dearth of empirical knowledge on the social protectiotr--state legitimacy relationship by hypothesizing that war affected people＇s experiences of accessing and using state social protection programs can contribute to building state legitimacy in a post-war context. Fisher communities in Trincomalee, Jaff^a and Marmar districts were the sample sites to explore ethnic and geographic variations in people＇s experiences of social protection program delivery. The exploratory study used qualitative methodologies to understand how the state delivers and how citizens access and use programs and in what ways these experiences shape people＇s perceptions of the state. Given the complexities of making the causal link between program experience and legitimacy, the study used an analytical framework that explored the relationship based on symbolic values, which underpin both program delivery and experience. Whilst the study provides insights on how citizens perceptions of the state are shaped by every day encounters with the state through access and use of social protection programs, it also highlights the nuances in the link as not only what benefits are delivered, but how programs are delivered is an important component of program experience which shapes people＇s perceptions of the state.

The Path of Human Rights Development with Chinese Characteristics in the New Era:the Coordinated Promotion of Social Rights Protection and Economic Development

The principle of marxist theory on the dialectical relationship between the economic base and superstructure is an important theoretical basis for recognizing the mutual relationship between social rights protection and economic development China and the West have different practical experience in handling their relations But a proper handling of their relations is conducive to promoting the development of human rights It is one-sided to either emphasize too much on social rights protection or to excessively pursue economic development The in-depth interaction between social rights protection and economic development is that they promote and restrict each other It is the right choice for human rights development with Chinese characteristics in the new era to promote social rights protection and economic development in a coordinated manner We should not only lay a solid material foundation for social rights protection with the high quality and efficiency of economic development, but also take social rights protection as the ultimate goal and strategic means to provide sufficient driving force for economic development And social rights protection and economic development should be synchronized.

Effects of Social Security Spending on Income Distribution and Poverty Reduction in China

Reasonable income distribution and eradication of rural poverty are vital for building a moderately prosperous society in all respects in China.This paper primarily examines the income distribution and poverty reduction effects of social security spending.Market income and redistribution policies are two determinants of income gaps.Based on CHIP2018 household survey data,we find that inadequate income redistribution policies have contributed to yawning income gaps,and that social security spending is more redistributive than personal income tax and social security contributions.After estimating the redistribution effects of social security spending and itemized incomes,we find that pension payments have contributed the most to household income gaps,and that subsistence protection and rural pension payments help improve income distribution.With respect to the poverty reduction effects of social security spending,we have estimated China’s current poverty incidence and the poverty reduction effects of pension payments,healthcare,and educational allowances with CHIP2018 data,and discover that an increase in social security spending may effectively reduce rural poverty.In building a moderately prosperous society in all respects,China should increase social security spending,focusing on specific target groups,and promote the role of social security spending in regulating income distribution and offering social protection to rural residents.

Chinese Citizens' Right To Work and Social Security Effectively Protected——An interview with Zheng Silin, minister of labor and social security

Following is an interview by staff reporters of the Human Rights magazine with Zheng Silin, Chinese minister of labor and social security. The interview was meant in part to celebrate the tenth anniversary of the implementation of the Labor Law of the People's Republic of China that falls on January 1,2005. We are publishing this transcript with a view to providing our readers with information about how China has worked persistently to protect citizens' right to work and social security and the achievements it has made in this regard. We need to remind our readers of the fact that back in March 2004, the National People's Congress, China's highest legislature, approved a recommendation for revision of China's Constitution. In accordance with the recommendation, the Constitution had one more clause added: The state shall establish and improve a social security system commensurate to the level of the economic and social development.

