| ObjectivesTo understand the implementation situation of rural public health service through the investigation of the development situation of rural public health service in Xishan district of Kunming. To gain the truly feelings about rural public health service among the urban residents, the party and government cadres, the staff members of rural public health service and medical personnel. To find out problems, summarize the successful experience, and pertinently put forward rationalization proposals in order to further improve the construction of rural public health services, establish a sustainable, healthy and steady develop rural public health service system, enlarge the benefited range, to provide the scientific basis for health level for Xishan people's governments and the public health administrative department.MethodsThis research used cross-sectional epidemiological method. The related data such as appraisal situation, encashing financial situation, general conditions, providing health service situation, health index, development situation of the rural public health service of village's medical institutions, health service ability, traffic and communication situation, clinic prescription, development situation of rural the public health service, etc. were collected from statements and questionnaires in 2008 in Xishan District.Using stratified cluster and simple random sampling method to select government cadres, management personnel, medical personnel and rural residents, survey the rural public health service opinions and suggestions. All the data were analyzed by SPSS statistical software package.Results1. In 2008, frame and pattern of rural public health service had established, and operation mechanism was feasible basically. Usage of funds was reasonable. The district, township, countryside levels'departments had completed basic files or ledger of relational rural public health service by verifying. Rural public health service in district, township countryside level developed basically, according to the province, city, district relevant document regulations and requirements. District CDC, district maternity and child care centers, health law enforcement supervision, district people's hospital had true reports of their public health service related works.. Town health centers had true report. Village clinics had complete files or ledgers, no misrepresentation or fraudulent practices. Further improved contents of rural public health service, evaluation mechanism and regulate special fund supervision mechanism of rural public health service were expected.2. In 2008, Xishan District had five rural public health services, including basic medical services, disease prevention and control, maternity and child care, health supervision and health education, all of them were supplied 109650 times. According to the standard of supplement, the government should expense 441207 Yuan in theory. But actual expense was 422661 yuan, including expenditure of basic medical services (4860 yuan), expenditure of disease prevention and control, patriotic education and health education three works (211978 yuan), maternity and child care work (204072 yuan), expenditure of health supervision work (1751 yuan).3. This investigation surveyed 3 towns with a total people 2023 from 523 households. In 2008, rural resides annual average income was 12000.00+12750.00 yuan, the average expenditure was 10000.00±14000.00 yuan. The income of average doctor was 2000.00±3200.00 yuan, accounting for the total expenditure was 20.0%.The prevalence rate of two weeks was 6.67%. The prevalence rate of chronic disease for current year was 5.19%. Hospitalize rate for current year was 8.30%.4. The equipments of village clinics based on the relational function were reasonable, but the service ability was not strong, level of medical treatment was low. The qualified rate of rural public health service was above 69.0%.5. The situation of awareness of government contributive rural public health service was that all of management personnel and 42.9% of party and medical personnel had known government bought rural public health service in 2008.20.0% of party and gorvornment cadres had known government contributive bought rural public health service in 2008. But 90.5% of rural residents had not known government contributive bought rural public health service in 2008. 6. The awareness of the specific development services of 5 items rural public health service:80.0% of party cadres did not know the specific development condition of rural public health service; 57.3% of medical personnel did not know the specific development condition of rural public health service. All of management personnel were general awareness.7. The evaluation of specific service projects in rural public health service showed that 58.3%～66.7% of party and government cadres considered the currently rural public health services and standard of supplement was unreasonable and the project was not enough.68.6%～84.4% of management personnel considered the currently rural public health services and standard of supplement was reasonable and the project have been enough.60.0%～66.7% of thought the currently rural public health services and standard of supplement was reasonable and the development project have been enough.8. The evaluation of rural doctors professional ability:rural doctors self-evaluation showed that all rural doctors could handle general common disease, frequently-occurring disease, but only 16%～33.0% of rural doctors could handle such normal childbirth, fracture, lavage and general trauma, identify high-risk pregnancy such as problems or disease. Evaluation of party and government cadres showed that nearly 60.0% of party and government cadres thought the present village clinic existing rural doctors (2 people) still could not complete all of the public health service projects. The suggestion was that the number of rural doctors should be in 3 to 4, degree level should be at least bachelor's degree or above. Evaluation of management personnel showed that nearly 72.7% of management personnel thought the present village clinic existing rural doctors (2 people) still could finish all of the public health service projects. The suggestion was that the number of rural doctors should be in 3 to 4,degree level should be at least bachelor's degree or above. Evaluation of medical personnel showed that nearly 55.3% medical personnel thought the present village clinic existing rural doctors (2 people) still could not finish all of the public health service projects. The suggestion was that the number of rural doctors should be in 3～4,degree level should be at least professional school or above.ConclusionsXishan district have established basic framework and pattern of rural public health service. The operation of subsidy funds showed good development trend. The service quality evaluation scheme was basically feasible and the usage of funds was reasonable. Social overall satisfaction was higher. Through the government purchased the rural public health services, rural residents improved their health consciousness. On a certain extent, the purchase of rural public health services improved the phenomenon of "Cure difficult, Cure expensive", and also improved the rural health resource availability, narrowing the gap between urban and rural residents health level, which played an important role in stable the rural society. We suggested that the related department should to strengthen management and establish supervision mechanism of rural public health service subsidy funds, perfect quality inspection system. It is necessary to strengthen rural doctors'technical level and comprehensive service quality training in order to improve rural doctors'public health service ability.
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