On The Survey Of Present Situation Of Grass Root Public Health System And Its Development Plan

Since the effectuation of Reform and Opening Policy, China works a miracle of high speed economic development in 20 years on end. However in contrast, the development of the public health system is obviously slow. In 2003, the SARS, the wantonly spread virus led to a conspicuous problems and conflictions in the public health management and executions system. Thanks to the lesson and the revelation of SARS incident, the Central Committee of the Communist Party of China, the State Department and all levels of Party committees and governments attached the importance to constructions of the public health to a never approached height. The constructions has been developed dynamically all around the China. It is imperative that the local governments should construct the public health system in terms of their practical situations. This research studied Chaoyang District, Changchun City, and fully investigated institutions, outlays, staff, equipments, management and mechanism etc. of the basic public health system. The research expatiates and analyzes from contents, functions and features of public health. It has collected and coordinated data of public health system in many developed countries, consequently outlined orientations of reform of basic public health, and framed establishment of public health system. Based on the comprehensive analysis, this article puts forward the construction plans of basic public health system with pertinences. Chaoyang District is located in the mid-south of Changchun City, with 248 square kilometers under governed. The population is 683 thousand. It includes 26.6 square kilometers urban area with 616 thousand people, and 221.4 square kilometers rural area with 67 thousand people. The current public health system is mainly composed of sickness prevention and control system, sanitation supervising and execution system, city community health service system, village community health service system, and medical rescue system. The results of investigation showed that there are six major problems of Chaoyang District public health system. They are: 1. The investment of government is insufficient and the direction of investment has problems. From 1994 to 2003 the rate of government public health investment in overall fiscal expenditure fluctuated between 4.4% and 6.9%. The increasing speed is lower than GDP and fiscal expenditure's increasing speed. Government investment took 30-33% in gross income of public, and prevention is always despised. The imbalance between city and country is obvious; 2. The functions of institutes are not clear, and efficiency of the management of public health system is low. It is mainly manifested that the district government is weak to control, functions of board of health is misplayed, functions of sickness control centre and supervising office are crossed, and the community health service organizations place much more attention to efficiency than to service quality; 3. The quality of health care team is not satisfactory, and capability of service is low. The education background of health specialists is generally low. The service cannot meet the people's need to the more and more variable health requirements; 4. The infrastructure is insufficient, and the technologies of health are lagged behind. The inspectionequipments and facilities are too old to provide technical support to some emergent public health events; 5. The emergency response system is underdeveloped and the ability to cope with emergency needs to be improved. Emergency events system only executes inside of district medical system. It has not become the common understanding of all levels governments (departments) organizations and all society; 6. Public health system stays far behind and the health care system is insufficient. The subject expatiated and analyzed the contents, functions and features of public health. The information and situations of public health systems of US, UK, Canada, Germany, France and Singapore such developed countries were collected and packed. Consequently pinpointed orientations of reform of basic public health, and framed establishment of public health system. Based on it, this article brought forward the construction plans of basic public health system with pertinences. Firstly, the orientation of government function needs to be clarified, and the public health policies should be stipulated. The policies include public health development, reformation of investment and financing system in health project and improvement of subsidy in healthcare. Secondly, the government should establish a sound public health system and ensure the public health projects in all aspects. a comprehensive public health system should be framed, including disease forecast and control system, sanitation supervising and execution system, medical rescue system, community health service system, health education system and health information system. Thirdly, we should establish a perfect emergency system, tosolve emergency events efficiently. We should build up emergency control and organizing system, forecast monitoring and reporting system, emergency forecast system, emergenc y response and rescue specialists team, material reserve system and forecasting information networks. Fourthly, we should develop community health service to solidify the foundation of public health service networks. We should define the overall aim of community health service, scientifically layout institutes of community health service, enhance management of community health service, and complete logistic of community health service policies. Fifthly, we should strengthen the personnel management, and optimize human resource of local health system. We should intensively develop training program of public health , deepen distribution system of personnel matters, and emphasize on construction of medical health culture. Sixthly, we should advance country public health to promote the harmonious socialism society. We should complete village public health service system, intensify construction of the infrastructure of country public health institutes, develop thorough education for country health in a wider range, and explore new type of cooperation system of country health.