Study On Implementing Policies To Promote Application Of Proper Technology Of Traditional Chinese Medicine To Community Health Service Centers In Urban Areas

Background:In recent years,China has issued serials of policies to encourage and support development of the traditional Chniese medicine(TCM) which proper technology finds a good entry-point in community health services(CHS).To better integrate TCM to CHS,the Ministry of Health, National Development Reform Commission(NDRC) and other ministries and commissions in China issued 18 documents from 1997 to 2008.Shanghai Municipal Government and Pudong New District Government also issued 9 related documents to promote application of proper technology of TCM to CHS.At present,some technologies of TCM such as acupuncture/fire pot/massage and so on are popular in CHS,.However,there are many gaps which are waiting to be filled up.As policy is the key to promote dessemiating and applyinginnovative technology,we conducted the policy study on the application of the proper technology in community.Aim:To explore factors influencing application of TCM proper technology to CHS through reviewing Central and local governments' policies and analysing recognition of TCM proper technology among residents,health workers in CHS centers in Pudong New District,in order to promoting sustainable development of TCM proper technology in CHS centers.Research content:1.Reviewing,analying the relevant policies issued by central and Shanghai Municipal governments as well as Pudong District.2.Investigating and analysing interior management and incentive mechanism policies in CHS centers in urban areas of Shanghai.3.Understanding the current situation of the skills and knowledge of TCM by health workers in CHS centers.4.Surveying needs and acceptance of TCM in residents.Methodology:reviewing documents related promoting application of TCM from different levels of governments was applied to policy analysis.Qualitative and quantitative methods were employed to collect data from health workers in CHS centers and residents in communities,Results:1.The contents in the policies on TCM at all levels of governments have positive and effective influence to ensure and promote application of TCM in community health services.The policies of TCM at all levels of governments clearly define positioning,financial security,personnel training,promotion of TCM proper technology in urban CHS centers,which could have specific requirements,and implementation of a positive and effective to ensure and promote the Chinese medicine in community health services development.2.There was lag in local medical and health policies for implementation of the national policies.After the national policies issued,their implementation in the region still lagged behind, including the performance in the health insurance settlement,assignment of Chinese medicine practitioners from high level hospitals to CHS centers,management of TCM formulations, pracising in multiple clinics by TCM practitioners and so on.There is no medical insurance billing line in more than two-thirds of the sites.Only 45.45%of the CHS centers developed some relaxed policies for development of the quantitative indicators of health insurance.The TCM practioners from high level hoptitals have not exerted their all rolesin the CHS centers.3.The development and implementation of TCM policies within CHS centers were still out of touchThe present results found that formulation and implementation of the TCM internal policy in the CHS center's were not matched to that from national and municipal governments.,showing less special performance characteristics of TCM in the their centers.27.27%of the centers did not have the special department of traditional Chinese medicine;TCM proper technology was not applied at all health stations,only 36.36%of the health stations could be fully operated; 54.55%of the CHS centers were not rehabilitation beds managed by TCM;27.27%of the centers could not encourage and support their staff to have continuous TCM education or to go out to study for TCM.4.Lower professional skills of TCM among the health workers in CHS centersCurrent TCM capabilities in CHS centers could not meet the need of the resident.The present survey found that 7.27%of the health workers had not received the formal training of TCM and its proper technology;only 54.82%of the residents indicated that the community health service centers and the traditional Chinese medicine treatment types meet their own needs; 24.49%of the residents indicated that the professional level of,TCM practioners was general; there are 36.36%of the CHS centers where no senior TCM specialists with higher professional level practice.In the past three years,it is found that no scientific research article was published by CHS centers.5.Less special and practical health education related to traditional Chinese medicine in CHSThe present study found that 28.14%of the residents had not received TCM health education; 51.01%of the residents who received the TCM health education could not understand the materials related to TCM health education.Only 6.06%of the residents could understand whole contents of the TCM health educational materials.It is necessary to strengthen the TCM health education content and methods.Suggestions:1) The local TCM policy system should be more pertinent.2) Policy on social insurance to cover TCM should be more emphasized.3) TCM intervention should be strengthened in public health area.4) TCM should be promoted more in community through CHS centers.5) More general practitioners should be trained in different ways,especially the skills of TCM should be emphasized.6) Motivation and advocacy of application for TCM among the residents should be emphasized.