The Application Of Comprehensive Evaluation Methods On County-level MCH Institutions Health Resource Allocation In The Regions Of Health IX Project Supported By World Bank

ObjectiveTo understand county-level MCH institutions health resource allocation and utilization situations,evaluate the use efficiency and equality of health resource in project-county MCH institutions,provide basis to government for formulating health policy and strategy.MethodsComprehensive evaluaton method,Lorenz curve and Gini coefficient were used in the process of data analysis.ResultsThe number of personnel,funds,equipment,beds and area of business houses in project-county MCH institutions had been greatly elevated compared with those in the baseline survey.The MCH service utilization capacity had also been significantly improved.There were highly coherence among the 5 comprehensive methods depending on Kendall-W coefficient of concordance test result(W=0.735,P=0.000).There were siginificantly correlation between the comprehensive evaluation methods and combination methods,weighted average combination method were an optimal model of these(r=0.96,P=0.000).According to the classification result,the superior institutions accounted for 15.9 percent of 107 project-county MCH institutions,medium for 72.9 percent and inferior for 11.2 percent.The efficiency eavluation of the health resource showed:the low input but high output institutions accounted for 19.6 percent of 107 project-county MCH institution,low input and low output accounted for 31.8 percent,high input and high output accounted for 32.7 percent,high input but low output accounted for 15.9 percent.The Gini coefficients of health technical personnel,area of business room,health money allocation determined by the population distribution were 0.3293,0.3738,0.5214,and 0.5050 respectively.The health resources were reasonable equity according to the distribution of population,but that of geography were not optimistic.All of the four geographic Gini coefficients excessed 0.6 and were in the inequity danger status. ConclusionsThe implementation of Healthâ…¨Project played an important role in the development of maternal and children health.But the health resources allocation in the project counties had still discrepancy.The population equality of health resources was reasonable,but the geographic equity was highly dangerous.These led to low use efficiency of health resource to some extent.Some suggestion were given to the government:to build regional health planning,adjust the health resource allocation structure,utilize and allocate new health resource reasonably,exert the efficiency of the resources.In addition, combination evaluation methods are more scientific,stable and reasonable than single comprehensive evaluation methods in the health resource evaluation.