Implementation Status And Effect Of Basic Public Health Service Equalization In Three Counties Of Ningxia Province

In China, the differences between economic development level and health investment, and urban-rural dual structure lead to the different supply of public health services. The central financial transfer payment, tax distribution system and problems of health service system bring about the outstanding phenomenon of the inequality of medical security, resource allocation, service availability and health outcome between urban and rural, districts and the crowds.Providing basic public health services can satisfy people’s growing health service demands, and it’s an effective means of adjusting reasonable layout and configuration of health resource, also it is one of the important ways to achieve goal of "Health for All-Objectives:General objective of this study was using grounded theory research method to understand basic public health services equalization status of three counties in Ningxia, to analyse basic public health services effect of three counties, to reveal problems of basic public health services equalization in Ningxia that exist in the implementation process, to put forward reasonable and conducive policy recommendations to deepening the development of basic public health services. Specific research purpose as follows:(1) Describe organization, service ability, health financing and performance appraisal of basic public health services equalization in the three counties of Ningxia;(2) Describe basic public health services equalization implementation present situation in the three counties of Ningxia, analyze the implementation effect, discuss existing problems; (3) Combining implementation and problems, put forward reasonable suggestions and advices.Methods:Data from the Ministry of Education, the major task of philosophy and social sciences research projects "Deepening Medical and Health System Research" sub-topic2" Study of Promoting Gradually Equalization of Basic Public Health Service". Three counties Xingqing District, Yinchuan, Yongning County, Yinchuan and Yanchi County, Wuzhong, are selected according to the regional economic development. Survey21institutions and40service staffs through quantitative questionnaires and qualitative interviews.Arranging interview information by WORD and using Weft QDA for integrated analysis, and literature analysis and statistical description throughout the text. Using grounded theory analysis summed up the status of implementation of the basic public health services in the three counties, the implementation eflect, and problems which may exist.Results:(1) Three counties achieve organization guarantee through the three levels of decision-making, management and execution layer, and a clear division of responsibilities among various levels.(2) The existing number of per million population health institutions of Xingqing District, Yongning and Yanchi were1.16,4.21,7.77,Xingqing District and Yongning Couty were below the national average(6.99), while Yanchi County was higher than the national average(6.99); per million population health technical personnel number of the three counties were21.08,25.30,21.12,significantly lower than the national average(43.82).(3) The health services funds for grass-roots using the packing fee and prepaid, and the subsidy amount increased year by year, but not fully put in place in time, and there is no enough office grants.(4) All of three counties carried out the nine public health services, from the project implementation indicators, in addition to the rate of elderly medical and the rate of health management of Yongning did not reach the target requirements stipulated by the state, three counties all meet the national requirement of other projects. (5) Incentives and assessment of basic public health service in three counties promote each other. After taken incentive measures, the enthusiasm has improved, but still need to further strengthen; test measures were rigorously, and made results related to rewards and punishments measures.Conclusions and Suggestions:Starting from the basic public health services to implement till now, there was a certain effect, not only in the quantitative indexes such as inputting rate of health records, system management rate of key crowds and chronic illness, but residents who personally experienced the basic public health service are also very satisfied, and said they wanted to take the initiative to seek the basic public health services.Basic public health services in Ningxia area still has some problems:Lack of basic public health service equalization system guarantee; Insufficiently provide capacity of basic public health services equalization; Unhigh level of contribution and management of basic public health services equalization; Consciousness of some residents and difficult management of the floating population; Basic public health services and medical security system not match.Suggestions:Strengthen leadership’s perception of importance of the basic public health services equalization; Establishing mother law of public health system, to guarantee the implementation of the basic public health services; Improve safeguard measures for health service personnel, and improve work enthusiasm; Strengthen capital regulation means, make sure funds fully in place and effective used; Chang grass-roots health workers’concept, give full play to the function of the grass-roots health services; Targeted to strengthen health education, focus key groups, and improve the residents’ health consciousness.