Allocation Of Public Health Manpower In Township Health Centers Based On Equalization Of Basic Public Health Service

BackgroundTownship health centers play a pivotal role in rural healthcare network to link the preceding with the following. The development and function of township health centers is closely related with economic development and policy. There are many problems in township health centers, such as pursuit of profit because of the lack of government investment, inefficiency, low level of human resources, etc. According to Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System Reform issued in2009, improving the community-level health service system is an important content. Rural public health service should be undertaken by township health centers and village clinics. Public health service system has been enhanced comprehensively to promote the urban and rural residents to share the equal public health service through the implementation of major public health service items and items of basic public health service. The implementation of national basic public health service, is an important content of promoting the gradually equalization of basic public health service, and it is a key task of deepening medical and health system reform. In the course of gradually equalization of basic public health service, the function of township health centers should be clearly defined, financial security should be ascertained, and talent teams in township health centers should be strengthened. Recently, the construction of public health in China has being in a great progress, but the investment of public health manpower is planless and aimless. It is even more important to allocate public health manpower in township health centers scientifically and reasonably based on equalization of basic public health service.Objectives1. To investigate the developing condition of basic public health service in the basic medical institutions in rural areas. To keep abreast of rural residents’ demand of public health service and influence factors.2. To establish theoretical principles and a demand forecast framework of public health manpower allocation in township health centers.3. Analysis of influence factors of demand about.4. To establish demand model of public health manpower allocation in township health centers in rural areas.5. To put forward some suggestions about the development of public health human resources in township health centers.MethodsTo present the method and thinking of enhancing the function of public health service and optimizing public health manpower allocation in township health centers based on the objectives of this study. To establish a demand forecast framework of public health manpower allocation in township health centers. Multistage stratified random sampling method was used to draw900families in Gaoyou city of Jiangsu province. And permanent population was inquired with a self-made questionnaire about demand of basic public health service. Main conditions of public health human resources, such as age, educational background, academic title and specialty were investigated in21township health centers in Gaoyou city. We used the cost of the time on each service item to make standard man-hour by investigating public health personnel in21township health centers. Then, we could evaluate the total quantities of public health services and present the scheme of public health manpower allocation according to the investigate. Qualitative research is to work out standard operating procedures for each kind of basic public health service based on expert counseling.ResultsSocial development, demographic changes and more health demand of residents call for greater requirements of public health manpower allocation in primary health care institutions in rural areas. Life style and health-related behaviors are main factors affecting the health. The elderly health care demands rise rapidly because of the aging of population structure. Physical health and mental health are often interrelated and interact on each other. The health service model should change in accordance with the disease spectrum. Prevention and control of chronic illness and infectious disease will not slacken off, especially, enhancing health inquiry and health education prescription is effective method to prevent and control chronic illness. Public health manpower in basic medical institutions in rural areas should meet the public health service demand of rural residents.We forecasted the public health manpower in township health centers in Gaoyou city, the number of professional public health manpower should be160.56to complete ten items of basic public health service, which corresponded to2.55per10,000people. The number of professional public health manpower should be170.53to complete all public health service, which corresponded to2.71per10,000people. The number of professional public health manpower should be166.04in accordance with adjustment coefficient to complete all public health service, which corresponded to2.64per10,000people. ConclusionsThe main findings1. There are some major health problems and public health service demands of rural residents, such as lower awareness rate about health documentation, lack of cognition of physical examination, the general existence of health risk factors, the irregularity of preventing and controlling of infectious disease, unsubstantial emergency response mechanisms of child care management, lower regular breast、cervical cancer examination of married women of childbearing age, lack of pointed geriatric health service, lower level of healthcare system management of chronic illness, and imperfect working method of mental illness management, etc.2. The structure of public health manpower is unreasonable and the number of public health human resources is deficient in township health centers.3. The progress of different items of basic public health services is unbalanced.Policy proposals1. It is important to design suitable criterion of public health manpower in township health centers.2. It is expected to increase the number of public health human resources, optimize the structure of public health manpower and bring in professional talents.3. It is necessary to increase government investment to improve the factors which is closely related to health and to promote the health level of rural residents.4. It is essential to promote the quality and ability of public health human resources in township health centers to meet the public health service demand of rural residents. Healthy lifestyle should be promoted by health education. Public health manpower are supposed to strengthen intervention on key crowd to remedy the defects of township health centers, such as the promotion of emergency response ability of child care management, the increased breast、cervical cancer examination rate of married women of childbearing age, strengthening of Obstetrics, setting-up of pointed geriatric health service, strengthening of supervision and guidance of chronic illness, and paying enough attention to mental health services.5. It is also pointed out that the capacity of public health management of township health centers should be promoted.