Evaluation On Rural Health Developing Project In Hainan Province

ObjectivesThis study aimed to describe the situation of rural health in Hainan Province, to assess execution of Li Kashing Foundation donate rural health developing project in Hainan Province (RHDP), to summarize experience and shortage of the project, to discuss effectiveness of RHDP on developing rural health in Hainan Province, and finally, to provide certain suggestion on rural health policy.MethodsThis study, which was under the classic evaluation model and based on 360°feedback evaluation, carried out baseline investigation, mid-term evaluation, and final evaluation on RHDP. The methods of the study mixed quality and quantity research plus information index, collected all the data from stakeholders (manager, executor, beneficiary) of RHDP, analyzed the data using many statistic ways and evaluating methods, for example KirkPatrick's Four-Level Model of Evaluation, Fuzzy Matrix Assessment, Maye Index, Data Envelopment Analysis.ResultsRural health situation of Hainan Provence. Two weeks prevalence of residents was 20.76% in 2007. The attendance rate was 73.41%. Chronic disease prevalence was 27.48% and heal rate was 70.46%. Health level was different in different nation and region. Han ethnicity was better than other ethnicities. East and West region were better than the middle region. Talents were the first reason which restricts the development of rural health institutions. Resent human resource was old and most of them had low education level even blow middle school. Environment health department was bad and had many dilapidated building. The health center building score was 73.9 and geographical layout score was 80.2. The necessary equipment configuration rate was low. Equipment evaluation of compliance rate was 85.1% in those health agencies which bad capacity was more than 19. Village health clinic's compliance of equipment was 60.0% while the lowest degree of satisfaction was medical equipment to villagers, only 79.5% was satisfied. Low income was the most discontent thing to the doctors working in the health center. The top six factors that influenced rural health service demand, provide, and utilize were lack of doctors, lack of medical equipment, government founding, rural inhabitants' health care consciousness of self-protection, carry out of health policies and economic-transportation condition. The factors leading to high fees and hard attendance were transportation condition, economic condition, capacity of health departments and NCMS policy. Accomplishment of the project. This project had a good management chain and had successfully progress. Everything was done in time except part of building project was late because of founding and geography condition. There were some problems about found because of the complicated financial audit. Project effectiveness. There were 100 public health centers,1000 village health clinics, more than 1000 health personals and nearly 30,000 people benefit from the project directly, while about 200,000 to 300,000 people would get benefits in short term and millions people would profit from it in long term. After the project, Chronic disease prevalence declined, the ratio of visiting doctor after getting sick in two weeks and the ratio of curing chronic disease rise, skills of doctors levels up, environment improved, the assessing scores of buildings and distribution rise, equipment dispose rate was higher, and health center became more efficiency.ConclusionsThe project played an important role in Hainan rural health developing and health personnel training, it enhanced health services ability of sanitary institutions and lift up the levels of people's health. The key to develop rural health is making more investment to base sanitary institution, restoring human resource, changing the environment situation, while using the project experience and enlarge the effectiveness of the project.