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Healthcare and Education in China

Living in China exudes a certain fascination for many foreigners, and we are sure its charm will speak to you too. If you are about to embark on expat life in China, make sure to read our InterNations Guide. Here you’ll get info on topics such as transport, accommodation, healthcare, and education.
Rickshaws are a convenient and environmentally-friendly mode of transportation.


The standard of the Chinese healthcare system may not be equal to what you are used to. However, in major cities with a sizable middle class and a large expat population, e.g. Beijing and Shanghai, there are quite a few international hospitals and medical professionals.

Expatriates living in Guangzhou or Shenzhen often take advantage of the proximity to Hong Kong, where medical facilities are excellent. If you live in a smaller city, require complicated treatments, or need to deliver a baby, it may be advisable to take a plane to Hong Kong or return home. Apart from the obvious lack of equipment, rural areas are being abandoned by doctors and nurses in favor of the big cities, resulting in personnel shortages.

Generally speaking, you should take good care of your health before you go to China. Ask your family doctor for a comprehensive check-up exam to make sure you won’t require any minor surgeries or treatment while abroad.

Medical Insurance

In case you need to see a doctor during your stay in China, make sure that you have sufficient health insurance coverage before departing. China introduced some basic healthcare for its citizens outside the government sector in the late 1990s. As of October 15, 2011, foreign employees living in China have to pay into the official Chinese health insurance system and are included in its coverage.

However, this will definitely not cover your needs adequately. Most expats opt for a private health insurance policy from a local or international provider.

According to their insurance status, people go to see a doctor at a local hospital or a private clinic. Ask your expatriate contacts, your employer, or your embassy to recommend a clinic with a medical practitioner who speaks English or your mother tongue. Private patients usually have to pay in cash at the clinic (to be reimbursed later on), and medication is purchased from the hospital pharmacy.

No matter if they are covered or not, most expats take our private health insurance. Read our Extended Guide article to find out all about private health insurance in China.

Health Risks

Keep yourself informed about major health risks in China. Unlike what Western media might have suggested during the SARS panic or the bird flu outbreak, more common health threats are posed by other diseases.

Widespread illnesses include malaria, dengue fever, Japanese encephalitis, rabies, hand-foot-and-mouth disease, schistosomiasis (a worm infection caused by bathing in infested rivers), and others. However, with some precautions you can stay healthy: Get all recommended vaccinations (MMR, DPT, chickenpox, flu, polio, as well as for the diseases mentioned above, and also hepatitis A & B and typhoid); take prophylactic drugs (when visiting malaria-infested areas); pack a travel first-aid kit; protect yourself against insect bites; and observe proper hygiene during your stay.

A word of warning for patients with severe respiratory diseases, disabilities, or special needs: Air pollution is a major issue in China’s megacities, as TV audiences could see during live broadcasts from the Beijing Olympic Games in 2008. The smog may put an undue strain on your respiratory system.

Moreover, Chinese society is still developing in the area of disability rights and special needs. It can be very hard to find adequate facilities for you or your children.

Domestic Help

Since it is far from unusual for expats living in China to employ domestic staff, kids under the age of three are often taken care of by an āyí, a nanny and domestic helper. In most cases, household help is recommended by word-of-mouth referrals from other expatriates.

Always ask prospective staff for their ID card. You can use a copy of the ID to run a background check. It is far easier (and less paranoid), though, to simply call their previous employers and ask them for an honest appraisal of their former āyí.

Domestic workers are specialized in their tasks. Those working on an hourly basis mostly cook, clean, and do your laundry, while nannies are live-in caretakers. In a big city like Shanghai, the latter usually get a salary of 3,000 to 6,000 CNY per month. The higher end of the aforementioned scale is reserved for nannies who are fluent in English and have a child-rearing background or education.

Childcare and Education

If your children are older than three, there are pre-schools and kindergartens catering to the international community in bigger cities, but they may have waiting lists. Younger schoolchildren, who still pick up the local language easily and are not preparing for a university diploma, might be sent to a Chinese state school. However, check out the school’s facilities first and try to find references for the school to make sure your child is in good hands.

As far as educational approaches are concerned, staff members in a Chinese-only environment often prefer more rigid teaching methods and a stricter attitude than what is now common in Western (or international) schools.

There are many international schools throughout China, including in the provincial capitals. However, sometimes these schools only have a limited number of places available and/or their tuition fees are very high. Consulting the official website of the International Baccalaureate provides you with a directory of IB World Schools in your area. For some parents, homeschooling their children via correspondence courses is a last, but necessary, resort.

Our Extended Guide article on childcare in China takes a more detailed look at childcare in China. It also covers the differences in teaching methods and different types of childcare.


We do our best to keep this article up to date. However, we cannot guarantee that the information provided is always current or complete. 

David Thyne

"At the first Shanghai Get-Together I met several American expats. I am very grateful that they shared their experience with me."

Diana Anhaus-Brey

"It is just so easy to find other international people and global minds with InterNations. I didn´t know there were so many in Shanghai."

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