上海市耐多药结核病患者经济负担研究

目的基于上海市近年结核病诊疗费用减免政策,探索耐多药结核病(multidrug resistant tuberculosis,MDR-TB)患者疾病经济负担及其影响因素,为优化MDR-TB诊疗费用减免政策和综合管理模式提供依据。方法收集上海市2017—2019年确诊MDR-TB患者情况和诊疗费用减免情况数据,开展针对疾病经济负担的问卷调查,建立涵盖患者人口和社会经济情况、临床特征、疾病经济负担和诊疗费用减免情况数据库,明确患者疾病经济负担和灾难性卫生支出(catastrophic health expenditure)发生情况。以多元线性回归法分析可能影响患者疾病经济负担的因素,以多因素logistic回归法分析不同比例下灾难性卫生支出发生的影响因素。结果196例纳入研究分析的MDR-TB患者平均年龄为(44±16)岁,男性139例(占70.9%),上海户籍占46.4%,49%的患者为家庭主要劳动力。治疗期间,患者自付诊疗费用中位数为4.0(四分位数区间2.0~6.5)万元。113例患者获得减免诊疗,减免费用中位数为2.6(四分位数区间1.3~4.9)万元。若自付费用占家庭年收入的40%及以上,有47.8%的患者会发生灾难性支出;若不考虑减免政策,有59.8%的患者发生灾难性卫生支出。上海户籍(OR=0.3,95%CI为0.1~1.0)、更低家庭收入水平(P_(trend)=0.002)、医疗保险类型[(农村合作医疗保险/外来人口综合保险(OR=13.3,95%CI为1.0~171.2),无医疗保险(OR=17.5,95%CI为2.7~113.0)]和既往结核病治疗史(OR=3.3,95%CI为1.1~10.0)可能影响灾难性卫生支出的发生。结论上海市MDR-TB患者的自付诊疗费用较高。医疗保障力度较小和家庭经济情况不佳的患者更易发生高额自付费用,导致灾难性卫生支出。上海市MDR-TB诊疗费用减免政策有效降低了患者的经济负担。

Fast and Accurate Detection of Masked Faces Using CNNs and LBPs

Face mask detection has several applications,including real-time surveillance,biometrics,etc.Identifying face masks is also helpful for crowd control and ensuring people wear them publicly.With monitoring personnel,it is impossible to ensure that people wear face masks;automated systems are a much superior option for face mask detection and monitoring.This paper introduces a simple and efficient approach for masked face detection.The architecture of the proposed approach is very straightforward;it combines deep learning and local binary patterns to extract features and classify themasmasked or unmasked.The proposed systemrequires hardware withminimal power consumption compared to state-of-the-art deep learning algorithms.Our proposed system maintains two steps.At first,this work extracted the local features of an image by using a local binary pattern descriptor,and then we used deep learning to extract global features.The proposed approach has achieved excellent accuracy and high performance.The performance of the proposed method was tested on three benchmark datasets:the realworld masked faces dataset(RMFD),the simulated masked faces dataset(SMFD),and labeled faces in the wild(LFW).Performancemetrics for the proposed technique weremeasured in terms of accuracy,precision,recall,and F1-score.Results indicated the efficiency of the proposed technique,providing accuracies of 99.86%,99.98%,and 100%for RMFD,SMFD,and LFW,respectively.Moreover,the proposed method outperformed state-of-the-art deep learning methods in the recent bibliography for the same problem under study and on the same evaluation datasets.

The Causes of Contagion： Rational or Irrational Behavior？

The threats concerning financial stability seriously affect the overall functioning of the economy at a local, regional, national, and continental level instead of a global level, and therefore, the emphasis is laid on analyzing the causes and effects of such threats. Financial crises in the current decade, as well as those in the past have shown that a major cause of instability in the global market is the so-called financial contagion. This leads to a natural question： whether similar authorities could specify and mitigate these shocks through efficient calculation followed by stability measures taken by banking networks. To answer this question, an empirical research was conducted by analyzing the degree of contagion induced by markets in Central and Eastern Europe, based on an econometric model, involving over 17 European countries, from January 2006 to January 2013.

