Analysis Of The Probability Of The Family Care Service By National Population And Family Planning System

Objective:To explore the developing way of transition in national population and family planning system, and to explore the way of assurance of health rights of famers to impel health promotion in rural areas, by describing family care (services of health education, health examination and health consultation to children, adults, reproductive, middle-aged and old people) from the project counties in2012.Methods:The foundation on which the research was built was the five counties (A-E) in the two middle provinces of China, Project County from "Develop Family Care Service and Play Its Role in Prevention of Infectious Disease and Health Education"(hereafter referred to as "Family Care Project"). This paper observed the service process of the counties providing family care in rural areas. First, to understand the managers and the providers’idea, feeling, demand and need about family care, it adopted interviewing method, focus group discussion, self-investigation and observation method, which were distributed in each stage of the care exercises. Second, by new institutional economics, interest group analysis, behavior change theory related to health and manager ability analysis, it concealed the reasons of the certain "phenomenon" in the process of care exercises. In the end, it adopted assessment frame to evaluate the service effects at the end of observation period.Outcomes:It first formed the service effects of health care. Institution change of the five counties was divided into three styles, which were a snare institution change (CD), obliged institution change (AE) and delayed institution (B). Based on the health demands of its farmers, C and D considered its own abilities and carried out targeting care exercises correspondingly, which brought in better effects because of the "diversity" target; A and E endured the ways once used several years before to operate family care, provided "health education, health examination and health consultation" to the total villages and towns altogether, which meant "orderly management"; while B was lost into an awkward situation from inside and outside of the system and some institution obstacles, in nascent stage and delayed institution. The second outcome was about the probability assessment of the family care service by national population and family planning system. Five counties tried excellent care services in2012; however, there were some distance from integral, hyperdimensional and concentrative services to the existing ones. Followed by probability assessment frame, there were some subjective or (and) objective aspects, such as policy omission, performance measurement of the service troop, management and service deficiency and effects difference form the original intention of the family care, etc., to be improved in the future. It lastly produced theories about rural health promption. Currently,"super ministry" would provide better platform about the resources integration of health care, and then it was necessary to consider seriously about famers’ needs to yield a service integration frame. Under this frame, central and local government provided public product and some feasible quasi-public goods, in fact the two level governments needed to weigh their responsibility and capabilities. Government also needed to be responsible for assessment, policy research and assurance. In a word, it was necessary for government to form institution environment good for health, conduct families and their members concern about health care and prompted various resources of society to develop health facilities by ways of institution layout and institution equipment.Conclusion:In current situation, national population and family planning system was confronted with some obstacles in the process of family care, nevertheless, energetic probe of health care had carried out,"manager ability" substantially promoted the Family Care Project, and the integration of the project and family planning routine was effective for people’s health. The preferable developing direction was to design institution based on service integration in national level, focused on famers’health need, not the providers’need, to make good institution layout effective and make good institution equipment workable as well.