An Evaluation Study On Centers Of Disease Control And Prevent In Public Health Emergency Preparedness In AnHui Province

BackgroundPublic health emergencies refer to the events that occur unexpectedly and can cause or potentially cause mass destruction to the public's health, including epidemics of public health importance, diseases outbreaks in the large population with unknown causes, large scope food poisoning and occupational poisoning, and other events that can severely affect public's health. They have a direct impact on public's health, economic development and society stability. Prevention and control of public health emergencies requires multi-sector effort and strong, effective leadership. Of all organizations involving in public health emergency preparedness, centre of disease control and prevent (CDC) is the key organization providing strategy and measure. Since CDC plays a central role in the early recognition, early diagnosis, early reporting, early quarantine, and early treatment, its capacities in public health emergency preparedness (CPHEP) significantly influence the process and results in handling public health emergencies. Therefore, CDC's CPHEP is the critical component of a nation's public health preparedness system. However, that CDC has insufficient capacities in dealing with public health emergencies is a worldwide problem, China has no exception. The SARS crisis taught us the importance and necessity of CPHEP building. An evaluation of CDC's CPHEP is the initial step for CDC CPHEP building. However, up to today, evidence-based scientific research on CDCs'CPHEP building is still to be seen. Objectives1. To develop a comprehensive questionnaire suitable for CDC in China to survey CDCs'CPHEP;2. To survey the current status of city- and county (district)-CDCs'CPHEP in Anhui,China;3. To build a CPHEP evaluation model for CDC in China;4. To evaluate city- and county (district)-CDCs'CPHEP in Anhui;using the CDCs'CPHEP evaluation model.MethodsThe questionnaire was designed by consulting literature, overview and Specialists. We made a cross-sectional study on basic situation of emergency public health response by the questionnaire in 121 CDCss in AnHui Province, China. A CPHEP evaluation model was developed using the factor analysis.Results1. An indicator system framework for evaluating CDCs'CPHEP includes 7 domains and 96 indicators. Seven domains are base information of CDC, surveillance and early warning, laboratory management and diagnosis, public health emergency preparedness plan, epidemic intelligence capacity information reporting and communication, and staff training.2. The results from the questionnaire survey on CPHEP of city-level and county (district)-level CDCs showed that Emergency public health response has made better progress. But events of emergency public health could be not reported in time. Public health department cannot early detect event of events of emergency public health . Few of CDC have media plan and spokesman of emergency public health.Staff and expertise of emergency response is insufficient. Technology and equipment is not enough.3. A CDCs'CPHEP evaluation model was developed based on the factor analysis as follows: C = 0.659C1+0.213C2+0.128C3 where C is a CPHEP score, C1 is a capacity score for preparedness of public health emergencies at CDC, C2 is a capacity score for judgement of emergencies at CDC, C3 is a capacity score for detection and disposal at CDC,4. The results of CPHEP evaluation of city-levlel and county (district)-level CDC in Anhui using a CDCs'CPHEP evaluation model showed that CDCs'CPHEP varies. Overall, city-level CDCs'CPHEP were better than county-level CDCs'; county-level CDCs'CPHEP were better than district-level CDC.ConclusionsThis study is the first one in China to evaluate a Chinese city,county and district level CDCs'CPHEP, using epidemiological methodology. It develops practical tools to evaluate CDCs'CPHEP for city and county (district) in China based on large scale survey data.The major contributions of this study include:1. A CDCs'CPHEP evaluation model was developed to evaluate city,county and district level CDCs'CPHEP in China first time. 2. A fator analysis, combined with CDCs'CPHEP evaluation results, was used in China first time to systematically analyze a Chinese city-county (district)'s CDCs'CPHEP situation with evidence based recommendations to improve CDCs'CPHEP building in Anhui.