Study On Building Of Basic Level Of Health Personnel For Pasturing Area In Xinjiang

Objective:By investigating three animal husbandry counties of Xinjiang,starting with demand and utilization of health service for herds,forecasting the basic level of health manpower in pasturing area with demand model of health manpower, and analysing supply and need with the current status and qualitative research,we discussed construction of the basic level of health manpower in pasturing area to provide the base in decision-making for staffing planning and capacity-building of the basic level of health manpower in pasturing area in Xinjiang.Method:It was investigated by using two phase stratified-cluster sampling method. The first,three areas including Yili region,Tachen region,Altay region was chosen from four areas in Xinjiang(Yili region,Tachen region,Altay region and Boertala region).The second,sampling counties were chosen with principle of the herds proportion and characteristic representative these areas and they were Xinyuan county, Shawan county and Altay city.They were chosen from the areas where herds grazes together.Questionnaire was finished by Kazakstan undergraduated students of medical college,Shihezi university who were eligible and good at Chinese and Kazakstan.1720 families,8112 people (1055 nomadic families,5243 people and 665 resident families,2869 people) and 106 health manpowers in 9 basic hospitals in pasturing area including doctors nurses and skill health manpowers were surveyed. Database was built by Epidata3.0.Data were written down by inputing two times.Statistic analysis was used by Spss13.0 andχ2 exame was used for rate comparetion.Result:The two-week prevalence of attendance rate was 6.8%, The two-week prevalence of absence rate was 53.6%, hospitalization rate was 5.1%, none-hospitalization rate was 27.8% for investigated people in pastoral areas of Xinjiang in 2007. The two-week prevalence of attendance and hospitalization rate of herdsmen was well below the national rural level in 2007, The two-week prevalence of absence rate and none-hospitalization rate was higher than the national rural level. The difference of two-week prevalence of attendance rate and none-hospitalization rate between nomadic and resident herder was not statistically significant. The two-week prevalence of non-attendance rate for nomadic herds (55.8%) was higher than that of residents of herds (48.2%), but hospitalization rate for nomadic herdsmen (4.4%) was lower than that of resident herders (6.5%). The proportion of choice for treatment of medical institutions set up in the animal husbandry point and using township hospitals for hospitalization were higher than that of residents of herdsmen. The satisfaction rate of outpatients for herds in the pastoral areas was 57.0%.The satisfaction rate of inpatients was 72.6%. No matter outpatients or inpatients,what the pastoralists were most unsatisfacted with the hospitals were mainly focus on the too high hospitalization cost,unconvenience to hospitals and bad technic. The number of health manpower and medical technical personnel in pastoral hospitals of Xinjiang was serious short. The total number of health manpower in the 9 basic hospitals of 3 pasturing counties was 106.The number of medical technical personnel, doctors, nurses per 1000 population of pastoralists in pastoral areas was well below the national rural level and Xinjiang total level at the same time. The structure of the degree of education and the post was not reasonable, the proportion of medical personnel with junior post was too large.Conclusion:The health status of herdsmen in Xinjiang was poor, the current health services can not meet the demand for health services. Utilization of health services was insufficient at the same time and nomadic herders were more serious than settled herds.The patients'responsiveness was comparatively back on health service,and the degree of saticfaction was low. Nomadic herders were more seriousthan settled pastoralists,The outpatients'responsiveness was the worst on the following issues,such as on the time took on the way to hospitals and on waiting for treatment in hospitals,were worse than residents of herdsmen.Every stage of governments should increase the investment to health in the pastoral areas. The number of the personnel should increase, which were mainly ones with senior degree of education, especially those graduated from secondly junior colleges and universities. The diathesis of the personnel in the pastoral hospitals should be improved and the health service system of the grassroots in pastoral areas should be strengthened.