SOCIAL PROTECTION INNOVATION AND CHALLENGES IN CHINA AND AFRICA： SELECTED COMPARATIVE PERSPECTIVES

This contribution concerns social protection innovation in China and Africa as regards aging populations and social security extension to informal workers. China has adopted and extended several contributory schemes and non-contributory arrangements. Yet, the country faces significant challenges in terms of a funding gap, high urban contribution rates, inadequate benefits and an existing benefit gap, inequality in the treatment of public versus private sector workers, and insufficient migrant worker coverage and portability arrangements. While population aging is less of a problem in most African countries, African retirement arrangements experience challenges in relation to funding limitations, and a host of shortcomings as regards contributory schemes and non-contributory arrangements. China has seen a decline in the numbers of those who work in the informal economy. Ensuring proper coverage of such workers have included strengthened labor market regulation： An integrated approach is called for. In Africa, access by these workers to social security is limited. Attempts to achieve coverage extension have included conceptual developments, institutional initiatives, tailor-made design modalities, and a range of supportive arrangements （such as access to finance and to markets）. All these developments reflect a new appreciation of the leading role of the state in the provisioning of social security.

Chinese Experiences in Addressing Rural Extreme Poverty and Marginalization

Seeking to alleviate and eradicate Bao （the minimum livelihood guarantee system） extreme povertY, the Chinese government has extended Di to the entire rural sector. It has also enhanced agricultural policies and strengthened its promotion of rural socioeconomic development. In more-developed regions of the country, the Di Bao program-in combination with integrated urban and rural social insurance and public services-has significantly reduced rates of poverty and financial vulnerability, and additional employment-promotion policies have created opportunities for Di Bao recipients to achieve incomes above the poverty-line. However, because of the high number of extremely poor households in disproportionately poor areas and the paucity of locally-available financial resources there, the intensity of intervention is still insufficient. Inadequate coordination of policies and shortcomings in the targeting of subsidies have resulted in both under-coverage and welfare-leakage as well. Consequently, in China＇s efforts to eradicate extreme poverty, increasing the effectiveness of poverty-reduction strategies in poor areas remains a key prioritY.

Rural Labor Migration and Poverty Reduction in China

Using various sources of data, this paper examines the contributions of rural labor migration to economic growth and poverty reduction in China. The results show that there is still a significant number of people living in poverty in rural areas, while the effectiveness of migration on poverty reduction has declined, implying an urgent need for new approaches to poverty reduction. China＇s experiences could also be valuable for the formulation of development strategies in other developing countries.

Inequity in catastrophic costs among tuberculosis-affected households in China

Background:There are limited nationally representative studies globally in the post-2015 END tuberculosis(TB)era regarding wealth related inequity in the distribution of catastrophic costs due to TB care.Under the Chinese national tuberculosis programme setting,we aimed to assess extent of equity in distribution of total TB care costs(pre-treatment,treatment and overall)and costs as a proportion of annual household income(AHI),and describe and compare equity in distribution of catastrophic costs(pre-treatment,treatment and overall)across population sub-groups.Methods:Analytical cross-seaional study using data from national TB patient cost survey carried out in 22 counties from six provinces in China in 2017.Drug-susceptible pulmonary TB registered under programme,who had received at least 2 weeks of intensive phase therapy were included.Equity was depiaed using concentration curves and concentration indices were compared using dominance test.Results:Of 1147 patients,the median cost of pre-treatment,treatment and overall care,were USD 283.5,USD 413.1 and USD 965.5,respectively.Richer quintiles incurred significantly higher pre-treatment and treatment costs compared to poorer quintiles.The distribution of costs as a proportion of AHI and catastrophic costs were significantly pro-poor overall as well as during pre-treatment and treatment phase.All the concentration curves for catastrophic costs(due to pre-treatment,treatment and overall care)stratified by region(east,middle and west),area of residence(urban,rural)and type of insurance new rural co-operative medical system[NCMS],non-NCMSalso exhibited a pro-poor pattern with statistically significant(P<0.01)concentration indices.The pro-poor distribution of the catastrophic costs due to TB treatment was significantly more inequitable among rural,compared to urban patients,and NCMS compared to non-NCMS beneficiaries.Conclusions:There is inequity in the distribution of catastrophic costs due to TB care.Universal health coverage,social protection strategies complemented by quality TB care is vital to reduce inequitable distribution of catastrophic costs due to TB care in China.

