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Abstract
The concept of policy capacity is often used to explain the success or failure of governments or countries in conceiving of, developing, and implementing policies, but is often poorly systematised. Wu et al provide a framework for understanding types of policy capacity, arguing that three kinds of capacity, distributed across policy systems, are needed for effective implementation. This paper applies that framework to a discussion of China, a country that has been managing a fundamental transformation since at least the late 1970s, which has underpinned the country's growth and development. The paper focuses on a subset of China's reforms – reforms to the healthcare system since the 1990s. Discussion of policy capacity shows (1) that policy capacity is dynamic and adaptive, in response to changing challenges due to rapid transformation in the country; (2) that the development and distribution of capacities has, overall, been government-directed, with strong research and analytical support from public think tanks and universities; (3) that understanding of policy capacity is evolving, with government paying increasing attention to the need to develop a learning state and society in response to increasingly complex problems of development. Examination of the Chinese case has relevance for how other countries develop and adapt policy capacities over time to manage rapid transformation, uncertainty and shocks.

China's engagement in global affairs has changed substantially in the 2010s. One aspect of the country's global reorientation has been its increased interest in, and willingness to play a role in, global health. In the early 2010s, the UK Department for International Development (DFID) initiated a collaboration with the Chinese government on a programme to support the country to play a greater and more effective global role in health and explore how the UK and China could work together on issues of key concern and contribute to improved global development outcomes. The programme worked with key Chinese agencies to carry out capacity building, support analysis of China's approaches to engagement in global health governance and assistance, and provide support to government decision making. It also trialled several small-scale interventions in third countries through which Chinese agencies gained experience of working on health programmes overseas. The article reports on the main findings of an evaluation commissioned by DFID to learn from the programme. The programme provided support at a key time in China's global reorientation; however, there is a need for continued development of capacity and systems for China to play the role envisaged by the country's leadership. There is also a need for continued exploration on the part of China and partners of how to effectively collaborate to support improved global outcomes.

In July 2017, IDS hosted a workshop on 'Unpicking Power and Politics for Transformative Change: Towards Accountability for Health Equity', with the aim of generating dialogue and mutual learning among activists, researchers, policymakers, and funders working towards more equitable health systems and a commitment to Universal Health Coverage (UHC). This issue of the IDS Bulletin is based around three principal themes that emerged from the workshop as needing particular attention. First, the nature of accountability politics 'in time' and the cyclical aspects of efforts towards accountability for health equity. Second, the contested politics of 'naming' and measuring accountability, and the intersecting dimensions of marginalisation and exclusion that are missing from current debates. Third, the shifting nature of power in global health and new configurations of health actors, social contracts, and the role of technology.For the first time in IDS Bulletin history, themes are explored not only in text but also through a selection of online multimedia content, including a workshop video, a photo story and a documentary. This expansion into other forms of communication is explicitly aimed at galvanising larger numbers of people in a movement towards UHC and the linked agenda of accountability for health equity.The articles and multimedia in this IDS Bulletin reflect the fact that while the desired outcome might be the same – better health for all – accountability strategies are as diverse as the contexts in which they have developed.

China is engaged in a major debate about the future of its health services. One reason for this is government's recognition that basic preventive and curative health services are an essential component of an anti-poverty strategy. This article outlines the major issues a strategy for re-establishing effective services in poor rural areas will have to address. It argues that government will have to develop a systematic approach to reform, that takes into account the economic and institutional environment within which the health services function. (IDS/DÜI)

By the late 1970s most of China's rural population had access to basic health services at a reasonable cost. Since then the transition to a market economy has affected the rural health services in a number of ways. This article outlines how changes in the system of health finance and a radical decentralisation of public administration have led to cost increases and deterioration of some health services. It argues that policy makers need to redefine government's role in the health sector in the context of the emerging market economy. (IDS/DÜI)

This paper describes the design of a World Bank funded rural health rehabilitation and reform project. The project was designed between 1995 and 1998

AbstractThe changes which have taken place in the Chinese economy since the late 1970s have affected rural health services in a number of ways: local prepayment schemes have collapsed and most people pay in cash for medical care; health facilities have more autonomy from the government; and political mobilization for health has decreased. In the less developed parts of the country poor households cannot get the health services they require and health facilities face financial problems. China's policy makers face an imposing agenda of issues which could lead them towards a fundamental redefinition of the relationships between users and providers of health services, third‐party payers, local government health departments and local professional and community organizations.

Inequality is a key political issue of our times. It has political consequences, fuelling conflict and raising legitimacy chal‑ lenges for regimes around the world, in democratic and non‑demo‑ cratic settings alike. At the centre of these challenges is the question of accountability: who can be held accountable, on what basis, how and by whom for tackling or failing to tackle which inequalities. In the field of global health, inequality has long been a key issue. A significant body of work — in global health and health systems research — has approached the issue of health inequalities and in‑ equities by highlighting the role of social determinants (Marmot, 2015; Wilkinson; Pickett, 2006; Barreto, 2017). A more recent and less developed stream of work frames them in terms of political de‑ terminants: in other words, seeing them as issues that may be ad‑ dressed through politics as well as policy.

Inequality is a key political issue of our times. It has political consequences, fuelling conflict and raising legitimacy challenges for regimes around the world, in democratic and non‑demo‑ cratic settings alike. At the centre of these challenges is the question of accountability: who can be held accountable, on what basis, how and by whom for tackling or failing to tackle which inequalities. In the field of global health, inequality has long been a key issue. A significant body of work — in global health and health systems research — has approached the issue of health inequalities and in‑ equities by highlighting the role of social determinants. A more recent and less developed stream of work frames them in terms of political determinants: in other words, seeing them as issues that may be addressed through politics as well as policy. As a contribution to this literature, and building on the decade-old consensus around the importance of political will in the expansion of access to health services, this Novos Estudos dossier focuses on the politics of ensuring accountability for health equity - or for reducing health inequalities.