Research On Management Functional Division Of Rural Public Health And Optimal Strategy

ObjectiveRural public health is an important assurance for social stability and economic development. The optimal strategy analysis on management functional division of rural public health is designed to aim at looking for these issues that the structure of rural public health administration and performing function faced, determining who should take the main responsibility for rural public health administration and fundamental and feasible functional division. An optimal strategy is recommended for the development of rural public health administration.MethodsThe methods of stratified typical sampling and random sampling have been chosen. The information about function implementation of those main administrative organizations has been collected. Through individual depth interview, nominal group discussion, and the result of document study, we obtain main embarrassment in the process of administration. Descriptive statistics is applied to analysis the results of the questionnaire.Results1. There are at least 14 related departments of rural public health administration in county level. A phenomenon exists in performing function repeatedly and cooperating difficultly in a certain degree. Township Health Center performs the management functions of public health in township level.2. The dissatisfactory management functions performed by main public health administrative organization are: Health Bureau focuses on the functions of animal epidemic prevention and quarantine, authentication and surveillance of health related products; Health Inspection bureau focuses on occupational health, environmental health and cosmetics inspection; The Centers for Disease Control and Prevention focuses on the major chronic non-communicable disease control, organizing health education and physical examination on professional crowd; Maternal and Child Health Centers focuses on reproductive health supervision, monitoring of birth defects. Township Health Center focuses on supervising health education that performed by the village clinic.3. There are three aspects of main difficulties lie in front of rural public health administration. (1) Institutional aspect: no root law for public health, repeated functions of administrative organization; (2) Organizational aspect: inadequate supervision on immunization, contorted reimbursement mechanism, lots of problems exist in the process of health law enforcement, unsound disease information surveillance network. (3) Mechanism aspect: the capital investment on public health by the government is deficient in gross and unbalanced in structure, unreasonable distribution in human resource of public health.4. Public health products have several characteristics, such as non-competitive, non-exclusive, positive external, high cost-effective of input-output. All of the above characteristics determine the government is one who takes the main responsibility in public health administration.5. A kind of blue print is designed for rural public health to adjust its organizational structure:①set up Public Health Committee.②transfer several public health administrative functions of health department to other departments.③integrate the County Hospital and the Maternal and Child Health Care Center.④implement hierarchical management on the Health Inspection Bureau.⑤deprive of the supervision function on public health from the township health center.6. Basic administrative functions of rural public health go like this: the Health Bureau has 19 items, the Health Inspection has 7 items, the Centers for Disease Control and Prevention has 12 items, the County Hospital (including maternal and child health care center) has 8 items.SuggestionWe suggest that the current inefficient situation of rural public health administration can be changed in these ways:1. The public health and economic development indicators in the performance appraisal of the government officials should be treated equally.2. The public health root law legislation should be valued.3. The coordination and cooperation among the related public health departments should be adequately functioned.4. The transfer-payments from the central government should be increased, and especially these funds should be distributed to grass roots and poverty area.5. The special funds of public health should be fully assured and be used reasonably.6. Allocation of high-quality management team.7. The health education should be organized continuously.8. The information management network should be built up quickly based on the current resources.