Effect of financial support on reducing the incidence of catastrophic costs among tuberculosis-affected households in Indonesia:eight simulated scenarios

Background:The World Health Organization's End Tuberculosis Strategy states that no tuberculosis(TB)-affected households should endure catastrophic costs due to TB.To achieve this target,it is essential to provide adequate social protection.As only a few studies in many countries have evaluated social-protection programs to determine whether the target is being reached,we assessed the effect of financial support on reducing the incidence of catastrophic costs due to TB in Indonesia.Methods:From July to Septem ber 2016,we interviewed adult patients receiving treatment for TB in 19 primary health centres in urban,sub-urban and rural area of Indonesia,and those receiving multidrug-resistant(MDR)TB treatment in an Indonesian national referral hospital.Based on the needs assessment,we developed eight scenarios for financial support.We assessed the effect of each simulated scenario by measuring reductions in the incidence of catastrophic costs.Results:We analysed data of 282 TB and 64 MDR-TB patients.The incidences of catastrophic costs in affected households were 36 and 83%,respectively.Patients'primary needs for social protection were financial support to cover costs related to income loss,transportation,and food supplements.The optimum scenario,in which financial support would be provided for these three items,would reduce the respective incidences of catastrophic costs in TB and MDR-TB-affected households to 11 and 23%.The patients experiencing catastrophic costs in this scenario would,however,have to pay high rem aining costs(median of USD 910;[interquartile range(IQR)662]in the TB group,and USD 2613;[IQR 3442]in the MDR-TB group).Conclusions:Indonesia's current level of social protection is not sufficient to mitigate the socioeconom ic im pact of TB.Financial support for income loss,transportation costs,and food-supplem ent costs will substantially reduce the incidence of catastrophic costs,but financial support alone will not be sufficient to achieve the target of 0%TBaffected households facing catastrophic costs.This would require innovative social-protection policies and higher levels of dom estic and external funding.

Determinants of household catastrophic costs for drug sensitive tuberculosis patients in Kenya

Background::Despite free diagnosis and treatment for tuberculosis(TB),the costs during treatment impose a significant financial burden on patients and their households.The study sought to identify the determinants for cata-strophic costs among patients with drug-sensitive TB(DSTB)and their households in Kenya.Methods::The data was collected during the 2017 Kenya national patient cost survey from a nationally representative sample(n=1071).Treatment related costs and productivity losses were estimated.Total costs exceeding 20%of household income were defined as catastrophic and used as the outcome.Multivariable Poisson regression analysis was performed to measure the association between selected individual,household and disease characteristics and occurrence of catastrophic costs.A deterministic sensitivity analysis was carried using different thresholds and the significant predictors were explored.Results::The proportion of catastrophic costs among DSTB patients was 27%(n=294).Patients with catastrophic costs had higher median productivity losses,39 h[interquartile range(IQR):20-104],and total median costs of USD 567(IQR:299-1144).The incidence of catastrophic costs had a dose response with household expenditure.The poorest quintile was 6.2 times[95%confidence intervals(CI):4.0-9.7]more likely to incur catastrophic costs compared to the richest.The prevalence of catastrophic costs decreased with increasing household expenditure quintiles(proportion of catastrophic costs:59.7%,32.9%,23.6%,15.9%,and 9.5%)from the lowest quintile(Q1)to the highest quintile(Q5).Other determinants included hospitalization:prevalence ratio(PR)=2.8(95%CI:1.8-4.5)and delayed treatment:PR=1.5(95%CI:1.3-1.7).Protective factors included receiving care at a public health facility:PR=0.8(95%CI:0.6-1.0),and a higher body mass index(BMI):PR=0.97(95%CI:0.96-0.98).Pre TB expenditure,hospitalization and BMI were significant predictors in all sensitivity analysis scenarios.Conclusions::There are significant inequities in the occurrence of catastrophic costs.Social protection interventions in addition to existing medical and public health interventions are important to implement for patients most at risk of incurring catastrophic costs.