An Evaluation Study On Primary Health Care Institutions' Capacities In Public Health Emergency Preparedness In Border Areas With Minorities Of Guangxi Province

Objective:In this study,we used a multiple approach with a comprehensive literature review and expert consultation to develop a questionnaire for evaluating the primary health care institutions' capacities in public health emergency preparedness in border areas with minorities of Guangxi province.According to above survey results,the status of the emergency system of primary institutions in Guangxi border minority areas was evaluated by factor analysis.Recommendations for improvement of the emergency preparedness of those primary institutions system in Guangxi province were made based on previous evaluation and factor analysis.Methods:1.An indicator system framework was established by comprehensive literature review and Delphy(Del Phi)expert consultation.2.A questionnaire was developed to survey the current situation of the primary health care institutions' capacities in public health emergency preparedness in border areas with minorities of Guangxi province.Thereliability and validity of the questionnaire were evaluated base on above survey data.3.The questionnaire survey was conducted to investigate the status all county general hospitals(a total of 22)in Guangxi province.In addition,3township health centers(a total of 66)in per county were selected by random.4.According to the situation study results,a evaluation model was developed by factor analysis.5.Strengths,weakness,opportunities and threats(SWOT)analysis was performed to evaluate the primary health care institutions' capacities in public health emergency preparedness in border areas with minorities of Guangxi province.And all the recommendations were based on SWOT analysis.Results:1.An indicator system framework for evaluating the primary medical institutions' capacities in public health emergency preparedness in border areas with minorities of Guangxi province includes 7 primary indicators and 30 secondary indicators for county general hospital;3 primary indicators and 12 secondary indicators for township health center.2.The reliability and validity of the questionnaire based on the evaluation indicators system showed that the Krone Bach coefficient of each dimension is more than 0.6.The results of Correlation Analysis between the various dimensions of the questionnaire show that the correlation coefficient ranged from 0.21 to 0.73.Therefore,it is considered that the questionnaire has good structural validity.3.The results of questionnaire survey show that county general hospitals had basic capacities to dealing with public health emergency.However,there are still obvious deficiencies in the early warning,information reporting,medical rescue,emergency supplies reserves.For township health center,lack of medical staff,beds,emergency plans are more prominent problems.4.For county general hospitals,the model includes 4 common factors,such as security factor,early warning factor,bed factor and information factor.Among them,the contribution rate of safeguard factor to the model(30.13%)is the most important factor.According to the model,the comprehensive ability scores of 22 county general hospitals in the border area were calculated respectively,and the comprehensive ability scores were arranged from small to large,which were divided into three levels: "weak","medium" and "strong".The results showed that the 7 counties with weak ability of emergency preparedness were all in poor counties,and the 3 counties with strong emergency preparedness are all in non poor counties in coastal areas.For township health center,the model includes 2 common factors: early warning and service factors.Conclusions:1.In this study,the indicator system framework was established by comprehensive literature review and Delphy(Del Phi)expert consultation.It would be more scientific and credible after two rounds of expert consultation.2.The questionnaire had good internal consistency reliability,content and construct validity.The utility model can be used for investigating and evaluating the capacities in public health emergency preparedness of county general hospitals and township health centers.3.The comprehensive evaluation model established by the factor analysis method is basically consistent with the results of survey.4.Suggestions on strengthening the capacity building of public health emergencies in primary health care institutions in Guangxi minority areas First,increasing investment in Public Health Emergency Preparedness.Second,to establish and improve health emergency organization and operation management mode.Third,to amend the county health emergency plan and technical programs to further improve the health emergency plan system.Fourth,to further improve the construction of early warning network.Fifth,to enhance the laboratory testing capabilities.Sixth,to strengthen emergency medical rescue capabilities.Seventh,establish and improve health emergency reserve.Eighth,strengthen the communication and cooperation among departments,departments and health emergency response.Ninth,the establishment of cooperation with other countries in the prevention and control of communicable diseases surveillance and response mechanisms.