Study On Strategies For Chronic Non-infectious Disease Prevention And Control Based On Community Health Management

Background: Death sequence of chronic non-infectious disease has been raising rapidly, with the changes of disease spectrum and death constitute. According to the WHO statistics, 58millon people died and 61present died of chronic non-infectious disease (NCD) in 2005, such as cardiovascular diseases, malignant tumors and respiratory diseases. 2009 Chinese statistics yearbook displayed that NCD dominate the top three in five disease cause of the city and account 66.39% for the cause of death. Multiple data showed that NCD has become an important public health problem to harmful of people's health and social economic development. Therefore, it's urgent needs to research and develop appropriate and practical strategies and measures of NCD prevention and control, in order to stop the occurrence and spread of NCD.Objective: To understand the situation of NCD knowledge, attitude and behavior of community residents, health staff and directly related institutions staff in Hefei and Chengdu. To understand difficulties and problems of NCD prevention and control in two cities and summarize the experience of NCD prevention and control, and then put forward strategies for chronic non-infectious disease prevention and control that based on community health management, in order to provide new control concept and basis for NCD prevention and control.Methods: Using qualitative(questionnaire survey) and quantitative(in-depth interviews) methods to investigate the three kinds personnel in Hefei and Chengdu, compared the situation of NCD prevention of two cities and the variation of knowledge, attitude and behavior of NCD prevention and control in three groups, and summarized experience of NCD prevention and control.Results: The results of qualitative research showed that the awareness of NCD knowledge of community residents in hefei and chengdu was 59.1% and 61.5% respectively, the awareness of community health staff was 92.2% and 88.9% respectively; and the awareness of directly related institutions staff was 87.0% and 86.3% respectively. The rate of positive attitude hold of community residents and health staff were high and the rate of directly related institutions staff was lower than 50 percent, especially in "willingness to undertake the control". Statistical significant was found between community residents on behavior of NCD with different cities (P < 0.05). The rate of "using electronic health records to develop disease diagnosis" was around 30% of community health staff. Statistical significant were found between directly related institutions staff in"to participate or not to participate NCD prevention and control activities organized by directly related institution"and"to participate or not to participate the meeting of NCD prevention and control organized by health institution"(P < 0.05). The results of quantitative research showed that all community health staff could acknowledge the effect of electronic health records in NCD prevention and control, but degree of electronic health records utilization was low. Directly related institution staff could not acknowledge the responsibility and mission of NCD prevention and control. The consciousness and behavior of community residents of NCD prevention and control were stay in passive participation.Findings:①the rate of knowledge was greater difference between different groups, and the rate of knowledge was obviously different between different question;②the rate of community residents correct behavior was lower the rate of correct belief hold; and there was obvious differences in specific actions between two cities;③the utilization of electronic health records was generally low in two cities;④directly related institutions staff was lack of attention and initiative of NCD prevention and control; ⑤c oncentration training was the most popular form for all kinds of training in health staff;⑥health staff has higher training need of NCD prevention and control knowledge, such as NCD intervention methods, health management, etc.Conclusion: The resident was not comprehensive mastered in NCD knowledge and its compliance and participation was not high, so it's should strengthen acknowledge of the importance and urgency on NCD prevention and control of community residents, in order to help them changing unhealthy behavior, or way of life. Community health staff should acknowledge the position and role of electronic health records in NCD prevention and control, and strengthen the management and utilization of electronic health records. Meanwhile, directly related institutions staff should participate in NCD prevention and control actively and joint meeting to exchange experience and feedback achievement of NCD prevention and control at regular intervals.Suggestions: To construct the strategy for chronic non-infectious disease prevention and control based on community health management, the strategy including four sections:①strategy for improved initiative and enthusiasm of health staff and directly related institutions staff in community;②strategy for improved compliance and participation of community residents;③strategy for strengthened management and utilization of electronic health records;④strategy for formulated intervention package of different stages and different populations.