Effects of health poverty alleviation project from the perspective of vulnerability to poverty: evidence from five Chinese prefectures

BACKGROUND: The Health Poverty Alleviation Project (HPAP) has received widespread attention as a primary means of preventing poverty caused by illness. However, further evidence is required to confirm the effects of HPAP. OBJECTIVE: This study examines the effectiveness and mechanisms of action of HPAP using data from a special survey conducted in five Chinese prefectures in 2018–2019. METHOD: This study uses a three-step feasible generalised least-squares method to measure the farm households’ vulnerability to poverty. Hierarchical linear regression and propensity score matching were employed to assess the poverty-reduction effects of HPAP. A mediating effects model was used to test how these policies alleviated poverty. RESULTS: The mean vulnerability to poverty among farm households was 0.367, with 11.89% experiencing both poverty and vulnerability, particularly in areas of deep poverty. This study has found that HPAP significantly reduces poverty and is more effective in reducing the vulnerability of non-poor farm households than poor farm households. Additionally, the results suggest that improving human capital stock and reducing medical expenditure are the two pathways through which HPAP can alleviate farm households’ vulnerability to poverty. CONCLUSIONS: This study suggests that the vulnerability to poverty perspective should be incorporated into poverty alleviation policy formulation. HPAP enhances differentiation and precision. Thus, a long-term mechanism of HPAP should be developed.