The Study On Management And Extension System Of Appropriate Health Techniques In Rural Areas Of Gansu Province

Objectives Establish appropriate health technique (AHT) management and extension system in rural areas, from which AHTs could be extended effectively and continuously in Gansu province and then general level of health of dwellers in rural areas could be improved.Methods (1) With related data review and staff interview, the problems arisen in the process of extending appropriate health techniques in the 10th five year plan were summarized. (2) The selection system of AHTs was formed with the establishment of AHT selection index system and selection mode. (3) Training management system was established through different level training, effectiveness ensuring measures, experts selection and evaluation, multi-way of training, trainee qualification restriction and the whole training quality ensuring measures that include contract, test, supervision and guide and trainer selection. (4) The dissemination system was framed with the establishment of AHT extension management system, extension quality ensuring system; the exploring of extension policies, the measures of extension implementation and the investigation and evaluation of the effectiveness of extension.Results (1) During the 10th five year plan, problems come out in the process of AHT dissemination in Gansu province were limitation of AHTs in the state source and insufficient consideration of requirements of rural areas in the process of AHT selection; single training mode, low conformation of trainees' major to the training contents and low activeness of trainees in the process of AHT training; and comparative little attention of leaders, profit promoted extension, limited facilities and medicine and limited publicity in the AHT dissemination process. (2) The selection system of AHT to rural areas was framed, which included AHT selection index system, the evaluation and admittance system of AHTs in the state source, the feedback and modification system of AHTs in the state source and AHT selection mode in rural areas. With the system, 19 state level AHTs and 4 provincial AHTs were selected. (3) The system of AHT training effectiveness management, supervision and guide and whole process management was established. Specifically it was composed by mode of multi-level training, net of AHT training experts, conformation management of major of trainees to training contents and the whole process management. The system brought better training effectiveness than that of the 10th five year plan. (4) The widespread extension system of AHT in rural areas was framed. It included set groups which were multi-level leader coordination group and AHT supported expert group and AHT information media; AHT extension effectiveness ensuring system which was composed by AHT extension consulting office, supervision and guide group and quality control group; AHT dissemination policies which were expanding the AHT reimbursement in New-type rural cooperative medical care, AHT extension collaborated with organization appraisal in health industry, health staff assessment, continuing medical education, general training of health staffs and Chinese traditional medicine research; AHT implementation measures which were a variety of publicities, extension follow-up survey, filling in and handing in questionnaires and periodic evaluation; AHT extension effectiveness investigation and evaluation which were AHT receiver investigation, AHT extension area population health state improvement investigation, single AHT effectiveness evaluation and the whole extension program evaluation.Conclusions With establishment of management and extension system of AHT in rural areas, early work of AHTs selection, training and dissemination in rural areas has made progress, and sound basis was made for the later continuous AHT extension. AHT selection index system provides foundation for AHT evaluation, admittance and elimination in the state source. Also, the system helped to avoid the problems of the 10th five year plan when doing the AHT selection work in the 11th five year plan, that is, the selection took the real condition of medical institutions in rural areas, medical capability of doctors and requirements of population into consideration. The training management system brought appropriate trainees and their initiatives which promoted the training to go forward efficiently. With establishment of AHT extension system, multi-level leaders attached great importance to the program, which provided a sound circumstance for the AHT extension; AHT was publicized in a high degree so that health staffs and rural dwellers obtain abundant knowledge of AHT; program related staffs and institutions were able to communicate smoothly; AHT extension effectiveness was ensured.